Methylcobalamin needed for back leg weakness?

Status
Not open for further replies.
Julie and Alice

Julie and Alice

Member Since 2014
Please can anyone advise about the use of methylcobalamin?
Alice, my sweet cat has only been diagnosed with diabetes following ketoacidosis nearly 3 weeks ago now. She is quite weak but her back leg weakness seems to fluctuate throughout the day. She seems at times to be 'plodding' a little with her front feet too. One minute she is dragging herself up the stairs like an old struggling lady and at others gets up reasonably quickly & normally, just a bit slower & weaker than before. It seems worse AFTER her insulin and FOOD & better when she is starving hungry and due her insulin! I wonder if this is the stress hormone that helps her at those times as she is really desperate to eat. Do I need to know the B12 status before supplementing? Can it be harmful to supplement if her B12 is normal? The vet is willing to do the B12 test first. If I should supplement, which is the best one to use? Should I do it via the vet or just buy some online somewhere? Any advise concerning this would be really helpful. I don't want to delay treating her if she would benefit.
Many thanks,
Juliana
 
You can buy it from many health food stores just choose one that has no sugars or the toxic to cats xylitol in it. Excess is urinated out so doesn't matter if she doesn't need it. It takes 4-6 weeks to work and works best when the cats BG is under control.

Are you home testing her blood? That will give a much better picture of whats going on here.

Since she had ketoacidosis I really hope you are also testing for ketones

Wendy
 
See my signature link for some tips on urine testing for ketones.

B vitamins are water soluble, and excess is excreted via the kidneys.
 
Hi Juliana. Wishing the best to you and your cat!

From my research, these seem like the two most popular methyl-B12 supplements on here:

VitaCost 5mg:

60 count:
http://www.vitacost.com/vitacost-vitami ... capsules-3

100 count:
http://www.vitacost.com/vitacost-vitami ... 0-capsules

iLifeLink Zobaline 3mg:

60 count:
http://www.ilifelink.com/zobaline-for_d ... blets.html

http://www.amazon.com/ZobalineTM-Diabet ... ine+feline

They differences between them are minor. Vitacost is a capsule that you open up to sprinkle the contents onto food. Zobaline is a pressed tablet that you can either give as a pill or easily crush to add to food. Vitacost contains a small amount of rice flour, which is a carb, though one member reports that it has no adverse effect on blood sugar levels. Zobaline is marketed specifically for diabetic cats, and therefore contains no carbohydrate additives. Cost-wise, Vitacost is cheaper on a per pill basis.

Alternatively, you could get a prescription from your veterinarian to have a compounding pharmacy formulate a liquid version for you to inject.
 
Juliana,
I have some methylcobalamin (Zobaline) left over from treating my own kitty & I am UK based.
The neuropathy can resolve with insulin therapy, but if you would like to try the supplements I can send you some?

Juliet

cat_pet_icon
 
Hi Juliana,

I'm wondering too whether there could be an element of joint problems or arthritis...? Does that seem possible?
If so then some of us have found that glucosamine and chondrotin supplements such as Cosequin can help.
I have some leftover capsules of that if you'd like to try them out...?
(And I do hope you'll consider Juliet's kind offer of Zobaline. (Those aren't available in the UK and need to be bought from the US. That's not difficult of course, but getting some from Juliet would enable you to get your kitty started on the methyl B12 sooner...))

Eliz
 
Hi Juliet & Eliz,
I would love to take up your offer of Zobaline! Its really kind of you to offer them to me. I have been wanting to reply since I first read your reply & I am really sorry, I must seem ungrateful. The truth is I seem to have NO time since Alice became ill. I have been trying to find time to sit at my computer. I cant explain how she is taking up all my time but she is! I am so sleep deprived! I watch her constantly, I follow her around out the back garden & spend time coaxing her to eat at the right times along with some lovely cuddles! My life fits around her! I work a couple of days & hate leaving her with my husband (not as diligent!)

Yes I would love to try the Zobaline, I will happily pay you & refund postage. I will PM you with my details (hope I can master that!).

I don’t think its arthritis as although she has always had a ‘clicky’ left hip, this is different. It fluctuates hour by hour & is quite severe, usually after insulin & eating & better when starving & ready for insulin & food. It upsets me to see her struggling up the stairs and then jumping her back legs down. The odd thing is, she RAN upstairs yesterday afternoon (first time since ill!) but its gone again.

I have focussed now on what I think is the main problem so I will post it seperately under a new title “Help please re insulin & high sugar swings”. I’d appreciate your opinion. I am thinking I need a vet who will prescribe a different insulin but not sure, if correct or where to get one.
Many thanks
Julianax
 
Hi Juliana,

Juliet has the Zobaline.
I have Cosequin (for joint problems).

To PM Juliet for the Zobaline you only need to click on the little 'PM' icon below her profile pic on the right hand side of any of her messages (her user name is 'Dr Schrodinger'.) That will take you to a page where you can write your message. :smile: The message you send will remain in your 'outbox' until Juliet reads it.

I do so know what you mean when you say that Alice is taking up all your time. I think we can become uber-focussed when our pets are ill, and, even when we're not actually doing something for them it's almost as though the brain finds it hard to think about anything else.
It probably sounds like a cliche but it will get easier. In fact, it will probably get a lot easier. It's just new territory for you at the moment. But managing Alice's diabetes will become routine; your 'new normal'. You won't feel the need to watch her all the time, and it will soon take up a lot less mental energy too.

I do hope you manage to get some good rest. I-)
(Another UK member here, Diana, also recommends setting aside some quality 'me time', in the form of bubble baths, chocolate, a nice glass of wine, or any other lovely treats. You have to look after yourself too! :smile: )

Eliz
 
Hi Eliz,
I have just spotted your post. Thankyou! You really do seem to understand! I am sooo tired I feel unwell not functioning well now, also very irritable. I stay up until about 00.30am to make sure Alice isn't hypo & then wake once & finally at 5.30 -6.30am but its as though I am not getting off into a proper sleep. I feel I am trying to find an answer to a problem that I cannot solve. At the moment, getting a better insulin. No vet around here seems to use anything other than Caninsulin. Alice's BG is going all over the place - 8.3 five hours after shot (lowest ever) followed by 32+ seven hours later! You & others here have really encouraged me. I am grateful for your kind support as this appears to be a busy site but you found time for me - many thanks, you have lifted my spirit on several occasions

Best wishes

Julianax
 
Juliana said:
Hi Eliz,
I Alice's BG is going all over the place - 8.3 five hours after shot (lowest ever) followed by 32+ seven hours later!
Click to expand...

Aha, now that looks like 'rebound' (also referred to as a 'bounce').

When the blood glucose drops low the body can compensate by putting more glucose out into the system as a protective measure. This can also sometimes be accompanied by counter-regulatory hormones the purpose of which is to keep the blood glucose levels up. (The counter-regulatory hormones cause temporary insulin resistance, so it may be that the next insulin shot seems to have less effect than it typically would.)

'Bounces' can happen when the blood glucose drops too low and/or too fast.
By "too low" that doesn't necessarily mean 'dangerously low'; it can happen when the blood glucose drops to a level lower than the cat has become accustomed to. Cats' bodies seem to get used to high blood glucose levels, and even perfectly safe lower numbers can be perceived as a threat. This can be a very temporary phase which passes quite quickly.

Do you know when Alice gets her lowest BG number of the cycle? Is it usually five hours after the shot? If so then it's unlikely she's gone lower than that 8.3 (149), and her body may just have reacted to that safe (but lower than she's used to) number.

Incidentally, regarding hypoglycemia, I would recommend putting together a 'hypo kit' that you can grab if you ever need to. This can be used during an actual hypo situation, or, as a way of preventing a hypo if it looks like the numbers are going to drop too low.
Lower numbers themselves may not be a problem at all, they may be a very welcome sight. For example a nadir (lowest blood glucose number) of maybe 4.5 (80) might be a nice thing to see. But seeing a 4.5(80) 2 -3 hours after a shot might indicate that the blood glucose could drop too low, especially if the blood glucose is dropping fast. So, the number itself isn't as important as where it's headed. And sometimes a low carb snack is sufficient to slow the drop and avert any problem (but not always).

Hypos are very uncommon in cats that have their BG monitored regularly. But they do occasionally happen. (Bertie has had 3 hypos. He's quite a tricky diabetic...)
My own hypo/hypo-preventing kit is very basic and consists of a higher carb wet food and a tube of liquid glucose (sold for cooking purposes).
There are a couple of hypo 'stickies' on the board here, and I'll post the links to them later. It may be information that you'll never need, but it is as well to read it through just in case.

Eliz
 
Thanks Eliz,

Now that makes perfect sense! I wondered if I was giving her too much insulin. It rings true as I have noticed before that the lower the number the higher it swings afterwards. Even the first cople of days in Hospital it got higher each day on the insulin. Tonight her 'high' before her insulin was only 20.9 which is rare for her, it is normally 25 - 30. I cant figure out any connection for this lower number. For the first time I REDUCED her insulin to 2.5 units of Caninsulin from 3 units this evening (only 3 hours ago) to see if it made any difference. It concerned me that it could drop from such a high number so much in a short time & only stay 'low' for about an hour before zoomed up even higher. Do you think I did the wrong thing?
She has been the best yet today in herself - (nothing to do with change of dose as it was before). She has been more awake & when it came to eating this evening she managed ok without having to leave it for over an hour to drink water! Later after she had eaten she was more energetic & actually ran in from using the garden! It was a real joy to see! :-D The lower blood sugar makes a huge difference to her. My vet said that high blood sugar doesn't make them feel unwell - I can see that is not true for Alice.
 
Sorry Eliz I just noticed I didn't answer your question:

'Do you know when Alice gets her lowest BG number of the cycle? Is it usually five hours after the shot? If so then it's unlikely she's gone lower than that 8.3 (149), and her body may just have reacted to that safe (but lower than she's used to) number."

Yes, according to the only curve I've done so far her lowest is about 5 hours. I don't know if that varies at all. That is when I tend to test her & feel I can go to bed without worrying about a hypo. Last night, 5hours & 15 mins after her shot her BG was 14.5. She was actually asking for food, I gave her a tiny bit & left a little in the kitchen (which is a first). This morning it was still there & she wasn't desperate to eat but rather more relaxed. Her BG was 27.2 & she took a little while to eat. Anyway - she seems to be going the right direction which is great! I'd like to stop these swings & see her levels level out but I'm doubtful that will happen on Caninsulin.

I so have some 'Glucogel' incase of a hypo thanks. I'm not sure I'd spot it though as often I take her food to her in her bed & she eats loads but hasn't bothered to fetch it!

Thanks for the great advice & support - I'm off to find my chocolate & a cuppa now as advised!
Julianax
 
Hi Juliana,

I can see why you're losing sleep if you're always testing Alice 5 hours after her evening shot. :-|
(But I do understand why you feel the need to do that. It can be a scary thing when the blood glucose numbers first start to come down.)

Bertie is also prone to steep drops at times. But I learned that, with him, if I do a test 2 hours and 3 hours after the shot I can get a measure for how 'active' the insulin cycle is likely to be, ie. how far he may drop by the peak of the cycle.
So, if for example, he's 8(144) 2 hours after the shot and 7(126) 3 hours after the shot, then that would tell me he's only dropping about 1mmol per hour; and with an hour or two to peak (he has a moveable nadir) that should be fine and I'd feel OK to go to sleep. If he was 8(144) 2 hours after the shot and then 5(90) 3 hours after the shot, then that would mean he's dropping at 3mmols per hour, and with another hour or two to peak that might mean he could drop too low. So I'd feed him a snack, test again in half an hour, and see how that has changed the speed of the drop.
It may be that you can use Alice's data in a similar way...? Maybe there is a period early on in the cycle that could clue you in to what is going to happen with her..?

Something else I'm wondering about - if you're up in the night anyway - is (something we touched on a while back) giving Alice 3 shots a day, but smaller doses (total day's insulin divided into 3 doses).
I do wonder if that might level out Alice's numbers, reduce the chances for steep drops (and subsequent bounces), and enable you to relax enough so that you can sleep.... I'm not suggesting you do this, I'm just pondering whether that might make a difference....
confused_cat

Oh, here's the link to the hypo info I mentioned:
viewtopic.php?f=28&t=15887

And here's a link to a thread where folks are discussing strategies for dealing with 'bounces' which might be of interest to you. (There is quite a bit of FDMB jargon in the thread (the references to 'yellow, blue and green' numbers refer to the colour-coding on the Google spreadsheets that folks use here. And US blood glucose numbers are different (we multiply ours by 18, or divide US numbers by 18)).
viewtopic.php?f=22&t=84824

Regarding spreadsheets; if you wanted to set one up for Alice there are some techy people here who would gladly help you with that (I'm not one of them!). Once it's set up you'd be able to enter Alice's blood glucose readings onto there, and people here would be able to access the document and see exactly what's happening.

Eliz
 
Hi Eliz,
That sounds a great idea on how to get a nights sleep! Unfortunately I will have to wait for my new test strips to arrive as discovered last night that there are only 4 left. I have got through about 70 strips since coming out of Hospital! I am rationing them as don’t know when new ones will arrive. I could tell her sugar was high this morning as she drank+++ immediately after first few mouthfuls of food.

I had thought about giving insulin over 3 times but it would mean always being at home around 4pm to space it equally. Also I wonder what would happen in the night at the nadir point, especially if she’s not eating alot. I work a couple of days a week & for the future it means we cant ever have an afternoon out. I would really like to get a longer acting insulin for her.

I did download a spreadsheet but I cant upload it even reading the instructions. It asked me to load ‘Google chrome’ which I did but still no success.

Another question..! I tested Alice’s urine today using a new human lab stix & it instantly showed leucocytes+++ (highest). I rang the out of hours vet who said it could give false results but to get a urine specimen to the lab. I will try and catch one tomorrow! She finished a course of antibiotics only 2 weeks ago as she showed high leucocytes in her blood. No one said where the infection was. Could this be a false positive because she of using human test strips?

Thanks for link to 'Bouncing'. That is definitely what she is doing. I have cut her insulin down to 2.5 units from 3. The first day looked better but since she has bounced high again. She then seemed off colour & was slow to eat but made up for it later.

Thanks again,
Julianaxx
 
Hi Juliana,

Sorry to hear that Alice may have an infection.
(I too have used 'human' test strips on my cats as I haven't been able to locate any 'animal ones'. (I wonder if they exist...?))
Did she have a UTI (urinary tract infection) previously? Cystitis maybe? Just wondering if it's a recurrence.
Here's hoping her urine test results at the vets come back clear.

Regarding setting up the spreadsheet with Alice's numbers, it could be worth your posting in the Tech Support forum. Your post will be seen by some knowledgable folks who can help you.

Regarding longer lasting insulin, it may take some 'strong-arming' to persuade your vet to prescribe it. But if the Caninsulin isn't being effective in Alice then the 'cascade system' does definitely give the vet the flexibility to prescribe an alternative.

As I said before, vets vary in their willingness to prescribe alternative insulins. And it may be a matter of phoning around and asking vets if they stock alternative insulins, or if they'd be willing to write a prescription for an alternative. (I've heard that there are some vets that stock Hypurin bovine PZI, for example. But I don't know where they are!)

If a vet is willing to prescribe another insulin then they can either order it in for you OR sell you a prescription to enable you to get the insulin from a pharmacy.
Some people find they can save a few quid by getting the insulin from a pharmacy. A vet can charge up to £15 for writing a prescription. But the insulin itself could be quite a bit cheaper from a pharmacy (though will have VAT added if sold for animal use). You might get a vial of Hypurn bovine PZI, for example, for maybe £60 (or less) in total if a vet writes a prescription. My vet charges me around £80 for a vial of Hypurin bovine at his clinic. The vials are big and last a long time.

In order to get an alternative though you'll need evidence that Caninsulin isn't being sufficiently effective. And, in Alice's case, I think your best chance of providing that evidence is to gather hometesting data to show that the Caninsulin's duration is insufficient.
If you can show that the insulin is consistently lasting less than 12 hours in Alice's system then that may be sufficient evidence.

Others have shown that Caninsulin dropped their cat's glucose too much, or too fast, or both.

My own vet also wanted reassurance that I would be hometesting. (That was somewhat ironic because he was initially opposed to my wanting to hometest!). That's because the longer lasting insulins are well, 'longer lasting'. The doses/duration can 'overlap'. Caninsulin is (usually) out of the system completely by the time of the next shot.

Regading the 'bouncing' - that can be a very temporary phase while the cat gets used to lower numbers. But some cat's remain 'bouncy' for a long time. You may quite suddenly find that Alice drops to a lower number and then doesn't bounce up high.

Keeping fingers and paws crossed for you both!

Eliz
 
Status
Not open for further replies.
Back
Top