Merlin’sMama
Member Since 2022
Sorry you are sick. Hope you feel better soon.
New bewildered member
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Merlin’sMama
Member Since 2022
Ok, so continuing on with my bewilderment, I have a few more questions. You people are so wonderful. Thank you so much.
1) the vet hasn’t gotten the insulin in yet, so I’m stuck in this limbo with Merlin. I have been feeding him more frequently a little bit at a time, thinking this would keep his blood sugar steady because he is so hungry. Am I wrong? Should I be working on getting him on a low-carb twelve hour feeding schedule before the insulin begins?
2) should I just stick with this crabby vet for now until I can find a better one, even if she wants to use Caninsulin? (She won’t tell me what one she ordered)
3) can I let this vet keep him in for twelve hours so that we at least start on solid terms with a proper dosage?
4) if I do that, should I continue the (unspecified) prescription food she wants us to use?
5)if I don’t go with this vet, should I find another vet, have his blood tested again, and start all over, adding to his time without insulin?
6)can I ask for the libre monitor to start with? Does it work for cats?
7)can I use the pen instead of the syringe, if it’s available?
8) once we start the insulin, if we let the vet do a 12 hour curve, how often will we need to test?
9)if we don’t let the vet keep him for 12 hours, how will we know how much to start with?
ok… I think that’s it for now. I must be reinventing the wheel here, but I just need to ask for myself. I hope it won’t be terribly wrong if I choose to let the vet keep him. It seems the most sensible to me right now.
Thank you all, again!
1) the vet hasn’t gotten the insulin in yet, so I’m stuck in this limbo with Merlin. I have been feeding him more frequently a little bit at a time, thinking this would keep his blood sugar steady because he is so hungry. Am I wrong? Should I be working on getting him on a low-carb twelve hour feeding schedule before the insulin begins?
2) should I just stick with this crabby vet for now until I can find a better one, even if she wants to use Caninsulin? (She won’t tell me what one she ordered)
3) can I let this vet keep him in for twelve hours so that we at least start on solid terms with a proper dosage?
4) if I do that, should I continue the (unspecified) prescription food she wants us to use?
5)if I don’t go with this vet, should I find another vet, have his blood tested again, and start all over, adding to his time without insulin?
6)can I ask for the libre monitor to start with? Does it work for cats?
7)can I use the pen instead of the syringe, if it’s available?
8) once we start the insulin, if we let the vet do a 12 hour curve, how often will we need to test?
9)if we don’t let the vet keep him for 12 hours, how will we know how much to start with?
ok… I think that’s it for now. I must be reinventing the wheel here, but I just need to ask for myself. I hope it won’t be terribly wrong if I choose to let the vet keep him. It seems the most sensible to me right now.
Thank you all, again!
Paulina
Member Since 2020
Sorry just to be clear are you asking about how many carbs is low carb medium carb and high carb?? Or did i not understand you
?
Paulina
Member Since 2020
Hiya! Hopefully someone gonna comment on this one as I remember that all I’ve read it was be careful as it can upset their tummy
Merlin’sMama
Member Since 2022
I think I figured out the chart, but I don’t know which percentage I should give to Merlin or how often until he starts on insulin.Sorry just to be clear are you asking about how many carbs is low carb medium carb and high carb?? Or did i not understand you
Merlin’sMama
Member Since 2022
That would be great! I hope that’s true.
Teetee (UK)
Member Since 2019
Hi Jill,
Yes that's the line you should be looking at for the carb content, as i said in a previous post my cat eats Sheba fine flakes in jelly that has 2.5% carbs, also the comments box gives you vital info like added ingredients like vegetable protein, sugars etc that can raise blood sugars.
The last four boxes contain the packet label info that printed on the cat food box or tin etc. This is very useful when it comes to double checking ingredients because manufactures can and do change things, i always double check the numbers on the list to what's on the food packet.
This tool is also brilliant for checking foods that are not on the list or for calculating foods that could have had their ingredients changed, have a go, it's easy to use, i use it all the time, just enter the typical analysis into the boxes and press calculate, it will give you the carb content.
https://secure.balanceit.com/tools/_gaconverter/index.php?
Teetee (UK)
Member Since 2019
Hi Jill, i will try and answer as many as i can but i will tag in a couple of other members just to double check everything or anything else to add.
@FrostD @Bron and Sheba (GA) thanks ladies.
1) I would feed Merlin just as much as he wants at the moment as he's not on insulin yet, but feed him low carb and no dry food.
At the moment his body not producing insulin and this in turn stops any nutrients being absorbed into his body resulting in weight loss and Merlin being ravenous, insulin acts like a key opening the cells in his body so the food can be absorbed.
When he starts insulin feed him his normal breakfast and supper but let him graze throughout the day, say small meals 3,4 and 5 hours after his insulin.
2) You might not have a choice regarding the vet, just keep searching today and have a ring around and yes caninsulin will have to do, but if caninsulin is given you should try and explain that Caninsulin was developed for dogs but used on cats until Prozinc was developed which is specifically for cats.
3) Personally i would prefer to do the curve at home because some cats stress badly at the vets and this can raise their BG at lot higher than usual giving false readings, so i would tell the vet you will do this at home.
4) No, that food is far too high in carbs
5) I can't be too sure about that, some vets will insist on another blood test, maybe if you take the printed out results they might work with that.
6) I haven't used a libre but is you search the forum some have had good results using it but some say that they fall off.
7) A pen if i remember correctly only gives doses in half units so you couldn't give smaller doses inbetween, say a fat or skinny dose or a quarter of a unit. If a cat needs a reduction we nearly always reduce in 1/4 units.
Here is a beginners guide to caninsulin and a piece about pens.
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/
And the prozinc board.
https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/
8) Testing is done every time prior to giving insulin plus well i do Duke at 3,4,5 and 6 hours but some do it less, but i would say at least 3 times during each AM/PM cycle.
9) The normal starting dose i cannot say but certainly not more than 1 unit to start with.
A couple of question from me now Jill
1) Are you home testing Merlin?
2) Has Merlin had a fructosamine test?
Bron and Sheba (GA)
Member Since 2015
You can try feeding a low carb diet for a week to see if it lowers the blood glucose levels if you are testing the urine for ketones.
If you just continue to not give insulin and not test for ketones, you are running a very real risk of your kitty getting ketones in the urine, which can quickly lead on it DKA which can be a life threatening and expensive illness to treat in cats.
I would make it a priority to find a vet who will give you some insulin now. It’s just ridiculous that they don’t have any insulin on hand or at least be able to get some quickly. If they prescribed Lantus you could pick it up from a pharmacy the same day with a prescription. It’s a human insulin, very suitable for cats, and I can not imagine that most pharmacies would not have it in stock.
I think the time has come for you to jump up and down to get your kitty started on insulin.
And if you are hometesting, it is not necessary for you to hand over your kitty to the vet for them to do a curve. It is absolutely fine for you to do it at home.
If you are successful in getting the insulin, please check with us first about the dose you have been told to give.
Merlin’sMama
Member Since 2022
Thank you so much for your answers. I finally talked to the vet! She will have the insulin in tomorrow, which means we can get him started Thursday morning. She said that only Caninsulin is available here, so I guess that’s that. She has also ordered the Libre meter. She wants to start with half a ml dose and observe him in the office to see how he responds. I have to say, I am more comfortable with this than with doing his first dosing at home, so I’m going to go for that as the dosage she is starting with is low. She said she has ordered Royal Canin diabetic wet and dry food that I can buy if I want to, or feed him whatever low carb I choose. She is going to show us how to do the injections on Thursday and practice with water…Is that normal? She also said that it’s ok to keep him on the food he has normally been eating for now and then ween him off it later. Luckily he is not picky, so that wont be hard. I have been testing his urine with ketostix and it has been normal every time. Whew. And I don’t know about the fructosamine as she wouldn’t send me a copy of his blood work…
Hendrick Cuddleclaw
Member Since 2022
yes many vets will have you practice shoot with saline solution
Teetee (UK)
Member Since 2019
Hi Jill
Is Prozinc not available in Ireland? seems strange, i thought it would be available everywhere. I will tag @Paulina to she if she knows any different.
Also are you sure about the half a ml dose, maybe half a unit on a u40 syringe, half a ml is a massive dose, it can't be right and you need to double check on that with the vet before any insulin is given.
Good news about the food.
The fructosamine test is a test to determine the average blood glucose levels for the past two to three weeks, this result is not stress affected so it's more accurate for diagnosis.
You can insist for a copy of his blood work, either via email or printed, after all that is what you paid for, that's ludicrous.
It would help now that Merlin is starting insulin is to set up your spreadsheet and your signature, this will be vital for anybody that helps regarding dosing for Merlin.
This page was set up by @Bron and Sheba (GA) giving loads of info and how to set everything up. If you do struggle to set it up there is always somebody here to help.
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
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Merlin’sMama
Member Since 2022
She must have said half a unit. I was so excited to be talking to her I must have written it down wrong.
Merlin’sMama
Member Since 2022
I had a little hunt online, and it seems that, although it’s authorized for use in the EU, Prozinc isn’t available in Ireland.
Paulina
Member Since 2020
Also I would request a copy of the blood work first and fructosamine and post it for admins. This way they can see if the starting dose is ok. Not sure if it was mentioned here - he had that fight with fox and although his mama said that he started loosing weight before - I was thinking what kind of medication he got that time? Did he get steroids?
Merlin’sMama
Member Since 2022
He got antibiotics and a single shot of “painkiller.” I’m not sure what it was. I will find out though. And I will not leave until I get a copy of his blood work.
Should I wait to find a vet that will prescribe Lantus? Could Caninsulin do more harm than good?? I was so happy to get him started on something to help him. Is it better to start sooner on Cansulin than later on Lantus? Now I will be up all night worried again.
Should I wait to find a vet that will prescribe Lantus? Could Caninsulin do more harm than good?? I was so happy to get him started on something to help him. Is it better to start sooner on Cansulin than later on Lantus? Now I will be up all night worried again.
Paulina
Member Since 2020
Don’t worry!! U said he has no ketones so one day more or less wouldn’t do any harm. I’m not experienced in types of insulin at all so better if someone else answer but I would ask the vet what’s the story with prozinc and lantus as u can say that ur friend from Galway was using prozinc and now on lantus and u would like some explanation how is that possible that’s not available in ur vets…
Merlin’sMama
Member Since 2022
I will ask her, but she’s the one who wrote me a condescending email about “googling different types of insulin”. I am thinking I might phone around different vets to see if they would prescribe lantus. I did read that if caninsulin doesn’t work, the vet can change, but I don’t want to use Merlin to prove a point that’s already been proven…I just need to know that caninsulin wont hurt and may help at least for a while til I find another vet. I don’t know.
Merlin’sMama
Member Since 2022
Hugs from all of us to you. Thank you!
Thank you
Hendrick Cuddleclaw
Member Since 2022
tagging some members who might be able to help with that question.
@FrostD
@Wendy&Neko
@Bron and Sheba (GA)
Bron and Sheba (GA)
Member Since 2015
Yes it is Ok to start with caninsulin and then you can relax while trying to get a better insulin.
1/2 U is a good dose to start with. Make sure you feed 1/2 hour before you give the dose.
Are you going to be testing the blood glucose levels?
Please do test for ketones. Your kitty has had an infection and is a diabetic so it’s important you test. Don’t think just becasue he had no ketones at diagnosis that he can’t get them. Hopefully he won’t, but please test.
BEGINNERS GUIDE TO CANINSULIN
Hendrick Cuddleclaw
Member Since 2022
<3 Bron
My girl started on Caninsulin (in Canada). That's what the vet knew. It wasn't until a locum vet came into the office that she got onto Lantus. It will be fine, just not ideal, to be on Caninsulin for a while. It will be much better than not being on insulin at all. In the UK, vets have to prescribe Caninsulin or Prozinc until it's shown one of them doesn't work. I know, Cork is not the UK, but a lovely town I enjoyed visiting.
The Libre is also a good way to start with home testing, but you should also take the time to start learning how to home test. Libre's last a max of two weeks, some cats take them off within days. You'll want to get something like a onesie or surgical suit or something like a sock you can pin around on top of it, to prevent kitty from accessing and removing it. More tips and info here: FreeStyle Libre: video, demonstration, explanations, tips – discussion!
The Libre is also a good way to start with home testing, but you should also take the time to start learning how to home test. Libre's last a max of two weeks, some cats take them off within days. You'll want to get something like a onesie or surgical suit or something like a sock you can pin around on top of it, to prevent kitty from accessing and removing it. More tips and info here: FreeStyle Libre: video, demonstration, explanations, tips – discussion!
Merlin’sMama
Member Since 2022
Thank you, Wendy. I wrote to our old vet in the US to ask her advice. I will go with the Caninsulin if it’s all we can get, but maybe we can switch, if it doesn’t work. I just hate to start something that is doomed to fail when we could have started off with Lantus had I tried harder. Grrrrrrr.
Merlin’sMama
Member Since 2022
No ketones so far. Vet didn’t call today. I felt reassured that things were happening and we’d be on track when I talked to her yesterday. She said she would call when the Caninsulin came in. I guess it didn’t.
Merlin’sMama
Member Since 2022
Hi everybody. We STILL have not heard back from the vet about initiating Merlin’s treatment! We are changing vets!
Angela & Cleo
Member Since 2022
That's INFURIATING!!!!!!! Good for you for taking back the control. Perhaps the next Vet will get your gorgeous Merlin on a better starting insulin!
Did you start Merlin on a lower carb food yet?
I also had a Libre put on my Cleo and it stayed on the full 14 days+ but the sensor stopped working after 10 days. The readings on the Libre did teach me the immeasurable value of home testing. Have you started a routine of home testing his BG? There are a TON of tips and tricks found on this board. If you're looking for them, you might want to start a new thread.
If you start testing the BG now, it could show how Merlin's BG responds to different % carb food. That information is great to know when he is finally on insulin.
Merlin’sMama
Member Since 2022
The first vet called me and left a message after I sent my husband in to get a copy of the blood work. She said that the monitor will be in tomorrow and we can set up an appointment for Merlin on Monday to place the monitor, and start the insulin, and monitor him for the full day in the office. She said he would need sedation to place the monitor. Is that true? It’s making me all wishy washy about going to a new vet… But, tomorrow I will be talking to the new vet (having sent him the blood work) and I will know what exactly his plan would be. His receptionist hadn’t heard of Lantus, though, so I think that using anything other than Caninsulin is rather hopeless right now. His reviews online are stellar, though, and he doesn’t have a gargoyle for a receptionist like the first vet. She will be super pissed off with me when I tell her we aren't going to go with her. A part of me thinks we still should, because she has all the stuff and is ready, on Monday. Will it take over a week for the new vet to order insulin and a monitor? I don’t know. What do you all think? Meanwhile, Merlin is hanging in there. Still no ketones in his pee. He was eating a lot for two days, but now has tapered off a little. I will get lancets and a monitor tomorrow if I can find them in a pharmacy… I did not realize how small-town “big-city” Cork is.
Merlin’sMama
Member Since 2022
I have a copy of his blood work now. Should I download it somewhere, or will it go into the scary spreadsheet I haven’t looked at yet?
Merlin’sMama
Member Since 2022
Hi Paulina! Could I ask your vet’s name in case the new vet is open to new ideas about different insulin (Lantus)? His receptionist said she’d never heard of that and it probably isn’t approved for veterinarian use blah blah blah…
Paulina
Member Since 2020
And i thought Galway is small as u Cant buy here what u want only whats available…
Paulina
Member Since 2020
My vet is Ark Vets in Knocknacarra Galway ( i used to be seen by Aidan but now whoever is available at the day of the appointment which i hate to be honest as I would prefer one vet always)
Paulina
Member Since 2020
Also remember the Youghal vet and the boarding cattery?? I know u said it’s bit too far but maybe if they can give the prescription is worth to try? Maybe just give them a call to see if they know lantus or prozinc??
Merlin’sMama
Member Since 2022
Ok! Thanks, Paulina. Yes, I get the feeling Ireland is still emerging from being mostly a great big cow farm, but it thinks it’s really continental and hip.
Merlin’sMama
Member Since 2022
And do you pick your insulin up from a pharmacy/chemist, or does the vet supply it?
Paulina
Member Since 2020
The prozinc I was getting from the vet but lantus I bought in the pharmacy - the vet just had to give me the prescription for it and the for the syringes too.
Teetee (UK)
Member Since 2019
Hi Jill
Regarding the insulin, i don't know if it's the same over there in Ireland but here in the UK vets have to use the cascade system by law.
I don't know if your vet will prescribe Lantus as it's a human insulin and they only prescribe human insulin if the animal insulin is not working, it's called the cascade system.
This means that vets have to use insulin designed for animals but if they don't work then human insulins can be used.
This is the UK version but like i say i don't about Ireland.
https://www.gov.uk/guidance/the-cascade-prescribing-unauthorised-medicines#about-the-cascade
Regarding the insulin, i don't know if it's the same over there in Ireland but here in the UK vets have to use the cascade system by law.
I don't know if your vet will prescribe Lantus as it's a human insulin and they only prescribe human insulin if the animal insulin is not working, it's called the cascade system.
This means that vets have to use insulin designed for animals but if they don't work then human insulins can be used.
This is the UK version but like i say i don't about Ireland.
https://www.gov.uk/guidance/the-cascade-prescribing-unauthorised-medicines#about-the-cascade
Teetee (UK)
Member Since 2019
It's not that scary Jill, infact it's a life saver and i honestly could not be without it.
Take a look at my Duke's spreadsheet, all his blood glucose readings/Lab results and any remarks are there for which i can revert back to when i want, or for a member to see if i require any help. The most important thing about having a spreadsheet is for when you need help from a member, the member must be able see Merlins spreadsheet so that they can help with any dose changes etc. A member cannot advise without seeing Merlins data otherwise it would be guesswork.
Remember there is always someone here to help you set it up.
Merlin’sMama
Member Since 2022
I have decided to stay with the original vet because she has finally got everything in, and I bet another vet would have to wait just as long to get insulin and the libre device. We are taking Merlin in on Monday to place the libre, (which the vet says he will have to be sedated for), begin the insulin, and do the curve for the day at the vets. I hope the sedation won’t lower his BG, but I don’t think I have a choice about that. Poor old guy, I just want to get him treated as soon as possible, despite my personal preferences for vet personalities. As soon as I have a curve, I will do the spreadsheet. My main concern right now is finding a low carb wet food all three of my picky cats will eat. They sure are hooked on those crunchies!
Teetee (UK)
Member Since 2019
Good idea Jill, you can always switch vets after Monday once Merlin has started his insulin if you are not happy. Those crunchies are a no no, probably very high in carbs, what are they?
As for food it's a case of trial and error, cats are cats. One day my cats love a certain flavour and the next day they won't touch it lol.
Merlin’sMama
Member Since 2022
Same with my cats. It took so long to find a food they would all eat after moving to Ireland. No Fancy Feast here. Usually they just lick the gravy off and leave the meat chunks. Then they load up on crunchies all day and night. I’ve tried taking away the crunchies, but the other two cats eat nothing and vomit water all day rather than eating wet food. Merlin will eat some pates for a few days then get bored. I’m worried my other cats will suffer most when I remove the crunchies. Merlin too, as he also loves them at night. I’m going to try mixing in an all protein crunchy with them to start phasing them out. Their beloved crunchies right now are “Purina One Bifensis Dual Adult,” I think a European brand?
Teetee (UK)
Member Since 2019
I can't say about removing the dry food from the other cats, personally i would, but Merlin really needs to be off the dry food as its massively high in carbs and not doing him any good at all, it just keeping his blood sugars up. It might say the carb content on the packet.
If you do reduce Merlins carbs then you need to be checking his bloods regular because lowering carb content of the diet can reduce blood glucose significantly, and the insulin dose may need to be reduced so as to avoid hypoglycemia.
Foods that contain gravy can also be high in carbs but not all, double check it on the carb calculator to be sure.
Try your cats on wet food in jelly instead to see if they like that, mine do prefer jelly rather than gravy.
Jill could you start a new thread as this is nearing 100 posts and the max is only supposed to be 50.
Just name your new thread New bewildered member continued and include a link to this thread so people can revert back if they wish to catch up.
Also could you please include a link to your new thread here.
If you do reduce Merlins carbs then you need to be checking his bloods regular because lowering carb content of the diet can reduce blood glucose significantly, and the insulin dose may need to be reduced so as to avoid hypoglycemia.
Foods that contain gravy can also be high in carbs but not all, double check it on the carb calculator to be sure.
Try your cats on wet food in jelly instead to see if they like that, mine do prefer jelly rather than gravy.
Jill could you start a new thread as this is nearing 100 posts and the max is only supposed to be 50.
Just name your new thread New bewildered member continued and include a link to this thread so people can revert back if they wish to catch up.
Also could you please include a link to your new thread here.
Paulina
Member Since 2020
Hi ladies!! I actually called my vet to ask and they said it basically depends of the vet supplier which insulin they have and also as long as the pet is under the vet care they can prescribe insulin which u can then buy in the pharmacy
Diane Tyler's Mom GA
Member Since 2018
I answered this on your new thread from today
https://felinediabetes.com/FDMB/threads/new-bewildered-member-continued.262958/
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