New Member. 28/04/2021. Introducing Nick

[Nick's Human]

Hello all, Nick is a UK based male, long haired (possibly Maine Coon cross) cat. Adopted four years ago and estimated to be 13 years old. He is also an adorable, placid boy!

Nick was diagnosed diabetic on March 5th 2021 following a trip to the vet, after me noticing an increase in drinking and peeing and noticeable weight loss (He was a big boy 7kg> when he first came to live with us and diet/weight management has been ongoing but slow!) He is now weighing in at 4.5kg. He is on Caninsulin, currently at 4iu which has been increased by .5iu increments following glucose curves at the vets.

Alongside the insulin, diabetic food has been slowly introduced and his regular satiety food decreased (both dry foods). We were seeing some effects of the insulin on the curves, until the most recent one on Monday (26th April) where numbers at the lowest point have increased significantly (from 12 to 29 mmol/L) The vet has suggested Nick may have Acromegaly as the insulin was having no effect, they explained a little about this and I've been doing my homework, the forum has been very helpful (and I already know the situation with his food being dry is not something that is recommended here, and that the changes may be a contributory factor).

We had reached a point where Diabetic food was solely being given and I can't help but wonder if this has affected the numbers we are seeing on his most recent curve? The satiety food has more fibre content than the diabetic food, which I see benefits some cats?

The vet had recommended that we increase the Caninsulin a full unit, to 4.5iu but warned to watch closely for Hypo (kinda scared me to be honest!) having stated this was quite a high dose given his weight. Having done my homework Monday night I called my vet Tuesday (yesterday) morning and said that I would like to reintroduce the satiety food at the percentage it was at when his previous curve was done along with an increase of .5iu of insulin to see if the results improved as it seems that the insulin HAD been having some effect up until this time when his diet is solely diabetic food? So, this is what were doing, his next curve is due May 7th.

Of course I am new to all of this and the vet is the professional, however I see a wealth of knowledge being shared here on the forum and see that vets can be somewhat limited in their thinking, especially when it comes to options with prescribing insulin. I can't help but feel that its a little extreme and sudden to be investigating Acromegaly when there has been evidence of insulin working.

I think I would like to try and change his diet to wet food gradually before considering tests for Acromegaly.

Any thoughts and advice you may have is very much welcomed.

 

[Wendy&Neko]

Hello and welcome from someone who had a Maine Coon cross with acromegaly, and started on Caninsulin. If you haven't seen it already, we have a food list for the UK that gives the names of appropriate low carb foods. UK Cat Food List You are right that dry food is not appropriate, it is higher carb food than is suitable for a diabetic cat. The vet "diabetic" food is diabetic in name only - great marketing isn't it!

Changing to wet food first is a great idea. Are you home testing Nick's blood sugars? That's the only way to safely make the switch. Changing to low carb wet food cat make a sudden and huge change in the amount of insulin needed. The other thing that home testing might tell you is if you are missing some low numbers that is causing his body to do what we call "bouncing", which can temporarily cause higher numbers. Here is the description: Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Note, I'm using the US mg/dl scale for blood sugar instead of mmol/L we are used to the rest of the world. 200=11.1, 300=16.7. Divide mg/dl by 18 to get mmol/L. Since this board is hosted in the US, that's the convention we use here.

A couple more things to start, trying not to overwhelm you. Caninsulin is not a great insulin for cats - it's a dog insulin. If you can get your vet to get you on Prozinc, that would be better for him. It's a longer lasting insulin in cats.

And lastly, if Nick has only been on insulin since early March, it's too early to test for acromegaly. Research at the Royal Veterinary Clinic (one of the most knowledgable places about acromegaly), showed that cats tested too early, or within 73 days of starting insulin, have a good chance of false negatives for acromegaly.

So a plan going forward. if you aren't already, I'd start learning to do home blood testing. Tips here: Hometesting Links and Tips - includes numerous links, instructions, pictures, & videos. And this UK list mentions some supplies: UK Diabetic Cat Food Info Once you are comfortable home testing, start the switch to a more appropriate diabetic food.

 

[Nick's Human]

Thanks so much for replying and the info Wendy&Neko. The glucose meter arrived today, I tried unsuccessfully to test using Nick's paw pad (one not walked on) I will hopefully build up confidence to test using his ear. I tried testing myself and got error messages so I definitely need more practice! Good thing I bought extra lancets and strips. Will try again tonight before feeding and Insulin, I'm wanting to change his food as soon as I know what his BG is, I have Butchers Classic ready to go.

I've been reading LOTS since I first posted and from the info you gave me regarding the insulin and acromegaly I'm feeling that there are definitely other things to consider before I agree to testing.

I know it's helpful to have some idea of BG so I'm sharing the only info I currently have of curves done by my vet. Apologies if it repeats some of what is already mentioned above but I thought it may get confusing if I missed bits out.

Nick was diagnosed 5th March, I was told his BG was 32.72 mmo/L. He was started on 2iu of Caninsulin around ten days later. His diet had been RC Satiety dry, I asked about diet change and was told it wasn't necessary and would probably make very little difference but I could try DM if I really wanted to! So, we slowly added Purina One DM dry in, until he was solely on this (Yes, I know..dry food

) The following two curves are from this period. His most recent curve, which was 26th April I don't have details of but was told his lowest reading was 29.6 mmo/L and the vet spoke to me about Acromegaly and suggested the insulin was having no effect at all. At that point I started looking for more info than I'd already seen, as my feelings were that the insulin had shown some signs of working and that maybe we were missing something. That was when I found FDMB. My first step is to change to low carb wet food (once I get testing started) second one will be to think about changing to Prozinc if things still aren't looking great.

7th April:
9am 40.8 mmol/L
fed and insulin administered 2.5iu (9.15am)
9.40am hi
10.45am 38.9 mmol/L
11.40am 33.9 mmol/L
12.40 31.1 mmol/L
1.40pm 25.3 mmol/L
3pm 27.6 mmol/L
3.40pm 18. mmol/L

16th April:
9am 31 mmol/L
fed and administered insulin (3iu) 9.15am
9.45am hi
10.30am 35.8 mmol/L
11.30am 39.6 mmol/L
12.30am 27.4 mmol/L
1.30pm 28.9 mmol/L
2.30pm 25.8 mmol/L
3.30pm 26.8 mmol/L
4.30pm 12.9 mmol/L
5pm 30.9 mmol/L

 

[Wendy&Neko]

Thanks for the update. I see that on the 16th he got down to 12.9 (232 in US measurements) so you are seeing some insulin action at 3 units. Note that it's not unusual for cats to be stressed at the vet clinic and have higher blood sugar. I had a non diabetic cat test over 11 at vet's office, and 3.0 and home the next day. Yet another reason we suggest home testing.

As for ear testing, start with rubbing the tips of his ears. Give him a treat after you've done so. You want to associated treats with testing. Preferred treats are low carb. Freeze dried all meat treats are popular.

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
Use 26 or 28 gauge lancets

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear