New member… 28.09.2022 - Morag

[Angela Horton]

Hello,

I have been recommended this forum as a useful resource of information on feline diabetes.

I have two diabetic cats; Sabrina who is now diet controlled remission since April 2021 (her diabetes was steroid induced) and Morag who we rehomed at the beginning of this April knowing she was diabetic. Since

Since April we have been trying to regulate her blood glucose levels and in May I moved her from Caninsulin to Prozinc. During that time I have been trying to find a food that suits her… we have transitioned her from Whiskas +7/+11 cat food through to Sheba Fine Flakes, with cooked chicken for snacks, Feringa wet food, Beutenah cold pressed food. Most recently (within the last 10-14 days) she has moved completely onto Royal Canin diabetic wet food which although a higher carb content (13.49%) is much better for her poops and her PS BG numbers seem to be getting a little better. I am now just moving her across to Purina ProPlan diabetic wet food tins which is only 3.75% carbs.

I complete Morag’s a.k.a. MoMo‘s curve tests at home and email them across to my Vet. I use a human meter Aviva Accu Chek. I also check her ketones using the OnCall Dual meter..

She is on 1 1/2 units of Prozinc twice a day with her pre-shot reading being taken at 7:30am and 7.30p.m. and fed at 8am and 8p.m. During the day she has breakfast at 8am, snack meals at 10am, 12:30pm, 3pm, 5pm. Dinner at 7:30pm then a snack at 8pm, 10pm and then 1am.

I record all of her info on a spreadsheet and ask for peer advice on the UK Feline Diabetes Support should I need it along with vet advice. I have a very good relationship with MoMo’s vet.

 

[Sienne and Gabby (GA)]

Angela -

I'm so sorry no one replied to your post!

This is a link to some of our basic information -- helping us to help you. You've already done much of the basics by setting up your signature and having the spreadsheet. The biggest challenge is your spreadsheet. Ours is almost identical. However, when you enter your data in mmol/L (the World template) on ours it converts automatically and enters the values on the US tab. Most of us on this site are from the US so the automatic conversion makes it easier. If there's anyone in the UK group that can check into why the numbers aren't converting, that would solve the problem.

One concern is that the food you're using is high in carbs. We consider low carbohydrate to be under 10% carb and most of the members here tend to feed in the neighborhood of 5%. The carbs are likely keeping your cat in higher blood glucose numbers. This is a link to information on diet and diabetes from a vet who has a wonderful website on feline nutrition.

We use a strategy for guiding our dosing. This is a link to the Prozinc forum where you may want to look over the sticky notes at the top of the board. Doses are increased roughly every 7 days if you're not seeing nadirs (lowest point in the cycle) that are in closer to a normal range. You've been holding Morag's dose at 1.5u for a month. However, there's no way to really know how low the dose is taking the numbers without at least one test that's closer to nadir.

I'm also tagging one of our members who's in the UK - @Elizabeth and Bertie

 

[Angela Horton]

Angela -

I'm so sorry no one replied to your post!

This is a link to some of our basic information -- helping us to help you. You've already done much of the basics by setting up your signature and having the spreadsheet. The biggest challenge is your spreadsheet. Ours is almost identical. However, when you enter your data in mmol/L (the World template) on ours it converts automatically and enters the values on the US tab. Most of us on this site are from the US so the automatic conversion makes it easier. If there's anyone in the UK group that can check into why the numbers aren't converting, that would solve the problem.

One concern is that the food you're using is high in carbs. We consider low carbohydrate to be under 10% carb and most of the members here tend to feed in the neighborhood of 5%. The carbs are likely keeping your cat in higher blood glucose numbers. This is a link to information on diet and diabetes from a vet who has a wonderful website on feline nutrition.

We use a strategy for guiding our dosing. This is a link to the Prozinc forum where you may want to look over the sticky notes at the top of the board. Doses are increased roughly every 7 days if you're not seeing nadirs (lowest point in the cycle) that are in closer to a normal range. You've been holding Morag's dose at 1.5u for a month. However, there's no way to really know how low the dose is taking the numbers without at least one test that's closer to nadir.

I'm also tagging one of our members who's in the UK - @Elizabeth and Bertie

Hi Sienne and Gabby

Thanks for your message. I’ll ask in UK group about the conversion on my SS - I don’t know why it’s not working…

MoMo and Food…
If you look back through MoMo’s SS you will see that I transitioned her to Sheba Fine Flakes when she came to us in April 2022. As we weren’t getting the results I wanted on it and the amount she was eating of it just wasn’t sustainable, so I moved her to Feringa tinned wet food and Beutenah - it’s all detailed on her SS. We weren’t getting the duration with insulin - NADIR on Caninsulin was around +3 to +4 and Prozinc was getting a better NADIR, but her numbers were still high and flat. So after her vet talking to the manufacturer of ProZinc we decided to try her on diabetic food (not my first choice due to the higher carb content - the Royal Canin that she’s now almost transitioned from was 13.49% carbs. The Purina ProPlan DM wet food tins she’s now on is 3.75% carbs so under the magic 10%). The diabetic food does seem to be better for her as her poops are now more formed, smaller and don’t smell so much.

ProZinc
We had been holding her dose at the same amount as I was changing the food she was eating, so didn’t want to change too many things at the same time. UK advice for ProZinc seems to be to hold the dose for longer 10-14 days to see how it is working. I’m trying to get a reading near to her NADIR and as you know it’s not always possible. Sadly my attention to MoMo did slip for a couple of weeks as we rather suddenly but not completely unexpectedly lost our beautiful 18yrs old Siamese kitty - the shock of how sudden we lost her really knocked me and then the following week we unexpectedly lost one of our bunnies. I’m not making excuses just trying to give a bit of background which Elizabeth and Bertie will be fully aware of. Work has also quietened down a little so I’ll be able to give MoMo the attention she deserves.

I hope this answers your queries? I will take a look at the files you’ve tagged when I’m back on a PC as it’ll be easier for me to look at them there.

Thanks again for taking the time to reply

Angela & MoMo

 

[Elizabeth and Bertie]

I have been recommended this forum as a useful resource of information on feline diabetes.

Hi Angela! Welcome to FDMB. Nice to see you here.

 

[Sienne and Gabby (GA)]

Thanks so much for the background. Making one change at a time makes good sense.

The ProPlan is definitely lower in carbs. What we've seen here is that cats often tire of it. The ingredients are far less than ideal -- it's not a good quality food. I suspect that the Prozinc manufacturer may be supportive of "prescription" food. There was a class action suit here in the US involving the manufacturers of what can loosely be referred to as "prescription" food. The pet food manufacturers lost the suit as they could not prove there was anything medically prescriptive in their foods. I'm not overly familiar with the foods that are available in the UK. Elizabeth is and may be able to offer greater insight than I can based on her experience. (There's a list in her signature.)

Please let us know how we can help.

 

[Angela Horton]

Just an update on MoMo. We moved her back to Caninsulin on 10 November as it seemed to be working better for her. I've changed her diet to just Purina DM tinned wet food (3.75% carbs) and Sheba FF (1.96% carbs). Her poops still need some work, so I've just started adding a second psyllium husk capsule for her food - one with breakfast and one with dinner. Her SS is updated daily & I've managed to get it formatted so that the numbers are copied across to the US tab as well.

 

[Bron and Sheba (GA)]

Hi Angela, good to hear an update.
your SS is very difficult to read. I’m in Australia so I understand and the world numbers but it’s very hard to move the SS around to see everything. From what I can see you are no giving enough insulin with either of the insulins..Prozinc or Caninsulin. I’m not sure what you went back to 0.5 units when you swapped back to the caninsulin? if you could put a coloured line across the SS for when you did the swap over back to Caninsulin, it would be easier to see…is that possible?

I would try and get at least one test in during the pm cycle to see what is happening.
I’m going to tag @Suzanne & Darcy about the dose as I’m not a Caninsulin user.

 

[Angela Horton]

Hello Bron

Thank you for your reply.

What device are you viewing the spreadsheet on? I very often find it difficult to view on a mobile or tablet.

We started back on Caninsulin at 0.5 of a unit as per the vets instruction. I did query this with her but she said no to start on that dose (even though she has regular high ketones). Following advice from the UK Feline Diabetes Support group Moderators I’ve been increasing her dose to the two units where we are at today.

Adding a line onto her spreadsheet for the change of insulin has been on my to do list! I’ll get it done today.

I know I should be getting a reading during the evening cycle. I will try to be better at this.

I did try to do a curve yesterday but her auto feeder didn’t go off so she didn’t get anything to eat between 08.00 & 15.00hrs. I will do another one over the weekend.

 

[Bron and Sheba (GA)]

Hello Bron

Thank you for your reply.

What device are you viewing the spreadsheet on? I very often find it difficult to view on a mobile or tablet.

We started back on Caninsulin at 0.5 of a unit as per the vets instruction. I did query this with her but she said no to start on that dose (even though she has regular high ketones). Following advice from the UK Feline Diabetes Support group Moderators I’ve been increasing her dose to the two units where we are at today.

Adding a line onto her spreadsheet for the change of insulin has been on my to do list! I’ll get it done today.

I know I should be getting a reading during the evening cycle. I will try to be better at this.

I did try to do a curve yesterday but her auto feeder didn’t go off so she didn’t get anything to eat between 08.00 & 15.00hrs. I will do another one over the weekend.

I am viewing it on my iPad.
Can’t believe the vet said to go back to 0.5 units with ketones in the picture.
How often are you testing for ketones? Looking at the SS it looks like every few days. I would recommend you test every day with the readings you have been getting. Has Morag ever had DKA? Those ketones reading are high.
I can see you are giving frequent snacks during the day and night which is great. With ketones in the picture I would be aiming to give her 1 and a half times as many calories as she would normally eat. It is food and insulin which is needed to keep the ketones away.
I would be increasing the dose every three days until you get her into much better numbers. At the moment she is in high numbers most of the time.
I am surprised that Prozinc did not work for her. Maybe you were not increasing the dose fast enough. With ketones you don’t want to be leaving the dose at the same amount if it is not lowering the BGs. Does that all make sense?

 

[Sienne and Gabby (GA)]

I'm viewing your spreadsheet on my laptop and have the same problem. I suspect the issue is that you have the cells frozen. I can see date column and the next column that's visible is the Remarks -- the view goes from column A to column AB with nothing visible in between and no bar to slide the view from left to right. This may be an issue with using OneDrive vs Google but I can't say that for certain. (I use OneDrive at the office and don't have the issue with viewing spreadsheets.)

 

[Angela Horton]

I am viewing it on my iPad.
Can’t believe the vet said to go back to 0.5 units with ketones in the picture.
How often are you testing for ketones? Looking at the SS it looks like every few days. I would recommend you test every day with the readings you have been getting. Has Morag ever had DKA? Those ketones reading are high.
I can see you are giving frequent snacks during the day and night which is great. With ketones in the picture I would be aiming to give her 1 and a half times as many calories as she would normally eat. It is food and insulin which is needed to keep the ketones away.
I would be increasing the dose every three days until you get her into much better numbers. At the moment she is in high numbers most of the time.
I am surprised that Prozinc did not work for her. Maybe you were not increasing the dose fast enough. With ketones you don’t want to be leaving the dose at the same amount if it is not lowering the BGs. Does that all make sense?

Thanks for the reply.
I know, that's why I checked it with her.
I'm trying to do every few days at AMPS & NADIR, but she's had a lot of jabbing recently so I've kept off doing more than needed for a couple of days. We've only had her since April and not since then. Wow! That could be a lot of food given what she currently eats. I'll see if I can calculate it and work out how much food she'd need.
That's what I have been doing with the help of the UK Feline Diabetes Support group but I have to work it around when I'm around to keep an eye on her so any increases aren't done on a Sunday, Monday & Tuesday as I'm out at work on Monday and Tuesday morning.

 

[Angela Horton]

I'm viewing your spreadsheet on my laptop and have the same problem. I suspect the issue is that you have the cells frozen. I can see date column and the next column that's visible is the Remarks -- the view goes from column A to column AB with nothing visible in between and no bar to slide the view from left to right. This may be an issue with using OneDrive vs Google but I can't say that for certain. (I use OneDrive at the office and don't have the issue with viewing spreadsheets.)

Thanks for the reply.
Yes, I do have Column A and Rows 1-6 frozen so that they can be seen when I scroll through the SS. I don't know why you're getting the view you are. Google Sheets doesn't work for me on my iPhone.

 

[Sienne and Gabby (GA)]

You may need to install the Google sheets app. I use an iPhone and don't have a problem. FWIW, I can view your entire spreadsheet now.

What it looks like to me is that Morag has never been given enough insulin to get his numbers in a better range. In addition, the doses have been held for too long. If you stick with a dose that's not getting your kitty into a desirable range, you risk glucose toxicity developing. The name sounds a lot worse than it is. What it means is that your cat's system treats those higher numbers as his new "normal." It makes it harder to get the numbers into a better range. It will just take persistence. With the dosing method we use, you want to evaluate the dose every 7 days and increase if numbers aren't where you want them unless a dose reduction is warranted.

If you're going to stick with Caninsulin, please take a look at the information about it's use/dosing on the Caninsulin forum. IMHO, Prozinc is a better insulin but that's entirely your choice.

 

[Angela Horton]

You may need to install the Google sheets app. I use an iPhone and don't have a problem. FWIW, I can view your entire spreadsheet now.

What it looks like to me is that Morag has never been given enough insulin to get his numbers in a better range. In addition, the doses have been held for too long. If you stick with a dose that's not getting your kitty into a desirable range, you risk glucose toxicity developing. The name sounds a lot worse than it is. What it means is that your cat's system treats those higher numbers as his new "normal." It makes it harder to get the numbers into a better range. It will just take persistence. With the dosing method we use, you want to evaluate the dose every 7 days and increase if numbers aren't where you want them unless a dose reduction is warranted.

If you're going to stick with Caninsulin, please take a look at the information about it's use/dosing on the Caninsulin forum. IMHO, Prozinc is a better insulin but that's entirely your choice.

Thank you for your reply. I'll look at increasing her dose to 2.25units from tomorrow. For now, I'll stick with Caninsulin.

 

[Angela Horton]

I am viewing it on my iPad.
Can’t believe the vet said to go back to 0.5 units with ketones in the picture.
How often are you testing for ketones? Looking at the SS it looks like every few days. I would recommend you test every day with the readings you have been getting. Has Morag ever had DKA? Those ketones reading are high.
I can see you are giving frequent snacks during the day and night which is great. With ketones in the picture I would be aiming to give her 1 and a half times as many calories as she would normally eat. It is food and insulin which is needed to keep the ketones away.
I would be increasing the dose every three days until you get her into much better numbers. At the moment she is in high numbers most of the time.
I am surprised that Prozinc did not work for her. Maybe you were not increasing the dose fast enough. With ketones you don’t want to be leaving the dose at the same amount if it is not lowering the BGs. Does that all make sense?

I've calculated her calories and she's on way more than needed at the moment, so I need to get the insulin dose right...

 

[Bron and Sheba (GA)]

Let us know if we can help in any way.