New Member (Kozmo Kat) UK

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Annie & Kozmo

Annie & Kozmo

Member Since 2020
Hello - Kozmo, our 12yo Burmese was discharged from hospital today after being diagnosed with Diabetes on Thursday. He’s on 1 unit of Caninsulin twice a day and his curve will be retested in two weeks.

He’s on 20ml Gabapentin twice a day (permanently) for arthritis in his hips/pelvis (our steel plated cat). He’s also on penicillin to treat a reoccurring ear infection and eye drops for conjunctivitis.

We’ve ordered a blood glucose testing kit and KatKin wet food (95% fresh real meat).

Our new vets are leaning towards the idea that stress from an ear procedure under general anaesthetic three weeks ago combined with steroids may have triggered Kozmo’s diabetes. He lost 1kg in a very short period and although he was never a big eater (and extremely fussy), now that he’s home he’s prowling the kitchen and meowing to be fed. It’s tough seeing him like this but we know he must wait until 7pm! He found a stack of his old food in the laundry and I’ve taken a cute video of him pawing at it, telling me he wanted to be fed right now.

As far as administering the insulin goes, my husband is an ex-medic so this shouldn’t be a problem for him (and I have to stop being so squeamish and put on my brave pants!).

So... I’ve never posted on a forum before. I hope this post is okay and look forward to learning as much as possible to assist us and our beloved kitty.
 

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Awwwww, he's gorgeous!!!

Welcome to the forum! I'm sorry about the diagnosis, it can be scary and intimidating at first, but FD is a very manageable condition. One of the things that can really help you take control of the situation is to home test blood glucose. Two weeks is a long time to go without assessing how Kozmo is responding to insulin, especially a fast-acting insulin like Caninsulin. It's also not the greatest to do it at the vet-- not only is it expensive, but a lot of times the stress of being there elevates the cat's BG, and you get inaccurate data.

How was Kozmo diagnosed? Did they do a fructosamine test? Did he show any ketones or was he in DKA while in the hospital?

Here is some information put together by one of our UK members:

Info UK INFORMATION (Food, Insulin, Vit B12, and other 'need to know' stuff)
 
Frangipannie said:
Hello - Kozmo, our 12yo Burmese was discharged from hospital today after being diagnosed with Diabetes on Thursday. He’s on 1 unit of Caninsulin twice a day for now. His curve will be read(? Taken? Tested?) in two weeks.

I’ve never posted on a forum before and look forward to learning as much as possible to assist us and our beloved kitty.
Click to expand...


Welcome! I am new here as well (DX 5/08/20) and this forum has been priceless!!!!! I can not sing its praises enough! My cat was also started on Caninsulin (Vetsulin) and as of now (a little over a month in) he is on 4.5 units and still showing high numbers. I just ordered Prozinc and plan to change him over next week. From what I read on here Vetsulin works for some but is not the best choice overall. If you are planning on home testing (highly recommend!) you can easily do the curve yourself and save the vet cost. It is also very helpful to test and monitor his numbers yourself so that you get a better idea of what is actually happening to your cat when you give the dose and you are able to test more often than waiting on the vet. I took my cat to the vet for the initial diagnosis and prescription and, with the help of this forum, I have been doing everything myself at home. If I would have relied on my vet I would probably still have no idea what is going on with my cat or the best way to help him. My cat is also VERY NERVOUS when he has to leave the house so glucose levels at the vet would be way off due to stress. At home he purrs and comes straight to me when it is time to test so he is comfortable with the process. We are here for any questions and to guide you along the way :cat:
 
BIG smile here Heather.

Welcome to FDMB! You've found the best darn site to help you help your beautiful Kozmo!
We are glad you found us and get ready for the brave pants to come out of the closet!
Having never posted on a forum before you may need help setting up a spread sheet and signature you can find that info here:
Suggestions, Tech Support & Testing Area
Dont worry if you have problems with it . There are plenty of people here to help you all you have to so is ask. Ok?
We WANT to help you help Kozmo. :bighug:
jeanne
 
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I noticed you added a bunch of information to your original post. Great info, but just fyi, when you need to add something it's better to just post a new reply on a thread. When someone returns to a thread after reading it, the forum software takes them to the "first unread" post automatically, so they won't see things you've added to an earlier post without scrolling up, which most people don't do :)
 
Thanks to all for your warm welcome and helpful advice. I’ll set up my signature and will add content to my thread rather than edit my original post (makes sense now). Sorry about that!

Kozmo has been struggling with an ongoing ear infection since July 2019. Kozmo had a blood test in October 2019 and all was normal. Surolam was prescribed for the ear (with unsuccessful results) three times before a swab was taken. The results showed a staph infection so antibiotics were prescribed 21/02/2020. Although the infection cleared immediately, it soon returned. Two more courses of antibiotics after that (including lockdown period). One week before Kozmo was scheduled for investigation of the ear, he was prescribed Gabapentin for his arthritic pain (Metacam hadn’t worked and he was howling constantly) and Prednidale to reduce inflammation in the ear so they could see more during the planned procedure. We had a new cat! He was sleepy and relaxed but the howling had stopped.

Investigation of the ear produced no results and we were told that some cats just happen to have reoccurring infections for no reason - get used to it. We were sent home with another course of Prednidale. We had asked the vet to take blood and urine samples while Kozmo was under - to give him a (hopeful) clean bill of health. When we called the surgery for the results, they said they didn’t take blood and Kozmo’s bladder was empty.

For the next two or so days, Kozmo cringed every time we came near; not like him at all. He became more lethargic and we put it down to the Gabapentin. Over the next few days, his appetite increased to ridiculous levels and he started drinking copious amounts of water. He was still on Prednidale and we read that the side effects were increased thirst and appetite. So, hungry and thirsty from Prednidale and lethargic from Gabapentin was what we thought.

The day after surgery, Kozmo developed conjunctivitis and a week later passed a massive foul-smelling yellow stool.

On Monday 8 June, we dropped a urine sample to the vets and they called to say his sugars were extremely high. We were asked to drop another sample to them on Friday 12 June. We called back and booked him in for a blood test on the Friday. We stopped giving him Gabapentin.

Thursday, 11 June Kozmo was flat, completely lethargic. He’d stopped eating but was drinking and peeing a LOT! We called the vet and took him straight up. They said he was a very sick boy with a dehydration level of 10. They had to administer fluids before the could obtain a urine sample, and when they did it contained ketones. He was given the lowest dose of Caninsulin and we took him to a vet hospital when our vets closed (we didn’t realise they don’t have 24 hour care facilities). We took Kozmo back to the vet on Friday morning and his glucose levels hadn’t reduced. We transferred Kozmo’s care permanently to the vet hospital and he spent Friday night there.
They called on Saturday morning to say that Kozmo’s glucose levels were stable enough to take him home with 1 unit of Caninsulan twice daily. No ketones were present. They said to come back in two weeks for a curve test.

We’re waiting on delivery of a human BGM today and intend to use it before each shot. Kozmo has self fed (not overweight) until now and is struggling with hunger. He’s lethargic without Gabapentin and with it.
I just wrote a book! I’ve probably missed events and could have made it more clinical if I knew how. I have a feeling there’s another place to file this rather than this thread?
 
Welcome to FDMB!

A couple of thoughts...

First, Caninsulin is really not the best choice of insulin for a cat. It was developed for use with dogs whose metabolism is much slower than that of a cat. As a result, you give an injection and after about 8 - 10 hours, it's used up. This causes numbers to swing from high to low to high again. Caninsulin does not have adequate duration for treating feline diabetes. The American Animal Hospital Assn recommends either Prozinc or Lantus for treating feline diabetes. This is a link to their guidelines for diabetes treatment. In addition, Caninsulin can cause your cat's numbers to drop rather quickly so monitoring is critical.

Hopefully, Kosmo is doing much better. Ketones can be life threatening and it sounds like your vet handled the situation well. You may want to purchase Ketostix. (I'm not sure what they are called in the UK.) These are strips you dip in your cat's urine to tell you if ketones are present. They should be available at any pharmacy/chemist. They are a wonderful bit of prevention. With a cat this is post diabetic ketoacidosis (DKA), it's important to make sure your kitty is eating and that you're getting enough insulin in to keep the ketones at bay. It's possible that the ear infection was a contributor. The basic recipe for ketones is an infection/inflammation + not enough calories + not enough insulin.

It's also possible that the steroids contributed to the diabetes developing. If your cat needs to be on steroids, it may be harder to get his blood glucose under control. Steroids and diabetes are not best of friends but the good news is you can adjust a dose of insulin to compensate for the need for steroids.
 
Sienne and Gabby (GA) said:
Welcome to FDMB!

A couple of thoughts...

First, Caninsulin is really not the best choice of insulin for a cat. It was developed for use with dogs whose metabolism is much slower than that of a cat. As a result, you give an injection and after about 8 - 10 hours, it's used up. This causes numbers to swing from high to low to high again. Caninsulin does not have adequate duration for treating feline diabetes. The American Animal Hospital Assn recommends either Prozinc or Lantus for treating feline diabetes. This is a link to their guidelines for diabetes treatment. In addition, Caninsulin can cause your cat's numbers to drop rather quickly so monitoring is critical.

Hopefully, Kosmo is doing much better. Ketones can be life threatening and it sounds like your vet handled the situation well. You may want to purchase Ketostix. (I'm not sure what they are called in the UK.) These are strips you dip in your cat's urine to tell you if ketones are present. They should be available at any pharmacy/chemist. They are a wonderful bit of prevention. With a cat this is post diabetic ketoacidosis (DKA), it's important to make sure your kitty is eating and that you're getting enough insulin in to keep the ketones at bay. It's possible that the ear infection was a contributor. The basic recipe for ketones is an infection/inflammation + not enough calories + not enough insulin.

It's also possible that the steroids contributed to the diabetes developing. If your cat needs to be on steroids, it may be harder to get his blood glucose under control. Steroids and diabetes are not best of friends but the good news is you can adjust a dose of insulin to compensate for the need for steroids.
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Thanks for your advice, Sienne. And thanks to the FDMB, I am now fully aware that Caninsulin isn't the best for cats and definitely not the best for Kozmo. After each shot, he quickly falls asleep and stays that way unless he's searching the kitchen and meowing for food. Our vet asked us to feed Kozmo twice a day before shots but his hungry behaviour and vomiting (saliva) close to feed time had us very concerned, so I posted on your Feline Diabetes Facebook group and was quickly relieved to hear that most people feed their cats snacks between meals. I plan to feed him 30g of boiled chicken breast with the broth water twice between meals. I hope this is okay and not too much.

We have purchased ketone test strips and are awaiting delivery, despite our vet's advice that it wasn't necessary. Kozmo's steroid treatment was over a period of two weeks and he's no longer on them.

I believe that Caninsulin and Prozinc are the only insulins approved in the UK for cats. Unfortunately, Prozinc is currently unavailable here and I don't know how long this will continue, otherwise I'd be demanding Prozinc in an instant! We changed vets on Friday, and I'm not sure if we're comfortable enough to request that he be changed to Lantus when Kozmo is reviewed in two weeks. May I ask what your thoughts are on this?

Annie
 
I feel like there have been some other recent UK people around here who have their cats on lantus... I'm wondering if they've relaxed the rules with the unavailability of prozinc? Though even then you may need to demonstrate that the caninsulin "isn't working well" first. I wish I could remember more, I'd tag the users for more details on how they made the switch. I do think it's at least worth bringing up to the new vet.

And I agree with Jeanne, even if your vet ultimately disagrees about home testing, he can't stop you from doing it in your own home!

Speaking of home testing, are you still waiting on a meter? I am a little concerned with what you describe about Kozmo's reaction to his shots, especially since we seem to be talking about steroid-induced diabetes. Sometimes that kind of FD can linger for months or longer, but sometimes it fades once the steroids are removed. It's really important to start testing soon so that we can make sure that the insulin dose is appropriate.
 
Nan & Amber (GA) said:
Speaking of home testing, are you still waiting on a meter? I am a little concerned with what you describe about Kozmo's reaction to his shots, especially since we seem to be talking about steroid-induced diabetes. Sometimes that kind of FD can linger for months or longer, but sometimes it fades once the steroids are removed. It's really important to start testing soon so that we can make sure that the insulin dose is appropriate.
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We received our BG monitor late yesterday, in time for his second shot, and it took many attempts to work out what number to dial the pen to. By that stage Kozmo was fed up and struggling to get away... his reading was HI and we couldn’t hold him down to get another. We put that reading down to a snack three hours prior and the stress caused to all three of us trying to grab that droplet.

We’ve worked out a calm way that we think will work and will be testing before his second shot shortly.
 
@Elizabeth and Bertie is around on occasion.

You can always change your subject line to something like "UK members" (chance the subject in your first post in the thread) and hopefully, people will read through to catch your questions.

I do think Lantus can be prescribed for cats in the UK. In general, it's not approved for cats, even in the US. It's an off-label use. Nevertheless, it is recommended and effective. There's a good deal of research supporting it's. use and we an supply the links. At one time, Caninsulin was the only insulin prescribed in the UK and your cat had to have difficulty with it and the caregiver had to pressure their vet about switching. That has since changed but, no doubt, there are still vets who like Caninsulin.

Either Lantus or Prozinc are good insulin for cats. If Prozinc is in short supply, which I suspect is the problem, I'd forcefully but tactfully insist on Lantus. It's a human insulin so will be available. Do you know if you need a prescription for Lantus? (In Canada, you do not.) While I'm hesitant to suggest you go around your vet's back, sometimes you need to do what you need to do.
 
Annie & Kozmo said:
Thank you. @elizabeth and Bertie’s settings aren’t unavailable to me.
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Hi Annie, waving to you from Surrey!

Caninsulin isn't the easiest insulin to use in kitties, but some kitties have done just fine on it. And there are ways of working with it to get the best out of it.
Prozinc is the other insulin licensed for kitties here in the UK, but, unfortunately, and as you know, it is unavailable at the moment... We're all hoping that is just a temporary thing...
If it turns out that Caninsulin isn't working well for your kitty then your vet can prescribe other insulins. If Prozinc was available it would just be a matter of switching to that, because it is another veterinary insulin. But, your vet can also prescribe human insulins, Lantus and Levemir, under the 'cascade' system of prescribing. Whether a vet will do this or not is largely a matter of luck. Some vets are very helpful and very willing to prescribe alternative insulins; others not so much...
Getting blood glucose data from hometesting is the best way to actually see how the insulin is working in the kitty's body. And that data can be shared with the vet so that they can see what's going on too. Quite a few UK folks have done this in order to make the case for a change of insulin. But the vet is only obliged to prescribe an alternative 'if' it is clear that the current insulin isn't working sufficiently well...

Do you know if your kitty will need to stay on the steroids..? I'm guessing that's something that isn't known yet...?

Edited to add: I didn't know my settings were unavailable! All these years and I didn't know that, hahaha! I've ticked a box now that 'I think' means people can see them.

Eliz
 
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