newly diagnosed cat in Edinburgh UK

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Snuggles and Danny

Snuggles and Danny

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Hi,

Snuggles (age about 9) has just been diagnosed as diabetic, and the vet sent me home with Caninsulin, 2 units to be given twice daily to start with, and Royal Canin Diabetic dry food. She's very nice and happy to talk things through with me, so I said I had heard that wet food was better, but she replied that no, dry is better because the energy is released more gradually. From reading explanations here it seems that the opposite is true, but I found it impossible to disagree with her because she's a vet and I'm not, but now I'm feeling quite stressed. Why do most vets believe one thing and everyone on the internet exactly the opposite?

Can anyone recommend a vet in Edinburgh (UK) who they are happy to have treating their diabetic cat? I've been very happy with mine up until now, but I'm worried that Snuggles will not do as well as he could with this treatment.

Thanks,

Amy
 
I think the difference is that vets have to treat many species and many diseases. They may have a class on FD, but not extended info. Usually their nutrition classes are sponsored by cat food companies, many of which produce dry food. All we know is feline diabetes, and after 15 years and thousands of cats, we have a protocol we know works.

As far as the food - a vet who posts here often and who is a feline diabetes specialist - says this about wet lo carb food: www.catinfo.org

Cannisulin is not a favored insulin here. We feel, in most cats, the cat goes down fast and it usually doesn't last a full 12 hours. But my understanding is that, in Europe, you have to try canninsulin first. Then, if it doesn't work well, the vet may prescribe something else.

We have a old time member who, I think, is still in Edinburgh - Steve & Jock. You might send them a private message. Go to this page memberlist.php?mode=viewprofile&u=336 and choose the pm button.

In the end, it is your cat. You can feed him what you want. You can do research on the internet and ask questions of your vet, and decide what you think will work best. If you want us to help, we would be happy to. Everyone who answers your post is paying it forward for help they received when they needed it.
 
Hi,

Thanks for your reply Sue and Oliver - I've been reading up and gathered that it's difficult to get anything except Canninsulin here, so I'll see how that goes first. My vet is cat-only so it's very difficult to get past the feeling that they must know what they're doing, especially when you're standing there talking to them, but I know that they aren't necessarily always right - I've disagreed with human doctors before but this is my first time trying to disagree with a vet and I think it will take some getting used to :) I think I will try feeding good quality wet food and giving blood ear tests, and see what happens when Snuggles goes for his next checkup.

It's good to know that there is such a large and supportive community out there, and I've read the "letter from your cat" about not getting too stressed, but I haven't managed to follow the advice yet!

Amy
 
Please make sure you're testing and starting on a low dose of insulin if you're changing the diet. Caninsulin is very harsh and there's a bigger risk of hypoglycemic incidents with it. Please read this information about how to handle Caninsulin: http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=302

Caninsulin typically does not work very well in cats, but I know that in Europe it's always the first thing prescribed. Please don't hesitate to go back to your vet (or a new vet) in a month or so and get a prescription for a slow acting insulin like Lantus or Levemir if you can't get your cat regulated. The remission rates for the L insulins are much, much higher, and regulation is far easier. Also, they're safer because you won't have a lot of dramatic ups and downs.
 
As Julia said, you do want to be able to get blood glucose levels before you change food. When we switched from dry to wet, Oliver went down 100 points overnight. If we hadn't been testing, we would have given too much insulin. Here is a video of testing: Video for hometesting
 
While Caninsulin is far from the best insulin, it's not bad for dogs but not cats, I know that it's tough for you to ask for a different insulin.

If possible, you may try approaching your vet to discuss the use of Lantus.... I doubt that Levemir is possible for you, but I do know a few others in UK that have managed to obtain Lantus for their diabetic cats.
Caninsulin does not last the full 12 hours so your cat will be without for a few hours until the next shot. As a result, the cat's BG will be going up and down all the time and that's not good for the cat.

you could try printing out the info in the stickys at the top of this forum, then take them to your vet.

Dry food is too high in carbs and you will find that lower carbs will give you lower BG and a need for less insulin or maybe even NO insulin as several cats are DIET CONTROLLED.
 
Snuggles and Danny said:
Hi,

Thanks for your reply Sue and Oliver - I've been reading up and gathered that it's difficult to get anything except Canninsulin here, so I'll see how that goes first. My vet is cat-only so it's very difficult to get past the feeling that they must know what they're doing, especially when you're standing there talking to them, but I know that they aren't necessarily always right - I've disagreed with human doctors before but this is my first time trying to disagree with a vet and I think it will take some getting used to :) I think I will try feeding good quality wet food and giving blood ear tests, and see what happens when Snuggles goes for his next checkup.

Amy
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Amy,

Other than Canisulin (it is really an insulin for dogs, hence the name), you can also get Lantus, Levemir (rare) and Hypurin (PZI) in the UK. To get Lantus and Levemir, your vet needs to write a cascade prescription. It only means additional paper work for your vet.

I was in London, UK just last week and got two vials of Hypurin (PZI) from our old vet. He requires a prescription from my
current vet in Saudi Arabia and was able to dispense the insulin without any problems. Sue mentioned Steve & Jock, he
used to live in London but moved to Edinburgh last I heard. His kitty Jock was the first kitty ever to use Levemir for feline diabetes so I know it is possible to get Levemir in the UK but may be more difficult to get than Hypurin or Lantus.

I HIGHLY recommend that you try to get Hypurin from your vet because I know for fact you can get this in the UK. PZI has a much longer duration than Canisulin. There are many experienced PZI users here, and you will get lots of help and support.

Feeding your kitty a low carb, high protein diet is an integral part of managing your kitty's diabetes. I understand how you feel. I was in your situation three years ago. I trusted my vet. I never questioned anything he told me. You would think that our vets should know the best, right? Well, I learned the hard way. I almost lost my Major following my vet's advice on diet - feeding kibbles even after he became diabetic and using kibbles to firm up his stools when Major had liquid diarrhea and dehydrated.

I can give you some info on low carb wet food in the UK if you need any suggestions.
 
Hi there! I just moved to Belfast from Edinburgh in July. Which vet are you with at the moment? The only one I used in Edinburgh was Braid Vets (I was at the Leith Walk practice) but I know there's a cat only vet up towards the top of Morningside and maybe they'd be a bit more intuned for what's going to be good for cats, as that's the only species they work with. Here's the link for them: http://www.catclinic.co.uk/. I know Braid was constantly trying to get me onto their own food, so pretty sure they'll not be helpful in that respect.

*Edit* Sorry, just went back and saw you're with the Cat only vets, there goes that theory! If you do look into Braid Vets, I will say I was overall pretty pleased with them, though I didn't have a diabetic cat at the time I was with them. I found one of the vets (German lady vet I think) to be pretty rude to one of my cats, but sweet as anything to the kitten, which I didn't particularly appreciate, but everyone else there was lovely.

Might also be worth getting in touch with the Royal Dick Vet School and see if they have any suggestions or have someone who might willing to help!

That being said, I'm meant to have my cat on the hills diabetic stuff and haven't used it since I brought him home over a month ago, cheap and cheerful whiskas pouches have so far served us well. Being the UK, also on Caninsulin and as you'll hear around here, it's not ideal for cats, but I've had some success with a sliding scale (adjusting the insulin dose based off the blood glucose test), but I'm still learning myself and as they say, every cat is different!

I'm crazy homesick for Edinburgh and sending you all the best to you and your kitty in Auld Reekie! As I'm just over the water, feel free to PM me or anything if you're needing more local type help!
 
Jock, of Steve and Jock, was the first cat on Levemir. He may have some advice on getting around the UK's roadblocks to getting a better insulin. Do contact him.
 
Thanks for all your replies - I have sent a message to Steve and Jock to see if he has any specific Edinburgh advice. I read up on diabetes diets last week when Snuggles had his checkup and the vet had me do a urine test (positive which led to today's blood test) and have been buying a few packets/tins of lots of different recommended foods from online shops, to see if I can fine one which both cats like. Danny has no health problems but is a much fussier eater, so if I can find something he likes too, feeding will be easier. Lily's kitchen unfortunately was not popular today, Bozita is sometimes eaten but not always. I've read the advice on transitioning from dry food - Danny will be harder to crack I think. I've also ordered some fortiflora in the hope that spraying it on various foods will make Danny like them more.

I will try home BG testing - which testing kit do UK people recommend? I'll have a look in Boots tomorrow. I'm not going to start the insulin until the weekend so I can be around to monitor Snuggles reaction (and no doubt obsessively wake him up to make sure he's not in a coma, etc).
 
Regarding monitors, I use the Accu Chek Aviva nano, which I got off of ebay. I think those sorts of things end up being rather expensive because they'd be covered by NHS if you were a human diabetic, and not so good if you're a human with a diabetic cat (boots wanted to charge me £15 for 200 lancets) Ebay is a very cost effective way to get a hold of testing supplies, I think I picked up my meter for £7 (with shipping) and with enough hunting around, have picked up 100 test strips for £20-£25

But with any meter, price the test strips, because they end up being the costly end of it, the meter might come cheap, but you have to keep replacing the test strips (I've gone through nearly 150 test strips in the past month, running curves, and generally screwing them up, not enough blood, etc) but my usage is slowing down.

If you have a friend or family member who is diabetic, they might be helpful getting you set up with a meter as well!
 
moof86 said:
Regarding monitors, I use the Accu Chek Aviva nano, which I got off of ebay. I think those sorts of things end up being rather expensive because they'd be covered by NHS if you were a human diabetic, and not so good if you're a human with a diabetic cat (boots wanted to charge me £15 for 200 lancets) Ebay is a very cost effective way to get a hold of testing supplies, I think I picked up my meter for £7 (with shipping) and with enough hunting around, have picked up 100 test strips for £20-£25

But with any meter, price the test strips, because they end up being the costly end of it, the meter might come cheap, but you have to keep replacing the test strips (I've gone through nearly 150 test strips in the past month, running curves, and generally screwing them up, not enough blood, etc) but my usage is slowing down.

If you have a friend or family member who is diabetic, they might be helpful getting you set up with a meter as well!
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Thanks, very useful advice, I'll have a look on ebay. I'm sure it will take me a while to get the hang of it all too.
 
Snuggles and Danny said:
Thanks, very useful advice, I'll have a look on ebay. I'm sure it will take me a while to get the hang of it all too.
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It's a very strange moment in your life when you're upset because your cat has failed to bleed enough to get a reading, thus wasting a strip. :o :shock: :shock: lol
 
I rang my vet (a good thing about them is that they're always willing to talk on the phone) but unfortunately they're actively against home testing so I think I'm going to have to find another one :( Do you think it is a bad thing to delay starting the insulin until I find a sympathetic vet who hopefully would prescribe Lantus instead of Caninsulin? I haven't started Snuggles on insulin yet because I wanted to wait until the weekend - he's now just about on an all wet food diet (though not very happy about it) and I'm going to test his BG as soon as I get hold of the equipment. He doesn't have any new symptoms (still peeing too much), is cheerful and playing and sleepng and purring normally. Has anyone tried ringing up unknown vets and asking them about their treatment of diabetic cats? Are they willing to talk to you before you register your pet?
 
If you can't reach Steve through his PMs, look him up at his new bookstore in Edinburgh : "Pulp Fiction". He is really the go-to guy in your area.

It used to actually be illegal to hometest in the UK (considered practicing veterinary medicine without a license)- so much so that an underground network was started, called Sugarcats. You may want to check in with them, as well : http://www.sugarcats.com

Did you ask your vet why he was against hometesting? Some vets think it will hurt or traumatize the cat (not true!) and others are afraid you will become too numbers-obsessed (can be true!) But it certainly would be better to deal with a vet who is on board with it.

If you are holding off on the insulin, definitely do the food switch now. However, I would suggest starting the insulin, anyway, just because the sooner you start, the faster Snuggles will start getting better. If you're nervous about starting at 2u twice a day without being able to hometest (and I would be, too!) then start at something lower, like 0.5u or 1u.

Important : Caninsulin is a U40 insulin (meaning it has 40u in each ml), unlike human insulins, which are U100. That means you cannot use the same needles for both without a conversion chart. So, I am assuming your vet sold you the U40 syringes with the insulin, right? Use those, but if/when you switch to Lantus or Levemir, you will need new needles, or the conversion chart.

Best of luck!
 
Did you connect with Steve ?

You do not need your vet's permission to home test. Snuggles is
your cat.

But, it sounds like a different vet would be in order.
 
KarenRamboConan said:
If you can't reach Steve through his PMs, look him up at his new bookstore in Edinburgh : "Pulp Fiction". He is really the go-to guy in your area.
Click to expand...
Thanks - I sent him an email to the address in his profile, so hopefully he'll read that. I'd feel a bit like a stalker turning up in his bookshop though!

KarenRamboConan said:
It used to actually be illegal to hometest in the UK (considered practicing veterinary medicine without a license)- so much so that an underground network was started, called Sugarcats. You may want to check in with them, as well : http://www.sugarcats.com

Did you ask your vet why he was against hometesting? Some vets think it will hurt or traumatize the cat (not true!) and others are afraid you will become too numbers-obsessed (can be true!) But it certainly would be better to deal with a vet who is on board with it.
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Wow - it doesn't seem to be illegal any more, I think my vet's objections are exactly as you suggested above - too much fuss, not worth it, and not necessary to have so many numbers. It came across like a human doctor saying "just take the pills and don't worry about the complicated details, I'm a doctor and I know best".

KarenRamboConan said:
If you are holding off on the insulin, definitely do the food switch now. However, I would suggest starting the insulin, anyway, just because the sooner you start, the faster Snuggles will start getting better. If you're nervous about starting at 2u twice a day without being able to hometest (and I would be, too!) then start at something lower, like 0.5u or 1u.
Click to expand...

As far as the food goes, I'm trying to feed just wet at the moment, but my other cat has never been keen on it so it will take him a bit longer to get used to the idea I think. At the moment I have wet food down for Snuggles to eat when he wants, and a secret stash of dry food to supplement Danny when he asks. I don't want either of them to stop eating! I will try to do a home test tonight but I'm nervous about changing the dosage myself - the vet also does not want me to do that, and I would have to tell them so they could adjust future doses. However, I really don't want hyoglycemia, so...

KarenRamboConan said:
Important : Caninsulin is a U40 insulin (meaning it has 40u in each ml), unlike human insulins, which are U100. That means you cannot use the same needles for both without a conversion chart. So, I am assuming your vet sold you the U40 syringes with the insulin, right? Use those, but if/when you switch to Lantus or Levemir, you will need new needles, or the conversion chart.
Click to expand...

Yes, the vet made sure she gave me the right sort of needle (red cap) , and told me to complain if they try to give me the wrong sort in future (orange cap). Actually thinking about it, that implies that they have other cats on a different sort of insulin, so maybe if Caninsulin doesn't work out they will be willing to try Lantus. I'm not sure yet what I will do about switching vets, I may just not mention the home testing for now, as there's no guarantee I can find any vet around here who will be more accommodating.
 
I will try to do a home test tonight but I'm nervous about changing the dosage myself - the vet also does not want me to do that, and I would have to tell them so they could adjust future doses. However, I really don't want hyoglycemia, so...
Click to expand...

Completely understandable, but there lies the beauty of hometesting, you can see how your cat reacts and respond accordingly. The mantra start low and go slow is an excellent one, you can always add more insulin, but you can't take it out and if you've got a quiet weekend coming up you can run a curve to watch what a particular does, keeping on hand some dry food and honey or golden syrup in case it all goes a bit pete tong (starting out on a low dose and not shooting below 11, however, are good ways to avoid a hypo).

Canninsulin will also just run it's course after about 8 hours, so on a bid (two shots a day) schedule, you're not likely to have any overlap or left over insulin in the system
 
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