One month in... having a hard time. Caninsulin - Canada

[Bobbi513]

Hello All,

I am about 3-4 weeks into treating my newly diabetic Cat, and am having a hard time with it. Initially the vet prescribe 1unit of Caninsulin twice per day, but I found this dose to be to harsh, dropping her 10+ mmol/l per dose when her starting levels were low teens, so I adusted her dose to 0.5unit twice a day. This seemed to work well for the two weeks as it was dropping her within the normal range, and returning to low-mid teens in time for her next dose. Starting on week 3 though her levels have raised to high teens-low twenties, so I increased her dose to a 1unit twice per day, but now instead of dropping 10+ mmol/l she is only dropping a few mmol/l and returning to her high levels well before her next dose is due - though she is not going past the low 20's. Yeasterday basically to try something different I gave her 1unit in the AM at 18mmol/l, then I gave her a 0.5unit at mid-day at 15mmol/l and then 1unit in the PM at 13mmol/l hoping it would stabilizer her around the low teens for a morning shot 12 hours later but in the AM she was only showing 6mmol/l and then rebounded to 18mmol/l a few hours later so at that time I gave her 1unit again. I am at a loss of what to do now, is this all over the place normal or is her insulin going bad or something? Do I keep giving her 1unit and see if her low point starts dropping furthur like it was before? or Due I increase her dosage to 1.5units? Am I just making a mess? *cry*

 

[Sue and Oliver (GA)]

Re: One month in... having a hard time.

I am sorry you are having such a hard time. It is quite hard to regulate with Canninsulin in some cats. It tends to hit them early in the cycle and takes them quite low. Then they bounce up before the 12 hours is up. It sounds like you were trying to shoot three times within a cycle? (I am not sure I am reading your post correctly) We have had people shoot three times daily with an insulin like Canninsulin but it is tricky and you really have to monitor. You'd divide your total dose for an am/pm cycle into thirds and give 1/3 every 8 hours (assuming the number is definitely rising and above 200) I know of no one who is presently doing TID (3 shots daily) so you wouldn't have anyone who could advise you.

Is there any chance you can get another insulin? Are you in Europe? I know it is difficult there to get an alternative, but I think if you can demonstrate that you have tried Canninsulin and it is not working for your cat, you can get an insulin similar to PZI or perhaps one of the human insulins that work well (Levemir or Lantus)

I would suggest you add your country in your subject line and see if anyone is near you and has experience with another insulin. We do have several people in the UK who are using or have used Canninsulin and maybe they can help.

One thing that would really help us (and you) is to put your numbers in a spreadsheet. We have a World Version that will convert your metric numbers to our US ones. Here are the directions: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 Be sure to use the World version so it will convert.

 

[Bobbi513]

Re: One month in... having a hard time.

I am actually in Canada. Basically my main concern is that she had went from 1unit dropping her mmol/l by 10 to only dropping her by like 4 or 5 mmol/l and then it went back to dropping her by 10 or so a few days later, I am just wondering if that is because there is something wrong with my insulin or does that just happen sometimes. I tried dosing her 3 times (full dose, half dose, full dose) in one day to see if I could lower her levels to the low teens rather then the low 20's but it didn't really work as well as I had hoped, she dropped too low so rebounded a bit, so I don't think I will try that again. Her normal dose is 12 hours apart, she was originally hitting her lowest point about 6 hours in which is good, but lately it hasn't been so consistent, sometimes wearing off quicky, othertimes lasting the full 12 hours. I do keep charts all all her readings, both of her daily readings and of the curves I have done.

 

[Elizabeth and Bertie]

Hello and welcome to FDMB!

Oh, I do sympathise... I had this experience with my cat initially. However, please don't lose hope. It's very early days. And just recently two cats on Caninsulin have even gone into remission (become diet-controlled) on this forum!

What are you feeding your cat at the moment? And how often are you feeding?

 

[Sue and Oliver (GA)]

If you are in Canada, there is no reason to struggle with Canninsulin - unless you want to try longer to get it to work more consistently. You can get Lantus or Levemir at a pharmacy (I am pretty sure without a prescription).

BUT they work very differently than Canninsulin. They are shed insulins so they work longer in the body and have overlap. It will be important that you read the information on the forums for those insulins (they work about the same) and learn about dosing, cycles and what to do with low numbers etc. it seems complicated at first, but they are much more predictable than Canninsulin in terms of expected levels and drops.

The starred topics (stickies) at the top of the page are the one with the info:

http://www.felinediabetes.com/FDMB/viewforum.php?f=9

 

[hmjohnston]

The problem with Canasilin is that it is a very short term insulin- it might last 8 hours in a cat if you are lucky and it acts FAST which means, as you have seen, it drops them down hard and then goes away leaving them to surge back up in the numbers.

I can tell you are testing at home YAY!!! I would suggest either dosing on an 8 hour schedule or switch to a long lasting insulin that can use the 12/12 schedule.

hmj

 

[Bobbi513]

Thank you very much for the info. I am going to keep on the Caninsulin for now but may look at trying Lantus when I am back from holidays in a few weeks. We are making some progress, as her coat is in much better shape and her cough has finally gone away after over 6 weeks, and she is back to playing again (she is 8), She is on wellness grain-free canned food twice a day. So its not all bad news.

 

[Julia & Bandit (GA)]

I would change insulin as soon as you are able to either Lantus or Levemir. Caninsulin does not work well in cats as it does not have a duration of action long enough to offer adequate control over blood glucose levels. Cats metabolize insulin twice as fast as people or dogs, so they need a 24hr insulin administered twice daily (which lasts 12 hrs in a cat) to fully control blood glucose levels.

And just recently two cats on Caninsulin have even gone into remission (become diet-controlled) on this forum!

Keep in mind that the remission rate for Caninsulin (on a low carb, canned diet) is about 25%, which is nearly the same as the remission rate from diet change to low carb, canned food alone. That would lead me to question whether it was the insulin that caused the remission or the diet change. When you contrast that to the 86+% remission rate with Lantus or Levemir, I would not stick with the Caninsulin any longer than you have to. There is a window on remission, and the longer you wait to start a longer acting insulin, the more your chances of reaching remission diminish. The dosing protocol for Caninsulin does not recommend continuing Caninsulin if remission is not reached in 6-8 weeks.