One week newbie

[ShannonO'C]

Hi everyone, our 4 year old Maine Coon was diagnosed last week. We are from the UK and the vet gave us Caninsulin. His bloods were 27 mmol/l when he was first tested by the vet. At first he was on 2 IU, but was very lethargic after injection, so after discussing with the vet we have dropped the dose to 1IU. He is a very fussy eater and we have so far tried around 10 or more different wet foods and several dry but he won't go near any of them. All he will eat what he has always had Iams dry food and raw 5% fat ground beef steak, and a little chicken breast. We have cut the portions right down to 15g dry and 50g beef twice a day, with a maybe 10-15g chicken if he gets really hungry in between meals. We tested his bloods last evening (10 hours after his shot) and it was 9.1 mmol/l. This morning he wasn't interested in food so we didn't inject him, we checked his bloods around 14+ hours after his last shot and it was 10.5 mmol/l. He has just eaten (15g dry 50g beef) around lunch time and we are thinking we should check his bloods again. What is the best time after injecting to see what effect the shot is having?

Shannon and John

 

[Anitafrnhamer]

I would think that testing a minimum of 1 hour would give you an indication. You could do a home curve and test hourly. I am not familiar with this type of insulin as we used Lantus.

My main point in answering your post is that obviously it is so important to keep your cat eating so you don't end up with the added complication of hepatic lipidosis. However, it would benefit your cat to get it completely off dry food. The carbohydrate content of dry food is too high and contributes to the development of diabetes and if diabetic keeps the glucose high. All cats should be on a wet only diet with less than 10% carbs. An easy formula to remember is: 100-(protein+fiber+fat+moisture+ash) that will give you the carb content. You should be able to pick up any can of wet cat food and look on the label at the Guaranteed Analysis for these numbers.


Anita and Squeaker

 

[Sue and Oliver (GA)]

Lots of things have helped transition cats to wet. Some include

sprinkling with parmesan cheese or tuna juice
warming it until nice and stinky in the microwave
sprinkling with dry food that has been crushed or with a favorite treat
Fortiflora - it's a probiotic that is sold online and sometimes in the vet's office ( not sure about UK vets). It has the animal digest that makes dry food so irrestible to cats You sprinkle it on top

Have you seen this website: www.catinfo.org The vet there has great ideas for transitioning reluctant cats from dry to wet.

As far as canninsulin, it varies for every cat. Some do okay with it and drop to their lowest point 5-7 hours after the shot. In a lot of cats, it has a harsh onset (any where from 1 to 4 hours after the shot) and then goes back up pretty fast, lasting less than 12 hours, sometimes more like 8. My understanding is that vets in the UK have to use it first. When you have the data and can demonstrate that it has a harsh onset and doesn't last long enough, they can switch to other insulins.

Here is a thread on low carb UK foods:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=64843

You might add UK to your subject line. (go back to your post, choose Edit and then add it to your subject.) We have lots of UK users who should be able to help with food and insulin choices.

 

[BJM]

Could you add a few things to your signature, to help us give you better feedback?

To edit your signature

Go to the top left of the screen.
Click on User Control Panel.
Click on Profile
Click on Edit Signature
A text box displays.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name, cat's name,
city, state,country
date of Dx (diagnosis)
insulin
meter
any other pertinent issues like food issues, DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Then Click on Submit to save it.

And, can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid forA storing the info; no math required.

 

[Critter Mom]

Hi Shannon and John, and welcome to FDMB.

I'm in the UK, too. Saoirse was first treated with Caninsulin but later with Lantus (insulin glargine). Caninsulin is more suited to canine diabetics (name's a bit of a giveaway), but by EU law Caninsulin must be tried first in cats since it is currently the only insulin approved by the EU for animal use. There are trials of more cat-friendly insulins going on at the Royal Veterinary College at the moment. Patients accepted onto the trial get treatment plus free food and testing supplies (Alphatrak meter and consumables). The RVC are always keen to hear about newly diagnosed moggies so it might be worth contacting them for a chat. Ruth is very kind and helpful. If the Caninsulin doesn't help your little one enough we can advise you further on how to go about getting a more feline-friendly insulin (e.g. Prozinc, Lantus) prescribed through the UK drug cascade rules.

Caninsulin typically has a fairly hard and fast onset (although every cat is different - some do OK on Caninsulin). Also, because Caninsulin is made up of two types of insulin - amorphous and crystalline - some cats may show a second nadir later in the cycle when the effects of the crystalline portion of the insulin are at their peak period of effect. To establish the Caninsulin onset, I'd suggest tests at +2, +3, and +4 initially, and also at about +7 to see if there's a second dip. On an ongoing basis, you can also monitor clinical signs to roughly gauge the onset time by observing if your cat starts looking for food any time after about an hour since the previous injection was administered, though this will not give you an indication of how far the BG is dropping.

It would help to know what type of meter you are using, since human meters read lower than pet-calibrated ones such as the Alphatrak 2.

FWIW, Saoirse was also very lethargic on the Caninsulin and it took her body some time to adjust to it. Even then, she struggled while she was on it for 9-10 hours out of every insulin cycle (very lethargic and withdrawn, tried to hide come injection time). Lantus didn't have the same poleaxing effect and, while she might grumble a bit when her injection was being administered, she didn't go out of her way to avoid the Lantus injections.

Zooplus do a wide range of diabetic-friendly foods. Here's a link to the forum list of foods available in the UK, along with their carbohydrate ratings.

 

[BJM]

You may find this Vetsulin/Caninsulin Guide helpful if you continue with Caninsulin.