Really new - day 1 (UK) advice please!

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Jobi & Tumble

Member Since 2013
Hi all,
Well, a real newbie here, my Tumble was only diagnosed about 5 hours ago! She's about 12 yrs old (a rescue kitty 10 yrs ago so not totally certain on age!) who had in the last two weeks suddenly started drinking and peeing lots, but with no other apparent signs it took a while to figure out who was that thirsty as we also have three other moggies. Managed to get to the vets this evening for her to be checked, and the suspicion of diabetes confirmed with a level of 25. (We're in the UK.)
So, in a little bit of shock, but very reassured from here that this isn't the end of the world for her.

I have some (probably typical newbie) questions:
The vet prescribed caninsulin, twice a day, starting with 5ml. Is 25 very bad or just bad as a level?
My first real question is around feeding: she has been on measured portions of IAMS light practically forever, as she is a real greedy guts and always eats any food that's left down. Should I be switching her to canned/wet food ASAP? And does that mean start the transition or just stop totally with the dry? Or should I be letting the insulin have an effect for a few days (weeks?) before any changes?
Secondly, the vet simply said come back in a week when he'd retest to check the dose of insulin - it seems that general advice here is testing regularly is key, should I be heading to Amazon for home testing stuff before that? If so, any advice on recommended kit would be very welcome.
Oh, and I only have 3 syringes, any advice on cost effective replacements?

[edit to add UK in question title]
 
Re: Really new - day 1 advice please!

Hi Jobi! Welcome! You've found the absolute best place to help Tumble. Thanks for mentioning that you're in the UK. There are some active members here who are also in the UK so they'll be able to help more with specific advice regarding good brands of things that are available to you.

I'm in Canada, so I use the same blood glucose numbers as you, but the Americans are on a different system and since they are the bulk of the folks on this board, it works better if you speak their "language" :lol: You get the numbers they can understand by multiplying ours by 18 - that's why you'll see people talking about such high numbers. (When you start keeping track of the BG testing levels there's a really handy spreadsheet available that will automatically convert the numbers to keep everyone happy!) So 25 x 18 is 450, and yes that's high. You want it roughly between 4 and 10 in your numbers.

It's good you already know that you should switch to a low carb wet diet. That will help a lot. If your cat will eat it, you could just switch, but some tummies do better with a gradual change. The REALLY REALLY IMPORTANT THING is that a diet change can drastically reduce the blood glucose levels. It is best to switch the diet BEFORE you start insulin as it could make a huge difference. There is a cat on here right now who was eating dry food and on 11 units of insulin, but went down to more like 1 unit of insulin after the diet change. If you are switching after you have started insulin, you absolutely have to be home testing to keep your cat safe. A great approach would be to switch the diet to low-carb wet food while you learn to home test blood glucose levels, then you can start insulin afterwards. A lot of vets don't suggest home testing because they think it will scare people off, but it's so dangerous to be giving insulin blindly when you don't know what the cat's blood glucose is, so by all means start home testing whether the vet thinks you should or not :-D

Also you said the vet prescribed 5 ml (I think you mean 5 "units" as there are many many units in a mL) which seems like a pretty high dose. I'm not familiar with caninsulin but with the other insulins the starting dose is usually 1 unit and you work up to what you need.

I would suggest the best way to talk to the people who can help you with Caninsulin and other UK specific advice would be to edit the subject line of your original post to include "Help in UK please" or something of that sort!

All the best to you and Tumble!
 
Re: Really new - day 1 advice please!

We have several UK members. I've sent them messages to see if they can give you specific advice on food/testing supplies. Here is a thread from a recent UK member that may help

http://www.felinediabetes.com/FDMB/viewtopic.php?t=106507

Yes, you should test at home, especially with Canninsulin. It is a rather harsh insulin and you want to stay on top of the numbers. No, you want to wait till you are testing to change food as it can make a big difference downward in blood glucose levels.
 
Re: Really new - day 1 advice please!

Hi Jobi,
Welcome to the board!

I'm not that familiar with caninsulin, except to say that for cats, Lantus is considered MUCH better and there are way better remission stats for lantus then for caninsulin.

Ideally, you start home testing the cat's BG levels, and then switch to a low carb wet food diet. Just switching to low carb wet food can cause a cat's BG to drop significantly (100ml/dL or more) and if you are not home testing it can be very dangerous to just switch once you start giving him insulin.

As to the type of syringe, it depends on the type of insulin you use whether you need U-40 or U-100 syringe. I'm not sure what type of insulin caninsulin is. They are not interchangeable. :smile:

Check out - viewtopic.php?f=28&t=60261 for some basic information on what you need for home testing.

Here is a guide with some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Re: Really new - day 1 advice please!

Hi Jobi, I'm in the UK and have been pointed in this direction by another member. You've already been linked to mine and Toby's horror story by Sue, and I'm pleased to say that Toby is doing so much better since then :-D

Caninsulin is definitely a 'harsh' insulin. It has a fast onset, meaning that your cat tends to drop pretty quickly on it; the lowest point after giving a dose of insulin, or 'nadir', tends to be after around 4 hours, rather than the 7ish that people tend to get with other insulins. But all of that said, it can and does work for lots of cats, it's just very important to hometest whilst using it, and please start with no more than 1 unit.

I can only give my own experience because I haven't encountered other feline users of it, but the Codefree meter (available from Amazon) seems to be pretty accurate and is easily the cheapest available when it comes to buying strips for it. It compares well with the Accu-Chek Aviva (another good meter), and I've compared it to the meter vets tend to use, and it was lower by the roughly 2mmol that we expect and account for around here.

As others have said, you should implement diet change before starting insulin, or very gradually (or a little of both, depending on how tolerant the cat is).
As for food, off the top of my head the Felix in jelly that comes in pouches and Butcher's Classic are both low-carb foods that are readily available, but you may want to consider one of the foods that another member (who really knows her stuff!) suggested to me.

Elizabeth and Bertie said:
From Zooplus: Bozita canned food is popular and very economical. I think it's about 4% calories from carbs. (Bozita also do a chunks in jelly type food, slightly higher carb, in tetrapacks). The link is here:
http://www.zooplus.co.uk/shop/pet_food/ ... ita_canned
Bozita is also available from some independent pet stores and garden centres.

Also from Zooplus are Catz Finefoods and Grau 'grain-free'. Some of the Catz Finefoods are very low carb indeed. And Zooplus have mixed trial packs of it available at the moment, so it's a good chance to try out the different flavours.
The Grau 'grain-free' has about the same carb content as Butchers Classic, I think (about 8%), but it is a premium food with high meat content. It's pricey though, but can be quite economical in the huge 800g tins. There is a trial pack of Grau grain-free available at the moment too (but the yellow tin in the pack works out too high in carb for diabetics...)
http://www.zooplus.co.uk/shop/cats/cann ... z_finefood
http://www.zooplus.co.uk/shop/cats/cann ... uches/grau

Zooplus offer free delivery on orders of over £25. The parcel will need signing for. (Or I think there is the option of getting the parcel delivered to a post office to be collected from there).

The Happy Kitty Company also have some good foods that may be worth a try.
Some of the Mac's grain-free varieties are very low carb. It's a good quality economical food too. Ropocat is also available from the Happy Kitty Company, as is (going up in price range and quality) Granatapet. Granapet is popular with many cats, and most varieties are very low carb.
Delivery costs for orders over 5kg (equivalent of around 13 x 400g tins) is £3.95. But The Happy Kitty have some special trial offers going on too (including postage costs) which may be worth considering.
http://www.happykittycompany.co.uk/pages/special-offers

There are lots of other good foods out there too. For specific varieties and carb values do have a look at Juliet's (AKA 'Dr Schrodinger' here at FDMB) 'Useful Food Chart For Brits'.
https://docs.google.com/spreadsheet/ccc ... mWmc#gid=1

Eliz
Click to expand...

Toby eats almost exclusively Bozita now, and both loves it and is doing really well on it.

You'll probably want to get your syringes on Amazon, too (although, to be honest, that price isn't much different than straight from the vet for me).

Best of luck with Tumble, and please don't hesitate to ask any more questions you have - you're in the best place to do so :-D
 
Many thanks for the warm welcome and replies already :-D . Sounds like my immediate plan should be to get a home test kit, and not swap diet until I can monitor the effect it has having started with the insulin.
I think though, I need to get some sleep before trying to decipher what size syringe I have / what units this "5" really means. I think I read on the canninsulin vial that it was U40... but it's been a long day already and I don't want to get anything way wrong to risk disaster. I can at least remember where the vet showed me the dose came too!
 
Jobi said:
Many thanks for the warm welcome and replies already :-D . Sounds like my immediate plan should be to get a home test kit, and not swap diet until I can monitor the effect it has having started with the insulin.
I think though, I need to get some sleep before trying to decipher what size syringe I have / what units this "5" really means. I think I read on the canninsulin vial that it was U40... but it's been a long day already and I don't want to get anything way wrong to risk disaster. I can at least remember where the vet showed me the dose came too!
Click to expand...

Caninsulin definitely uses U40s :smile: Sleep well!
 
Just caught Becky's post... I'll do all my maths in the morning to drop to 1 unit if I've been told 5 rather than 0.5 - it sounds like a good plan to go slow at first, & I'd be much more comfortable with that!

Thanks for all the links too :-D
 
Hello from another former Caninsulin user. We did switch after I did some reading here. Caninsulin is quite commonly prescribed by vets in Canada who aren't up on the latest for cats. I'm glad you are going to start with a lower dose. My Neko started at 1 unit and ended up at 5, and she has a high dose condition.

One of the other posters suggested trying to switch your kitty to wet food first and learn to test. Then decide based on those numbers if you need to start insulin. We just recently had another person on here do exactly that. She had the Caninsulin and syringes and home, but decided to switch foods first and now her kitty is testing in normal numbers - so no need for insulin.
 
OK so the morning after the night before...
Checked the syringes again, this time noticing the 1ml label by the big 40 number on the scale, and found the glossary of terms to see that means each of the individual marks between the numbers is one unit. Feeling better coz I now know that means the vet did prescribe 5 units per shot, even though he said he'd start with a very low dose...
So far so good. Now get the vial out and set up ready with a one unit dose. By this time all the furry family are around my ankles wanting breakfast, so sort out the bowls, sticking to Tumbles normal food for now. (BG meter on order after all the replies!)
Go to grab scruff to inject - and :oops: Tumble slinks away. Hmmm. Maybe need to bribe with the food first :? . Bowls go down, and much munching occurs. Try to sneak up behind her and - ohmygod_smile no, she can be a slippery customer when she wants. Well, I'm not crawling under the table to get her, and now have visions of being led on a merry dance all round the kitchen waving the syringe about :lol: so decide to try the old 'just ignore her' trick.
Sure enough, sitting in my usual chair with my breakfast, inviting Logan (civvie kitty #1) onto lap for his normal morning time brought out Tumble to her normal morning perch on the arm of the chair. A few purrs later and shot done without any reaction from her. :smile:

What's the usual or recommended pattern of test/inject and feed? It seems test/inject comes first then the feed, but is it better to do them close together or wait a while?
 
Hi Jobi and welcome from another UK member. I don't have a diabetic kitty at present so my knowledge isn't particularly up to date, but the basics will always be the same and I did treat my Tom for a couple of years so I absolutely understand that you will have lots of questions - which is fine. This board is incredible!

You have some great advice here already. Becky is relatively new but has an excellent grasp of what FD is all about. One of our long-standing members, Elizabeth, has an absolute wealth of knowledge and I'm sure will be along to help when she can, although she does have her hands full at the moment.

So nothing mew to add, but I will be around to read your posts when I can and fill in any gaps if possible. Meanwhile, here's wishing you the very best of luck with treating Tumble!

Diana (in Surrey)
 
Good job on tricking Tumble into her shot! It's best for Caninsulin to make sure there is food on board. So the order should be test, feed, shoot. Often people here will give the cat insulin while their head is in the bowl. If for some reason Tumble has an off day for appetite, you don't want to give insulin then find she's feeling finicky. When I started on Caninsulin, my vet suggested feeding and waiting a few minutes (to make sure it wasn't scarf and barf) before giving insulin.
 
All the support and advice is really welcome - the future doesn't look so scary now.
This forum is definitely wonderful!

And lol - just seen this great smilie cat_pet_icon Tumble's all black, and although has always freaked at being picked up, adores nothing more than sitting next to you and having continual smooths, patting you with a paw if you get tired and want to stop!
(Bristolian lingo slipping out there - smooths = skritches/stroking/scrags!)
 
Amy & Papaya said:
Hi Jobi! Nothing advice-wise to add, but I had to say I love "smooths" . . . must add it to my vocabulary :-D
Click to expand...

Try googling "I bin smoovin the cat" for more Bristolian... It seems that Bristol (UK) is the only place I know that says smoothing the cat! While I'm not Bristolian by birth, this is the one West Country saying that always made perfect sense to me cat_pet_icon

Tumble seems to be getting used to the idea of her scruff being manhandled, and I'm eagerly awaiting the arrival of a home test kit...
 
You're doing great! Keep us posted and keep asking questions. You may have more when the test kit arrives,

Diana
 
Hi Jobi and Tumble

We are in the UK and have found this forum / the people on it an absolute Godsend it saved our little one's life and we continue to rely on advice and support from its members.

We started out like you with an 10 year old rescue who was diagnosed and we didn't know the first thing about diabetes. Bailey has been on insulin now for almost a year and he is pretty steady at the moment although he has slowed down a lot (also age could be a factor here) he is still doing his thing and is a happy cat.

Just wanted to share with you as others have pointed out Canninsulin was the first insulin Bailey was on for the first 8 months and he was swinging all over the place on it as it is so harsh (it's actually an insulin designed for dogs).

If Tumble doesn't seem to settle on the Canninsulin then we would very much recommend Lantus which your vet can prescribe only if the Canninsulin is deemed not to be working effectively (as Lantus isn't yet licensed for cats over here). Lantus will give you a much flatter curve with much less peaks and troughs which is much better for the cat (within the safe range) but also with Bailey we noticed a distinct marked improvement in his demeanour and clinical signs he is a lot lot happier and more himself on Lantus and we find it much easier to regulate him.

Home testing is a must although a lot of vets in the UK push for the blind testing method which is to all intents a game of Russian Roulette - home testing can seem daunting at first I know it did for us but you will get the hang of it. We give Bailey a treat (zero carb!) each time we test him and now he comes to us when he knows it's time and he is as good as gold. At first it was a very different picture and we were very low about doing the home testing thinking we could never get the hang of it but we did do very quickly.

You will have a lot of support on this forum and we are nowhere near as knowledgeable as most of the kind folk on here but we have had expereince and learnt the hard way in a lot of respects. It will all seem very daunting at first but you will get there - anything you need please let us know and the very best of luck to you both!

Barnes and Bailey
 
Thanks Diana, I'm sure I will have loads of questions when the home test kit arrives - I have my fingers crossed it's tomorrow.
Will definitely get some zero carb treats in in anticipation.
So glad I have you guys rooting for us with all your tips.

cat_pet_icon
 
Hi Jobi,

I'm another Britisher (really sorry not to have checked in with you sooner to say 'Hi' and 'Welcome'...but I'll say that now, somewhat belatedly: Hi Jobi! Welcome to FDMB :-D ).

You've had some really great advice. There's no doubt that FDMB is the best place for help and support on the planet (and possibly in the cosmos too... ;-) ) for folks with a diabetic cat.

Did you get your testing kit?
Any questions at all? Please do ask. We are here for ya!

Eliz
 
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