UK Noob with newly diagnosed bony kitty

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Quick update:

Milo's BG was off the scale all day yesterday, with 'HI' every 2 hours. :shock:
They managed to get a reading of 33.3mmol/L (600!) on the hospital analyser in the evening (i.e. top of the scale for the hand-held meters) & gave him 3 units rather than the usual 4. He wasn't tested O/N.
This morning he was

AMPS: 22.5 (405)
+2: 18.7 (337)

Looks like yesterday was truly a Somogyi day for my little man. I've just been to see him & he looks so much better. he's coming home this evening at 7pm so I can get a PMPS & shoot him in the comfort of his own home.

He wasn't eating his tinned food, so they've given him A/D, and a bowl of Hill's W/D!!! :evil: NOOOOOOOOO!!! I managed to control my reaction (just) and they've removed it.

27% f&*$%^** STARCH!! FOR A DIABETIC???!! ohmygod_smile The Nursie (supposedly the diabetes specialist) just really didn't get it. "But, that's designed specifically for diabetic cats & that's what we feed them...". I'm afraid my work-persona came out (I'm a University Lecturer & a Zoologist) "Now a cat's an obligate carnivore, right? It catches prey. Have a think about what a cat eats in the wild. What's the carbohydrate content of a sparrow or a field vole?". Oh dear. I managed to smooth things over in the end.

Anyway, all good news about Milo. I'm glad he was there yesterday. I would be panicking if this had happened at home, despite their unscientific ideas about feline physiology. So it's home tonight, on a lower dose. We even managed to raise a purr out of him whilst at the Vets. Woot!! :-D :-D
 
Somogyi - Gosh..... Well if that is the case thank goodness you didn't increase the dose to 5 units! :shock:

So, the day before yesterday, when you did the curve at home, you got a normal/typical Caninsulin curve, no sign of 'rebound' pattern there. But yesterday at the vets he was 'hi' all day. I'm trying to work out what happened between those two events...

OK, options... Hmmm....

Could it be possible, I wonder, that there have been low BG drops happening regularly that just haven't shown up on any test data collected so far? Perhaps he's been dropping low, then rebounding, then settling out a bit, then dropping low, rebounding etc...?

Or, could it be that the effect of removing his dry food meant that the evening dose (on the day you did the curve) was too much in those circumstances; so he dropped too low (or too fast, or both) overnight and rebounded. That would certainly be enough to cause the high readings at the vets.

Or... Was dry food available for Milo at the vets throughout the day? In which case that might be responsible for those high numbers, or would certainly exacerbate them....

Juliet, are there any very low readings amongst the test results collected during any of the curves done by the vet?
 
Elizabeth and Bertie said:
Somogyi - Gosh..... Well if that is the case thank goodness you didn't increase the dose to 5 units! :shock:
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Indeed!

Elizabeth and Bertie said:
So, the day before yesterday, when you did the curve at home, you got a normal/typical Caninsulin curve, no sign of 'rebound' pattern there. But yesterday at the vets he was 'hi' all day. I'm trying to work out what happened between those two events...
Click to expand...

Well if you look at the curve I posted again, there is only an hour between the 2 lowest numbers, and then suddenly the BG shoots up. I'm not sure how caninsulin normally 'wears off' - does it rebound so quickly usually?




Elizabeth and Bertie said:
Could it be possible, I wonder, that there have been low BG drops happening regularly that just haven't shown up on any test data collected so far? Perhaps he's been dropping low, then rebounding, then settling out a bit, then dropping low, rebounding etc...?
Click to expand...

Maybe, yes.
Elizabeth and Bertie said:
Or, could it be that the effect of removing his dry food meant that the evening dose (on the day you did the curve) was too much in those circumstances; so he dropped too low (or too fast, or both) overnight and rebounded. That would certainly be enough to cause the high readings at the vets.
Click to expand...

This is my theory, yup.
If it was Somogyi, then rebounds can last up to 3 days, and I had no strips between that last high test & what was recorded in the clinic 12 hours later.
The first 'Hi' test would have been +3 or +4, at 10 or 11am. We only admitted him at 9.30am which isn't enough time for any dry stuff that he may have eaten there for the sugars to be absorbed, especially considering he already had a belly full of meat. My guess is that he had been 'Hi' most of the night.

Have a looksee: http://www.caninsulin.co.uk/Somogyi.asp ... ement_cats

Elizabeth and Bertie said:
Or... Was dry food available for Milo at the vets throughout the day? In which case that might be responsible for those high numbers, or would certainly exacerbate them....

Juliet, are there any very low readings amongst the test results collected during any of the curves done by the vet?
Click to expand...

Apparently he hasn't really touched the dry stuff (thankfully) but has been stuffing his face with A/D.

The only time he has ever been near the region of 4-5 (72-90) - that has been recorded - is on neutral insulin in the clinic. Mind you, we only have 3 or 4 curves for him in total with 2 hourly tests, so it might just be the case that low readings have gone undetected so far.

I'll take some more tests tomorrow throughout the day & see what's happening.
 
Dr Schrodinger said:
Well if you look at the curve I posted again, there is only an hour between the 2 lowest numbers, and then suddenly the BG shoots up. I'm not sure how caninsulin normally 'wears off' - does it rebound so quickly usually?
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Caninsulin certainly can do that in cats. It has a reputation for steep drops and sudden exits. Some folks try to give three shots a day to try to compensate for this. I did that for quite a while myself (5am, 1pm and 9pm, I think) until I persuaded the vet to prescribe a longer lasting insulin....

What was Milo's evening pre-shot number on the day you did the curve? Was it considerably higher than the morning pre-shot?
(Edited to add; Sorry, just checked back through posts and realised you'd run out of strips at that point.)
 
So if what I recorded was actually a normal caninsulin curve, then what has happened to him yesterday, I wonder? Maybe I screwed up his injection & didn't realise? I still make the odd cock up, so maybe that was it? :shock:

I suppose the only way to determine what's going on is simply to collect more data.
 
What you're describing does look like a fairly typical Caninsulin curve to me - when it wears off, it often wears off fast; it's gone and that's that - but I think one of the things to bear in mind is that there isn't always a typical or normal response - various factors can come into play that can throw a curve ball at any time. Even if you're feeding exactly the same food and giving exactly the same dose, you may not always see what you expect to see... it really is an ongoing effort, as so many of us here know, and requires a lot of dedication. In other words, it's a labour of love!

Keep smiling and remember those treats - for yourself - this is a challenge and you need to stay grounded :smile:

Diana
 
Dr Schrodinger said:
...Maybe I screwed up his injection & didn't realise? I still make the odd cock up, so maybe that was it? :shock:

I suppose the only way to determine what's going on is simply to collect more data.
Click to expand...

Juliet, I think it's pretty unlikey that you screwed up the shot. So please don't be hard on yourself. It is a possiblity that the elimation of dry food had a strong effect on reducing Milo's BG's, and perhaps the evening shot was too high a dose as a result of that.

Or, maybe the 'somogyi' theory is the answer but the low numbers haven't yet showed up in the data collected so far.

Or, (looking at that curve you did again) maybe the initial part of the BG drop was too fast for Milo and triggered a rebound (if more than about 5.5 mmols per hour at any point). Though, I don't think that's quite enough to account for those really high flat numbers....

It's really hard to know exactly what happened. I do a lot of curves on Bertie (in fact every day I produce a kind of 'mini curve'...) and I know that - even with all the obvious variables under control - food, insulin dosage etc - the numbers can still vary quite dramatically, and for no obvious reason... It can just leave you scratching your head and thinking "Whut???"

Yes, I think you're absolutely right that what is needed in Milo's case is more data.... Let me know if you run out of test strips. I had a load arrive today! ;-)
 
"Curiouser and curiouser" said Alice.

What a beautiful curve on 3 units! Sorry about the pic quality. Rubbish phone & rubbish lights at home! His nadir was 4.9 (88), which is the lowest recorded so far. Apparently he started eating at this time, so appears to be self-regulating to an extent, and he's slowly risen to 18 by the end of the curve.

I don't think I'll bother beating myself up about maybe screwing up an injection. :lol: If he's now responding like this on 3 units, I am happy. He's happy to be home & has already made a mess by spreading his food around the kitchen floor. Typical boy. ohmygod_smile
 

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Hi Eliz,
No numbers for him yet today, I'm afraid.
Yesterday:
PMPS: 25.3 (456) EDIT: THIS WAS 2 HRS LATER THAN NORMAL.
+4: 19.0 (342)

So he was dropping slowly. I decided to go to bed at 1am - I was knackered. I left loads of food out for him & let him settle, and then checked him when I woke periodically throughout the night.

This morning I thought I would shoot him blind & just watch him until this evening. I'm going to have to shoot him blind for his morning doses this week & I want him to settle down a bit into a routine, really. He hasn't been for a poo since friday, so I'm a bit worried about that. But he seems quite bright & purry today, despite being 'full', and he's still eating, so I am expecting a stinky eruption at some point!

I'll do a PMPS & a +4 or +5 tonight & see where he's at.
 
Dr Schrodinger said:
Hi Eliz,
This morning I thought I would shoot him blind & just watch him until this evening. I'm going to have to shoot him blind for his morning doses this week..
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I don't understand. Why are you "going to shoot him blind...this week"? Did the meter pack up? :?
 
Because I honestly don't think I'll have time before I go to work. I will try, but it's taking me about 20-30 mins to do each test at the mo. I'll get up earlier & see, but I have such a massive workload at the moment I'm not sure how much I'll be able to fit into each day. I was thinking if I have to shoot him blind, I might give him 2.5 units instead of 3 in the morning? I dunno. Not sure how I'll fit everything in at the moment.
 
Testing does get easier with time.

Perhaps it would be helpful to use some of the Secondary Monitoring Tools listed in my signature link. They aren't as precise as blood glucose testing, but may provide useful clues on how he is doing.
 
Hi Juliet,

I do completely understand how life gets busy sometimes, so much so at times that there really don't seem to be enough hours in a day (I've frequently put in requests to the Almighty asking for 36-hour days, but so far she hasn't come up with the goods ;-) )

However (well, you must have known there was a 'however' coming...) testing before each insulin shot is probably the single most important thing you can do to keep Milo safe. There is no other way of knowing whether the cat's BG is high enough to give the shot. Many of us here have done routine pre-shot tests only to find - totally unexpectedly - that one day our cat is in 'normal' numbers.

And you got a nice nadir number yesterday. So that may well suggest that Milo is responding better to the insulin now that the dry food has gone.

Testing can be difficult at first. But it does get a lot quicker with practice. Are there any aspects of testing that you're finding particular difficulty with? Are you finding it hard to get enough blood for a test? (That's usually the most common issue at first). Please let us know how we can help you with this...
 
Juliet, Mishka has been on insulin for 9 yrs. 3 months and never have I given her a shot without testing. She can throw some weird numbers. Main example....her amps this morning was 57. If I had shot her without testing I very well could have put her into a hypo situation that definitely would have required an ER visit to keep her up. If I had shot her and gone out, I probably would have found her dead. She is on compounded PZI. She also still had some canned food left that she had been eating......didn't matter.......she still gave me a 57.
 
Juliet, I am loath to stick my oar in if it's not wanted but I do urge you to think carefully about shooting without testing first. These are early days in Milo's treatment and as I think I said yesterday, he could throw you a curve ball at any time. He is your cat, of course, and you are his care-giver - but pretty well everyone here would say that it is always better to be safe than sorry.

Diana
 
Oh, come now, people! You can lay the emotional blackmail on a bit thicker than that, can't you??!!
Pffft. You weren't even trying there!
I KNOW what this means and I can only do my best. The last test took 5 mins....
We'll have a go tomorrow morning.
He's just scored a 26.4 (476) at +10.5 which scores himself a shot and a treat (or 3).
 
If you absolutely have to get blood, you can prick the vein. Just be prepared to get a drop on a clean fingernail for the test and to apply pressure quickly, because most vein pricks bleed profusely. With one good head shake, the room starts to look like an abbatoir! I guess that's one way to redecorate, lol.

If you really want a guilt trip ... if this were your diabetic child, would you ever risk the chance of injecting insulin without knowing it was safe?
 
BJM said:
If you really want a guilt trip ... if this were your diabetic child, would you ever risk the chance of injecting insulin without knowing it was safe?
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Comparing a pet with a child is invalid both ethically and in the eyes of the law, but nice try!

Thanks for the tip all the same. And yes, obtaining a sample is the most laborious aspect, both for me & the cat. He's compliant & patient, but my aim is imprecise. I shall try freehand.
 
Just giving you one of our frequent justifications, hence the small font.

Legally, I generally agree, but how do you figure ethically, or even morally, for that matter? It probably depends on what assumptions folks are starting with as 'givens'. Different assumptions will logically have different conclusions.

And ... if you are responsible for an animal's care and well-being as an owner, hired caretaker, or veterinary professional, at what point would it be considered neglect? Nonfeasance, misfeasance, or malfeasonce?
Different animal laws the world around and really a discussion for over in Community.
 
BJM said:
Just giving you one of our frequent justifications, hence the small font.
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It's not a justification.

BJM said:
And ... if you are responsible for an animal's care and well-being as an owner, hired caretaker, or veterinary professional, at what point would it be considered neglect? Nonfeasance, misfeasance, or malfeasonce?
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This all implies that I am contractually obliged to pretest my kitty, which is not the case. I am more legally obliged to follow the instructions of my vet, the qualified professional. (As are all of us on this board, regardless of which country we are in!)

BJM said:
Different animal laws the world around and really a discussion for over in Community.
Click to expand...

Well don't start the conversation in this thread, then?! :lol:

Back on topic:

Managed AMPS this morning. Got up at usual time (6am). Luckily Milo bled first time with no trouble.
AMPS: 25.6 (461)

Got to work at 8am as usual. ~O)

The last couple of nights his +4 has been disappointingly high at ~16 (288). I wonder if there may be a difference in efficacy of delivery between the VetPen I use at home & the vial/syring at the Vet? Or maybe the batch of insulin? Or maybe the home environment? Could be any or a combination of the above, I suppose....
 
Could be a difference in depth of delivery?

I know for Lantus, we treat the pen as a mini-vial and use the syringe to withdraw and shoot the insulin. The Lantus pens hold 3 mL of Lantus instead of the 10 in a vial, which results in less waste as sometimes a vial starts losing potency before one is done with it. Also a syringe enables us to do slight adjustments to dose - just over or under a line, in between, etc. As a scientist, that may bug you because of the imprecision; the folks here seem to make it work.
 
They are 12mm. I hadn't even thought about depth of delivery or using the cartridge as a vial! There's always waste!
Oh Dear. Rookie error. ohmygod_smile

Thank you!
 
That's a hypothesism, not a fact, so not guaranteed to be the reason for differences. It just seems logical.
Force of delivery may differ between a pen and a syringe, too, which would affect depth and possible dispersion.
Isn't observational research fun? ;-)
 
Dr Schrodinger said:
The last couple of nights his +4 has been disappointingly high at ~16 (288). I wonder if there may be a difference in efficacy of delivery between the VetPen I use at home & the vial/syring at the Vet? Or maybe the batch of insulin? Or maybe the home environment? Could be any or a combination of the above, I suppose....
Click to expand...
Hi Juliet,

When you first came to this forum you said that your 'optimal outcome' would be remission. It strikes me that in order to help you work toward your goal what would really help you is more data about how the insulin is working in your cat now. Without data it can be nigh impossible to work out why any given number is as it is; and sometimes even with data it can be impossible to work that out because there are so many variables, not least of which is 'the cat' itself....
confused_cat
But the more data you collect you more you will get a 'feel' (terribly unscientific, I know!) for how your cat utilises insulin. Doing 'curves' is useful because it helps to show the pattern of the insulin cycle. Curves help us identify when the insulin starts to work ('onset'), when it reaches peak (BG nadir), and how long the typical duration is. Curves also show subtler information about, for example, the time during which the BG drops the fastest; when the drop slows down; and how quickly it rises again.

Having that information from the curve allows us to target our ongoing BG testing more effectively. A preshot test is done, and then maybe a couple of 'spot checks' at different points of the cycle. Quite a few people who are out during the day have set their alarm clocks so that they can do a spot check during the night!

Preshot numbers and spot checks will also help to identify changes to the numbers and to the pattern. If your cat starts to go into remission (fingers crossed here!) he will be dealing with two lots of insulin, the exogenous/injected insulin and his own... This might become apparent because the cat's preshot numbers get lower and lower. Or it might become apparent because you notice sudden drops elsewhere during the cycle: Maybe the number you get at peak is way lower than you were expecting. Or maybe the BG starts to rise after peak but then drops again after feeding the cat a snack. All of these changes are easier to pick up if you have a good feel for what the situation is 'now'. It will also help you to identify if your insulin has 'sparked out' or if you are getting poor absorption from particular shot sites.

Eliz
 
Hi Eliz,
Yep, I know what you're saying & yes I agree. I am doing more tests than I post on here. I just haven't transcribed them yet. I did 4 last night, for e.g.
However, overnight tests will only be possible on the weekend, as will diurnal curves, unless I can work from home (which is not looking likely this week :sad: ). Unfortunately I have to think about the bipedal inhabitants of my house as well the the quadrupedal inhabitants!
 
Hi Eliz. No. He hasn't gained a thing.
He's more wobbly too, but is still constipated, and not eating so much. I gave him a teaspoon of olive oil & a lump of butter last night, but nowt's shifted yet.
I'm picking up needles & insulin from the vet this evening, so will ask them what else I can do. BG was down this morning (20.2).
 
Many of us with kitties suffering constipation use 1/8 teaspoon of Miralax (polyethylene glycol), plus plenty of water in the food (its an osmotic) to help them.
 
Poor little Milo....

As BJM says, Miralax is great for constipation; but sadly it's not easily available in the UK. We can buy it online from the US but it will take a couple of weeks to get here (longer term though that might be worth doing...?)

Have you tried liquid paraffin for the constipation? Being a mineral oil it isn't digested in the way that other oils are so it just goes straight through the system... Some people put a little drizzle onto each meal until something happens.... And it should be easily available from pharmacies. There are also flavoured paste versions especially for cats (Katalax and Defurrum, one or other of which you should be able to get from your vet) But they smell of Marmite, and Marmite seems to be a 'love or hate' thing - for cats as well as people!

The constipation may be sufficent reason alone to account for Milo's reduced appetite. (I could tell you the story of when I was put on iron treatment for severe anaemia....but I won't go there.... Suffice to say that I have some sympathy with how MIlo may be feeling.... :-| )

If the constipation is severe then the vet may actually suggest sedating Milo and removing the hard poo manually. Does he have any leakage from his bum (Milo, I mean - not the vet.... )? Sometimes hard poo gets stuck and then you get leakage coming around that from other stuff that's backing up in the system and trying to get out of the body. ('FDMB' eh? Where else could you have conversations like this! :lol: )

Ahem <Eliz clears her throat>.... Moving swiftly on.....

Ongoingly, it might be helpful to try to get Milo to drink more (easier said than done, I know..), and/or to add a little water to his canned food. Water fountains really encourage some cats to drink. And some cats love the water that either chicken or fish have been cooked in. And some cats like diluted natural yoghurt.

Re the weight gain thing, I have a cat that I'd started to worry about because he was a bit skinny. No other health problems, just getting old and a bit skinny... It was suggested to me that I upgrade his diet from regular 'food in jelly' to premium foods that had higher (and better quality) protein content; and since doing that he's put on a nice bit of weight (in just a couple of months). I started out by trying him with 'Lily's Kitchen' cat food (available from Waitrose (and online)) and that seems to have made a big difference to him. And inspired by that I'm now also feeding other foods (only available online) such as Grau 'grain free'. And strangely, not only did these foods benefit my skinny cat by adding weight to him, but they're also benefitted Bertie by being lower carb than what I was feeding before...

If you want to try any of these foods to see if Milo will eat them just let me now and I'll set a few cans aside for you (and maybe your OH can pick them up after work one day..?)
Edited to add; I could leave the cans on the doorstep here to be collected so that you (or OH) don't get trapped in a conversation with Chris! :lol:

Sending 'happy poo' vibes to Milo...

Eliz
 
I was just eating my lunch whilst reading that! *puts sammich down*

I think I have some liquid paraffin in the cellar for cleaning the parts for my lil car. I'll have a look. He might have *ahem* laid eggs by the time I get home. I shall wait & see (how exciting...).

He loves Applaws wet food, so I'll feed him the pumpkin stuff tonight. With respect to water, I've started adding it to all their canned food & mushing up all the chunks with a fork. I have caught Milo's sneaky sister Lola, sucking all the jelly from ALL the food that I put out for them before poor Milo even gets a sniff! Turning all their food into a meaty 'gruel' stops her greedy little tricks. Bad girl. cat(2)_steam

Getting either of them drinking isn't a problem at all. They love water & they love running taps & the bathroom. The attached happens every morning, when they're both well.

Thanks for the offer of the Grau. I might take you up on it. I have a couple of other brands to try at home too.

Thanks! I'm loving the Happy Poo Vibes!!
 

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Dr Schrodinger said:
Thanks for the offer of the Grau. I might take you up on it...
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Well, I'm happy to put together a little 'taster selection box' of foods for you to try: Grau 'grain free', Lily's, and also a couple that I get from Germany, ie Catz Finefood and Granatapet. If your cats like the German foods then I can order you some next time I order...
 
Um, my cat went into remission and I never once did an all night curve. In fact, I did relatively few curves. Preshot tests and spot checks, yes.

FWIW

:)
 
Tonight might be interesting.
PMPS: 12.5 (225)! Half the usual! I gave his usual 3U
+1: 15.8 (285) He's eaten one and a half cans of applaws in the past hour.

I'll keep testing through the nadir. Honey and high carbs are poised for deployment.

EDIT: Happy Poo Vibes worked. He laid a huge one at the vets & they forgot all about it....
 
Dr Schrodinger said:
Tonight might be interesting.
PMPS: 12.5 (225)! Half the usual! I gave his usual 3U
+1: 15.8 (285) He's eaten one and a half cans of applaws in the past hour.
Click to expand...

Oooh, interesting preshot number....
And I'm glad Milo is feeling more comfortable! ;-)
 
PMPS: 12.5 (225)
+1: 15.8 (285)
+2: 15.4 (278)
+3: 15.1 (272)
+4: 16.6 (299)
+6: 24.6 (443)
.
I was wrong. Not an interesting evening. Almost an inverted curve. Sigmoidal, even. But at least he's eaten a fair bit of chicken & had a tiny poop.
 
Quick Milo Update:

After a week of settling in, he's now eating properly! flip_cat

The 'wobbly' back legs have all but gone & his coat is looking more shiny & less like he's been sleeping in a ditch. Lola is helping groom him, too.
I am hoping his new found appetite is making him put on weight but I am too nervous to weigh him at the moment in case he hasn't.
What I have noticed is that he is drinking & peeing far less. We only have one water bowl out at a time now, & I change the litter box less often. Both he and his sister are doing proper carnivore-style 'scat' poops now, rather than the more human-style they used to produce on their dry food. (Lola's also losing weight & her dry skin is clearing up!).

So, as long as he keeps troughing away at the canned food, we can think about sorting those BG numbers out. I put together a spreadsheet (in my sig) & am keeping notes about his demeanour, which should help me convince the vet to switch to a new insulin. The Caninsulin really doesn't last long enough for a 12 hour cycle, and he's bouncing back up really quickly. His BGs are all over the place at the moment, but I am hoping they will settle now he's eating properly.

Many, many thanks to Eliz & Bertie for the donation of a multi-flavour tasting bag of multinational canned foods. dancing_cat

They've munched their way through about a dozen different species since friday! In a vegetarian household it's a very odd thing to have that many different types of meat in the kitchen, but I am very, very grateful.

Juliet
 
Wow, Juliet,

Great news that Milo is feeling better (woohoo!) and that his appetite has increased!

I'm really, really pleased to hear this. I feel that you've had quite a tough time since Milo's dx. I know his weight loss has been worrying you too. I'm SO glad that you can see some improvement in Milo now (and glad to hear that the lovely Lola is doing well too...)

Here's hoping this is just the beginning of good things to come!
 
Yeppers, I got a bit scared & stressed. Thanks for your help & support, Eliz.

I think I have 'shared' his spreadsheet properly now. Please let me know if you can't see it.
 
Hi Juliet,

Just had a look at Milo's numbers. The Caninsulin does drop him but he swings up so high again doesn't he... Do you think your vet would be willing to prescribe a longer lasting insulin if you show him/her this data?

Eliz
 
Yes, he seems to be entirely insulin-free 6 hours post injection. Which is just rubbish. :cry:

Nice Vetman Martin (whom I have never met) just called me back after I had left a message with Reception. He nice man. He's looking into getting hold of some Hypurin Bovine PZI for Milo & will phone back when he knows more. :-D He was surprised about the amino acid similarity, but is glad we're home-testing! NicemanMartin has used Lantus before & had good results with it, but would prefer to prescribe PZI if he can acquire it easily. I don't mind which Milo tries.

Things are looking positive. :mrgreen:

We like nice men. Or I do anyway!
 
Oh, thank goodness for Niceman Martin! :smile:

Just a quick question: If Niceman Martin has had good results with Lantus why would he prefer to prescribe Hypurin..? confused_cat
 
Elizabeth and Bertie said:
Just a quick question: If Niceman Martin has had good results with Lantus why would he prefer to prescribe Hypurin..? confused_cat
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Because he knows more about it & how cats respond to it, I suppose. He's only prescribed it once - I'm not sure why, I didn't ask, but I will. He's slightly wary of the glargine 'hype' because what has been published so far has only been a small sample size (or that was my inference, anyway).

I told him about you & your vet, Eliz. He wasn't aware that the supply issues over PZI had resolved themselves.
 
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