UK Noob with newly diagnosed bony kitty

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Dr Schrodinger

Dr Schrodinger

Member Since 2012
Hi All,
I've been reading up on these boards for the past few weeks. We live in the South of England, so please be patient with my spelling & metric units!
One of my cats (Milo) was diagnosed 6 weeks ago & has now gone from 2 units of caninsulin twice daily to 4 units twice daily (using his funky VetPen). He crashed dramatically with ketoacidosis a couple of weeks back & was hospitalised for a few days while he was stabilised & his dosage increased. His BG seems to be stabilising but his bodyweight is still dropping (from 3.85kg to 3.71kg in 2 weeks). I'm currently waiting for his latest fructosamine results.

He's a 12 year old indoor cat (Maine Coon cross, so he's a big chap), he's been declawed (he hails originally from the good old US of A) but we got him from a shelter here in the UK 5 years ago. He's been on high carb dry food ever since (I know, my bad), and the vet wants to keep him on this diet 'til his BG is stable. He no longer has ketones in his urine, but is still losing weight. His appetite isn't great, and he's still drinking & peeing a lot, and his faeces is more regular now. He's back to his old self with his behaviour & demeanour (he's an overly affectionate stalker!), but...

My concern is primarily that he's just not putting the weight back on following ketoacidosis & that this *may* be remedied by a lower carb/higher protein diet. We haven't started home-testing (yet) but I am tempted to go against my vet's wishes & start him (and his overweight sister) on 80% meat food from Applaws (UK brand), whilst home monitoring his BG. Is there any other way that I can get him to eat more? I've tried cream, cheese, tuna, chicken etc. He nibbles at it but doesn't fill his belly properly.

Any advice would be appreciated!

Thank you for this board. It's brilliant.
 
Welcome to the board! There's lots of good people and good information here. I know there are a number of "international" people who understand metric and I'm sure they'll be along soon.
We switched my Chester to wet food before we started insulin. Since you're already trying to get him stabilized, it might not be a good idea to do a big food switch right away. Changing food drastically like that can have significant effects on BG levels. Maybe you could just add in some of the good wet food as more of a supplement?
Home testing is easy and I'm glad I'm doing it. It gives me a better idea of what goes on from day to day. We're still not regulated, but at least I can see what's going on.

Welcome!
 
Welcome!

Given that he has experienced DKA, take a look at my signature link on Secondary Monitoring Tools for info on ways to test for urine ketones. If you get a positive test, its time to go to a vet, asap, because he may be headed back there.

Plus, some of the other monitoring tactics will help provide information about his status that is a bit different from just a blood glucose - more of a "how is he feeling and behaving" assessment.

If you start making diet changes and are not home blood glucose testing, you could wind up with a hypoglycemic episode. This can be fatal, so I strongly encourage you to learn the blood testing before you start changing the food. This will save you money as you can do the glucose curves at home without the impact of vet stress raising the numbers and resulting in incorrect dosing based on incorrect numbers.

Caninsulin was developed for DOGS, not cats. It doesn't last long enough in cats, due to their higher metabolism. It is unlikely his BG will become stable on this, so it is prudent to consider a diet change. Here's a link on Canned cat food for EUROPEANS and International buyers which you may find helpful. Any food changes should be made gradually to reduce stomach upset and to allow you time to observe the impact on his diabetes and adjust as needed.

Additionally, lets see about educating your vet on Lantus, as there is a proven protocol to treat diabetic cats Here are the AAHA Guidelines While the cost may seem high initially, if you get it in the pens rather than the vial, you can use almost all of the insulin in the 3 mL pen before needing to use a new one, so the cost actually works out better. And the glucose control is superior to Caninsulin.
 
Hello and welcome to FDMB!

I'm from the UK too (Surrey).

I see that you've already had some great advice.

Yes, a wet food diet would be better. My cat was on dry food too at the time of his diagnosis. That's the same for a lot of cats here too! But it's important NOT to make the switch to wet food unless/until you are able to test your cat's blood glucose at home. We can help you to learn that, if you are willing to have a go. :smile:
 
Elizabeth,
Glad you saw this - I was about to PM you since you're" in the neighborhood" :-)
From what I've read here, it seems most UK kitties are initially put on caninsulin... is it difficult to get a vet onboard with a more appropriate insulin there? I notice your sig says hypurin pzi, which is better. I'm thinking a change from caninsulin would benefit Milo.


Dr. S,
Did Milo's bloodwork indicate anything beyond diabetes might be in play? Given the continued weight loss, I'm wondering if his thyroid might be a factor...

Carl
 
Thanks, People!

Yes, I wondered why my feline was receiving canine meds.... my vet practice have looked after all my animals over the years & are very understanding of me & the furries, but I am not sure if they are in their comfort zone with DM. I believe they only have 3 diabetes patients despite it being a large practice with 3 branches in a 15 mile radius, so, it may well be the case that their own information isn't complete. Thank you for the links. I am working my way through them as I type.

I would prefer to switch to recombinant insulin, anyway, purely from a biological & metabolic point of view. But I'm a scientist with experience of working alongside vets in the research lab, and I am reluctant to voice my opinion at this early stage and hesitant to march into the clinic brandishing pdfs, but I suppose I need to think about a more bilateral relationship with them in the long run. At the moment I am mostly worrying about my puddytat & his plummeting bodyweight. :sad:

Remission would be the optimal outcome. How long has it taken others to achieve this?

Elizabeth & Bertie - Great! Thank you! Same County! Who is your vet?

Carl & Bob - We discounted thyroid issues during initial diagnosis, but it's something to keep in mind, I suppose.

Thanks again. I'm now going to rub his paws with butter....
 
Some kitties go into remission very quickly, needing only a diet change to become regulated. Some kitties never do, but lead long healthy lives. I can only speak for my kitty, Bob. It took ten weeks or so for him to become diet controlled and off the "juice". That does seem to be less time than most, but every cat is different, as we say.
Carl
 
Carl & Bob said:
Elizabeth,
Glad you saw this - I was about to PM you since you're" in the neighborhood" :-)
From what I've read here, it seems most UK kitties are initially put on caninsulin... is it difficult to get a vet onboard with a more appropriate insulin there? I notice your sig says hypurin pzi, which is better. I'm thinking a change from caninsulin would benefit Milo.

Carl
Click to expand...

Carl - Hi, I didn't see the message actually. Hope (& Baby) PM'd me! So she beat you to it! ;-)
Yes, Caninsulin is typically what's prescribed here, and in the rest of Europe too, I think. A very few vets will prescribe Lantus/Glargine, but there aren't currently many vets who know how it works (but I think Lantus/Glargine may be promoted in the UK soon; there's a manufacturer keen to introduce it here...) Some vets will prescribe Hypurin PZI (a long lasting depot PZI (and the only available PZI here now)) if the Caninsulin doesn't work... We started out on Caninsulin, but it didn't work so we switched. Our vet was only willing to do that because I hometest. Because of the longer duration of Hypurin the vet wanted to be sure that I only gave the shots if necessary.

Dr S - Yes, Carl's right. A switch to another insulin may be helpful.. Would you be willing to learn to hometest your cat's blood glucose? That would help you to gather evidence to show how the Caninsulin is working (or not!) in your cat's system?

My vet is Guy at Cobham Park Veterinary Clinic.

Eliz
 
Eliz,
All useful information, thanks!
I may suggest that my vet speaks to yours....actually, I might even go visit yours myself. I drive through your neck o't'woods twice a day on my commute, anyhoo!
Oh, I can't believe I've found a local who is/has worked through the same issues! Excellent!
I would like to start home-testing the Milo Cat. He's generally quite amenable to any kind of human attention so I think it will become quite straightforward with practice.

You lot have really cheered me up about this!

I wonder why UK vet practice hasn't quite cottoned on about Caninsulin, yet? Inertia in the system? Fingers in pies? Hmmmm....
 
Hi there from another Surrey, UKer (there aren't many of us!). I don't have much to add to what others have said other than I do suggest that you follow Elizabeth's advice as closely as possible. She's been through some ups and downs with her cat Bertie but is currently in a good place and has a wealth of knowledge and experience that she is kind enough to pass on.

Other than that - yes, I do encourage you to home-test. Knowledge is power, as they say, and seeing exactly how the insulin - any insulin - is working in your cat at a given point in the cycle is vital information to help anyone assess the overall situation.

Best of luck!

Diana
 
Dr Schrodinger said:
...Remission would be the optimal outcome. How long has it taken others to achieve this?
Click to expand...

Hi Juliet,

I think 'remission' is probably the "optimal outcome" that everyone with a diabetic cat hopes for! But not every cat gets there. Some cats, like mine, have to stay on insulin permanently. But quite a number of cats DO achieve remission. And cats that are newly diagnosed (and those that haven't been diabetic for very long) seem to have the best chance.

For some very lucky cats, all that is necessary to achieve remission is a short course of insulin and a change of diet (switching from dry carb-laden food to a low carb wet food diet). Who knows, maybe your cat will be one of the lucky ones..... But having a cat that continues to need insulin isn't the end of the world. Yes, it is a commitment on our part. But the rewards of seeing a happy and healthy cat are well worth it. cat_pet_icon

I'd suggest that the first thing you do is learn to hometest. That will help to keep your cat safe (from hypoglycaemia) and will give you a vast amount of information about how insulin is working in your cat.

Once you've learned to hometest you can start to phase out the dry food safely. Removing dry food can reduce the BG significantly in some cats and so must only be done with careful monitoring (including reducing the insulin dose as necessary). I live fairly close to you and so will gladly give you a hometesting demo if that is useful....?
 
Dr Schrodinger said:
...I would prefer to switch to recombinant insulin, anyway, purely from a biological & metabolic point of view. But I'm a scientist with experience of working alongside vets in the research lab, and I am reluctant to voice my opinion at this early stage and hesitant to march into the clinic brandishing pdfs, but I suppose I need to think about a more bilateral relationship with them in the long run. .....
Click to expand...

How about trying the interested owner routine ie eager to share the news, because after all, the vet can't read up on everything!
"hey I was doing some reading and found this veterinary article on feline diabetes. I thought you might be able to look it over, then tell me what you think about the ideas"
Or
"Did you hear - there's a vet in Queensland who worked with a feline diabetes group in Germany and they've figured out a way to use Lantus in cats that's pretty successful if the owner is willing to do home testing and follow a low carb diet with the cat. Here's the web link if you'd like to check out some of her articles"
 
BJM said:
Dr Schrodinger said:
...But I'm a scientist with experience of working alongside vets in the research lab, and I am reluctant to voice my opinion at this early stage and hesitant to march into the clinic brandishing pdfs, but I suppose I need to think about a more bilateral relationship with them in the long run. .....
Click to expand...

How about trying the interested owner routine ie eager to share the news, because after all, the vet can't read up on everything!
"hey I was doing some reading and found this veterinary article on feline diabetes. I thought you might be able to look it over, then tell me what you think about the ideas"
Or
"Did you hear - there's a vet in Queensland who worked with a feline diabetes group in Germany and they've figured out a way to use Lantus in cats that's pretty successful if the owner is willing to do home testing and follow a low carb diet with the cat. Here's the web link if you'd like to check out some of her articles"
Click to expand...

Yes, absolutely agree with BJM about the "interested owner routine". S/he may be intrigued by what you have to say, and perhaps really interested in learning a new approach.... Or as my Granny used to say, "You catch more flies with honey than with vinegar." ;-)
 
Great comments here - take heart that all of us really understand and are cheering you on from the sidelines!

Diana
 
Juliet,

Here is a link to a good page of basic info/instructions on hometesting. It was from this page (and a hefty bit of encouragement from folks on the forum here) that I first learned to test.

http://www.sugarpet.net/bloodtst.html

It is important to reward your cat for every attempted test (whether successful or not). Your cat will very soon learn to associate testing with treats and cuddles. Some folks give a treat after every test. I crumble a few treats for Bertie and test him while he's eating them.

I think probably everyone develops their own style and finds their own ways of fine-tuning the technique. It is something that you and your cat will work out together. ;-)

Something I've found helpful is to always test in the same place, which in our case means on the end of my desk. And I only ever give treats when he's in his 'testing spot'. He never gets treats anywhere else in the house. And if he jumps up onto that spot I usually give him a treat or a cuddle or a quick brush whether I'm testing him or not. So the testing spot has become his 'happy place'. That makes life a lot easier!

If your cat isn't used to having his ears touched, or doesn't like having his ears touched, then you can start getting him used to that - before you start testing - by holding or massaging his ear and then giving a little treat, or by incorporating 'ear-handling' into grooming sessions.
 
All useful advice, thank you people.

We will see what Milosevitch's fructosamine results are like and then form a plan. He has wrapped himself round a couple of cans of A/D since last night, so clearly his appetite needs stimulating with stinky stuff to build him up a bit.

In the meantime his Mum and reluctant Dad are looking at glucometers. A bipedal friend has also been recently diagnosed so we'll haggle a 2 for 1 deal if possible!

Elizabeth - that is a very kind offer, thank you. I shall take you up on it once I've discussed things in detail with the vets.

Thanks again!
 
Good to see you are making plans :-)

Look on ebay for glucometers (and supplies, ie strips and lancets) - they are often sold there by human diabetics at a fraction of the cost you'd pay in a chemist.

Oh and as for the fructosamine test - bear in mind that it will only give an average of the subject's BGs over a period of time, not a single BG at any specific point, so as BGs will vary (perhaps considerably), this isn't going to give you all the information you need. Only spot checks, which you can do at home, can do that, to see how the insulin is working at different times in the cycle.

Keep going - a positive attitude is half the battle!

Diana
 
My cat was diagnosed this September and she was also in caninsulin 1unit twice a day. I followed my vet instructions and switch to md dry. After 6 weeks when I bought her for a fructosamine test. Her BG was even higher. The vet want me to increase to 1.5 units twice daily. After one week when I got my blood glucose meter, the first BG test showed high. I was thinking to switch Caninsulin to Lantus. I also stop all the prescription md dry. My cat BG gone down a lot after 3 days. I was thinking to see another month before I switch to Lantus. It happened that my cat got into remission just one month after stopping all the dry food. I think diet control is very important. Now she was off insulin for 3 weeks and her BG is between 2.8(50) -4.8(86). I still give her spot check from time to time and control her diet.

viewtopic.php?f=28&t=85515
 
Udong said:
My cat was diagnosed this September and she was also in caninsulin 1unit twice a day. I followed my vet instructions and switch to md dry. After 6 weeks when I bought her for a fructosamine test. Her BG was even higher. The vet want me to increase to 1.5 units twice daily. After one week when I got my blood glucose meter, the first BG test showed high. I was thinking to switch Caninsulin to Lantus. I also stop all the prescription md dry. My cat BG gone down a lot after 3 days. I was thinking to see another month before I switch to Lantus. It happened that my cat got into remission just one month after stopping all the dry food. I think diet control is very important. Now she was off insulin for 3 weeks and her BG is between 2.8(50) -4.8(86). I still give her spot check from time to time and control her diet.

viewtopic.php?f=28&t=85515
Click to expand...

That is a great story! :smile:
It does illustrate - so perfectly - how vital it is for us to be actively involved in the care of our diabetic cats. Feline diabetes is a home-managed illness. If you had blindly followed your vet's advice your cat would not be in remission now; in fact you would have been perpetuating your cat's insulin dependence. Hometesting and safe removal of dry food enabled your cat to become diet-controlled.

You really did a brilliant job. Those BG numbers are just beautiful. Well done!
dancing_cat :RAHCAT dancing_cat
 
Udong said:
viewtopic.php?f=28&t=85515
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This ^^^ is fantastic & one hell of an achievement! Amazing work, Udong! I hope Dongdong stays insulin free. :thumbup

My plan to switch both cats' food is to gradually switch to this low carb dry stuff first: http://www.applaws.co.uk/cat_dry.php whilst monitoring Milo's BG at home.

Milo's sister, Lola, is a fatty (6.5kg = 14 and a half lbs??) and has been for a while. I had her bloods checked & she is normal range, she's just FAT, so she needs attention too. Once they're both on the low(er) carb dry stuff, I'll start switching them to wet. Lola is a potty-mouthed fusspot & will only lick off the gravy/jelly from wet food, and a solely wet food diet has given Milo gastritis before (but he will eat anything if he's well). So it'll be troublesome.

Both me & my partner are out of the house 12+ hours a day & are used to free-feeding our kitties, but this may have to change, too, I suppose? They ain't gonna like change...

Taking a little more perspective of what has happened with our animals, we have kind of let them go to seed a little, which makes me feel awful.

We're both used to cats (these are the sixth & seventh kitty we've had together), but, we've never had indoor cats before.
I think it's just not sunk in that:
1. They get very little exercise
2. They don't supplement their diet themselves.

All our previous felines have had a 'healthy' extra diet of spiders, frogs, moths, mice, voles, bunny rabbits & birdies, which take varying amounts of energy to catch!

Udong - you have inspired me to have a look at DIY cat food, too.
 
Dr Schrodinger said:
...Both me & my partner are out of the house 12+ hours a day & are used to free-feeding our kitties, but this may have to change, too, I suppose? They ain't gonna like change...
Click to expand...

Hi Juliet,

Many of us here free-feed our cats canned/wet food. Why do you think that needs to change? Is it the weight issue?

Dr Schrodinger said:
...Taking a little more perspective of what has happened with our animals, we have kind of let them go to seed a little, which makes me feel awful...
Click to expand...

Don't be too hard on yourself. I think there are quite a few of us here for whom a diagnosis of FD was a real 'wake-up call'.... My cats were 'on the chunky side' until then, and eating dry food too.... Ironically, Bertie's FD diagnosis - and the switch to a proper diet - has improved the health of all five of my cats.

Dr Schrodinger said:
...Udong - you have inspired me to have a look at DIY cat food, too.
Click to expand...

There are quite a few people having a go at DIY cat food now. The appeal of it seems to be growing. I've recently started supplementing my cats' diets with home made raw food. They wouldn't touch it at first - didn't even seem to recognise it as food! - but now they're starting to look up at me with tears in their eyes when I offer them canned food! :roll:

Eliz
 
Thank you all for the encouragement.
Elizabeth, you are right. If I followed my vet advice, Dongdong will be on insulin forever. I also need to pay c$200/month for fructosamine test and c$100 for the syringe and prescription food.
Dr. Schrodinger, I hope your cat could be remission soon too. Control diet and home test are very important. I am lucky that Dongdong is so calm in blood glucose testing. I usually heat up the room where she stay. When I touch her ears are warm enough. I just get everything ready and do it quickly so that she don't get too stressed.

My Dongdong has been on dry food all her life. She never touch canned food for I have 2 other cats that eat canned food. When she first got her insulin shots, she seems to be very hungry but still refuse to eat any wet food. While I was cooking she wants to try some of our food. I gave her some chicken breast (wash with hot water) she seems to like it. From that time on she switched to home made food. I read online that for cat 1 lb needs 15-25 calories/day. Dongdong is 12 lbs so she needs appro. 180- 300 calories each day. I usually feed her 150 gram of food per day. Here is a site that I calculate the calories, protein, fat and carbs. On the top left corner you can type in the food and search. A lot of home made food is 0 carbs. Dongdong likes her food warm. At the end of the day when her food is cool I put a little hot water to made it warm. She can not eat food that takes out from the fridge. Cold food make her vomit. I need to heated up a little first.

http://fatsecret.com/calories-nutrition ... nt=100.000
http://fatsecret.com/calories-nutrition ... nt=100.000

I also add taurine as a supplement on Dongdong's home made food.
http://allnaturalpetcare.com/blog/2011/ ... emade-foo/
 
Juliet, have you managed to get a glucose meter yet? Reason I ask is that I've been rummaging through my diabetes supplies over the Christmas hol and realise that I have a new Contour XT meter that you could have... It only has about 8 test strips with it but they can be bought on Ebay at about half the RRP. So, if you want it, let me know and I can get it over to you this week sometime...
 
Wow!
Yes. Please!
I had a very confused wander around Boots this afternoon to no avail....

I'll PM you my mobile number. I'm back at work on Tuesday, so I can pop by yours on the way home? How much do you want for it?
 
Heads up!
The calorie estimates for cats and dogs are different than for humans.
8.5 calories per gram fat
3.5 calories per gram protein
3.5 calories per gram carbohydrate

Also, home made diets need a number of supplements, beyond taurine, added to ensure they are nutritionally adequate. For an example recipe, please go to Cat Info.
 
Quick update:

I met the fantastic Elizabeth & Bertie yesterday afternoon! They gave me my own glucometer kit & a practical tutorial on testing. Thank you, Bertie, and thank you Eliz & Chris!

Once home, I immediately turned Milo's left ear into a rather ornate piece of classical English lacework, but drew nothing but dust & disgust. Poor mog.

Gave up for a while & he had his usual 7pm injection of 4 units caninsulin. He has been drinking massively again over the past 2 days, so I wasn't hopeful. At 8.30pm I tried bleeding him again & managed to get a sample. Glucometer read 19.5mmol/l.

I wasn't happy about this. Not at all.

I have taken away all dry food & put both cats on canned only. Based on http://binkyspage.tripod.com/nonusfd.html, they are happily scoffing Felix Chicken in jelly. No problems with getting them feeding. They will chew my legs off if the bowls aren't on the floor promptly! I'm free-feeding them as normal.

This morning, I tested Milo at 7am before his injection. 26.2mmol/L. I gave him his shot. I'll make myself late for work & test him again after a couple of hours to see if it's dropping at all. I fear that the Caninsulin is not even touching the sides (so to speak) & he may have to go back to the vets for an alternative insulin. We'll wait & see what his BG does today.

Poor little chap. He's glassy-eyed & wobbly, even on this high dose. :cry:
 
Aw, shucks, Juliet, we're blushing here. (Well, I think Bert is blushing but it's hard to tell under that black fur.... ;-) ) It was lovely to meet you too!

Well done, you, for getting those blood tests done. Brilliant stuff!

When you say that Milo is "wobbly" are you referring the the back leg weakness that he's had for a little while? Or is this a differnt 'wobbliness' that is just apparent this morning?
 
Hi Juliet, I sympathise with what you're saying and completely understand your fear that the insulin is not even touching the sides... I've been there :cry: Do try to bear in mind that treating FD is a long-term thing - a marathon, not a sprint, as is popularly said here - so try to take it one day at a time. You just need to be committed and try to stay cheerful with the help of whatever floats your boat - for most of us it's wine and/or chocolate ;-)

I'm glad you've met Elizabeth, she's brilliant (don't blush Eliz, you deserve the compliments!)

Keep going...

Diana
 
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He's a little stumbly, Eliz. Not the back leg neuropathy. He's also not purring this morning, which is very out of character. I'll give it an hour & see if the insulin kicks in. It's a good job I can work from home this week.

Diana - you're not far away either! Thanks for the encouragement, neighbouroonie! :-D I am not known for my patience & my brain finds it tricky to think long-term. :YMSIGH:
 
Juliet, just a thought, I know this is unikely but is there any way that Milo could have had access to any anti-freeze? The reason I ask is that this is the time of year when accidental poisonings happen (cats, dogs and small children are poisoned by the stuff every year). I don't want to alarm you, just wanted to 'rule that one out'... That 'wobbly legs' thing kinda worries me....

Edited to add: Juliet said no access to anti-freeze. Phew!
 
Antifreeze? No. He's an indoor puddytat. We keep our antifreeze in the cellar, but he never goes down there (too much of a chicken!) & it's on a high shelf, anyway.

Well, I decide to work from home completely today & am doing a full glucose curve to help persuade the vet that I'm not doing anything untoward by switching his diet.

Shot at 7am:
07:00 25.2mmol/L
09:29 15.8mmol/L
11:30 11.5mmol/L
It seems to be going reasonably well so far, but the bleeding is tricksie, despite Milo's ears being the size of a barn door.... :-D

Eliz, you're right. This hometesting malarkey will cost a fortune in treats!
 
Wow, Juliet, I don't think I've ever known anyone attempt a curve so soon after learning to test! :shock: Brilliant stuff!

And you've got a nice BG drop there too. Milo should be coming up to insulin peak (blood glucose nadir) pretty soon.

For the benefit of folks in different time zones, and using US numbers, I'll rewrite your info in 'FDMB-speak' ('AMPS' means morning pre-shot number; 'PMPS' is evening pre-shot number. To get US numbers you multiply 'rest of the world' numbers by 18. And '+2.5' means 2.5 hours after the shot was given.)

AMPS: 25.2 (454) gave 4 units Caninsulin
+2.5: 15.8 (284)
+4.5: 11.5 (207)

One of the criticisms of Caninsulin is that it can have a very short duration in cats, and can be pretty much out of the system in as little as 8 hours. So, it will be interesting to see how Milo does on this insulin.

Is he feeling any better at the lower numbers? Any less 'wobbly'?
 
Yes, these are heartening numbers - a nice not-too-steep-or-fast drop (which can make a poor kitteh feel very out of sorts) and at least you can see that Milo is definitely not insulin-resistant, but that Caninsulin works as it usually does. As Elizabeth says, it will be interesting to see at the next test if he levels out and stays there for a bit, or starts to climb again. One of the problems many owners have with Caninsulin is its duration (whoops, just noticed that Eliz has already said that so apologies - but maybe not such a bad thing as the more often you hear things from us on this board, the more it will start to sink in and make real sense).

Carry on as you are, you're doing great!

:RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT

Diana
 
Elizabeth and Bertie said:
Wow, Juliet, I don't think I've ever known anyone attempt a curve so soon after learning to test! :shock: Brilliant stuff!
Click to expand...

Well, I had a brilliant teacher!

Elizabeth and Bertie said:
And you've got a nice BG drop there too. Milo should be coming up to insulin peak (blood glucose nadir) pretty soon.
Click to expand...

Yes. I'll do another test in an hour & then I'll have run out of strips, so a quick run into town is in order!

Elizabeth and Bertie said:
To get US numbers you multiply 'rest of the world' numbers by 18. And '+2.5' means 2.5 hours after the shot was given.)

AMPS: 25.2 (454) gave 4 units Caninsulin
+2.5: 15.8 (284)
+4.5: 11.5 (207)
Click to expand...

Thank you, Eliz. I can add another one now:

+5.5: 11.1 (200)

Elizabeth and Bertie said:
One of the criticisms of Caninsulin is that it can have a very short duration in cats, and can be pretty much out of the system in as little as 8 hours. So, it will be interesting to see how Milo does on this insulin.
Click to expand...

Yes, I would like to see how long it lasts. One of the reasons I have thrown myself into it is because I feel powerless without the knowledge of what is happening to him. I haven't seen any of his clinical data from the vets for his previous curves & have no idea of what they fed him throughout. Having a good baseline of data from which i can make my own observations is vital if I am to improve his condition.

Elizabeth and Bertie said:
Is he feeling any better at the lower numbers? Any less 'wobbly'?
Click to expand...

He's perked up a bit & is chirruping in his Maine Coon accent, but is still wobbly on his back legs. He's not very good at taking corners today.
 
For the wobbly hind legs, he may need supplemental methylcobalamin (methyl B-12). This may be purchased over the counter/online. It has to be the methyl version.

OR, it could be low potassium levels - the vet would need to check that with bloodwork.
 
Aaaaaaaaaaaargh!!

Apparently fructosamine was really high too. The vet wants to increase his dose to 5 units twice daily. Don't know what to do. :cry:

(BTW Thanks for the tip, BJM)
 

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Your curve shows that the insulin is not lasting long enough (only 8 hours) which would support switching to one that is longer acting, such as Lantus, Levemir, and maybe a form of PZI if available in the UK (Hypurion?)

There is a small amount of room to increase the dose (within the green band), but I'd err on the side of caution and increase by only a small amount, such as 0.25 or 0.5 units on a day I could be home to monitor for possible hypo.

Another tactic would be testing and dosing every 8 hours, which is difficult for most folks to schedule.
 
Dr Schrodinger said:
Apparently fructosamine was really high too. The vet wants to increase his dose to 5 units twice daily. Don't know what to do. :cry:
Click to expand...

Juliet, a couple of questions for you...

When was the blood sample for the fructosamine test taken? Was he only eating dry food at that time? Or during much of the preceeding two weeks?

Do I understand you correctly that now you're testing you're phasing out the dry food and replacing with low carb wet food...?

If 'yes' to the above then the fructosamine test info may already be 'out of date', and a dose increase should not be made on the basis of that test.

Further, it's generally considered a good idea to only make one change at a time. Phasing out dry food and increasing insulin dose at the same time is NOT a good idea. You might end up giving Milo too much insulin....

If you're working from home and able to test Milo this week then maybe you see how phasing out the dry food alters his BGs over the next few days, and then consider what dose increase might be appropriate after that? I agree with BJM that any dose increase should be small and also done at at time when you can monitor.

Chin up, Sweetie - You're doing a brilliant job. :smile:
 
Yes, I agree the fructosamine test will be out of date now I've changed his diet.
I've discussed with the vet a number of ways forward:

1. Stick with the diet change & monitor him on the same dose.
2. Change the insulin - but the only available alternative is Lente, at the moment. :-|
3. Increase the insulin by a fraction & monitor him while he gets used to his new diet.

She's not comfortable with leaving the insulin alone. If she was me then she would increase the Caninsulin & see what happens, whilst doing a full 24 hour curve. This would have to be done in the surgery, as I have to work.

She's not happy with me changing his diet, at this stage, although, in fairness, he was supposed to be stable, when clearly he isn't. I have phased out the dry stuff completely now.

I'm taking Milo to be checked over tomorrow first thing to rule out anything else. He's now very hot & grumpy. In the meantime I'll give him 4.5 units this evening and test his BG before I go to bed.

Thank you.
 
I sense your frustration but try to stay positive - you are already making great strides and this is a process, just as it would be in a human.

You also have a head start in being a scientist because you understand a lot of the basics. When I was treating my FD cat I was all at sea 100% of the time because I just don't "do" numbers or anything related. I used to be a journalist, now I teach art - I have zero left brain function and am virtually dyslexic with numbers (or whatever the right word is). However, I just did my best, and that's all any of us can do. You're doing really really well - just carry on as you are and give yourself credit (and lots of treats!) for it!

Diana
 
Dr Schrodinger said:
...She's [the vet] not comfortable with leaving the insulin alone. If she was me then she would increase the Caninsulin & see what happens, whilst doing a full 24 hour curve. This would have to be done in the surgery, as I have to work.

She's [the vet] not happy with me changing his diet, at this stage, although, in fairness, he was supposed to be stable, when clearly he isn't. I have phased out the dry stuff completely now.

I'm taking Milo to be checked over tomorrow first thing to rule out anything else. He's now very hot & grumpy. In the meantime I'll give him 4.5 units this evening and test his BG before I go to bed.
Click to expand...

Oh, Juliet....

You sound SO disheartened.... (((Hugs))) to you,

It's very early days. And I just can't believe what you've achieved in such a short time! This time yesterday you didn't know how to hometest. Today, you learned to test, did a curve (and produced a graph of that!), and removed dry food from your cat's diet. You're moving so fast that I can hardly keep up!

I know it's difficult when our vets say one thing and the (potentially crazy) people on the internet say something else. We've all been there.... But if I had followed the advice of the vet who diagnosed Bert's diabetes then Bert would not have been alive last night to demonstate hometesting to you: That vet recommended I have Bert PTS. If Udong (whose post you were so inspired by) had followed the vet's advice about what to feed her cat then that cat would still be on insulin and not in remission now....

Our vets advise us. People on this forum advise us. But each of us has to weigh things up and make - what we consider to be -the best choices in the interests of our cats. And it really isn't easy....

The only advice I would give at this point is to take care with any dose increase this evening. You've only just removed dry food and Milo's BG may still be settling out as a result of that.

And regarding insulin, there are other options. But that's for another time...

Please don't lose heart. You should be congratulating yourself on all that you've achieved for Milo over the last 24 hours....

Eliz x
 
Thank you, Ladies!

Yes, I am frustrated & feeling a little powerless. I've run out of test strips & there aren't any in my town! I'll play it safe & not increase Milo's dose this evening.

He's tottering around the house, he's just filled his belly with meat, and I have raised a few purrs & chirrups. I'll take him to the vet tomorrow along with a 6 pack of tinned food & ask them to do a 24 hour curve on him at a slightly higher dose (4.5 units) and go from there. There's no way on this earth that I'm having him eating crappy food again, but that spike after 8 hours has really pissed me off. We stick to no carbs & insulin from now on & get him stable.

Eliz - our local s'market stocks those Thrive treats that Bertie loves so much! Milo shall have a present for when he gets out of hostible. Yay!
 
just to make things more stressful for you :(

a curve at the clinic may not be worth the cost because IF he is stressed and IF he is one of those cats who have elevated bg levels due to stress, the numbers could be inflated more than they would be home.

honest, you do NOT need a 24 hour curve to determine how he's doing. You are testing at home and you've started a diet change which can take a few days to see full effect. If you keep him at home and monitor his urine for ketones and get pretests and spot checks, you'll know if the diet change is having sufficient effect.

Sorry, I know this makes things tougher

Jen
 
Don't apologise, Jen.
I know all of this anyway, but I just don't have the test strips or the time to monitor him at the moment. The strips are on order but will take a few days to arrive. If I can't do a BG test myself, then (now his diet has changed) he needs to be monitored by someone else!
He seems much perkier this morning. He's had his usual 4 units caninsulin, and has a massively full belly of meat (which hasn't happened in a while) and is purring his huge furry head off at me. I'll let the vet check him over, do a ketone test, and maybe keep him in to do a detailed curve to see if that spike appears again.
 
Juliet, I'm glad to see that you have a plan - that's what's important to help you feel in control. It's so easy to throw your hands up in the air and feel powerless, with all the various things to think about. I'm also glad to hear that Milo is a happy bunny this morning - that tells you what you need to know more than anything, so you are doing something right! It is important to take note of all the little differences in behaviour, as you've detailed here - easy to overlook in our state of panic!

I'm assuming you've ordered test strips from ebay - much cheaper than any high street chemist, although you might want to find a local supplier who you could get supplies from in an emergency.

Cats do love Thrive, yes - rather expensive though, about £3 for a little tub from Sainsbury's. You may like to keep a little stock of cubed chicken or ham in the fridge as well, as treats. And don't forget treats for yourself too (don't under-estimate the importance of these things!)

Diana
 
He's at the hostible for the weekend under the eye of a different Vet with different ideas.
His BG has been high all day & she suspects Somogyi.

BUUUUUT......NO KETONES!! Weeeeee!!

So, plan is to decrease dose (Yay!) and do another full curve at 2 x 3 units. She asked if I wanted to do it at home (see? Different ideas!) but I declined as I want some sleep....
 
Dr Schrodinger said:
He's at the hostible for the weekend under the eye of a different Vet with different ideas.
His BG has been high all day & she suspects Somogyi.

BUUUUUT......NO KETONES!! Weeeeee!!

So, plan is to decrease dose (Yay!) and do another full curve at 2 x 3 units. She asked if I wanted to do it at home (see? Different ideas!) but I declined as I want some sleep....
Click to expand...

Juliet, just PM'd you to ask how Milo is, but I see that you've posted an update here, so you don't need to reply.

Am SO pleased to see that there's no ketones! (Phew!) dancing_cat
 
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