Vet cross with me giving Caninsulin

[Sueffun]

Hi
I have one cat Toby who is 14yrs old that was diagnosed with diabetes last year, he is now in remission after 3 months of Caninsulin and I have recently changed him to a raw food only diet and he is very well.
My Siamese Alice was smelling of ketones on Saturday evening and again on Sunday morning so I did a glucose test and it was 11.2, she had also been drinking and peeing a lot in the past week.
My hubby is a surgeon and he suggested I give her a small dose of insulin as we were worried about ketoacidosis. Later in the afternoon it went down to 5.9
I took her to a vet on Monday morning and he was not happy that I had given her insulin and proceeded to tell me off and that now they don't know her G levels, she might not have diabetes and it could go sky high because I gave her the insulin, I was very upset as I thought I had done the correct thing.
They admitted her as she was very dehydrated, BGT 29 and it came down to 16 yesterday afternoon, but they are still not giving her insulin as they say she is pre diabetic" did a blood test that could detect her glucose for the past 3 weeks and it was going up all the time.
My other vet ( different practice) had given her depomedral for her asthma 6 weeks ago and this vet thinks that triggered it, he is still going on about my misuse of the insulin and I feel he is blaming me for the fluctuations in her glucose levels even though that was on Sunday morning and it's now Tuesday.
She is still on a drip and syringe fed on hills wet MD.
Any thoughts as to why they wouldn't give her insulin now as her BGL is still not normal, this vet also doesn't like Caninsulin and is looking for a "pen" type of insulin for small doses for her, unsuccessfully as we are in S. Africa..

 

[Tanya and Ducia]

Hello and welcome,

My Siamese Alice was smelling of ketones on Saturday evening and again on Sunday morning so I did a glucose test and it was 11.2, she had also been drinking and peeing a lot in the past week.

Very typical symptoms.

we were worried about ketoacidosis.

I test my cat's urine for ketones at home using human dip sticks which here in the States can be purchased at any human pharmacy. Do you have anything like that where you at? Giving insulin was in my humble opinion absolutely right call by your husband howver it should be very carefully monitores by home testing her BG especially prior to injection. I am puzzled as to why your vet would oppose it...Was he worried about possible Hypo? Perhaps someone else will weigh in later on to offer another opinion.

She is still on a drip and syringe fed on hills wet MD.

Hill's md has 13% of carbs - high for pre- and for diabetic kitty, for any cat at all for that matter. It could be the main culprit in higher BG.

he is still going on about my misuse of the insulin and I feel he is blaming me for the fluctuations in her glucose levels even though that was on Sunday morning and it's now Tuesday.

Kitties with suspected ketoacidosis need insulin and food, and to be monitor for possible infection and/or inflammation... Otherwise one "invites" ketone development.. I understand you vet wanting to see flatter cycles, we all do, - not drops/spikes however keeping ketones at bay with insulin and food is by far more important. The BG numbers can be regulated with time. The main enemy now, as I see it, is ketone development. It is my humble opinion.

My hubby is a surgeon and he suggested I give her a small dose of insulin as we were worried about ketoacidosis. Later in the afternoon it went down to 5.9

What dose do you give?
How often?
What is her food intake? How much/how often?
There are people on this Board who used Caninsulin for long and I am sure they will be along to share their tips/ opinions to help you out. Or you can post in the Caninsulin Forum a well - wealth of collective knowledge for you and your kitty.

his vet also doesn't like Caninsulin and is looking for a "pen" type of insulin for small doses for her, unsuccessfully as we are in S. Africa..

I use Glargine or Lantus insulin but possible it is available in the US only... Is that what you referring to as "pen" type? Starting with small doses of Lantus makes sense to me..What type does your vet proposes?

My vet is still cross with me for home testing and dose adjustment without consulting him...Could your vet possible be offended by your surgeon husband "hijacking" his, the vet's authority in the matter?

Please keep posting either here or in the Caniunsulin section of the Board.

Best of luck to you and Alice!

 

[Nan & Amber (GA)]

Hi--

Tanya has already made some excellent points! I'll just add a few things.

1. Caninsulin is an "in and out" insulin. It's not really likely that there could be any direct effects of the shot you gave after 2+ days. As for indirect effects-- it is possible that, if the insulin took her BG very low, Alice's body could still be reacting and raising BG in response. But fluctuations up and down from a single shot? Never heard of that. Frankly, I think your vet is having some control issues .

2. The "pen" insulin certainly sounds like Lantus/glargine, which is a good insulin for cats. You might also want to look into a new formulation of glargine that has become available recently, Basaglar-- it seems to act very similarly to Lantus, and might be more easily obtained where you are.

3. I agree that giving insulin wasn't a bad move given the strong suspicion of ketones-- you may have headed off a true emergency situation! That said, when ketones are in play, it's probably safest to just go straight to the vet. Tanya mentioned urine dipstick testing for ketones (dipsticks should be available with the human diabetic supplies in pharmacies); we usually recommend that any reading over "trace" warrants a trip to the vet.

Finally, welcome to you and your kitty!

 

[Wendy&Neko]

I use Glargine or Lantus insulin but possible it is available in the US only.

We have had members world wide use Lantus/Glargine insulin. In many countries you can get it in cartridge form for cheaper. It is like a pen refill. It should be available in the human pharmacies. Some countries, like Canada, you do not need a prescription to get it. You might want to talk to your local pharmacist. You still need to use U-100 syringes to administer it, as opposed to the U-40 syringes used for Caninsulin.

It is a good idea to get bloodwork done before starting insulin, to make there is nothing else causing or contributing to the high blood sugar.