Cedric from The Netherlands says hi!

Hello! Please meet Cedric. He is a 11,5 year old European Shorthair and a real gentleman!

He never begs for food, does not jump on tables and although not a cuddler cat, he always seeks company and likes to be present in the same room as his owners.



Unfortunately for the last months his appetite is increased in such a way that he spends hours waiting in front of his automatic feeder. When he started to get aggressive towards us at moments when we tried to prevent him stealing food from the fridge, we knew we had to visit the veterinarian.

He was drinking a lot and eating every scrap of food he could find. Every time we opened the dishwasher to put in a dirty plate, Cedric was jumping in the dishwasher and frantically began licking from dirty dishes to still his hunger.



Although the vet first suspected a thyroid problem, blood tests soon revealed that the blood glucose level was too high (I believe 22 mmol/l) and a glucosamine test confirmed the diagnose of diabetic. With the exception of his glucose levels, he is a very healthy cat weighing 5KG.

We went home with a Caninsulin starter kit and instructions to give Cedric a dose of 1,5 IU Insuline, twice a day with 12 hours in between.

After a week we had to return to the vet to measure his blood glucose 4 hours after his last injection. We were very happy to see the blood glucose already as low as 5,6 mmol/l! The vet even took a second measurement as she didn't believe the result to be this good with only 1,5 IU.

We did a second measurement about a week later, confirming the results were consistent. The only problem is that Cedric's behavior is not changing! He stays hungry!

The veterinarian could not find any other cause and asked us to lower to dose to 1 IU Caninsulin, twice a day.

We have been administering the lowered dose for two weeks now. The results are not great. Even though Cedric stays to be a very active cat, he is restless and too much focused on food. Only a few hours a day, often between 11h and 13h, he is relaxed and seeks for a quiet place to sleep.

The veterinarian talked about an alternative insuline, Prozinc that might yield better results.

As we say in Dutch: "meten is weten" (to measure is to know), so we learned how to do home glucose testing. Here is the result of our first day curve that we measured yesterday.



(Cedric eats 24g of Royal Canin Veterinary Diet - Urinary S/O Moderate Calorie at 7:30h and 16g at 15:00h)

What can we tell about this day curve? Can I already rule out Acromegaly as possible cause?

I am looking forward to exchange experiences to make the lives of diabetic cats (and their owners) as good as possible. Pardon me for using KG / mmol/l, the Dutch forums do no seems to be so active and I do not think diabetic treatment should differ across borders.

 

Welkom Matthijs en Cedric. Mijn familie komt uit Utrecht.
We have members from all over the world but mostly in North America. The time zone difference might make some answers come slowly but you are both in the right place. You will get better answers to health questions in Feline health / Main forum.
Cedric is a handsome boy, our Andy looks just like him.

 

Welcome.
Waving to you from Canada. Thank you for all the tulips. Much appreciated.
Come over and post in the Feline Health Forum where more eyes will see you.
It is fantastic that you are home testing. (To convert to US numbers, you multiply by 18.)
We can help you in all sorts of ways.
As you can see from your curve, caninsulin (designed for dogs and not the best insulin for cats) drops cats hard and fast during the early part of the cycle. More information can be found here: Caninsulin Guide.

 

@Wendy&Neko

 

It's too soon to know if Cedric has a high dose condition like acromegaly. We typically do not even begin to consider this until a dose is close to 6.0u.

One immediate thought is the carbohydrate content of what Cedric is eating. If the Royal Canin is dry food, it is very high in carbohydrates. You are essentially giving a diabetic sweets for his meals. You want to look for canned food that is low (less than 10%, or better, around 5%) carbohydrate. I'm not familiar with what brands of food are available in The Netherlands but some of our European members may be more knowledgeable.

You will want to gradually transition Cedric to a canned food diet. Reducing the carbohydrates can have a dramatic effect on blood glucose numbers so it's wonderful that you are testing.

 

My kitty started on Caninsulin too, and it similarly didn't last the entire cycle, so we switched to Lantus. She also was going crazy for food. Turns out she did have acromegaly. Though we don't suggest to people to test for acromegaly until they get to 6 units, there have been acrocats with doses as small as 1 unit. The only way to rule it out is a blood test, but it's too early to test for it. For one thing, a study by Dr. Woolhead at Royal Veterinary College showed that testing for IGF-1 (the marker for acromegaly), within 73 days of initiating insulin therapy can have a large percentage of false negatives.

Start a new post in the Feline Health forum, and we can help you with suggestions for a better diet, and giving you more control over handsome Cedric's diabetes. Once he spends more time out of high numbers, his appetite will reduce.

 

Thank you all for the warm welcome! I will pass on the compliments to Cedric.

Yesterday, we got a call from the veterinarian with the request to increase the insuline dosage back to 1.5IU. We need to check the glucose level again on Saturday, 4 hours after his insulin shot.

If the Royal Canin is dry food, it is very high in carbohydrates. You are essentially giving a diabetic sweets for his meals. You want to look for canned food that is low (less than 10%, or better, around 5%) carbohydrate.​

Yes it's dry food. We started using "Royal Canin Veterinary Diet - Urinary S/O" when he had urinary bladder problems (struvite). When he gained additional weight and became about 6KG we switched to the "Moderate Calorie" version as recommended by the vet.

So my understanding was that this is already low carb, but reading from the bag, most it seems to be rice. I do find it difficult to read what the percentage of carbohydrate is. Protein is 34.0%, that does not sound bad.

My kitty started on Caninsulin too, and it similarly didn't last the entire cycle, so we switched to Lantus. ... Turns out she did have acromegaly.​

Ah, so seeing the glucose level drop as response to insuline, does not rule out acromegaly. The example curves online show a flat line with high glucose levels and total insuline resistance.

Start a new post in the Feline Health forum, and we can help you with suggestions for a better diet, and giving you more control over handsome Cedric's diabetes. Once he spends more time out of high numbers, his appetite will reduce.​

Yes, let's hope his appetite reduces. I will find some more info about the diet options that are available and join the Feline Health forum.

 

A rough calculation shows the "moderate calorie" well over 35%. There is a list of low carb foods available in the EU at the bottom of this UK food list. A lot of people order from zooplus.
UK Cat Food List

See you in the Feline Health Forum.

 

Those example curves just show the dose is wrong, We have plenty of regulated acromegalic cats here

 

Hej und Willkommen Holland Cedric from an oldie in Schweden, Sweden.

Great you are home testing already. I understand you have to start with the Caninsulin (=Vetsulin) but do know that both the insulins Lantus and Levemir are better and affordable too.

But first we start with the better food, all home testing and the insulin you use right now and get you all set up. 22 mmol is in the high blood glucose, bg, level.


Annhu, = Anne and Herr Hu are from Germany and uses a very low carb dry food. Maybe it will be a better suited dry food for Cedric too.


Välkommen

Ann

 

Hello Ann, thank you for your message.

Yes, it is very unsettling to watch Cedric be uptight and scouting for food all the time. The blood glucose level was 5.6 mmol/l today (4 hours after 1.5 IU Insuline), so he is responding well to the increased dosage.

The challenge is to extend the duration of this good blood glucose level.

 

Matthijs, you have not posted in the main forum yet. You and Cedric will get a lot more attention and help there.