UK Choice of insulin

Hi All,
My cat Freddy was diagnosed with diabetes last week. His senior check in September showed him to be borderline diabetic and the vet advised a change of diet. I tried the MD diet for a while but I read online that it wasn't the best idea. I switched him to Bozita (canned) and he seemed to be doing well. I did still give him milk and some treats which I realise now wasn't a wise move. Last weekend Freddy seemed to be very hungry and was drinking more. He was still playful and happy but on Tuesday morning he came in from outside and lay on the ground panting. I took him to the vets immediately and he found his blood glucose to be over 25 and his urine to contain ketones so he put Freddy on fluids and started him on Canininsulin. He stayed in the vets for two days and I was instructed to give him 4.5 units twice a day. On Saturday the vet tested him again and was pleased that his BG was down to 18. After finding this site I went and purchased a home testing kit tonight and will start using tomorrow nailbite_smile I have been reading a lot here and notice that most people seem to be giving their cats Lantus. Can anyone advise if Lantus is a better insulin?
Thanks in advance :smile:

 

The best insulin is the one which works for your cat.

That said, we find Caninsulin doesn't always last a full 12 hours in cats. Lantus and Levemir generally last longer than 12 hours and overlap helps keep the glucose levels more stable. Both do require a lot of consistency in schedule and dose to work optimally. Hypurin PZI tends not to have overlap and is available in Europe. It is a bit more flexible in that you may be able to adjust the dose based on pre-shot test and historical data you have on how the cat responds.

 

Thanks for your reply.
I will maybe see how Freddy goes with the Canininsulin. The ones that last more than 12 hours sound better though. It is good to know there are alternatives if this one does not work for him.

 

We strongly advocate home testing and we have a great grid sheet to share your data for review. Instructions are here.

We suggest using an inexpensive human glucometer with pet-specific reference numbers. Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

* * * * * * * * * * * * * * *​

Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)

 

Understanding the spreadsheet/grid:

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +5 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

Hello!

(Wow, your Freddy looks just like my Bertie!)

As BJ said there are other insulin choices available in the UK if it can be shown that Caninsulin isn't effective.
Here comes the 'Boring Bit' :
By law, vets in the UK have to prescribe a veterinary medicine before they can prescribe a 'human' medicine; and currently Caninsulin is the only veterinary insulin suitable for cats. If Caninsulin doesn't suit the cat then the vet can, under the 'cascade system', prescribe the next thing on the list that may be of benefit, and that will mean prescribing an insulin made for humans. Some vets do this very willingly, some take more persuasion. Alternative insulins include Hypurin Bovine PZI, Lantus and Levemir. All are long-lasting insulins.

The alternative insulin you're most likely to be prescribed is Hypurin Bovine PZI. That's because there used to be a veterinary PZI and most UK vets will still be familiar with PZI insulin. But currently there are more UK folks on this forum on Lantus than there are on Hypurin.

Please know though that Caninsulin suits some cats just fine, and some cats have gone into remission while on it. ('Remission' means that the diabetes can be diet-controlled.)

Well done for getting a glucose meter! I know testing sounds scary, but the info it gives you will put you SO much more in control of Freddy's diabetes.

Eliz

 

Hi again,

Here is a link to some hometesting pics and info (I learned to test from this page):
http://www.sugarpet.net/bloodtst.html

Testing is much easier if the cat has warm ears. If the ear isn't warm you can warm it by massaging it, or by putting something warm against it (ie a pill bottle filled with warm water, or a 'rice sock' (a few spoonfuls of rice or other grain in a sock or small bag, which is then gently warmed in the microwave.) If the cat's ears are already warm you may get away with doing nothing.

Some of us have found that, initially, a teensy weensy smear of vaseline on the edge of the ear can help the blood droplet to 'bead up' and stop it disappearing into the fur.

It seems often to be the case that one ear bleeds more easily than the other. I don't know why that should be. And it is certainly true that the ear bleeds more easily over time. I think it creates more blood vessels (angiogenesis) because of those miniscule injuries we inflict!
There are very few nerve endings in the edge of the cat's ears, so this should not hurt your cat.

You can introduce the cat to the idea of testing in stages, by getting them used to the sights and sounds of the testing kit and getting them to associate that with pleasant things.
Bertie was almost 7kg of pure attitude, so I knew I'd only be able to test him if he was OK with that. So, I'd massage his ear and then give him a little treat. Then rattle the test strip vial and give him a little treat. Then click the lancet pen close to his ear and give him a little treat, etc. Then, when I came to try a test 'for real' I found I could crumble a few treats and test him while he was munching on those.
Now he comes running when he hears me rattle the test strip vial! And I can test him while he's asleep in his basket too... cat_pet_icon

Be patient with yourself. It'll probably take a few goes to get the hang of things. But I'm sure you'll do just fine.
If you have any questions just ask. :smile:

Eliz

 

Thank you for all your advice BJM and Eliz.

I was able to download the spreadsheet which I can see will be really useful. I have been having real trouble testing him though. Out of 11 attempts I only got one reading. I tried when he was sleeping and I warmed his ear but I just don't know why blood is not coming out. I have made an appointment with the vet for tomorrow so I will get him to show me if I'm doing something wrong. I am going to ask him about the other insulins too as I think Freddy has been quite tired the last few days so maybe the Canininsulin is too rough on him. I really need to get testing so that I can see how it is affecting him. I am going to ask about getting strips for testing for ketones too.

Freddy is very like Bertie

 

If you absolutely, positively, must have blood,(*) you can aim for the vein directly (I freehand and can see it to do that). Just be prepared to blot firmly and quickly as it gushes when nicked.

* like if you think he may be going hypoglycemic on you!

 

Here are some more testing tips that might help https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

But maybe we can help refine your technique

- Are you free handing the lancet or using the tool?
- what are you warming the ear with (cold ears are such a PITA)
- What do you put behind the ear to press against?
- What size lancets are you using?

Wendy

 

Hi Wendy,
I am sorry but I did not see your post until now. I have been having a bit more success with the testing but it still takes a good few goes I have been using the Accu-chek fastclix. The lancets come in a little drum tool. I have been warming the ear and using a cotton wool pad to press behind the ear. I am hoping that it gets easier as I get more practice. Freddy doesn't really like sitting still when I'm doing it but I have been rewarding him with treats afterwards so maybe he'll come round. I will read through the tips you sent me now. Thank you for your help.