? 5 Jan | Girlie AMPS 140; +3=58; +9=92: Zobaline for hind leg weakness?

Condo: http://www.felinediabetes.com/FDMB/...89-7-81-switched-to-human-meter-today.189074/

Day 2 of Human meter (Contour Next) and Cycle 16 of Levemir 0.1.

Has anyone used Zobaline? I ask because Girlie's hind legs are wobbly (she's pretty easy to push over), and she doesn't have a lot of strength in them: she has trouble holding herself up for a lengthy LB visit. Not sure how I stumbled across the things below, but I was wondering whether there's a test I can have the vet run to check this or whether there would be any harm in giving her the Zobaline to see if there's an effect?

Girlie certainly has all of the following (from the Zobaline page):

• progressive weakness in the hind legs
• loss of ability to climb stairs or trees
• inability to jump to higher surfaces
• lack of endurance
• needing to rest more after short walks.

SISU B12 post

Neuropathy and diabetes in pets

 

I believe quite a few folk have/do use it.
It can take a while for you to see improvement, but members have had success with it.

 

Do you know if a blood test needs to be done beforehand to establish some sort of deficiency, or is it a shot in the dark kind of thing and not harmful to give even if not exactly needed?

 

I think that most people give it based on signs of neuropathy. I've not seen anyone comment about a blood test.

It's water soluble, so any excess gets flushed out with pee.

On another thread http://www.felinediabetes.com/FDMB/...-pmps-234-2-25-247-5-220.189066/#post-2102704
cg is concerned about this overloading the kidneys in ckd cats. On Tanyas site, I can't see anything about that being an issue, in fact b vits can be helpful for CKD cats, all be it B12 would be given at a lower dose to alleviate CKD symptoms, it may be safest to ask you vet.

I'm still looking through info to see if I find anything more on the subject, may need to pick some brains.

 

I used it with Gizmo for a few months. He started to have hind leg weakness so I ordered a bottle. He just finished the bottle yesterday so I am going to see how he does without it. Not sure if it actually helped him or if his leg issues were due to something else, but he did improved. Many people here do use it. I didn’t have any blood work, just started him on it. Hoping he does well without it, but if not I will definitely be ordering more.

 

That's great to know! I think I might check with the vet but order some just the same to see if it helps Girlie at all.

 

Thanks so much, Gill - am looking at that post now.

 

Girlie at 58 on +3. As this is already C16 on 0.1 of Levemir, I thought I'd see how she goes with just the 6% food rather than throwing in the 8%. This might push her into shark territory by her +4, but if so, I'll be curious to see how easy it is to bring her up out of it; or she might just surf in the really low greens. I've got today, Saturday and Sunday and then back at work, so I'd like to take this chance to closely monitor while I can.

So interesting: Contour Next she's 58; Freestyle lite she's 34 and AT2 she's borderline at 68. I've chosen the Contour Next to follow, so I'll be curious to see where we are in an hour (or less if she seems to need a test earlier).

 

Darrah, I thought it was made clear to pick one meter and put aside the others for your peace of mind!

 

I know! I'm just comparing the FSL and the Contour Next as I know there will be late nights when I'm too lazy to warm her ears and will reach for the FSL instead. I just want to get a few days data of the two for my own interest. I leave the AT2 aside; was just curious when I saw the super low reading on the FSL, so thought I'd see what the AT2 read. I'm actually feeling quite confident just relying on the Contour Next, so I'm not stressing - about that at least! - I promise!

I just so love the way her SS looked yesterday and today that that's good enough for me; and she doesn't seem any different, so there you go!

 

You can get your vet to run a B12/folate test to check for any general insufficiency (not uncommon in cats with digestive/GI issues) but as mentioned above B12 is a water-soluble vitamin so even if B12 levels are OK any excess is excreted in the urine. On the subject of which ...

Reposting text here (originally posted here):

This is some of the advice from Tanya's Site cautioning about size of dose of B12 for CKD kitties (a tad tricky to find):

Vitamin B12 and Diabetes

Cats with diabetes tend to be given relatively high dosages of methylcobalamin. However, Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial(2010) House AA, Eliasziw M, Cattran DC, Churchill DN, Oliver MJ, Fine A, Dresser GK & Spence JD Journal of the American Medical Association 303(16) pp1603-1609 found that humans with diabetes and kidney disease caused by the diabetes who were given three B vitamins, 25mg/d of vitamin B6 (pyridoxine), 2.5mg/d of vitamin B9 (folic acid) and 1mg/d of vitamin B12 had a lower GFR (a measure of kidney function) and an increased incidence of strokes. The study states "Because these vitamins are water-soluble and renally excreted, vitamin toxicity may be more of a concern in patients with impaired renal function."

Cats with diabetes are usually only given methylcobalamin for up to three months, until the diabetes is regulated, but the humans in this study were taking cobalamin for 36 months. It is also not known which form they were taking, but most probably it was cyanocobalamin. These patients had severe diabetes as well as advanced CKD and were receiving multiple treatments apart from B vitamins.

I would not give more than 1 mg a day to your CKD cat, and personally, I would feel more comfortable giving 500mcg (0.5mg) only. Be guided by your vet as to the most appropriate dose for your cat.

[Emphasis mine]

Source link: http://www.felinecrf.org/vitamin_b.htm#methylcobalamin (at very end of page).

(Note: The above page also mentions caveats about: B12 supplementation and skin irritation; possible B12 contraindication in patients with cancer.)


------------------

@Girlie's mom - Another thing that might be worth getting checked is Girlie's potassium levels (blood test). Potassium deficiency can cause muscle weakness.



Mogs
.

 

Hi - re: Zobaline. Yes. I use this and can confirm an obvious improvement in rear legs. Please note: BG must be reasonably well controlled and it takes time (i.e. 3 mos) to see improvement.

The scientist in me did request a baseline blood test from the vet before, but no deficit was noted. It wasn't worth the $100 to do the test because it did help her.
I love my vet and find him to be *very* knowledgeable, but since this isn't a drug, he was skeptical as a medical pro. His feedback was more focused on how any excess would not be harmful (as Gill mentioned any excess is peed out).

Use Zobaline if you can get it. If availability or cost is an issue, look for methylcobalamine (w/ nothing bad added) in the same dose. Some report 2x dose for first month or so helpful to start, but I didn't do that.

All the best to you and Girlie!!!

 

Thanks Mogs,

 

@Girlie's mom My Tyler has the diabetes wobbly gait + CKDII .

I have been giving the B12 methyl for a month now with no discernible difference, but there again me and Ty have a long way to go in getting his diabetes better controlled which I believe will in turn hugely help the neuropathy - which my vet ignored and called arthritis !

It was me that raised some concern over the dosing of the B12 methyl in a cat with stage II CKD as I felt I had read/been told to dose with caution.

@Critter Mom found the info. Thanks

 

Thanks for great info @Critter Mom. I was not aware of risks esp for CKD kitties. I won't recommend the 2x dose going forward, and will re-eval dose for my Rose who has developed CKD since DM DX. She has been getting 3.5mg daily.

Thanks!

 

@Carol in Chicago -

It can be so tricky balancing treatments/supplements when dealing with multiple chronic health problems. I think sometimes one needs to assess the potential risks on paper against the quality of life of the cat when making treatment decisions. I think that if I had an early stage II cat (ETA: with stable kidney markers) recently diagnosed with diabetes and exhibiting signs of severe neuropathy I'd dose the B12 to help the neuropathy while working to improve BG regulation. All going well, with resolution of the neuropathy I'd ease back to the B12 dosing guidelines recommended on Tanya's site. Another time when I might up the B12 supplementation short term would be during a moderate to severe pancreatitis flare.

It's such a juggling act with multiple issues, and it can be very tough deciding which condition to prioritise (and always with the awful fear of making the wrong decision ... ).


Mogs
.

 

Oh well Silver has had 1000mcg every couple days and is none the worse off. Fixed his neuropathy in ten days. Worked for him anyways. The secrete our what they don’t need.

 

I am so glad this topic came up, I had no idea it may not be good to give B-12 long term.

 

I’d imagine it would only be needed until the neuropathy cleared?

 

Yep, that is what I learned today.

 

Thanks so much for all of that info! Girlie's potassium has been fine in all of her labs since pre-diabetic, but I'll make sure they keep testing for that.

I wonder who decided that cats with diabetes would be regulated within three months - and what that regulation would look like...? "Cats with diabetes are usually only given methylcobalamin for up to three months, until the diabetes is regulated," - but perhaps Girlie is odd in not being regulated within three months? Hmmm...

 

Thanks so much Carol! And I might ask @Critter Mom : how would you define the BG as being reasonably well-controlled or regulated?

I'm wondering whether Girlie would qualify as either (although she's looking fab on the human meter, she didn't look so fab on the AlphaTrak2). Any thoughts?

 

So the Zobaline tablets are 3 mg / tablet and the suggested dose is 1/day. Is this too much, then, @Critter Mom and @Carol in Chicago ? I'm assuming I could give Girlie 1/2 a tablet a day, perhaps?

Is there a difference between giving general B vitamin supplements and something like Zobaline (methylcobalamin)? I understood that there would be and that it was the methylcobalamin that was needed to address any sort of neuropathy - that just generic B vits wouldn't do that. Would it then be necessary to give the methylcobalamin as well as othr B vits as well?

@Marje and Gracie , do you have any thoughts on this?

Girlie is little (just under 8 lbs).

 

Me too.

Me either. Glad I decided not to order more for Gizmo. Although with his higher numbers, he might need a bit more. I believe he was on zobaline for 2 months (1 pill a day and I think 60 pills in the bottle).

 

I'm just looking at Girlie's SS: how strange that she seems to have her nadir as early as at AM+3, which is early for the Levmir, and then starts going up steadily after that. This is cycle 16 of the 0.1. I guess I'll try giving her lower carb foods to see how she goes with those...?

Don't get me wrong: I love the greens! I'm just wondering what's happened to her duration. But perhaps it's because the 6% carbs are now too high for her on the 0.1 Unit? There certainly doesn't seem to be enough wiggle room for a dose increase right now, so I assume I'll just let her keep going on this dose until a change is needed.

 

If you are giving methylB12 for anemia caused by CKD, she also needs to get a multiB vitamin. If you are giving methylB12 for neuropathy, she doesn’t also need the multi B vitamin. Since she has CKD, I would stick with the dosing amounts that Tanya’s discusses although it might take longer for the neuropathy to improve.

I gave Gus B vitamins (methylB 12 and multi B) for over three years for his CKD. He did really well with it and it kept anemia at bay.

It looks to me like she might be onsetting early, not nadiring early. She might have dropped a little lower today after onset but the 6% might have stopped her. I found that as Gracie’s dose got lower, the number of carbs it took to control her numbers was less and she was more easily overcarbbed. We’ll have to see what she dos the rest of this cycle.

 

You're right re: the early onset, Marje. I wonder why? I usually give her just a little bit of 6% for her pre-shot and then give her the 8%, but today I just stuck with the 6%. I'll try giving her lower carbs than that tomorrow during the day and see how she goes with that.

 

I dug into the B12 thing a week or two back (I lose my sense of time) as indeed, quite a few people here seem to use/have used it, sometimes to spectacular effects. In particular, I dug through the B12+kidneys thing, and honestly, what I found is that this seems to be an issue if you give cyanocobalamin (because the kidney's have to deal with the discarded CN groups to flush them out). If you give methylcobalamin (the bio-available version of the vitamin) then indeed, if it's not used, it just comes out in the wash.

I had decided to give some to Quintus, as his balance and hind legs were getting worse, but his BG improved so quickly and his general state improved at the same time, so for the moment I'm holding off ("if it ain't broke, don't fix it"). But I have the pills sitting on the counter.

If Quintus showed clear signs of neuropathy I would be giving him some without hesitation.

The only thing I'm not certain about is the dose. 3mg seems to kinda "come out of nowhere" (it's the dose Jasper was given -- the pre-zobaline version xobaline). In a thread that I can't lay my hands on, I asked people what dose of methylcobalamin they were giving, and if it seemed to be working. I remember there were a few people giving much lower doses (like 0.250 mg per day or twice a day) and seeing results. So my suspicion is that 3mg is way over the minimal efficient dose. As said, it seems to excess is flushed out, but if a tenth of the dose is enough, why give 10 times?

Hope this helps.

 

Thanks so much, Stephanie. Looks like the advice is to follow what's on Tanya's CKD website (see post #11 above with link). I think I will order it; Girlie is just so wobbly, yet her potassium is fine (labs are in a separate tab on her SS). Poor thing is a bit nauseated; she's been licking her lips since yesterday, so I just gave her a 1/4 tablet of Cerenia. I hope this helps her...

I've been madly trying to find a safe vet or reliable pet sitter to come stay at my house for two weeks (probably less as I don't think I can be away from her that long) at the end of February. Scary to leave her after what happened over Xmas at the vet's, though! I have an appointment with them on Monday to discuss what happened over those five days and why. I can't say I trust them with her again, though...

Anyway: thank you for that info, Stephanie!

 

Very helpful. Thank you.

 

This was for @Girlie's mom.

 

It's entirely possible your cat ALSO has arthritis. my vet said many cats over the age of 10 have it, and just about every cat over 15 has it. wouldn't hurt to add some cosequin/dasequin to the mix. If you give sub q fluids for the ckd you probably don't have to worry too much a out how much b12 you give as it will be flushed out. If you don't, you could try giving half the amount or half the amount every other day. sorry to hear ty is still struggling. I agree getting her bg under control is probably going to be the turning factor. It often takes more than a month. How much b are you giving?

 

I'd like to second that (there was a study that showed that 80% of cats over 8 or 10 years old had arthritis, or something). Quintus has had a wobbly gait for years due to arthritis. Arthritis can be checked for through palpation, x-rays, or giving painkillers to see if the cat starts jumping on the chair and moving more again. In Ty's case, if the wobbliness appeared in conjunction with the diabetes, that would point more towards neuropathy, I guess.

 

You've gotta try adequan shots for arthritis.... I'm telling you. Cc is so so much better since starting it. Her limp is much better (unless the weather is bad), more playful, and she gets on the bed and chairs much easier.

I also give b12. I was giving just b12 methylcobalamin by itself, but just this week I started giving zobaline. I have been breaking it in half and giving half in the morning and half at night. cc had some leg weakness which I think it's more from arthritis then neuropathy, but I figure it can't hurt to give and it might help with energy levels.

 

Thanks, will definitely look into it! I’m keeping the B12 handy, was just wary of adding another variable to the mix when things seemed to be improving so much... situation still feels fragile!

 

I've been giving Maggie Zobaline almost since the start of insulin. Definitely saw a quick improvement, although I'm sure the insulin play a part too. Did 2 tablets for the first month. After reading all this, I may stop for now and see how she continues to do. I also do Adequan, B12 methylcobalamin, and B-Right a multi-B vitamin.

 

What multi-B are you giving your kitties?

 

I don't think Zobaline is easy to split in 1/2 (it will easily crumble into a pile of dust). IMHO you should select the appropriate dose of methylcobalamin for nephropathy. You might try something like this. I believe it was @JanetNJ who recommended this brand but I bought the wrong strength. In light of this discussion, it may have been a happy accident!

 

From people here, I've heard many good reports about using Zobaline.

 

My best answer is “she’s a cat”. Gracie’s levemir curve was puzzling until I figured out that she was actually nadiring at +14/+15. She didn’t always do that but every spring when she always did so much better, she got this amazing duration and lots of green.....good carryover and overlap.

There are several lantus cats that are early onset....Asia and Sienne’s Gabby right off the top of my head.