5 Units Insulin Pen M/D Canned Food & pretty bad neuropathy

Discussion in 'Feline Health - (Welcome & Main Forum)' started by avogel, Jan 20, 2010.

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  1. avogel

    avogel New Member

    Joined:
    Jan 16, 2010
    Hi, Just looking for some insight. My male cat was dianosed about two+ months ago. He is about 8 years old and has always been a large cat. The neuropathy and water intake came on pretty quickly. We started at 3 units of Lantus SoloStar insulin. We have gradually moved up to 5 units, he has been to the vet for a glucose curve once. The vet said she thought it was not all that bad because his levels did not spike throughout the day. I don't feel like we have gotten much information from the vet. She is open to allowing use to test at home but we have not had much luck getting enough blood for his ear to get a reading. Since he started insulin he demeanor has improved he is not as lethargic as he had been and he is better at grooming himself. However he still seems to be drinking alot of water and urinating a lot as well. Needless to say the neuropathy has not improved much either. Unforunately, due to his neuropathy and I am assuming the diabetes he is not always making it to the litter box and ends up peeing on the carpet. I spoke to my vet about using methly B12. She was open to the idea but concerned with the additional chemicals that could be present with human supplements. She suggested that we try using an injectable B12. He has had two doses of the B-12 as recommend in a once a week dose. I know I should be patient but I am concerned that the injectable B-12 will not be as effective as the methly B-12. I would love to find a vet in the area that has more experience with feline diabetes but it seems impossible to determine if a vet might be a specialist in this area. Any suggestions would be greatly appreciated. Thank you.
     
  2. Chloe and Kipper (GA)

    Chloe and Kipper (GA) New Member

    Joined:
    Jan 3, 2010
    Welcome, so glad you are here. Many members have had to either find a vet in perfect harmony with how we treat here (long shot) or just taken over the care of our sugarcats. Treatment is basically 1, 2, 3, and sometimes 4.

    1. TESTING: The best treatment depends on testing. I use (many members use) the Walmart brand glucometer, ReliOn Micro, along with their lancets, and, of course, the testing strips for the ReliOn Micro, which takes just a dot of blood and needs just the smallest size sample on the market. Some free hand it with the lancet, something I never accomplished, and some use a lancet device (I use the Soft Clix so I can set the depth, aim better, and the spring mechanism makes quick work of it).
    ReliOn Micro glucometer kit (comes with a case and a lancet device) $12
    ReliOn lancets (I use the 31 gauge) is $3.75 or so for 100 count and only $6.50 or so for 200 count
    ReliOn Micro testing strips are about $21.74 for 50 count.

    Home testing is the way to treat.

    2. INSULIN: Lantus is used by many members and a great choice by your vet. The insulin board here can help you with dosing. I can tell you 5 units twice a day is a monstrously high dose and I am sure the high carbohydrate food you are feeding is making that high dose work, for now. Vet has prescribed an excellent insulin for kitty.

    3. PROPER FOOD: Check out Binky's list and find wet/canned or raw food that has under 10% carbohydrate, and at the beginning feed as much as your baby will eat, but DO NOT SWITCH TO LC FOOD UNTIL YOU ARE TESTING AND START AT 1 UNIT TWICE A DAY. Switching to the right food had drop kitty like a rock. Vet here is wrong on food choice.

    4. For neuropathy, I have been giving my Kipper who had severe diabetic neuropathy the MB12 (methylcobalamin) from Vitcost and he is doing beautifully. Other members have had good to great success.

    Hope this is helpful for you to get started. There will others along who will chime in and help you.
     
  3. Karen & Pearl

    Karen & Pearl Member

    Joined:
    Dec 28, 2009
    It *has* to be methyl B12. Lots of cats take what you get at the healthstore, so there is no concern there. It's quite possible you have missed your cats best dose of lantus. Vets always start up higher, but really, you should start at 1u and work your way up. I'm so glad you are trying to home test! It's SO important. Have you seen our tips and videos? Have you tried warming his ear really well? I used to dampen a washcloth and put it in the microwave for a few seconds and put it in a sandwich bag (test it on your ear first - it should just be quite warm) and hold it on the ear 15 to 20 seconds. Others use rice in the toe of a sock warmed in the microwave. It REALLY helps. Keep something firm behind the ear. I personally find my finger behind the ear with a setting of about 2.5 on the lancet device and use quick firm pressure works best. Try it on your finger to get an idea of how much pressure.

    Lantus and levemir often give long flat readings. That's their beauty, so it's no wonder that the vet isn't seeing spikes. That doesn't mean anything if those numbers are very high. You can see improvement so that is good, but honestly, your best bet right now, if I were you, I'd want to go back to 1u twice a day and get your testing down (if you live near someone they would gladly come over and show you). Also, it's easier with something like the Relion Micro from Walmart or the Aviva or Freestyle that take TEENY amounts of blood. I don't know what meter you are using. Once you can do that and track the numbers, you can look at switching to a wet low carb food. There is truly no worry about using the methyl b12. People with more experience can tell you how much they use. He CAN come back from this.

    Let us know what city you are in. Someone might be near enough to help in person.
     
  4. JJ & Gwyn

    JJ & Gwyn Member

    Joined:
    Dec 28, 2009
    > We started at 3 units of Lantus SoloStar insulin. We have gradually
    > moved up to 5 units, he has been to the vet for a glucose curve once.

    Lantus is a great insulin to work with, and kudos to your vet for choosing it for you; many vets recommend older insulins which aren't as good as Lantus. Unfortunately, it also appears that your vet is treating Lantus as if it were one of the older insulins; it isn't, and it has to be handled differently. You really should re-start the Lantus at 1 unit twice a day, and then very gradually work your way up from there. There are a lot of folks here using Lantus (I'm not one of them), and they can help you with recommendations on dosing.


    > She is open to allowing use to test at home but we have not had much
    > luck getting enough blood for his ear to get a reading.

    Are you using a regular human glucometer, or a pricy one the vet sold you? The vet glucometers usually need more blood than the human ones; they're also way more expensive, and the strips are harder to get as well as being more expensive. A human glucometer is just as accurate, less expensive to buy, and the strips are easier and less expensive to get.

    On testing: are you warming the ear beforehand? A warm ear is one of the keys in getting blood samples. A lot of folks use a rice sock to warm the ear beforehand, or rub the ear between our fingers to encourage circulation. You can also 'milk' the ear for blood after pricking. Finally, if your cat is a head-shaker, you can gather the blood on your fingernail before it's shaken off, and test from there. Other than that, check out Hometesting Links and Tips here http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287.


    > However he still seems to be drinking alot of water and urinating a
    > lot as well.

    The drinking and urinating will clear up as the diabetes comes under control.


    > Unforunately, due to his neuropathy and I am assuming the diabetes he
    > is not always making it to the litter box and ends up peeing on the carpet.

    Do you know that it's neuropathy? A lot of cats with unregulated / under-regulated diabetes develop urinary tract infections, and urinating in inappropriate places is one of the signs of a possible UTI.


    > Needless to say the neuropathy has not improved much either. [...] I spoke
    > to my vet about using methly B12. She was open to the idea but concerned
    > with the additional chemicals that could be present with human supplements.
    > She suggested that we try using an injectable B12. He has had two doses of
    > the B-12 as recommend in a once a week dose. I know I should be patient but
    > I am concerned that the injectable B-12 will not be as effective as the methly
    > B-12.

    There are two types of B-12. The type that's most used is cyanocobalamin; the not-much-used-at-all type if methylcobalamin.

    *If* your vet is giving injections of methylcobalamin, then that's more effective than oral methylcobalamin. If your vet is giving injections of cyanocobalamin, that is probably less effective than oral methylcobalamin. (In all probability, your cat is getting injections of cyanocobalamin.)

    You *can* start your cat on oral methylcobalamin, which you can find online or at some health food or vitamin stores. Some brands contain sugar and others don't, but most of us don't worry excessively about that. Nor, for the most part, the other ingredients. (I tend to stay away from those with mannitol, sorbitol, and xylitol, but my Gwyn has a *lot* of problems.)

    Please note that the cause of diabetic neuropathy is diabetes, and the only real cure for it is to get the diabetes under control. If the diabetes isn't controlled, then the methyl-B12 can help slow the progression. Once the diabetes is under control, the cat's neuropathy will start to heal on it's own, and the methyl-B12 can help speed the healing. But the methyl-B12 won't work on it's own; you need to control the blood sugar levels.


    Has anyone talked to you about testing for ketones? Ketones are a not-common side effect of unregulated or under-regulated diabetes. While they're not common, they *are* (unfortunately) one of those problems that, if they do occur, can turn Very Bad (quickly. Low levels of ketones may be treatable at home; high levels of ketones may require hospitalisation at a 24-hour care facility. You can read more about ketones here http://petdiabetes.wikia.com/wiki/Ketones.

    To test for ketones, stop by the diabetes section of your local pharmacy and pick up ketostix. You stick them in fresh urine and, if ketones are present, the strip on the stick changes color. (Larger color changes indicate the presence of more ketones.) IIRC, it's about $15-20 for a bottle of 90 sticks.


    Also, does your cat have any other health issues going on at the moment, besides the diabetes and the urinating and the neuropathy? I'm asking because a lot of times a cat will be borderline diabetic and something happens -- inflammation, infection, pain, something -- and the blood sugar levels rise because of the problem and the cat becomes a full-blown diabetic. If you can treat the cause of the increased blood sugar levels, you increase the chance of getting your cat into remission (that's where your cat doesn't need insulin). So if there were any other health issues present, even something comparatively minor like tartar on the teeth, I'd suggest getting those treated sooner than later.


    The two other things you're going to hear about from a lot of folks here is to switch to a low-carb food. Changing over to a low-carb canned (or raw) food will definitely lower BG levels, and lower the amount of insulin your cat needs. A low-carb diet is one of the key components in getting any cat into remission. However, please do not change diets until you're fairly comfortable home-testing blood sugar levels; with the levels of insulin you're giving at the moment, changing diet without home-testing could have Bad Consequences.

    If you have any questions, feel free to ask; we're all here to help each other.
     
  5. Spacey & Ella

    Spacey & Ella Member

    Joined:
    Dec 28, 2009
    How do you know its neuropathy??
     
  6. kate and lucky

    kate and lucky Member

    Joined:
    Jan 3, 2010
    Hi,

    As others have said 5u is an extremely high dose. The majority of cats here are on between .5-2.0u as a rough guide. They have got to that dose by starting at 1u and increaseing in incremets of .25u. This is so they don't mis the ideal dose.

    Do you have any bg readings you can share with us?

    Can you tell us what food and how much you are feeding?

    Lantus has given superb results in terms of getting cats into remission and being diet controlled, but this can take time and as I said above by not missing the optimal dose.

    If you can, try and get a bg reading before you feed and shoot the insulin (am/pm either is fine) and then again at +6.
    Any readings taken at vets usually have a stress factor in them (fight or flight response)so your readings at home will be far more accurate. If your usung a penlet you can go as high as setting 4 (we used that and didn't go through the ear). Milking/stroking above and below where you have pricked will help the blood spot show.

    As for neuropathy, here is a link that has been given to other users for kitties in the past. Gives you information on methylcobalamin and general facts about neuropathy:
    http://www.lifelinknet.com/siteResource ... e-cats.asp


    Can you confirm that your kitty is walking down on his hocks (both of them) and possibly has dificulty jumping.


    If you can provide the above information we can help you with the next step.It is immportant that you go to a pharmacay and get some ketodiastix.These are urine strips and test for keytones (main cause is lack of insulin). You have to be mindful of these when working on finding a cats ideal insulin needs.It can be a life threateneing condition and hence the need for observation.

    Also worth considering the comment about a possible UTI and missing the litterbox.

    Is he peeing, pooping, playing, preening, purring ok (commonly known as the 5p's! :smile: )

    Please keep asking questions there lots of advice and support available on this board. It can seem overwhlming but once you get into the swing of it, all easily manageable.
     
  7. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
  8. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    What symptoms did you see that led you to determine neuropathy?

    When Maui had neuropathy she was walking on her hocks (flat footed) and it was like walking on her knees. She couldn't jump and had to stop and rest.

    I looked around for a methyl b12 product and found this one that I chose, because it does not contain additives or any chemicals or anything that could be bad for a cat.

    http://www.vitacost.com/NSI-B12-Methylc ... 0-Capsules

    Ingredients:
    Vitamin B12 (methylcobalamin) 5 mg 83,330%
    Other Ingredients: Kosher gelatin (capsule), rice flour and magnesium stearate.

    I mixed one capsule daily in Maui's breakfast. She usually consumed most if not all of it and what she didn't eat, I wasn't concerned as she was getting enough in her system.

    There are other brands and types available, but I chose this as it doesn't contain any sugars and the rice flour was minimal. She also didn't get the capsule itself.
    Did you immediately start at 3 units?

    We ask because the typical starting dose is 1 unit or 1/2 unit. And over the course of time (after an initial 5-7 days) the dose can be adjusted, as long as you have the supporting home testing BG data to go with it.

    It is very possible that the 3 or even 5 units of insulin is way too much for the cat.

    While yes there are cats that do require a lot of insulin, the amount is worked up to over the course of time and with the collection of BG home test data. In some cases additional vet testing is needed to determine if the cat has acromology and will require higher doses.

    But until that is determined the recommended starting dose is 1 or 1/2 unit.

    If you have not yet done it, please go to the Lantus forum and read all the starred posts at the top of the section. This will give you tons and tons of information and tell you practically everything you need to know about handling, storage, usage, dosage of Lantus.

    It's nice that your vet is open to allowing you to home test - however - YOU DO NOT NEED A VET's permission to home test. Remember this is your cat and you are the one responsible for him, nobody else.

    What is the vet going to do, if you home test - send the testing police after you and take away your meter? Sorry, don't mean to be facetious but I find this kind of attitude unacceptable. (I had a vet who forbade me from home testing - I no longer use that vet).


    An unregulated cat will continue drinking and peeing a lot, once the cat gets regulated on an appropriate insulin dose, these issues will lessen and eventually return to normal.

    Also, please tell us what type of food you are feeding the cat.

    The ideal foods are low carb canned or raw. Dry food is not recommended, nor are temptations, pounce style treats.

    However, before you remove dry food, you MUST be home testing because a food change can lower the BG levels and reduce the need for the amount of insulin current being used.


    Again, this is another reason why home testing is vital.


    Finally, please tell us where you are located. There may be members in your area who could provide in person support and help teach you how to home test.
     
  9. ceil99

    ceil99 Member

    Joined:
    Dec 29, 2009
    Welcome to our FDMB family and be patient with yourself. You sound like you really love your cats, so you have come to the perfect place. Get some chocolate, sit back and get ready to read. Also, remember Every Cat Is Different. (ECID) Also, remember opinions may vary sometimes on this board, so you may get different views. Unfortunately, that is human nature.
    Sorry this is very long, but there is a lot to say! Also, remember we were ALL newbies once and are feeling just like you are right now! :) OK……..breathe………. :RAHCAT

    You do not need any type of prescription food or “special” diabetic food. Use Janet & Binky’s chart at http://binkyspage.tripod.com/canfood.html. . Low carb is best for diabetics. I try to stay around 10% or under. I feed Whiskas, 9-Lives and mostly Friskies. Diabetes is very treatable and does not cost as much as you would think. If you are giving a high dose of insulin and feeding dry, be careful with switching to canned food. You MUST reduce the insulin at the same time you switch to canned food.

    Please create a profile if you have not already done so (viewtopic.php?f=6&t=531). It will help us to help you. We need to know what kind of insulin you are on, what needles you are using (U-40 or U-100), what are you feeding, how much insulin you are giving and when, BG test results, etc. There are many people on this board from all over the world, so it will be helpful to know what area and time zone you are in. :coffee:

    Remember that your cat is YOUR cat, and YOU are paying your VET to help you take care of him; diabetes was probably a day or two worth of notes when the vet was in college; it is probably NOT a day-to-day existence with his own cat trying to maintain a quality of life. Sorry to say, but I would have overdosed my guys on insulin if I followed my vet's advice. Vets, unfortunately are not as knowledgeable as they should be on diabetes.

    Sometimes, as I did, you have to take a leap of faith and trust these people on this board who deal with diabetes day in and day out. Trust me. You will not be disappointed. OK………..breathe again……….get some chocolate…….. cat_pet_icon

    Also, please realize that it takes insulin about a week to settle. START LOW AND GO SLOW!! The usual starting dose from our experiences is 1u twice a day for at least a week. Insulin in cats is NOT and I repeat NOT based on weight. This is a misconception that a lot of us have gotten from our vets here. pc_work

    You have to be patient, as I also had to learn!! Do not adjust the dose upwards based on one test. Don’t freak out based on one test result. As long as the levels stay on the high side, keep the same dose twice a day for at least the initial week period and you should see improvements. When you have some time (hee hee), read my profile doc at http://docs.google.com/View?id=dfqss8sg_1cpgwhbd9 .


    If you are not hometesting already, you really need to start!! Hometesting is VERY important. Most of us here us any human meter. Think of it as a human diabetic does. *If it were you or a child of yours, you'd be testing blood glucose levels at home prior to each shot; you'd be working with your doctor to determine a proper dose based on those shot results, correct?* Some vets do not agree with hometesting and I cannot for the life of me understand why. Most vets, sadly are not knowledgeable enough in feline diabetes. Insulin is a VERY powerful drug and you NEED to hometest before giving a shot. This is very important. The vet would rather have you bring the cat to them, stress it out more, which may spike the levels anyway and then they can charge you $$. Hometesting saved me a lot of money and it is VERY important for you personally to know the cat’s levels and how it is reacting to the insulin before you shoot so you do not pass up your ideal dosage.

    Thanks to everyone's help here I learned to home test 2 cats and they both got off insulin within 3 weeks with diet change…but of course, they reacting both DIFFERENTLY with the process. If I can do it with 2 cats twice a day (and more on curve days), ANYONE can do it. It does NOT hurt them as much as you think it does. It just stings for a moment and then it is gone, you can try it on yourself. Also, put pressure on the ear after poking and it should minimize the nub. They won't mind it once they start feeling better. I use the True Track meter (CVS or Walgreens brand) which I love. And, the strips are also reasonable. Also, remember to give them a treat after the test. Here is a link to a member videos on hometesting:

    http://www.youtube.com/watch?v=_zE12-4fVn8
    http://www.youtube.com/watch?v=cZ6iXetR398

    I would not feed DRY food if at all possible. Of course, it is better than nothing – you MUST get them to eat if you are giving insulin, but if there is any chance, get them off the dry. I took my guys off dry and within a month they were off insulin. Again, remember that switching from dry to wet can cause a drop in blood sugars, so you MUST reduce insulin at the same time to make sure you are not giving too much insulin. I truly believe also that I saved some of my many others from developing diabetes. I also saved so, so much money changing them all to regular canned cat food.
    When Blackie and Jackie got diagnosed, I was afraid to start shots. The people on this board made me realize it was no big deal. (They went on PZI insulin around 3-25-06 and went off on 4-18-06! :) Please also realize that diet plays a BIG, BIG part in insulin needs. I switched my cats off dry food to all wet and I was never so happy. It was a challenge to try to regulate 2 cats at once.


    Welcome to the Sugar Dance. flip_cat
    Welcome to the Vampire Club.

    If I can do it, ANYONE can!!!
    It does get easier. Trust us.

    You need to test BEFORE you shoot. It usually goes: Test, Feed, Shoot



    There's a saying something like "better the sugar level is too high for a day than too low for a minute".
     
  10. cyndi and fuzzy

    cyndi and fuzzy Member

    Joined:
    Jan 4, 2010
    I am not a pro on this by any means but did want to address the B-12 issue and neuropathy. If it is in fact neuropathy, Xolbane B-12 or the Methyl is good for it. my cat was diag with diabetes two years ago, i had been gone and the neuropathy was so bad upon my return home that his back legs are actually bent like a rabbits, but the xolbane B-12 has worked wonders, fuzzy now jumps not only down but also up again, he can go from a kitchen chair to a counter top, with no claws...I get my B-12 from a site called Lifelink.com, they sell vitamins and have the special b-12 that says for cats, comes in 3mcg tabs and i have given fuzzy one twice a day for two years, I crush it up in his food. I swear by it. First thou make sure thats what it is. Good luck, there are alot of very knowledgable people on this site for you to get info from.
     
  11. avogel

    avogel New Member

    Joined:
    Jan 16, 2010
    Thank you for all of the great information. It is almost overwhelming. We are going to look into a new food for Oscar, since many have said that the M/D is not the best. So it is my understanding that it is more important to look for low carbs. Our vet recommended high fiber and moderate fat food. We will be biting the bullet a getting on the testing bandwagon. We have the Bayer Contour meter. As far as the nueropathy, I a pretty certain that is what his condition is. he walks down on his hocks on his back legs only. When he was first diagnoised we had a full line of blood work done to ensure that there were no other underlaying conditions. I have purchased a methyl B-12 suppliment and we think we will still continue with the injectable suppliment as well since it is a water soluble vitamin. This will be an interesting journey.
     
  12. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    Good news ! You will NOT regret hometesting

    Jen
     
  13. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Do you know what kind of B12 the injectable is?
     
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