Caninsulin - inject first then feed or other way round?

Hi everyone

Hope I'm posting this question in the right forum, this is only my second post. I'm currently using Caninsulin twice daily, 8 units each dose. Crystal was first diagnosed on 10 March and has been steadily working up to this level following weekly blood tests. I have just started home testing this week. I usually give the first dose betweeen 06.00 and 07.00 followed with the second dose around 17.00 - 18.00. I am doing my first curve test today, so far started at 27.9 mmol/L then came down to 21.6 at +2. My vet has told me to inject insulin before food, which I am doing, although there isn't much time between testing, injecting and feeding as Crystal is always ravenously hungry, usually all completed within 5 minutes. I've noticed a few people testing, then feeding, and finally injecting over a 30 minute slot. I am confused - what is the best order, am I doing it wrong?
I live in France and my normal vet is away on long term sick leave and I don't quite have the same rapport with her colleague. He hasn't told me too much, prescribed Royal Canin diabetic dry food (now ditched) and not mentioned ketone testing, which I'm also concerned about and will be off to the pharmacy to get some strips later today. I'm feeding wet canned food, Friskies terrines at the moment. Any advice would be very welcome.
Suki and Crystal

 

I'd probably test, feed, then shoot within about 15 minutes.

If he were really high at pre-shot(say over 400), I might test, shoot, wait 15-30 minutes, then feed, to allow the insulin to start knocking down the numbers before new food got in there.

There is frequently a food spike around +2 hours after the shot. Spreading out the food into mini-meals can keep that spike from being too high.

 

Hello and welcome to the board,

Are those wet foods in gravy or jelly? If jelly, they may well be low carb which would be good. However your insulin isn't that great. Have you spoken to the vet about lantus, levemir or prozinc? Those are better for cats and have a better chance of remission than caninsulin. Which is more for dogs.

You do not want glipizide, it's a pill designed to stimulate the pancreas to produce insulin. And the problem is that the pancreas is damaged already and glipizide just stresses it even more.. Making the problem worse!!

To convert your meter mmol/l to the vets mg/dl simply multiply by 18.

Cats with uncontrolled diabetes can't process food properly, so we tend to recommend you feed them as much as they want. Just watch their weight.

Wendy

 

I don't think ProZinc is available in France, though I could be wrong.
Hypurion PZI may be available and less expensive than Lantus or Levemir.

 

Thanks folks, I really appreciate your help and thanks for the welcome. I did my first all day test yesterday starting at 27.9, then 21.6 @ +2, 16.2 @ +5 (which I think is the peak for Caninsulin), 16. @ +7, 23.0 @ +10 and then 16.2 @ +3 (after second dose of 8 units) and finally 17.9 @ +6 just before bed. This morning her reading was 29.5 at 06.45 am and I've just taken a +2 reading of 20.9. so looks like the trend is downwards and then increases just before the second dose at approx 11 - 12 hour interval but she is obviously very high during the night. I've been leaving food out for her but she either scoffs the lot before bedtime or my 3 other civvies (one of which is also called Tiggy!) get to it so unless I get up about 3 am there is nothing for her until early morning.

I'm feeding her Friskies canned terrines, very meaty with just a little jelly. I let her graze all day but her hunger seems a little better over the last 2 days although she has lost a lot of weight and is a skinny little thing with a very fat belly. Tried her on some semi cooked chicken tighe yesterday but she wasn't impressed and left the lot, although she loves raw chicken (but I'm not sure about the bacteria aspect for this?) and goes crazy for tinned tuna in natural jiuce. She is showing signs of her old self and actually came and sat on me for a long cuddle yesterday, something she hasn't done for weeks and quite a surprise considering what I'd been doing to her all day. She also had quite a long grooming session, also something she has been avoiding lately, and generally looks a bit brighter despite her high readings. Even brought home a very large fat mouse but unfortunately she didn't eat it.

Haven't spoken to my vet about other insulins yet so I don't know what is available here, aiming for a visit next Monday for a comparable blood test and to check her weight. Noted your comments about Glipizide so I shall be warned if my vet wants to go down that route. Haven't been able to do a Ketone test yet as she is very elusive about her toilet habits and prefers to go outside when no one is watching but I shall keep trying, perhaps I'll catch her when she's in at night using the litter tray.

Thanks again
Suki and Crystal

 

Re-arranged so we can 'see' it better. Multiply by 18 for mg/dL.
AMPS ~ 27.9, 8 units
+2 ~ 21.6
+5 ~ 16.2 (which I think is the peak for Caninsulin)
+7 ~ 16
+10 ~ 23.0
PMPS ~ ???, 8 units
+3 ~ 16.2
+6 ~ 17.9
AMPS 29.5 (at 06.45 am)
+2 ~ 20.9

We're all in different time zones, so we reference tests by how long it has been since the shot. Deciding if numbers are heading too low and what to do depends on how long it has been since the shot.
Please always test before you shoot.

 

thanks for making it clearer, the PMPS test was +10 at 23.0 just about an hour before I gave her the second dose that's why I didn't take another test but will try n future. Crystal was a bit uncooperative yesterday and the PMPS test was abandoned after 5 attempts to get blood and then she bit me so thought it best to calm her down and try later. Some days are better than others I've found, even over the short time I've been testings (6 days). C'est la vie as they say here.
Regards
Suki & Crystal

 

thanks for making it clearer, the PMPS test was +10 at 23.0 just about an hour before I gave her the second dose that's why I didn't take another test but will try n future. Crystal was a bit uncooperative yesterday and the PMPS test was abandoned after 5 attempts to get blood and then she bit me so thought it best to calm her down and try later. Some days are better than others I've found, even over the short time I've been testings (6 days). C'est la vie as they say here.
Regards
Suki & Crystal

 

thanks for making it clearer, the PMPS test was +10 at 23.0 just about an hour before I gave her the second dose that's why I didn't take another test but will try n future. Crystal was a bit uncooperative yesterday and the PMPS test was abandoned after 5 attempts to get blood and then she bit me so thought it best to calm her down and try later. Some days are better than others I've found, even over the short time I've been testings (6 days). C'est la vie as they say here.
Regards
Suki & Crystal

SORRY THIS IS APPEARING 3 TIMES, A COMPUTER GLITCH THIS MORNING.

 

Hello Suki and Crystal,

Regarding insulin, I think the situation in France is much as it is in the UK: Caninsulin is used first - and continues to be used - unless it becomes evident that it isn't working well for the cat.
And if it isn't working well then your data from hometesting will be your best friend when it comes to persuading your vet to let you try a different insulin.

Lantus and Levemir are available in France, and I think there is a preference there for Levemir over Lantus.
Hypurin Bovine PZI can also be bought (with a vet's prescription) from online pharmacies in the UK; but given that Lantus and Levemir are already available in France those may be your better options.

Regarding food, I'm guessing that you have a Zooplus that you can order online from?
Zooplus do lots of good wet foods for diabetics including; Bozita, Grau grain-free, and Catz Finefood (all the Catz Finefood flavours except the Rabbit one, which is slightly higher in carbs than the others).
And if you are able to get Granatapet in France (or Ropocat, or Mac's grain-free), then those are really good too.
You may find this thread about foods in Europe (and elsewhere outside of the US) useful:
viewtopic.php?f=28&t=64843

If any new foods are lower in carbohydrates than what you're currently feeding Crystal then it'll be important to monitor her blood glucose during the food change. That's because her blood glucose may drop and less insulin may be required.

Welcome to FDMB!

Eliz

 

Hi Eliz (& Bertie)
Thanks for your helpful comments, sorry for the delay in answering, had to go out most of the day and was busting a gut trying to get home in time for Crystal's test and shot but was an hour late but hopefully no harm done - I'm feeling quite stressed by it all at the moment and it has taken over my life but hopefully things will calm down (for both of us) as I get more adept at handling the situation. I'm going to try to research the online food available over the weekend and see what's available, (thanks for the link and food suggestions). Will be seeing my vet on Monday so would like to have as much info available, plus my spreadsheet, as he was talking about glipizide pills, which someone said was the last thing she needs, so a little more research to be done on that too so that I'm fully prepared.

Thanks again
Suki & Crystal

 

Per Dr Pierson of Cat Info, you can add 20-24% plain meat or poultry to cat food to boost the protein content and reduce the carbs.
Use cooked with canned, raw with raw.

 

that's a good idea, hadn't thought of that, thanks.
Suki & Crystal