Caninsulin question

Discussion in 'Feline Health - (The Main Forum)' started by Tilou, Feb 3, 2018.

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  1. Tilou

    Tilou Member

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    Jan 20, 2018
    Hi - I'd be interested in comments from anyone using Caninsulin three times a day, as they find it doesn't last 12 hours, on what's happening with Bob's glucose readings...

    We've been using this regime for a couple of days now, dividing Bob's injections (from 3ui in morning, 2ui at night) into 2ui in the morning (around 6am French time), 2ui eight hours later (2pm), then 1ui at 10pm.

    However on checking his blood glucose, four hours after his 2pm shot, yesterday and today, we've had readings of 19 and 23 mmol/l, respectively.

    I thought that we'd see a dip in glucose levels by that time, especially as his last meal had been mid morning, so can't work out why it's staying so high.

    I don't want to increase his next dose (1 ui at 10pm) in case of any problem overnight while we're sleeping.

    Is this usual in newly diagnosed diabetic cats?

    One thing to note, Bob is no longer spending any significant time at the water bowl and has become quite active again, spending time in the garden in the early hours on mouse hunts!
     
  2. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Welcome from neighbouring francophone Switzerland!

    Less drinking and more active is indeed an encouraging sign :)

    I think it would be interesting to get a more close watch on his BG. Would it be possible for example to monitor every two hours for the whole day? Or get enough spot checks that a picture starts forming?

    It helps to put all your measurements in a spreadsheet like this one: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    This is what most people around here used and we're used to reading and interpreting numbers in that format. If you need any help setting one up just send me a PM (click on my name, Start Conversation). I have a French version but despite the France address you seem to be an English-speaker ;-)

    A few questions that might give useful information:
    - when was Bob diagnosed?
    - did he develop diabetes following pancreatitis or cortisone use or any identifiable "cause"?
    - what food is he eating?
     
  3. Tilou

    Tilou Member

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    Jan 20, 2018
    Bonjour Stephanie

    Thank you for your reply. We are Brits resident in France (near Calais), hence the use of English ;)

    I've seen mentions of the s/s on the forum and having read through the link you kindly provided I will make a copy on my laptop to use. Unfortunately it would be quite difficult to get two hourly blood tests from Bob, as he retains an element of his feral nature that he arrived here with and it would be more likely that I'd be the one donating the blood!

    I am though building up a picture of the effectiveness (or otherwise) of the insulin - although his three times a day regime has only been running for three days now - by taking the chance to do a test when he's sleeping. I have to use his pads as he does not like his ears being touched.

    Bob was officially diagnosed only three weeks ago, although I'd had my suspicions since before Xmas. Unfortunately he was ill with an infection that masked the diabetes when we took him to the vet back in November, so was only treated for that. It was a weekend of incontinence in January that saw us back at the vet, where the blood test revealed his diabetes.

    The cause was most definitely his being overweight. He weighed 8.5kg last January, so we'd had him on a controlled diet. By July he was down to 7.5kg, then in November he dropped to 6.5kg with an infection, but by January he was down to 5.5kg (again this rang alarm bells). He's now stabilised at 6kg.

    Bob's always been principally a wet food eater, who takes a munch at some biscuits. The vet, naturally, played on our ignorance and sold us a bag of Royal Canin diabetes biscuits and decreed that was what Bob had to eat for the rest of his life! But he wouldn't eat them, so having found this forum, I discovered the recommended wet food and initially got him some Almo Nature tins and RC diabetes wet sachets, as that was the only thing locally available.

    I have since ordered a variety of tinned low carb wet food (via ZooPlus) and both Bob and our non-diabetic cat, Joey, are happily testing the different varieties. Favourites are the Almo Nature (chicken and tuna) along with the meat varieties of the Integra diabetic range. They've turned their noses up at the Fine Food and Granata tins!

    Apologies for the ramble - but hopefully this will give you an idea of how we're getting on. (Btw, husband is diabetic too, so I'm now watching the pair of them for potential hypos!)

    Best wishes, Tilou
     
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  4. Tilou

    Tilou Member

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    Jan 20, 2018
    NOTE: I've just input Bob's data into the WRONG SS! Tried to copy and paste into the Worldwide one and it's a total mess. Blast!

    UPDATE: SS now available. Please read the Remarks column as Bob's current insulin regime is three injections a day, not two as per the SS format. Thanks.
     
    Last edited: Feb 4, 2018
    Reason for edit: Update
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  5. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Well done on the spreadsheet! That will definitely help.

    The problem you'll have with the SS is that it's designed for injections 12 hours apart. If you're doing three injections a day it would be good to try and make that visible on the spreadsheet by moving the PM columns to be at +16 and adding a +8 injection one in the middle. I'm not sure how to read it at this point.

    Here we try to at least test before injecting insulin (like humans... you don't want to inject a cat whose BG is too low!), and try and get at least another test somewhere in the day, and do a curve every now and again (every two hours, though I'm not sure with caninsulin).

    Completely appreciate the challenge of having a tricky cat to poke and having to balance that with how much data you want/need. Some ideas:
    - have you been working on desensitising his ears? when he's relaxed or getting scritches, try and involve the ears. Stay below his "no way!" threshold and back off if you hit it, but continuing with the pleasant stuff. The worst part of testing for the cat is not so much the prick as the fiddling with the ears, but if you can work on that multiple times a day in tiny doses (baby steps), you'll probably be able to get somewhere
    - are you treating after you test? this helps create a positive association. Most people have a small ritual. Same place, same sequence of events, ends with a lovely treat.

    I don't have direct experience with caninsulin, so really not sure if people here have tried the 3x/day regimen or not. Hopefully some of the vetsulin/caninsulin people will chime in.

    FWIW, if your vet is open to discussion, you might want to see if you can get him switched to ProZinc or Lantus/Levemir, where you'll manage with only two injections per day, and where (it seems to me based on hanging out here and doing some research) you'll get better results.

    Caninsulin was developed for dogs. Cat metabolism is faster, so the effect of the insulin is often shorter, which is probably why you're on a three-per-day regimen.
     
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  6. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Oh, forgot: are you familiar with bouncing? Keep it in mind when you see high numbers, that they could be there because they are following low numbers. Hence the interest in testing.

    Quoting from a sticky in the LL forum:
    • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
     
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  7. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    And another thing (goldfish brain day): usually the idea is to try and find a dose you can use consistently from cycle to cycle rather than varying greatly (4ui once, 1ui after). I think if you go to the caninsulin forum you might find instructions on how to deal with finding the right dose. It's also important to feed consistently over each cycle, as food input is the other part of the equation.

    With caninsulin I think the best is to test and feed, then wait 20-30 minutes before shooting to make sure food is "on board".

    http://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/
     
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  8. Tilou

    Tilou Member

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    Thank you again for the information. Despite living with a human diabetic for 35 years I'm currently finding this whole experience a veritable mine field and very stressful :banghead:

    I've tried to take a glucose test before Bob's 2pm shot and, despite having a good drop of blood, I had three strips come up with error! I'm really not impressed with my machine's failure on this, given the price of the strips, and am considering returning it and sourcing a cheaper human variety.

    I tried to put an extra column in the SS to reflect the additional insulin shot, but failed miserably. I actually managed to corrupt my original copy of the SS :(

    Our vet is good but he's not receptive to being questioned or taking on-board alternative suggestions. He falls into the stereotypical French man "I'm in charge, you know nothing" category. He sent us away after the follow up blood test last week with a "see you in a few months" after telling us to alter Bob's insulin according to our meter readings. I got the impression he was not happy with us home testing as that loses him €40 every time.

    Interesting info re the "bounce". I'll have to ensure that is not what we are experiencing and try to get some more tests done - once I can resolve this meter/strip problem.

    I will soldier on using the information you have provided.

    Merci bien ;)
     
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  9. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Courage et bonne chance!

    You can use a human meter. I’ve heard ear is less painful than paw, so I’d work on getting friendly with those ears. Recipe for cats: lots of repeated small events that go well.

    Humans vs cats: humans can tell you they are starting to feel off when they drop. Cats can go from fine one second, seizing the next. Also, more complicated to control the cat’s food intake than the human’s (normally...).

    Sorry about your vet. I’m working with a group of francophones on this board, from France, and it seems caninsulin is the gospel and me vets are indeed quite firm in their beliefs. We had a kitty diagnosed diabetic right behind a pancreatitis without a fructosamine test. 1ui caninsulin morning and evening, don’t test, come back in a week. By the time we talked the C.G. into testing the cat was giving 0.9g/l whenever they tested. No, it’s not that the meter didn’t work, it was that the cat wasn’t diabetic, like we thought from the start. The vet actually said the meter had to be wrong — only to backtrack when he did a curve (er... line) at his clinic.

    Not to bash vets, they need to know everything about everything and not just for cats, but it seems diabetes is really a poor parent here.

    A French vet friend and I have been digging around for sources since Quintus was diagnosed, and honestly, we didn’t find much in French that was up-to-date (not surprising, most research is in English...). It saddens me once again to see what serious consequences a language barrier can have.

    Sorry, got lost in my musings here!

    Keep us posted on the progress and fiddle with those ears (while you do something pleasant, then treat!)
     
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  10. Tilou

    Tilou Member

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    Jan 20, 2018
    Merci!

    I know how difficult it is here in France, as I've had to source all the equipment from the UK - even the urine strips. I can understand their protectionism, but it is a little frustrating. In general our vet is brilliant - he's had to deal with all eight of our cats over 14 years - but he is very set in his ways.

    I shall have to try and get Bob used to having his ears played with. He's never been a "treats" cat, unfortunately. He arrived here as very nearly feral in 2006 and spent 5 years having to be kept separate from the other cats. Eventually we got him to integrate - as the others got older and no longer cared too much to defend their territory from him. We don't even really know how old Bob is, so we are just grateful for every day we have with him.

    Love your musings - mine tend to be more on a par with ranting, LOL
     
  11. Tilou

    Tilou Member

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    Jan 20, 2018
    Just venting my frustration...

    Another two Alphatrak strips wasted! Plenty of blood from Bob's pad, but strips came back with error! I'm beginning to suspect I have a batch of "bad" strips. They are the ones that came with the machine, are dated July 2018. I have four left, only got 11 readings from the rest. I've made a request to the Amazon marketplace seller to see if I can return the machine. Really annoying as I've ordered a new pack of strips (£50 for 50!) so I'll have to return them as well.

    :mad:
     
  12. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Imagine Switzerland! Can't even get stuff shipped from http://www.vetboutiquedupiemont.fr -- cheapest AT strips I've found. Luckily I'm not far from the border and have friends on the other side.
    Is there anything he likes? A special scratch, rub, pet? toy? have you tried stuff like tiny bits of chicken?
    So, first thing, just to make sure because I missed the obvious for quite a while and it resulted in a lot of wasted AT strips: are you clear that the little pointy things on the side of the strips are designed to puncture the membrane of the blood drop? There is a tiny canal in them that aspirates the blood. Once I understood that it completely changed the angle with which I approached the blood drop, aiming to "lance" the drop with the pointy thing rather than "apply" the side of the strip to the drop. Tell me if it makes sense.
     
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  13. Tilou

    Tilou Member

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    Jan 20, 2018
    Wow, that is a better price for the strips given I've just ordered them from UK at £47 + £4 postage. If you ever need anything from here and your friends are unavailable to help let me know.

    Bob is such a funny creature, he really doesn't have any little foibles that can be exploited, apart from a love of butter!

    Re the strips, I've been putting the pointy bit right onto the blood drop and getting no reading. Then when I reset and try again the strip fails with the error message. I've had an email from the seller with a helpline number to call tomorrow, so am hoping they can resolve the problem.

    I'll let you know how I get on :)
     
  14. JanetNJ

    JanetNJ Well-Known Member

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    I see you use the Alphatrak. Be sure you are dipping the small protrusion off the edge where the black dot is. That's the straw that sucks the blood in. You don't put the drop on the dot, and you only use one side, not both.
     
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  15. JanetNJ

    JanetNJ Well-Known Member

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    Once the strip has touched blood you can't reuse it. You have like 30 seconds to add additional blood if you didn't get enough the first time.
     
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  16. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Use that! tiny quantities, mind you.
     
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  17. Tilou

    Tilou Member

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    Hi Janet - I've been dipping the pointy bit in the blood but nothing happens. If I do it again (even quickly to beat the 30 seconds) I get the error message. I shall be calling the company who sold me the machine today, as the strips were part of the starter pack and I suspect there's a fault in the batch. I've ordered a new pack of strips, which I hope will work.
     
  18. JanetNJ

    JanetNJ Well-Known Member

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    And you aren't dipping until you see the little blood drop symbol on the screen, and you are holding it in place in the drop until you hear the beep, correct?
     
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  19. Tilou

    Tilou Member

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    Jan 20, 2018
    That's correct. I wait until the screen shows the blood drop symbol and then I hold it in place. So far only 11 of 21 strips have beeped and given me a reading. The rest have not beeped but given an error message.
     
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  20. Tilou

    Tilou Member

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    Jan 20, 2018
    Managed a test! 33.7 (groan).
     
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  21. Diana&Tom

    Diana&Tom Well-Known Member

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    Hello from a fellow Brit (in Surrey) - I try to at least say hi to UK newbies here and the clue was in the thread title... Caninsulin.... so you're not actually in the UK at present but many of us in the UK and mainland Europe have experience of working with it, so you're in the right place.

    Forgive me if I've missed earlier info, but I would just say that three weeks after dx is not long at all to see appreciable progress in diabetes treatment. Yes, the insulin should be working, but it may take a while for a cat's system to adjust to exogenous insulin and you may not see the results you want or expect for a little while. It's excellent that you've got Bob on a wet diet though - that's a great head start and should make a difference to bg in itself.

    It's very brave of you to attempt three times daily dosing - the times you've worked out seem very manageable - and I wish you the best of luck with that. Many people find it's tricky because if you get an unexpectedly low pre shot number it may throw you and you have to decide whether to dose then, not dose, or stall - in which case the routine goes out the window. My suggestion is to continue if that's what you've decided on, but don't get into a pickle with it if it doesn't quite work out - you can always switch to twice daily dosing which may or may not work for both you and Bob's bgs. It's true that Caninsulin doesn't usually last 12 hours in cats, but unfortunately there are no "definites" in FD and ECID (every cat is different) as we say here.

    I sympathise with the issue of testing equipment and the concern of bad strips - it will be interesting to see what the helpline people say. Hopefully they'll send you another tub as a gesture of goodwill. Meanwhile you can always use a human meter as a temporary measure at least, to gauge what effect the insulin is having. It's a personal choice of course but at least with a human meter you might find it easier to obtain strips, and they're cheaper? The only thing of course is not to mix readings from both types of meter on your spreadsheet - it's one or the other. Sorry if this is obvious - it is I know, and you sound very clued-up already, but that's for the benefit of anyone else reading this thread (on which topic - that's what we try to do here, cover all bases, because some people do tend to "lurk" for a while before posting, so giving a full picture is for the benefit of everyone).

    I think that's all I can say at the moment but just wanted to wish you good luck! Keep posting here - FDMB is a real goldmine of experience and working in conjunction with a good vet, can save lives and sanity!!

    Diana
     
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  22. Tilou

    Tilou Member

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    Hello Diana, thank you for your message - it is much appreciated.

    We've been in France since 2006 and Bob joined us shortly after, as an abandoned cat who was on the verge of becoming feral. I think it was his survival instinct that has caused his insatiable desire over the years to eat everything he could (basically the food from our other seven cat's bowls) that resulted in his diabetes due to becoming overweight. If nothing else, his diagnosis has brought home the truth about the unsuitability of so many cat food products on the market!

    Thankfully Bob has always been a wet food eater, so we haven't had to battle any change in feeding habits, apart from buying the low carb products recommended by others on this wonderful forum.

    I did wonder if I was setting the goal a little high in thinking that we might see a quick response to the insulin. Probably because our vet suggested that after two weeks of Bob being on 2ui in the morning and evening he would look to lower the dosage to 1ui. I think the vet got a bigger shock than we did on Bob's return visit to see his BG had gone up.

    I'm quite happy with the three doses a day regime (husband has been diabetic for 35 years) as we don't think the Caninsulin was effective after 8 hours. This was noticeable even before getting the blood meter, as Bob went back to hugging the water bowl as the effects of the insulin was wearing off.

    Our vet is quite happy for us to increase and reduce dosage according to the readings we get and he laughed when we said about monitoring for the possibility of hypos, as he considers Bob's BG be be too high at the moment to worry about that. But having a husband who can have a BG reading in the 400s one minute and then be hypo-ing at 35 the next, we are being extra vigilant with Bob - hence my frustration at the strips failing.

    I've had a message from the seller of the Alphatrak telling me to contact the USA help line (!!) and no offer of a replacement pot of strips. But I suspect it is the strips and have ordered a new batch - due for delivery next week, so with only three left I might have to resort to using hubby's meter (but won't muddle the numbers on the SS).

    I hope our messages are helpful for any lurkers and that they dive in and join the conversation. The vast amount of information I have found on the forum is proving invaluable - as are those people, like yourself, who are all experiencing FD.
    I appreciate all the help I've been given.

    :bighug:
     
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  23. Diana&Tom

    Diana&Tom Well-Known Member

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    Hi again Tilou
    Just one other thing ... I'm sure you know that all sorts of things can elevate blood glucose and give a "false" reading - vet stress (bg at the vet's is commonly higher than at home) as well as infections, commonly UTIs. I just wonder if Bob's initial dx and insulin dose was based on a single reading at the vet when he had a UTI, which prompted the vet to prescribe the higher than usual 2u starting dose? Most cats start on 1u and the dose is increased as necessary, not reduced. It is *possible* that the 2u is more than he needs and that could be causing a bounce and those very high numbers... I'm certainly not saying that this *is* the case but it's the sort of thing we mull over here and every now and then it turns out that a kitty is simply on a wrong starting dose... just something to think about!
     
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  24. Tilou

    Tilou Member

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    I'll bear all this in mind, especially the "bounce" that was brought to my attention yesterday. I did wonder if the experience of being at the vet would elevate the results. Bob's original blood test threw up some very strange numbers!
     
  25. Tilou

    Tilou Member

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    Bob's original blood test attached.
     

    Attached Files:

  26. Diana&Tom

    Diana&Tom Well-Known Member

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    My French is pretty good but which is the result for blood glucose?
     
  27. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    GLU 4.21 g/l => 421
     
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  28. Diana&Tom

    Diana&Tom Well-Known Member

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    Of course, silly me! I should have realised. So 421 in "non-US" numbers (ie what the rest of the world uses) is about 23, which certainly looks like a diabetic number BUT if Bob had a UTI at the time that number could be higher than it might have been if he hadn't had a UTI. But then I was only guessing at a UTI, diabetics are prone to urinary issues anyway with or without infection and obviously, if Bob was drinking a lot (def sign of diabetes) he's going to pee a lot too.

    Sorry - just thinking aloud really. It seems as if the vet's dx was most probably right, but I'd still say the starting dose is too high. But then maybe that's how vets in France are taught, using a different system to the UK and other places we're used to hearing about here.
     
    Last edited: Feb 5, 2018
    Reason for edit: Sp
  29. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    You know, most people here use human meters. If your hubby has a meter (does he have to pay the strips) you might just want to steal it for a bit. With the SS you're looking for trends. Pet and human meters get close on low numbers ("take action" for hypo prevention is 68 on the AT and 50 on a pet meter -- divide by 18 to get mmol/l). They diverge more with higher numbers. But mainly you're looking at the shape of the curve, and making sure your cat stays safe from hypos. If you use the human meter just put a big red block or something in the SS to indicate where the change is. (You can look at what I did with Quintus's for strip change, it's not pretty but it makes things visible.)
     
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  30. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    @Tilou was a fructosamine test done?
     
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  31. Diana&Tom

    Diana&Tom Well-Known Member

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    I wondered that. Tilou, if you don't know - tbis test checks blood glucose over a period of two or three weeks, as opposed to a single spot test, and for that reason is used by vets as an indication of diabetes.
     
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  32. JanetNJ

    JanetNJ Well-Known Member

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    Just know that is not the norm. I can count on one hand the number of times my alpha have me an error that was not user error.
     
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  33. Tilou

    Tilou Member

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    Just to say that vets in France do have their own way of doing things. Starting dose of 2ui am and pm changed to 3ui am and 2ui pm when second BG test was higher two weeks later. We were also told Bob had to eat Royal Canin biscuits only, no wet food - and he sold us a big bag, saying that our other cat, Joey, was not allowed to eat them, which he promptly wolfed down the minute I put them in Bob's bowl!
     
  34. Tilou

    Tilou Member

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    Hubby gets his strips free, so I might have a go with his meter, although the Amazon marketplace seller who sold me the AT is not going to refund, so I'm landed with it anyway.
     
  35. Tilou

    Tilou Member

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    No. The only test done is the one on the attached sheet, plus a follow up glucose last week where it had risen to 5.27g/L (he didn't repeat any of the other tests from the original visit).
     
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  36. Diana&Tom

    Diana&Tom Well-Known Member

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    Well, it's not our place to question a particular method of treatment just because we're not familiar with it, and doing so would only muddy the waters for you, Tilou. The way forward is probably to read here as much as you can to familiarise yourself with how all the aspects of treating FD come together (type of insulin, dose of insulin, food) and use that knowledge to discuss anything you're concerned about with your vet.

    Have you read the beginner's guide to Caninsulin on that forum? It was updated only recently by a group of us here working together to make it as useful as possible to everyone.

    And do keep asking questions. We are all rooting for you and hoping you can get those high numbers down soon.
     
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  37. Tilou

    Tilou Member

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    Jan 20, 2018
    Hubby had one years ago :) but nothing even suggested on that front by our vet. There are cultural issues at play here. In general cats in France do not receive the attention that dogs do. On receipt of the original blood results the vet said Bob's kidney's were "very, very bad". Of course, with that diagnosis the vet also sold us a bottle of Semintra (€38), which we'd used before with a cat that did have severe kidney problems and only lived for two months after diagnosis. Needless to say I was devastated that Bob was going to endure the same fate.

    However on checking the results back at home we could see his creatinine clearance was normal and there was nothing to indicate a problem with the kidneys - that's also when I find this forum, posted the results and members with animal veterinary backgrounds were able to tell me that they could not see anything indicating kidney problems either.

    Hubby has monthly creatinine clearance blood tests and his comment was "I wish my results were as good as Bob's on that issue".

    Unfortunately we have always been seen as a "cash cow" by the vet due to our attention to the health of our cats, which is not the norm within our local rural population.

    Apologies for the gripe.
     
  38. Tilou

    Tilou Member

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    Jan 20, 2018

    This forum is proving invaluable. Twenty years of owning nine cats and we are learning something new everyday.

    Yes, I read the Caninsulin guide, which is excellent. I'd previously read the company's guide on their site but they tend to keep the info for the public quite basic and only allow veterinary professionals access to the nitty gritty (I was a researcher in a previous life and happily spend my days trawling for info on anything I'm interested in or need to know about).

    Don't worry, I'll have plenty of questions (and moans) ;)
     
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  39. Diana&Tom

    Diana&Tom Well-Known Member

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    I get what you're saying - not an easy situation for you and such a shame that the vets don't understand that cats are as dearly-loved parts of the family as dogs. I guess you just have to plough on and inform yourself as much as possible as I suggested earlier so you are in the best position possible to communicate with the vet.
     
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  40. Tilou

    Tilou Member

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    Jan 20, 2018
    Whoo hoo! Just got my first urine strip test done for Bob. No ketones but was showing high glucose (qualifying the blood test I did half hour earlier, another high one at 32).

    Sounds silly to be whooping at this but Bob is an outdoors cat and when I realised where he was heading I had to use a lot of stealth to follow him, slide a tray underneath then pour the pee into a pot. Tray was a hastily grabbed ice cream container lid (it was washed clean), pot was a lid from something of hubby's in garage. Bob was happily relieving himself onto a pile of wood shavings in the wood shed!
     
  41. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    No ketones is great news and it's important to celebrate victories in the midst of the stress of all this. Now to attempt some more tests - use DH's meter and strips, I would - and try to collect enough data to form a picture of what the doses you're giving are doing.
     
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  42. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Update on the AlphaTrak meter problem:

    Have just come off the phone from Zoetis, the UK supplier. Great customer service (unlike the Amazon marketplace seller who has washed their hands of the problem). They did acknowledge that the strips in the starter pack had been "hanging around a bit", as they are only dated until July and said if they weren't stored correctly (extreme temperatures) that could cause a problem. But they thought it is more likely to be a machine issue than the strips. They will take a look at the machine (and replace if necessary) if it continues to fail with the new strips (due to arrive in the next few days).

    Onwards and upwards!
     
  43. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Well done on the pee collection!! :woot:
     
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  44. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Merci :) I did manage to get it all over my hands, but avoided spillage on my clothes! Now I know where he heads for I've got an appropriate tray and pot at the ready.

    Also, I've just tested Bob on hubby's meter... 347 mg/dl, 19.2 mmol/L by my calculation - that's 5 hours after his 14h dose of 2ui.

    He was 32.2 mmol/L this morning, 5 hours after his 6h 2ui shot. So seems to be moving in the right direction.

    He's due 1ui at 22h to keep within the vets recommended 5ui per day.

    The one thing we've realised is that the way we are currently allocating the 5ui over the three 8 hour periods might not be conducive to Bob's eating pattern. He is eating more during the late evening and early morning (wakes me at 4am, then 6am) than he does in the afternoon (virtually nothing as he sleeps most of the day) to a little munchie during the early evening before sleeping again until we go to bed, which is when he starts his night patrol.

    I'm beginning to think that he should have 2ui in the evening slot (22h) to cover his eating through the night* before his 2ui shot at 6 in the morning, and reduce him to 1ui in the afternoon slot (14h) - although he's prone to these high 30s at around midday, which is why we've been giving him the 2ui in the 14h time slot.

    Any thoughts on this conundrum would be appreciated.

    *We've never had set feeding times for our cats, as empty bowls just meant I was up all night feeding whoever wandered in and started wailing, so even though the others have all gone OTRB, we continue to leave food out for Bob and Joey, a veritable "help yourself buffet" for grazing on.
     
  45. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

    Joined:
    Dec 9, 2017
    When dosing twice a day, I think we usually try to make each "cycle" (from one injection to the next) the same: same amount of insulin, same amount of carbs in. I think caninsulin works best with proper "meals" before the injection.

    Lantus or Levemir, which provide flatter curves, are (again, I think) maybe better suited to grazers.
     
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  46. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

    Joined:
    Dec 9, 2017
    food and insulin are the two sides of the equation. you need to balance the two. that means that as you control insulin, you do need to control the food to some extent, particularly with a shortish-acting insulin. It doesn't mean you need to force-feed the cat, but you need to know when he is eating what, either because he has patterns and you know them, or because you put down the bowl.
     
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  47. Tilou

    Tilou Member

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    Jan 20, 2018
    Again, thank you for the info - it could be the explanation as to why Bob's readings are so up and down. When we were trying to help him lose weight we tried to stick to a routine, but after so many years of grazing it was impossible. He would just go outside and feed off the wildlife!

    Looks like we are going to have to have a chat with the vet.

    Unfortunately hubby has been rushed into hospital about an hour ago (hence my sitting here online at 1 'o' clock in the morning!) as he has multiple health issues. I'm his full time carer so am having to balance looking after him and learning all about feline diabetes.

    I think the ambulance medics thought I was mad when I said I wasn't accompanying him to the hospital because I had a diabetic cat to look after! Although hubby is not one to have me tag along anyway - he prefers me to stay put until he knows what's going to happen to him at the hospital. So if I disappear for a couple of days you know I've got my hands full o_O
     
  48. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Wow you for have your hands full. Hopefully your husband will feel better soon so he can come home and that things settle down.
     
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  49. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Update: hubby home from hospital but still on medication for infection.

    I've also taken delivery of new strips for AT pet meter, which are working fine.

    Bob's readings have been up in the 30s again, so taking into consideration vet's advice to increase the Caninsulin dose as necessary, I gave him 3x 2ui yesterday (2ui every 8 hours) and 2ui this morning. His reading after two hours was down at 16, now - 2 hours later - it's up to 28. He is due his next 2ui Caninsulin in 4 hours, so I suspect it'll be well over 30 by then. I'll try to get a reading in the hour before his insulin injection is due.

    He's not going mad on the drinking of water (sticking to normal consumption), he's no longer incontinent, eating well and maintaining his weight at just about 6kg.

    I don't see us getting his blood glucose down below 15 without upping the dosage of Caninsulin above the maximum recommended dosage for his size (6ui over 24 hours), which we're not prepared to risk.

    I've updated his SS with the latest readings.
     
  50. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Glad to hear DH is home, one less thing to worry about!

    Also good news that you have new strips so now you can do a few more tests when possible and get a better idea of how the doses are working. I'm trying to think of people here who have experience with TID dosing but can't pinpoint anyone offhand... I think it would help if someone could look at what's going on to at least give you some encouragement about the way forward... You're right to discount the possibility of giving a higher dose at the moment, but it may be that Bob is what we call a "big gulper", ie needs higher than "usual" doses of insulin to keep his blood glucose down.

    I'm going to tag one of our very experienced UK members, @Critter Mom , who always gives sound advice and whose opinion I would trust. Meanwhile, it's good that Bob's clinical signs are improving.

    Hang in there!
     
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  51. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

    Joined:
    Dec 9, 2017
    Good news on the hubby and strips! And the drinking and peeing. And adapting the SS for TID!

    It seems on first glance he's not getting much duration from caninsulin.

    FWIW French vets recently have access to a heads-up regarding the AAHA guidelines for FD, and in particular the recommendation of using Lantus: http://www.lepointveterinaire.fr/ac...des-recommandations-sur-le-diabete-sucre.html (I do not remember if you wanted to get Lantus but couldn't, or if you were interested in trying it or not -- just putting this out there).
     
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  52. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018

    Hi Diana

    Yes, all good news (to a degree). Much relief.

    There's no doubt in my mind that the Caninsulin doses are not lasting, even given 3x a day.

    I'll be interested in Critter Mom's opinion - I see that she has "liked" some of the posts on this thread so has read my mad rants o_O :)
     
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  53. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018

    Hi Stephanie

    Thanks for the link. I shall save it to show our vet on the next visit.

    I've been reading up on Lantus (actually posted up another thread about it here yesterday) as hubby uses it as his long acting insulin.

    It seems more suitable for the increased metabolism of cats, so I am going to ask the vet if we can give it a go.

    Note that I have the AT strips and can test more frequently (when Bob isn't putting up a fight!), I'm going to gather up as much data as I can over the next couple of weeks to lay down the evidence in front of the vet.

    Onwards and upwards!
     
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  54. Tilou

    Tilou Member

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    Jan 20, 2018
    Oops, "now" not "note"!
     
  55. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Dec 9, 2017
    Based on my limited experience but many readings, I really think Lantus is better adapted.
     
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  56. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    So do I - just need to persuade the vet :)
     
  57. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Update: Just tested Bob. 7 hours since 2ui, glucose now at 30.3 so have given him his next 2ui, which would normally have been due in an hour. On the data collected today, the Caninsulin only seems to last a couple of hours before glucose levels start rising. I'm going to give this 2ui TID routine a week and see what happens.

    Just to note: Bob's food intake since 7am (his morning injection) has comprised of 70g tin of Almo Nature chicken and 75g Animonda Integra Protect Adult Diabète food (other cat ate the other quarter of the pot), of which some is still left.
     
  58. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Something funny going on, ladies...

    Less than three hours since his 2ui (14:15 French time) - after a reading of 30.3 (see previous message) - Bob's just tested at 35.6

    He's only eaten a small piece of wet food left in his bowl from this morning, about ten minutes before this latest test, so can't see it being that.

    Curiouser and curiouser (said Alice).
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I see you are dosing Caninsulin TID. I know you started this because you felt that there wasn’t enough duration with BID dosing. It’s possible that the dose really is lasting longer than 8 hours by varying degrees and you’re getting varying degrees of dose overlap. That creates a situation where the dose level is fluctuating and conceivably is too high sometimes. That can lead to lows you aren’t catching with tests. That could cause bouncing and elevated numbers.

    Just my two cents. I have no experience with this dosing regimen.
     
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  60. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes I think there's something funny going on, which is really why I tagged Critter Mom to see if she had any thoughts. We know Caninsulin doesn't have a full 12-hour duration but it *might* be a matter of adjusting the dose BID as well as trying the current TID... so very hard to know what to do for the best and it is just a matter of trial and error really. The trouble is, in France your vet is doing things differently to what most of us here might suggest, ie starting at a lower dose and working up... on the current regime Bob is getting quite a lot of insulin and we simply don't know if that's right or not... it is easier to get a clearer picture on BID dosing. But time will tell and at the end of the day, you have to take everything into account - what the vet says, what we might say here, and what your instinct tells you.
     
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  61. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Kris has posted just before me and said more or less what I've been thinking... it really is just a guess but this is a possibility to consider.
     
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  62. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    It's a veritable minefield. I'm really at a loss at the moment as to what to do.

    I'd been warned of the possibility of "bouncing" and it may well be the problem.

    Our French vet started Bob off on 2ui twice a day. Then after two weeks upped the dose to 3ui in the morning and 2ui at night, and told us to adjust from there as we thought necessary.

    Having discovered that Caninsulin in cats doesn't necessarily last 12 hours, and taking into consideration Bob's high readings after 4 or 5 hours, we decided to try TID, but stick to the 5ui per day that the vet prescribed.

    As can be seen on the SS, it hasn't made any difference. We realise that Bob's eating regime may not be conducive with the spread of units we have been giving over the 24 hour period. Only an increase of an additional 1ui last night (to counter the high reading) brought his BG down to under 20 this morning.

    Now it's rocketed again, I'm not sure what to do next.
     
  63. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Ok, just tested again. Looks like we had a bounce! It's dropped slightly back to 31.7 and that's 6 hours after the last 2ui were given.

    I shall test again in a couple of hours, which is when we would be giving Bob his third injection (normally 1ui).
     
  64. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    It is a minefield and I really sympathise. I think in your shoes I'd go back to BID dosing, try 2u at 12-hour intervals, and try to get as many tests as possible - that's the only way really to see what's going on here.
     
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  65. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    That's what I was thinking. If the next test shows BG going down, I'll miss out on tonight's shot, retest in the morning before giving any insulin and go from there.

    Thanks once again to everyone's input. So much appreciated :kiss:
     
  66. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes give it a go but it might take a couple of cycles to get a better idea.
    After tonight it would be good to aim for some consistency in dosing so see what happens and come up with a plan perhaps... we can suggest and advise here, but you have to bear everything in mind and do what you think is best. We are not here to bash vets but they are not always right as many people on this board will attest.
     
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  67. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Just tested at 30.7 - down from 31.7 two hours ago, so not a huge drop.

    Now can't decide whether to give him the shot tonight or just leave it until the morning. He will eat through the night.

    :banghead:
     
  68. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    More fun with Caninsulin! I just started a new vial (on a cat that already bounces) and it's like starting all over again. I generally start a new vial at 80% of what I was dosing before, I know I'm not the only member who has seen this. My vials are nowhere near their expiry date, frustrating.
     
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  69. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    When in doubt, and with a number this high, you could always give a token/reduced dose - say 1u or 1.5u - and see what that does. It's so frustrating not knowing what to do, I know... are you giving Bob too much insulin or not enough... only trying the different permutations will tell. But when you've decided what to do tonight and then get tomorrow's amps, stick to a dose BID for a couple of days and see what happens.
     
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  70. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Hi - I'm only in the first vial, so I can see this is going to be fun. Bob was diagnosed on the 16 January, so just coming up to week four.

    Do you stick rigidly to the expiry after opening?

    The reason I ask is that I have read on a veterinary website that although Caninsulin is marked to be used for only 28 days, tests showed that it is still active up to 42 days.

    Obviously I'm checking the vial for any signs of separation, floating bits etc, but it all seems ok at the moment... and at €34 a pop I'm inclined to not bin it yet.

    Interesting that you're experiencing the bounce. It's my first confirmation that that's what is happening to Bob. I've not been testing that much until today as AlphaTrak starter pack strips were failing and I was wasting so many, plus Bob was not very receptive to the tests and drawing more blood from me!
     
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  71. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018

    Just been having this discussion with hubby as to what to do and our plan is to give a shot tonight (in about an hour) - 1.5ui is a good idea.

    Then test Bob in the morning when he settles down after breakfast for his sleep.

    Then we'll start a BID routine of 2ui 12-hours apart and see how that goes for a few days.
     
  72. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Can I ask who said 28 days? The 2 I just got expire in August but I never go past the 1/3 remaining point, I see Noah's numbers go up and I know it's time to change. Once I had something floating in a vial, it looked like an inch long thread. Kind of coarse and uneven. We never heard back from the manufacturer. Are you using the official Caninsulin syringes? They're very anal about switching. Mine were 1 cc marked in 40 increments so there's math involved in switching, something I cannot ethically advise you to think about right now.
     
  73. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Tilou,

    Just seen the tag. Had a very quick glance at your spreadsheet and I'm concerned that Bob is currently very high and flat on the TID dosing schedule (even with the switch back to Alphatrak meter, the numbers are of concern).

    NB: I've never attempted TID dosing with Caninsulin but I have used it and I'm quite familiar with the 'expected' action profile per the manufacturer's guidelines.

    I'm quite concerned about Bob's BG getting to such high levels at the moment. I will write more tomorrow (I have health problems and I can't manage a proper reply right now - so sorry!) but my immediate worry is risk of Bob starting to throw ketones because his BG is so high. For safety I'd very much recommend that you immediately start checking Bob for ketones every day. If you can't reliably catch him peeing I'd recommend getting a blood beta ketone meter (e.g. Abbot Freestyle Optium Neo). The ketone test strips are not cheap but the ability to test for ketones reliably and catch any issues very early makes the BBK meter a smart investment if regular urine testing can't be assured (better for the cat and the wallet - veterinary treatment for ketosis and DKA is $$$). Also, keep a close eye on Bob's clinical signs and behaviour (in case something medical might be driving numbers upwards).

    I think your decision to go back to BID dosing in order to get a better handle on how Bob's responding to the Caninsulin is a good idea. It would help you all enormously if you could follow the regular testing routine:

    * Withhold food for 2 hours prior to preshot test (ideally keep Bob inside - not sure if this is feasible for you).

    * Do preshot BG test, feed and wait 20-30 minutes.

    * Give insulin dose.

    * At the moment I'd suggest getting tests at +3 (earlier if Bob comes looking for food sooner - can be a pointer to dose onset, or possibly a very early nadir) and +5 after each dose. If you want to find out more about dose duration, you could also snag a test at +8 to see if the dose is wearing off (assuming a 12/12 dosing schedule here).

    Again, sorry I can't write more just now. Before I post again it would help me to know the following:

    1. Carb info for ALL the foods Bob eats. Here's the UK food list for you to check (includes products available at Zooplus):

    https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

    2. What is the situation re insulin choices in France (particularly Prozinc, Lantus and Levemir)?


    Mogs
    .
     
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  74. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    The "throw away 28 days after opening" is the usual disclaimer you find marked on many pharma products. I tend to ignore, as I consider it just a way of the companies forcing us to buy more than is necessary. That's why I did some research to see what the actual life span of Caninsulin is once the vial is "opened" (even although it's effectively sealed again after you withdraw the needle due to the rubber top).

    We were given a bundle of individually wrapped 40ui needles by the vet. The needles are rather thick on them though, so I sourced an alternative, on a French veterinary supplies website, with thinner needles that were recommended for use with Caninsulin and were not too pricey.
     
  75. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018

    Hi - sorry to hear you are unwell, so appreciate your response.

    Just to update from last night: we tried to get a pre-shot BG test this morning and the only ones with enough blood to test was from myself and DH (and he's on blood thinners, so plenty on that front!). Bob went into full feral mode unfortunately. So I've given him 2u to restart a BID schedule of two shots 12-hours apart and will try to get a BG test in a couple of hours once he has settled down.

    I've managed to get one ketone urine test from him (last week) which showed no ketones. He's an outdoor cat, so stealth is required to hunt down where he's peeing. Fortunately, due to the inclement weather the wood shed has become the preferred place (plenty of chippings on the floor!) So I will try and catch him when he visits it again.

    Withholding food is a difficult one as we have always had a running buffet and both Bob and our other cat start kicking off from around 4am to be fed - as that's when they've finished off whatever was left in the bowls from the previous evening.

    Re food: I order from Zooplus France. Bob's current diet is:

    Animonda Integra Protect Adult Diabète 100g in small foil tins - beef, chicken and rabbit (didn't like the fish variety)

    Almo Nature Legend 70g tins - chicken, chicken & tuna

    Royal Canin diabetic sachets 100g (which I have as back up for when I run out of the other food and am waiting on an order delivery).

    He does also like a few biscuits and takes some of the RC diabetic variety sold to us by the vet (who declared that's all he should be eating!)

    As for other insulin types, I will have to speak to the vet as he gave us no other options other than Caninsulin.

    Tilou
     
  76. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    What does Bob need blood thinners for? Noah has cardiomyopathy and an enlarged heart.
    @Stephanie & Quintus Nothing other than Caninsulin in France, does that sound right?
     
  77. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018

    Oops, apologies, it's my hubby that's on the blood thinners, not Bob. That's why we have so much fun trying to test Bob as DH ends up scratched and can't stop bleeding. As he's also diabetic (hubby) he ends up getting a BG test, not the cat :rolleyes:

    I need to speak to the vet to find out if he has anything other than Caninsulin available. I have Lantus as that's what DH uses, but I wouldn't use it on Bob.
     
  78. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    I just have to say you don't sound at all like some of the terrified first timers we see here. Having a sense of humour is important, this is not the darkest hour of your life.
    Because I'm handy with a syringe and my wife and I see the same family doctor the 3 of us decided to save the system some money by having me give my wife her B12 injections at home. This is apparently "inappropriate" so I'd like to ask the internet never to repeat that and everyone have your hard drives wiped later today.
     
  79. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Lol... I have to have a sense of humour otherwise I'd be madder than I already am! And I'm all for beating the system ;)
     
  80. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Yup! Had nine cats and a dog with our first diabetic cat. Only humour can pull you through that.
     
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  81. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    This is when a sense of humour really helps. The cats are eating the dogs food, the dog loves cat food, the cats love splashing the water completely out of their bowls, I just came back from seeing another neurologist, my mom called to say her cable is out, the vet said she needed to discuss your non-obese young and apparently healthy cat's lab results.
    hannah&nigel001 (4).JPG
     
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  82. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

    Joined:
    Dec 9, 2017
  83. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Off to a great start with Bob's BID routine.

    2u yesterday morning. After 3 hours BG down to 24. After 6 hours up to 30.2

    2u in evening, then another 2u this morning (12 hours later).

    Note: (and gripe!) Can't get pre shot test as Bob will not sleep until he's eaten. The only food I currently have (due to delayed delivery from ZooPlus because of snow) are 70g tins of Almo Nature shredded chicken that I paid an extortionate price for in Gamm Vert yesterday.

    The two cats have eaten six tins since lunchtime yesterday, plus a piece of fish last night and then Bob had a tablespoon of normal cooked chicken before he would go off for his sleep this morning.

    At which point test taken, 2 hours after shot, BG is at 36.6

    I don't think this is working :(
     
  84. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Unfortunately, with FD - unless you're one of the few lucky ones - you may have to be prepared for the long haul. We say here all the time that this is "a marathon, not a sprint" - ie it can be a long and winding road, not a short straight one. It may be that Bob needs more insulin - nothing wrong with that if he does, cats need as much as they need - but we do need to see more bg tests to determine exactly how fast the dose is dropping him, and what a typical cycle looks like. It does seem that the Caninsulin simply isn't lasting very long, and at high numbers like he's giving you at the moment, 2u has quite a lot of work to do. Or it may well be that a different-acting insulin with longer duration would suit him better. When are you going back to the vet? I'd have a word to discuss your options. These ongoing high numbers won't be making Bob feel too great. Show the vet the numbers you've been getting and ask him what he makes of them and what his suggestions are re dose increase and/or another insulin.

    Sorry I don't have anything more constructive to say but it really is a case of hanging in there. Some kitties are really hard nuts to crack so don't think you're alone - very far from it. If you read other threads here and look at people's spreadsheets you'll see what I mean.
     
  85. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    I'm beginning to realise that we've been messing about too much with the dosage. I'm going back to the vets recommended dosage of 3u in the morning and 2u at night temporarily as I've printed the SS and made up a graph to show the vet. I'm going to pop in there tomorrow and see if I can grab a word with him.

    I'm also going armed with the link that Stephanie gave me (earlier on the thread) recommending French vets use Lantus.

    Bob isn't his usual self - hasn't been for a while - but saying that he hasn't shown any major changes in habits. He's always been lazy and sleeps a lot, so that hasn't changed!

    Ironically I have a surplus supply of Lantus in the fridge, as DH uses it and is always over-prescribed by his GP. I've probably got enough to keep Bob going until the end of his days!

    Unfortunately DH is not recovering well from his hospitalisation so things are a bit stressful at the moment.
     
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  86. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Maybe you just hit your first bump on the road. I can't contribute too much medically here but I can tell you a story and I'll do it quickly. The cat in post 81 is Nigel, our first diabetic cat. Not only did he have textbook curves he would leap onto the table to be tested and he loved going for car rides, how could things get any better? On the other hand Noah, Nigel's brother, has never been crated in his life. He has some form of PTSD perhaps? His numbers are all over the place, he is a high dose bouncer.
    So, everything Diana said about the long haul is true. As I said before I really was happy for you that you got off to such a good start without any dysfunctional crying but the instant I read about "DH is not recovering well from his hospitalisation so things are a bit stressful at the moment." it brought back a lot of memories. All the charts and recommendations that made so much sense at one time can just make you want to pull your hair out. Have patience and know we are here for you.
     
    Last edited: Feb 13, 2018
    Reason for edit: left out word
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  87. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018

    Now I've welled up ready to cry at all the wonderful support on here... but hopefully not in a dysfunctional way o_O

    I appreciate it's a long road, guess I'm a little impatient :rolleyes:
     
  88. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Take that as something positive. You wouldn't feel that way if you didn't love and care for Bob.
    It can really suck when life doesn't go as planned but this is the one place you can go for some sanity and understanding.
     
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  89. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Here's a published study about treatment of diabetic cats with longer-acting insulins. Given that Caninsulin doesn't have sufficient duration in Bob I think a change to a longer-acting insulin may be the way forward for him. It may be helpful to discuss the document with your vet.


    Mogs
    .
     

    Attached Files:

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  90. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Merci for the info :) I'm going to print off Bob's SS and take it to the vet and ask about a switch to Lantus, so I shall take this doc as additional evidence.
     
  91. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes - another insulin would seem a better bet. It will probably depend on what the vet sees as a decent period of time to stick with Caninsulin - Bob hasn't been on it long and there is scope to increase dosage, but these ongoing worryingly high numbers might speak for themselves and persuade the vet to try Lantus.
     
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  92. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    I agree. Tested Bob today (wouldn't let us near him yesterday for BG) and he's just recorded 25.4, two and a half hours after 3u. I'm inclined to keep to the 3u/2u regime until we see the vet, rather than increase.

    Unfortunately DH is not recovering too well from his infection that hospitalised him, so am juggling the two issues at the moment.

    I anticipate getting in to see the vet tomorrow, all being well.

    Btw, did get a urine sample for ketones yesterday - all clear.
     
  93. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    It's a shame you can't get pre-shot tests (it's ok, we understand why!) as without those numbers we don't know how well a specific dose is dropping him later in the cycle. So we can only assume that the 25.4 at +3 is a decent drop from pre-shot on a dose of 3u, which means he's been very high again then.
    Good news about no ketones, that's always the big worry so keep up with the tests if you can.
    Sorry you have so much to think about - it never rains, etc...
     
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  94. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    One more thing to baffle you may be the lack of consistency in Bob's numbers. Meters are legally allowed to be off by quite a bit, sometimes when Noah's numbers just don't look right I'll test him again and in a 30 second window I'll get readings 10% apart. And that's at home when he's relaxed, some cats produce numbers at the vets office that don't make any sense. Nigel not only loved car rides he adored our vet but that's where reality ceased to exist.
    Sorry about DH. In our case the vets office is halfway to the "hospital" where the "doctors" are. Amazing how quotation marks give away a persons true feelings.:rolleyes:
     
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  95. Kailee § Dallas

    Kailee § Dallas New Member

    Joined:
    Jan 22, 2018
    Hello

    J'étais à Caninsulin 9 mois et mon chat ne descendait pas assez de temps, est à Lantus il va beaucoup mieux et vit à nouveau



    J'étais à Caninsulin pendentif 9 mois et mon chat ne descendait pas assez de temps, depuis longtemps à Lantus il va beaucoup mieux et vit à nouveau
     
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  96. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    More ammunition for your vet, Tilou!
     
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  97. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    What Google thinks Kailee said:
    I was in Caninsulin for 9 months and my cat did not go down enough time, for a long time in Lantus he is much better and lives again.
    reply
    I am thinking of switching Noah to another insuling, his numbers are just too high.
    Je pense à changer Noah pour une autre instance, ses chiffres sont trop élevés. :banghead:
    Bonjour Dallas, bon chat! :bighug: :)
     
  98. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Merci pour votre message. Je vais demander à mon vétérinaire de changer l'insuline de Bob à Lantus.
     
  99. Tilou

    Tilou Member

    Joined:
    Jan 20, 2018
    Good news. Bob switched to Lantus. Starting on 1u morning and evening. May have to increase dose slightly if BG remains too high. SS will be updated with test results.

    Thank you for all your help.

    :cat:
     
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  100. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    VERY good news. You must have had less of a struggle with your vet in getting him to agree than most of us here in the UK do. 1u sounds an excellent starting dose. Do test whenever you can so we can see how the dose is affecting Bob's bgs.
    You may also find it helpful to post on the Lantus ISG (insulin support group) forum here where insulin-specific experts will talk you through any questions - if you title a new thread saying you're new to Lantus, hopefully you'll get lots of replies.
    Best of luck!
     
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