First questions...

I am new in this field and I am still full of questions, even if I read a lot about it since one week.

Here are some informations before my first questions

- He is 7 years old.
- Between 7-8 kg (I am going to buy a baby scale tomorrow).
- Diagnosed diabetic one week ago
- He receives Caninsulin 0.05 cc/ml twice a day (we do it at 8:45 in the morning and then 20:45 in the evening) since one week.
- Check up in less than two weeks to the vet clinic

- He has this behavior trouble : he would eat without ending, so we have to give him a portion of food everyday and avoid him to steal the food of the other one...
- Since several years, he ate Royal Canin vet neutered male (dry food) and one day he began bigger because of us : we made the mistake to let him eat at will, just hoping that he would regulate himself… and he didn’t.
- The vet put him on diet, he lost weight, but not enough.
- Then we moved in Iceland. My researches online made me discover the fact that apparently, cereals are not good for a cat. So I gave him Carnilove Chicken and salmon.
- I made the mistake (another !) to give the portion written on the package. And it probably was a way too much because my poor cat gains weight again…… Then I down it step by step, but still, it was probably too much, otherwise my cat would have loose more weight (isn’t it ?) (for now : 264 kcal).
- Our vet here don’t agree with us about the food and just proposes me food with cereals (see lower). And with christmas, it is not easy to reach them (vet clinic) to take the time to speak...

- We just bought a blood sugar monitoring : we will try tomorrow and the days after.
- We read a lot of article of Dr Lisa Pierson.
- Now we know now that it is better to regularly control the weight of the cat to know if the quantity of the new food is not too high, or to verify that he doesn’t loose weight too quickly…

- We live on an island where there are not a lot of brands which exist in the field of pet food… for example, for the wet food, there is nothing good.
- We think that wet food is better than dry food for a cat, especially if he has diabetes (less carbonhydrates)……

- We leave the country for a few days in 2 weeks, we are stressed because we don’t know what to do and we run out of time (changement of food for example : the transition is supposed to be long and watched, injections of insulin by who ? –our neighbor, cat lover, is going to feed our cats, we are afraid of hypoglycemia….)

Here are the questions (nb : I tried to get my answers in the FAQ, please excuse-me if I missed something…) :

- My first question is about the food.
The quantity of Carnilove that I gave him was too high : I just followed the recommendations of the brand instead of control the weight of my cat.

The vet just asked me to give him Royal Canin veterinary Diet Diabetic DS 46, without a comparison with the food that my cat ate before ! This food (Carnilove) had less carbonhydrates than RC Diabetic….. and the vet –who tries to give me the better answer- still tells me to give RC Diabetic to my cat.

Here you can find the analys of both of them concerning the proteins, the carbonhydrates, and the fat. Carnilove : protein 40% - fat : 20% - carbonhydrates : 20%

RC Diabetics : protein 46% (from a lot of cerals also) – fat 12% - carbonhydrates : 27 %

I still hesitate. Carnilove are grain free, so with less of carbonhydrates. But they have more fat. I am wondering if it would maybe have been better to continue Carnilove but slowly decrease the portion… the goal is also to help my cat to loose weight.

(When we will be back here, I thing that I am going to try to buy wet food from abroad, for both of my cats -if possible, because no company wants to ship here…).

What is your advice between Carnilove (with a better control of the portion) and RC Diabetic ?

(Nb : I will have to change of brand soon because those Carnilove Chicken and salmon are not made anymore, I am thinking to Orijen, which are similar, with less fat : 17%. But first, your advice between Carnilove and RC Diabetics please ?).

- I am also terrified about the idea of hypoglycemia….. so, second question, if I down the quantity of the old food, I know that I have to do it progessively to do it without danger... do you have advices in terms of days, % of decreasing etc ? And how adapt the quantity of insulin ?

- What is the normal level of sugar in the blood of a cat?

Thank you

 

Hi and a very warm welcome to you..... please try to take a deep breath and relax...
Feline diabetes is NOT a death sentence, however it does have challenges that can be overcome by learning more about the disease itself. This will take time and you will have hands on experience.

I am not a expert and because it is a holiday it may be a day or 2 before 1 of our highly qualified experts can welcome you properly with more clarity.

Here is what I would like to suggest to you...
1) I am SO glad you are so willing to learn and home test your sweet kitty.
2) we do our very best to feed under 10% carbs for our diabetics and even those in remission. If a cat does go into remission it will still be a diabetic and need to be on a low carb preferably wet food. Dry food is not any kittys friend-
3) Home testing is CRITICAL and your fears of a hypo incident are in a way good that you are aware of this and there is info on the forum of how to handle it.
4) a normal cat who is not on insulin can have a wide range from very low even 30s to around 120
for a cat on insulin we have to protocols 1 is tight regulation and the other is a slower method depending on your schedule. Tight regulation gives your kitty a better chance of remission although many have also gone in remission on the slower method.
5) If you are changing to a lower carb food it is even more critical that you are testing because just a change in food can drop the bg (blood glucose) sometimes drastically and you may need to intervene to keep kitty safe.
6) depending on the insulin (for lantus or levimer ) we dose our pre shot on how low the dose takes the cat around mid cycle usually. On a shorter acting insulin like vetsulin or pro zinc I "believe " the dose is based on a pre shot number--
the protocol is to test-feed shoot (t/f/s)

I am going to bump this up for more expert eyes...
Please keep asking questions there is tons of info and there is lots of VERY helpful reading on the forum.

I want to stress again that is really great that you are home testing and so interested in controlling the diabetes.
May I ask if your kitty was a steroid induced diabetic?

Bumping this up
@Wendy&Neko
@Marje and Gracie

 

Welcome to FDMB!

Let me be sure I understand. He’s on Caninsulin right now. You are using a syringe which measures cc or ml and not units, correct? if you are giving 0.05 cc/ml twice a day than that is the equivalent of 5u of insulin which is a fairly high dose of insulin.

You said the % carbs in the Carnilove chicken is 20%. Is that the guaranteed analysis on the can? If so, the actual % of calories from carbs might be lower but without the typical nutrient analysis of the food, we don’t know. However, when I google Carnilove, it is all dry food so I wouldn’t be surprised if the carbs are that high. That “might be” why his dose is so high. What does his blood glucose look like and are you hometesting? Is it possible to switch him to lantus or levemir insulin?

Is it possible to find a low carb canned food there that you can slowly switch him to? You would need to be hometesting to do this because when you switch from a high carb dry food to a low carb canned food, the insulin needs can change dramatically and quickly. You’ll need to be able to test him and catch the numbers.

Just as a note, I think Jayla thought he might be on lantus so you can disregard her references to tight regulation and how we actually dose the insulin. For Caninsulin, you dose on the preshot.

Please let us know how we can help.

 

I'm new here too so I don't have a lot of expert info, but I can say I feel like I'm in the same position. My cat would eat until he weighs more than I do if I let him. And, with this new diagnosis, I'm also worried about a planned week out of town soon. I will watch this thread for the advice you get.

 

Low carb wet or raw food is best for a diabetic cat. But do NOT change the diet until you are testing his blood sugars at home. We have seen a cat go from 5.5 units of insulin to zero after removing dry food from his diet. That was a very scary time for the caregiver. You are right to worry about hypos. Any change should be done slowly and with monitoring the blood sugar.

Tagging @Tiina and Hugo who is in Finland, she may have some suggestions for manufacturers who ship low carb canned cat food. Another option is to make your own food. Dr. Lisa Pierson's website has a formula for making your own. Some people in Europe by the TC Feline premix and add it to plain meat to make food.

 

Caninsulin (Vetsulin in USA) is a u40 insulin so 0.05 ml would be 2 units of Caninsulin.

I would feed the Carnilove vice the RC. Just feed less to control weight. All cat food is high in fat so no need to get a food with less fat, just feed less/enough to reach and then maintain the desired weight.

 

@jayla-n-Drevon, thank you What do you mean by "we have to protocols 1 is tight regulation and the other is a slower method depending on your schedule.

@Marje and Gracie :
exactly, my syringue is in cc/ml. For now, my cat doesn't seem to do hypoglycemia at all !
The vet said "we are going to do it seriously to treat him and let him a chance of remission. Do it like it and see you in 3 weeks for the chech up !". Without anything about home testing or adjust tje quantity of insulin. However they are not agoin hometestting because they gave me some names of brands that they use for a glucometer (also recommended by Dr. Lisa Piersen).

The % that I wrote for Carnilove are the one written on the package ; for the carbonhydrates, I did 100-proteins-fat-ash-fibres-moisture. Or it is possible to use this wonderful tool :
http://www.scheyderweb.com/cats/catfood.html
I am glad that you talk about "% of calories from carbs". I saw it in one of the articles of Dr. Lisa Pierson, and I didn't understand : is that the same thing that I calculated ?

About the fact to change for Lantus or Levemir, it will depend on the vet and on what is available on our tiny island....
What do you mean by "For Caninsulin, you dose on the preshot." ? Do you have more details please ?
Thank you.

@Wendy&Neko :
About the hometesting : we will begin today... yes we need it.
Do you have an idea of how to proceed to change the food progressively while testing and adapting the quantity of insulin ? I mean in terms of numbers, step by step...

@Tiina and Hugo : hi ! Is somebody could help us to get wet food in Iceland from abroad ? Because here we have nothing except RC and Hill's and I am not sure that I can trust these brands...
YES, I would like to give my cats wet food, but we cannot find something here.

About the homemade food I have to look at it.

Another question : as we are leaving in 2 weeks, 2 days after the check up, what do you recommend to me : change the food now (depending on the blood sugar testing/adapt the insulin etc) or wait for our return mid-january ? The vet just asked me to give him RC Diabetic for a cat of 7kg.

@Larry and Kitties : I just saw your reply ! Thank you very much for your advice ! Do you have some recommendations about how to proceed to drop the quantity of food ?

(This forum is a treasure... I feel very grateful...)

 

I would get at least a week of data in, testing with his current food and insulin dose, so you can see how he is doing on this dose. You want a dose that doesn't take him too low. Caninsulin's low point is around 4-6 hours after the shot, so do some testing then. Once you have that data, then post back here and someone can give advice on what to do next. Any food transistion would be done slowly.

 

HELP : my cat got his injection. He threw up so I gave him exactly the same amount. He diden't throw up but almost, and his belly makes this weird sounds ! What can I do ?

 

Weird sound? Can you discribe what the sound is?
And did he eat the same amount of food?

 

Wait.... Are you saying you gave two injections right in a row? If so, that might be too much insulin, and you are going to have to be prepared to monitor very closely and do some feeding to keep blood glucose from dropping too low.

Please reply as soon as possible-- this is a potentially dangerous situation!

 

No he gets one shot at 8:45 and the second one at 20:45 !

I gave him more of his food and he is ok now... hypoglycemia ?

For the sound of the belly, it was a sound of when you are going to throw away or when you are starving for example...

 

OK, whew!!!!

What kind of food did he eat? Is it a new food (possibly causing the vomiting)? And do you still have the old (higher carb) food that he is used to eating? It's important that he have some food with insulin, especially with a fast-acting form like Caninsulin. If the new food doesn't agree with him, it would be better to continue to eat the higher carb food until you can get him transitioned to a low-carb food that doesn't make him throw up-- insulin with no food is a quick recipe for hypoglycemia.

You haven't started hometesting blood glucose yet, correct? Do you have a meter yet? If so, now would be an excellent time to try to get your first test, just to see where he is-- but first priority is getting some food into him.

 

Oh, sorry, I was so focused on the shot times I missed that he did eat a bit more. That's good! So, just keep an eye on him like you normally do after giving a shot, watch for any unusual behaviors and be ready to intervene by giving him a bit more food if you think he might be going too low.

 

And, now that I have time to read this thread more carefully, I see that you do have a glucose meter! So I'll add that the other thing you can do is to get some practice in on the hometesting-- there's no reason to think he's in danger of hypoglycemia right now, since he ate again after vomiting dinner and isn't behaving differently, but the test is the only way to really know what is going on today and going forward.

Sorry for maybe scaring you earlier, but it sounded like maybe you had double-dosed the insulin, which, yikes! Glad it was a false alarm, keep up the great care you are taking of your kitty!

 

@Nan & Amber : thank you

For now I decided to keep going to give him the Carnilove (you can see all of my questions above and in my first post if you want to read, I wrote all the details about my cat and the story of his disease).
I decided to not listen to my vet so I hope that I made the right choice). I am just trying to control the portion, and decrease it very slowly... because I think that his food was good (for a dry food...) but I gave him too much of it (he has 2-3 kg to loose now).

I'm trying to find a good wet food that a company could send me here in Iceland (we have nothing here) but I will begin to do the transition mid-january when I will come back to monitor everything, adjust eveyrything etc.

We will test him this evening before his shot and after. At least we will try, we are beginners !

Edit : I just saw your last post, no worries

 

We were all beginners at one time. I suggest you practice testing blood glucose today and try to get a test done around the middle of the time between the two injections. That will tell you how low your kitty is going on this food with this insulin dose. Testing before the evening shot is also important. Make sure that he has not eaten for 2 hours before that shot. You do it in this order: test, feed, wait 25 - 30 minutes, give insulin.

 

Hi there and greetings from Finland. You have found the best site for advice, we started this sugardance in February and we have come a long way with my cat Hugo.

I mostly order his low carb wet foods from Zooplus. But I studied their site and it looks like they aren't shipping to Iceland, which is a big shame. They really have the best selection of a variety of foods that suit our kitties. Perhaps you could send them a query if they could add your country to their list? What food brands do you have in the supermarket? For example, Sheba Classic pates or terrines? I know those aren't really that good quality, but the carb content is 3.9% in the classic trays with no added sugars. I sometimes give them to Hugo for variety. Also I use Sheba Delicacies the chicken variety multipack from the supermarket. It has 2% of carbs. Then Almo Nature has some tin cans and trays that I can buy from the market, but they don't have added vitamins.

Do you have petstores that sell more quality foods? Like Mac's, Miamor, Animonda Von Feinsten and Animonda Carny, Applaws and such? I use all of those as I like to vary Hugo's foods and these I can buy from petstores, but they tend to cost a lot more there than in Zooplus. I hope this was helpful to you. Remember you can use the cat food carb calculator http://scheyderweb.com/cats/catfood.html to count the carbs from brands available to you and there is a mobile phone app you can download that is a real treasure. I have spent a great deal of time in cat food aisles with that app, counting away carbs and getting funny looks from other people. But it's worth it. The app is available from appstore and play store. It is called Carb Calculator for Cat Food.

Sending you lots of strength and wishing you a Happy Christmas. Just ask if there is anything I can help you with.

 

@Kris & Teasel, thank you !

@Tiina and Hugo : oh thank you so much for helping me !
About Zooplus, I already asked and unfortunately their answer was no...
I don't think that we have Sheba in our supermarkets...

We have some pets stores with brands of food but nothing very good in wet food. Here are the links if you want to have a look :
http://www.gaeludyr.is/kattafoour-is/
http://dyrabaer.is/kettir/fodur-1
In the vet clinic we have the classic vet brands (Hill's, Royal Canin) (with a crazy price).

I knew for the link to calculate the carbonhydrates but not for the app, thank you ! Nice

Merry christmas to you also !

 

The Natures Menu foods look like they'd be a lot better for diabetic cats than anything dry....the Chicken and Turkey is less than 8% carbs

This Meowing Heads Hey Good Looking looks OK too (about 3.5%)

 

@Chris & China
Awesome thank you ! Just... what do you think about the phosphorus ?

In less than 2 weeks, I will leave the country for 10 days.

What would you do :
Wait for my return, keep giving him the dry food and drop the quantity slowly + keep going with the insulin + monitoring ?
Or begin to change the food for a wet and low-carb food + monitoring to adjust the insulin quantity ?
(He got the insulin on the 17/12 for the first time)

 

Is there any kidney failure (CKD) in the picture?

I'd go with this...10 days is a long way away and it would be better to get him onto low carb food sooner rather than later as long as you're able to monitor while you're doing it!

 

@No, no CKD

Even if it is a neighbor and not me who will take care of him during these 10 days ?

If I do it, I will start tomorrow (and I leave my home on the 8th).
Do you know any document which could help me to adjust the insulin depending on the the blood sugar levels please ?

 

Unfortunately there's no set of specific rules about what dose to give if BG is at a certain number. Every cat is different. You need to accumulate BG data at a variety of doses and then use your judgment based on how your kitty responds. We go more by whether to raise or lower a dose and by how much rather than if BG = x, then inject dose = y.

The best thing to do now is begin a testing routine and log the data in the spreadsheet we use here. Others here can view your spreadsheet and offer advice about dosing. If you start today you'll have enough data to make decisions about dose for the caretaker when you leave for 10 days.

 

Yes, I agree with Kris-- if only cats were predictable enough that we could confidently say "if you get this number, inject this amount"! As you start to home test and start to collect some data on how your cat is responding to insulin, though, you may be in a better position to do that kind of thing for your cat. Right now, step one is just to see where your cat is now on the current dose, so you can figure out how to manage a food change and your upcoming trip in a way that keeps him safe and hopefully gets him on the road to better management of the diabetes.

For help with dosing decisions, you might want to also put a new post in the Caninsulin/Vetsulin sub-forum-- I've only used Lantus myself, so I'm not too familiar with how one proceeds with Caninsulin, but there are several people on this site who do know that insulin well and might be able to give some more specific tips.

 

Thank you so much !

@Kris & Teasel : could please tell me where is the spreadsheet ?

 

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
There are people here who can help you set it up if needed.

 

Sorry, I create a thread in Caninsulin but nobody is replying and my cat is supposed to get his insulin NOW so....

First blood test succeed (so, on reference before) :

3.9 mmol/L (70.2 mg/dl).
Tested 2 hours 30 after having a little bit of food (dry food for now), at 20:32.

Then I gave him his food (I kept 1/3 of the food for after the shot).

With this normal BG (normal BG is 60-120 mg/dl if I well understood), am I supposed to give him the Caninsulin (second shot of the day, 0.05 cc/mL recommended by the vet) ? He was supposed to get it at 20:45.

Thank you !

 

No, do NOT give insulin with a BG this low!

 

Do not shoot at that level. It is too low especially for Caninsulin. I can't stay on but I will bump your toher thread up. You could add a "?" icon to the title to get more attention.

 

With this reading of 70, don't shoot!

Caninsulin is a sharp insulin, that creates a bid drop only one or two hours after the shot.

Usually, you should skip the shot as soon as the BG is less than 200 mg/dL.

 

If you could give BG values in either mmol/mL or mg/dL we'd understand them immediately. Using cc/mL is confusing.

 

I DID IT !!
What should I do now ??? (he's eating the left part of his food now)

 

cc/ml is for the insulin, not the BG !

 

Do you have high carb wet food at home? Do you have honey or other sugary syrup at home? You must be ready to test his BG frequently starting at about 1 hour after the shot. Post the BG number here.
Please read this info:
http://www.felinediabetes.com/FDMB/threads/hypo-links-be-prepared-just-in-case.48385/

 

Yes I have always have honey with me in case of.

Ok thank you !!

 

My error. I'm sorry. I meant that we would understand you better if you said how many units of insulin you are giving instead of just telling us to what mark on the syringe you fill with insulin. What did your vet say about units of insulin?

 

Be prepared! You have given a big dose of insulin at a very low BG number. Caninsulin begins to work quickly and can bring down BG very fast. I strongly recommend that you call your vet for advice. If that office is closed, is there an emergency vet you can call?

 

It's equivalent to 2 IU, as written by Larry in message #6 of this thread.

 

I also suggest that you start a new thread with the question mark in the title asking for help from other people on the forum. You'll be busy monitoring for the next 6+ hours at least unless you take your kitty to see a vet.

 

So 0.05 cc/ml = 2 IU ?

 

Yes !

 

Then call them for advice. Tell them your kitty's story, type of insulin, dose, etc. They can help you faster and better than I can.

 

Caninsulin is dosed at 40 IU per ml.

So 0.05 ml is equivalent to 40 x 0.05 = 2 IU

 

I fully agree with @Kris & Teasel : you should call the nearest vet now, at least for advice.

And I would also start to test his BG right now.

 

Proper insulin syringes have a scale of numbers that means units of insulin. 0.05 cc/mL just means volume of liquid. Different insulins come in different concentrations. That's why we don't use volume of liquid when we talk about dose.

 

And that would be good also to change the title of your thread into something like "low PMPS but full dose of Caninsulin injected"

 

@Sif , are you still there?

 

Yes I was on the phone with the vet.
She did'nt worry at all, I don't understand.
She said "oh 70.2 that's very good compare to when we had him at the vet clinic, it was 372.6 !".
I asked about hypo, she said to give him honey if he has trouble. She said that Caninsulin acts in a few minutes.

For now my cat seems to be ok, just calm. When I show him a toy he wants to play... if it continues like this, that's nice but weird !

 

Could you please test his BG now, to see where he is?

 

BG : 66.6 mg/dl

(I already gave him a little bit of honey. Behavior still normal)

 

Ok, I have just created a new thread for you: http://www.felinediabetes.com/FDMB/threads/pmps-of-70-but-full-dose-of-caninsulin-injected.170273/

This will draw the attention of all the online members.

Be prepared to test every 15 minutes, and do not forget to breathe!

 

You gave the insulin about one hour ago. Yes, your vet is right. It does act fast. The part that can be a problem is that its biggest effect won't be happening for a couple of hours. Your kitty's BG is dropping and can drop a lot more before he gets to that point.

 

Thank you Capoo!

 

It's quite late here in Paris.

Is it ok @Kris & Teasel if I leave you?

 

I am and will watch him

 

Yes. Thank you for your help. Ah, Paris ...

 

Please test BG every 15 minutes for now and post here as soon as you are finished. Do you have any canned cat food that has gravy or sauce in it? That can be useful instead of always giving honey. Honey acts fast but doesn't stay long. The gravy has starch in it and acts longer. Dry kibble is good too but takes longer to take effect. If the BG is falling too fast, you'll have to give very small amounts of high carb gravy to help keep it from going too low. Not too much at once because you want him to keep having an appetite for gravy. We call this process "steering" the BG with food.

So:
1. test BG every 15 minutes
2. post here
3. wait for advice from me or someone else who's watching.

 

@Sif
Please do the rest of your posts on the 911 thread that Capoo started for you on the main health forum. More people will see it there and you'll get more helpers. In my post above I gave you instructions and asked you to post on this thread. Please post on the 911 thread instead.

 

New BG, Sif? Please post in the 911 thread.