Floyd - newly diagnosed in UK

Hi Everyone, my 12 yr old Ragdoll Floyd was diagnosed last week. I took him to the vets thinking he was dying of kidney failure, as he'd shed what seemed to be most of his body weight over the space of a couple of weeks, and was drinking and peeing like an elephant, and the next thing I knew I was told he had developed diabetes and was in severe DKA. After almost a week in the vet hospital he is thankfully back to a thinner version of himself, and is eating all this prescription Royal Canin food ravenously! Thankfully he doesn't seem to mind his jabs at all, and is making it easy for me, which I'm relieved about.

I have a couple of questions. Firstly, I'm beginning to realise that a lot of people buy their own supplies for less than the vets charge. I'd welcome any pointers for suppliers of syringes and insulin in the UK (he's on ProZinc), as his insurance is only covering 80% of costs which leaves us in for around £500 per year based on the vets' estimate.

Secondly, I gather home testing is recommended. I'm keen to do this as I'm terrified of a hypo, and also the vets are asking to have him in for weekly glucose curves until he stabilises, then quarterly after that, and if I can do it at home and save some money (plus get more accurate readings as no scary vet spike) I'd much prefer to do it that way. What monitors do people recommend in the UK, and is it important to get a pet specific one or are human ones OK?

Thirdly, are there cheaper alternatives to the prescription food, and if so are they as good? I asked the vet nurse about feeding another low carb food instead, but she fobbed me off by saying that this was a 'more scientific' diet (which doesn't even make sense as an adjective!). Am I going to be putting him at a disadvantage by feeding an alternative? He has always had Felix fish in jelly in the past.

Thanks so much for having me here. It's a whirlwind of new info but I'm hoping this is all going to become second nature soon.

 

Hi, what's your name? and welcome with Floyd!
We've got a lot of people here on FDMB that are from the UK or like me i'm your neighbor I live in The Netherlands.
@Marlena @TempestsMum @Elizabeth and Bertie can help you with buying your stuff online in the UK for much less money indeed! Don't buy things for the high prices they charge you at the vets! It's not necessary.

Well it's also not necessary for you to go to the vets to get his BG tested because A. it's expensive indeed to go there once a week, and B. it's not a reliable test because most kitties get stressed going to the vets what causes there BG to sky rocket, so those numbers don't mean anything!
Home testing is recommended! With prozinc it's advised to test all the AM and PM pre shot moments and get some midcycles (if you can, don't know if you work fulltime or anything but just try to grab them when you can)

This third question is the best one, and this is the answer: no you don't need prescripted food please throw that away as soon as you can. Those dry kibbles and even wet foods are full of carbs and cats when they have diabetes (and even if they don't have diabetes) don't need carbs. Cats eat raw food in the wild, there are no carbs in them, or almost no carbs. If you then compare that to what is in the prescripted food that is a world difference! Some contain 40% carbs, can you believe that? The people i've tagged can help you with the best low carb food that is available in the UK.
This nurse you are talking about has no clue what she is talking about, but don't feel frustrated, almost all of our vets or nurses don't understand it....
I still believe they get paid somehow by these big animal companies to sell those 'prescripted foods' or something,, Oh well I don't know but it's really bad for your kitty!

If you want to get set up with Prozinc and need dosing advise, please come over to the prozinc part of this forum so we can help you with that.
Also a google spreadsheet set up would be nice so when you begin home testing we can see what Floyd is doing!

Hope this info is a little bit clear for you, if not please ask! we are all here to help eachother.
And we do all understand that everything is really overwhelming after the diagnose, you will get the hang of this as soon as you get your test kit! Then you are all ready to hop on this sugar train !

 

Thank you for the tag Ruby.

Hello and welcome to you and Floyd. I'm in the uk too!

I use a pet specific meter that cost me £90 and the strips for it are reasonably expensive too(alphatrak2) however I buy freestyle lite strips that are about half the price of the AT2 ones. But many people use human meters and that's ok too!
I would never ever give insulin without pretesting if I had followed my vets advice to the letter my kitty would be dead or had a very serious hypo on the instructions I was given!
I was told they didn't believe In curves and I was to have those tests done for fructosimine (I can never spell that!) every two weeks. My vet has received my spreadsheet info instead whether he likes it or not! Remember you are the one paying for all this (and paying their wages!) and they work for you, not the other way round.

I'm pretty sure my vets not happy with me and I'm not his favourite customer. But you know what.. So be it!

I feed Sheba fine flakes poultry and occasionally for something different whiskas +7 fish but only once a week or if she's bored with the poultry. The information I have is that fish (unless human grade) isn't the best idea to feed as it's usually the older fish that's been lying on the dock and bits no one wants so not really good for them.

There are loads of foods you can buy online or at the supermarkets that are safe to feed. @Elizabeth and Bertie can post their list link for you. It's fabulous and I highly recommend giving it a good read.

 

Hello and welcome. In the absence of other health issues you don't need 'prescription' food, here is the UK low carb food list https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

I buy all my supplies online, u40 syringes with half unit markings, around £10 per 100, http://www.vetuk.co.uk/insulin-syri...nsulin-syringe-with-needle-box-of-100-p-11335
keto-diastix, one tub (lasts a long time) for periodically checking the urine around £10 https://www.amazon.co.uk/gp/product/B004M9OIGC/ref=oh_aui_detailpage_o05_s00?ie=UTF8&psc=1
generic lancets, around £10 for 200, https://www.amazon.co.uk/200-Home-H...t_1?ie=UTF8&psc=1&refRID=KAMG75Q1WRRDT1NY46WM

In terms of meters, the pet specific Alphatrak 2 is pricey - around £70+, as are the strips, I found the cheapest price at Animed UK
If you buy a human meter you will need one which takes a small amount of blood and with cheap strips as the strips will be your biggest expense.

How much is your vet charging for the Prozinc? You can get it online as well but will need a vets prescription and a reliable supplier. Insulin is the only thing I buy from the vet but my vet is very good about pricing and I only live about 10 minutes away so can pop in to pick it up when I am passing.

 

Hi Ragdoll's human!

Most people use ordinary 'human' glucose meters. Some prefer to use the animal-specific meter, 'Alphatrak', but the test strips are very pricey.
In terms of human meters the Accuchek Aviva is popular with Brits. It's easily available, needs only a small blood sample, and the test strips (the main cost of testing) can often be bought more cheaply online rather than through pharmacies (Ebay often has good deals).

You absolutely do not have to feed prescription food! Any good quality low carb wet food is just fine. And it may be that you can continue to feed what you were feeding before.
HOWEVER, please do not change his food until you are testing his blood glucose at home. Lowering the carb content of the diet can significantly reduce blood glucose levels in many cats, and this may mean that the insulin dose needs to be reduced accordingly.

Has Floyd had any steroid treatment recently? (Steroids can trigger diabetes in susceptible cats).

Welcome to FDMB!


Eliz

 

Hello and welcome from another UK'er. I used to feed Frankie and Romulus the Felix fish in jelly. From memory, I think it has about 9% carbs and under 10% is recommended. I now feed Felix Senior As Good As It Looks which is about 8% carbs. I also use the pet specific Alpha Trak meter. I get the strips online, they are much cheaper than from the vets although still pricey. I got it before I knew any better and I am used to his numbers on that meter now. I do have a human one for back up, just in case.

 

Thank you so much for all your replies. I've ordered the AccuChek Aviva monitor so I can keep an eye on his levels at home. I also switched him from the prescription food to Sheba Fine Flakes which he and his sister LOVE! So weird, they've never been hugely into their food before, and we've struggled to keep weight on them both recently (Floyd for obvious reasons has gone down to skin and bone), but they are going crazy for this stuff! Floyd was in for his glucose curve this week and has put on just over a kilo in the 2 weeks since being admitted with DKA, which is amazing!

And on the subject of his curve, the vets were really pleased with his numbers. So pleased in fact that he asked me to reduce his insulin by a unit. When I pointed out that he was only on half a unit twice daily, he said to leave him on that and bring him back in for another curve in a fortnight so they can get a pre-insulin reading (I'm actually a bit annoyed they didn't get this this time, as I made sure to get him in before his jab was due, and before feeding him, for the very purpose of getting this reading, but obviously something went wrong and they weren't able to take it, or forgot, or whatever, but the first reading they took was 30 mins after eating and having his jab), and if the numbers look good there's a possibility he can come off the insulin!

His numbers were:
08.15 : fed and jabbed
08.45 : 15.3
10.45: 3.3
11.45: 3.3
13.15: 3.9
14.15: 5.1
15.15: 6.9


Does this look good to you guys? Looking at some of your charts the numbers seem quite low. The vet did give me a reminder of the symptoms of hypo and to be on the lookout, so I'm slightly concerned about that now. I hope my meter hurries up and arrives soon.

 

OK, so I was just reading the hypo sheet in the ProZinc forum, and it says that hypo readings are 3.6mmol and below. Given that Floyd was reading 3.3 on his vet curve, should I be concerned about their advice to continue on the current dose for a further fortnight before coming in for another curve? I am concerned now...

 

Was this a curve done at the vet's office using a pet meter or lab machine. If so the numbers are mostly in the normal range with some lower than is aimed for . It is too bad there is no preshot reading, since the one at 8:45 would have been food influenced. When using a pet meter the aim is to keep the numbers no lower than 3.8 (68 US), especially earlier in the cycle (time between shots) When using a human meter the aim is to keep the numbers no lower than 2.8 (50US)

Readings are listed according to shot and time.


AMPS no reading
+.5 15.3 (275 US)
+2.5 3.3 (59 US)
+3.5 3.3 (59 US)
+5 3.9 (70 US)
+6 5.1 (92 US)
+5 6.9 (124 US)

 

Also if the curve was done at the vets office, there could be some stress involved which could give higher readings. The dose may need to be lowered. I will tag a few experienced Prozinc advisors. @Sue and Oliver (GA) @Elizabeth and Bertie @Sharon14 @Bobbie And Bubba @Alexi

 

Thanks so much for your reply. Yes it was at the vet office, using a pet meter I believe.

 

Ok Thank you for the additional information. Some of the numbers are a little lower than we would like to see when using a pet meter. Also with curves done at the vet's office some kitties will be affected by stress and show higher readings because of that.

What dose are you currently giving? How long until your next shot is due?

Hopefully some of the experienced Prozinc advisors will be on soon and give you better directions with what sort of dosing would be safest.

 

Also in order to get more people seeing your post, if you could start on on the Feline Health section:

http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

where there is more "traffic" there. And in the Prozinc section:

http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

where the prozinc "people" will check in.

You could do a new post with a title such as "Prozinc dosing advice needed" and put the "?" icon from the drop down box at the left side of your title section. Also if you could put a link to this post it will give some background information .

 

For some reason I didn't get an alert for the tag, those numbers are on the low side and he is getting a good response to the insulin and change of diet, he may well be heading for remission and it can happen very quickly. Do you know when your meter will arrive? For safety I think the dose should be reduced and not wait 2 weeks. You may even be at the stage where you need to start skipping injections.

I will ask @Rachel and @Ruby&Baco to look in as well - can you start a new post in the Prozinc forum with a link to this thread. It is a shame the vet didn't get a pre-shot test but you really need to be starting home testing ASAP now.

Also - print this out and put it somewhere handy, you will be glad you did if you ever need it http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Have you a hypo kit? http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

 

Thanks for tagging me Alexi! The numbers are definetely on the low side and that even considering that Floyd was at the vets for his curve what involves stress for most kitties.
I don't know what you are giving Floyd right now but I will suggest you to lower the dose 25-50% as I think Floyd is even lower when he's at home on the same dose.
What do you think yourself?

 

Oh sorry I just saw that you posted that he's on 0.50 right? I would suggest going down to 0.25 or even 0.10.

 

I would agree to halve the dose immediately, pending the meter arriving and to start testing ASAP @Ragdoll there is a thread already started for you in the Prozinc forum so can you click the link and post more in that thread as we are having a problem tagging people at the moment, but if you reply there the Prozinc regulars will see it.

http://www.felinediabetes.com/FDMB/...k-needs-some-dose-advice.164633/#post-1773575

 

Your numbers are in the low range, especially as it was done in a vet's office and with a pet meter. If those numbers were with 0.5 unit, I think I would be tempted to not shoot until you get the meter. Once you see what his numbers are at home and with a low carb diet, then you can start with a small dose and monitor carefully.

 

I'm with Sue on this. I think with those low numbers, I wouldn't feel comfortable shooting without testing.

 

Hiya,
Some folks in the UK use these generic syringes from VetUK. They are a lot cheaper than the brand name U40 syringes...
http://www.vetuk.co.uk/insulin-syri...nsulin-syringe-with-needle-box-of-100-p-11335

But if it looks like a kitty needs a very small dose then it's also possible to use U100 syringes (together with a conversion chart for using U40 insulin). This can make measuring small doses much easier.

Waving 'Hi' to you from a rather soggy Surrey.... x

 

Thank you all very much for your advice. I've gone ahead and ordered another meter which should arrive sooner, as I noticed the estimated delivery date for the one I ordered last week has slipped to the beginning of October for some reason. Hopefully this one should arrive in the next few days.

We've actually had some further news about Floyd's test results from his stay during his DKA episode. His aldosterone levels are apparently sky high which isn't good news, and could mean a tumour in his adrenal gland. He's going back in to the vets on Monday for further tests, so they will also be able to recheck his glucose readings, and I can discuss reducing his insulin dosing with his vet.

In the meantime I am being extra vigilant for any signs of hypo, and am armed with honey and gravy laden food in case it is needed.

Thank you again for all your support, it is much appreciated.

 

Thank you so much, I'll head over there now x

 

@Ragdoll, I don't know where you are in the UK, but, if you want help with learning to test a cat's blood glucose there may be someone who lives near you. Do shout out if you need help.

Eliz