High BG levels, no improvement after 1 week (UK)

Hi everyone, I'm James, I'm new here and I'm posting on behalf of my mum Jan and our cat Tigger. He was diagnosed last Monday after taking him to the vet due to lathargy/excessive appetite, thirst, weeing and weight loss. His BG level was tested to be off the vet's scale at 30+, so we didn't really know what the true figure was. He was started off Tuesday evening on 2u of Caninsulin every 12 hours and was scheduled for another vet visit and blood test Wednesday. The BG level was still off the scale at 30+, so again no true reading. He was then moved up to 3u of Caninsulin every 12 hours and that was started Wednesday evening. After subsequent vet visits and blood tests Friday and today (Monday), his BG levels were shown to still not have dropped below 30+. This evening he was increased to 4u per 12 hours. We've seen a good improvement in his energy levels over the week and he seems to be pretty close to his normal self, although obviously still not 100% and with a lot of weight lost. He is also drinking considerably less and weeing normal amounts. The BG levels are really baffling though...I know it's only been a week, but to have his BG readings still 30+ is pretty worrying. They tested his urine on Wednesday and found ketones but no blood and they say his kidneys are fine so far.

We've also adjusted his diet to include both his regular wet food and a newly introduced diabetic dry food (high protein, low carb) and his appetite is still high.

A little bit about Tigger - He's roughly 12 years old, never been overweight (although we noticed he started to gain a little bit of a hanging belly several months ago), normally very active, with spurts of very energetic playful behaviour. He also normally prefers to graze small amounts of food throughout the day. It would be great to talk with people in similar situations or with people who have advice regarding his insulin/diet/BG and if any changes would be advised, or if it's simply a matter of giving it more time despite his levels.

Thanks a lot
Jan and James

 

Re: High BG levels, no improvement after 1 week

Hi there

are u located in Canada or Europe?

You'll want to multiply your numbers by 18...so a 30 x's 18 would be 540
Majority of the members here use U.S readings, and that helps a lot to understand your numbers.

I just want to say your experience sounds a lot like mine when we were on Caninsulin. Turns out home testing is the way to go, and my kitty was overdosed on Caninsulin before I sought help from a better vet at the time.

You may want to consider trying another insulin like Lantus (Glargine) or Levemir, a lot more gentle and longer lasting. You don't need a vet prescription for these if you are in Canada.
In the U.S, Vetsulin is the same as Caninsulin and has had issues. See this link viewtopic.php?f=19&t=311

As for diet, again, I walked out of that vet's office with $30 and 40 dollar bags of dry diabetic food. One for Luna, the diabeitc and one for my non diabetic kitty Wrong answer. Dry food does not help control numbers. Plus I learned once finding this website, that I did not want a second diabetic kitty, so both went on a low carb wet food diet.
Please research your options on the drawbacks of a dry food diet for cats.

FDMB HEALTH LINKS
Do have a read thru in Dr Lisa's feline nutrition web site. Plus the important section on how to slowly and safely transition from dry to wet.

This food charts link will help pick out good wet food brands, but DO keep in mind, YOU WANT TO BE HOME TESTING and possibly lower the dose if/when you switch diets (ETA: however with ketones present, you'll want to keep on track with that, you can check for ketones at home too by purchasing a Ketodiastix kit at any pharmacy)
Janet & Binky's Food Charts Most kitties will drop in numbers once they start a low carb diet, so you'll want to monitor at home and be prepared.


You'll really want to learn to home test. You don't need vets permission to do this. Plus it's less expensive than weekly vet visits, and a lot less stressful for kitties.
Home Testing Links

Others will be by to give you some guidance, in the meantime, do consider home testing.

 

Re: High BG levels, no improvement after 1 week

I'm just adding the link for Caninsulin users, unfortunately there isn't much activity in that forum, as many have switched over from Vetsulin/Caninsulin to other insulins.

Do stick around this Health forum thou - lots of help and activity here.


viewtopic.php?f=19&t=302

 

Re: High BG levels, no improvement after 1 week

Hi, thanks alot for the advice.

We are in England and actually were a bit confused with the different scale lol, so thanks for clearing that up. We've actually ordered some of the diabetic wet food tonight at the vets, mainly because that's what he prefers but I had also read about the benefits. I think we're going to give it another week on Caninsulin with any necessary increases of the dose, but we'll ask the vet if we can switch to another insulin if there's still no improvement. I did however read somewhere that Caninsulin is the only one prescribed in the U.K? if anyone has any advice regarding this it would be appreciated. The home testing does make a lot of sense, I think we were just waiting for Tigger to be in a more regulated state without needing frequent vists to the vets, before considering this...we'll see how it goes over the next week. Thanks a lot. -James

 

Re: High BG levels, no improvement after 1 week

Ok! Hello in England!

I will cross post your thread in community - I do know there are a few Europeans who frequent the board, and we'll see if they can stop by to help ya out with what's available in your area.

You could also add UK to your first subject/title line to get their attention. Just hit "edit" and add UK to the title line. And then hit "submitt"

Check back often ok? And keep us posted!

 

Re: High BG levels, no improvement after 1 week

Just wanted to add, increasing the dose without home testing may be a bit unsafe, as you have no idea what he is doing thru any given cycle.
Not to mention shooting up to 4u blindly.
We highly encourage safety on this board.
Unfortunately most vets don't encourage home testing, but trust me, it is one of the best and safest ways to know how any insulin is working for your cat.


Please reconsider purchasing a meter at your local pharmacy sooner rather than later.

You can still use the "x 18" method to post the numbers that your vet is getting.

 

Much appreciated regarding the cross-posting. :smile:

It is slightly worrying to have him up to 4u after going through 2u and 3u within one week, but his BG is so high I just think the vet doesn't know what else to do. I'm going to see if I can buy a home testing kit soon...I'm more in favour than my mum to not completely go on the vet's opinion alone. We'll let you know how it goes. Thanks.

 

They should not have sent him home with ketones present in his urine. Please.get Tigger back to a vat ASAP for treatment of the ketones. If your current vet doesn't want to treat the ketones, find a new one.

 

Hi James,

welcome to FDMB :mrgreen: Best place for diabetic kitties!

I'm a UK bod, just live in Germany.

I'm really not sure what is going on with the Caninsulin and why if the manufacturers of it's sister-Vetsulin (exactly the same just a different name for non-european countries)are saying Vetsulin is unstable, that they haven't given the same warning on Caninsulin. Or, that they have and vets are either ignoring or haven't received this information.
Personally, I would be inclined to contact the Vetinary association, or whoever oversees vets in UK and ask the question.

Vetsulin is unstable and unpredictable in essence-not a safe way to treat your kitty.

That aside, working up to 4u in 7 days is poor practice too.
Is your cat stressed when at vets?
uckuy had white coat syndrome and her bg could go more than 100 points higher at vets than it actually was. (fight/flight syndrome)
540 isn't end of the world. Lucky was 457 I think.

As for food-dump the prescription-expensive rubbish with Vet making a nice profit.
I fed Felix 'As good as it looks'-this is 3.4% in carbs (I prefer under 10% as same as what getin mice, natural food source).Lucky put all her weight back on and barely ever drank from her water bowl.
Cats natuarally have a low thirst drive, so need encouragement.Dry food just takes even more away from them.
Lucky was always a free feeder. Went home, picked up the dry, replaced with wet, never looked back and never a problem with her being piggy.

Whiskas MMM even lower at 1% but I couldn't find it in the UK when I was home last December so they may have stopped making it.
There are some others, such as tesco's one I can get you the list if you want it.

What I did with Lucky's was add water to the wet to, just to get that bit extra in her.

The lower the carbs, the less insulin you need because the lower the bg number from the carbs.

As I said before, Lucky was 457. Went home, swapped fro wet. Vets wouldn't prescribe insulin initially (long story and hell of a battle).Went back a week later and her bg was 257! Still too high, but that was the difference between the foods.

As for keytones-were they trace? If moe than trace, Monique is right,Tigger should be under vetinary supervision as keytones can be life threatening.If trace, can sort of maage at home, but you should be home testing and getting lots of water in them.Adviseable to test for keytones until a cat is regulated. Essentially one of the main reasons for keytones is lack of insulin.That's not to say 4u isn't too high as it's not the only reason. You have no idea what that 4u is doing to your cat. Getting 30 each time means nothing. I'm assuming this was either a fructosamine test-if so, this is an average bg over the previous 1-3 weeks. Well a week on it won't have changed much. Could mean that at +4 hrs after insulin Tigger was at 5!but once insuin ran out s/he was at 35. Therir of very little value.Alternatively it could have been an intravenous blood draw and that was Tiggers bg there and then. How long was it since insuin? Again could have been on it's way out.

Please read the stickies in the Caninsulin/Vetsulin forum-lots of info about what Caninsulin is and how works in cats.
Unfortuantely I doubt you will be able to access Levemir/Lantus in UK-they are human insulins and UK is woefuly behind just about every other country in terms of Feline diabetes.
There is a new insulin-Prozinc. Came out kast November, vets can prescribe and it seems to have had some success. My english friend got it for her cat and managed to get her into remission (diet controlled) within 4 months. It's similar to PZI-so if you get it, they would be the people to advise. I only feel comfortable offering advice on Caninsulin/Vetsulin and Levemir/Lantus as these I have experience of (or they have near as identical action)

I would consider 'shopping around' vets if that's possible.
There's huge amounts of ino here on FD and if you go to catinfo.org-tons more. Up to you how much you dig into it.I'm a 'I've got to know everything I can person', others are different.You will get lots of help/advice and support here if you want it.

Can buy glucometer on ebay and strips for around £5-10 depending on type and timing.Accu check avibva and One touch ultra are both good, but there are others.Accu uses slightly less blood-but I like both.We can help you with the hometesting and tips to make it easier.Lucky was an extremely fractious cat (hadn't been picked up in about 12 years!)so I know that because we did it, I'm doubtful that there's a kitty that you can't do it with.You have to be prepared to put the time in.

Ketodiastix atre what you want-think you'll have to get them off the net as Cheryl (newbie like you) couldn't get them from Boots or Lloyds-can check or if you know of an independent.Maybe even your vet? Can get for around £6-10 a bottle (100 strips so will last vey long time).These test glucose-(just gives you an idea how much glucose kitty excreting) and if kitty has keytones, how bad they are. As I said earlier, until cat regulated should monitor for keytones-lose kitty and/or very expensive vet bills!

Please keep asking questions, we will help you anyway we can.

Sorry this is long, but it's a marathon not a sprint! :mrgreen:

 

Hullo from Hastings, E.Sussex(UK)

Hullo,
If I can help you I will.

We treated 3 diabetic cats (one at a time) and if we oldies can, so can you.

Bushey, our last cat came to us on Caninsulin and a b/g of 35!!

As I still had some of Katy's Insuvet (beef) PZI in the fridge, I tried it on him and had an immediate improvement.

Caninsulin is ideal for canines ie dogs

Insuvet (beef) PZI is only one atom away from cats own insulin. It is worth a try.

You will be told to get a new vial of insulin (@£30+ a time) each month. We actually got 6 months out of each vial as long as it is kept in a fridge.

Avoid ANY dry food. Most cats get on very well with any tinned food IN JELLY and dont really need dry.
If you look at Janet & Binky's food lists you will find that a mouse (ideal food) is about 4% carbohydrates
Tinned food is aprox 5-10 % carbs
Dry food can be anything up to 50% carbs!

Do try to get a glucometer (try Ebay) and you will find instructions here. If you live near it might be possible to help you.
Keep some glucose powder (about£1) in the house in case of HYPO
I will send a PM with my phone number if you want to talk

Mary

 

Hi and welcome!

I see you have already received tons of incredible info and advice, so I will just add from my own experience and what I feel is important.

I too started on Caninsulin for my Shadoe, and got absolutely no progress; her numbers stayed high and horrible. I switched her onto Lantus and she immediately started to act better and her numbers improved. You can see her spreadsheet in my signature to see her numbers. Both my cats are high dose kitties, so they do get alot of insulin but are doing just fine on Levemir.

I am in Canada so I have used BG Conversion Calculator to convert my numbers from home testing to values that the others on this site know. I put both values on the spreadsheets because my vet needs the numbers you know but this site needs the others.
So try out the converter and you will have the numbers to post here.

Home testing is vitally important because some cats show no signs at all that they are low. I have caught both of mine at low numbers and needed to feed to bring the numbers up.
List of Hypo symptoms
How to treat HYPOS – They can kill! Print this out!
Jojo’s HYPO TOOLKIT

Food - get rid of all the dry of any kind - it will cause high numbers. My Shadoe gets ahold of even a small mouthful of dry foods and her numbers skyrocket!
See if there are any foods in this list and stick to below 10% carbs.
Forget about the expensive vet food, even the wet stuff.
Binky’s Food Lists

Ketones are bad; please find out from the vet if it was just a trace. Still, get some Ketostix and test the urine yourself at home and post right away if your test strip shows even a trace for ketones. There are many people here who can help you with what needs to be done.

OK I likely repeated much, but I feel some things can't be said too often.
1. Home test, you may save your kitties life.
2. Feed wet low carb foods, you may not even need any insulin or only a very small dose.
3. Test for ketones when you have high numbers, they must be resolved asap.

Finally, thanks so much James, for helping your mum Jan and her kitty Tigger.

 

Hi, just like to thank you all for your replies and helpful information...it's quite overwhelming the amount of support here. You're all amazing.

So we took Tigger back to the vets for his appointment this evening for another BG test, roughly 11 hours after his last Caninsulin shot, and his reading came out at 7.1 (127 mg/dl) which obviously took us by surprise and was a fantastic improvement. He was as stressed as usual with being at the vets and consequently did a nervous piddle with which we took the opportunity to test for ketones...they came out as trace as before, but pretty much the opposite end of the chart from the reading last Wednesday. We dont really know what's caused the turnaround, the increase in dose to 4u or the time elapsed since the start of treatment, but we're hoping it's something we can effectively manage now. We're keeping him on 4u Caninsulin per 12 hours for now, but we've purchased a home monitoring system and ordered some keto-diastix strips and he isn't booked in for a stressful visit to the vets for another 2 weeks, at which they're going to do a fructosamine test for a more useful look at his levels.

We've taken on board the advice to practically cut out dry food, although the vet assured us the diabetic dry is no worse for him than the wet...I think it's just an individual thing and that he would do better with as little dry as possible. We'll see how it goes...we obviously want to get him to the stage where he needs as little reliance on insulin as possible.

Thanks again...we'll keep you updated :smile:
-James