My Boy Yogi help please :)

i think i keep posting in the wrong forum, hopefully this is the right one now


Hi i posted in the new user section last night and i have just spent my morning at work creating a spreadsheet can someone please have a look and give me some advise.

He has started on the PZI insulin and i know i havent done a very big curve since being on this new insulin, its just difficult while im at work i will aim to get one this week,

He isnt improving, he has gone from 10 kilos down to 6.5 kilos

I cant feed him wet food as it has always given him diarrhea this has always happened

He is drinking heavily and urinating alot,

He is very perky and has a good appetite,

Thank you

 

This forum is fine; you can get experience from other ProZinc users here. It's a small but friendly forum. If you have an emergency, post on the Health forum also where you will have more eyes.

There are lower carb foods that are dry - not ideal because wet food is better (see www.catinfo.org) but better than high carb dry. @Carol & Murphy has a kitty with food issues and I know she knows the dry possibilities. It looks like you are in the UK so @Elizabeth and Bertie may also have some ideas.

It is hard to regulate a kitty on dry, but he is very high. Tell us more about how you give the shot (where/before or after eating). Does he have any other medical issues? On any meds?

Does your vet seem like he knows about FD? He did start on a higher than usual dose and it has been raised by full units pretty fast. too much insulin can look like too little sometimes, but I am reluctant to give dose advice until we have some more info.

 

Hey there Hazel. I am sorry you are having such a time with Yogi. He is very high and I am wondering if you are checking him for ketones also. If not it would be a good thing to do. You can pick up ketones sticks and check his urine. The excessive drinking and peeing is because of the diabetes being uncontrolled and it should get better as Yogi gets more regulated.

I did read your thread from the health and wet food vs dry and wet is definitely better as the carb count is too high in dry. We want to see the carb count to be under 10 %. I am not familiar with the foods available to you in England .Here is a food chart for Europe.
http://www.felinediabetes.com/FDMB/...for-europeans-and-international-buyers.64843/

 

Hi Hazel, glad you made it here. You weren't posting in the wrong forum, this one is just more tailored to your insulin, so better for dosing advice. Sue and the others here are great advisors and I'm sure they will help you to help your kitty.

 

Hi, i have been injecting him around the scruff of his neck he has always got food down and he grazes when he wants, as he lost so much weight he got so thin i was just trying to get him some weight on,i really wish his stomach could cope with the wet food, i though it was doing well with cooked chickens but then the diarrhea started again, my vet has been very very good and he seems to know alot. I
have been reading alot on the internet and i have had him tested for cushings,EPI and Hyperthyroidism which he hasn't got,

Im booked in at the vets again on Wednesday its becoming my second home, how long dOes it take to regulate a cat?? what damage is it doing to him reading high and not being able to regulate him quickly??,

 

Hi Hazel @Hazel ,
I'm in the UK and am using Hypurin PZI. Just going to have a quick read of your posts and will be right back...

Eliz

 

Hazel, when did you start on Hypurin? Do you have blood glucose data for the past few days?
.

 

i have attached the spreadsheet, the ones from the 2nd April is the Hypurin, i havent managed to do a full curve, i started him on it 9 days ago,

 

Okey dokey, Hazel.

Have I understood correctly that Yogi's blood glucose levels are higher now than when he was first diagnosed? If that is the case then it may well be that the insulin dose is too high.
It might be that Yogi's blood glucose is dropping too low and then 'bouncing' up high in response to that. (When the blood glucose drops too low the liver can release stored glucose to raise the blood glucose level, and also counter-regulatory hormones, the purpose of which is to try to keep the blood glucose high for a while. This can look like insulin resistance, but is temporary; though it can last a few days...)

However, that being said, there are some cats who do need high insulin doses.

Hypurin is vastly different to Caninsulin. I'll try to explain some of the differences.
Caninsulin tends to have a fairly short duration in the cat's body, and can often be 'done and dusted' in as little as 8 - 10 hours. (There are exceptions to this general pattern).
Hypurin is a very long lasting insulin and can last longer than 12 hours in the cat's system. So, there is generally an 'overlap' in the doses; with one dose wearing off as the next dose is starting to work. This means that there should be some insulin active in the cat's system 24/7. So, Hypurin has, for want of a better word a 'stronger' effect. And many people switching to Hypurin have found that they needed less of this than they did of their previous insulin. When switching to Hypurin caution is needed, as it may become necessary to back pedal on the dosage....

Well done for learning to hometest. That's brilliant!
It would be great to have more hometesting data so that we can work out what's going on with Yogi's blood glucose.
Firstly, we recommend testing before every insulin shot. That it really to check that the blood glucose is high enough to warrant being given that shot.
After that, we need to know how low the blood glucose is dropping on any given insulin dose. So, a couple of tests taken during the insulin cycle would be helpful. (Every day will be slightly different, but patterns will emerge)
We don't know when Yogi has his lowest number of the cycle, but, with Hypurin it could be anything from between 4.5 to 7 hours after the insulin shot. Some of us have found that it can be helpful to get a test about 2 hours after the insulin shot, as this can be a predictor of what may happen later on in the insulin cycle. Some people who are out during the day make a point of getting a 'before bedtime' test last thing at night.
Do you feel able to get some more tests, Hazel...?

Eliz

 

thank you for so much detailed information, i can get more tests, its just difficult when im working, but i will get as many as i can,

when i first took him to the vets its was because he was urinating more then normal, he tested his bloods then and they came back at 13mmol, he said just change his diet,
i went back a week later as he hasn't improved and they tested his blood again and it was mid 20's, so he said we will start him on insulin, since then i have had nothing but high readings,

i have a very thirsty cat, he is only urinating at my front door, currently i have bin liners all over my wood floor, but with the amount of mopping i have been doing the water is raising my flooring, but hey this is the price i pay for my baby,

Before the diagnosis he was going to the toilet once every couple of days he never had diarrhea except when he ate wet meat, but now he is going 2-3 maybe more times in one day,

Will he ever get right??

 

Hazel, what were you feeding him initially, and what did you change his diet to...?

With a little bit of luck there is every chance that he will be just fine.
.

 

well as he isnt eating wet food, i have brought every dry food that ios meant to be better for diabetes, i have a bag of science plan diabetic, purina diabetic and the hills, he defo doesn't like the hills, he wont entertain them, can you recommend any other dry food that might be better,

hopefully when the diarrhea providing i dont over due it, he can stomach some wet food but prob only a pouch every couple of days, but at the minute its just flying straight through him

 

Hi Hazel

I replied on your thread in Feline Health. Here's a link to my first post on that thread:

http://www.felinediabetes.com/FDMB/threads/my-boy-yogi-help-please.156023/#post-1649709

Eliz has a wealth of experience in the use of hypurine bovine PZI; you're in good hands.


Mogs
.

 

Thank you Mogs, i have just read through everything should i reply back on this post or on that post??

yogi has always snored loudly from being a kitten, it was only this year i thought i would just for peace of mind get him checked,

The diarrhea started after the insulin, i thought it was because i given him wet meat but i have stopped that now and it has continued,

the weight started to increase when i put him on this new PZI, but i havent weighted him for a day or two as i was getting obsessive with it,


everything else you have written is spot on

thank you

 

No probs with replying here, Hazel. Re the continuing diarrhoea I'd definitely ask your vet to run the SNAP fPL for pancreatitis (or Spec fPL if he can't do the in-house SNAP test and needs to send the sample to an external lab for pancreatitis testing and it might be a good idea to get liver and kidney panels done as well). It might also be an idea to drop in a stool sample to the vets to see whether that might shine light on why the GI upset. Yogi needs to get as much benefit as possible from his grub. I'm pleased to hear that he is starting to regain some weight on the hypurin. It's no bad thing to keep monitoring his weight daily. Also, secondary monitoring of his water intake might be very beneficial at the moment: it might reveal subtle signs of improvement that the BG results aren't showing yet. (Weigh bowl + water in grammes then weigh again before refreshing it. The difference in grammes is the equivalent of the number millilitres of water drank - 1mg weight of water = 1ml volume of water).

@Elizabeth and Bertie, @Sue and Oliver (GA) or other members replying here: is it possible for a moderator to merge threads? Link to the start of the other thread is below:

http://www.felinediabetes.com/FDMB/threads/my-boy-yogi-help-please.156023/



Mogs
.


ETA: I've just posted a cross-link from the other thread to this one so that people on Feline Health following Hazel and Yogi will know to come here for further posts and updates.

.

 

Bobbie - that link doesn't work (at least for me)

 

ok thank you, im getting to the point where im dreading going home from work to see him, i dont like to see him like this, but i know he needs my help.

with regards to the previous post, squaliesmom thinks the dose might be to high, this is what i was thinking how do i go about lowering it? do i stop it altogether and the start again or do i drop down a little bit each day?

 

Hi Hazel - I can't advise on dosing, but I do have a kitty who cannot tolerate much wet food - goes back years where it triggers vomiting (and pancreatitis) there's a few of us here on the board who have similar issues. My cat has IBD and chronic pancreatitis so I have learned to not buy wet food with carrageenan or the various gums (guar gum for example) and low fat as well. As far as dry food, the lowest carb low starch food I give are: Evo (don't know if you can buy in UK) Young Again Zero Carb (available only on-line), Wysong Epigen 90, and Waggers (www.waggers.com) I also use Purina DM dry when he won't eat anything else, and Royal Canin glycobalance - these latter two kibbles don't seem to affect his blood sugars too much. I will say that the young again, Evo, Epigen and Waggers can cause diarrhea when 1st introduced so do it slowly. ZiwiPeak has some air dried venison and lamb that is on the UK list of foods- I bought some for Murphy -but he won't eat it yet, but I am hoping he will eventually.
Another thought With all his diarrhea and high sugars, do check for dehydration (skin tenting, tacky gums)

 

Carrageenan triggered a massive pancreatitis flare in Saoirse. Would definitely recommend avoiding it. (It is used by some researchers to trigger an inflammatory response. )


Mogs
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Hopefully between the home testing, the vets and some input from experienced members here you'll soon find a way to improve things for your dear Yogi and he will soon start feeling much better. BTW, I'm in the UK too and things would not have gone nearly as well for Saoirse had I not found FDMB and learned so much about how to better help her. (She was absolutely wretched and was physically in a desperate state after the vet treating her at time of diagnosis put her on Hill's w/d Dry and Caninsulin. She did much better on Lantus, another long-acting, more cat-friendly insulin. I learned about Lantus here.)


Mogs
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everyone has been great, thank you all so much, i really hope things start to improve, i willing him to get better,

 

And there are now a lot of crossed fingers and paws around the world willing the same!


Mogs
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Thanks for letting me know that Carol; it didn't work for me either. Will have to try it again.

 

This one should work. Note that the list was complied in 2011 and not up to date.


A-Z list wet canned food UK and Europe.pdf

 

Check the link in @Elizabeth and Bertie's signature for an up-to-date UK food list.


Mogs
.

 

Thanks Mogs, I forgot that Elizabeth had it linked to her signature.

 

i have been looking at the A-Z list of UK food and i'm going to give the garu gourmet ago, now they do a grain free, do you think this would be better for him with the diarrhea or worse?

 

Dear Hazel,
welcome you to the group.
I'm really sorry you are having such hard time with your beloved Yogi but we are here to help.
Don't worry too much about his very high numbers at the moment, you will test your patience at the beginning of that journey.
Your cat's very high numbers may indicate another health issue as well as diabetes but let's take care of FD first.
First and most important thing is to understand that high numbers may be due to bouncing from lower numbers which cat's body is perceiving as danger and would try to correct throwing more glucose. But we need more data from you to see what's going on.
Elizabeth will guide you through, she is very experienced and a wonderful person.
I will look again at your SS tomorrow. Your 2 units of Hypurin is rather a high dose to start with but maybe your cat needs it, it is difficult to say now.
Please take deep breaths, this is a long journey but your efforts will pay off.
Sending you prayers and hugs, see what happens tomorrow.
Marlena

 

Hi, thank you for you words, tonight its the best he has been he has been very calm and only one pee, normally i have had about 6, im clinging on to hope, i have a gut feeling that his insulin is to high, i want to reduce him but not sure how to go about this, i am going to get more readings, and i will post them when i do, i did a reading tonight before his insulin and it was 36mmol so still high but he seems quite calm, maybe because he has a shampoo and blow dry, less drinking as well, is ketone's are neg, lets see what tomorrow brings

 

Hi Hazel,

I'm glad to hear that Yogi hasn't been peeing as much today. Celebrate all the small good things as you go along - it helps!

I know it might not feel like it just now but you are making all the right moves to help Yogi get better.


Mogs
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Hello Hazel,
How are you and your lovely Yogi doing?
Just need to ask you some questions:
1. could you tell me what's written on the box of insulin you use - there is so many PZI/ProZinc insulins that I think we need to be sure what's in your vial, especially that now ProZinc human recombinant U40 insulin is available in the UK for use exclusively for cats and it's different then Hypurin!
So if you have Hypurin it should say Hypurin Prozinc 100% bovine U100 insulin. There is also Hypurin lente and ultralente, they are isulins for humans.
2. did your vet dispense insulin in the surgery or did you get a prescription which had to be filled in at a regular pharmacy?
3. have you ever tried feeding your cat raw species appropriate diet (homemade) or prey model diet or did you ever give him a piece of fresh meat or a chicken drumstick to gnaw on and did he like it?
4. did you test your cat at home after DX and before starting insulin and what number did you get?
My understanding is you're not at home a lot due to work commitments so maybe frequent testing will be a problem.
When you start insulin, your cat's system has to sort of get used to it so you might be getting a very confusing picture in the first many weeks of treatment and it's very difficult to lay it in your head that you give a dose which should give this result but you get an unexpected result - does it make sense? I'm trying to assure you that the wonky numbers you are going to see at first are indeed normal but the whole process is just trial and error. I went through hell with the initial treatment of Rocky and, frankly I did not know what I was doing because I was so stressed!
What I would like to suggest to you is to read a lot all the information provided here, print it out and keep it handy so when you need to make a decision you have it at your disposal. There is a lot to learn, for example how the insulin works, how to do injections properly (proper technique), how to fill the syringes, what to do in case of hypo (be prepared) etc.
Also, could you fill in Yogi's SS please when you can and maybe change the BG values to European.
I'm keeping my fingers crossed for you and Yogi and I hope I will be able to give you a lot of moral support and shoulder to cry on if you wish.
All the best
Marlena

 

@Marlena, she has the US/World version. At the top, just choose Us or World and it will convert.

 

It didn't work for me, never mind, I can try again, thanks.

 

Oops, sorry Hazel, I have found , in another post, my own answers to the questions I asked you so I think you can just ignore them.

 

When you have a moment, could you add a few more tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

 

Hi, update on my boy yogi, he is currently up to 12 units of insulin twice daily and we have now seen a massive improvement, he is hovering between 13mmol and 25 mmol. i have a question though, i checked him blood this morning before his insulin shot and he was at 12mmol, now i dont know what to do when he is this low, do i give him the 12 units as normal, do i give him less insulin or do i miss the shot completely, this morning i did retest an hour later and he was 16mmol but i had to leave for work so i didnt give him his shot this morning as i didnt know what to do

Any advice please would be great

thank you

 

You can always still for 20 minutes WITHOUT FEEDING and see if he rises up in those cases.

 

yeah i waited an hour and he went up to 16, but im worried if i give the 12 units as normal im going t send him to low, so shal i give him say 6 units instead of his full dose?

 

Hmmm...it's hard to say. Since your SS isn't filled in, I can't really give good advice because I can't see what he's done in the past. I'd say you should probably go with your gut. If you feel that 12 will be too much, go with 6.

 

He has always been reading HI, this is the first time i have had anything under 36 mmol, i will get it updated