My cat is newly diagnosed

Hi, I am in the UK and my 11 year old cat was diagnosed with Diabetes last Friday and my mind and emotions have been on red alert ever since trying to gather the fortitude to inject her, observe what I am meant to be observing and learn all I can, all with the awareness that it seems I cannot know what will happen - in a way! This period of stabilising is a little like diving into an ocean and not even knowing where I am headed and what to look out for as good signposts or bad ones!

I have gleaned lots of information from these boards and for now am just trying to get to grips with injecting. Ellie has never been a lap cat, she is part siamese and fairly wiley and does things on her own terms. I am having terrible trouble doing the injection. Any ideas? The vet suggested meal times, we have a long acting insulin (insuvet pro zinc?) and are trying once a day at 6pm. Well it was 6.15 the first day, 7.15 the next and not trying to edge back to 6pm again! We have been advised not to change the food at the moment. She wont let me come up behind her when she is eating, she bolts her food anyway and head bobs about. For now one of us tempts her with small bits of food as she slowly follows the trail, my partner gives her the shot! As you can imagine this is not ideal long term. I dont think it hurts, she just hates people coming up behind her, thoughts please, will she get used to it?

AS others are, I am worried about hypoglacemia and watching her like a hawk and wondering if she will have fainted in the night! A little dramatic as within 24hrs of her first insulin shot she was like a different cat, truely amazing and weird at the same time.She stopped scavenging for food - this happened in the week before I took her to the vets, her obsession with the kitchen tap has stopped and urination in the litter tray is almost half the amount by the looks. I am wondering if we would now by now if the 2 units we are giving are too much - i.e she seems fine for the three days we have been giving it, would we perhaps know by now? I think the answer to that is no as if she excersises more or not eat as much things change - is this right - I am just trying to work out if there is a "likely" time for a hypo if one was to happen - I am sure I will relax in time, its just a lot to take on.

thanks for reading, I am going to take each day as it comes, but heartened to see such a change in her in such a short time.

Sally

 

Welcome to the board! You seem to be on top of things. Have you thought about home testing? I can't be sure you aren't because you do have some numbers.It is the best way to know if your cat needs insulin and how she is reacting to the insulin throughout the day. I never used that insulin but we usually start at 1 unit and work up from there if necessary.
A low carb diet is best but the food change should be done with home testing to make sure she doesn't drop too low. Have you found the info with the list of hypo symptoms?
As for giving the shot, are you tenting the skin? And what size needles are you using, that may make a difference? I know I am not much help, haven't done this in almost 2 years, but I know you will do well. Keep us posted.

 

Hi - just injected again without too much fuss, but taking two of us to do it. Yes, we are using the tenting method, the vet and nurse showed us in the surgery and we practised on Ellie there, with water. We pick the skin up near the scruff of the neck with one hand and feel for the dip, put the needle in here, wait for a "pop" feeling and then push the plunger. We practised on an orange to get used to this sensation of popping and then pushing plunger. Tonight we put her on a surface (using floor before) and the tiniest drop of milk and stroking her head and talking to her and she didn't even notice. My partner is a wreck now - we are trying to remain confident and "in charge" as I dont want her to get the upper hand as it were as this would make things worse.

I cannot remember any of the numbers from her blood results, the vet and nurse gave me so much information, it was bank holiday in the uk and they did not want to leave her for 3 days so we went in on the Saturday morning to learn how to inject and that was it, they gave me a phone number to all whenever i need. I am going back on Saturday without Ellie for a chat and I think they are showing me home testing and then Ellie has another blood test the week after (2 weeks after diagnosis). They have said that getting the right dose may take a while and not to worry about changing food at this point, just be consistent with it and the insulin for now and monitor. I am writing down changes in water, food, bood and litter tray. Anthing that goes up or down or different.

Yes, I have a printout of the hypo symptoms stuck on the fridge door along with my daily chart and the vet gave me one as well - I am a teacher, so learning and observation come naturally, but have to say that doing this for my cat has an emotional aspect that is hard to get used to (I am not a mum - this is the nearest to having a dependant that cant talk or tell you anything that I have ever had!).

I will ask the vet about home testing if they dont mention it. Ellie is fairly consistent with her activity level - well she was before she got ill, I was not even sure she was ill, we moved house, she was getting older and on a diet, so the weight loss was initally a thumbs up from the vet and the drinking from the tap was put down to moving house. I can hardly believe I put her lack of usual behaviour down to getting older, she is following me about again, curious and playful when encouraged, but as I say, she is an indoor cat and fairly routine so I am hoping the levels dont go up and down too much but home testing would be a reassurance I imagine. The thing she always has had is a nervous temperament, jumpy and stressy, so I imagine this would also change her glucose levels, along with food and excercise changes - is this right?

 

"The thing she always has had is a nervous temperament, jumpy and stressy, so I imagine this would also change her glucose levels, along with food and excercise changes - is this right?"
Yes...that is right. We do have some members in the UK so some of them may be able to help you with the home testing or at least where to get the supplies and the foods when and if you change her diet. And I hope your vet is on board with the testing at home. Being at the vet can riase the numbers as well.
Don't beat yourself up too much over not noticing sooner...I think we have all done that. She is getting the help now...it will take time but I know you can do it.

 

Hi and welcome to FDMB :mrgreen:

Can you tell us what food you are feeding?
Hometestesting is definitely the way forward.

Glad to hear they have only prescribed 2u, though the ethos of this board is start low, go slow.
As Jill has stated there are a few of us Brits on here, most are American or Canadian (food will be different)
Food plays a significant part in bg numbers. The carb content is what drives up bg, particularly dry food.

Cats should receive insulin (regardles of the type) twice a day due to how fast their bodies metabolise it.'Insuvet Protamine Zinc:
Insuvet Protamine Zinc has a medium to extended duration of action and is administered subcutaneously. The onset of action is normally 2–5 hours post administration, with a maximum effect at 12–24 hours and a maximum duration of 24–36 hours.
The veterinary surgeon should be aware that the onset, peak and duration of activity has been reported as being variable between dogs and, in cats, can be half that achieved in dogs'

pet diabetes-excelent source of information:
http://petdiabetes.wikia.com/wiki/Category:Insuvet
http://petdiabetes.wikia.com/wiki/Insuv ... amine_Zinc

It looks as if this is also PZI-You will see we have a forum for this insulin on the board. May be worth cross-posting in that forum.http://petdiabetes.wikia.com/wiki/PZI (see at the bottom about the UK version)
It definitely should be administered twice a day. Because ECID (Every cat is different) that is why we advocate starting on a lower dose of 1u and then through hometesting, adjust the dose accordingly.

I really hope you do have a good vet, but already unsure how knowledgeable they are if they are telling you to only administer once a day.
I would be inclined to dose twice daily but at 1u. Then with hometesting (it really is easy once you get into it, usually a matter of days)increase/decrease as necessary.
If you look at the non-essential section of the health board (I think) there is a sticky on 'convert a vet'.
You need to be careful if you look at switching food as if you drop the carb content it can affect the bg number and what dose insulin is needed.

I would recommend getting 'ketodiastix' to test for keytones. This is a test strip that you place under the 'pee' stream and then check the colour code.
http://petdiabetes.wikia.com/wiki/Ketoacidosis

If you have the list of hypo symptoms your well in control.Just make sure your familiar with how your kitty normally is,. Hometesting again would be an indication if kitty's bg was dropping too low.

I would also ask your vet about getting Levemir. Steve/Jock managed to get Levemir in the UK (we're currently in Germany) This along with Lantus has been shown to have the best chance of remission in cats.
Keep asking questions. Good luck

 

Thank you all for your encouragement and advice. I have fed her all her life on Hills (now I regret this as I understand the logic between this and diabetes) She has been on the Senior Light version for a couple of years. I think the vet wants to change this food to a higher protein one, but also think they didn't want to introduce lots of changes at the same time - there is an awful lot of information to understand and get right. With regard to the injecting twice a day - they did say this was likely & more usual, so am not sure why they said try once a day. I was also not told in detail about what the onset, peak and duration times mean or the fluctuating levels of glucose during the day and how they relate. They did mention all this but think are going to explain it in more detail on Saturday.

I am keeping records to show them and a close eye on any signs of high drinking and urination levels as well as lethargy, wobbles, tremours, she seems fine at the moment. I am not sure I can remember what she was like before as we moved house around the time the vet said the diabetes probably started, so she has never had a clear pattern of behaviour in this house. Although I am noticing things coming back that she did in the previous home, more alert, looking out of windows, following me about, the diagnosis is making me hyper vigilant as I know that I need to look for changes in behaviour etc but she herself must be feeling a little disorientated at her new found energy!

I will definately ask about home testing, my limited understanding is to do this before administering insulin to check for glucose levels and adjust the dose if need be ? The vet has told me that twice a day is more common and that remission is possible, he didn't mention any other insulins, perhaps I will mention the others if/when we talk about twice a day. Would you say from experience that long lasting and once a day insulin injections were not as effective at managing things?

I am a bit blinded by the medical words and numbers, I dont know what Ellies figures are, but I will on Saturday I think, I do know the vet said she was borderline from the blood test they took last friday but the subsequent fructomisine (?) test showed she was consistently not managing her blood glucose levels well for the past two weeks. Again, it doesnt help me much in being proactive with knowing the implications and best treatment, I am trusting the vet at present.

Thank you again
Sally

 

No worries-I have some hope in your vet! :mrgreen:

Hills is not a good food in terms of carbs.
I would recommend Felix or Tesco own brands. I have posted this info on 'Angieb's' thread close to yours here on the health board.

I would consider dropping dose before changing food as this is where you can get big drop in bg number and therefore not so much for insulin to work against.

Longer acting insulin and twice dosing are two different things.

Longer acting insulins-Lantus/Levemir have been found to have excellent remission rates in cats. Vets may not be keen as human insulins and you can get them from any pharmacy or even internet (one you have Ithink you can only get from vet-guaranteed money for them)
Go to the Lantus forum and read the stickies, consider printing the info about them off also. Take this to vet. You'll very quickly know how interested they are in learning by their response to you being proactive in learning.

The difference between short/intermediate and long acting insulins is onset (when start working on bg's), peak/nadir (when insulin working at it's hardest and thus the lowest bg number you get in a cycle. A cycle being 12 hours) Duration, how long the insulin works for in your cat. IN the short, eg caninsulin at best up to 10 hours. Intermediate is around 12 and longer acting can be 12-14 (called carry over and is possibly one of the reasons research has found such good results in respect of remission-this is my muse on it and I don't want to confuse you)

It is quite possible from what you have said that the move tipped kitty into diabetic numbers. Stress can seriously raise bg numbers. This is why often bg readings from the vets aren't particularly reliable, especially if your cat has white coat syndrome.
The Fructosamine test is a guide (not a huge amount of use, other than confirming diabetic).It gives you the average glucose concentration over 1-3 weeks. If it's 300, it could still mean at some point in the day kitty was 500

If you click on people's spreadsheets (in their signatures) you can see how much a cats bg numbers can change throughout a day. If a cat is tightly regulated (Lucky was once on Levemir for a while) you can have cat staying in pretty much non-diabetic numbers all day, every day. Other cats are harder to regulate. ECID (Every cat is different)

In essence-you want twice a day dosing.Preferably (unless any health issues?) starting at 1u twice a day.
Change to much lower carb and wet only cat food. Have a go at hometesting.

As for getting your cat used to shots, alot of people shoot whilst kitty eating. Can also just speak in soothing tones and your right, kitty will pick up if your tense or stressed, so have some chocolate and talk as much for yourself as for kitty. Practice is the key :mrgreen:

 

I think I am getting it :shock: I am aiming for balance! To get that I need to know Ellies blood glucose pattern (curve?) and to do that I need to take blood from the ear every 2 hrs and then test before insuling injections to adjust the dose according to her blood glucose levels. I also need to change to wet food with lower carb content and twice daily injections to get a good constant in insulin supply. - is that right?

I am not confident to put all of this in place at the same time and going to try working with the vet to do this in stages as they suggested, but will definately put my learning into the pot (I am a teacher and coach, so learning and collaboration is my nature - the vets re-inforced the success is due to working together, so hoping it will be ok) Am I right in thinking that changing to 12 hourly injections on the slow release insulin I have would not be great without knowing her glucose curve yet - or perhaps not.

The order I think I am following is:
*Learn to home test and create a glucose curve - with assistance from vet who is showing me this saturday
*Re-test blood at vets in 2 weeks as advised
*Adjust insulin accordingly at same time as discussing with vet whether to swap to twice daily injections
*Wait a while - maybe another week or two and adjust the food and monitor the glucose levels.

The main message I have been getting is slowly and surely and patience, so as long as Ellie seems ok with what I am doing at the moment, which she does, I thought it best to change things in increments, so I can identify which factor is causing changes. If it is better in your experience to make these changes all together and without the vets input, please advise - I am just terribly worried I will get muddled with what is going on for her if I try and master this all in one go.

Her health and well being are at the forefront of my mind and she seems not to be having any adverse reactions at the moment. I am sorry, I still dont quite get the relationship between insulin, blood glucose and the changes througout the day. I may be being naive but if the insulin is covering the whole day and food is being eaten throughout the day there shouldn't be any big peaks and troughs. I am injecting Ellie at 6pm when she has a large amount of her food, she then has a large amount first thing in the morning and 3 shorter feeds in the day (I work from home). Is the ideal to match the peak in glucose levels for Ellie with the peak release of insulin? (I think i am getting muddled with what I need to achieve)

I appreciate the glucose curve and daily testing will find out the maximum blood glucose level in the day and the current level before injecting which will refine the whole thing, but I hope that for the rest of the week the 2 units once a day as a slow releasing type will be ok until we refine things at the weekend. What do you think?

Sally
P.S I hope my vet is not giving me the insuvet protamine zinc to make money, I realise it is only available at the vets :smile: Luckily I took out pet insurance at the end of last year, the first time in 10 yrs of having her (intuition?) and she is covered for all the treament for life, including the insulin, bar the excess of £75 - Phew!!

 

Woohoo lucky you :mrgreen: I missed out on the pet insurance as when I moved abroad couldn't find anyone to cover Lucky and then let it go! :roll:

Your first paragraph is about right.

The insulin is not working for a full 24 hours. As I said it has a duration of about 12 (I'm NOT knowledgeable about the insulin your using, so please bear that in mind, but definitely know no insulin works for 24 hours in a cat)
Hope I'm not coming across as blunt (it's midnight here and trying to be succint-in a bizarre way :roll: )

Is it possible for you to ring and speak to vet before Saturday? I would recommend splitting the dose initially and therefore shooting 1u twice a day 12 hours apart.
Get your hometesting down to a T.
You don;t need to test every 2 hours all day every day, just when your trying to get the initial dosing sorted out and then you do what we call spot checks. What you must always do, is test before a shot (kitty must not have eaten for at least 2 hours before this test to get an accurate bg number)
Food raises bg number.

If (and only if fwiw) you drop to 1ux2, you could change food now.Go for a slightly higer one that I would use once your hometesting like Felix in Jelly (8.3%).
You also need to get the ketodiastix I mentioned (boots/lloyds any will sell them, relatively cheap) This monitors for keytones.
I've been posting to you and Angieb who is also in UK, without going through all posts right now can't remember who I've posted links too (please check her thread)

Keytones basically occur if a cat isn't getting enough insulin, so important to monitor for just as much as not over dosing. Real easy if kitty doesn't mind being stalked in the litter tray.

If she's borderline diabetic you do need to monitor. Shame you haven't got any numbers.

See if I can make this make sense to you (please bear in mind I'm a bit tired)

Over time feed kitty 40% carbs (some dry foods!)carbs release lots of sugar=glucose. Glucose rises.
In Pancreas have beta cells. Beta cells release insulin. Insulin cancels out glucose. Numbers come down.
Keep doing this and beta cells become overwhelmed (tired) and stop working so well, evn stop working all together. No insulin being released (or less). Glucose levels in kitty begin to rise. Kidneys then trying to expel the glucose through urine. Kitty gets dehydrated. Kitty pees a lot, become lethargic.All your signs of diabetes.

Enter exogenous insulin courtesy of good bean (you!-we refer to humans as beans here )This new insulin does the work of the beta cells. Insulin gets to work on glucose. However, unlike natural insulin, it can't be controlled as well on an 'as needs basis'

Think of humans-latest thing is that human diabetics have a machine type thing with a needle inserted in them and a monitor. They automatically get a prick so often (set by doctor or huiman I assume). Machine tests humans bg. Too high and machine then releases an amount of insulin to balance bg again.

Unfortunately we don't have such a thing for cats (yet!)
This is why the longer acting insulins seem to be having better results. Levemir for example binds on receptors and isn't 'set loose' in the blood straight away. This means it is released over a longer period of time and is more gentle (for want of a better worsd) in bringing bg level down.

Short acting insulins such as caninsulin, release all at once, hence a quick dramatic drop of bg but then no more insulin to work on bg for rest of day (when kitty going to eat again)

This is very layman way of explaining.
Kitty naturally has bg 250 in the morning. You feed kitty. Bg (glucose is now being released from food, via the break down process of food)bg raises to 350.In sulin starts to work on this once administered (onset). Keeps working (depending no it's duration, so whether short/intermediate or long acting).Short and insulin used quick. First meal of day dealt with, but then kitty eats again (plus glucose being releasec throughout the day)no insulin left to work on this bg. Bg then carries on rising.Get to next shot time and you have a high number again

Please look at Luckys ss for caninsulin and you can see this.

Long acting it takes a couple of hours to start working on the bg and because it keeps releasing the bg level is kept lower for a longer period of that cycle (12 hours)
Look at Lucky's Levemir numbers and you can see this.


You have to look at the bg number for when insulin working at it's hardest (peak/nadir). This is the lowest number in the cycle and where signs of hypoglycaemia could show.
With Caninsulin you usually have to accept a higher bg at the beginning and end of a cycle to avoid kitty dropping too low at peak/nadir.
With Levemir you get a much more balanced bg number because it is released more slowly.
The reason behind the pre shot test is to check kitty is not already at a low number (you can see where this has happened on Lucky's ss and I had to delay her shot till a comfortable number to know she wouldn't go to low when I wasn't around to monitor)

Your peak glucose levels will be when kitty has no insulin, so no your not matcjhing the 2. What your trying to match is that you get her in non-diabetic numbers for as much of the day as possible.
This is not an exact science as there is still alot not known about diabetes.
One thing that is for sure-with the advent of commercial cat foods, particularly dry there has been a dramatic increase in the number of cats being diagnosed with diabetes (not just caused by obesity). Same applies with humans. In the main cats have type 2 diabetes, but unlike humans (who can just diet cotrol this type) cats still need insulin. What it does mean is that kitty has a chance of going into remission and then being diet controlled (by feeding a very low carb food for rest of ktty's life)

So much for the short reply!!! Sorry.

If after all this your not sure-that is fine. She is your kitty, you can see her, I can't you know her I don't.
So if you want to wait till Saturday, go for it. Could be proactive by at least getting the ketodiastix and start testing. There will be a glucose coloyr striop too and that gives a rough guide how concentrated her glucose is.

Can you when you go confirm that this insulin is indeed the actual or equivalent of PZI? This is one of the difficulties that insulins can vary depending on what country your in.
I do know Steve/Jock (in UK) were the first to ever use Levemir in a cat so it can be prescribed by vet.
My vet here (British Army) prescribed it and I just got it from local pharmacy.
I've made same offer to Angieb. If you would like a phone call to talk anything through, private ,message me your number. I wdon't think I will be on the board till Thursday now, but there are a number of Brits on the board and you could pm Steve and ask him how he ordered Levemir if your interested in considering it.

Really hope you can convert vet-woefully lacking in UK.
Good luck :mrgreen:

 

Wow, so much knowledge, thank you. I think I have my head around what the ideal goal is for Ellie and the strategies for achieving this and testing to see how are body is responding. The vet advised me that the insulin we are using is long acting, I take your point that although it says 24hours it may not last that long with cats as their metabolism is so fast. I am guessing the vet wanted us to perhaps start low and build up, he did say that shots twice a day and more units might be needed in the long run. He advised that the onset time was 2-5 hours and peak 12-24 and duration up from 24hrs to 36hrs. I know that this doesnt really mean much without me knowing her glucose levels and to see them work in tandem as it were.

As a beginner I really don't feel comfortable to change anything without working together with the vet, although from reading threads here, it looks as though you are all confident and support each other enormously. I am reluctant to take on things too quickly but do appreciate the high level of care and attention that is possible to stabilising the glucose levels at a constant throughout the day.

The injections have gone much better for the last two days, we have put Ellie on the kitchen surface and distracted her, rather than the floor where I think she felt threatened as we came "at" her from a greater height! She has also remained drinking less and peeing less and not scavenging for food anymore, she is even greeting me at the door when I come in and seeking company which she has not done for a long time. I am beginning to think that moving house has had a big effect on her stress levels, we had to move twice last year! She almost doesnt seem to recognise her habits in the house, I think she has been sick the whole time we have lived here - only 4 months.

Home testing is something I am discussing at the vets on Saturday and seem to remember them saying they would supply the equipment, I really want to work with the vet on this as in the event of an emergency she will go to them. The nurses are great too and are available to cat sit for holidays etc and give the injections.

I want to learn to home test and also Ellies glucose curve so that I better know what her "natural" rythem is and eleviate some of the stress of a hypo - although I also see from what you are saying that if I tested before each injection, the likelihood would be minimised. Am I right in saying that within the first couple of weeks of diagnosis the levels will be all over the place as the body needs to "rid" itself of excess glucose and adjust to the insulin action - or is it fairly immediate? I am saying this as although she looks well and ok on this dose, I imagine that an immediate improvement would be expected as her glucose levels were really high and that things will level out and the only way to know is to test throughout one day - glucose curve? I guess I am saying that although stressfull to wait to see vet, I think I would not be able to interpret the results at this stage and would appreciate the vets back up when I begin to do these tests - I think I will be taught on Saturday.

I really want to make sure she stays stable and slowly develop confidence and understanding for a hopefully long term treatment plan. I will address the food at a later date too - i am just too nervous to change all things at once, infact I am very emotional about the whole thing. If I think about it, it is quite overwhelming to have the "power" to help her wellness and at the same time potentially make her very ill - all with a tiny injection and whether I test regularly in the end or not, I fear this feeling will not go away and somehow effect her well being through my anxiousness! Anyone with words of wisdom on this would be appreciated :sad: I advocate the most non invasive approach to animal behaviour and as such have always had a relationship with Ellie that really respects her cat nature - the independant, bossy boots that she is, she comes when SHE wants etc and its strange for me to be imposing this treatment on her. Its a moral and emotional adjustment to make - I never intended to be a vet nurse, but equally will do anything for her quality of life if I feel confident I am doing just that and not tipping her into more stress - I still believe the ear testing regularly would not be a welcome event for her, the handling etc its a very tricky balance for me to find, I am sure I will find it.

Any thoughts on the emotional side of this changing relationship with our pets gratefully received.

Sally

 

Hi Sally

Just jumping in for a minute with my two cents

Most of us were pretty emotional when our cats were first diagnosed with diabetes....I was a mess LOL! But the more you can learn, the more of a role you can play in decision making, the more control you will feel.

A couple of quick points....

1. hometesting is the most valuable tool you can have. my vet was against it and I agreed with her and even left this message board when people insisted too loudly...then Squeak relapsed and I realized that I was being an idiot and I started testing. Good thing I did as he was soon offf of insulin. I could have overdosed him...

2. I've hardly ever see a cat go more than 12-14 hours on a dose of insulin. So twice a day insulin really is best. Yes, you can start off slow if you really need to, but you won't get nearly the results that way as the body will go unprotected for approx. half of the day.

3. your vet and you DO need to be a team, so when discussing what you learn from us you do need to be respectful and non-combative. But at the same time, you are the one ultimately responsible and therefore make the final decision. So LEARN and QUESTION and be proactive.

I hope this helps

Jen

 

thank you for your response. It's only been 5 days since the diagnosis and am just getting head around things, I appreciate all the advice and knowledge and as a teacher and therapist using integrative approaches I am well used to accepting that there is never just one factor in a situation, this board has really helped me refine the key ones though. I am confident my vet is not against home testing, they asked me to make the appointment to come back in a week to show me how and did warn me that twice daily injections were likely - I really think they were just being cautious with the initial steps I am now taking. I am not really understanding the duration/action of the insulin though and will tell the vet I have learnt that experienced people have not found it to last 24hrs and seek their advice.

I am trying to trust at this point - looking back I can see that my intuition told me there was something wrong with Ellie a long time ago and I took her back three times for advice before they suggested blood tests - I wonder whether vets, much like doctors are not geared up for preventative medicine and more inclined to investigate and treat when something clearly presents. I would have paid for a blood test even if there was a slight inclination of diabetes a long time ago - but I guess they might get accused of ripping people off if they did this too often and nothing found. Another reason to publicise the possibility of testing your cat at home I imagine.

I get the impression most people here are in the States and also that vets there are not advocates of the type of are promoted on here - is that right? My vets has a diabetic clinic and does actively promote the prescence and increase in feline diabetes - BUT I guess they are still tied to commerciality with the suppliers of pet food and medicines!!!

Complicated world
Sally

 

It sounds like you have very reasonable vets so I look forward to reading of your progress

I am from Canada but in general, most vets do not fully understand the role diet plays and most still push poor quality dry. Norh american vets though are better about hometesting; UKers used to have a sort of 'underground' website to support testing your cat!!!

Jen

 

Thanks Jen
I am mustering all the patience I can find (was never good at that) and hope that the vet and myself make sure and steady progress. There has been some confusion over the type of insulin I am using, whether it is a PZI (?) and am open to suggesting a different one to the vet when I visit if a certain type has proven more effective from peoples experiences. I understand that medicines are differently branded in the UK than the states and Canada I presume. I have read another thread from a newcomer where she is using the same insulin and a member (sorry I cant check the name while typing this reply to you) asked if she had packaging or myself, so.... I have uploaded some images of it on the other site to see if this helps with advice. Mainly for me the aspect that I was told this was a slow release and acting insulin - up to 36hrs, although the packaging does say the timings are less for cats than dogs. Anyway, the info is there for anyone that is interested and able to make sense of

As for underground, i can imagine there was, as I say, many doctors and vets I imagine dont think the laymens input is helpful a lot of the time, but, we are the ones experiencing first hand the illnessess outside of the doctors/vets office. The nurse at the vets did say she would be freaked out if she had to adjust to her cat having diabetes, she was very helpful and even gave me her mobile telephone number to call over the weekend if I needed to, I feel lucky to have this support.

Sally

 

Do a google for the petdiabetes wiki and once you find it click on the link to insulins and finsd yours. I would do it for you but I am on my blackberry and it is a pain lol

And trust me, your insulin does not last 36 hrs in cats!

Jen

 

Thank you, the insulin is definately a PZI. Going to phone the vets today to ask if I am right in assuming we are going to be shown how to home test at our appointment on Saturday, if not, tell them we want to and ask for the numbers Ellie had on her blood tests last week and also if I can get a meter from them. I can see that getting readings is the only way to see how fast/slow Ellie is metabolising and using the insulin in her body and its not that helpful to say the insulin is long acting but can be half the timings in a cat! You would think they might give a little more specific information on their products.

Anyway, I am looking forward to finding out more, Ellie still seems really fine, I cannot believe how glossy and soft her coat is - the vet said the scruffy look was old age (guess it could have been, but happy to have shiny fur back!) :smile:
Sally

 

Hi,

before I forget. With diabetes the first thing affected is the endocrine system-ie, the fur. This is why Ellies coat was probably scruffy. Some kitties get the silky look back, others don't so much.

You don't actually need to get a meter from your vets. You can get one from Boots/Lloyds, any pharmacy that sells meters.
The accu check aviva and one touch ultra seem to have their strips most commonly sold on ebay (usually the cheapest place to buy them. Unfortunately and annoyingly, it's people selling their prescriptions and making a profit!!!)

If you bought one off the vet they may try and sell you the Alpha track. This is the only animal meter, has had mixed reviews. Expensive and so are the strips (I believe only available from the vets too)

Changing to low carb food is the best way, but need to be hometesting as this can have a dramatic effect on bg numbers.

As for behaviour and change in relationship. I hadn't picked Lucky up pretty much since she was a kitten (15 when diagnosed). Hadn't needed to, as soon as I sat down she was on my lap. Slept on the bed every night (this changed after diagnosis).
She was a very fractious kitty so I had the difficulty of giving shots and testing. Enter the burrito method-wrapping her (fairly tightly initially) in a small throw. Gave me more control, less clawings and actually like Pavlovs dogs quickly became a signal to her as to what was coming so she wasn't surprised. Became cuch time (still had the occasional hissy fit just cos she wanted to sleep etc, but perseverence won out)
One important thing is that kitty will pick up on your stress/nervousness so godd to talk to kitty as will help keep you calm too.
Good luck

 

Thank you, your advice about a meter follows a boggling few hours trawling the internet, I saw the vat/dog version and the price for it and strips! I then moved onto the One Touch Ultra and its not for retail anymore so will try getting one from Boots tomorrow. All looking good here, I can't quite believe my cat has returned, she is up to things she hasn't done for a while, her behaviour similar to before we moved house (twice) last year. Interesting about the coat, this was the reason I took her to the vet the first time, last November, it was really greasy/spiky down the centre, it really is amazingly soft now. Feel bad still that she has felt so ill for a long time and that I "wrote" it off, weird to have her old self back, I do hope it continues.

Good news with the injecting, it has gone swiftly and smoothly for the past two days, she has hardly noticed, I distract her and partner injects - will move on to one person over the weekend. Her drinking and litter tray use has gone back to normal and the scavenging for food is a lot less, the only time in the day where she seems a little bit like she is seeking food and not so alert is towards the end of the cycle, just before her insulin, although I think this is when her "down time" was previously, afternoon nap.

Going to vets on Saturday to chat through things - hopefully get the meter bought tomorrow. On the whole though, I am astounded by her progress, although very wary that I am having beginners luck and still terrified of something going wrong, particularly as she is so lovely to have around again, company, she stopped following me around recently and sat on her own. Its great to have her personality back.

Many thanks for your responses, I appreciate it
Sally

 

That's lovely to hear :mrgreen:

One more thought:
The needles your using. The thinner the gauge, the less painful for kitty. Most people use 30g or 31g. The higher the number the thinner the needle.
When German vets first gave us needles they were 26g! Poor Lucky, wasn't nice.

You can order your own syringes off the net too. In the UK, the only ones I think you can get are BD micro fine. Not at home at present but will post the exact name (a number of different ones!)

As long as she's not hunting for food a lot around the peak time, this is good. That can be a sign her bg is too low
You can get meters from ebay, but obviously you have the number of days it's posted for and then how long it takes to post. First one I bought here was around 30 euros, then got a back up one (thank goodness as dropped first one in her bowl of water!) off ebay for about a fiver.

Look forward to hearing how vet visit goes. Setting up a spreadsheet sounds complicated but there's usually a technical bod on the board that will help. That's how I managed to get Lucky so tightly regulated (kept in non-diabetic numbers all day pretty much every day)

Remember, most cats have type 2 diabetes. Still need insulin, but with close monitoring you have a shot at getting them off insulin. Anything over 250 is damaging to beta cells and kidneys (renal threshold) so that's your first goal and then you work from there.

Good luck and happy reading :mrgreen:

 

Thank you for the info on needles, we have been given BD Micro fine needles 29g, the injections are still going almost effortlessly, thats because I only put the treat down and my partner injects her - seriously though, she doesnt even notice and seems to have got in the rythem of the new routine.

The time she seems most keen for food is at the meal time when her injection is due and perhaps a little before. I am still not sure when the peak time is. We visited the vet today and it was an appointment with the nurse to ask any questions and see how things were. Taking Ellie on wednesday for a blood test. She said all the clinical signs were good, I raised my concern about not knowing the peak time and possibilty of glucose levels being low in the night (we give her the shot at 6.30pm) and she agreed that this was a worry for us, but that all the signs suggest things are going well and they would suggest doing a full glucose curve at home if things de-stabilised in anyway, for now she suggests small steps, and to check the blood next wednesday. She asked lots of questions about clinical signs and what to watch for, there is a slight increased desire for water at the end of the afternoon and higher hunger, which might suggest BG is high, but she was not suggesting upping the dose but to wait and see but also suggested it was more likely we would need to than lower it. I am keeping really detailed notes on Ellies behaviour, drinking, eating and urinating and her mood.

I am keen to get the results of the blood test and hopefully we will be on track. Contrary to advice here I feel I want to do the minimum of invasive tests as possible, and although I can imagine the ear tests would become not hurt as such and it would provide greater "control" from me and less worry, I am keen to use clinical signs and blood tests at the moment, but would move forward with other things if it becomes clear managing the levels is not happening.

I would still love to know when abouts to look for the peak of insulin, guidelines say 12-24hrs for this insulin. I hear what is said that no insulin acts for more than 12 hours on cats but am inclined to think that it is as her behaviour and clinical signs seem fairly consistent. I have read that it is only available in the UK, perhaps it is new ??? information from the manufacturer does declare that it metabolisese faster in cats than dogs and that the action, peak and duration times listed would be considerably less but it looks like this dose is managing something. Of course I cannot "see" what is happening internally and the blood test will show this and we can adjust from there. I can't find anyone on this board that is having good clinical signs at the beginning of diagnosis on one injection and this insulin.

The advice and information here is really helping me make informed choices and gain confidence in what is right for me and my cat, at the moment, and awareness of what might come next and possible decisions I can make.

Sally

 

"Best"??? I did not know this research. Best compared to what? There are many cats why have gone OTJ on PZI of recent. PZI is a great insulin with many advantages over Lantus and Levimir. Some cats who have gone from PZI to Lantus recently have has as poor results on Lantus an when they were on PZI. The idea that Lantus or Levimir somehow have higher remission rates than PZI is unproven. Lantus and Levimir are great insulin choices too but speaking from my own personal experience, the proselytizing on unproven grounds and without knowing the whole cat is not beneficial to the bean and ultimately the cat. The seeds of doubt that are planted are counterproductive to healing the cat.

SallyBrighton, there is a PZI specific forum here for help specifically with PZI insulins. You are more than welcome to join us there:
http://felinediabetes.com/FDMB/viewforum.php?f=24

 

Gator

Hi,

sorry you misunderstand my last post.
Lantus and Lev are part of the Rand protocol. The German Diabetes katzen forum and Queensland studies have stated that Lantus/Lev showed the highest remission rates in the studies undertaken.

Not on my own computer at present so don't have the studies to hand but will try and remember to dig them out.

I have suggested beans come to the PZI forum. I also asked if anyone knew the insulin. It seems to be one that has been prescribed recently a number of times by UK vets, but wasn't clear if it was PZI. Still unclear if this is a new form of Prozinc (also asked for input on that).

There seems to be a general lack of anyone with experience posting much in health these days. Beans are being pointed to individual isg's a bit too quick at times (I actually agree with you, in this and the other recent Prozinc cases, they need beans who use the same insulin. I've pointed out that I don't).

People don't know how to easily set up profiles and spreadsheets as well as being reluctant to get into hometesting. It does indeed make it difficult to advise.
As for not knowing the whole cat, vets in UK don't work like that. They basically don't know and I would not be surprised if it is only because of the recall on Caninsulin (Vetsulin) that they are prescribing anything else.
I can categorically say that my friend who graduated as a vet nurse last year, didn't even do a full day on feline diabetes and knows nothing of the stuff I was doing for Lucky-that is very scary. Sadly understandable. Unlike Docs vets don't tend to specialise a great deal until they get into practice and then it's mainly pets, livestock,tropical,zoological etc.You can only begin to think of how many different pets there are, then their congruent illnesses and pathologies-mind boggling.

So, long winded way of saying sorry if I have offended. Not my intention. Like you, want to try and help newbies as been there myself and learnt an awful lot to pass on.

 

Re: Gator

From what I know they show very good remission rates for Lantus. But I did not know Queensland did studies on PZI [and of course which "protocol" did they try with PZI - that's a bit of a trick question] let alone comparative studies on PZI vs Lantus?

There is only one ProZinc™ - and I am not aware that it is available in the UK it has only just become available in the US. But ProZinc is not the only PZI and is hardly the "best" PZI flavor [but is is a good option if available in your area]. Insuvet should be an excellent insulin as it is 100% bovine insulin. I do not have specific experience with it but as a PZI insulin I would *expect* it's characteristics to be very similar if not identical to other PZI insulins.

I've seemed to notice some topics not getting as much attention as they may have used to in Health. I know I do not watch the health board enough myself. I don't think many from PZI watch the Health forum. The folks who do the regular "triage" in Health are so incredible at it that also hesitate to interfere. I also get frustrated when I come to Health and clear and unneeded bias towards L&L over PZI are expressed so routinely. PZI has fewer users and that means less eyeballs on Health too for PZI support. We are highly appreciative when we are notified in PZI of newbies - sadly that's not happening as much either recently.

You are preaching to the choir here - the SS and profile are critical - I completely agree.

The vet who prescribed our PZI was not prescribing it for the "whole cat" either. But as it turned out it was the right insulin for the whole cat, for H. It took me a while to understand this and have confidence in this under the L & L proselytizing.

No offense taken. This board has a history of L & L proselytizing [I know people do it with the best intentions though]. And, as I said, I did not find it helpful in the past and quite to the contrary it corroded at my confidence when I needed confidence the most. I don't think many understand this point. Further, getting between the vet and the owner [and causing potential friction in that relationship] by recommending a different type of insulin that may or may not be "better" and for exactly how much "better" is questionable as well.

Anyway, I know this has gone a little off topic, so SallyBrighton, let me just say that L&L are great insulins and PZI is a great insulin too. Each have their advantages - so do have confidence your kitty is getting an excellent choice of insulin. There other insulin choices out there so keep reading, reading, reading all the stickies in Health and other resources on this great site. We also have some PZI specific reading in the sticky at the top PZI forum. Keep home testing and get your SS and profile together and come join us over in PZI if you like. :smile:

 

So it does look like this is a new insulin to replace PZI.This is where you need to post in PZI group for specific advice on how the insulin should work.
You can do alternative monitoring without bg testing, but would need to post for advice in that group.
Hard to help with dosing advice without bg numbers.

Good luck-PZI group is going to get lively by the look of this weeks newbies :mrgreen:

ps-see Gators post.
Gator, I'm sure PZI was tested, I'll have to find it (it might be in the Rand protocol in Lantus isg, if not will look tomorrow).

It's either this thread or the other UK newbie that the pics of the insulin carton were posted. Prozinc is definitely being prescribed in UK by the looks of it.

 

Hi - Many thanks for all your messages and the suggestion to look on the PZI board, I am almost certain that the insulin falls into this category and it's only after reading your conversations that I kind of "get" that different types act differently. I think the stumbling block has been knowing the characteristics of the insulin I have been given.

I am continuing with observations only at the moment and having a blood test at the vets on Wednesday, Ellie seems to continue to be well in her clinical signs, but am keen to find out the BG levels.

I will start using the PZI board when I have some numbers to share.

Thanks again

Sally & Ellie (who is lapping up the sunshine now instead of sitting by the kitchen tap 24/7 - poor thing, I still feel shocked I did not pick up on her ill health ages ago, the vets suggested old age and I agreed and as she was tubby all her life the weight loss was praised! I am definately telling all my cat loving friends about signs of diabetes to watch out for)

 

Hi

any update?
Did you confirm it is PZI?

 

Kate, any update, was PZI tested?

 

Gator

Hi,

not heard anything. Not heard from AngieB either.

Hoping to speak to a friend of mine over w/e that I think may have used this insulin and did manage to get her ktty OTJ in a short space of time.

 

Hi - I did not check with vet if this is a PZI insulin - duh! I just presumed it was (not sure why now - information overload). Vet did not take a full blood test, we are going to do this again in a week. She was really upfront when I talked about home testing, she said this is what you are meant to do ideally, and to get a glucose curve to see when the peak time is and other patterns.

However, as Ellies clinical signs were great and weight is going back on, she wanted to wait another week to see how things progress on the dose we are using, she did mention that some cats do not "carry" the insulin longer than around 12 hours but from the looks of it Ellie was as the reading was good - although not ideal yet. She kept emphasising doing things in increments, which I agree with and the main thing being the quality of life for cat and the dangers of too much insulin being worse than not enough for now.

So I am afraid I cannot confirm if the insulin I am using (Insuvet Protamine Zinc) is a PZI - but I can say that I am relieved my cat is looking and seeming 100% better than she was two weeks ago and I am beginning to feel confident that I have a handle on things at the moment. I am in two minds about whether I want to tightly control - although I understand that this is possible and from reading that this improves the liklihood of remission, however I also feel I may not be as dedicated/confident as you guys to keep up the regime and therefore wonder if a half way place, where perhaps my cat is going into high glucose for parts of the day is better than me administering a tighter care plan as it were.

Have you experience of cats being "well" on less of a tight testing and administering plan?

Sally

 

Hi Sally,

thanks for checking in.

I am gong to see if I can find out if it is PZI, but if you do remember next time you go in to ask that would be very helpful.
I can't remember who said it now, but this lloks like a relatively new insulin and as such not a lot of feedback to go by.

Yes you can regulate without being tightly regulated. What I couldn't say is whether this would affect kitty's longevity. Partuicularly if the glucose is causing renal damage. You could do alternative hometesting where you just use a keto diastix to measure approximate glucose concentration. There is an isg for it here.
Obviously you wouldn't immediately see any changes, but ultimately it is your choice.

I did have a friend whose cat was on the best part of 5u Caninsulin for 3 years before Cancer took him, though he was a young cat and I still think had she have known about FDMB etc he would have been around a lot longer.

I had to travel with my job and took Lucky with me. It was the only way I could a living and look after her (she got so stressed in vets cattery). That is why I was aiming for remission because we would have had our freedom back in all sorts of ways.

Glad to hear Ellie sounds much better. :mrgreen:

 

Re: My cat is newly diagnosed>UK phone numbers

Hello,

I am also in the UK, and if you scroll down on this page http://www.sugarpet.net/otherblo.html you'll find a list of people who are willing to talk to newbies with diabetic cats. Very useful.

Good luck, it certainly takes some getting used to, much perseverance and a pretty tolerant kitty!

Kay