New to the forum and quite scared.

Discussion in 'Welcome to the Group - Post an Introduction Here' started by aliasbr1, May 31, 2015.

  1. aliasbr1

    aliasbr1 New Member

    Joined:
    Apr 2, 2015
    Hello everybody!
    I'll try to make this as brief as possible. Our 13 year old male cat "Picky" was diagnosed in February after a set of very stressful events at our home. Prior to that, he was already diagnosed with a slight arrhythmia that was controlled and medicated properly.
    We started to administrate him 1 unit twice a day of Caninsulin and a pill of Metformine twice a day, we also changed his meal to Royal Cannin's diabetic and got ourselves a BG meter to test him at home. His tests were never good, except for about a couple of times, they were always over the 500's. We started to gradually increase his insulin intake up to 8 units a day which is what we are giving him now and still his tests are over the 500 range.
    In the middle of all this odyssey we got him blood tested and noticed his kidneys were also failing so we started an intensive treatment that gave good results, but he is still under control. The vet changed his food again to half renal control, half diabetic (all dry kibble) which is the only "good" type of food I can get where I live.
    I also got him checked by a diabetes specialist last week and he wants to keep raising his insulin at least for a couple more units and see how it responds.

    I'm aware this is a hard case but I still wanted to have other views and insights.

    Thank you all in advance.
     
  2. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Welcome to FDMB.
    So where do you live? We may have some ideas to help you out.
    The first thing we'd encourage would be canned food only to ensure the kidneys aren't stressed by insufficient water.
     
  3. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    Hi there BJM. I live in Argentina.
    Sadfully right now there's not a better choice of food on the market due to the strict customs rules. However, as a part of Picky's kidney treatment we are giving him 150 cc a day of subcutaneum serum (with 1 cc of a Hepatone and B12 vitamin), and two 10 cc syringes a day of a potasium bicarbonate + water solution via oral. So we are sure he's quite hydrated. We are also injecting him 3 times a week with Epogen to raise his blood cell count.
     
  4. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Perhaps making your own food would be the way to go - there is a recipe for raw food that you might be able to make with local ingredients at Cat Info. Have a read and see what you think.

    We had another gal here from South America. She was actually treating an anteater with diabetes,
     
    Last edited: May 31, 2015
  5. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    I've talked about making the transition to raw food to both vets, but I guess they are quite orthodox and enfatically recommended the dry kibble over any other natural way. I, on the other hand, always leaned towards the natural stuff.
    I just have the feeling that the insulin is not working, or possibly my cat's system became inmune to it.

    I've already been to that site you just shared the link with me. I'm going to give it another look.
    Thank you so much for your concern!
     
  6. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    Hi and welcome. :)

    Is Friskies cat food not available in Argentina? I ask because they have a pet food factory there - it seems strange that they would manufacture it there and not make it available for sale!
     
  7. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    Hi and thank you! :)
    For all I know, Friskies is made by Purina, we don't have Friskies but we do have several Purina products available such as Pro Plan, Cat chow, Excellent and a few more of inferior quality, however, all the vet's I've talked to, recommend Royal Cannin above Purina by far.
     
  8. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    Friskies is made by Purina, but I was thinking of the canned wet food rather than the Cat chow type of food. Those are, indeed, not good for cats - especially diabetics. If you are able to give some brand names that do sell canned food there, either I or someone else can help you work out if any of them are low enough in carbs for Picky to eat. :) I'm trying to look on Google, but there seems to be limited information available - it looks as though maybe Whiskas and Kitekat might sell their brands there - some of those might be suitable if they really are available near you.
     
  9. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    Not sure about Kitekat, but we do have Whiskas, just not the canned type :(.
    I don't know why but there seems to be a shortage on all of the canned food types. We even used to get Hill's, which I'm told is one of the best.
     
  10. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    I'm not convinced by Hill's to be honest. My 2 cats started out on Hill's, then were switched to Royal Canin Urinary S/O (on prescription from my old vet in the UK). I'm convinced that one, or the other, or a combination of the 2 over the years contributed to Rosa's diabetes.

    It does look as though Walmart Argentina does sell the Whiskas canned and pouches. If they're the same as in the USA, they should have an option to ship direct to you if you don't have a store near you. The ground foods (molida) all come in around 10% carbs, which is the maximum we usually like to see for diabetic kitties, but when it's all you can get (and it's definitely better than the dry food) those might be worth trying if you can find them.

    I do see that the selection of canned food on the Walmart Argentina site is tiny compared to what is on offer here and I can only assume that other stores have the same problem. That makes it difficult. It does look as though it may well be a case of going with the best you can get or, as BJM says, making your own cat food at home.

    The other thing is that, generally, metformin isn't one of the recommended treatments for diabetic cats as it forces their pancreas to work harder where what is usually needed for cats is to allow their pancreas to rest and hopefully heal. Insulin is usually the recommended way forward for cats because they do have the ability for their pancreas to heal if it's allowed support and time to rest.
     
  11. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015

    Wow you took the time to check my local walmart website. Thank you so much!
    Well, I also think that what Whiskas offers locally is very poor variety-wise, I didn't knew they still selled canned cat food and to be honest, there is this popular belief that Whiskas is a very poor quality food compared to Royal Cannin, and also the price disparity helps you believe that.
    As for the Metformine, the "new" diabetes specialist suspended it last tuesday, and now my cat is only on insulin plus the medication for his renal treatment.
    For all I've read here and at other places I'm more and more convinced that food almost comes first on a diabetic treatment. The problem is I don't know how to handle it with such conservative and orthodox vet's who put their chips only on the best food available on the market.

    Thanks again!
     
    Last edited: Jun 1, 2015
  12. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    You're very welcome. :) That's what this place is all about - we'll all give you as much help as we can whenever we can. :)

    I had always thought the more expensive food I was giving my 2 girls was better too. Then I found out that a lot of the cheaper brands - Friskies and Fancy Feast are 2 of the main ones here - are actually more species appropriate for cats than most of the foods that are marketed as being "good" and are therefore more expensive.

    I'm glad your new specialist suspended the Metformin. It sounds as though he's a bit more up to date on diabetes medication which is great. :) Unfortunately, yes, food does play a big part in getting good regulation of diabetic cats. It really does seem that your options might be limited though of course you don't have to feed the food your vet recommends. Maybe using the Whiskas wet food that you can get and mixing in some plain cooked chicken to reduce the carb content might work as your options are so few.
     
  13. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Per Dr Pierson of Cat Info, you can add 1 part plain meat or poultry to 5 parts cat food, mix well, and measure out meals to improve the protein content and reduce the respective fat and carbohydrate content. That may help with the canned food situation.
    And price can reflect marketing more than it reflects quality.
     
  14. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    Yeah, I know that not everything that shines is gold. But you keep constantly hearing bad stuff about those food, and once they're labeled as terrible it's hard to convince yourself that they might be good. Anyway, I'm going to try and mix wet food with the dry kibble and see if that helps.

    Today I meassured my cat again, and that horrible "Hi" word appeared on my Optium Freestyle BG meter. So I called the diabetes specialist vet and he told me to reduce the amount of insuline to 2 units twice a day because maybe we are having a rebound effect. I've read somewhere that that's something that can happen so, we'll see.

    Thanks again, you all have been great!
     
  15. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    He may be bouncing from too high of a dose and going too low. You want to test around the likely nadir, or lowest glucose post-shot, and keep him safely above 50 mg/dl on a human meter. That'll be around +3 to +4 hours after you give the injection for Caninsulin/Vetsulin (same thing).
     
  16. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    That's called the Somogyi effect, right? I'm affraid that's possibly what's happening in this case. Picky is extremely light (2,8 kg, -around 6,17 lbs.-) so probably 6, 7 or 8 units a day was way too much for him, and this also could explain why I got a 115 mg/dl measure once in a lifetime, but then I tested him again within a few days and I got Hi, then the vet icreased the dossage again and again untill we got to 8 units. :(
     
  17. Anitafrnhamer

    Anitafrnhamer Member

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    Jul 9, 2013
    I would add here that if your cat is in renal failure you will need to watch his phosphorus level on the blood work. If it gets too high it will increase the damage to the kidneys. It may be necessary to add a phosphorus binder to food. Do you know what the kidney values are? They could simply be elevated due to the diabetes not being under control.
     
  18. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Actually, Somogyi refers to sustained overdosing, not the reaction to a fast drop or drop to an unfamiliar numbers. It has not been convincingly demonstrated in feline diabetes. Check some of the posts by @Sienne and Gabby on this subject.
     
  19. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome to FDMB!

    I suspect you are seeing those high numbers due to the carbohydrate content in what you're feeding. The Royal Canin diabetic dry food is 38% carb. You would need to be giving a huge amount of insulin to offset that amount of carbohydrates. (There are fewer carbs in vanilla ice cream.) As for your vet and the food issues you mentioned, why would you have to let the vet know what you're feeding your cat? Frankly, change the food and see the results -- then tell the vet. It's very hard to argue with the facts and with success!

    Is there any possibility of your vet considering a switch to Lantus (glargine) or Levemir (detemir) instead of Caninsulin? As the name suggests, Caninsulin was developed for dogs It doesn't have the duration that cats need and, in addition, it is quite harsh. It tends to produce big drops in numbers. At least in the US, the American Animal Hospital Association recommends either Lantus or ProZinc for treating feline diabetes.
     
  20. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    Both vets agreed that the kidney failure could be a result of the diabetes. When we detected it through a blood test his levels were:

    04/09/2015

    Glucose: 257 mg/dl (Strangely "low")
    Uremia: 189 mg/dl
    creatinine: 2,7 mg/dl
    TGP: 192 ui/l
    Alkaline phosphatase: 75 ui/l
    Cholesterol: 368 mg/dl

    After a bit more than a month of treatment:

    05/13/2015

    Glucose: 279 mg/dl (Strangely "low" too)
    Uremia: 78 mg/dl
    creatinine: 1,2 mg/dl
    TGP: 192 ui/l
    Alkaline phosphatase: 41 ui/l
    Cholesterol: 201 mg/dl

    Thank you!
     
  21. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015

    When I last talked to the diabeter specialist vet, he told me to reduce the dossage to the half to see if he was having a rebound effect and if that didn't work he would consider switching to other type of insulin. Not sure which one yet. I'll google to check if the ones you recommend are available here in Argentina. And I'm also going to try and get in touch with a pet nutritionist to see what can I do about his food. I got his contact info through a Holistic and naturistic vet that also helped me with some anthroposophy remedies I gave my cat when his kidneys were failing bad.

    Thank you!
     
  22. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    BJ referred you to some of the posts I've written about Somogyi.

    I wrote this up for someone last week:
    I would Google Lantus, Prozinc, or Levemir and see if you get any hits off of Argentinian websites. From what I can tell, Sanofi (the manufacturer of Lantus) has a website for Argentina.

     
  23. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    That's interesting. I've already checked your posts on this topic after BJ referred them to me. What led me to believe my cat was probably suffering from the Somogyi effect was this article: http://www.caninsulin.co.uk/Somogyi.asp
    I've already googled Lantus, and yes, as you say , it's available locally. You suggest switching to Lantus before waiting a few more days with a lower dose of Caninsulin?
    On another note, I've also mailed Purina asking them for wet food available locally and info on those products Carb percentage.
     
  24. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback without having to go look in all your past posts.

    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.
    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
    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.

    Always click the Save Changes button at the bottom when you have changed anything.
     
  25. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    Sure! I'll do it now! I'm sorry I didn't do it before.

    Edit: I'll improve the signature with more details in the next few days.
    Last notice, I just meassured my cat like you suggested at the Nadir point and we got a 470. He's not that vocal today, but he's still drinking a lot.
     
    Last edited: Jun 2, 2015
  26. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    I've got to say I still find this confusing. What just about every article I've been able to find on Somogyi on the internet, including some later research papers that were written to try and prove or disprove the existence of Somogyi (as well as the link you've just provided) states that it's a direct response to a blood glucose level that has fallen rapidly and/or to very low levels and rebounded...and therefore is exactly the same as what we would call a bounce. And that it can happen in one-off instances or on a daily basis if the hypo that causes the rebound isn't noticed and the insulin isn't reduced. Even the Wiki article that was linked shows it as a direct response to a low blood glucose event - and that it becomes chronic when it happens on a daily basis because the hypo event goes un-noticed. But that explanation is different from what I see quoted on here which is that with Somogyi, the numbers will always be high due to chronic overdosing. The way most of the articles read is that the only real difference between what we call a bounce and Somogyi (or rebound hyperglycemia) is that generally we've noticed the low point our cats have got to so are expecting a rebound and know we need to reduce the insulin dose where it seems that in human patients, that hypo is often missed because they're not testing overnight so the rebound numbers occur during the day every day (which I guess could look like permanently raised numbers simply because the low points are being missed every time). Can someone point me in the direction of some information that actually shows Somogyi causing permanently raised numbers without the preceding hypo that all these sites seem to state is what happens because I can't find anything to support that and I am genuinely interested in the difference.
     
  27. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    I just found a little Fancy Feast can in my kitchen that a friend brought for my cats once. I've been trying to find the info online on what is it's carb percentage but I'm a little bit confused because it doesn't shows up as "Carbohydrate %" I'm assuming it's where it says "Grasa" (Fat) but I'm not 100% sure.

    Is this one right here: http://www.productosparamascotas.cl/home/358-purina-fancy-feast-salmon-con-salsa-85-grs.html

    I'm assuming the US version for this flavor would be this one: https://www.fancyfeast.com/gourmet-cat-products/wet-cat-food/gravy-lovers/salmon-feast-in-gravy
    But I'm not 100% sure. Anyways, I opened it and Picky almost gun robbed it from me. He ate that thing like there's no tomorrow.
     
  28. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    The Fancy Feast Classic Pates are below 10% calories from carbohydrates.
    You might see how this calculator does. Once you have those numbers, you apply them to the calories per gram from each source.
    There are
    3.5 calories per gram for protein
    8.5 calories per gram for fat
    3.5 calories per gram for carbohydrate
     
  29. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    God! you guys have answers for everything, I love this place!
    I did the calculator thingy for the Fancy Feast flavor I just gave Picky, and got this: http://i.imgur.com/JUnZ8HX.jpg
    I'm a little lost between the two types of Carbs. :(
     
    Lori & Lulu likes this.
  30. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Was it a classic pate? Or a different food?
    19 / 52 = 36.5 %calories from protein
    22 / 52 = 42.3 %calories from fat
    11 / 52 = 21.1 % calories from carbohydrate
     
  31. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
  32. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    I don't want to hijack the thread so only one comment on Somogyi. If a dose of insulin has been gradually and systematically increased, then there would not be a situation of chronic overdosing. I am most familiar with Lantus and Levemir and there is no research on Somogyi with these types of insulin. I can't speak to Caninsulin which is a shorter acting type of insulin.
     
    aliasbr1 likes this.
  33. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    I will note we just had a new person whose cat Brimly was on 15 units of Novolin NPH BID and running high. The cat had been able to compensate for the overdose and to out eat the excessive insulin. Home testing showed the dose too high. Halving it to 7.5 was too much. Taking it down to 5 was too much. Brimley got a 12 hour period off insulin, and is being restarted at 1 unit BID.
     
  34. aliasbr1

    aliasbr1 New Member

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    Apr 2, 2015
    That's interesting, well Like I posted before, we lowered Picky's dose to 2 units twice a day last monday and I will test him tomorrow. Monday night test gave me 470 but today he's been meowing, drinking and urinating even more than on monday. And also he's awake all the time. So, I'm guessing his BG is not lowering. I already talked to the vet today and if after tomorrow's test we still have high numbers I'm sure he will change insulin. And I'll get in contact with a nutritionist before starting to make a mess in the kitchen.
     
  35. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Gravy is usually some sort of flour as a thickening agent and thus increases the carbohydrate level. If you drain off the gravy, you'll drain off some of the carbohydrate.
    Gravy can be helpful if your cat's glucose starts going to low and you need to bring it up.
     

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