Newbie in desperate need of advice pls

Hello everybody, I am in the uk and have 5 cats one of which is diabetic.

Hope you guys can help me as I am losing faith in my vet. Will try not to ramble too much!

My lovely Nimbus cat has been diabetic for 4 years. When first diagnosed he was put on PZI and i was told to feed dry kitten food. His dose gradually went up to 6 units a day and was stable for a time. He then had a fructosimine test that was very high to his dose was upped to 7 units. One evening Nimbus looked drunk, convinced this was a hypo I took appropriate action and went back to vet. Vet convinced it wasnt but we stopped insulin for a couple of days and started caninsulin at 1 unit twice a day. Has had similar episodes which vet now says must be dodgy hips and still having very high fructosimine tests so now up to 3 units twice a day. As vet suggested cat may be insulin resistant I have started googling and discovered to my horror I have been feeding my cat incorrectly and that I could home test. So now gradually switching to wet food. When he had a wobble the other day I used my mums glucometer and measured Nimbus blood and it said "low blood sugar below 1.1" I gave him syrup straight away and phoned vet. Vet still says that not somogyi swing or hypo and that the meter would not have been accurate. When I tested later that evening it had gone up to 26.6. Vet did say to lower to two units twice a day and have him in for a glucose curve. I want to switch my cat to wet food as I am sure that is the main problem but dont know what to do about insulin. What would you all do? Thanks in advance.

 

Hi and welcome to FDMB :mrgreen: Your in the right place!!!

I'm from UK, just don't live there at the mo. Most peeps here are from USA/Canada, but we're from all over the world! Foods are a bit different as are some of the laws and accessing things like the really good insulin!

We used Caninsulin-frst and foremost, can you keep hometesting?
It is a lifesaver. Don't bother with vet and glucose curve. BG's can go up as much as 100 points at vets (Lucky's did).
Hiuman glucometer is fine.Vet will be thinking alpha track (animal) exorbitant price and strips.

You use a human one and stick with that. There's about a 20% variance, minimal and doesn't matter as long as your not switiching between types of meter.
We used one touch ultra and accu check aviva (not at same time)

Got strips off ebay (sweet if you've got someone who can get them on script?!)

Somygi rebound is very likely after your 1.1 reading. I too lost faith in vets here and went through 4! Even the 4th one didn't really know what they were talking about but at least gave me what I wanted! Almost all my advice came from here (you do want to make sure that anyone who is advising on dosing knows your insulin, there's a lot of difference between them)

Unfortunately your highly unlikely to be able to get a prescription for Lantus or Levemir-by far have shown them selves to have excellent reults in cats.Both are human insulins and not approved for cats. UK works on a cascade thing.They have to go down a list and Caninsulin is at the top!!
However, an insulin called Prozinc was released onto market last Dec and is specifically for cats. Been positive comments about it (I can't advise on it as haven't used it). Like PZI.


So, case of asking whaether vet will switch you.

Going back for now to Caninsulin,

Cat foods-what do you feed?
How much?
Weight? and what should weight be?

Dump the dry asap but!!! Get some hometests in first. Dry can rbe as much as 60% carb, wet as low as 3.4%!!Significant impact on how much insulin needed.
Some cats do have resistance to insulin, but you have to work this out over time, and guess what?! We have a support group for that too :mrgreen:

Let you take this in and then come back with more q's :mrgreen:

 

Thanks so much that is really helpful.

Yes I can keep testing at home now. Vet did mention the same one as you and yes it mega expensive. Will carry on with my mums meter for now (one touch). If not completely accurate it will still be relative.

My cat was on Royal cannin light or fit cat but have looked into the wet food and the best one I can get in the UK seems to be bozita. My cat seems to love it and is now more interested in the wet than the dry but I still put dry down and will wean off gradually. He weighs about 13lbs. Vet has not commented that he is too fat so assume he is ok. He is a rescue cat so not really sure of his breeding but looks very much like a russian blue.

I will definitely ask the vet about the prozinc. I dont think the caninsulin suits as he was obviously having a hypo as the insulin peaks. Vet keeps saying that if he had any hypo episodes it would average out the fructosimine values bringing it down, but from what I have read I dont think that is true.

I am happy to attempt my own glucose curve but if he had a hypo yesterday and is somygi swinging could that effect him for a few days and also should I still be giving insulin at all? Should I carry on with the insulin at 2 units twice a day as the vet suggested and then try to do a curve in a few days time? I have taken in so much information I cant make out what to do for the best. :?

Also when do you recommend I test my cat and how often etc. So sorry for so many questions. I am so glad I found this forum though it may take me some time to get the hang of it as I am not very pc literate. I see I managed to post the same thing twice.

 

Great that you are hometesting. Once you start getting numbers on your own, you'll have a good idea of what dose your cat should be on.

Since you've had the rebounds, hypos and are switching from dry to wet food, I'd think about starting at 1U of insulin twice per day. Changing the food is going to cause the blood glucose(BG) to come down naturally.

Assuming you're giving insulin every 12 hours, check the BG a minimum of twice per day, before each shot. I'm in the States and the numbers are in the 100-200 range for Tucker, when looking at your number I'd multiply by 18 so that I could get a better sense of what they are.

You had a big swing that day you tested, under 20 to over 470. The high number later that evening could have been caused by rebound, your cats liver producing glucose to protect the body or it could have been caused by the syrup you gave (which was the right thing to do ) or a combination of both.

If this were my cat, I'd test AM and PM PS (PS = pre shot). Then I'd get a few tests at +2, +4, +6. +8, +2 means two hours after the shot, +4 means four hours after the shot and so on. You don't have to get them all on the same day. Maybe today get an AM and PM and a mid-day +6 (6 hours after the shot), then tomorrow do 4 hours, just to get a picture of what's going on.

The One Touch meter is a great meter. Are you pricking the ear and getting blood that way?

 

Yes I am getting blood by the ear.

Thank you for your advice, I am overwhelmed and relieved at how helpful and friendly this site is.

Will give the one unit twice a day and blood test as suggested.

 

Keep asking questions and post your blood sugar numbers, we can help you intrepret them. Pretty soon you'll be an old hand at this

 

Hi again,no probs. Don't worry about the pc literacy, plenty of us like that! I still can't do the posh quote thing in a pink box and I've been her 2 years!!!

The swing can last for up to 72 hours, but that's not a reason to not test.

When is next shot due?
Can you get a bg reading and say how many hours after shot it is now?

We record as this:
AMPS (Morning bg before shot given)
+1
+2
+3 and so on.This is 1 hour after shot, 2 hours after and so on.
PMPS (Evening bg before shot)

With Caninsulin to get a curve-ALWAYS get amps and pmps. Then I would get for a curve:
+1
+3
+4
+5 if this number higher than +4 don't get anymore till +10 (this will then show you how quick his bg's rise)

Caninsulin is an intermediate acting insulin. Onset is usually just over an hour (when it starts to work on bg's)

Peak is between +3-5 (usually 4 ) hours after shot.This is the lowest bg number you will see (and when hypo often can be seen (can happen anywhere in the 12 hour cycle though-with Caninsulin between +1 and 5 most likely.

Have heard others say Bozita. Need to find english thread I posted on the other week,I listed all UK foods can give that are cheap and low carb.Will try and hunt it out for you. I've never seen the bozita (other UK newbies have mentioned it)
We used Felix 'as good as it looks'

2U-Get a couple of readings if poss and I'll make a dosing suggestion to you. Whatever happens, you must be comfortable with what I or anyone else suggests.If your not, feel free to ignore me! :lol: (I'm already thinking drop to 1u for the next 1-2 shots)
Seriously though, insulin is powerful stuff, so caution is the way to go. you can see kitty I can't.

Just seen Cindy has posted. The other thing you need to get are KETODIASTIX-these test for keytones, something you should monitor for in an unregulated cat.

 

newbie, so no advice, but want to assure you that you found the right place! these folks are wonderful with advice and support.

good luck to you!

celi & binks

 

Hi,

finally found the thread.
All the info I have on UK low carb wet food is in 5th post from the top.

viewtopic.php?f=28&t=23642&p=236045#p236045
I also try to explain how you can work out the %carbs in any food (looking at the % ingrediaents on back of tin or box)


Good luck :mrgreen:

 

Thanks again everybody for advice and welcome.

Will start to test regularly and go with the 1U twice a day. Will get you guys to help me interpret them if thats okay.

Kate and Lucky - thanks for the thread on uk foods. It is very handy to know what else I can get as my other cats are quite fussy and I will need to mix it up a bit to get them all eating wet food. Also can I buy the ketodiastix without prescription? Are they the sticks for humans that change colour with urine? Again you will have to let me know what I am looking for :?

Nimbus and I are so grateful for all the advice

 

Hi,

about to sign off for the night.

Can try boots/Lloyds pharmacy for the ketodiastix-yes they are urine strips. Usually have glucose test strip on as well.
However one of the other UK newbies short while back said they couldn't get them. DID a google search and could get them off ebay or other pharmacy site.

Vet may have them too.

Foodwise-just by a tin (Butchers-kittys quite fussy from what I gather) or a single pouch (Felix) and see how you get on. Then your not wasting money.
Whisks MMM was the lowest (can't remember if I menton it in that thread) but don't seem to be able to get it.

You also want to find some high carb wet food, so if he goes low you can get his bg's up quick smart and hold them up (tends to last longer than the syrup, though this is your first port of call if low like your 1.1 as it's immediate.Wet food takes maybe 15-20 mins. Dry can take over an hour which is too long and send numbers ot the moon)
I used Offen Scmuse (something like that. It's Felix but the German name for it. This was 25% carbs. Kitekat in gravy pouch I think was about 18%)

Over time you learn what foods and %carbs can get kitties bg up and as you gain confidence you can tweak. I knew another kitekat I used which was 11% often was enough to bring Lucky up but only learnt this over time.
ECID=Every cat is different.

Just bear that in mind especially with foods and how they react to carbs (call carb sensitive)

Let us know what your test bgs are and we can help you figure this out.

Night from across the sea :mrgreen:

 

Yes, the ketodiastix (http://petdiabetes.wikia.com/wiki/Urine_testing_stix) are the same as the human kind - no prescription. You, unfortunately, will have to find a way to get the cat to pee on them. (Don't worry - we all have our little tricks. We put Oliver in a room with a litter box full of aquarium gravel. He would go and we would test.)

 

Night, night. great info ta.

 

Greetings from Essex

Welcome to the FDMB community! You have found the best place to be and you will find a wealth of knowledge and expertise her. You have also found a group of wonderful people who are always willing to offer support and advice so keep posting.

Having read your post, I would suggest that you might wish to consider changing your vet to one who has greater knowledge and experience in treating felines with FD. Seven units each day is an awful lot of insulin and without hometesting to confirm a need for high dosage, it sounds potentially very dangerous.

The advice regarding fructosamine tests conducted at the veterinary surgery is right. A cat will be stressed out during the process and the readings will be high and therefore, unreliable. Stick with your OneTouch Ultra and try to complete a curve and post the results here as soon as possible.

It is important that you take a urine sample from your kitty on a regular basis to test for the presence of ketones. I found that the best way to do this is to get a long handled plastic cooking spoon (They are really cheap in ASDA) and wait for your kitty to enter the litter tray. I was given the invaluable information that when a kitty starts to wee it is an involuntary action and he/she cannot stop until the bladder is empty. As soon as your kitty starts to go, just slip the spoon underneat the operational area and you will have your sample. This is much better than filling the litter tray with non absorbent crystals, which my kitty would not consider using! You can get Ketostix from Boots the Chemist. They always seem to have them in stock and they are not too expensive. (On the subject of cost, there are some good deals to be had on testing strips on eBay but I would advise buying from a seller who has a good feedback rating)

I would also advise that you move gradually away from dry food. It is not helping your kitty. I advise the gradual transition as a rapid change will have a marked effect on your test results and it is likely that when the transition in diet is complete, you may find that less insulin is required. Your hometest results will confirm this. The best low carb food for FD felines is Butchers Classic Cat Food. It can be hard to find but Sainsburys always have it in stock. If you can't get Butchers, any food in jelly should be OK. Avoid the foods in gravy as they have a much higher carb content (I guess they could be useful if you want to get BG levels up more quickly)

It is great that you are hometesting ... It really is a lifesaver. Correct interpretation of hometesting results reduces the risk of hypo greatly.

I will send you my contact details via Personal Message. It would be helpful if you could let me know your whereabouts in the UK. Most of the UK FDMB members know each other and I may be able to put you in touch with someone who lives near to you. If I can help in any way, just pick up the phone or send me an email (Details in the PM)

Love

 

Just to clarify:

Nimbus is on 2u BID at present not 7u.

You need Keto diastix not ketostix (these only test glucose)

Butchers Classic although good, not all cats like it (hence my suggestion of getting a tin/pouch of a variety).Anything jelly is lower carbs than gravy.But some higher than others. Felix in jelly in a tin is 8.3% and Felix 'as good as it looks' is 3.4%.Just as an example.I prefer under 5% (a lot here go for under 10%) because mice-natural food source of cats, provide 5% carbs and I'm all for nature! :lol:

Agree with Simon on the ebay-try and get somene with 100% feedback (99% ok to).

As for urine testing, I just found that as long as I didn't make any sudden movements, Lucky was cool about me popping the urine stick under her. She must have been different though, cos if startled no more pee. Don't want to make a big deal of the keytones, but because they can be life threatening you need to test for them. That's why as soon asyou get some numbers can look at your dose.
Remember to remind us how long it is since you got that 1.1 and what shots you ave given since it (Somygi-we need to take into account)
Also, say exactly what food you have given.

Just as an example when Lucky was first tested at vet 454, went home picked up the dry and fed only Felix. 1 week later tested at vet again (so both accounted for vet stress) and she was 257. This was with no insulin, heck of a difference.

Oh and just so you don't think I'm too mad (the time), we're an hour ahead here and have a longday ahead!


I know what I forgot to ask you-13lbs-about 6.5kgs?If so, I'd agree that's probably an ok weight.(I can find the weight chart if you want to see it? somewhere!)Lucky was around 5kg at best and she was a skinny cat.
If your ever worried and want to get some more meat on him-fresh boiled chicken (not roast).Packed with protein,negligible carbs. :mrgreen: I also used this when she needed coaxing to have her ears tested, she could be extremely fractious.

 

First, welcome to the site! I hope the info you have received is making you feel no longer desperate.

As I am in Canada, I can't say much about what foods would be good to get, but I can say that my Shadoe cannot eat ANY dry food, not even a small mouthful, or her BG numbers go through the roof!
She ate mostly dry before dx, but once I heard on this site how bad it was, I switched to all wet. I have a civvie who eats only dry so there's the trouble ... Shadoe is a little thief when she has a carb craving! I have caught her jump up, grab a mouthful, jump down and then a couple hours later she had HIGH numbers when I tested. There have also been many cats no longer need insulin after a food change and many others who have needed much less insulin. There was one cat getting 20u insulin and went down to around 1u after food change. Food makes a huge difference with our diabetic kitties.
My Oliver loves raw chicken; I slice up raw skinless boneless chicken breasts and give the strips as snacks and after testing or between meals. My Shadoe refuses raw, but loves chicken lightly steamed. It's high protein and low carb, so it's perfect as a snack.

Vets are very good at some things, and are needed for a great deal. Unfortunately, very few, it seems, know much about feline diabetes or how to treat it. For that reason, I take ZERO advice from my vets on the subject, but rather rely on the good people on this site who really know about FD and all related issues and treatments.
My vet office is the place for blood work, Xrays, ultrasounds, dental work, and checkups. The rest I get my info and support elsewhere. Actually, it is I who give info to my vet office about diabetes.
I like them for their strengths.

I have two high dose kitties; you can click on the links in my profile to see their spreadsheets and profiles. My vet office knew nothing of the tests for acro and IAA, so I had to provide them with the info to have the tests done. I gained the info on the tests from this site.

I first started with Caninsulin, but it's not long lasting so ended up being of no use for me. I switched to Lantus, and then to Levemir when acro test was positive. I cannot comment on PZI but others like it and can give more info and advice.

Testing is vital - hometesting, and not vet curve testing. When tested at vet office, my Shadoe is very high, and my Oliver goes much too low! Either way, their numbers at the vet office are not real. I live a couple blocks from the vet office and I can test Shadoe at the office before leaving, then again when we get home, and she has already come down when we get home. Vet numbers are not true, they are stress colored.

Testing becomes very easy and not hurtful at all; mine sleep through pokes to the ears.
The tests are very important because you need to know how your cat is reacting to the insulin. I tested Shadoe tonite at +6 and found her too low, so I had to give her some higher carb food. She was asleep when I tested her, purring and just fine, so there were no signs of her being low. Many cats don't give you signs, as I am sure you know! They are pretty secretive things!

Once you have test numbers, please post them so that others here can let you know their meaning. Post the time and dose given, then the times and test numbers.
Starting at a low dose would be safer, say 1u, until you know what sort of numbers you get on tests, and especially when you are making improved food changes. After then, you can see the true BG numbers and make decisions if an increase is even needed and how much.

Last thing to mention is that you will very likely see your cat improve, cat more like healthy days, but the test numbers do not improve as well. Don't worry; the numbers will follow later on.
The most important thing is to see your cat happier and healthier. The rest will happen in due time.

 

Morning everyone, feel so much better for posting on this site and actually feel at long last I will be in control of my cats diabetes.

Nimbus had the 1.1 reading on Friday lunch time and 26.6 fri evening. Did not give him any more insulin in case he was rebounding and started again with 1U last night (sat). My husband does 12 hour shifts and is not off until wednesday. I plan to do testing every 1-2 hours that day as he will be around to help me. Nimbus doesnt overly struggle but until I get the hang of it would rather have an extra pair of hands. Hubby off for four days so hope to get to the point that I can do it myself in that time so that I can continue testing every day. Also by Wednesday I hope that any effects of the rebounding will have gone and the readings will be more realistic and I am going to completely cut out the dry food while he is on a low dose. Around everyday between now and wednesday to keep a very close eye on him.

As the protamine zinc worked quite well for several years whilst nimbus was on dry food I am wondering if he would be better off on that or the prozinc. Hopefully armed with my own glucose curve my vet will be open to discussion.

I am really worried that Nimbus obviously was having hypos quite regularly - will it have done any permanant damage? Also my vet is really convinced that if they had have been hypo episodes it would have bought the fructosamine levels down (which have been up in the 800-900s). He said that the lab told him that if Nimbus was rebounding then it would average out the fructosamine test bringing the levels down. :?

So angry at myself that I have not looked into this sooner and blindly followed what my vet said :cry:

Kate and lucky - I microwave chicken breast (assume that is more or less same as boiled) for my dog sometimes and always split it with Nimbus so pleased I can give him a bit extra if he needs it. My mum is going shopping tomorrow so is going to try and find me some stix. In a few weeks the clocks go back here so will be in the same time zone as you!! :mrgreen:

Thanks again everybody all your advice will really make a huge difference to my cat.

 

The fructosamine test doesn't tell you much, other than you cat is unregulated and having many highs and lows. It is nothing more than an average of the BG numbers over the last couple of months, and seriously, you can get that very same info from your meter at home!

By testing at home,your cat is happier and not stressed and you are alot richer because you are not paying for the useless tests! Actually, the test IS of use, but just not if you are testing on your own. When a cat is first dx, it's good to get the test because if it comes back not too bad, then maybe your cat has not been diabetic all that long. The only times I have had a couple done was when it was included in a bundle of several tests, like a package deal. They always come back saying mine are good, and so would yours, once Nimbus is regulated.

Please don't be upset with yourself; you are here now and very soon, you will have Nimbus up and back to his old self again. Believe me, you are not the first and you will not be the last who 'followed the vet blindly'. Once you take charge of the situation, you and Nimbus are in the driver's seat now, and the vet is not in control.

Those differences in numbers ... 1.1 (20. yikes) and 26.6 (479) ... is just like taking a tennis ball and pounding it into the ground.... it sure does bounce high. For some kitties, it can take up to 3 days to clear, but hopefully Nimbus will steady out sooner.

There is a conversion tool, if you like:
http://www.felinediabetes.com/bg-convert.htm

I made myself a chart of them all so that I could post here with numbers the majority would recognize.

The others can say more about the particulars of those insulins so you can make a good choice of what you want for Nimbus.

 

Thanks so much Gayle, I must remember to post both figures - have got calculator at the ready for when I ask you guys advice with my curve.

 

Kate just realised you said you are an hour ahead and so when our clocks go back in October I will be 2 hours behind you not the same time as you as previously i thought ohmygod_smile I am not very good with time zones :lol:

 

I got tired of converting all the time, so I made a sheet for reference. I have attached it in case you can open and use it.

I take copies of my spreadsheets to the vet, so I need to have one set of numbers, but for the people on this site, I need the other set! I finally started putting both in each box on our sheets, and everybody is happy!

 

"somewhere, beyond the sea
are our friends on the FDMB"

it's so cool that people all over the globe are working together to help the sugarcats!

celi & binks