Noah, getting nowhere with Caninsulin

Discussion in 'Feline Health - (The Main Forum)' started by Noah & me (GA), Jan 16, 2018.

  1. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    I need to seriously consider changing Noah from Caninsulin / Vetsulin to another insulin, reasons listed below.
    Noah is about 13 years old. These are Noah's preexisting medical conditions; (This is as brief as I can be)
    > Noah has cardiomyopathy as did his brothers and parents. As I understand it there is no definitive test for cardiomyopathy, it's a conclusion reached by symptoms, reasoning and ultrasound tests.
    From the Google drop-down list; (all italics are quotations with some editing for brevity)
    "How long can a cat live with cardiomyopathy?"
    Cats that develop congestive heart failure have reported survival times varying from 3 months to 2 years....Cats who's first sign is a blood clot require intensive care and may survive less than 6 months.

    Noah has lived well past his best-before date. I have never seen him short of breath, mouth breathe or have trouble with the stairs. He has had three ultrasound tests (minimum $500 with diagnosis) and I don't want to put him through the stress of another test.
    > Noah has an enlarged heart, so big it has partially torn through the cardiac sac. This has been confirmed with x-rays and two ultrasounds diagnosed by a feline internal medicine specialist.
    From the Google drop-down list;
    What are the primary symptoms of a cat with an enlarged heart?
    >Listlessness and/or depression No, he just takes things easy like any old cat would.
    >Lack of appetite. No, he eats the right food at the right times and maintains the correct body weight.
    >Weakness/sluggishness. No, I've never seen this.
    >Partial paralysis as blood clots become more common. He never favors one side over the other or shows any signs of partial paralysis.
    >Abnormal heart rhythm. see footnote 1
    Difficulty breathing, possibly with a cough. Never.
    From the Google drop-down list;

    What are the symptoms of congestive heart failure in cats?
    Blue or gray gums or tongue.
    Loss of appetite.
    Weakness or lethargy (tiredness)
    Hind limb paralysis.

    Only these last three all describe what happened to Noah's two brothers and his Momma.
    Difficult or rapid breathing / collapse / sudden death.
    Zoe died in the back of the car, Simon died in the waiting room, Andrew died 12 hours after being admitted.
    footnote 1 Abnormal heart rhythm Noah leaves the house for emergencies only. To say he is stressed does not begin to describe it. He has never been crated and is terrified of windows. I'm not dragging him to the vet to confirm a 13 year old cat has an abnormal heart rhythm.
    Noah needed all his teeth pulled years ago but had only a 10% chance of surviving the surgery. That is why he gets transdermal BUPE.
    FINALLY, the change in insulin. Noah is a high dose bouncer ranging from 2 to 6 units. As a very general rule of thumb Noah gets about 1 unit for every "90" on his meter. For example, a reading of 180 divided by 90 would be 2 units (0.05ml) of Caninsulin. His curves never make sense and his nadir is never anywhere near the 6, 8 or even the 10 hour mark. I believe he is also becoming insulin resistant (at least to Caninsulin). In addition my medical problems are sudden on-set and Noah misses his PM shot maybe once every 10 days. He is very agreeable to being tested and injected, has never run off to the basement or bitten anyone. I try and keep his timetable to 9AM/9PM.
    Thanks to all who have waded through this, I thought everything here was relevant.
    Noah thanks you as well. :)
     
  2. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    I don't have any experience at all with congestive heart failure, so I can't really offer any insights there, though it sounds like Noah is doing about as well as he could be with that kind of situation. :cat:

    About a possible insulin change, it does seem like it would be worth it to try a longer-lasting insulin and see how Noah responds, since he's just kind of treading water (at best) with the Caninsulin. So then the question will be, which insulin to try.

    If I remember correctly, you're in Canada? Which means that at least Lantus will be OTC (and possibly Levemir?) and thus an easy switch, but I'm a little hesitant to suggest a depot insulin when you can reasonably expect a skipped shot here and there. It's not impossible to do a depot insulin under those circumstances, and it might be worth it for the "flattening" effect of the L-insulins, but if something like ProZinc is possible, it might be better to start there. That one, though, I believe is vet-only, and thus will require a prescription? How does your vet feel about ProZinc, or any other alternates, is s/he willing to prescribe or is s/he stuck on Caninsulin?

    How often are you typically able to test during the day? I know you don't have an online spreadsheet going that we can look at, but just to get an idea of how closely you monitor.

    Give Noah a scritch from me!
     
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  3. Myagi and Heidi

    Myagi and Heidi Well-Known Member

    Joined:
    Oct 30, 2017
    :bighug: Dickson, I hope whatever you decide to do with Noah's insulin gets him improvements and works well for you both. :bighug:
     
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  4. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Although I love and respect our vet I'm not so sure about Noah's diagnosis of heart "failure". I know diagnosis is hard with an uncooperative patient but either almost everything we've been told is partially wrong or God finally gave us a break. We certainly deserved one after these last few years. Yes we are in Canada and since I'm partially disabled (that's the very first time I've ever said that out loud) I can test anytime and change Noah's schedule.
    Noah's spreadsheet. Although I've been doing this for years and with two cats the day will come (or would have come already) when someone would have looked at Noah's spreadsheet and thought "Good gawd, what are you doing to this poor cat?" Nigel's numbers were straight out of a textbook. I used to print his numbers and curves in color and did everything short of a PowerPoint presentation. With Noah it looks more like I'm using a fire extinguisher to inject him and a sun-dial to keep track of time.
    I will give Noah a nice tuxedo brush, clean his eyes, pull his tail and make sure he knows where it came from. For all his problems he is very patient and loving. Our last yellow cat. :bighug: :)
     
  5. Tracey&Jones

    Tracey&Jones Well-Known Member

    Joined:
    Dec 12, 2016
    No advice to add but will give these :bighug::bighug::bighug: and some chin rubs for Noah.
     
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  6. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    Hi sorry to hear Noah is not doing so well, did the vet said what kind of cardiomyopathy he has? Is he getting some medicine to help with it? How is his blood pressure, keeping his blood pressure under control will help him?

    No vet is really shure how this heart issues are going to evolve with our kitties, some times it advances with time some times it doesn't vet can take some preventive measures to help his heart and that usually helps

    Babu is almost 15 years old (his birthday is coming on February) and was diagnosed with hypertrophic cardiomyopathy almost 5 years ago, so far the desease has not really advanced (just a very little more thickening of the walls but nothing mayor yet) and let me tell you that other than getting a little short of breath when he runs (which could also be because he's been a potato coach all his life even as a kitten ) and the vet listening to some murmur he has not presented any other sympthoms .

    He does get an eco cardiogram every 4-6 months together with a electrocardiogram but actually the vet comes to my house to do them (on rare occasions we've made them at the vet's office) and she (the vet) allows him to be seated while doing it so that he doesn't get stressed or angry (he can be pretty hard to handle when angry) with the echocardiogram is very important that they are as relaxed as possible

    Babu was on Lantus and he did OK even though he was a diver and a bouncer till his last drop of insulin (wouldn't brag about his SS) he is now OTJ and paws crossed he continues like that I think if like you said you can monitor him closely and keep the shooting schedule pretty regular you could consider Lantus

    :bighug::bighug::bighug::bighug:
     
    Last edited: Jan 16, 2018
  7. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    I was very nervous about switching Squallie from Vetsulin to Lantus, but it was one of the best things I could have done for him. The difference is like day and night! I hope whichever insulin you choose really starts to work for sweet Noah. :bighug:
     
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  8. PussCatPrince

    PussCatPrince Member

    Joined:
    Nov 25, 2017
    Me too. You're a smashin' bloke. :bighug:
     
  9. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Cardiomyopathy does not mean heart failure. Neko had hypertrophic cardiomyopathy too - enlargement of the left ventricle. Either because she has Maine Coon heritage or because she had acromegaly, or both. She was diagnosed with that about 3 years before she passed. She did have heart failure 2.5 years after the HCM diagnosis - then it went away for a while, but came back. She was on Plavix to prevent blood clots. Inappetance was one of the symptoms, along with a higher resting respiration rate. Besides Babu - we've had other kitties live long lives with HCM, if managed. The proBNP blood test can be used as a diagnosis tool.

    We too started on Caninsulin, then switched to Lantus, then finally Levemir. (also OTC in Canada) She was much flatter on Levemir, but it's ECID.

    Best of luck, whichever you choose.
     
  10. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Thanks Lucy, Wendy and everyone else. Wendy, that diagnosis was made years ago and what I remember was more shock and few details. It was right after Zoe died just before Christmas, my mom died a week later, so there were more tears and less note taking. Noah is one of those cats that do more than defy the odds. You only have to keep an eye on him, he's respected by the other cats and never does puppy things like swallow a battery (although his brother Andrew swallowed a staple and just pooped it out). I didn't want my post to sound tragic, just thorough. This will all work out, it always does.
    Wendy, how's life in North Van? Cynthia grew up in Cranbrook and went to BCIT. She was out of the house the day after high school graduation and like me has no desire to visit "the old gang". Half of them are either in prison or live in trailers with six screaming kids. Blech! :(
     
  11. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
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  12. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    We hit double digits Celsius yesterday, windy now and wet probably on the way. Good day for birds here.

    Scritches to Noah.
     
  13. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Explaining Vancouver to someone that's never been.
    San Francisco without earthquakes, with Burnaby, without cable-cars, with Grouse Mountain, without Fisherman's Wharf, with Granville Island.
    Stanley Park and the seawall, no Oakland.
    Too bad my mom and dad picked Victoria, the newly wed and the nearly dead.
    Driving in Victoria...
    driving_victoria.JPG Have a good day Wendy, I need new glasses.
     
  14. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Member

    Joined:
    Sep 15, 2017
    Off this important topic, why do you hate penguins so much? Close encounter possibly? Did one kick you as a child? I guess the only creature I’m disgusted with & terrified of is slugs! Eeeeeeweeee
     
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  15. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Member

    Joined:
    Sep 15, 2017
    From one that has very little experience with insulin, Baby’s numbers were all over the place with novolin. Once in prozinc she leveled out a good deal & then went into remission.
    I still have the question of, did Baby have an episode of hyperglycemia due to a horrible UTI or is she truly a diabetic kitty? Were her numbers leveling out do to getting the UTI under control or the switch of insulin & low carb diet? Maybe a little of both! Never to be known?!?
    Just expressing my fondness of prozinc in any case. Your choice will be the correct one as you know your kitty & are very intuitive to his needs! Give Noah an extra neck massage & xox from me too!
     
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  16. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    I like penguins, I've just been penguined to death by ads with penguins for banks, shopping malls, car dealerships etc. Talking penguins, singing penguins, dancing penguins. It's just not clever anymore. I was bitten by a chimp at a zoo in Holland when I was 3 but that didn't traumatize me like penguins do now.
    There's a bad joke I've told before about a woman in a local shop who became an acquaintance because she had a diabetic cat but she wasn't too smart. Their mascot and fridge magnets have penguins so one day I asked her why penguins don't just fly away when the Eskimos come for them. She rolled her eyes and told me that penguins can't fly! And that's why some 60 year old people are perfectly happy making minimum wage and can never seem to get a date.
    My favorite penguin, the Rock-Hopper! Looks kinda like Sid Vicious doesn't he? Nasty little birds aren't they?
    rockhopper01.jpg
     
    Last edited: Jan 19, 2018
    Reason for edit: replace singing w/dancing
  17. Myagi and Heidi

    Myagi and Heidi Well-Known Member

    Joined:
    Oct 30, 2017
    Random!!!! Love you man!
     
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  18. Becky & Baby Girl Kitty

    Becky & Baby Girl Kitty Member

    Joined:
    Sep 15, 2017
  19. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Island girls! Always think they're so special.
    Surrounded by water, ocean water, DEEP ocean water!
     
  20. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Usually when someone is switching L/L are recommended, but if you decide to try Prozinc, you will be very welcome in our cozy little ISG! :)
     
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  21. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Thanks to you & Sam :)
     
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