Tinker the diabetic tom

Discussion in 'Welcome to the Group - Post an Introduction Here' started by Helen, Mar 1, 2015.

  1. Helen

    Helen New Member

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    Mar 1, 2015

    Tinker (13 yrs ) has just been diagnosed diabetic, I have researched all this week end . I am booked at the Vet on Monday,when I shall be inducted on how to manage his diabetes,incl. insulin injections.
    Has anyone got any initial hints for me,please ?
     
  2. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Hi Helen and welcome to the forum

    I would edit your title if you can as GA stands for guardian angel and tinker is obviously not that :)

    It's great that you have found us early on and have been doing some reading. The main methods we use to control diabetes is:

    The use of a long acting insulin such as lantus, levimer or prozinc. These insulins will give you much better and longer control of blood glucose than the short acting ones such as Novolin, humilin, vetsulin
    http://www.felinediabetes.com/FDMB/...-from-aaha-convert-your-vet-if-needed.131187/

    Testing blood glucose at home with the use of either a human meter (cheaper) or an feline specific meter. This will allow you to keep your cat safe at home, better Taylor the insulin dose and avoid expensive and stressful trips to the vets. The vet will take readings but they can be significantly higher due to the stress a cat is under.

    http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

    The use of a low carb wet food. This alone can reduce a kitty's blood glucose by over 100 points and hence the amount of insulin needed. Food should be changed over slowly and if you have already started the insulin then care must be taken to check blood glucose regularly. In an ideal world changing the food would occur before starting insulin but then again it's not a good idea to withhold insulin if blood glucose levels are high. You want to find a food that gets less than 10% of calories from carbs:

    http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

    I would certainly go to the vets with an idea as to what insulin you would like to try.

    I hope that helps

    Best wishes

    Sarah
     
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  3. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hello Helen and Tinker,
    Welcome to FDMB :bighug:

    Please be reassured that feline diabetes is a very treatable condition and, with good care, a diabetic cat can live as long and as happily as a non diabetic cat.
    When it comes to managing feline diabetes, knowledge is most definitely power. And I see that you've already been researching the subject; good for you!

    Sarah (phlika29) has already given you some great info. :)
    (BTW, to edit the title of your message just click on 'thread tools' at the top right hand of your post, and you'll be given the option to edit the title.)

    Where are you in the world? (The country you live in will determine what foods, insulins and glucose meters etc are available to you.)

    You should be aware that not all vets are up to speed with the best ways to manage feline diabetes. But that's OK; they can't know everything ;). Feline diabetes is a 'home managed' condition, and it for you to decide exactly how you will manage Tinker's diabetes on a day to day basis.

    The reality is that most people out there with diabetic cats give 2 insulin shots a day (dose specified by their vet) and that is basically 'it'. Or, maybe the vet also recommends a specific 'veterinary diet' for diabetics, and the caregiver feeds that also. But that may be the extent of the vet's knowledge and the caregiver's involvement. However....
    If the caregiver is willing to do more there is a great deal more that can be done. :woot:
    And, who knows, you may be lucky and get a knowledgeable and supportive vet as well! (That would be great!)

    The people on this forum are not vets. They are 'ordinary' folks who manage their cats' diabetes on a day to day basis and pool their knowledge. But that means that there is a lot of wisdom and real experience here about what 'works' - and what doesn't.
    Quite a few diabetic cats on the forum go into remission (ie, can get to a point where their diabetes is controlled by diet alone. That doesn't always happen, but Tinker may be one of the lucky ones.)

    May I ask some questions:
    How did your vet diagnose Tinker's diabetes? Have you been given an indication of what his blood glucose levels are?
    What are you feeding Tinker at the moment?
    Does Tinker have any other health issues that you are aware of?

    Best wishes,

    Eliz
     
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  4. Helen

    Helen New Member

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  5. Helen

    Helen New Member

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    Mar 1, 2015
    Hi guys,thanks for all your information.It's good to have people to swap ideas with.I live in England on the south coast.I was wandering if I would be able to do a quick pin prick blood check on Tinker ,as I used to do on "humans",as a nurse,I believe it may be possible .I can't get to his urine ,because he goes outside all the time .He would rather cross his legs than use a tray !!! He was rescued by me and neighbours from the park next to our houses ,10 years ago. Eventually I adopted him.We thought he was about 8 months initially,in fact he was 3 and needing vet care.He became a beautiful cat,healthy,except for a mild heart murmur.So,there you are, that is Tinker Story.
     
  6. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi Helen,

    I'm in Cobham, Surrey; (and Sarah (Phlika29), who replied to your post above, is also in the UK).

    Yes, absolutely you can do that! And in fact we strongly recommend it! :)

    Most of us here test our cat's blood glucose at home using ordinary glucose meters made for humans.

    With cats the tests are usually done on the outer edge of the ear (it shouldn't hurt as there are very few nerve endings there). Some folks prefer to test the paw pads.
    Here's a page of pics/info from the Sugarpet website showing the process of ear testing:
    http://www.sugarpet.net/bloodtst.html
    And here's the link to the FDMB compilation of info, tips and tricks, and example videos.
    Hometesting Links and Tips

    It helps enormously if the ear is warm.
    And rewarding the kitty with a treat for each test (or attempted test) can very soon mean that the kitty sees testing as something to look forward to.

    Eliz
     
  7. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Helen,

    Because you're in the UK it is highly likely that your vet will prescribe Caninsulin (known as 'Vetsulin' in the US) for Tinker.

    Vets in the UK are required by law to prescribe a veterinary medicine before they can prescribe a 'human' one, and currently Caninsulin is the only veterinary insulin in the UK. (That being said, some maverick vets will prescribe a human insulin as first choice, but they are very few and far between).

    If it turns out that Caninsulin doesn't work well for Tinker then you should be able to get an alternative insulin. In the UK the available insulins are Hypurin bovine PZI, Lantus and Levemir. The one you'd get would probably be determined by your vet's own preference and previous experience.

    Some cats can go into remission from their diabetes (ie, get to a point where their diabetes can be controlled by diet alone). Quite a few cats on FDMB go into remission.
    If Tinker is a good traveller then you could consider trying to get onto the Royal Veterinary College's 'remission trial'. That would give you immediate access to longer lasting insulins (for free!). But it would involve a number of journeys to the RVC. Several UK members here have got onto the trial.
    Here is the link to more info:
    http://www.rvc.ac.uk/research/resea...tre/projects/feline-diabetic-remission-clinic

    And here's a link to the Caninsulin/Vetsulin User Guide (written by FDMB member Kimmee):
    Vetsulin/Caninsulin user guide
    There is some useful info in the guide, and it is a good starting point.

    Eliz
     
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  8. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Me again...

    Helen, your vet may try to sell you 'prescription' food for Tinker. You don't need it.
    Most of us here feed our cats ordinary decent quality canned food that is also low in carbohydrates.

    What are you feeding Tinker at the moment? Wet food? Dry food?

    Eliz
     
  9. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Helen,

    We're in the UK, too. You may have noticed that most people here have links to online spreadsheets in the signatures at the end of their posts. A spreadsheet makes it really easy to keep a record of Tinker's BG data and clinical signs, and you can share the link with members here and also with your vet should you wish. (Works great with our vets!) Here's a guide to setting up a spreadsheet and linking it into your forum signature. You'll need to use the World mmol template.

    http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

    As Eliz says, Caninsulin does work for some cats but frequently it doesn't have a long enough duration in cats because they metabolize insulin so quickly. Also, Caninsulin tends to drop blood glucose fairly hard and fast in the early part of each cycle and this can make some cats feel quite crummy (including Saoirse). The data and notes that I recorded in Saoirse's spreadsheet provided our vets with the evidence needed to get Lantus (aka insulin glargine) prescribed for Saoirse.

    I also recommend contacting the RVC. Even if you don't participate in the trial, Ruth is very, very helpful. She and our vet had a discussion about Saoirse's problems with Caninsulin and I think that also helped us to secure the Rx for the longer-acting insulin. I think that Sarah (@phlika29) had a similar experience with Ruth.

    I also echo Eliz's sentiments about 'prescription' food. Saoirse was initially prescribed Hills w/d dry by our vet at the time, which is essentially kitty cornflakes (more carbs than the non-diabetic diet she had previously been eating). I wanted to feed her low carbohydrate wet food. We can help you with food sourcing. There is a good range of low carb, species-appropriate food available, especially online from The Happy Kitty Company and zooplus.

    Looking forward to hearing how Tinker and yourself got on today at the vets. :)
     
    Last edited: Mar 2, 2015
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  10. Helen

    Helen New Member

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  11. Helen

    Helen New Member

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    Mar 1, 2015
    Hi thanks
    I think I need to get used to all this before I get around other things.I have had an eventful morning,we start Insulin on Wednesday.Regards
     
  12. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    The early days can be overwhelming. All the best with starting Tinker on insulin. :)
     
  13. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Hi Helen

    Where are you on the south coast? I live in poole, dorset and would be happy to help in any way if I am anywhere near to you. :)

    It can be stressful in the early days but it does soon become just part of daily life. Take some time and re read all the messages here and the various links.
     
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  14. Helen

    Helen New Member

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    Mar 1, 2015
    Well that is a coincidence I live in Poole too. That is very kind of you.I will keep it in mind .There is lots to adapt to , both for me and Tinker.
    Someone asked what food Tinker has. Felix or Whiskers.2 sachets and biscuits AM & PM at the moment, as he is always ravenous.But he has lost a lot of weight and the food will be adjusted as insulin takes effect
     
  15. Helen

    Helen New Member

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    Mar 1, 2015
    I was just wandering .Is it safe to leave Tinker on his own?
     
  16. Helen

    Helen New Member

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    Mar 1, 2015
    Yes We discussed it .
    the vet suggested Felix which Tinker likes.He has 2 sachets twice daily + biscuits at the mo. as he is always starving and losing weight
     
  17. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Wow!
    That is a coincidence.
    Maybe Sarah could give you a hometesting demo...? ;):)
    .
     
  18. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    What do you mean, Helen?
    Do you mean after giving him his insulin shot?
    .
     
  19. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Kudos to your vet for not trying to sell you prescription food!

    Newly diagnosed diabetics are often ravenous. That's because their bodies can't utilise all the food they're eating.
    We often suggest that folks feed new diabetics as much as they want within reason.

    Once Tinker's blood glucose levels get more under control his appetite should settle down.

    Eliz
     
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  20. Helen

    Helen New Member

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    Mar 1, 2015
    Sorry ! yes
     
  21. Helen

    Helen New Member

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    Mar 1, 2015
    I have another Question . Which make of human glucometer should I be buying. ? During my research I found that some are more accurate than others ,bearing in mind I am in England.
     
  22. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    This is a difficult question to answer...
    The reality is that most people with diabetic cats do just give the insulin shots and trust/hope that the cat will be OK; and they often are!

    But the only way to know for sure what the cat's blood glucose is doing is to test it...

    For those who are willing to test we suggest that, as a minimum, the blood glucose is tested prior to each insulin shot (what we call the 'preshot' test). That is to make sure that the cat's blood glucose is high enough to warrant being given that shot (sometimes the cat may surprise us with a low number!)
    For folks new to dealing with diabetes we recommend that no insulin is given if the preshot level is below 11 (200). That's just until people have gathered a little data to see how the insulin is working in the cat's body; after that it's usually possible to give shots at lower numbers.

    Then, another really helpful test to do is about 2 hours after the shot (what we call '+2'). By that time the insulin will probably have started working, and a test at that point can often be a good indicator of how 'active' the cycle may be (ie, how much/fast the blood glucose may drop).

    With Caninsulin it is quite common to see the lowest number of the cycle at around 4.5 - 5 hours after the shot (+4.5 - +5); but Tinker's lowest blood glucose may be a little sooner or later than this.

    With some cats Caninsulin can drop the blood glucose quite fast, and a snack/mini-meal fed and hour or hour and a half after the shot can help slow the drop down.

    If you're going out and need to leave Tinker on his own then it would be good to leave some food available for him if possible. If he's likely to scoff the whole lot at once then you could consider a timed feeder.

    Eliz
     
  23. Critter Mom

    Critter Mom Well-Known Member

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    I use an Alphatrak 2 but I also have an Accu-Check Aviva as a backup meter. I haven't used it that much but it seems fine (and I'm paranoid! :oops:). I think Sarah may have the same. @phlika29 and @Elizabeth and Bertie - can you recommend some meter brands for Helen (and where she might get reasonably priced test strips for same)?
     
  24. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Quite a few UK folks seem to like the Accu-Check Aviva.

    I've tried a few meters but have always come back to my trusty One Touch Ultra. But I think the Accu-Check uses a smaller blood sample.
    The test strips can be a lot cheaper on Ebay.
    (I do have an Alphatrak also but found the ongoing cost of test strips way too pricey for me...)

    Incidentally I do have some spare (unused) One Touch Ultra meters. I used to offer them, routinely, to new UK members, but stopped doing that because I began to wonder if I was scaring them off! :eek: (Too much, too soon, and all that....) But if you'd like one to use as a back-up meter just let me know and I'll be happy to post one to you, along with some test strips. :)

    Eliz
     
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  25. Helen

    Helen New Member

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    Mar 1, 2015
    You guys are great Thank you so much :bighug: for all the info.You are right...too much to absorb,but I am getting there .
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    I know there's a lot of info on this thread, but you've got links to all the basic stuff in the one place that you can refer to as and when needed without having to scout around the forum for them. When Saoirse and I started out, I found that reading, then re-reading, then re-re-reading helped things to sink in a bit better (but then my memory's banjaxed :oops: ;) ) .
     
  27. phlika29

    phlika29 Well-Known Member

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    Hi

    I use the accu chek aviva. It does seem to need a fair bit of blood but I guess you just get used to it. I would buy the strips off eBay as they are lot cheaper thsn in the shops.

    I would be more than happy to show you the hometesting ropes:). Anything I can do to help.

    Ideally in the long term you want to find a food that is low carb and that will mean feeding a wet food. When you swap you will need to be hometesting though. There are a fair few available now in the uk. Do you think you would consider ? I will try to find a couple of useful threads.

    So are you going back to the vets tomorrow for the insulin? I am free tomorrow night if you want some help. I am in oakdale. Will PM you my mobile number.
     
  28. phlika29

    phlika29 Well-Known Member

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    How did it go at the vets? Phone me if you want to or if you want me to come over and have a chat I can do that too. :)
     
  29. phlika29

    phlika29 Well-Known Member

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  30. Helen

    Helen New Member

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    Mar 1, 2015
    Thank you for the food threads .We have decided on Felix ,the vet thinks it's ok.
    all went well at Vets.I gave Tinker the insulin and he seems ok sofar.I am keeping an eye on him.
    My family are around,too so all's well:cat:.I did call you,but you were not around.Bests:)
     
  31. phlika29

    phlika29 Well-Known Member

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    Lovely to speak to you tonight. So to confirm the vet has started tinker on 1.5 units of caninsulin.

    As discussed just in case Tinker's blood glucose levels go a little low then you will want to follow the protocol linked below.

    http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

    As you aren't yet testing glucose at home then you just need to watch out for:

    With regards the food, it is great that tinker is already on a wet food. I am not sure about the exact carb content of Felix jelly but hopefully @Critter Mom will be able to help working it out.

    Most people on the forum tend to either free feed or to feed small meals, often. Cats on caninsulin tend to get an surge in appetite after about 2 hours after receiving insulin and so it is best to feed him again then and then a little later in the cycle.

    It would be great to find out what other members do with a cat on insulin that is an outdoor cat. Is this an issue? Remi is purely an indoor cat and so I don't know what the advice is in this respect.
     
  32. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Bertie has free access to outdoors (though generally only walks out through the back door, then clambers up onto the conservatory roof and yowls to be let in via the office window.... ('Wash, rinse, repeat...' :arghh:))

    We're fortunate in that there are no other houses with catflaps in the immediate vicinity, so Bertie doesn't snaffle food elsewhere.

    And if it looks like his blood glucose has the potential to drop lower than I'd like I shut him in until I'm confident he's going to be OK.

    I've known of some folks here attach notes to their cats' collars saying, 'Diabetic, do not feed'. But Bertie isn't the collar type....:rolleyes:

    Eliz
     
  33. Critter Mom

    Critter Mom Well-Known Member

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    Hi Helen,

    If you can provide me with the typical analysis info for the Felix foods you're giving, I can work out the carbs for you. (Might take a few days - my concentration problems are very bad at the moment. :( )

    Protein
    Fat
    Crude Fibre
    Crude Ash
    Moisture
     
  34. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    (((Aine))) :bighug:

    Helen, I'm happy to do the calculation (I have a spreadsheet that does it!)
    Either let me have the typical analysis %'s or tell me which Felix and I can look it up online.:)

    Eliz
     
  35. Helen

    Helen New Member

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    Mar 1, 2015
    Sorry, been busy.It's felix in jelly either fish or meat.Tinker has had his insulin jab this am He spent a good night ,seems calmer this am.He likes spending time in the garden and going exploring but I am keeping an eye on him.Where to buy syringes? Thank you for your interest and help.
     
  36. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Glad Tinker is doing well. I think I would try to keep him close by the first few days at least.

    I used to buy mine online. I have linked some suggestions

    http://www.vetuk.co.uk/veterinary-supplies-insulin-syringes-c-141_154

    http://www.animeddirect.co.uk/caninsulin-syringes-05ml-pack-of-30.html

    http://www.medicanimal.com/Caninsulin-Syringes-30-x-0-5ml/p/I0000948

    Is this the felix you are using?
    http://www.catslikefelix.co.uk/food/adult/Pages/adult-pouch-chunks-jelly.aspx#description

    I am also linking @LynRich as she also lives in the UK and her kitty is on caninsulin.
     
  37. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Hi Helen,

    Wasn't sure if it was cans, pouches or foil trays, so looked them all up.

    The analysis percentage figures given for the Felix fish/meat in jelly cans and pouches are the same, and calculates to 9.3% calories from carbs.
    The Felix meat/fish foil trays calculate to 7.2% calories from carbs.

    For a diabetic we're aiming to feed foods that are less than 10% calories from carbs so all those foods fit that requirement.

    It may be that a slightly lower carb food would lower Tinker's blood glucose a bit (depending how carb-sensitive he is). But it's best to keep things as they are until you are hometesting (if indeed you choose to do that).

    Edited to add:
    Just looked back through your posts and see that you're feeding "sachets" (pouches?), so if it's just the meat/fish in jelly type that would be 9.3% cals from carbs.

    Can I just check that you're not feeding the 'As Good As It Looks' pouches? They can make some cats' blood glucose skyrocket...

    Eliz
     
    Last edited: Mar 5, 2015
  38. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Re the syringes, I see that Sarah has already given you some links. :)

    The vet will sell you some syringes to get you started. Caninsulin is a U40 insulin (40 units of insulin per ml) and is usually used with the corresponding U40 syringes that are specifically made for Caninsulin.

    They are much cheaper to buy online than from your vet.
    And it seems that VetUK now do their own generic U40 syringes which are cheaper than the branded Caninsulin ones. (I've never tried the VetUK ones so don't know what they're like). If you do decide to try the VetUK ones then you'd be looking to buy the U40 syringes that hold .5ml (the smaller of the two options).

    Note:
    If it turns out that Tinker starts to need small doses of insulin then there is the option of using U100 syringes instead of the U40's. It's much easier to measure tiny doses with U1oo's. And there is a conversion chart on the forum that explains how to use them with Caninsulin.

    Eliz
     
  39. Helen

    Helen New Member

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    Thank you very much for feed back,and looking up all the different types ,you deserve another gold star ....It is in fact pouches .No it's not "as good as it looks".It seeems adequate .As I have been advised by the vet.not to drop the carbs drastically, initially,I will continue to monitor the situation.Regards
     
  40. Helen

    Helen New Member

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    Thank you Sarah ,another gold star for you .... Regards
     
  41. Critter Mom

    Critter Mom Well-Known Member

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    Eliz, you're a star! (And thank you for the much-needed hug! :bighug:)
    .
     
  42. Helen

    Helen New Member

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    :bighug::cat:
     
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  43. Critter Mom

    Critter Mom Well-Known Member

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    BTW if ever you need to switch to U-100 syringes in the future, let me know. I get the 0.3 demi's from a pharmacy that sells 'em on ebay (reliable, and best price I could find).
     
  44. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Oooh, I'd like to know where you got those, Aine! I'm going to run out of mine shortly... :)
     
  45. Critter Mom

    Critter Mom Well-Known Member

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    Here's the link to the seller's ebay shop:

    http://stores.ebay.co.uk/stgeorgeshealth/

    I ordered twice from the above (£16.99 including postage for 100 BD Micro-Fine 0.3ml u100 Demi syringes - most recent order was November last). Just had a gander on ebay, Eliz, and they don't have any listed at the moment. It might be worth contacting them to see if they'll be offering them again. Best price on Ebay at the mo is £22.99 for 100 syringes (VetUK £23.50 for 100 plus postage).
     
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  46. phlika29

    phlika29 Well-Known Member

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  47. Helen

    Helen New Member

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  48. Helen

    Helen New Member

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    Thank you
     
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  49. LynRich

    LynRich Member

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    Nov 30, 2014
    Helen, I live in the UK as well, & my 8 year old cat Squiggles has diabetes. It's a lot of info to take in isn't it ? !

    She's on Caninsulin & used to eat Felix As Good As it Looks & ordinary cat bics . I've slowly changed her onto Natures Menu & Lily's kitchen which is high meat content & very low carb. She also has a few Hills M/D diabetic & weight loss cat bics. I think I read you've been discussing diets, & I assume when & if you decide to change her diet, you'll tell Tinker's vet.
     
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  50. Helen

    Helen New Member

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    Thank you
     

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