Very sick newly diagnosed cat, BG in 22s (400s)to over 33s (close to 600)

I´m a cat parent to Princess Kraken, a 16-year-old Bengal cat who was diagnosed with diabetes in late January of this year. In October 2018 she got very sick and went to the vet. She was "diagnosed" with kidney issues. However, there was no blood work conducted. She was put on Enalapril 2.5mg and got better. In December she got her yearly super stuffy nose. It's always the same nostril and a few times a day we would need to unblock the dried up snot from that nostril and encourage her to blow her nose. Some years that has been enough and it clears up over time. Some years she gets an infection and she did this year. She has damage to that nostril. I took her in to see the vet for antibiotics which she got. I weighed her as well because I felt like she was losing weight and she had lost a drastic amount of weight (2.8 kgs down to 2.1) I also asked for a blood panel to check her kidney issue and to just run a general panel. Her kidney readings were perfect. Her blood glucose levels were 24.3 mmol/L (437 in US readings) and the vet gave her the first insulin shot (5 units).
I unfortunately only found the amazing spreadsheet that is provided through this forum (and this forum itself) during the last week. I´ve read through posts about it and we are starting to use it as of tomorrow morning. We have registered all of her blood glucose readings into a google doc that her vet has access to but we were not asked to register the amount of insulin. We also made notes of anything that changed or if she was annoyed or didn´t eat all her meals (except dosing as this was for the vet who was telling us the doses) but that is all in Icelandic so illegible to most.

After that first dose, she was on 5 units for the 22nd, 23rd, 24th, and 25th of January. (ETA: we only have U100, not U40 syringes, doses need to be divided by 2.5 to get correct unit administered) We were told to check her glucose in the morning before insulin, then again 8 hours later, then 10 hours, then 12 hours before her next shot. She did show a curve each day and her glucose levels were slowly decreasing for the first 3 days with the lowest afternoon reading of 15.8 (284) on day 3. On day four her blood glucose was going up again with her highest reading to date 26.8 (482). Next morning down to 17.7 (319) and her pm before insulin test she was down to 3,9 (70). As per vet instructions, we didn´t administer any insulin that night. The morning after that she was 31.3 (563). Her vet cut her dose to one unit and took her off the kidney meds. For a few days she would be high for Am shot (red to black range per the spreadsheet) but low and in the green for the pm shot. Then her BG started spiraling upwards and the dose kept being increased. Since then her lowest reading has been 14.4 (259)in the PM with most PM reading in yellow to pink but most Am readings in red to black. She has slowly been increased in insulin and is now on 3.5 units. She hasn,t been glucose tested regularly for the last week, just every third day in the AM because her ears are super sensitive and she was getting bad bruising on her ears. She is still high reds to black every reading. One evening around the time insulin was in full effect she got super groggy, her head was rolling around and her eyes were glazed over and she was just lying in my arms like a wet rag... I freaked thinking she was going into insulin shock (not sure of the English word, dangerously low BG) and tested her BG and it was 12.2 (220)

But before she had that first appointment she was active, perky, ate normally, drank a bit more water than our other cat but not drastically. My only concerns where her nose and weight loss. Since then she has just slowly been getting worse and worse. She is dehydrated despite drinking more water, she sleeps a lot, she can barely jump off anything anymore, we have had to put a litter box in every room in the house because she just can´t make it to another room anymore, she is still losing weight, she sways as she walks and has balance issues. She sometimes just lays in my lap and pathetically mews, her crying mew. She gets more perky moments in between, especially when food is offered. Until last week she was constantly ravenous but then suddenly lost interest in food and became super weak and her eyes got weird, you could barely differentiate her pupils from the rest, it was like there was a film the same colour as her eyes over her pupils. She was on Royal Canin diabetic pouches so we tried switching her to Pussy deluxe two days ago and she loved it. She´s perking up and her dehydration is getting slightly less. But she only seems to have any energy for the first 90 minutes after feeding and then she just sleeps, (BG test is before meal and insulin just while she is eating or just after). We are considering transitioning her to a raw diet if we can find a reliable source of taurine supplement.
Her ears are fully healed, she has a vet appointment on Monday at 12, and we will be doing a BG curve over the weekend to see her current curve on 3.5 units (and using the spreadsheet from now on with all info included). In the last week, she went from her usual wanting to snuggle in our arms or on our lap or stay on our shoulders basically 24/7 to wanting to be alone in a separate chair.

I´m starting to worry that she´s dying in front of me and I´m being selfish and just prolonging that...

 

Hi Kitty and welcome. I am sorry to read about little Princess Kraken. I don't see the spreadsheet linked into your signature and therefore we can't see the data you have been able to get and will be getting this weekend. If you aren't able to link the spreadsheet, you can start a conversation with @Marje and Gracie or @Chris & China (GA) and they can give you some help.
Please do your best to get that spreadsheet showing, as the data will be important to advising members. You can post in the Caninsulin specific forum also http://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/ and perhaps the veteran Caninsulin users can offer some suggestions and advice.
Wishing you the best as you go forward!

 

If you can please send me a private message, I can help you with or do the SS for you. To send me a private message, just click on “Marje and Gracie” to the left and then “Start a conversation”. Thank you!

 

Hi to you and you bengal kitty. They are gorgeous kitties.
First of all I want to say that 5 units is far to high a dose to start your kitty on. The usual dose to start is 1 unit. I am glad the vet reduced to one unit. I don’t understand why he then increased it if your kitty was having green numbers. The subsequent red numbers after the green would have been a bounce from the green numbers and didn’t warrant an increase.
Did you PM Marje to get your Spreadsheet up and running. That is very important.
In my opinion this is what I think you should do.....
Go out to a pharmacy and buy a bottle of Ketostix to test the urine for ketones. It is a simple test. If the result is negative then I would reduce the dose back to 1 unit twice a day. Test before every shot and about 3 hours after each shot to see how low the insulin is taking kitty. Not every cycle is going to be low but if you are getting low numbers on that dose do not increase the dose.
Do you have high carb food and honey at home in case of a hypo?
I am going to tag @Kris & Teasel who is experienced with caninsulin and can help you.
Keep asking lots of questions. I don’t think your vet knows much about feline diabetes.

 

Diabetic cats who are not regulated and are in high numbers will lose weight because they can’t utilise the nutrients in the food they are eating. Give your cat as much as she will eat while she is still not regulated and losing weight. Give a good sized meal before the insulin dose and feed at other times in the day especially in the first half of the cycle.
What food are you feeding her. If you have been feeding a higher carb food that will keep the blood sugar levels(BSLs) high but you need to be careful changing over to a low carb diet as that can lower the BSLs quite a bit. You need to be testing the BSLs when you change over.
The balance issues and not jumping is probably diabetic neuropathy which is caused by high BSLs. It should improve once the BSLs reduce to more normal levels.
My cat Sheba got very thin and had neuropathy and was very lethargic but she did improve and eventually went off insulin so don’t lose heart.
They can have litter box issues as well as they need to go do often and often their legs feel weak from the neuropathy and they can’t make it.
But please get the Ketostix and test for ketones to make sure they are not present.
Feline diabetes is a very treatable disease.

 

Hey, thank you all for taking the time to respond!
I hadn't linked the SS yet as we are starting to use it this morning. If all worked it should be linked now.

Her old spreadsheet was basically just a running tally of her BG readings for her vet. It does not show the amount of insulin which was administered daily, which was 5 units the first few days, then down to one unit and was then slowly increased to 3.5 units. We don´t remember the exact dates that each increase took place. It´s only in mmol/L.

The old fairly useless chart is here:

Her vet didn´t think we needed a blood glucose meter for home use and said it was enough to bring her in once a week for an ear prick, and when stable once a month.
We didn´t listen and bought a meter and strips immediately and this morning I am beyond thankful that we did. If we had given her 3.5 units this morning I´m scared we would have killed her. Her AM reading was 11.5 (207). We haven´t really received any information on how to adjust doses or anything like that but just from reading this forum for the last few days and googling everything I can about dosing then no way was I giving her 3.5 We gave her one unit. Her +2 reading was 6.6 (119). She got her breakfast and I am not leaving her side and just watching her. She looks better today. She´s actually purring loudly for the first time in a week. She always wants a few sips from the bathroom tap after eating (has to be the tap, sometimes she just sticks her tongue out once, it´s about being treated like royalty rather than the water) and this morning she jumped up her self for the first time in a week. Before she would just sit and mew very quietly to be lifted up. She also sat and watched her sister play with interest and her mews are getting closer to regular volume. I´m not freaking out anymore like the last week. I was starting to feel like we were torturing her.
I have honey and higher carb food in case her blood sugar drops.

I went yesterday to the vet and got ketone strips (after reading about them here) and got these strips. The vet's reaction was basically.. "Why? you´ll smell it on her breath.". I didn´t get any instructions on how to use them. The getting a sample part I can do.. It´s the when should I be checking this? Could anyone advise on that? Does anyone know of good reading material on Ketones and how to and what everything means?
Other than the ones that are named the same way as in the LABS section of the spreadsheet I´m not sure where to input which data from the stix.

 

Yes! I can see the SS. Well done! I am so glad you are home testing. It is one of the most important things you can do to keep your kitty safe..
I would give Princess Kraken some normal low carb food now as her BSL has dropped quite a bit.
Test again in an hour and keep testing until it starts to go up again.
I would not give any insulin if the BSL is under 11 (200). Post and ask for help.. Hopefully Kris will be online soon and she will be able to help you with the caninsulin dosing.
It sounds like your vet doesn't know much at all about feline diabetes. Testing for ketones is extremely important....yes you might be able to smell her breath but by that time the ketones are probably moderate or high..we want to catch any ketones when there is a trace. You can check for the ketones at any time of the day it doesn't matter. But I would check daily while the BSLs are high..
Ketones develop when a cat is not getting enough insulin, enough food and has an infection or inflammation. If not treated it can lead onto DKA which is a serious and sometimes fatal illness. That is why we like to test for ketones. Here is a link.
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/
Will post this now so you can see my comment about testing during this current cycle

 

Looking at the "old fairly useless chart" I can see that it looks as if she was tested in the morning and in the evening and occasionally at other times. The problem with that is that if the readings were taken around the time the insulin was given but not about 3 or 4 hours later, then you are not seeing how low the insulin is taking the BSL. So day after day it looks like the insulin isn't working....when in fact she could well have been dropping low then bouncing up high again by evening....day after day.
Then there were some low numbers inbetween that should have been a really red flag for the vet. When cats feel they are dropping dangerously low their bodies release regulatory hormones and glucose into their bodies to "save themselves".. this sends the BSL skyrocketing and it is called bouncing. Bouncing can last from one to 6 cycles. Does this make sense?
Make sure you test before EVERY insulin shot and again during the cycle (usually around 4 hours for caninsulin but Kris will tell you more) to see how low the dose is taking kitty.
And if ever you are unsure of anything please post and we will help you.
You have come to the best possible place to help your Princess Kraken. There is a wealth of knowledge here from people who look after diabetic cats 24/7 and they will always help and treat your kitty as if it was their own.
ETA
When you have tested the urine for ketones you can document it in the remarks column of the SS.

 

I’ve just seen the 2.5 on the SS. Give your kitty some honey and high carb food now. About a tablespoon of food with a good drop of honey and test again in 20 mins

 

She is eating kitten food now and honey. Testing again in 10. I shouldn´t have dosed her

 

Don’t blame yourself.
She has earned a reduction in dose with that low number. @Kris & Teasel will help you with that.

 

She just ate some kitten food. Plus honey. And then asked for her meat food. She looks OK and even jumped up to the window sill to catch some sun.. and I'm about to test again.

 

3.0 (54), has free access to food.

 

I'd give her a bit more of the high carb food as we don't know when her nadir is (lowest point). We don't want to feed her up too much and fill her up in case we need her to eat later, so just give her another teaspoon of HC for now and test again in 1/2 hour.

 

Yes I have a tiny bit of the HC food close to her. But am not trying to entice her to eat. But if she wants it it next to her.
There's one type of the meat food that has a higher calorie count so after HC and honey I let her lick a tiny bit off my finger. It's 198 calories per 100 grams vs 120 to 130 for the other types. The kitten food is 399. Testing every 30 míns at the moment and sitting next to her to monitor her eyes and General condition. She still seems fine. Happy and chirpy.

 

Well respond to other points when I'm sure she's OK.. But yeah. Not trusting her vet at the moment.

 

You're not getting mixed up with carbs and calories are you? It's the carbs we need either to be high, medium or low, not the calories.

 

I see 4.4 (79) for +5...... that's good. She's safe at that number.
Don't feed her any more at the moment but keep testing.
You have done well.

 

The kitten food has high carbs and cals. Sorry! The meat food has higher calories but I´m unsure about the carbs. It´s the only one from that line that has gravy so she was just licking the gravy with a couple of flecks of meat from my finger, which would be the likeliest to be the part to contain the most of the carbs in the package. I doubt the gravy had any real impact on her BG, that was more of good girl treat for deigning to eat the "awful honeyed" food. I had to really push it at her for her to eat it. In behaviour, she is honestly quite dog like.. And she knows when she has to do sth. We had to train her to allow us to blow her nose which is quite hated. But even a tiny treat trains her fast to do as asked. It´s quite amazing and makes caring for her at the moment much easier than if our other cat was going through this.

Her BG is up to 4.4 (79). Continuing to monitor.

 

Thank you! She is still looking better than she has in a week. Her fur was horrible last week and it looks much, much better today.

 

@Gill & George would you be able to keep an eye on Princess Kraken please? It is getting late here in Aus.?

We will help you get her back to her former self. She was getting far too much insulin.
You will need to reduce the dose of her insulin down to 0.75 unit.

 

@Kitty Anderson
Have you tested again?

 

Yes. 7.6 (137) No food since the 4.4 reading. From what I´ve been reading in the forums then I expect she is going to bounce..

 

She looks like she is on the way back up, I would test again in one hour just to make sure.
Yes she will probably bounce from that low green today, so don't be surprised if the BSL is high. But don't be tempted to give a larger insulin dose. She has earned a reduction down to 0.75 unit. You will have to eyeball the amount....it will be half way between the 1/2 unit mark and the 1 unit mark. A magnifying glass helps.
Hopefully Kris will be along before too long to help you with the caninsulin management.
It is pretty late here in Australia, so I am heading to bed. I did ask @Gill & George if she could keep an eye on you but I think she has gone offline. But I think you will be OK now.
Keep asking lots of questions...it is a steep learning curve in the beginnning but knowledge is power.
Bron

 

Hi,
I'm here just in case, but it looks like the excitement has passed.

What sort of food was it then? Did she have High Carb?

If it was HC, don't give her anymore now, and double check at +7 to make sure the Blood glucose doesn't drop once the carbs have worn off.

 

So regarding the super weird blood test times. That was vet´s instructions. They lent us a BG meter for the first few days. Vet asked she be tested before insulin, then 8 hours later, then 10 hours later and then 12 hours before next shot. She called that performing a curve.... Which from my reading on this forum is bullshit and would not give a nadir. She wanted that done for two days then AMPS and PMPS shot for a few more. That was 5 units. Her first super low read we skipped insulin and she reached 33.1 the next morning.

26.01.19 -19:35- 3.9

26.01.19 - 19:38 - 6.1 (No insulin, the second reading is because we thought we messed up the first reading and this time she was pissed)

27.01.19 -7:35 --31.3 (Last 5 unit dose)

Thats when she was cut to one unit. for the PM. then every 3-8 days raised half a unit at a time. Vet kept saying don´t test her glucose levels for a week and then we will test to see how she is doing.

I just tested Ketones and no change to Ketone part but the blood one (RBC) is blue.. From what i can read that is +250..

 

Thank you!

It was kitten food with high carb, a little honey and a few licks of gravy from her meat lovers. As soon as I got the 4.4 (79) reading at plus 5 hours I took food away but between the 4,5 hour reading of 3 (54) and the 5 hour reading she had HC food by her but didn´t eat any of it.

 

So if Princess K, is still up two hours after she had the High Carb then you can both have a break.

The method your vet used for determining dose seemed very strange.

Where are you? Somewhere Skandic?
I'm in Spain.

I'm glad you tested this morning and reduced the dose.
I don't use caninsulin (I use Lantus, which is a long acting insulin and the dosing method is different), you might get some advice on the next dose on the caninsulin forum.
http://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/

http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
It seems like the 1u was a little too much today, it resulted in 150 (US )pts drop, so you may need to consider reducing the dose particular y if you are getting a preshots in the yellow range.
I would think that the 3u you have been shooting is too high.

 

Iceland! So Nordic.

In all honesty I don't think this vet has much experience with diabetes and cats.. Its doesn't seem like she was checking for nadir, just to see if her glucose was going down at all.

We weren't even supposed to be checking her glucose levels today according to the vet, just give her 3.5 units ... I shudder at what would have happened. We've never been giving any information on how to adjust dosage.. It was just some gut thing this morning. Wish my gut had said half a unit.

Kraken has been super sick for the last week.. Was completely losing her appetite, she has never, ever looked so close to dying... and I suspect she was dropping way to low and then bouncing like crazy on the 3.5 unit dose.

I've learnt so much from this forum already.

I'll head over to the vetsulin specific forum in a bit. After coffee, a cookie and a chapter in my book and a loudly purring Kraken who finally again wants to snuggle on my lap after a week of not wanting to be touched. So purry, so snuggly !

 

I'm so glad you found this forum, and Princess Kraken appears to be on the road to recovery! Well done, doing your own research. So many of us come here because our formerly happy, active, beautiful, and bouncy kitties have become anything but. Our Benny was looking like a little old man - scrawny, scruffy, lethargic, and pooping on the floor. We knew absolutely nothing about diabetes, but as soon as we got the diagnosis we began researching and it led us here. Fortunately, our vet is familiar with felinediabetes.com and uses the site for her own research, so we're on the same page.

Good luck going forward, and if you don't have the option of finding a new vet, then you can always politely agree with her while you do your own thing based on this incredible knowledge base. There's no rule that says you have to tell her what she doesn't want to hear, right?

 

I should have said Nordic then that would have included Iceland and Finland. The language on the no good chart, seemed similar to Norwegian.

Neither did my vet, but at least she wasn't gun ho about it, she was super cautious and painted a very bleak picture, I was glad to find this forum and have some hope at regulating my cat, which first time round took about 6months, he was in remission until a steroid shot some weeks ago made the diabetes rear it's ugly head again.

I see she is up again at +7, so looks like she's done dropping now as you are past that 2hr point from having had the High carb food, so I think you've earned a bit of break, cookie and a good read of your book.

If you don't get any response on the Caninsulin forum post here on the main forum, there is not as much visitors to the caninsulin forum as there is here on the main forum.

I'm glad she's purring and snuggly, low BG could have been making her feel rotten especially if it was triggering fast drops and bounces.

 

In all honesty.. If I come in saying I researched this thoroughly she is going to listen to me and work with me. I've been permitted to do a lot of stuff at home with my cats that she would have most people come in to the office to do.

When one of our cats who passed away was super sick I was doing stuff at home she would never allowed most people to do as that cat was always super stressed by the vets office. So I was giving under the skin fluids at home. She listens and respects what I say.

I think she just does not have feline diabetes. She herself said that most of her diabetics were dogs and her few cat diabetics stabilised super fast and weren't reading so high.

I have a background in humanoid healthcare.. So apparently that earns me more trust that when I say I've researched sth she believes I've done so thoroughly.

 

Icelandic would be closest to Old Norse! Good spot!

I'll talk all this through with the vet tomorrow including making very clear that if we had followed her advice that Kraken would probably (almost certainly) have been close to dying or dead..
I might also explain to her things like how to do a curve... and other things I've learnt from my research.

 

If her experience is with dogs, that might be the problem. Cats metabolism is much faster, so they will nadir earlier than dogs, caninsulin doesn't have as long a duration in cats as it does dogs. That might explain why she was getting you to check later in the cycle than we would expect a cat to nadir.

Also cats get so stressed at the vets, that I think vets get a really skewed view of how well a lot of cats(if not the majority) will tolerate the BG check at home, so they are concerned about putting the animal under a lot of stress which could in itself contribute to raised BG, our experience here is that our sweet sugar cats tolerate it very well, George often purrs all the while I'm testing and gets excited when he sees the glucometer (he's looking forward to his freeze dried treat or snack)


My vet was willing to work with me, she wanted to try caninsulin first, but from the research I did I felt that I wanted to try Lantus first as it seemed to give better results with cats, being slower to onset and not as prone to the fast drops of caninsulin that we often see. She agreed to me trying Lantus, I gave her the protocol I was going to follow, and access to the SS she left the dosing up to me and we talked often on the phone. Most of her Px are dogs so this was new to her.

If your vet is willing to work with you, frankly that's a huge bonus. I wouldn't burn any bridges.

 

I do think it's the dog thing. I've been reading up on dog diabetes as well and what she reccomended made way more sense for a dog.

One of the issues is that due to living on an island with a micro population (340.000 ppl) is that choices are limited. We can't order insulin from abroad, customs would confiscate it, they confiscate melatonin even..
Lantus isn't available and canininsulin is the only insulin that they feel comfortable stating that the supply will be sure. We have 5 vets offices in the entire capital area, one of them is horrible, one takes 90 minutes each way. Ours is considered one of the two best ones. They are looking into securing alternative insulin supply.. But they have been for a year without luck.

Kraken is definitely not stressed going to the vets, she actually loves going there. Everyone there loves her and she gets pets and snuggles and attention. She wants all the attention!

This vets office is super ready to work with me, and I can be super direct with them... Ever since my baby Veira (Icelandic feminine term for virus) died of liver cancer. My Veira got super super sick very suddenly. The vet on call was new at the office and had just moved here from Germany. The vets theory was that she had an intestinal blockage. Veira was x rayed and when we looked at the xrays I immediately saw her intestines were perfectly fine and pointed at her liver and said it was at least twice the size it should be and that she needed immediate further medical tests. This was on a Saturday. She argued with me and said I obviously had no clue what I was talking about. I asked for a second opinion and she refused to call out another vet. Made us squirt mineral oil down her throat for the rest of the weekend. I was there as the head vet arrived Monday morning and walked up to her and told her the Saturday vet was dangerously incompetent and that she needed to check her x Ray immediately. The new vet walked in while we were getting the x Ray and said that veira was a very clear case and that I was being hysterical and imagining things. The x Ray hadn't even hit the screen when the head vet hissed at her that she was wrong, to call in a replacement and leave for the rest of the day. She was in surgery 60 minutes later but passed shortly after coming home again. The head vet said if she had been called in on Saturday then veira might have had a chance..
That vet wasn't allowed to do anything more than basic yearly shots and deworming and such plus secretarial work for the rest of her contract.
Ever since then I can be direct as possible and they treat me like an equal.

 

For a 13.9 (250) BG reading I gave her 0.75 units.

 

I hope that the 0.75u is a bit gentler with her.

Not for humans? or is it just restricted to human use because of supply issues?


Since she dropped so much by +2 this morning, she may be experiencing onset pretty early, if this were me I would start by getting a +1, that way if you saw a large drop you could intervene earlier and try and manage the curve.

 

We just did another +2 and she is 8.6 (155) vs 6.6 (119) at plus 2 this morning. We split her dinner up so she got part at the shot, part now and part at +4. I´m thinking if she´s 5.8.. maybe 6 that the last 25% of dinner should be enough.. But under I´m thinking I should add a tiny bit of her HC. She is wet food, high meat content, the ones we buy are 97% meat, they do have one that has slightly higher carbs which we have a couple of before I did the math on them. Why can´t they include a carb count... grrr. Her HC is kitten kibble, she loves that stuff so much. We had to take that to the attic when I temp took in 2 fosters that came with kitten kibble. She would tear through humans for that stuff. Almost. It's in an airtight canister in a cupboard she hasn´t been able to reach since she was 14. She´s napping, in between waking up and walking around. She´s perky, getting louder... Jumping between stuff. This isn´t even the same cat as yesterday..

 

Ohh and Lantus! Yeah.. We have a universal healthcare system for meds and healthcare services. The way it´s set up means that some drugs for humans that vets would use they can´t get. Or they can´t get from the same supplier as the government does and while the government has a stable source vets do not. Or they pay the same price for it as the average feline user in the US. Add shipping fees. Now double that. Add 50 dollars. Thats the price the vet would pay to import. Our vets offices are super small generally. And there aren´t many. So it´s hard for them to ship in wholesale things that they only sold in limited amounts. Without being the govenrment but independent contractors they don´t skip all the tolls and customs placed on sth like human insulin. However as vets they do on Caninisulin because thats registered as a pet medication. So humans get human insulin free and pets get animal insulin cheap.

 

Thought it might be something like that.

She's getting a reasonable duration on the Caninsulin. So it's not all bad.
Could you order it from within the EU with a vet RX? 5 pens of lantus 70 euros here. Just a thought , or would it still be problematic with customs?

 

I believe that nadir can occur between +5-+7 so yes I think your maths seems sound , but I would probably make a decision on what to feed at +4 when you get that reading, feed (whether it's HC or her regular mealy) then check again no more than an hour later, maybe 30min later if your +4 was dark green.

 

Yup. If she yellow í think í might rest her ears.. She's already bruising. Super sensitive ears.. I want another curve tomorrow on way more calculated dosing than a panicked 07.30 am no coffee hell no I'm not killing my cat with 3. 5 units. I prick with just the pin, cotton behind. Super visible veins. Watched multiple sweet spot videos. Tiny smear of vaseline so I don't need to really squeeze . Hold gently but with a little pressure with a cotton pad after. Her ears just bruise super easily.

 

I found that applying pressure with a cold wet cotton pad helped with the bruising.
Also some pure aloe vera gel helped sooth his ears (though it gave problems with the blood droplet pooling), make sure you swap ears.

 

That's something I have actually been thinking of. Not ordering it because I would pay the same fees.. So shipping, import fees and tolls..
But I travel a lot.. Like way to much.. Way way to much. 6 months of the year My spouse is home with kids and cats.. I spent the last two weeks basically reading up everything I could. Everything ..
My spouse told me she was sick.. But not fully how sick.. He was talking to the vet every day.. They suspected insulin resistance .
When I got home I freaked.. She was terrible. I basically then spent all Thursday evening, all Friday and all Saturday reading everything I could.. And talking to the vet who was absolutely convinced she was insulin resistant.. But didn't want her poor ears to get to bruised.. They got pretty bad and she was freaking out when anyone touched them..

ETA: I might be able to pick up lantus in some European countries without a medical prescription And if its countries I stop in regularly enough I can bring it home as hand luggage.

If I try to order it from abroad it will be stopped by customs I don't have authority to order it in.

 

There was an english lady who would buy lantus when she visited France because it was much cheaper there (she had two FD cats) not sure how she managed that with prescription from uk vet in france???

If you don't hit the sweet spot, apply pressure etc they can get pretty sore, poor girl

 

She doesn't look it. Unless her resistance broke, just as you got home??

 

11.30 here, I've just got to give the furry gang their supper, check George and then off to bed, up at 5.30am to shoot.

You've got this you've been doing a great job. I can't quite believe you've only been dealing with it since Thursday, you've been handling it as a pro. If you run into low numbers, edit the thread title, use the 911 if necessary. My guess, given the numbers so far would be that she's not going to dip as low as she did yesterday.

 

Thank you!

 

I think she's been bouncing like a super bouncy ball... And going repeatedly into hypoglycaemia without dying.. Because spouse was basically always feeding her. Because the vet said let her eat well to put on weight.. And the skyrocketing to the moon.

She SLGS now. ..

 

Next study project so we can keep her safe with glucose testing.

 

Heartening to read all your good work and good help from everyone here. I just wonder: what are you feeding her? I've learned so much since M'row was diagnosed end of December 2018, most learning from this forum. Can you imagine, I didnt even know kibble was no good! You are in Iceland, I gather, so maybe you have different canned cat foods from here in USA. Anyway, here fancy feast classic is well thought of; there is much info on kinds of cat food, and even how to make your own. I loved hearing about how your kitty is getting her personality back, what joy!

 

Just a thought before I sign off, I might get a +3, hopefully she won't be doing anything crazy, but with the limited data you have so far we don't really know what her patterns are, I just had a gut feeling that I would grab a +3, stick to your feeding theory (unless she's too low of course)

 

Do you ever travel to Canada? Lantus can be bought over the counter there without a prescription.
Not sure about France,but I have a friend there who had a diabetic cat and I can ask her, if you travel there.

 

10.2 (184) She's good with her last 25% of PM food I think. Rest her ears for a curve tomorrow..

From just today's numbers I would say its more likely that a 0.5 to 1 unit dose every twelve hours with low carb wet divided into a few meals time is more appropriate for her than 3.5 units and fed every 12 hours....

 

Thanks ☺️ she's on the lowest carb wet food ivw found here. I'm calculating the back of every wet food I see..

 

I've been to Canada once for the Human Rights Coalition. But unlikely to go this year. France usually about once a year and I was Strasbourg last month. Belgium often but they're.. Stiff with meds..
I need to check some countries.. Bosnia and Herzegovina, Netherlands, Croatia, Serbia, Bulgaria Poland and Greece all come to mind. Either going or have friends that could get it to me.. And either OFC possible or in some í could get a prescription for myself easily... And a fiends a doctor in Germany. Im there regularly. I just need some time to research and set up a supply chain that keeps me safe based on usage, expiration dates and such. That could take a few weeks.

 

Lantus once opened lasts 6 months if stored in the frig. Kraken is only on a small dose so I would think you should get 6 months out of a cartridge. They can come as pens in some countries and you just take the cartridge out of the pen and use it with a syringe.

 

OK. So next once I've sourced some origin countries I can reach out. Realistically I could if lucky have it here on the 16th of march .. If unlucky . 16th of April..
So 2 to 6 weeks on canininsulin.
That's actually going to be super easy. Get two with a 14 month+ expiry date before opening and I have good time to ensure we always have enough.. I'll start working on that tomorrow

 

@Kitty Anderson
I have just read your thread on the Caninsulin page and noticed you said you were using 0.5ml U 100 syringes. These are not the correct syringes to be using with Caninsulin. The correct syringes are the U40 syringes.
There is a conversion chart that can be used with 0.3ml U100 syringes and Caninsulin but I don't think it works with the 0.5ml U100 syringes. The syringes you have at the moment will be delivering the wrong dose of the insulin. I have not used Caninsulin so I can't help much so I am going to tag @Elizabeth and Bertie @Rachel @Kris & Teasel and hope one of them will come online to help you.
In the meantime do NOT increase the dose at all until we sort out the syringe issue.

 

You divide. By 2.5.
So if you draw to the 2.5u line on a u 100 that's actually 1u of caninsulin.

 

But Is that with the 0.5ml U100 or just the 0.3ml U 100?

 

It's the difference between U40 and u100 calibration, doesn't matter the syringe size.

 

Well I always thought it was for the 0.3 ml syringes only!
I guess I have never thought about the 0.5 ml syringe as it just isn’t used.

 

I don’t think Kitty Anderson is using a conversion chart ... so that means that Kraken is really getting about 0.3units with the 0.75 on the U100 syringe. Right?

 

Sorry went btb was reading and fell asleep.

Yes that's correct.
Also filling to the 1u line on a u100 syringe would actually be 0.4u of caninsulin

 

Thank you both! Hér AMPS was 14.7 (265)
These were the ones that the vet said we should use.
I stuck with a 0.75 units on the U100 as her AMPS is slightly higher than last nights. Will continue to monitor.

 

Im sleep deprived at the moment. Of course it would apply to all u 100 syringes. I’ve just never had need to think about the 0.5 syringe.
I need an early night tonight! Thanks Gill

 

So you are actually giving a much smaller dose than we thought. Normally when using the u100 syringes with caninsulin you use a conversion chart ( instead of the U40 syringes that go with the Caninsulin). Maybe the vet uses the conversion chart and tells you the amount for the U 100 syringe.

 

That could be quite likely.. If we only have U100 dose insulins for humans then those would be the only syringes readily available... This is information she should have provided us with. But her PMPS last night seemed to respond reasonably to the 0.3 units (0.75 U100)

 

It did, I would stick with that dose for now.

 

Nite nite Bron

 

Is the cat food available in Iceland imported from Europe? Of so there's a food chart with many of the LC foods, might save you some time with the calculations.

 

Here's the link to the list
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

 

It’s only 7.15 pm here ! Still cooking dinner! But hoping to head to bed shortly afterwards.
Have a good day everyone.

 

I'm feeding her this brand.

http://www.meat.love/en/cats/pussy-deluxe/chicken-with-tuna.html
Its as close to home made human grade as we can get from a store. But if I can secure a supply of taurine then I want to make my own..
I'd need to read up thoroughly on which additives (taurine, egg shells Ect) she would need.. But if I can't get taurine I won't do it. Currently her food budget is 6.30 US dollars a day. Depending on the cost of taurine I could probably make the same for close to 2 dollars a day. If I can't she gets this while it agrees with her.

 

Going over the list we have Felix and Whiskas available in super markets. Carnilove is also available where we buy the pussy deluxe. Meowing heads is sometimes available but usually only the kibble.
The rest not really
Royal Canin, Science plan, Brit, Iams, Orijen and Akana are the most common here. Whiskas, Felix and Friskies are most common in supermarkets, but Friskies wet is only sometimes available.

 

at +2 hrs she is at 9 (162). Checking at +3, +4, +5 to try and catch her Nadir.

 

I have to order it all on line from Zooplus, none of it is available in the stores here.

Zooplus do a supplement to add for homemade food,https://www.zooplus.co.uk/shop/cats/supplements_specialty_cat_food/vitamins/155860
Don't know if they deliver to icelaIc but they do deliver throughout europe, German company, with websites for different European countries.
Perhaps you can get it delivered to a friend and pick it up on your travels? Not sure if they deliver to iceIcel??

 

They don´t send to Iceland but they do deliver to Germany and Belgium! I´m there often enough that this would be easy and I have an office address both places I can send to!

Thank you!!

 

PMPS is 9.8 (176). No insulin for Kraken tonight. Expecting higher BG in the morning but think I will stick with the 0.3 units in the am if BG warrants shot. She has a vets appointment at noon tomorrow and I´m demanding full bloodwork.
Did urine stix yesterday and today, no Ketones (YAY!!) but non hemo +25-50, and today protein ++100 and some changes to bilirubin that I couldn´t quite place.

Going from Thursday and Friday being convinced that she was dying in front of me, did not want to be touched at all.... To a happy cat that's snuggly and purry!! Just by drastically, drastically reducing her insulin. And saying **** this **** to blind shooting.

 

Kitty, maybe start a new thread and linking this thread in your new first post? You've turned the corner and are going in the right direction. Great progress and I'm so happy to hear that Princess Kraken is doing so much better. We are happy for you.

 

That seems to be nicely low carb, around 4.6% calories from carbs. It's pretty high in fat though...
(I'll add this food to the European section at the bottom of the UK list.)

It's great that you have the option to buy from Zooplus via Germany and Belgium! So many more options that way...

 

Both of you are in my thoughts today.