UK - Newly diagnosed - wrong insulin???

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Julie and Alice, Mar 20, 2014.

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  1. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Hi, my lovely black gentle natured moggy developed ketoacidosis last week & was admitted for 2 nights. She has lost all her weight. I inject 3 units of Caninsulin twice a day (& struggling to give it right). She is very weak & lethargic. I test her blood glucose it is always very high and oddly gets much higher overnight. She drinks loads in morning. My main query at the moment is that she is hungry+++ several hours before her insulin is due & fretting for food. I am trying to keep most of her food for injection times. After the morning insulin & food she becomes very lethargic & struggles to climb the stairs, her back legs in particular are weak. Amazingly they improve somewhat when she is hungry. We live in UK so not sure if any other insulins available. Any advise please. I am feeling very low as I love her so.
     
  2. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Re: Newly diagnosed - wrong insulin???

    Welcome to FDMB.

    If you edit your 1st post and put UK in the subject line, it'll get the attention of our UK members.

    What are you feeding? We recommend low carb, over the counter food. This post discusses canned cat food for EUROPEANS and INTERNATIONAL buyers.

    Are you home testing? We recommend using an inexpensive human glucometer with reference values for cats, so you know if it is safe to give the insulin and if the dose is optimal.

    There definitely are other insulins that could work better for your cat. Hypurion PZI and Lantus are 2 of them available in the UK.
     
  3. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Re: Newly diagnosed - wrong insulin???

    Hello and welcome to FDMB,

    It sounds like you've had a really tough time. (((Hugs))).
    But we will do all we can to help you deal with your cat's diabetes, and there is a lot of combined experience on this forum. So take heart!

    I have some questions for you, and I apologise in advance because there are quite a few...

    Was your cat diagnosed with diabetes last week at the same time as being diagnosed with ketoacidosis? Or was she diagnosed with diabetes before that?

    It sounds like you are testing her blood glucose at home.
    Are you testing before each insulin shot? And are you getting test results during the insulin cycle (particularly 3 - 5 hours after the insulin shot)?
    What are her test results like?
    Sometimes, when it looks like the insulin isn't working it can actually be that too much insulin is being given. That may or may not be the case with your cat, but it is not at all uncommon.

    How did your vet arrive at the 3 unit dose? Did you start at a lower dose than that and then work up from there?

    What are you feeding your cat at the moment? And how often are you feeding her?

    What problems specifically are you having with injecting?

    Are you testing her pee for ketones now? If not I would strongly suggest that you get a tub of Ketodiastix or Ketostix from a pharmacy so that you can monitor any change in her ketone levels at home. Anything above 'trace' is a reason for a vet visit, pronto.

    Sorry about all those questions.
    OK...
    Newly diagnosed diabetic cats are often really hungry. That's because their bodies can't utilise the food they are eating, so they want more and more. It may be that your cat needs more food than she is currently getting.

    The back leg weakness could be due to diabetic neuropathy. If so, that should improve once her blood glucose levels get under better control. But it can also be helped enormously by giving a vitamin supplement called methyl B12 (methlycobalamin). It is important to get one that is suitable for cats though.
    If it is the case, however, that she is getting back leg weakness 3 - 5 hours after her insulin shot then I wonder if that could be an indicator that her blood glucose is dropping low. Is she only affected by back leg weakness at certain times?

    Regarding insulin, as BJ says above, there are other options available. But in the UK vets always start out with Caninsulin first. The law here is that vets need to prescribe a veterinary medicine before they can prescribe anything else. And currently Caninsulin is the only veterinary insulin available for cats. If it turns out though that Caninsulin isn't working for your cat, then, under the 'cascade system', the vet can prescribe a different insulin. The insulin will be one that is made for humans but they also work really well for cats.

    Welcome aboard!

    Eliz in Surrey
     
  4. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Re: Newly diagnosed - wrong insulin???

    Thanks BMJ I will repost as UK as advised but still appreciate any help from any where!

    I am having to feed Alice Royal Canin Chicken & Rice as she is super sensitive to ANY other cat foods I have tried. She vomits them back! She tolerates lamb so I’m now feeding her some with her chicken and rice feed. I think she has inflammatory bowel. She was a rescue cat at 5 years of age, now 13 years approx. I was told she would be hard to place as very timid. She has turned out to be a friendly doting cat who follows me everywhere!

    I have bought diabetic Hills food but daren’t try it just yet as I don’t want to upset her gut at moment. I doubt she will tolerate it.

    I am home testing but less so last few days as I hate pinning her down & usually takes several stabs. I have the Alphatrak2. Its easy last thing at night when she is sleepy - even so, 4 stabs last night!

    Although only diagnosed 2 weeks ago in ketoacidosis I am recognising by her thirst & lethargy when her sugar is high as I tested regularly on her discharge. It never drops into normal, always raised. I think the illness was triggered when I introduced a dry hydrolysed allergenic food & guess its high sugar & quickly absorbed.

    Thankyou for the info about other insulins - I am so glad as I was told it had to be caninsulin. I still don’t know if it will start working but it is keeping her alive & no ketones when I’ve tested urine. I’m trying to do everything at same times but she likes a little food when her insulin is not due & can pester for hours, its quite distressing for both of us. I always add lamb in the hopes it will release its sugar more slowly.

    Its a very fast learning curve for me but I do want to learn quickly to get her stabilised. She is far from stable as yet although seems to be generally better in herself the last two days despite the thirst & high blood glucose.

    Thank you very much for your help

    Julianax
    Can you believe, she's just been sick - first time since home & wanting to feed again :?
     
  5. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Re: Newly diagnosed - wrong insulin???

    Hi Juliana,

    Your Alice sounds like a real sweetheart. :smile:

    Regarding her tummy sensitivity. That must be really difficult for you in finding foods she can eat. Have you worked out what she is actually sensitive to?
    Is it the case that she can tolerate poultry and lamb? If so, then there may be some other foods you can buy (online) for Alice to try. Have you heard, for example, of the Happy Kitty Company? They list 2 brands of 'sensitive' foods, both of which do a chicken and a lamb version.
    http://www.happykittycompany.co.uk/coll ... /Sensitive
    The foods here also have the advantage that they are much lower in carbohydrate than the Royal Canin food that you are currently feeding, and lower carb food could make Alice's diabetes easier to manage.
    Some folks also find that raw food is better tolerated than processed food.
    I do realise that you may not feel ready to try Alice on new foods, but just thought I'd mention a few that you might not have heard of, in case that might give you a few more options.
    Note: I should say too that in switching a cat to a lower carb food, it is essential to be monitoring the blood glucose at home, because the blood glucose can drop quite a bit when the carb content of the diet is reduced (and the insulin dose may need to be reduced also).

    How many meals a day does Alice get?

    Learning to hometest does take time and practice. But it will get easier. Honestly. Be kind to yourself!
    Sometimes a teensy weensy smidge of vaseline on the outer edge of the ear helps the blood droplet to 'bead up'.
    Are you rewarding Alice after tests (and attempted tests?). Most cats appreciate a food treat of some kind, but some are content with a cuddle or a grooming session, and they quickly learn to associate tests with 'positive experiences'. ;-)

    Eliz
     
  6. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Re: Newly diagnosed - wrong insulin???

    When the cat has another medical condition, you adjust the insulin dose around that as needed.
     
  7. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Re: Newly diagnosed - wrong insulin???

    Hi Elizabeth,

    Its great to find this site, thanks for your interest and advice.

    ‘Was your cat diagnosed with diabetes last week at the same time as being diagnosed with ketoacidosis?’

    Yes, 12 days ago. She also had raised white count, low potassium & salt. Also possibly parasite or allergy. She had an I.M antibiotic and worming tab. She has always been slim but lost all her weight now.

    I was originally testing glucose with Alphatrak2 but not for last few days apart from bedtime to make sure she isn’t low. She is stressed & desperate for food before her insulin (for some hours before). It takes 2 of us & then often fail & need several attempts despite having clicker set on highest (4) to get a sample. I can manage when she is relaxed, even then rarely first attempt. A vet told me to forget it and just measure her drinking water as a good guide. I am so stressed about testing her & guessed that there may be no point at the moment as nothing could be done as takes time to stabilise. Testing never showed a low & I have been up in the night to check on her & once took a glucose about 3.30am. I do have to do ‘Curve’ at some point so will have to rally around then!

    ‘Sometimes, when it looks like the insulin isn't working it can actually be that too much insulin is being given. That may or may not be the case with your cat, but it is not at all uncommon.’

    Is there a way of knowing this - can this be checked?

    How did your vet arrive at the 3 unit dose? Did you start at a lower dose than that and then work up from there?

    Increasing first night she had 1 unit, the second 2 units & then home on 3 units so really was quite quick. Even on the first night I noticed that her peaks of glucose were rising. Her vet picked up a glucose of 21 before treatment with ketoacidosis but that still seems to be a common reading & has been up to 31.6 since. The vet said this may be because her diabetes is getting worse. He did say I coud increase to 4 but meanwhile another vet thought that was too much so I have settled on 3 twice a day.
    ‘What are you feeding your cat at the moment? And how often are you feeding her?’

    Royal Canin Chicken & rice as she wont tolerate anything else apart from the dried hydrolysed allergenic food but I think that is what triggered the diabetes bout. She may possibly have had it before but she is a cat that NEVER drinks, only if ill & lost fluid. I think she got enough from her wet food as she did wee ok. She started drinking with the dried food but I thought it was just that it was dry. After a short time I stopped the dried to see if she was still drinking and she was, also went downhill very rapidly.

    ‘What problems specifically are you having with injecting?’

    I have lost confidence & get upset & worried before its due, hoping I don’t mess it up. On a couple occasions I have felt it is wet after the injection. The first time the vet told me not to reinject & I think I nearly lost her. She lay all day & looked like she may die. 3 hours after her next evening insulin she got up and started to eat again. Since, I have given her a unit more on the next occasion it leaked, I would never leave her like that again. I did check her sugar & it was the same as usual. It went against my gut feeling the first time, I cried all day!

    Are you testing her pee for ketones now?

    Yes I have once most days (when I can catch it!) & it is negative now (it was 4+ in Hospital).

    ‘Sorry about all those questions.’

    Don’t apologise I am grateful & relieved to find your site!

    OK...
    ‘Newly diagnosed diabetic cats are often really hungry. That's because their bodies can't utilise the food they are eating, so they want more and more. It may be that your cat needs more food than she is currently getting.’

    Yes, she eats more than she ever did & is actually pestering me for food now, her insulin is due in 30 minutes but she’s been asking for food for several hours & I keep giving her a tiny bit (about 5-10 grams) but it doesn’t really satisfy her. She eats well after her morning & evening insulin, I let her eat freely for a 2-3 hours or so & then she’s ok for a while. She does take most within the first hour post injection.



    ‘The back leg weakness could be due to diabetic neuropathy. If so, that should improve once her blood glucose levels get under better control. But it can also be helped enormously by giving a vitamin supplement called methyl B12 (methlycobalamin). It is important to get one that is suitable for cats though.’

    I did read that on Wiki & so asked the vet in the Hospital to give her some. All he had was a B12 with vitamins so I’m not sure how much B12 was in it or the type. I could ring them if you think I should. I also got some probiotic for her but haven’t dared to use it yet just incase it upsets things somehow.

    ‘If it is the case, however, that she is getting back leg weakness 3 - 5 hours after her insulin shot then I wonder if that could be an indicator that her blood glucose is dropping low. Is she only affected by back leg weakness at certain times?’

    Yes she seems much worse when she has eaten but perhaps not that long after her food & insulin in the morning. She then struggles to climb the stairs. I’ve not caught a low reading though. I feel that it is when her sugar level rises as it improves later in the day. She goes very ‘drugged’ looking & dopey after her food/insulin. I’m guessing that her food is quickly absorbed as it is easily digestable but Royal Canin don’t know what the GI is for it. It is suspected that she has inflammatory bowel disease as intolerant of most foods (like its owner!).

    I took note this evening that the back leg weakness was worse again after food & insulin. Tonight I ‘invited’ her upstairs 2 hours after insulin & food. She seemed weaker. Oddly not that long after she seemed to improve again.

    Today I checked her blood sugar at 16:10 (8 hours after insulin) - it was 22.1 She had not long vomited (a first since ill).

    Again at 21:00 hours (2 hours post insulin & food) 19.9

    ‘If it turns out though that Caninsulin isn't working for your cat, then, under the 'cascade system', the vet can prescribe a different insulin. The insulin will be one that is made for humans but they also work really well for cats.’

    Phew!! How long should I give the Caninsulin before asking for another insulin do you think? My poor pussy is starving hungry any time from at least 3pm until feeding time at 7pm ish and sometimes even ‘peckish’ before. I do give her a small spoonful hoping that it will get her through to insulin time when she can feed freely. I usually end up giving her 3 mini-feeds but she is stil ravenous! I avoid the kitchen as it gets her hopes up! We have moved to 11 hours apart as 12 was just too long for her.

    Some blood glucose readings (Insulin given with food at 8am & 7pm:

    15/3
    03:45 - 26.9 - in night, 7 & half hours after insulin
    07:45 - 25.6 (hungry++) 3 units & food given
    12:50 - 18.6 - 5 hours post insulin
    19:45 - 31.8 - 12 hours post shot - 3 units + food given
    23:35 - 20.8 - 3 hours 45 mins post insulin

    16/3
    07:50 - 29.2 - 12 hours since insulin (so went up in night) reluctant to eat at first. Insulin given.
    13:00 - 17.4 - 5 hours since insulin
    18:50 - 19.2 - 11 hours since insulin (time of insulin changed to one hour earlier as hungry+++
    23:55 - 17.8 almost 5 hours since insulin

    17/3
    0800 - 31.0 (hungry) - messed up dose of insulin (intended to have 3.5 units, so added extra unit.
    13:25 - 12.7 - 5 & half hours since insulin (wanting snack).
    18:50 - 29.3 (hungry++) Given insulin & food now.
    23:45 - 15.9

    18/3
    07:50 - 30.9 - 3.75 units insulin
    13:05 - 31.8 (5 hours since insulin)
    18:47 - 31.1 given 3 units (11 hours since insulin)
    19/3
    00.30am - 26.7

    Not sure if folllowing days wold be helpful or too much!

    Tends to be in the low 20’s lately, rarely below although got a 19.9 at 21:00 pm tonight (she had bought her food back once today).

    Thank you so much for your precious time & help.

    Best wishes to you & your puss.

    Julianax
     
  8. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Re: Newly diagnosed - wrong insulin???

    Ah, low potassium can also be a cause of back leg weakness. When cats are peeing a lot potassium is easily lost from the system. It could be worth asking your vet about a potassium supplement. In the UK many folks (with potassium-deficient cats) use drops to put in the cat's food.
    Sometimes the back leg weakness in diabetic kitties is caused by neuropathy and potassium deficiency.
    The B vitamin that helps with neuropathy is methyl B12/methylcobalamin.
    But the symptoms should also resolve once your cat's blood glucose numbers get into a better range.

    It can take a little while to feel confident about giving insulin shots. Don't worry, it's early days. (I was needle-phobic and had to practice on oranges at first!)
    There are a number of techniques. Some folks pull up a 'tent' of loose skin on the scruff of the neck and then inject though an imaginary door in that tent, parallel to the spine. I give Bert his shot while he's eating on floor and I'm standing next to him, so I pull up some loose skin between my thumb and fingers, and then give the shot almost directly down into the skin I'm holding. (You can 'feel' that the needle has pierced through the skin and gone into a sort of empty space underneath.)

    When some of the insulin ends up on the fur instead of inside the cat we call that a 'fur shot' here. And although it can be very tempting to give more insulin when that happens we always advise against it. The reason is that there is no way of knowing how much insulin actually went into the cat. Therefore, we run the risk of overdosing the insulin if we add more (and too much insulin can cause hypoglycemia.)
    However, in Alice's case, because of the high blood glucose levels at the moment, it doesn't look like it has caused harm yet.

    I do fully understand the frustration of seeing your cat in high blood glucose numbers coupled with the realisation of having done a 'fur shot'. It's an uncomfortable feeling. But at least, with Caninsulin, you could consider the option - if you want to - of giving the next shot early... Caninsulin is an 'in and out' insulin (it doesn't build up in the body like some insulins) and it has a fairly short duration. It can be 'done and dusted' in about 8 hours in some cats. (And some folks using Caninsulin do give shots every 8 hours. I did this for a long time (5am, 1pm and 9pm in my case). But not many people have a schedule that can accomodate 'TID' dosing.)

    We do see some new cats here who are are too high an insulin dose. Sometimes the initial starting dose was just too high. Sometimes the dose was increased too quickly and the appropriate dose was missed.
    Typically, we might see high 'flat' numbers, and possibly high numbers that are continuing to get higher. If the care-giver is only testing before giving the insulin shot - and sees only high numbers - they could be forgiven for thinking that the numbers are always high. But in fact what may be happening is that the insulin is causing the blood glucose to drop too low (or too fast, or both) at some point in a cycle, and then the body is responding to this perceived threat by putting more glucose out into the system (sometimes also with counter-regulatory hormones that will keep the blood glucose high for a time.) We call this 'rebound' or 'bouncing'.

    In the test results you've detailed in your post I can't see any evidence there of low blood glucose results. There was quite a steep blood glucose drop on 17/3, but this doesn't seem to caused a bounce because she still dropped from the following insulin shot. (The following day though her numbers were high and flat (unmoving).

    Many folks here enter their cats' blood glucose results onto Google spreadsheets so that everyone here has access to the data if necessary. If you're willing to set one up there are some smart techy people here who could help you with that (I am not one of them! :lol: )
    Seeing the data on a spreadsheet makes it much easier to spot patterns/trends.

    If the Caninsulin doesn't appear to work for Alice then - unless your vet is pro-active and volunteers to prescribe a different insulin - you'll need to collect enough data to show that it's not working sufficiently well. Some people here have used the data to demonstrate that the Caninsulin only reduces their cat's blood glucose for a very short period during each cycle. Some people have used the data to show that Caninsulin causes very steep blood glucose drops in their cat.

    However, Caninsulin does seem to work just fine for some cats. And quite a few cats on this forum have gone into remission while on it. ('Remission' means that the diabetes can be diet-controlled).

    Eliz
     
  9. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Re: feeding

    Until regulated, diabetic cats may need as much as 50% more food because they can't use what they are eating. If she seems to be starving, consider increasing the amount being fed.

    Some cats do much better with grazing, rather than set meals. I put the food out twice a day and all my cats eat some at first, then come back and nibble some more later if desired. Its mostly gone by the next feeding.

    For the scarfer, spreading out the food into mini-meals in the first half of the shot cycle can work, too, feeding after you test, then maybe some at +3 and +5. A timed pet feeder can be quite helpful for this. Another option is to freeze some of the food and put out bothe fresh and the frozen. The frozen will get eaten as it thaws.
     
  10. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Hi again Eliz

    I just realised I didn’t answer your post re diet. Thanks for the info re happykittycompany. No I hadn’t heard of it so am interested.

    Alice feeds normally on & off all day but since the diabetes/insulin I am controlling this a little more but it is very difficult. Most days now follow a similar pattern. Ie:

    Start food first as desperate for food (chicken & rice Royal Canin + a little cooked lamb) 7:50 am wait until she leaves it for a mo and then at 7.05am - shoot 3 units Caninsulin. She then goes back but not as ravenous, sometimes its about half an hour after the insulin that she is able to eat well as I guess her sugar is still high. She usually drinks water in the middle of the feed (she NEVER drank pre-diabetes). She may then lie down & come & go for a little more until about 10am.

    I get a bit worried if she eats after that as a vet said to try and get her to take most food within 1 or 2 hours after the insulin.

    Nevetheless she is always hungry again later in the afternoon. There is no way she can wait until 7pm at night (insulin 11 hours apart - used to be 8 pm but was even worse). At those times when shes not due, eg yesterday it was 12md, 15:00, 15:30, (I usually give about 10-20g only. I’m hoping this is ok. Today, because she had less than usual at 8am I knew she would be starving later at a bad time so I offered more at 12:15 even though 4 hours after insulin and she ate 55g eagerly with ‘pinch’ of lamb. She then settled until 14:50 & I gave her only 10g of her food & had included her new Hill’s Diabetic food (mixing 5g of each together). She was still very hungry and so I repeated this as 17:30pm and unfortunatley had to wait hungry then until 18:50 - insulin given at 19:00.

    She seems to be ok with the lamb if I don’t give too much but even though her food is chicken based she is not good if I give her fresh chicken unless it is just a a tiny taste.

    I don’t really know what she is sensitive to, probably proteins - fish, ham, but even other chickn based foods. Truth is, every single other cat food I have tried. She did however keep the 2 X 5 g of diabetic food down today!

    I haven’t tried raw food - is that ok to try? Is there any she should avoid?

    Thanks for advise re blood testing. I do use her brush as she loves that! she actually is exeedingly good & never complains, its just us that have to jab several times & then if she is hungry she is upset and keen to get to her food.

    I did take your advise re B12 & rang the vet & asked what B12 was in the multivitamins they gave her. Its seems that it wouldn’t be a therapeutic dose. She did her homework & rang me back. She said that B12 does not necessarily help the bag leg neuropathy but can help the diabetes! I also asked about Potassium supplements. They wont give anything without a blood test so I am to book her in to have both B12 & potassium tested next week. I dread taking her! Incidentally, this morning when she tried to walk downstairs she couldn't walk properly, she 'jumped' her back two legs down together & was wobbly. Later in the day it had improved.

    Reading on your site, I wonder if she has pancreas problems too because I know that her liver enzymes were raised. If she does, would that affect treatment at all?

    Thanks for brilliant advice! :smile:

    Julianax
     
  11. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Re: feeding

    Thanks BJM
    She certainly fits the description. She eats far more than she ever did!
    I do give her more, I don’t restrict her at the insulin times but after a couple of hours I do only give a little (see reply to Eliz). I wonder though how wise it is as if she has run out of insulin will it just raise her glucose level & be unavailable to her?

    I had wondered about a timed feeder for when the time comes that noone will be in the house for a while. Do you think I should leave some food out for in the night (she never did have food in the night before). By morning she has had a 13 hour wait from her last insulin. I’m wondering whether leaving say 10g wet food out may help - she is always starving now in the morning or will this just stop her stabilising?

    Good tip re frozen food, thanks!

    Best wishes to you Julianax
     
  12. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Frequent smaller meals help keep the pancreas from being overwhelmed. I'd put out some at night. I feed all 15 cats twice a day, with enough to graze until close to the next feeding.
     
  13. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Wow, 15 pussies! Love to see them! I am still unsure about the Caninsulin. Alice weighs just over 3kgs, so very small, she has lost all her weight, shes very very thin. It is only 2 weeks since diagnosis & so she’s not established I suppose on the Caninsulin. I have no confidence in it though knowing that it wears off quickly and that the advice is to give as much of her food at the time of the insulin. She does take most of it at the ‘right’ time but she is so hungry for several hours before her evening dose. I have started to give abour 10gs of wet food at a time, under an hour apart as it nears to her next dose but it still sends her to the water bowl so I am guessing that even that small amount is raising her blood glucose. She eats about 100G or more in the first 2 hours post-insulin morning and evening. I haven't managed to check her blood sugar today - I tried 3 times without success & that was with the help of my hubby holding her! I am sure it is high as she is still drinking alot.

    Do you think I am fretting too soon about the insulin. It just doesn’t seem right that the insulin runs out and she is starving hungry. The vet wants me to wait a month to see if it works but my gut feeling is that it is not right her asking for food all afternoon and me refusing to give more than a few teaspoons until ‘The time’.

    She appears a little better, no ketones in her urine but no energy, not playing and now not keen to climb the stairs as it is difficult for her - she was whizzing up them 3 weeks ago! She doesn’t seem quite as depressed and she has started to wash herself again which is lovely to see. She looks very sad most of the time though often sitting between her water bowl & her bed as though she just doesn't know what to do!

    If you think its worth pushing for the longer acting insulin would you advise the Lantus or th PZI to start with?

    Thanks for your help
    Juliana
     
  14. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You can feed up until 2 hours before the next shot when using Lantus, Levemir, ProZinc, or PZI.

    With Caninsulin/Vetsulin, if your data show duration to 12 hours, you can do the same. If your data show the duration is less, you need to pull up the food 2 hours before it stops working.

    Some folks use Caninsulin/Vetsulin on a TID or every 8 hour basis if the cat gets less duration than 12 hours.
     
  15. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Thanks BMJ. That's helpful. I don't actually know when it stops working but I'm guessing about 6 hours :? So she will either have to 'starve' for 5 hours or continue with snacks that seem to make her immediately thirsty. Hopefully she will settle or adjust to being hungry. Its very stressful to deal with but I am sleep deprived so not coping too well anyway. :sad: If only I could master the blood glucose tests. I have taken all advise but still pricked total of 7 times yesterday with not one sample!

    Best wishes & thanks, Julianax
     
  16. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Oh, (((Juliana))),

    Sounds like you're having a really tough time. :sad:

    May I ask you about the blood testing?
    Are you not getting blood at all? (Do Alice's ears feel cool or warm when you're testing?)
    Or is it just too little blood for a test? (in which case two ear-pricks really close together can sometimes give enough for a test.)
    Or is it disappearing into the fur? (in which case a teensy weensy smear of vaseline on the edge of the ear can really help.)
    Or is there something else going on? (Have you tried varying the test site to see if somewhere else bleeds better..?)

    When I'm having a problem getting blood it's usually because I'm not putting enough pressure on the underside of the ear. The lancet needs something to resist otherwise it just sort of pushes the ear away. This does sometimes happen to me especially if I am feeling tired. (Tiredness makes it so much harder for us to concentrate). So, I just try again and make sure I press on the underside of the ear with my finger (some folks use a small piece of tissue or cotton wool).

    I'm sure you will get the hang of this. Please do be kind to yourself.

    Big reassuring hug to you,

    Eliz
     
  17. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hello Juliana, I'm in the UK too and am just saying hi to send you my best wishes and moral support. You have already had some great advice here and I have nothing to add (am not an expert) - but do please take on board what has been said, and keep posting as often as you need to with further questions. If the query is very specific it's a good idea to start a new thread with a new subject header, so you get as many replies as possible.

    I do feel for you while you are trying to understand all this and do your very best for Alice, but stick with it and read as much as you can from this site - you won't find better advice or experience anywhere!

    All the very best

    Diana
     
  18. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Hi Eliz (& Diana),
    Thank you very much for advice again. Sorry I couldn’t reply yesterday (working etc).

    Well, you were right!! I wasn’t putting enough pressure under her ear, I was trying to stretch her ear so that it was tight where I jabbed. I now have cut a finger off a wooly glove & pushed it against her ear - bingo! I have done it twice now, unfortunately it has gone right through her ear but I did get blood - lots!! I always had it on the highest size for pricking (number 4 on Alphatrak 2). I will try it tonight on a 3 & not push so hard! I really didn’t want to fail again poor pussy!

    In the mornings her ears are cold. She is also desperate to get to her food & hates to be restrained.

    I do use a little vaseline. It used to disappear into her black fur. Is it better to prick on the inside or outside of the ear?

    Last night her blood glucose was only 12.7 (5 hours after Caninsulin). It was a shock as it is usually in the mid to top twenties. I panicked a bit & gave her a little food so that she wouldn’t go hypo in the night. I would normally have set an alarm & checked on her but as I was at work & so I fed her instead. I am barely functioning now with the tiredness - actually tried to dry myself in the shower this moring before I turned the water off!!

    This morning was the first morning she wasn’t begging for food when I got up. She seemed quite unwell & not keen to eat all day although she had a little. Her BG was 28.4 before insulin. She started asking for food around 3pm as usual (not due until 7pm) so that was difficult. She has needed a bit of encouragement though when she was finally allowed to feed.


    I had to go to the vets without her tonight because she took a look at the cat carrier & did a ‘U’ turn & went under the settee - couldn’t coax her out! I discussed the insulin with her vet & he has asked me to do an hourly BG curve for 6 hours. I have to try & take her tomorrow as need a blood test for potassium & B12.
    Sorry, I am digressing

    Thanks Eliz & Diana for the suggestion & support too.

    Best wishes JulianaX
     
  19. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    give her a little food maybe 2hours before if you can to calm her down.

    Whatever works for you! Black ears are tough to see whats going on. I think inside is better if they have furry ears.

    Can you ask the vet about Lantus?
     
  20. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You may find that shooting every 8 hours works better, at least until you can get a different insulin such as Hypurion PZI or Lantus or Levemir, all of which do last about 12 hours in the cat.

    If you absolutely, positively, must.get.blood, aim for the vein. When you hit that, it bleeds profusely, so be prepared to get your sample and blot for a good minute or two to help it clot ... and not have blood droplets shaken all over the room.
     
  21. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    HI folks,

    Thank you so much for the encouragement & help! I am feeling better about it today. Your reassurance re her high numbers & ‘curve’ helped, I felt the anxiety lift a little! She is the best she has been & not drinking quite as much and has managed to eat very well today. Her fur is looking better & she is cleaning herself. She looked a bit like a hedghog before - her fur looked spiky & also greasy (maybe from all the stroking?!) I can tell she feels somewhat better anyway. :smile:

    I had to inject her earlier than this evening as she was so hungry. I hope she can last out for longer during the night though. It is so difficult to ignore her. I gave her a little food before but she wasn’t satisfied. I still feel unhappy about this short acting insulin and plan to ring another vet to see if they may be willing to change her insulin if I register with them. I know its a long-shot as I read here of the difficulty of getting vets in the UK to use anything but Caninsulin.

    The glucose curve I did was an hour earlier than usual for her Canisulin & I’m now wondering if the starting point at 20.6 was lower than usual because her sugar shoots up as she gets stressed and hungry having to wait for food. I know I will have to to a BG then but I hate doing it when she is fighting to get her food as its a more stressful procedure then & a 2 man job!


    “What do you mean when you say that Alice "seems to be feeling unwell."? Any specific symptoms? Is she eating? Does her breath smell normal? Are you testing her pee for ketones?”

    By unwell I suppose I mean ‘doped’ looking, lethargic & depressed looking. Although better today than she has been, she’s not interested in playing even when something is dangled under her nose. She used to love retrieving something from under a mat but now just looks at me, completely disinterested. She lies around alot (normal for a cat I know!). She’s still wobbly walking, seems weak & off balance with her back legs & ‘ploddy’ with her front legs. She is catching her claws in things all the time. I hate to see her struggle with the stairs. Not many weeks ago, probably about 6 weeks, she was able to chase something & do a ‘back flip’ in the air! I had noticed though that she didn’t want to play for many minutes & eventually stopped all together before the ketoacidosis episode. Now I know why!

    I am testing her urine about once every two days (when I can catch it!), no ketones thankfully.

    “Many cats have lower blood glucose levels at night.
    Are Alice's morning pre-shot numbers higher than her evening ones?”

    I have to admit I tend to avoid the pre-shot BG as it is so stressful to get the blood at that time as she is so hungry and just trying to get me into the kitchen. I’m not sure there’s much difference but if its helpful then I’ll give it a go. It just means 2 delays before food for her. I was giving the food & then 10 mins later giving the insulin but having seen how her sugar goes up the hour after her insulin and food we at least give the shot first. I will do another curve though soon.


    “Giving Caninsulin 3 times a day ('TID') might be an interesting and useful experiment for you; but not everyone's schedule can accomodate that. (I did it myself for quite a long time (5am, 1pm and 9pm)).
    I recall seeing a post here (years ago) from someone asking if doing 'TID at weekends' would be of any value, and the consensus was that, yes, this could be helpful, since that would still be 2 days a week when the cat would have insulin in it's system around the clock.”

    I wouldn’t mind doing that but I was told by the Vetinary Hospital on discharge to keep her times absoloutely regular so that her body adapted and she would be easier to stabilise & not to vary her insulin by more than 10 minutes. Is that the case, is there any risk I could upset things by feeding at different times of the day for those days?

    Also, I worry that as she is so thin & so little area to inject would all those injections damage the area as I’m not confident injecting anywhere else into her fur (she has a small area shaved over her shoulder blades).


    “Have you tried giving Alice the shots while she's eating?”

    Yes, I tried that initially but she got upset and left her food & I had to feed her in the other room!

    “And what technique are you using? It may be that you just need to tweak it a bit, or try a different variation on the theme.”

    I have been pulling up the fold of skin & trying to inject almost parallel to her spine but struggle to find the depth without coming out the otherside. I now try not to insert too much of the needle. I tried your idea off injecting ‘down’ & I think that might help - thank you! My husband has still got to have a go!!

    Just seen the time! Better go as have to be up early (still sleep deprived!).

    Thanks again,

    Julianax
     
  22. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You might try giving her a couple of teaspoons to eat, then test before 15 minutes are up, then feed the remainder of the food.
     
  23. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Hi Juliana,

    The attitude of vets varies enormously here in the UK. Some are keen to agree a change of insulin and some are very reluctant.
    Juliet's ('Dr Schrodinger's) vet was, if I recall correctly, very supportive; and was also really impressed by what she achieved after the change of insulin (her cat, Milo, went into remission). Maybe it would be worth having a chat with Juliet; she may be able to make some suggestions as to how to present the data to the vet...?

    What part of the UK are you in, BTW?

    Eliz
     
  24. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Hi BJM & Eliz,

    Excellent idea re couple teaspoons & then test BG - will give it a go - thanks! This morning she wasn't quite so bad & accepted our 'attack' but unfortunately 3 stabs later and no success! We bundled it! :oops:

    Eliz, we are in Essex (Brentwood). Someone mentioned doing a 12 hour curve - I'm still working up to it but will pick a day! That might help vet perhaps.

    Julianax
     
  25. Dr Schrodinger

    Dr Schrodinger Member

    Joined:
    Dec 28, 2012
    Oh dear! Did you bundle the shot or the test, Juliana? No matter either way. It all takes practice for both cat & owner.

    BTW - I have found your Zobaline :D . Will get it in the post today - there should be over a month's worth if you give Alice a 5mg tablet each day.

    With regards to her being hungry - I freed-fed my Milo when I was trying to get him regulated (I still do). Both cats graze all day. If she is underweight & ravenous, I would just leave out some wet food for her. Caninsulin is fast acting, and if her blood glucose drops suddenly, she will automatically want to eat.

    RE: raw food - Nature's Menu make decent frozen raw food - but it is pricey. Both my cats love it. They also make pasteurised 'raw' in pouches - which is also great & low in carbs. Have a try & see if she'll take it? You can buy it at most pet shops on the high street or order it online.


    Juliet
     
  26. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Thanks Juliet!

    I will be watching for the postman now :smile: A big 'Thankyou'!

    It was the blood glucose test we failed on. After failed attempts & then my hubby drew blood & I thought as I was holding her he would then hold the 'stick' to it - I'd put it near to him but instead he told me. I was then only able to hold her with one hand & doing contortions to get the blood it barely touched then beeped - I panicked & touched it again because it had hardly touched it. I'm sure it was a false reading! We did not part friends (hubby, not Alice!) when I left for work, still very sleep deprived which is not helping!

    Did you free-feed with Caninsulin? I was advised to get her to eat within 1 one to two hours of injection. I now allow her to eat freely for two to 3 hours & if she hasn't come back for more I take it to her up to 4 or a tiny bit of food later. If her BG is extremely high I do let her eat longer ass he is unable to eat until it comes down, she wants to but just a mouthful & then drinks water++ Today her mornings BG was the highest ever at 32.5 at 07.55am & yet last night 5 & half hours after her 3 units she was only 8.3 - lowest EVER (that I've caught). That was only 7 & 3/4 hours after that low! It seems to be an inverse law. Then of course she doesn't feel like eating even when she gets it, though at first desperate for the food. She will a couple of hours or so later as the insulin works.

    I plan to ring another local vet & ask whether they would consider using another insulin if I registered with them. Do you have any tips please? I hear that Milo went into remission so I'd really appreciate any advice you have if you have the time.

    Going to rush off & ring this other vet now!

    Bye for now
    Julianax
     
  27. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Lots happened! All took off so quickly! Actually have a good vet now! She wants to get to the bottom of why diabetes! She dislikes Caninsulin!! She has an American accent which may be why she likes 'Glargine"? Anyway had LOTS of horrible tests. Its been an upsetting day all around for Alice and myself. In vets hospital all day. Blood tests, needle into bladder and liver as enzyme ALT raised. Could be 'lymphoma'. Also thickened duodenum (muscularis?) in keeping with inflammatory bowel. For some reason she couldn't do the needle biopsy. I wont know why until she talks to me tomorrow & all results will come in over the week I think. She is a sorry site. All abdomen shaved (ultrasound), already both legs shaved & her back for injections. She is very wobbly as was sedated twice & also very hungry. We've been told to leave an extra hour so that she eats more & then will know how much insulin to give (still Caninsulin today). She smells like disinfectant! I'll let you know the outcome. I wonder if anyone has a cat with lymphoma & diabetes?
    Juliex
     
  28. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Crikey, Juliana, that IS a lot going on...

    And poor Alice is currently a member of the 'suede tummy' club too. (The fur will grow back. Don't worry.)

    I've had a cat with lymphoma (intestinal), but he wasn't diabetic.
    Keeping fingers crossed here that Alice doesn't have cancer but, if it is cancer, then lymphoma tends to be one of the slower growing ones. What's more there may well be treatment options available to you (if that's the route that you wants to go (depending on Alice''s disposition)).

    It's good news that you've found a vet willing to prescribe a different insulin!
    A question that goes through my mind though is whether - IF Alice has cancer - Lantus/Glargine will be the best option. The reason I say this is because most folks here find that Lantus/Glargine needs to be dosed on consistent doses every 12 hours. If Alice has an illness that may cause her blood glucose levels to fluctuate then I wonder if a more flexible insulin (such as Hypurin bovine PZI) would be more useful. (With PZI you have more flexibility with dosing and with timing of doses).
    Maybe something to ask your (new!) vet about....?

    Sending you a huge, warm, reassuring (((hug))),

    Eliz
     
  29. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Please can someone advise me as to what is wrong with Alice at the moment. She has the strangest behaviour developing now. She came home from Hospital 3+ hours ago and was wobbly from sedation & pain relief. She checked everything out but a bit anxious of me to start with but came around. She had food at 18.40pm followed immediately by her Caninsulin (2.5 units). I thought she would be happier but she has not stopped going back & forth to her water bowls & standing in it, clawing in it in the same way as she does her litter tray & then flicking the water off her paws or licking her paws. Her eyes are dilated. She had a needle into her bladder & her liver & blood tests & ultrasound scan of organs. Her liver is enlarged & her ALT enzymes are raised (??). I have rung the night vet as it is very odd behaviour for he & it is as though she cant rest, she has to keep putting her feet inthe water. she has dragged her bowlof water across the kitchen floor doing this. Its not a one off, its as though she HAS TO. As though her paws may be bothering her or something. They did clip her claws while she was in today (the first time ever). I rang the night vet but she didn't know why and said it wouldn't be from the drugs. I asked if it could be from the biopsy, ie internal bleeding or something but she said she would be collapsed & pale. I have stroked her & dried her paws & they didn't seem to hurt as she purred and let me! She immediately went back to her water and did it again. Her blood glucose is 30.7 but has been over 31 and she had no odd behaviour then. I know its a difficult one but would appreciate any ideas as its distressing and worrying to see. Thank you.
    Juliex
     
  30. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    (((Juliana))),

    I have NO idea what would cause this. And it must be so distressing for you.

    Have posted a link to your post in the main health forum to try to catch more attention.
    viewtopic.php?f=28&t=116970#p1228326

    Eliz
     
  31. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Actually, some cats can have adverse reactions to anesthesia as well as any other med, just like humans do. If her pupils are still dilated, she is still clearing whatever they gave her.

    I would keep her in a limited area so I could check on her easily and wait it out unless you see something indicating pain.
     
  32. chuchunga

    chuchunga Member

    Joined:
    Mar 15, 2014
    I have seen very strange behavior in cats who have been under for a procedure. The affects can last sometimes up to 12 hours. I had a cat once that kept attacking a box for an entire night after coming back from the vet and having been put to sleep for a procedure. Def keep and eye on her but it could just be a reaction. Good luck. We are praying for you.
     
  33. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Thanks all. Really appreciate your support & wisdom. It makes sense & is reassuring. She has taken a break at the moment & sitting gazing. I think her insulin is bringing her BG down & with it hopefully she wont need as much water & hence the paddling in it. I feel happier - I'm not sure also whether she is missing her claws as they were clipped opportunistically whilst sedated & perhaps it feels a bit strange? Her eyes are still dilated so I guess you are right, its reassuring to hear about the behaviour of other cats after a procedure. She's not as agitated. Sorry if I made a fuss. Worrying now waiting for results - hope its not lymphoma.
    Thanks for prayers, I'm sure that's how I got this particular vet. I'd rung a couple of vet Practices re changing Caninsulin to longer acting but the current one presented herself to me in response to dropping a urine sample off there as my vet had gone to South Africa for 3 weeks & so I went back to the Hospital that treated her ketoacidosis, I'd signed to say I wouldn't go back for a year but I felt that as my vet had disappeared (despite asking me to do a glucose curve!) and only a locum there that might be acceptable.
    THANKYOU FOR YOUR HELPX
    Julianax
     
  34. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    How is she doing now? I am hoping better as the anaestheia wears off..
     
  35. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Yes, thanks, she is doing better today. Eyes are back to normal & more relaxed. Last night she was wide awake all night & wouldn't settle at all. Her blood glucose was worrying & so I was up checking it in night! She stopped treading water at the time she stopped drinking. I'm sure she was dehydrated as she has only passed urine once since being home 24 hours ago. I think it was a combination of dehydration, drugs & missing claws! She went MAD at her scratch post!!

    I thought I had the Caninsulin worked out in that the nadir was around 5 hours. Last night her BG continued to drop for at least 9 hours:
    21.05 BG 30.7
    00.35 BG 8.5 (huge rapid drop)
    03.40 BG 6.8 (lowest had been before and so gave about 10gms of Hill's Diabetic D/M)
    06.15 BG 5.7 (eek! Why is it still falling???) Never seen this before. She actually woke me with a distressed urgent meow & so I fed her another 10gms Hill's.
    07.50 BG 8.2 I then reduced her insulin & gave 1.5 units an hour after she had eaten but still not eating too well.
    13.55 17.4
    18.37 20.2 (before insulin & lower than usual pre-shot). I reduced insulin to 2.0 units Caninsulin. Had originally had 3 units but then I reduced to 2.5 see if it helped the sugar swings.
    19.48 (nowish!) BG25.8 an hour after giving her food (she ate little). Hoping she eats when the insulin kicks in but I guess I'll be up anyway after last night just incase the BG drops again.

    I'm waiting for the vet to ring me anytime now with some results from yesterday. The way she spoke I suspect she feels it will be lymphoma, I am really hoping not nailbite_smile
    Thanks for your help and interest in me & my cute furry friend (with the suede tummy!) She's actually just dropped off to sleep - tempted to wake her after last night!

    Best wishes to all
    Julianax
     
  36. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi Juliana
    I'm really sorry, I have no advice to offer, but I have been following your thread and just wanted to send you a big 'virtual' hug and say well done for hanging in there and looking after Alice so well. I know how very worrying and stressful all this is. Our kitties really are our babies and we would do anything for them, wouldn't we. You really are doing brilliantly.
    I'm really hoping that things get sorted for Alice (and you) very soon.

    Diana x
     
  37. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Julie,

    You must be SO relieved that Alice is feeling better.

    The low blood glucose may also be a response to the anaesthesia. Somebody posted (just yesterday, I think) that this can happen as an after effect. (I knew it could happen during anaesthesia but didn't know it could happen afterwards...)

    Big hug to you,

    Eliz
     
  38. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Diana,
    That is really nice, thank you! Yes, she feels like my baby, I love all pussies, but especially my own! I'm embarrassed to admit how fond I am of her to just anyone as several people have implied that I ought to have her put down & I don't think understand that it's possible to have a relationship with a cat. She's a little friend to me & so trusting & affectionate. I couldn't bare anything to happen to her. Thanks for your encouragement. I hope all is well with your kittie too. I do have a little good news so will post now!
    Julianax
     
  39. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Hi Eliz,
    Some good news! The vet rang to say that the liver biopsies (4) were all ok. She was really surprised as she said it looked enlarged and 'bright' on the ultra sound scan. She still has an unexplained thickening about a 1 cm long on her small bowel (duodenum). It could be lymphoma or it could be inflammatory bowel. Still a few more test results to come back but she thinks its safe to leave for now & plans to concentrate now on getting her diabetes under control. She has already ordered 'Glargine' insulin for her which may be here tomorrow! I did ask if the PZI insulin might be better for her but she said there was a better chance of remission with the Glargine :?: I am pleased she is changing her from the Caninsulin but at the same time getting anxious about how she will be in the swap over. She said she has to be on a low carb diet & so I have tried so hard today to get her to eat the Hill's diabetic D/M wet food. She liked it when I partially introduced it a couple of weeks ago but now she hates it! She hasn't wanted to eat it unless she is extremely hungry. I have weakened and given some of her Royal Canin sensitive food towards the end to help her eat a little more but I do think it causes the BG to shoot up. She even manages to pick out her old food & leave the Hill's! Any tips?!
    Anyway, its 1am now so I'd better go, her BG is safe now as late snack (17.3 nadir!).
    Thanks again for help Eliz
    Julianax
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Sorry to hear that Alice isn't liking her low carb Hill's M/d food anymore. I can't tell you how many times we hear from members here that their cat liked the Hill's M/d wet food at first and then refused to eat it. It's very common. Seems like once the novelty of that liver flavor wears off, the cat becomes finicky and won't touch the Hill's anymore.

    Idea #1. Perhaps a sloooooooowwww transition from the old food to the new food might help?

    Try mixing tiny amounts of new food with the old food.

    For example, on day one, use something like 7 parts old food to 1 part new food, stir together to mix up the flavors.
    Each day, decrease the amount of old food and increase the amount of new food.
    In a week, you'll have her switched over. Well, only if she cooperates. You may need to stretch out the food change a bit more and mix in even tinier amounts to start and it may take longer.

    Idea #2. Greater selection.

    Pick some of these low carb foods from the Canned cat food for EUROPEANS and INTERNATIONAL buyers post here in the Feline Health forum. Lot's more flavors to choose from and hopefully you'll find something your cat will like. If you find the post by Dr. Schroedinger, she has a link in her signature to a great spreadsheet with food options for Brits. Pretty up to date too!

    Idea #3. Add tempting taste toppers to the food and miscellaneous ideas.
    Food suggestions for poor appetite
    sprinkle food with :
    - forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
    - parmesan cheese
    - smashed crumbles of dry food
    - bonito tuna flakes
    - halo chicken treats -- crumble into dust over food
    - poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
    -powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

    other ideas of foods to offer your kitty to stimulate their appetite:
    - trader joe tuna for cats
    -baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
    - kentucky fried chicken
    - deli turkey /chicken
    - plain cooked ( boiled or baked ) chicken breast
    -canned chicken for people (watch the label that their are no onions)
    - chicken broth -- low sodium

    I sure hope some of these ideas work for Alice. ;-) I'm fresh out of ideas if none of these ideas work.

    ETA: That's not just good news on the biopsies, that's Great News!!!
     
  41. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Yay!!! :RAHCAT
    Alice's food sensitivity could support the 'inflammatory bowel' theory, maybe? Keeping fingers and paws crossed that it is just that.
    Did I give you a link to the Happy Kitty company (will check back through posts). I think they do a few good quality 'sensitive' (or single protein) foods that might suit Alice's sensitive tum..?

    I am thrilled that you've found a sympathetic and knowledgable vet. (Ha-ha! I told you vets in the UK varied in their attitudes, didn't I?!)
    From what she's said about Lantus and remission it sounds like she's familiar with the 'Roomp/Rand' feline diabetes research. (They're Aussie vets who developed a dosing/treatment protocol for Lantus.) 'Remission' means that the diabetes can be controlled by diet alone. Quite a few cats on this forum go into remission after a while on insulin and a switch to a lower carb wet diet. In the right circumstances the cat's pancreas can recover sufficiently to no longer need insulin shots.

    There's loads of info on Lantus in the 'stickies' at the top of the Lantus forums here. And there are some very experienced people in those forums to help and support you.

    I really feel that you and Alice have 'turned a corner' here, Julie! :D
    This could be the beginning of things getting better for Alice. (And you getting better sleep!)

    Big hug to you,

    Eliz

    PS. It could be worth starting a new thread about transitioning from Caninsulin to Lantus; and the Lantus bods will answer any questions that you have about that.
     
  42. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Hi Deb & Wink & Eliz,

    Thanks for your post re food! I feel bad Deb that you went to all that trouble when I didn't add that Alice, from day one of getting her from the rescue, vomited every type of cat food. Eventually she settled fairly well on Royal Canin Chicken & rice sensitive. Even then if I gave her more than a little extra cooked chicken it upset her. All fish upsets her too. She may have inflammatory bowel. We have to keep every blade of grass short as just a bit of grass makes her sick - I'm told its supposed to but it seems much more extreme, my last pussy never did. Amazingly the Hill's D/M is tolerated & like mentioned - she doesn't like it although she ate it today as she was ravenous! I have contacted the 'Happy Kitty Company" and ordered the Rupoat cat lamb sensitive. She loves cooked lamb and is tolerating it well, not enough to eat the Hill's though when its mixed in! Having said that, she has just tucked into the Hill's as I write! confused_cat

    My hubby says he thinks that she is 'going around the corner' Eliz, she is recovering though I would say from the keto-acidosis in that she seems to have more moments of normality now like rolling in the sunshine & washing - hope her suede patch doesn't burn! The Caninsulin saved her life but I cant understand why the vets are forced to use it on cats before anything else. If its duration is so short how could it possible give a level BG. It is a miserable business for her (& me) being hungry hours before she is allowed to eat (apart from a few grams of illegal 'treat' of Hill's & chopped lamb!

    The 'Glargine' as the vet calls it, didn't come but should be there tomorrow. We plan to start it tomorrow night nailbite_smile I will start the new thread "Help please re change Caninsulin to Lantus" as you suggested thanks. I've got to learn fast! Plan to try and upload a BG/insulin record sheet again. Like you Eliz, I am not too good at these IT things. :smile: I've got a little furry friend sitting helping me here, purring away- lovely! Actually just realised she is waiting for her lamb treat as the remainder Hill's sits there!
    Julianax
     
  43. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Juliana, no trouble at all writing up my reply on the food options. I'm just sorry that I did not realize that Alice might have IBD issues. My fault for not going back and rereading your entire thread, because you had mentioned the food sensitivities and I forgot about that.

    Would you be willing to put some information in your user control panel, profile tab, edit signature? It would help us to help you better and hopefully prevent us from making a mistake like that useless food advice in the future. ohmygod_smile Sorry about that.

    Some useful information to see would be your first name, cat's name, age and sex, diagnosis date, insulin used, meter used for testing, food fed, any complicating medical conditions like the IBD or the fact she has had DKA would be helpful to see at a quick glance.

    With some of the health issues that Alice has had, you might want to consider writing up more information in what we call a Profile. It's a google doc, sort of free form to give us more information about your cat. I think it would be really useful to have that available as well as the tidbits of information in your signature. How to set up a profile instructions are here in this post from over in our Tech Support forum.
     
  44. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Thanks Deb,
    I'll certainly do that tomorrow (almost beddy time & the fatigue is making it tricky at mo to concentrate) - got to test Alice BG now but will do asap (still get uptight about the BG tests!). You mustn't apologise for not remembering every detail, I only mentioned the gut problem in passing - I'm amazed at how dedicated you all are & how much you do remember. I appreciated your food tips & there are things I can still use from it.
    Julianax
     
  45. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I see that you did your signature update and it looks good! Very useful little tidbits of information to have there and we really appreciate it.

    One more tidbit of information that would be helpful to us in to add your general location in your user control panel, profile tab, edit profile. Just update the location field if you would. Country, state/province/county, closest city if you are willing to share that info . Right now we know you are in the UK because you say so in your subject header. But, there may come a post where you have left that info out and it's nice to see it over there under your avatar.

    Thank you for your kind words on my goof. I still feel a bit guilty for not remembering the IBD issue. Just the way I am.

    Sounds like you mean getting better, feeling better, improvement, passing a critical point after an illness from some of your additional description. I think we would say here in the US, "turning the corner". Just a difference in idiom it seems.

    We do so hope that Alice gets even better with the switch over to lantus. Sounds like your persistence and home testing results convinced your vet to make that change. Good job on being an advocate for your Alice! :RAHCAT
     
  46. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Thanks Deb! Will now try and do the 'rest'. My hubby cooked dinner to give me the time ;-)
    Julianax
     
  47. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Hi Julie,

    Re cat foods, I've thought of a few more that might suit Alice.
    Most are poultry/chicken based, and one is lamb.

    Catz Finefoods (available from Zooplus) do canned and pouch foods including, 'poultry', 'chicken and pheasant', and 'lamb and buffalo' (yes, 'buffalo'. Sometimes 'novel proteins' cause less problems for sensitive tums.)
    http://www.zooplus.co.uk/shop/cats/cann ... ans/364511
    And Nature's Menu (available online and from pet food stores) do pouches including 'chicken and turkey', and 'kitten food' (in which the only protein is chicken (although it does contain fish oil.)

    Rabbit is also often tolerated well by many cats. Have you tried Alice with rabbit? (Ha-ha - Sounds a bit 'Alice in Wonderland' doesn't it? (Oh, my fur and whiskers! ! :lol: ))

    Eliz
     
  48. Julie and Alice

    Julie and Alice Member

    Joined:
    Mar 19, 2014
    Thanks for more food tips Eliz,
    I have copied & pasted onto a 'Food Ideas' for Alice. I am a bit nervous about changing her diet at this moment until stable 'ish on her new insulin (now in tomorrow). I would like to give her a diet she enjoys so will try those later. I have ordered lamb fro the 'Happy Kitty' company. I received 48 cans of Hill's Diabetice D/M today - she had better aquire a taste! This evening I poked a few of her chicken & rice into the Hill's & then chopped some lamb & poured warm water onto it & poured it over the offending Hill's D/M with a little success!
    Julianax
     
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