Advise needed

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Alan

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My cat aged 10 has been diabetic for just over a year. We had him well regulated on his insulin Caninsulin.

When his sister died in the summer, his insulin levels when abit crazy but we have gradually improved his readings.

He varies from 7 to 15 on average. European readings when we check his levels with our glucometer usually just before feeding.

I give him between 1.5 and 2.5 units each time.

The problem is he gets very hungry. I feed him around 150g of wet in the morning with his insulin and the same in the evening.

He usually finishes this within a hour perhaps two.

But he meows more 2 hours or so before his feed and insulin shot. He has started ripping his fur.

Any suggestions would be helpful
 
Hi Alan,

We have very few people who use Canninsulin as it has quality control issues in the US/Canada and is seldom prescribed by vets here anymore. viewtopic.php?f=19&t=311 We have a few people in Europe who are using it; it does seem to be one of the only insulins prescribed there.

I would repost this over on Health. viewforum.php?f=28 You will get many more eyes there. And if you are dealing with allergies, you will get people who may have similar problems.

I am wondering if you are dealing with something other than the diabetes as he does seem fairly well regulated. Things to add to your post in Health - what kinds of food do you feed? (Wet lo carb? Flavors? Beef does seem to affect allergic cats....) I think 150 grams is about 5 ounces and that amount twice a day certainly seems adequate. We do say to feed more to new diabetics as their bodies don't process food well, but your kitty seems pretty well regulated.

Hope to see you over in Health.
 
Hello and welcome.

A couple of things to mention for you to have a look at.

Caninsulin works so quickly that often offering a snack about 90 minutes after the injection can take the edge off that hunger and also slow down the drop so it is easier on the system. Please have a loot at this info about using this insulin. With that hunger I wonder if he is dropping quite a bit in the mid cycle area ( 3-6 hours after shot ) perhaps indicating he is getting too much insulin.
viewtopic.php?f=19&t=302
What does are you currently giving?
How do you determine dose changes are needed?

Are you hometesting?
Would you mind sharing some recent levels and the time they correspond to the shot?
ie :

15mmol- +1 ( means 1 hour after shot )
11mmol +3
etc...

If you multiply these mmol numbers by 180, those of us who are used to seeing the levels that way can help you more readily.

The pulling hair....
-allergies
-hyper thyroid
-flea allergy dermatitis
these are just a coupe of things that come to mind and might be worth a blood panel check to see what more is going on. I have not seen hair pulling as a direct result of feline diabetes here on the board, only as a secondary issue.

I agree about crossposting to the health board.
I will keep my eyes open for your posts here as well.

Thanks Kimmee
 
Thanks for the reply.

I do home testing. Here are some of his readings: I only feed high protein wet food BOZITA. No beef or tuna.

I tend to test him in the evenings. I feed him at the same time as the insulin shot. The shots are 11 - 12 hours apart

14.5 mmol / 261mgdl insulin 2 units

10.7mmol / 192mgdl 1.5 units

15.2mmol/ 274mgdl 2 Units

11.2mmol/ 201mgdl 1.5 units

14.2mmol / 256mgdl 2 Units

I will do a curve this week and check to see how far it drops. I haven't done one in a while. The hair ripping he only does that when he is hungry and I guess I reinforce it as I respond to him with attention.
 
Alan,

Have you seen the spreadsheet we use? It is a great tool - color coded so it is easy for you (and us) to see trends and patterns. And it helps so much if you ever ask advice on dosage. The world edition lets you put European numbers in and we can switch to US numbers.

If you are computer savvy, it isn't hard. If not, just ask for help: Setting up a spreadsheet

I agree it would be a great help to get some mid cycle numbers. With Canninsulin, your nadir(lowest point) can be from 3-6 hours after the shot, so you need to get a few tests in to figure it out. They will give good information on what is really happening. It is possible he is dropping really low and bouncing back up. You don't know till you get some mid cycle numbers.
 
Hmmmmm I do wonder if hyper Thyroid may be a part of this equation?
Has he ever had his T4 levels tested? It happens in so many kitties that it would be good to rule it out as you try and sort this one. Having base level T4 anyway is a good idea now as he is getting older as well.

That kind of hunger and hair pulling has been seen with this.

His levels look quite even and I don't see that you are getting much bounce which would indicate too much, but a curve will help fill that in a bit as well.

Please keep us posted and we will help as we can :)
I am sorry about the loss of your other kitty, I know that can be hard on everyone.
 
Thanks. I have set up a new spreadsheet - and will do a curve today. I will do the sheet for a few days and then post for your comments.
 
Hi

I have set the spreadsheet up. Thank you for pointing it out to me its great.

I did a curve last night. The first in a long while and it seems he is unregulated again.

I appreciate its only a limited number of readings but do you think the Insulin shots are too high?

Secondly our vet always advised us to feed him in a 40min window after each shot.

We have allowed him to free -fee for +3 hours. But he tends to sometimes eat to fast.

This morning he was eating very quick and he vomited. I have decided to spilt the food into 2 portions

and so do not give him the lot in one go.I am away for a week so cannot do any reading until I return. It needs two of us to them!

Zimbas spreadsheet https://spreadsheets.google.com/ccc?key ... y=CNbgzdYO
 
Yowzers indeed.
Did you get a test when he threw up? Sometimes throwing up is a sign of dropping too low.

Those are some drops into low numbers that can be worrying as you know.
Really glad to see you have backed way off the dose.

For dosing in the future, it has been seen here that a steady dose works better with this insulin than dose hopping based on prehots.
The peak is hitting early, about +3 or +4 . It would be nice to try and get a bit more duration out of this. I would encourage sticking with a lower dose as you have today...do please also get ketone testing done during this time of honing in on a good steady dose.

I would also make sure there is a snack through about 90 minutes after food. I am betting that having food available for those first three hours has prevented him from crashing on you...yay for that.

YOu are not horribly unregulated on this insulin....you have a shallower curve than many working with it. I wonder if her has a bit of pancreatic activity.
I would let the lower dose work a bit, don't be surprised by some weird numbers if he shows you some rebound. After a few days, I might even try a pancreas test, if it were my kitty. ( I will add more on this, is a simple food test, but running off to work )
Try and get spot checks through the 12 hour insulin cycle as you can and let us know how you guys are doing.

It is great you were so on top of it to be doing a curve and all to see where he is at.
How is his general behaviour overall?
That is important as a part of the overall picture as well.

Kimmee
(scuse typos, hurrying )
 
thanks - I will try what you recommended - stick with lower doses. His behaviour is fine, playful, no diarrhoea.

I will do his numbers in the morning and keep him on low doses until I get back.
 
Great-
ps..I would be also thinking perhaps of a ' no dose' number...perhaps 180? If under 180 no dose required, if above 180...then perhaps that 0.5 as you are doing..more spotchecks will show how it does, ketone testing and paws crossed here.

Just to keep him safe yes?

:) Kimmee
 
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