? Novolin N Experiment

[Onyx & Klepto]

Hi Folks -

Looking for some advice from folks experienced in Novolin N. My diabetic/IDB kitty has been on and off Lantus for close to 3 years (was OTJ several times from zero carb diets), and it always worked great. 1.5U seemed to be her sweet spot. Back in November, I started seeing some sporadic 500's. In January, the 500's came on more frequently. But starting early February, she started going into the 600's, and seems to want to stay there! (no trace of ketones so far)

For the last few weeks, the only way I could get her out of the 600's, is by using .5 Novolin R. I bought all new insulins, hoping that was the problem. NOPE. Raised the dose by a whole unit (.5 at a time), but not much happened at all. So I started to suspect she might be becoming insulin resistant, or at least too used to Lantus. So my vet gave me a bottle of Novolin N to try. And I also just found out she's probably early stage 3 CKD. UGH. Which is probably what's truly affecting her BG. *sigh*

Given all her health issues, I'm no longer concerned with remission or any sort of tight regulation. Been there, done that. And treating both the diabetes and IBD has been a nightmare. I honestly just want to keep her numbers close to 200 so she's out of danger...so I can keep her as comfortable as possible for the remainder of her time. But it seems like I need some experimenting. So far, it seems like the Novolin N stops working after 5 or 6 hours. The R stopped at 3. So I'm doing 8 hour cycles, but it's too much for my work schedule. So my question is, has anyone here ever done any experimenting with using both Lantus AND Novolin N? Once the Novolin stops working, it doesn't take her long to get back to the 600's, so maybe a lower dose of Lantus can pick up the slack for the 2nd half the cycle? Or is maybe Vetsulin is worth a try?

I'd love some thoughts. I get the feeling this isn't the norm at all, but I'm sure someone here has gone through something similar.

Thanks for any feedback.
Brandi & Onyx

 

[MrWorfMen's Mom]

Hi Brandi, This board doesn't get much traffic anymore and the folks using Novolin, Humulin and Vetsulin here, post over on the Health board regarding those insulins. That said, there are some kitties with high dose conditions and their caregivers have used "R" along with Lantus/Levemir but I would not recommend considering doing so without the guidance of some very experienced folks. That experience would be best found on the Lantus/Levemir board.

Hope this helps you get poor Onyx sorted out! Love both your kitties names BTW!

 

[Onyx & Klepto]

Thanks, I'll check out the other boards. I'd already gotten guidance a while back on R with Lantus, so I have that one down. The N that's longer acting is what I need help with now. Maybe. Fingers crossed.

And thanks. Their names definitely suit them. Especially the little orange maniac Klepto. My crazy little thief!

 

[manxcat419]

To be honest, looking at her spreadsheet I'm thinking her insulin needs have simply changed this time - I don't think the Lantus wasn't working, just that the dose which looks as though you didn't take it above 2.5u never reached a high enough point to be effective this time around...maybe because of the CKD. Onyx really didn't even get close to being high dose with the Lantus - I'd have increased that rather than adding R while she was still on a fairly low dose.

Oh - one more thing to think about...if she's dehydrated from the CKD, that can raise BG levels as well. Sub-q's might help if you're not already doing them.

 

[manxcat419]

@Larry and Kitties - is Lantus and Novolin N one of the combinations you've used for any of your higher dose cats?

 

[Onyx & Klepto]

To be honest, looking at her spreadsheet I'm thinking her insulin needs have simply changed this time - I don't think the Lantus wasn't working, just that the dose which looks as though you didn't take it above 2.5u never reached a high enough point to be effective this time around...maybe because of the CKD. Onyx really didn't even get close to being high dose with the Lantus - I'd have increased that rather than adding R while she was still on a fairly low dose.

Oh - one more thing to think about...if she's dehydrated from the CKD, that can raise BG levels as well. Sub-q's might help if you're not already doing them.

Yes, you very well could be right about just needing the much higher dose, which is what I suspect with CKD. But...I wanted to see if she might respond better to other insulins, at a lower dose, before any dramatic lantus increases. With her IBD, if she has a vomiting spell her numbers have dropped into the 30's. and that was on a low dose. So if she's on anything high, I'd be so afraid of coming home from work to a dead kitty. Juggling multiple diseases with her has been so difficult. You never know when she'll skip meals or get sick. It's either weeks, or days. Lantus is very unpredictable in her with these bottoming out issues. So yes, I'm super scared to go any higher than 2.5 on Lantus. I'd rather find some "safer" alternatives, if at all possible. If nothing else works, high doses of Lantus will be the last resort. But I fear for my heart and nerves at that point...lol.

So far, she's at least getting some movement on 2 & 2.5U of Novolin N. But...it shoots through the roof after it stops working in 6 hours. The first dose (1.5U) of N took her into the 100's, but that was because she still had some Lantus shed left. So my gut is telling me that perhaps I could do the 12 hour cycles with both the N and a 1 or 1.5 of Lantus. Once the N stops, the Lantus will pick up the slack for the 2nd half the cycle. I'm going to post on the other boards today to see if anyone has ever tried it. I'll only test it on a weekend when I'm home to do a curve though. I'm also curious to see how she'd respond to Vetsulin.

And yes, with her IBD, I've had to give her fluids for the last 2.5 years. So no worries there. I keep an IV stand beside my bed. Oddly enough, she's quite hydrated right now and GAINING weight, which has my vet stumped. But I'm always prepared for the unexpected. My vet keeps me stocked in fluids and vials of Cerenia & Famotidine. THANK GOD!!!!

 

[Onyx & Klepto]

@Larry and Kitties - is Lantus and N one of the combinations you've used for any of your higher dose cats?

No, I'd never tried Lantus and Novolin N together. That's why I was looking for advice. I just know it's an option. I was doing Lantus and R, which only lasts 3 hours for her. Not a good solution for someone who lives alone and works.

I've read it's nearly impossible to keep a CKD kitty's diabetes regulated. So there might not be much I can do. But I'm willing to try what doesn't put her at too much risk when I'm not home.

 

[manxcat419]

No, I'd never tried Lantus and Novolin N together. That's why I was looking for advice.

I was actually asking someone who I know has used different insulin combinations for high dose cats to see if he had any input. But I don't know how often he's on the board at the moment.

Yes, you very well could be right about just needing the much higher dose, which is what I suspect with CKD. But...I wanted to see if she might respond better to other insulins, at a lower dose, before any dramatic lantus increases. With her IBD, if she has a vomiting spell her numbers have dropped into the 30's. and that was on a low dose. So if she's on anything high, I'd be so afraid of coming home from work to a dead kitty. Juggling multiple diseases with her has been so difficult. You never know when she'll skip meals or get sick. It's either weeks, or days. Lantus is very unpredictable in her with these bottoming out issues. So yes, I'm super scared to go any higher than 2.5 on Lantus. I'd rather find some "safer" alternatives, if at all possible. If nothing else works, high doses of Lantus will be the last resort. But I fear for my heart and nerves at that point...lol.

That would make me much more scared of adding a harsher insulin personally. Both R and Novolin N can drop the numbers a long way very quickly. Maybe Levemir that tends to onset later for a lot of cats might be a better option instead of the Lantus.

And yes, with her IBD, I've had to give her fluids for the last 2.5 years. So no worries there. I keep an IV stand beside my bed. Oddly enough, she's quite hydrated right now and GAINING weight, which has my vet stumped. But I'm always prepared for the unexpected. My vet keeps me stocked in fluids and vials of Cerenia & Famotidine. THANK GOD!!!!

That shouldn't be the problem for you then - and she's already used to fluids so they won't come as a shock to her with the CKD diagnosis!

I've read it's nearly impossible to keep a CKD kitty's diabetes regulated.

I can't honestly say I've had a problem with that, but then I refused all the renal RX diets when Rosa was diagnosed CKD. We've only had one tiny wobble with her OTJ status, and that wasn't from the CKD - it was from some jumped-up vet tech at a medical boarding facility deciding they didn't need to stick to the diabetic friendly food I'd brought for her. She didn't go back on insulin and got her own numbers back down, though it did take almost a month...but then the highest reading she threw me was in the 140s. Other than that we had one single reading of 152 when her hematocrit crashed, but that was likely due to her suddenly low hematocrit level.

 

[BJM]

When I had Spitzer, and he developed IBD, I too, ran into the problem of erratic food intake leading to erratic glucose levels. I couldn't increase the Lantus on the fly, so I tried a touch of R to bring him down if he was running really high. As you discovered, it doesn't last very long, so then I tried using tiny amounts of N when he was high, which worked a bit better.
... and then I freaked everyone out here by trying something even longer acting and non-depot (ProZinc) for those days he was high. I didn't have a chance to track that very long, as Spitzer threw a blood clot to his hind legs and was in such agony I had him euthanized. If you want to consider using that insulin, only do so working with your vet and having agreed upon guidelines to follow, otherwise you will be strongly criticized here for doing something that isn't standard practice. That, or have a really thick skin and be prepared for the controversy.

You do need to curve your supplemental insulin so you can learn how it works in your cat. Since you report how long R and N last in you cat, you may have done that, but if not, its a good idea to do that periodically as response can change.

 

[Onyx & Klepto]

I was actually asking someone who I know has used different insulin combinations for high dose cats to see if he had any input. But I don't know how often he's on the board at the moment.


That would make me much more scared of adding a harsher insulin personally. Both R and Novolin N can drop the numbers a long way very quickly. Maybe Levemir that tends to onset later for a lot of cats might be a better option instead of the Lantus.


That shouldn't be the problem for you then - and she's already used to fluids so they won't come as a shock to her with the CKD diagnosis!


I can't honestly say I've had a problem with that, but then I refused all the renal RX diets when Rosa was diagnosed CKD. We've only had one tiny wobble with her OTJ status, and that wasn't from the CKD - it was from some jumped-up vet tech at a medical boarding facility deciding they didn't need to stick to the diabetic friendly food I'd brought for her. She didn't go back on insulin and got her own numbers back down, though it did take almost a month...but then the highest reading she threw me was in the 140s. Other than that we had one single reading of 152 when her hematocrit crashed, but that was likely due to her suddenly low hematocrit level.

So your kitty has CKD as well? How long have you been dealing with both diabetes and CKD? I was so happy when Onyx was OTJ, it made life so much easier. But...her refusal to stay on the zero carb food always ruined that. Because of the IBD, I was never able to get her off the dry food, so low carb options are minimal. And she doesn't like most of them, and when she does eat them, she gets tired of them after a month or so. What a nightmare. Every time I tried some of the withholding tests, a vomiting spell would ensue. She gets really sick if she doesn't eat every hour or 2. So keeping the IBD in check always won out over forcing her to switch to wet. She is a stubborn little thing. There were times she went a few days without eating, brought on pancreatitis, but she would NOT touch that darn wet food. So I accepted defeat, to keep those ER situations at bay.

 

[manxcat419]

Rosa was diagnosed diabetic in January 2015 and CKD at the end of July. It's been a bit of a rollercoaster - we no sooner got her OTJ than we had to start dealing with the CKD, though I don't have the food issues that you have with IBD in the mix as well - only the usual ones of no cat wanting to eat the same wet food 2 meals in a row! I think when you can't take the dry food out of the mix - and clearly Onyx has to eat something - it's going to make staying OTJ that much tougher though better insulin-dependent than repeated ER visits. Can she eat the Young Again dry food? That's one of the few that I know is low in carbs. With Rosa I have to free-feed the wet food - initially it helped her to control her own BG levels, but of course with the CKD as well if she goes too long without eating she vomits acid. We give her Pepcid AC to help counteract that, but she still needs to eat little and often or she goes off the idea of eating at all. My civvie, Regan, is a picky little beast too. I switched them all to wet food when Rosa was diagnosed diabetic, but Regan would keep sneaking into our housemate's room to steal the dry food he gives his cats. I finally managed to put a stop to it after her last blood work when she came up with a slightly low T4 level and they asked me to make sure she stayed well-hydrated etc, but when I took her back for a re-check they told me she was losing weight and I need to allow her a little high-quality dry to stop it because she's obviously not eating enough of the wet food and they were concerned about either panc or hepatic lipidosis! Talk about difficult - we now have to bring her and a small amount of dry food into the bedroom with us and have her sit on the bed and eat her dry food while we watch a movie to make sure Rosa can't steal any of the forbidden food.

@BJM - thank you for the great information. I was hoping someone here would have had to try using different combinations and might be able to help, but I could only think of Larry when I was tagging! I promise I wasn't trying to knock the use of combinations of insulin - it's just one of those things that makes me a little nervous especially with an insulin that can hit hard and fast with a cat that can also drop fast. Depending on the cat, you do what you have to to get control. So I was trying to figure out a solution that was within the limits of what I know about various single insulins.

 

[Onyx & Klepto]

When I had Spitzer, and he developed IBD, I too, ran into the problem of erratic food intake leading to erratic glucose levels. I couldn't increase the Lantus on the fly, so I tried a touch of R to bring him down if he was running really high. As you discovered, it doesn't last very long, so then I tried using tiny amounts of N when he was high, which worked a bit better.
... and then I freaked everyone out here by trying something even longer acting and non-depot (ProZinc) for those days he was high. I didn't have a chance to track that very long, as Spitzer threw a blood clot to his hind legs and was in such agony I had him euthanized. If you want to consider using that insulin, only do so working with your vet and having agreed upon guidelines to follow, otherwise you will be strongly criticized here for doing something that isn't standard practice. That, or have a really thick skin and be prepared for the controversy.

You do need to curve your supplemental insulin so you can learn how it works in your cat. Since you report how long R and N last in you cat, you may have done that, but if not, its a good idea to do that periodically as response can change.

Awe, I'm so sorry BJM. Poor little guy. That had to be so scary. I actually have a blood clotting disorder myself, so I always worry about that with my kitties.

The IBD alone makes regulation so difficult...but we certainly did it. The CKD on top of it now, well...talk about a nightmare. I've been diagnosed with my own autoimmue disorder through this, so some days I feel like my head is ready to explode.

Yes, I do curves. I've been doing them regularly with these fast-acting insulins, to be sure. It's honestly crazy how her insulin needs are changing so fast. In November, when the CKD symptoms probably started, a single drop of R worked WONDERS!!! But now, a .5U dose only brought her into the 300's. Sometimes. So I really didn't like the idea of having to regularly increase that one. R dropped her fast...but the N has a very nice, gradual drop, which I like. Seems to be around 100 per hour (give or take), which I'm more comfortable with than the 300 or more in an hour. For emergencies, though, R Rocks!!!

I didn't think ProZinc was still available. I'm researching Vetsulin right now, so I'll check that one out, too. And I don't mind controversy and criticism at all. I used to get it all the time because I didn't do everything EXACTLY the way folks thought I should. But I got her OTJ in a little over a month, so it was worth it. I had to do what worked for my little girl, and it did. So no worries there. She is my #1 priority, not keeping the masses happy. I always appreciate and respect advice, but sometimes you have to know when to figure out what things will work best for your kitty. You gotta weigh ALL the options. Especially when you have a critter who is so far from the norm it's not even funny...lol

 

[BJM]

I'd probably go with a low basal dose of the Lantus that wouldn't take him too low if he didn't eat or if he vomited.
Then, if he was already high, use a a tiny bolus of the R or NPH in the morning and/or when you got home on an as needed basis.
You might choose the NPH if he could keep his food down for a couple hours before you leave, and otherwise, use the R just to get the higher numbers down a bit.

I haven't heard of any difficulties with getting ProZinc. Maybe check in the ProZinc forum.

 

[Onyx & Klepto]

Rosa was diagnosed diabetic in January 2015 and CKD at the end of July. It's been a bit of a rollercoaster - we no sooner got her OTJ than we had to start dealing with the CKD, though I don't have the food issues that you have with IBD in the mix as well - only the usual ones of no cat wanting to eat the same wet food 2 meals in a row! I think when you can't take the dry food out of the mix - and clearly Onyx has to eat something - it's going to make staying OTJ that much tougher though better insulin-dependent than repeated ER visits. Can she eat the Young Again dry food? That's one of the few that I know is low in carbs. With Rosa I have to free-feed the wet food - initially it helped her to control her own BG levels, but of course with the CKD as well if she goes too long without eating she vomits acid. We give her Pepcid AC to help counteract that, but she still needs to eat little and often or she goes off the idea of eating at all. My civvie, Regan, is a picky little beast too. I switched them all to wet food when Rosa was diagnosed diabetic, but Regan would keep sneaking into our housemate's room to steal the dry food he gives his cats. I finally managed to put a stop to it after her last blood work when she came up with a slightly low T4 level and they asked me to make sure she stayed well-hydrated etc, but when I took her back for a re-check they told me she was losing weight and I need to allow her a little high-quality dry to stop it because she's obviously not eating enough of the wet food and they were concerned about either panc or hepatic lipidosis! Talk about difficult - we now have to bring her and a small amount of dry food into the bedroom with us and have her sit on the bed and eat her dry food while we watch a movie to make sure Rosa can't steal any of the forbidden food.

@BJM - thank you for the great information. I was hoping someone here would have had to try using different combinations and might be able to help, but I could only think of Larry when I was tagging! I promise I wasn't trying to knock the use of combinations of insulin - it's just one of those things that makes me a little nervous especially with an insulin that can hit hard and fast with a cat that can also drop fast. Depending on the cat, you do what you have to to get control. So I was trying to figure out a solution that was within the limits of what I know about various single insulins.

No worries at all! We're all just trying to figure out what works, without killing out babies in the process. I was so nervous with the R in the beginning. You would laugh your ass off if you would have seen how many times I tested the pulled drop, before I gave it to her. But once I knew how she handled it, the fear went away. She burns both Novolins off FAST. In fact, today, the N stopped after 4 hours instead of 5. It's crazy. The CKD truly throws control out the window.

Actually, Young Again Zero Carb is what got Onyx is remission 3 times. AMAZING stuff! Sadly, last year the zero carbs no longer mattered. I'm guessing that's when the CKD began. What started out as carb-related diabetes, turned into something completely different. She's been on a keep-that-stinky-poo-food-away-from-me kick the past few months and won't go near the YA. My civie sure does love it though. And gaining weight from it. UGH! lol

 

[Onyx & Klepto]

I'd probably go with a low basal dose of the Lantus that wouldn't take him too low if he didn't eat or if he vomited.
Then, if he was already high, use a a tiny bolus of the R or NPH in the morning and/or when you got home on an as needed basis.
You might choose the NPH if he could keep his food down for a couple hours before you leave, and otherwise, use the R just to get the higher numbers down a bit.

I haven't heard of any difficulties with getting ProZinc. Maybe check in the ProZinc forum.

That's kinda what I was thinking, too, with the NPH. I was already doing it with the R, but it drops too much, too fast. I feel safer with the steady, slower drop from the N. I might start a trial later today to see what happens this weekend while I'm home.. Heck, it's possible for the rest of her days, I might have a continual experiment on my hands.

 

[manxcat419]

No worries at all! We're all just trying to figure out what works, without killing out babies in the process. I was so nervous with the R in the beginning. You would laugh your ass off if you would have seen how many times I tested the pulled drop, before I gave it to her. But once I knew how she handled it, the fear went away. She burns both Novolins off FAST. In fact, today, the N stopped after 4 hours instead of 5. It's crazy. The CKD truly throws control out the window.

You're doing your testing and that's all any of us can do to keep our kitties safe and healthy. I think as you get the CKD under control, you should find it has less effect on her diabetes - they all interlink at some level.

Actually, Young Again Zero Carb is what got Onyx is remission 3 times. AMAZING stuff! Sadly, last year the zero carbs no longer mattered. I'm guessing that's when the CKD began. What started out as carb-related diabetes, turned into something completely different. She's been on a keep-that-stinky-poo-food-away-from-me kick the past few months and won't go near the YA. My civie sure does love it though. And gaining weight from it. UGH! lol

I wish I could stretch the budget to accommodate that for Regan's dry food requirements so I wouldn't have to worry about Rosa sneaking a few pieces. But I'm already spending upwards of $500 a month in vet bills, plus Rosa's regular meds (her carafate alone runs at $150 every 3 weeks) plus the insanely expensive wet food to keep it low carb and low phos. Both of them are going to need dentals in the next few months and the last one we did was $600 just for one cat. And I've just had to buy a set of scales so I can keep an eye on Regan's weight - much as I'd love to find the extra money from somewhere, there's only so much I can do. I have to eat too!

 

[Onyx & Klepto]

You're doing your testing and that's all any of us can do to keep our kitties safe and healthy. I think as you get the CKD under control, you should find it has less effect on her diabetes - they all interlink at some level.


I wish I could stretch the budget to accommodate that for Regan's dry food requirements so I wouldn't have to worry about Rosa sneaking a few pieces. But I'm already spending upwards of $500 a month in vet bills, plus Rosa's regular meds (her carafate alone runs at $150 every 3 weeks) plus the insanely expensive wet food to keep it low carb and low phos. Both of them are going to need dentals in the next few months and the last one we did was $600 just for one cat. And I've just had to buy a set of scales so I can keep an eye on Regan's weight - much as I'd love to find the extra money from somewhere, there's only so much I can do. I have to eat too!

Trust me, I know what you mean. I spend more on her food and meds than I do my own. It's a LOT to keep up with. if I had kids or a family, I wouldn't be able to do it. When I wasn't working, right after her disagnosis, I really dont' know how I managed. I've wasted so much food with her. Luckily, though, Chewy's is amazing at refunding money when your kitties won't eat the food. So that has been a good thing. Young Again isn't so helpful, though. And they constanstly change their recipe, which I think has a lot do with why she gets turned off by it.

 

[Onyx & Klepto]

You're doing your testing and that's all any of us can do to keep our kitties safe and healthy. I think as you get the CKD under control, you should find it has less effect on her diabetes - they all interlink at some level.

How are you able to get the CKD under control? With the diabetes and IDB, my vet made it seem like there wasn't much of an option since she can't do the steroids. If there are other options, I'd love to hear about it. Especially since she's stage 3.

 

[BJM]

Chronic kidney disease? See Tanya's web site, if you've not done so at www.FelineCRF.org

There are some low carb, low phosphorus foods on the list from Cat Info, and someone has a shortcut list posted in Feline Health which gets bumped periodically.

Also, cooked egg white is low phosphorus, high protein (per Tanya's site), so you can add 1 ounce of that to 5 ounces of canned food, mix well, and divide into portions to help the mixture have lower carb, lower phosphorus, yet still be quality protein.(the 1 ounce tip is per www.CatInfo.org).

 

[manxcat419]

Trust me, I know what you mean. I spend more on her food and meds than I do my own. It's a LOT to keep up with. if I had kids or a family, I wouldn't be able to do it. When I wasn't working, right after her disagnosis, I really dont' know how I managed. I've wasted so much food with her. Luckily, though, Chewy's is amazing at refunding money when your kitties won't eat the food. So that has been a good thing. Young Again isn't so helpful, though. And they constanstly change their recipe, which I think has a lot do with why she gets turned off by it.

I'm right there with you on that. The expense, the wasted food, the frustration. Chewy's are great though - I've tried flavors of food that I wouldn't have dared order without them saying they'll refund if the cats won't eat it. Otherwise they'd be limited to only the foods I can at least find a trial can of locally! Maybe I'll get to try the YAZC at some point, but not right now...not with the last couple of months' vet bills.

How are you able to get the CKD under control? With the diabetes and IDB, my vet made it seem like there wasn't much of an option since she can't do the steroids. If there are other options, I'd love to hear about it. Especially since she's stage 3.

Rosa is Stage 3 now too - creatinine of 3.6 at her last blood work. Under control is more about slowing (or even stopping) progression for as long as possible and controlling the numbers you can - adding things like phosphorus binders when needed to keep the phosphorus level under control and potassium if her levels drop low along with anti-nausea meds if you find she needs them. And of course the sub-q fluids which help to stop them getting dehydrated when their drinking can't keep up. I have a list here https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/edit?usp=sharing that I compiled using the information from the catinfo.org site...I just put the numbers into terms I can understand, so I used the percentage of calories from carbs, but the phosphorus is shown as a dry matter percentage. It will depend a bit on whether or not there are any foods on there that Onyx can tolerate with her IBD. The only thing I'm not sure about is why your vet thinks she needs steroids for the CKD - that's not something I've heard of being used.

 

[Onyx & Klepto]

Okay, gotcha. Those things I actually knew. I was thinking you had a medication in mind to get in under control so I got excited...lol. So far, her phosphorus and potassium levels are normal, but her creatinine is 3.6, like your kitty's. I'll have to get the phosphorus stuff figured out before hers starts to be affected. I'm not even sure what it's like in her foods now. I'm afraid to look. There are so few foods she'll eat. And the ones good for diabetes, are bad for CKD and IBD. Drives me crazy. I'm always left picking the lesser of two evils.

And as far as the steroids go, my vet seems to think they're the answer for everything. UGH. It's what brought on the diabetes to begin with. He sent me to a few sites that said Stanozolol and fluids were the best course of treatment for stage 3. I haven't done much research on it, since I always avoid steroids. Thanks for sharing your spreadsheet. I'll go check it out.

 

[manxcat419]

If you're looking for somewhere to start with your research, this is a great site for CKD information http://www.felinecrf.org/

You may actually never have an issue with phosphorus or potassium - Rosa's potassium is on the high side of normal (unusual for a CKD kitty). Our old CKD girl had low potassium from diagnosis, but did well with a supplement. Rosa has high phosphorus and I give her a binder, but Shadow never had a phosphorus reading outside of range in the 3 years she was CKD.

Steroids - well, I'd really rather not! Unless she HAS to have them for her IBD, I'd politely refuse and request other options instead. The fluids I do agree with though - they're really the mainstay of CKD management for most cats.

You're very welcome to the spreadsheet...along with any other information I can help you with. These multi-condition kitties are a handful to keep under control. The more information we all have and can share, the better equipped we can all be to help them stay healthy for as long as possible.

I wouldn't say that the diabetes and CKD foods are mutually exclusive - the value of feeding a low protein diet to CKD cats is now debatable at best with a good amount of research having been done that shows that feeding a diet containing a good amount of high-quality protein is often the best option. I do know the IBD can make it tricky to find anything at all that she can eat though.

 

[Onyx & Klepto]

If you're looking for somewhere to start with your research, this is a great site for CKD information http://www.felinecrf.org/

You may actually never have an issue with phosphorus or potassium - Rosa's potassium is on the high side of normal (unusual for a CKD kitty). Our old CKD girl had low potassium from diagnosis, but did well with a supplement. Rosa has high phosphorus and I give her a binder, but Shadow never had a phosphorus reading outside of range in the 3 years she was CKD.

Steroids - well, I'd really rather not! Unless she HAS to have them for her IBD, I'd politely refuse and request other options instead. The fluids I do agree with though - they're really the mainstay of CKD management for most cats.

You're very welcome to the spreadsheet...along with any other information I can help you with. These multi-condition kitties are a handful to keep under control. The more information we all have and can share, the better equipped we can all be to help them stay healthy for as long as possible.

I wouldn't say that the diabetes and CKD foods are mutually exclusive - the value of feeding a low protein diet to CKD cats is now debatable at best with a good amount of research having been done that shows that feeding a diet containing a good amount of high-quality protein is often the best option. I do know the IBD can make it tricky to find anything at all that she can eat though.

Oddly enough, felinecrf.org is where I learned about CKD stuff last year. That site has tons of info. Love it!

And my vet knows how I feel about steroids, so he won't try pushing it. She needed them for the IBD as well, but I wouldn't do it. Fluids, B12 shots, Cerenia and famotidine have done wonders for her.

I just checked her Evo and it's 1.34% phosphorus, so it's not too bad. I was shocked the Young Again is .95%. I might have try getting her to eat it again. After they changed the last batch, she won't go near it. Might have to buy ANOTHER bag to see if they've changed it again. Just so expensive when she won't eat it.

How do you give your kitty supplements? I'm tempted to see if I can find a place that compounds a bunch of the vitamins into a shot or transdermal pen. I can't pill her, and she acts like you're trying to murder her if you shove a dropper of liquid in her mouth. Probably traumatized her by the forefeeding when she had pancreatitis. NOT good!

 

[manxcat419]

Oddly enough, felinecrf.org is where I learned about CKD stuff last year. That site has tons of info. Love it!

I love it too - so much information, including on the things not to waste money on which is always good to know!

And my vet knows how I feel about steroids, so he won't try pushing it. She needed them for the IBD as well, but I wouldn't do it. Fluids, B12 shots, Cerenia and famotidine have done wonders for her.

That's great! If you can get her through without steroids, it's so much better for her not to have them.

I just checked her Evo and it's 1.34% phosphorus, so it's not too bad. I was shocked the Young Again is .95%. I might have try getting her to eat it again. After they changed the last batch, she won't go near it. Might have to buy ANOTHER bag to see if they've changed it again. Just so expensive when she won't eat it.

Definitely could be worse. If she's happy eating it, I'd be inclined to leave that as it is for now - you can always add a phosphorus binder if you find she needs it later on. The Young Again is a good food I know, but if the formula changes that often it's always a gamble on whether or not they'll like the latest incarnation of it.

How do you give your kitty supplements? I'm tempted to see if I can find a place that compounds a bunch of the vitamins into a shot or transdermal pen. I can't pill her, and she acts like you're trying to murder her if you shove a dropper of liquid in her mouth. Probably traumatized her by the forefeeding when she had pancreatitis. NOT good!

I'm a mean cat mom - I make her swallow them! I can't say she enjoys the meds, but she does enjoy the cuddle and the baby food (with added Miralax that she doesn't know about) she gets after she takes them. Then again, I haven't had to force-feed her yet...if I ever have to do that, things might change. I do put her B12 shots into the fluids line though - I figure I can save her that much at least.

 

[Onyx & Klepto]

I love it too - so much information, including on the things not to waste money on which is always good to know!


That's great! If you can get her through without steroids, it's so much better for her not to have them.


Definitely could be worse. If she's happy eating it, I'd be inclined to leave that as it is for now - you can always add a phosphorus binder if you find she needs it later on. The Young Again is a good food I know, but if the formula changes that often it's always a gamble on whether or not they'll like the latest incarnation of it.


I'm a mean cat mom - I make her swallow them! I can't say she enjoys the meds, but she does enjoy the cuddle and the baby food (with added Miralax that she doesn't know about) she gets after she takes them. Then again, I haven't had to force-feed her yet...if I ever have to do that, things might change. I do put her B12 shots into the fluids line though - I figure I can save her that much at least.

lol...mean, mommy. That's funny. I had to get like that with the force feeding when she was so sick. I'd be crying and yelling at the same time, "Don't you know I'm trying to save your life??"
I wish they got it. Darn cats anyway!

 

[manxcat419]

I'd be crying and yelling at the same time, "Don't you know I'm trying to save your life??"

That happens a lot around here. I seem to be just on edge with it all enough that it takes very little resistance from Rosa to upset me right now - she's never been an easy patient and of course we seem to be adding meds every other week at the moment. I know she hates it all - she doesn't know she's got anything wrong with her because she feels fine (though of course I'm thankful for that), so if she happens to go ahead and show me how much she hates it, that's all it takes. But she's my baby - there's no way I can bring myself to stop the treatment when I know she could have years left yet with the right meds.

 

[BJM]

With IBD, the oral steroid, budesonide can be helpful as it has minimal, if any absorption, working only in the GI tract. Maybe do a post for more ideas in Feline Health to get input from others who have dealt with IBD more than I have.

 

[Onyx & Klepto]

With IBD, the oral steroid, budesonide can be helpful as it has minimal, if any absorption, working only in the GI tract. Maybe do a post for more ideas in Feline Health to get input from others who have dealt with IBD more than I have.

Hi BJM -

My vet and I discussed Budesonide several times, but never found a transdermal option. We were going to try the chews, but now with the CKD, I've put it on the back burner. Luckily, the IBD isn't so bad right now, which is shocking. Maybe because of everything else I've been doing for it. Right now my focus is getting the BG back under control so I can hopefully slow down the CKD. And a bit of good news...I'm into the 2nd cycle of using both a Novolin N and low dose Lantus, and it's going well. I'm sure it's going to require some adjusting as we go, but so far so good. I'm feeling positive for the first time in WEEKS.

 

[Onyx & Klepto]

That happens a lot around here. I seem to be just on edge with it all enough that it takes very little resistance from Rosa to upset me right now - she's never been an easy patient and of course we seem to be adding meds every other week at the moment. I know she hates it all - she doesn't know she's got anything wrong with her because she feels fine (though of course I'm thankful for that), so if she happens to go ahead and show me how much she hates it, that's all it takes. But she's my baby - there's no way I can bring myself to stop the treatment when I know she could have years left yet with the right meds.

I agree with you 100%!!!

 

[BJM]

One of the ways to use a supplemental insulin is to give it around +9 or +10, when the basal insulin starts wearing off. This helps keep it from going high at the end of the cycle and starting high at the beginning.
It also helps prevent the nadirs of the 2 insulins from overlapping, which could drop the glucose too much.
Just something to consider as you figure out what works best in your situation.

 

[Onyx & Klepto]

One of the ways to use a supplemental insulin is to give it around +9 or +10, when the basal insulin starts wearing off. This helps keep it from going high at the end of the cycle and starting high at the beginning.
It also helps prevent the nadirs of the 2 insulins from overlapping, which could drop the glucose too much.
Just something to consider as you figure out what works best in your situation.

thanks, BJM. I will definitely keep that in mind. So far, the overlap is working perfectly. Onyx is always a late bloomer on Lantus, but as I have to increase it, that could change as it works with Novolin. I'll be keeping my eyes on it for sure. I REALLY wish I didn't have to work this week.

 

[BJM]

@Onyx & Klepto
Hi Brandi

Just wondering how it is going.