Update - Remission?

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bbwyo

bbwyo

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A update on Kitty's situation. The last shot of Vetsulin was on Saturday 5/27 morning. Her numbers are holding in the mid 200's. The Vet has said to keep monitoring her but not back on insulin. I will actually see the Vet the first of next week, June 5th. If things hold I will not be giving more insulin until that visit from the Vet...(Yes rural Vet comes to your house).

She seems to be doing well overall. Possibly a little dehydrated at times but all else pretty normal...not quite her old self in that she doesn't have the energy. She has been a high energy kitty but is hitting the 10 yr mark this summer and with Arthritis.

I have no idea what to expect from here on out. We have been suspicious that the FD was the result of a couple of steriod shots late last summer and fall. When this was first diagnosed the Vet said she would be happy if we could get BG#'s of 250. (which she has) Does it just depend on Kitty's overall health whether or not one tries to kick up her system a little in order to achieve lower BG? How unhealthy is a higher BG? Before this hit blood tests from 2-3 years ago showed her to be very normal for non-diabetic cat in the 51-120's.

Last winter before she was diagnosed and she had lost so much weight I had tried to change her diet to a "high test" dry food. I think this may have been "the straw that broke the camel's back". She had dirhea and condition completely deteriorated ie. vet diagnosis etc. etc. After finding your site we are now successfully all wet LC. 3 FF Pure + 1 Classic FF. Over the last month I had slowly been reducing the W/D that the Vet had prescribed and even though it was a very small portion of her daily caloric intake may have accounted for her wild swings and low BG. As that has been settling down I have stopped feeding the W/D completely and if you look at the spreadsheet she seems to be pretty stable.

I've only been doing spot checks and it doesn't seem to matter if she's eaten recently or not.
I would love her to be her "old self" again but if she's getting along with higher GB would it be silly to rock the boat with trying to give insulin?

I thank all you who volunteer on this site. You have literally been a Godsend. I will definitely be supporting this group.
 
Your cat is not in remission and still needs insulin. With a human meter she would need to be consistently under 120(50-120) without insulin to be in remission. I'm not sure why you stopped giving it. You may need to give a smaller dose than before but he still needs it. Over time a high bg can lead to organ damage.
 
Thank you Janet. I stopped with the insulin because Vet said to. I agree I think she could use some help. And No I'm not sure it's not Diabetic neuropathy because I have noticed that the creaking is non-existent some days. I don't know that much about arthritis but don't think it comes and goes so noticeably. She seems to feel pretty good. I have been monitoring per Vet's instructions. I am going to talk with her in the morning. I really appreciate your input here because I wasn't sure about numbers. The Vet had said she would be "happy" with BG under 250?
 
bbwyo said:
Thank you Janet. I stopped with the insulin because Vet said to. I agree I think she could use some help. And No I'm not sure it's not Diabetic neuropathy because I have noticed that the creaking is non-existent some days. I don't know that much about arthritis but don't think it comes and goes so noticeably. She seems to feel pretty good. I have been monitoring per Vet's instructions. I am going to talk with her in the morning. I really appreciate your input here because I wasn't sure about numbers. The Vet had said she would be "happy" with BG under 250?
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She's probably not accustomed to people who actually home test.... If someone isn't home testing there's a risk of hypo with low numbers.

We can help you with dosing if you want to get her lower. If there's ever going to be a remission you have to get her into healing numbers where the pancreas can heal itself..... And that's under 120.

Keep in mind you are using a human meter....on a pet meter a reading like 278 like you had the other day could easily be a 330-350 on a pet meter. Plus I have a feeling these high numbers with no treatment are starting to cause neuropathy which is only going to gradually get worse.

You need to get her numbers down and I would start her on b12 methylcobalamin supplements such as zobaline.

She seems to drop a lot from a small dose of insulin. Id probably start trying with a half unit when over 200. Let's get her into those blues!
 
I could but we don't have a lot of options out here in rural WYO. The Vet I have is very open to working with patients but is a little conservative. We are going to talk later on this morning but she texted we could try Lantis or smaller doses etc. Also said the b12 M is more effective with injections but will discuss more later. I'm sure she will be fine with Zobaline to start. Any idea if injection better? Would really like to try to get her stabilized lower. She's more of an indoor cat but if she happens to be outside and sees rabbit or mouse seems to effect GB even if she doesn't eat it. Genetics!
 
bbwyo said:
I could but we don't have a lot of options out here in rural WYO. The Vet I have is very open to working with patients but is a little conservative. We are going to talk later on this morning but she texted we could try Lantis or smaller doses etc. Also said the b12 M is more effective with injections but will discuss more later. I'm sure she will be fine with Zobaline to start. Any idea if injection better? Would really like to try to get her stabilized lower. She's more of an indoor cat but if she happens to be outside and sees rabbit or mouse seems to effect GB even if she doesn't eat it. Genetics!
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For diabetic neuropathy the shots are not more effective. The shots are b12 cyanocobalamin.... The pills are B12 methylcobalamin which is better for this.
 
great! just got off phone with Vet who said go ahead with the B12 M, and start .25 cu Vetsulin and monitor. She also suggested using a little metamucil to slow down food absorption which might help with rapid metabolizing of insulin (or maybe just food)? I'm not sure I understood that correctly, she only offered it as an option. Do I have to order Zobalin or is it something they will have at Petsmart?
 
bbwyo said:
great! just got off phone with Vet who said go ahead with the B12 M, and start .25 cu Vetsulin and monitor. She also suggested using a little metamucil to slow down food absorption which might help with rapid metabolizing of insulin (or maybe just food)? I'm not sure I understood that correctly, she only offered it as an option. Do I have to order Zobalin or is it something they will have at Petsmart?
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It used to be carried on amazon but I don't see it on there now.

This is the b12 I use... You can just open the capsule and sprinkle it on the food. Vitacost Vitamin B-12 Methylcobalamin -- 500 mcg - 300 Capsules https://www.amazon.com/dp/B0046IET7C/ref=cm_sw_r_cp_api_ppynzb3ECKZ78
 
will find it. Also which pet specific glucose monitor is the best and do I have to order it as well?
 
bbwyo said:
will find it. Also which pet specific glucose monitor is the best and do I have to order it as well?
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You want to switch to a pet meter? I like the Alphatrak 2 but just know the strips are very expensive. You can get it on amazon
 
I guess I don't need to switch to Pet meter as long as I understand the difference in the readings. I'm all for making things less complicated right now.
 
bbwyo said:
I guess I don't need to switch to Pet meter as long as I understand the difference in the readings. I'm all for making things less complicated right now.
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Totally up to you. Like I said I have and use an Alphatrak.

Human meters run lower, with a greater difference between them at higher numbers. So in high numbers they might be 100+ numbers apart, but in low numbers they may only be 20-30 numbers difference.

I personally like having the same numbers as my vet, but before my cat went into remission I was spending about $150/month on strips. So it is pricy.
 
Hmmm. will have to think about that one. I just want to be sure I'm understanding what I'm seeing. What you are saying is that on a human meter if I get a 50 reading it could be a 70 or 80 in reality? I've read about this but seem to need the repetition. The Vet does a fructosomine (sp) test so my # will not be relevant. Do you have any suggestions for syringes for smaller doses? We are going to try .25 cu of the Vetsulin and it looks like that is tiny. Thx
 
Vetsulin is a U-40 insulin so you are probably using U-40 syringes? Those smaller doses can be difficult :smuggrin: but you could try using U-100 syringes with a conversion chart, which are apparently easier to do small doses. I just ordered some myself. My current insulin is also a U-40. Find syringes with half unit markings too. If your Walmart has not so clueless pharmacy associates, they carry U-100 syringes with half unit markings. I believe they are ReliOn brand (walmart brand too) U-100 syringes, 31g, 5/16" needle 3/100cc for about $9. The Walmart I went to try and get some has some dull crayons behind their pharmacy desk so I will try another one :p.

This is probably just an opinion but Fructosomine tests are irrelevant anyways because they are an average of high's and low's. Not a good indicator of how controlled her diabetes is under. (that sentence sounds awkward, my apologies my brain isn't telling me how to fix it :woot:). Don't try to get a conversion of human BG readings to pet BG readings in your head, it will drive you nuts! Not necessarily a 50 on a human meter is the other in reality but most likely higher on a pet meter. Feline blood is composed differently, hence why they have a pet meter ;). Hope something in this comment was helpful :cat:
 
JanetNJ said:
It used to be carried on amazon but I don't see it on there now.

This is the b12 I use... You can just open the capsule and sprinkle it on the food. Vitacost Vitamin B-12 Methylcobalamin -- 500 mcg - 300 Capsules https://www.amazon.com/dp/B0046IET7C/ref=cm_sw_r_cp_api_ppynzb3ECKZ78
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I ordered the product you are using. How necessary is the folic acid? Also read on one site (?big orange?) that it wasn't a good idea to crush tablets?
So does it matter if you just sprinkle the capsule? I do this with Dasuquin and it works great
 
I have started the Vetsulin again 1x daily .25 cu in the morning. Today is the first day I've pretested etc. because Vet said not to for a couple of days. I think she didn't want me to over-react AND also to give time for levels to settle down. So far so good. She is open to other insulins and on the Big Orange site it said that Prozinc was a good choice when trying to get a cat to level out at a low dose (maybe my interpretation) Also on this site they said that one shot a day was not going to be effective (again? maybe I didn't understand this). What are your comments on the above? Have I misunderstood something?

Also I would very much appreciate your help in getting her on the right track. Yesterday was the first day of shooting .25 and I didn't test much.
I guess I will know more in a couple of days but it sounds like prozinc 2x day would be a better insulin.
 
Bev,
*Just my thoughts again* Unfortunately, there's no absolute guarantee a specific insulin will level out a cat better than another. However, a longer lasting insulin like Prozinc may work better for Kitty since it doesn't look like (from the mid cycle data you have) Vetsulin is lasting 12 hours. Like the sticky's say, in some kitties it does not last the full 12 hours. If you want, peak over on the Prozinc thread and look for Susan and Timmy and Lisa and Smoky. They both switched from Vetsulin to Prozinc. Unfortunately, Smoky passed but I think Lisa still has his Spreadsheet up and he was on the smaller doses, like 0.2 - 0.6u range.

As for the 1 shot a day, you are correct, generally speaking it does not work out due to a cat's metabolism being much faster than a human :). I will tag one of my Prozinc buddy's, @Djamila . She might be able to word things better about Prozinc and lower doses :smuggrin:. I don't know your schedule but definitely try to get every PS test and some extra mid-cycle tests so we can see more data on her :cat:.
 
bbwyo said:
I ordered the product you are using. How necessary is the folic acid? Also read on one site (?big orange?) that it wasn't a good idea to crush tablets?
So does it matter if you just sprinkle the capsule? I do this with Dasuquin and it works great
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I've never had problems sprinkling it on. I give dasuquine as well. The folic acid is helpful but I can't speak to its being vital or not.

Cats metabolize insulin quickly, that's why they get 2 shots and not one.
 
The Vet said that it takes awhile for her system to adjust to the insulin so not to test for 3 days? Why do they say this? I almost skipped yesterday but relented and checked after 1st shot. Also Vet recommended metamucil to slow things down? Haven't decided on this. Janet I see you use Vetsulin. Are you happy with results? Any thoughts on Prozinc?
 
bbwyo said:
The Vet said that it takes awhile for her system to adjust to the insulin so not to test for 3 days? Why do they say this? I almost skipped yesterday but relented and checked after 1st shot. Also Vet recommended metamucil to slow things down? Haven't decided on this. Janet I see you use Vetsulin. Are you happy with results? Any thoughts on Prozinc?
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I had good results with vetsulin. My cat was in it for four months now and has been in remission for 9 months. The best insulin is whatever works for your cat.

I have never heard of using metamucil for diabetic cats before.
 
Thought Metamucil was a fiber supplement o_O. Haven't heard of fiber helping to slow a BG drop, mainly hairballs and poo help. Food can help slow the BG drops.
 
thnk the idea was to slow down food uptake? therefore metabolism. Think she said it might be worth a try.. so ??? wondered if anyone had heard anything like that?
 
bbwyo said:
The Vet said that it takes awhile for her system to adjust to the insulin so not to test for 3 days? Why do they say this? I almost skipped yesterday but relented and checked after 1st shot. Also Vet recommended metamucil to slow things down? Haven't decided on this. Janet I see you use Vetsulin. Are you happy with results? Any thoughts on Prozinc?
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Oh, and there's no reason to not test. not sure why he would say that. :/
 
bbwyo said:
thnk the idea was to slow down food uptake? therefore metabolism. Think she said it might be worth a try.. so ??? wondered if anyone had heard anything like that?
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I personally have not heard but you could try posting the question on Main Health to get more eyes :)
 
There is research on one of the insulins (I'm afraid I'm forgetting which right now) that did indicate that you can't know the impact of a dose until a few days. I'm guessing that's what your vet was thinking about there. However there is a difference between waiting to judge the efficacy of a dose, and not testing. Sometimes a cat will have a dramatic reaction on the first cycle of a dose change, and then level off. So on day one, it might look like a great dose, but by day three you know that she really needs a bigger dose than that. We encourage testing even while you're waiting because a dramatic reaction can sometimes by a hypo (BG below 50 on a human meter) and the cat might need you to intervene to bring the BG back into safer numbers.

And our protocols actually agree with that in that we recommend a dose be held for at least 3-6 cycles before the dose is changed in order to give time to see the real impact of the dose.

You did a great job today, by the way! And you're doing a great job of asking questions and gathering information about all of this.

As for the fiber supplement, I've heard of that in human diabetics, so maybe it's the same idea. It's not something I understand well enough to comment on though. okli,m

Prozinc and Lantus/Levemir are both great choices. You really can't go wrong there. You might want to read the Sticky messages at the top of both forums and read through some of the message threads and get a sense of which protocols would best suit your lifestyle and how you'd like to approach treatment. Both options are good and have good outcomes so there really isn't a right or wrong there. As Janet said, the best insulin is the one that works for your kitty. There isn't really any way to know which is better until you try them. Either way, there are great people around here to support you in learning how to manage all of this!
 
bbwyo said:
The Vita cost B-12 arrived today so will start in the morning. Do I understand correctly to use 1 whole capsule?
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Yep. You can do one in the morning and one in the evening. Just sprinkle it on the food and mix it in. Any extra b12 they just pee out. You can't overdose on it. By the way most adults are deficit in b12 as well so you can pop one yourself. Lol. I've tested the powder and discovered it has very little taste. None of my cats care when it's in the food.
 
JanetNJ said:
Yep. You can do one in the morning and one in the evening. Just sprinkle it on the food and mix it in. Any extra b12 they just pee out. You can't overdose on it. By the way most adults are deficit in b12 as well so you can pop one yourself. Lol. I've tested the powder and discovered it has very little taste. None of my cats care when it's in the food.
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You also give folic acid? I will watch to see when that is available agian. How much of that should I use?
 
bbwyo said:
You also give folic acid? I will watch to see when that is available agian. How much of that should I use?
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I don't give folic acid now but my cat never had trouble with neuropathy. I have given my other cat a b complex in addition to the b12 because he had kidney disease and anemia and needed the iron... That has folic acid in it. Nutrived B-Complex with Iron - 4 oz. https://www.amazon.com/dp/B000CQUCXC/ref=cm_sw_r_cp_api_WLvpzb8HHN3TM

You would still need the additional b12 as the b12 in this formula is cyanocobalamin not methylcobalamin.
 
ok. The vet said the b12-m wouldn't necessarily help arthritis but would help muscle strength. (which she had lost before diagnosed). I am thinking of doubling the Dasuquin when I hear the "creaking". My thinking is that more muscle will alleviate some of the creaking/discomfort...but she never seems uncomfortable just "creaky". Your question about the possibility of DN was something I had wondered about.

-Behavioral question. This morning AMPT was over 300. At +2 she had a big drop to 86. See SS. Her behavior is very normal, sleeping in sun, all 3 P's. When I look back at prior testing it seems like she has had a bigger drop after pretesting high in the AM. I know I need to do more regular before and after testing to confirm but have you noticed this with other Vetsulin cats? Also the other (6/10) evening she was very diabetic crazy ravenous eyes dialated and her bg test was lower than it was this morning? It's a sneaky disease but I'm trying to "watch and understand" what she is telling me. This is counter intuitive.
 
bbwyo said:
ok. The vet said the b12-m wouldn't necessarily help arthritis but would help muscle strength. (which she had lost before diagnosed). I am thinking of doubling the Dasuquin when I hear the "creaking". My thinking is that more muscle will alleviate some of the creaking/discomfort...but she never seems uncomfortable just "creaky". Your question about the possibility of DN was something I had wondered about.

-Behavioral question. This morning AMPT was over 300. At +2 she had a big drop to 86. See SS. Her behavior is very normal, sleeping in sun, all 3 P's. When I look back at prior testing it seems like she has had a bigger drop after pretesting high in the AM. I know I need to do more regular before and after testing to confirm but have you noticed this with other Vetsulin cats? Also the other (6/10) evening she was very diabetic crazy ravenous eyes dialated and her bg test was lower than it was this morning? It's a sneaky disease but I'm trying to "watch and understand" what she is telling me. This is counter intuitive.
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Wow huge drop... Too big. Crazy for such a tiny dose. Test again at 3 and feed. I loved vetsulin for my cat but I'm thinking your cat needs a more gentle insulin. Ask your dr about switching to lantus or ProZinc.
 
Did you see that! 3+ bg 129! HMMM? Thoughts! Im wondering about a different syringe. I try to mark and measure .25 but it's pretty difficult with u-40 s. I just fed again and she's pretty happy. taking another bath, conversant. ???
 
bbwyo said:
Did you see that! 3+ bg 129! HMMM? Thoughts! Im wondering about a different syringe. I try to mark and measure .25 but it's pretty difficult with u-40 s. I just fed again and she's pretty happy. taking another bath, conversant. ???
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Does your syringe have half unit markings? You could get u100's and use a conversion chart.
 
JanetNJ said:
Does your syringe have half unit markings? You could get u100's and use a conversion chart.
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yes i was reading about those. I have to go to town this afternoon and will see what is available. It sounds like the walmart relion ones are not as popular as others and that may be all that is available locally.
 
bbwyo said:
yes i was reading about those. I have to go to town this afternoon and will see what is available. It sounds like the walmart relion ones are not as popular as others and that may be all that is available locally.
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I ordered syringes from Adwdiabetes.com
 
bbwyo said:
yes i was reading about those. I have to go to town this afternoon and will see what is available. It sounds like the walmart relion ones are not as popular as others and that may be all that is available locally.
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i mean no they do not have half unit markers
 
JanetNJ said:
You can order them

https://www.adwdiabetes.com/product/18570/bd-pet-syringes-u40-29g-3-10cc-1-2in-half-unit
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thanks for info on ordering. I like the way you always say "if it was my cat":-) Not sure if this should be a new thread.
It has been just about a week on the new dosing .25 1x daily. It looks like she stays pretty stable at night but she has had a night or two when she gets the diabetic crazy hunger in the evening. I spread her meals out all evening with 1/2 FF Pure before bedtime (NC, HP) Is it too early to give up on the Vetsulin? we have talked before about how much she drops between preshot and +1/+2 test but she seems to be "Ok" during the day.

My concern is the numbers aren't stabilizing in the 126-127 range to allow for healing? How do I get there?
 
Curious how come you don't give insulin at night? If she's above 250 and you are around to test you might try giving a tiny bit more of a dose to get the nadir lower... Aim for 80-110 But make sure she's had a good meal first and test often.
 
i know but the Vet said to try the smaller dose once a day since she seemed to hit a point where she was getting really low numbers about 10 days ago. I have read you should go at least 6 cycles before changing dosing. I'm going to test her tonight at bedtime and see where we are in the morning. If you notice this morning's test was about the same as last night? I think the Vet is thinking her pancreas might kick in. I'm going to talk to the Vet in the morning about maybe trying prozinc or levemir. As an alternative I could continue with the Vetsulin but add a .25cu at night. BUT it seems like it hits her system pretty hard and doesn't last very long. Is it possible this might also be the case with any other insulin as well? What do you think?
 
JanetNJ said:
Curious how come you don't give insulin at night? If she's above 250 and you are around to test you might try giving a tiny bit more of a dose to get the nadir lower... Aim for 80-110 But make sure she's had a good meal first and test often.
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Do you mean adding another .25 cu dose at night? Then watching thru the evening?
 
bbwyo said:
Do you mean adding another .25 cu dose at night? Then watching thru the evening?
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Sorry but I have another question about having to be at the bg 126? number or lower for pancreas to start healing? Where does that number come from?
 
bbwyo said:
Do you mean adding another .25 cu dose at night? Then watching thru the evening?
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Yes. Vetsulin is ment to be dosed twice a day (unless of course you get a preshot too low to shoot which would be under 200 when you are first starting).

You don't have to her all night.... If you inject at 6 or 7 pm and do a quick check just before bed at 10 or 11 you will be able to see how the cycle is going.
 
bbwyo said:
Sorry but I have another question about having to be at the bg 126? number or lower for pancreas to start healing? Where does that number come from?
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Normal for a cat is 50-120 on a human meter. So when the numbers are in that range it gives the pancreas a rest where it can heal. Cats are unique in that they can heal and go into remission.
 
thank you Janet. I agree with everything you say. I dont' know what to think about the night time bg staying so stable. Do you think her body is adjusting to the introduction of insulin and once things settle down she will ease into the additional .25 cu and have a more gentle drop?
 
bbwyo said:
thank you Janet. I agree with everything you say. I dont' know what to think about the night time bg staying so stable. Do you think her body is adjusting to the introduction of insulin and once things settle down she will ease into the additional .25 cu and have a more gentle drop?
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Is she a lot more physically active in the daytime?
 
bbwyo said:
thank you Janet. I agree with everything you say. I dont' know what to think about the night time bg staying so stable. Do you think her body is adjusting to the introduction of insulin and once things settle down she will ease into the additional .25 cu and have a more gentle drop?
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Actually hold off on the increase for now... When she's getting those greens at +2 are you steering up? I am trying to figure out why she's going low and then back up...hmmm
 
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