Obtaining the PZI (insulin) from the vet has been a shmozzle.
I wanted the Beef, she got me the human. I requested three weeks ago that I really wanted the beef and haven't heard back. grrrrr
In the meantime, I am trying a new human insulin called Levemir. It is long acting and a basal insulin, like Lantus was. We are still in early days (barely two weeks) and I think Kitty's numbers are better than they were on 4 months of Lantus but still too high.
The feline diabetes fun and games continue.
Levemir, I hope you're the trick.
Showing posts with label Insulin. Show all posts
Showing posts with label Insulin. Show all posts
The Importance of Home Glucose Testing
We test Kitty's blood sugar at home, using a human glucometer. We prick the edge of his ear and use take a small drop of blood as a sample to measure how much sugar is in his blood. This is an absolutely invaluable tool for us, especially since Kitty has proven so difficult to regulate.
Case in point: Last week, his numbers were terrible. Worse than usual. I thought we had totally lost the plot in treating his feline diabetes. I was giving more insulin, but the response was poor. I had a thought: perhaps my Lantus insulin had gone "off"? It looked fine. Most people find that they get foreign matter, particulate or "floaties: in their Lantus as in indicator that it may be losing effectiveness. We had no such cue. The other issue is that Kitty is so wildly unregulated, we thought this was par for the course.
On a whim, I purchased a fresh bottle of Lantus on Sunday. His morning preshots have been 22-28 mmol/dlLlast week. This morning he was at 14.6 mmol/dlL. Last night I gave him 4U of insulin. Today I decided that I should reduce that and gave him 3U. When I came home at lunch, he was at 5.6 mmol/dl and quickly dropped to 2.7 mmol/dL. (Note normal ranges for healthy cats are 4-8 mmol/dL. For diabetics, we don't like them to go too far below 6 mmol/dL because they do not have the mechanisms as we do to prevent hypoglycemia (low blood sugar) which can have terrible consequences. However, I gave him some Pounce treats and once he was on his way up, I felt it was safe to go back to work. Luckily my employer is kind and patient; I was gone for over 3 hours!
Tonight, his preshot was only at 5.4 mmol/dL, four hours after I last tested him. Shooting at this level is asking for trouble, as today has proven. If I hadn't been testing him, I would be giving insulin blindly and possibly causing harm. I am going to wait and see if I can give him a shot later this evening. Hopefully we will be able to manage this overlap better, but for now, this is what we have to do.
Ignorance is bliss, but not when dealing with feline diabetes.
Case in point: Last week, his numbers were terrible. Worse than usual. I thought we had totally lost the plot in treating his feline diabetes. I was giving more insulin, but the response was poor. I had a thought: perhaps my Lantus insulin had gone "off"? It looked fine. Most people find that they get foreign matter, particulate or "floaties: in their Lantus as in indicator that it may be losing effectiveness. We had no such cue. The other issue is that Kitty is so wildly unregulated, we thought this was par for the course.
On a whim, I purchased a fresh bottle of Lantus on Sunday. His morning preshots have been 22-28 mmol/dlLlast week. This morning he was at 14.6 mmol/dlL. Last night I gave him 4U of insulin. Today I decided that I should reduce that and gave him 3U. When I came home at lunch, he was at 5.6 mmol/dl and quickly dropped to 2.7 mmol/dL. (Note normal ranges for healthy cats are 4-8 mmol/dL. For diabetics, we don't like them to go too far below 6 mmol/dL because they do not have the mechanisms as we do to prevent hypoglycemia (low blood sugar) which can have terrible consequences. However, I gave him some Pounce treats and once he was on his way up, I felt it was safe to go back to work. Luckily my employer is kind and patient; I was gone for over 3 hours!
Tonight, his preshot was only at 5.4 mmol/dL, four hours after I last tested him. Shooting at this level is asking for trouble, as today has proven. If I hadn't been testing him, I would be giving insulin blindly and possibly causing harm. I am going to wait and see if I can give him a shot later this evening. Hopefully we will be able to manage this overlap better, but for now, this is what we have to do.
Ignorance is bliss, but not when dealing with feline diabetes.
Top 8 things required to optimize treatment of a diabetic cat
Below is my Top 8 list of things that will help you to regulate your diabetic cat.
1) A diabetic cat: really, otherwise, what's the point? (small joke)
2) A glucometer used to measure blood glucose: We use the AccuCheck Advantage. Many people do not test their cats at home and the cats do just fine. However, it can save a lot of money by not getting curves done at the vets as well as time and stress on the cat. As well, it's is a great tool if something doesn't seem right and you want to see if your cat is suffering from hypoglycemia (low blood sugar).
3) A low carb cat food. Feed your cat what he will eat. However, if you can switch to a high quality low carbohydrate cat food, that may reduce your cat's insulin needs. My diabetic cat does not like wet food much, so I am feeding him Science Diet MD, a lower carb dry food available by prescription from the vet. He likes it, so we are sticking with this for now.
4) A cooperative vet knowledgeable in feline diabetes: We are lucky, our vet is wonderful and lets us do all our testing at home and then report in to her, where we make dosing decisions. It would be a nightmare if we had to take Kitty to the vets for this!
5)Insulin: A long lasting insulin such as PZI, Lantus, Caninsulin/Vetsulin.
6) Syringes: We started with Caninsulin and the syringes that we purchased did not work well for us. Kitty would fight his shots. We ended up buying syringes from the pharmacy, BD Ultra Fine, 31 gauge, short needles and have not had a problem since. Note that insulin comes in different strengths, U100, U40, U50 (all of which indicate the number of units of insulin ber ml). Therefore, if your cat is getting Caninsulin, a U40 insulin and you wish to use the U100 thinner syringes, you would need to inject two and a half times as many units using the U100 syringe. If you were giving your cat 2 units of Caninsulin, using the U100 syringes, you would take the insulin to the 5U mark. Please make sure to double check with your veterinarian before changing syringes. Ideally, it is best to use the syringe designed for your insulin, but there are options if you run into trouble.
7) Ketostix: These are available at any pharmacy and are used by people to check for ketones in the urine. Ketones are formed when there is a) not enough food and/or b)not enough insulin. The body starts to metabolize body fat, and a by product is ketones. A serious complication of ketones is possible diabetic ketoacidosis (dka), which requires immediate veterinary attention. If you ever check your cats urine and see ketones, it is best to contact your vet immediately.
8) Patience: Regulation is not a race. Start with low doses and increase slowly. Cats can live with high blood sugar for a long time (it has been 5 months for us with little improvement) but extremely low blood sugar can kill very quickly.
Good luck treating your diabetic cat!
1) A diabetic cat: really, otherwise, what's the point? (small joke)
2) A glucometer used to measure blood glucose: We use the AccuCheck Advantage. Many people do not test their cats at home and the cats do just fine. However, it can save a lot of money by not getting curves done at the vets as well as time and stress on the cat. As well, it's is a great tool if something doesn't seem right and you want to see if your cat is suffering from hypoglycemia (low blood sugar).
3) A low carb cat food. Feed your cat what he will eat. However, if you can switch to a high quality low carbohydrate cat food, that may reduce your cat's insulin needs. My diabetic cat does not like wet food much, so I am feeding him Science Diet MD, a lower carb dry food available by prescription from the vet. He likes it, so we are sticking with this for now.
4) A cooperative vet knowledgeable in feline diabetes: We are lucky, our vet is wonderful and lets us do all our testing at home and then report in to her, where we make dosing decisions. It would be a nightmare if we had to take Kitty to the vets for this!
5)Insulin: A long lasting insulin such as PZI, Lantus, Caninsulin/Vetsulin.
6) Syringes: We started with Caninsulin and the syringes that we purchased did not work well for us. Kitty would fight his shots. We ended up buying syringes from the pharmacy, BD Ultra Fine, 31 gauge, short needles and have not had a problem since. Note that insulin comes in different strengths, U100, U40, U50 (all of which indicate the number of units of insulin ber ml). Therefore, if your cat is getting Caninsulin, a U40 insulin and you wish to use the U100 thinner syringes, you would need to inject two and a half times as many units using the U100 syringe. If you were giving your cat 2 units of Caninsulin, using the U100 syringes, you would take the insulin to the 5U mark. Please make sure to double check with your veterinarian before changing syringes. Ideally, it is best to use the syringe designed for your insulin, but there are options if you run into trouble.
7) Ketostix: These are available at any pharmacy and are used by people to check for ketones in the urine. Ketones are formed when there is a) not enough food and/or b)not enough insulin. The body starts to metabolize body fat, and a by product is ketones. A serious complication of ketones is possible diabetic ketoacidosis (dka), which requires immediate veterinary attention. If you ever check your cats urine and see ketones, it is best to contact your vet immediately.
8) Patience: Regulation is not a race. Start with low doses and increase slowly. Cats can live with high blood sugar for a long time (it has been 5 months for us with little improvement) but extremely low blood sugar can kill very quickly.
Good luck treating your diabetic cat!
Somogyi Rebound in Feline Diabetes
Contrary to what common sense would tell us, there are times when the best solution to high blood glucose numbers is to give LESS insulin. This instinctively seems wrong. However, there is very interesting physiology to explain this phenomenon.
In a non-diabetic, there are two hormones that maintain blood glucose levels. These are insulin, and glucogen, both produced by the pancreas. Insulin allows the body to use sugar in the blood or to store it for later use. Glucagon is basically offering a moderating effect to insulin by causing cells to release glucose. Therefore, in a non diabetic, if the blood sugare goes too low, the glucagon will utilize some of the stored glucose. These hormones work together to moderate blood sugar levels.
In a diabetic cat, if the blood sugar drops too low or drops too quickly, the glucagon causes the liver to indiscrimintely dump glucose into the bloodstream. This causes the cat to become hyperglycemic (high blood sugar). It is the body's self defense mechanism to stop hypoglycemia(low boood sugar). This is a simplistic description of the phenomenon as there are other hormones and biochemical processes involved, however this is essentially the mechanism.
This sharp drop followed by unusually high blood glucose levels is known as Somogyi rebound.
Because of all the hormones involved in this process, this rebound may last several cycles,
punctuated by higher blood glucose levels. The blood glucose curves will possibly be flat and high, which normally indicates that more insulin is required. However, this is not the case and the treatment for somogyi is a REDUCTION in insulin, to stave off the precipitious drops that start the whole cycle.
Somygi is difficult to detect but if you are having trouble regulating your cat despite increasing insulin levels, please discuss with your veterinarian the possibility of somogyi rebound.
In a non-diabetic, there are two hormones that maintain blood glucose levels. These are insulin, and glucogen, both produced by the pancreas. Insulin allows the body to use sugar in the blood or to store it for later use. Glucagon is basically offering a moderating effect to insulin by causing cells to release glucose. Therefore, in a non diabetic, if the blood sugare goes too low, the glucagon will utilize some of the stored glucose. These hormones work together to moderate blood sugar levels.
This sharp drop followed by unusually high blood glucose levels is known as Somogyi rebound.
Because of all the hormones involved in this process, this rebound may last several cycles,
punctuated by higher blood glucose levels. The blood glucose curves will possibly be flat and high, which normally indicates that more insulin is required. However, this is not the case and the treatment for somogyi is a REDUCTION in insulin, to stave off the precipitious drops that start the whole cycle.
Somygi is difficult to detect but if you are having trouble regulating your cat despite increasing insulin levels, please discuss with your veterinarian the possibility of somogyi rebound.
Feline Diabetes Symptoms
So, today I am digressing a bit from our history to discuss Feline Diabetes Symptoms. If you have stumbled upon my blog and think your cat may have feline diabetes, here are a few things to look out for:
1) Increased drinking: (also known as PD, or polydipsia) the kidneys are working, trying to filter out the excess glucose from the bloodstream. This creates terrible thirst. This was the first symptom of feline diabetes that I noticed with Kitty.
2) Increased urination: (also known as PU, or polyuria-note that increased drinking/urination is often abbreviated as PU/PD) as a result of the increased water intake.
3) Ravenous hunger: the body cannot use the nutrition it is getting, therefore, the cat feels hungry all the time.
4) Weight loss despite ravenous hunger: Again, the body cannot use the calories it is getting.
These are all Feline Diabetes Symptoms.
If your cat is experiencing one or more of these symptoms, please schedule an appointment with your veterinarian. There are other diseases that have similar symptoms, so a medical assessment is absolutely necessary before beginning any treatment.
The veterinarion will usually do a full blood workup and urinalysis. The bloodwork in an unregulated diabetic cat will show elevated glucose levels. The urine will have glucose in it as well, as the extra glucose from the blood stream will "spill over" into the urine.
Your vet will check for urinary tract infections, because bacteria can thrive in the sugary environment of a diabetic cats urine. Note that the bloodwork may show compromised kidneys, which may or may not be real. Many cats, once regulated, have their kidney values return to normal.
The indicators od renal disease are increased creatinine and blood urea nitrigen (BUN). However, these numbers MAY be elevated due to the overwork on the kidneys because of the PU/PD.
Finally, the vet may do a test called a fructosamine. In layperson's terms, this gives a longer term average of what the blood sugar values are. It can give an indication of how long the cat has been diabetic, or in a diagnosed cat, how well controlled they are.
If you find out that your cat has feline diabetes, do not despair. In subsequent days, we will delve more into the treatment, costs associated with and current research on feline diabetes.
1) Increased drinking: (also known as PD, or polydipsia) the kidneys are working, trying to filter out the excess glucose from the bloodstream. This creates terrible thirst. This was the first symptom of feline diabetes that I noticed with Kitty.
2) Increased urination: (also known as PU, or polyuria-note that increased drinking/urination is often abbreviated as PU/PD) as a result of the increased water intake.
3) Ravenous hunger: the body cannot use the nutrition it is getting, therefore, the cat feels hungry all the time.
4) Weight loss despite ravenous hunger: Again, the body cannot use the calories it is getting.
These are all Feline Diabetes Symptoms.
The veterinarion will usually do a full blood workup and urinalysis. The bloodwork in an unregulated diabetic cat will show elevated glucose levels. The urine will have glucose in it as well, as the extra glucose from the blood stream will "spill over" into the urine.
Your vet will check for urinary tract infections, because bacteria can thrive in the sugary environment of a diabetic cats urine. Note that the bloodwork may show compromised kidneys, which may or may not be real. Many cats, once regulated, have their kidney values return to normal.
The indicators od renal disease are increased creatinine and blood urea nitrigen (BUN). However, these numbers MAY be elevated due to the overwork on the kidneys because of the PU/PD.
Finally, the vet may do a test called a fructosamine. In layperson's terms, this gives a longer term average of what the blood sugar values are. It can give an indication of how long the cat has been diabetic, or in a diagnosed cat, how well controlled they are.
If you find out that your cat has feline diabetes, do not despair. In subsequent days, we will delve more into the treatment, costs associated with and current research on feline diabetes.
Diabetes afflicts cats & dogs
According to the Wikipedia Entry on Diabetes in cats and dogs-
Diabetes mellitus strikes 1 in 400 cats and a similar number of dogs. Symptoms in dogs and cats are similar to those in humans. Generally, most dogs and about half of cats experience type-1 (insulin-dependent) diabetes, rather than the type-2 that's now becoming common in obese humans. The condition is definitely treatable, and need not shorten the animal's life span or life quality. In cats, prompt effective treatment can even lead to diabetic remission, in which the cat no longer needs injected insulin. Untreated, the condition leads to blindness in dogs, increasingly weak legs in cats, and eventually malnutrition, ketoacidosis and/or dehydration, and death.
According to research at Cornell University-
Diabetes mellitus-also known as "sugar" diabetes-is a complex but common disease in which a cat's body either doesn't produce or doesn't properly use insulin. During digestion, the fats, carbohydrates, and proteins that are consumed in the diet are broken down into smaller components that can be utilized by cells in the body. One component is glucose, a fuel that provides the energy needed to sustain life.
Insulin is a hormone produced in the pancreas, is responsible for regulating the flow of glucose from the bloodstream into the cells of the body. When insulin is deficient or ineffective, the cat's body starts breaking down fat and protein stores to use as alternative energy sources. As a result, the cat eats more yet loses weight. Additionally, the cat develops high levels of sugar in the bloodstream, which is eliminated in the urine. In turn, sugar in the urine leads to excessive urination and thirst. Cat owners often notice these four classical signs of diabetes mellitus: ravenous appetite, weight loss, increased urination, and increased water consumption.
Welcome to Sugar Cats!
Hi, and welcome to my Sugar Cats blog.
For years I have had a cat with diabetes. Throught the Internet I discovered there were many others like myself, looking for information and support for dealing with feline diabetes.
I discovered there are treatments for cats with diabetes or sugar kitties as we call them. There are various types of insulin for cats with diabetes.
I hope you find my blog helpful.
For years I have had a cat with diabetes. Throught the Internet I discovered there were many others like myself, looking for information and support for dealing with feline diabetes.
I discovered there are treatments for cats with diabetes or sugar kitties as we call them. There are various types of insulin for cats with diabetes.
I hope you find my blog helpful.
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