Anyone used caninsulin in cats?

Re: Anyone used caninsulin in cats?

Andrew Kent — Sun, 02 Jun 2013 09:04:26 GMT

I disagree that we should be happy with anything but tight control of hyperglycaemia in cats. Dogs yes, but the effect of glucose toxicity on cats means that we should aim to achieve tighter control. Ultimately if we do then we have a reasonable chance of 'curing them'.

Re: Anyone used caninsulin in cats?

Stephen Courtney — Sat, 01 Jun 2013 21:30:36 GMT

I have treated cats with diabetes and a requirement for prednisolone in the past and while it isn't ideal, it isn't a disaster either.

look at the bigger picture - the cat has to have the prednisolone, so stop beating yourself up.

caninsulin works, fine, but I',m not convinced you need to be unghappy with your current insulin, i doubt canionsulin would do much better, but i do prefer the 40 iu/ml composition for cats. the 10ml human bottles of U100 insulin don't last forever, and using stale insulin is a common cause of instability. using the insulin till it goes cloudy is a bad idea. I used to try to get clients to replace their insulin every three months, but since our previous insulins disappeared we are stuck with caninsulin, and now i am used to it, I much prefer it. the 2.5ml bottles last about 3 weeks for most cats, longer for some.

I don't think it is important to worry about random glucose levels, unless the cat is having hypoglycaemic events. I only do curves in difficult cases, as i feel the stress involved is unhelpful, though i do have a few clients who do BG testing at home with glucometers, and this can be useful, though it does rather depend on the client...!

I like to monitor fructosamine, and like to keep cats between 450 and 600 - sorry cant remember units - while accepting this means they are still pretty diabetic in some cases, it does minimise the risks of hypoglycaemia which is immediately life threatening. what i tend to do, if the cat is well and eating and not too polydipsic, and not losing weight ( many actually keep gaining weight, probably acromegalic, but as you can't fix that i tend not to look for it) and the fructosamine is reasonable, and the cat and owner are happy, then i am happy.

You are caught between a rock and a hard place with this cat, but I bet it is not as bad as you fear.

Cats don't get cataracts from hyperglycemia , the worst i tend to see in unstable diabetics is diabetic neuropathy, and i have a few nightmare elderly diabetics with multiple issues - one has kidney disease, pancreatitis and hyperthyroidism as well as being 19 years old. very dedicated owners too.....not sure how lucky she is.

I have little experience with glargine - jsut one case - the theory is that a type II diabetic on a weight loss program and glargine may well go into remission and come off insulin. I don't think it is likley that an established diabetic would do that, but am prepared to bow to experience of others. due to the cascade issue i rarely consider glargine, possibly because of uniformly satisfactory results with caninsulin.

Re: Anyone used caninsulin in cats?

patrick murphy — Sat, 01 Jun 2013 14:08:46 GMT

the original presentation of this research was at NAVC and that is what they used in their trials. lady announced, finally proof that the Atkins diet works, bad news, it's in cats.

Re: Anyone used caninsulin in cats?

Anthony Dennison — Fri, 31 May 2013 21:14:03 GMT

[quote user="Martin Atkinson"]

Cue an entrance for Tom or his RMB disciples!

[/quote]

Elections are over. No doubt this thread will resurface next year when they come round again

Re: Anyone used caninsulin in cats?

Martin Atkinson — Wed, 29 May 2013 14:13:45 GMT

[quote user="patrick murphy"]

special diets would be great, if they did not run out of them so often.

[/quote] Don't need special diets, high protein/low carbohydrate diets are the way go - basic canned kitten food. Cue an entrance for Tom or his RMB disciples!

Re: Anyone used caninsulin in cats?

patrick murphy — Wed, 29 May 2013 13:27:37 GMT

special diets would be great, if they did not run out of them so often.

Re: Anyone used caninsulin in cats?

Martin Atkinson — Tue, 28 May 2013 12:48:09 GMT

[quote user="David Mills"]

I find caninsulin very unreliable in diabetic cats. I usually find any reason possible to switch to glargine - despite its extra cost, there are some studies showing 80% of cats' diabetes resolves within 6 weeks of therapy. Unlikely in this case, but I would be reaching for this - and as Mr Flynn says, 6m in the fridge is fine.

[/quote] Whats happening I'm (almost) agreeing with you David? If you haven't already discovered them, the 3ml pen cartridges keep the cost down. I wouldn't be happy advising keeping glargine for 6 months once opened but having said that in desperation I've used a 3 year old out of date soluble insulin which worked perfectly well on a patient in DKA.

Re: Anyone used caninsulin in cats?

Hannah Wynne Richards — Tue, 28 May 2013 10:25:30 GMT

Caninsulin is great in cats (as well as being legal)

Wynne

Re: Anyone used caninsulin in cats?

Robert Wilson — Tue, 28 May 2013 09:09:24 GMT

I thought that our Cascade meant that we had to use a licensed product before anything else and Caninsulin is licensed for use in cats. I have always found it to work well and most cats stabilize on between 1 and 2 iu bid. The Vet Pen is also a great idea for owners.

Re: Anyone used caninsulin in cats?

John Flynn — Tue, 28 May 2013 07:58:26 GMT

[quote user="David Mills"]there are some studies showing 80% of cats' diabetes resolves within 6 weeks of therapy. [/quote]

I must say I haven't seen these dizzy heights of success myself, but i would still recommend glargine in this case over caninsulin (personal preference).

Here's some links on practical use if you;re considering it:

http://www.uq.edu.au/ccah/docs/diabetesinfo/link5.pdf

http://www.uq.edu.au/ccah/docs/diabetesinfo/link3.pdf

Re: Anyone used caninsulin in cats?

David Mills — Mon, 27 May 2013 22:47:05 GMT

Re: Anyone used caninsulin in cats?

Moira Hamilton — Mon, 27 May 2013 22:38:55 GMT

Anytime steroids have been stopped, it has a severe effect on the cat, there was nothing on the bloods or urine to indicate anything else going on, but it is possible, unfortunately due to the owners circumstances (fighting lymphoma) their income has recently halved and so treating with other things is difficult, I've already got her on dietary control, and the steroid dose is 1mg sid. I diagnosed her about 3 months ago, and still haven't got any stable results to do a glucose curve. At present the lowest I've got her down to is 13mmol/l glucose, she isn't as thirsty, but lately has been having a few bad days, though which disease is causing this is hard to tell, sadly since coming off steroids isn't an option will definitely see if canninsulin works better than the lente, at least she would be getting it fresh due to the vial size! Doubt I'll ever be completely happy with her levels

Re: Anyone used caninsulin in cats?

Andrew Kent — Mon, 27 May 2013 20:49:37 GMT

Could you think about something else for the IMHA - either chlorambucil or cyclosporine (though cyclo also affects diabetic control). As other have said, the diabetes may resolve off steroids.

otherwise the problem here is the EOD dosing so you haven't got a consistent level on which to plan your insulin therapy, it will be fluctuating. I don't think it is impossible to control a cat on steroids but it may be better if its on a stable dose every day.

as for caninsulin - go for it - is my first line and achieves good control in the majority of cases.

Andy

Re: Anyone used caninsulin in cats?

Dagmar Steele — Mon, 27 May 2013 20:30:12 GMT

I've just realised I made a mistake. I give it twice daily so should read bid. Language mess up, sorry!

Re: Anyone used caninsulin in cats?

Richard Sanderson — Mon, 27 May 2013 20:10:33 GMT

Caninsulin should be fine and is my first choice. I would commence at 0.25iu BID (i always use twice daily as they metabolise insulin faster than dogs) in the short term but would ensure the diabetes was cause not consequence. A diabetic cat on steroid therapy may have pancreatic islet amyloidosis (20% of the islet tissue is usually amyloid but some diabetic cats can have 80-90%), pancreatitis, renal disease, ketoacidosis etc. If could address this, it is possible the diabetes may be transient (~50%). Could the steroid therapy be cessated for a period or could consider a swab from prednisolone to methyl-prednisolone. Is the cat obese? Could you do a UPCR and culture (or cover with antibiotics if finances limited) in case of concurrent UTI. Or an abdominal ultrasound? Regarding diet I tend to try get high protein-low carbohydrate diets and if possible, to use it in a wet form as long as no concurrent renal disease.

Re: Anyone used caninsulin in cats?

Dagmar Steele — Mon, 27 May 2013 19:23:56 GMT

In Germany we have to use caninsulin as first choice in cats (cascade). Most of the time it works, if not, we swap to glargine. We usually start on 2 or 3 iE per cat tid and work our way up to not more than 2 iE /kg tid. Nver had good success treating diabetics on steroids.

Re: Anyone used caninsulin in cats?

John Flynn — Mon, 27 May 2013 19:11:01 GMT

I like glargine in cats and, while more expensive, I subscribe to the school that says if you refrigerate if lasts 6 months (few caveats with its use, so if not familiar and planning to use it, then do ask!)

Have used caninsulin in cats as well.

I'm a fan of changing to a low carb diet, which usually means a switch to wet food if fed on dry - many supermarket brands are low carb so doesn't have to be a hugely expensive switch.

Have never treated a cat on steroids for AIHA for diabetes, but I have treated a few that were on steroids for other reasons and never got stabilised until got them off the steroids - I hope you have better success!