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Posts Tagged ‘diabetes’

The new AAFP-AAHA feline life stage guidelines are published.

My initial thoughts, after a quick review:

I like that they recognize that the efficacy of dental treats/food is debatable.  One more “mark” against the myth that dry food benefits cats’ dental health! 

The use of dental treats and chews may be a realistic, practical alternative to daily tooth brushing, although data about their comparative efficacy is lacking.

 

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I’ve generally used a U-40 insulin (PZI-Vet) with U-100 syringes.  The advantages being that U-100 syringes are more widely available, and by using U-100 syringes with U-40 insulin I was able to make smaller dose adjustments.  (Before Meow Meow went off insulin, she was getting 0.2 units (two-tenths of a unit) of insulin!  NOT TWO UNITS – two-tenths of a unit!  No way I could measure that amount using a standard match of syringe to insulin.

Many find converting insulin to a different syringe confusing – and if, for that reason, you want to match – GREAT!  I recommend ALWAYS checking to make sure you KNOW which syringe and which insulin you’re using.  I’ve seen disasterous results when people don’t, and aren’t working with what they think they are.  Some insulins come in different strengths (like compounded PZI) and syringes obviously come in various markings – and there have even been cases where syringes were in the wrong box!  ALSO – make sure you understand whether your syringe is marked only for whole units, or also half units!  I’ve seen people advise others to count “lines” – well, whether you have lines only for whole units or whole and half units can DOUBLE YOUR DOSE!

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So, your cat is diabetic and you’re wondering which insulin you should be using to get those nasty blood sugar levels down (hopefully permanently so your cat can be managed on diet alone!)

My personal preference is PZI (protamine zinc insulin).  It’s duration is a little over 12 hours, which works well for a twice-daily dosing schedule.  (We WANT some overlap between doses, so we’re not dealing with very high blood sugar levels caused by no insulin being in effect.)   Once my supply of PZI-Vet by Idexx is exhausted, I’ll use a compounded PZI by BCP or Veterinary Pharmacies of America (VPA).  I’ve used BCP-PZI before with success – I noticed no difference between it and the PZI-Vet (except the lower cost).  As I’ve noted in the past, PZI-Vet by Idexx has been discontinued but that does NOT mean PZI is not available!  Compounded PZI is still available for use.

Louie says PZI works for me!

Louie says "PZI works for me!"

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My friend Adrienne said if vitamin B12 was a person, she thinks I might marry it. Maybe she’s right. I’m a big fan. Oh, I like lots of the vitamins, don’t get me wrong… love me some vitamin D for example, but you can overdose vitamin D, so you need to exercise some caution, and some feel supplementation of vitamin D can cause problems if you suffer from a autoimmune disease. As far as I know, while B12 is the only B-vitamin that seems to be stored by the body (in the liver), there are no known risks of overdose.

Where does vitamin B12 come from? It’s found in meat and dairy products. Vegans should consider vitamin B12 supplementation. Of course, my interest is in cats and if they’re fed properly (recognizing they are true carnivores) they should be getting vitamin B12 in their diet, but most commercial foods and homemade recipes supplement all the B-vitamins, just in case. The B-vitamins are water-soluble and, as I noted, generally not stored by the body, so there’s no known risk of overdose.

What can cause deficiency of Vitamin B12 in cats? Anything that causes excessive drinking and/or urination (diabetes, hyperthyroidism, kidney disease, etc.) can deplete B12 and the other B vitamins as they are “washed out” of the body. Giving sub-q fluids could deplete vitamin B. Chronic diarrhea can also deplete B12 as most B-12 is lost in fecal matter. Cats with an inflamed gastro-intestinal tract (such as cats with IBD) may not absorb B12 properly as it’s absorbed in the intestines. Vitamin B12 deficiency can cause anemia, neuropathy, other neurological issues, etc.
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 I’m pleased I’ve had more and more caregivers talk to me about putting their cats on a raw diet.  For those new to raw, I often recommend a pre-ground meat/bone product such as Hare Today, supplemented with a multi-vitamin/nutrient for cats such as Platinum Performance, as described in Dr. Elizabeth Hodgkins in her book “Your Cat: Simple New Secrets to a Longer Stronger Life“.

One problem – it seems some of these caregivers view this Hare Today/Platinum Performance combination to be some magical “cure” for what ails their cat (diabetes, IBD or chronic diarrhea, obesity, “allergies”, etc.)  In a way, it is a “cure” in that the cat becomes healthier and may no longer show any symptoms of their prior ailment (no more need for insulin, no more anemia, no more diarrhea, etc.)  However, in my opinion, it’s not so much that the particular food is a cure in that you’ve eliminated the *problem* (dry food). 
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I’ve worked with nine diabetic cats now – one of my own that was diagnosed after I adopted her (and responsible for teaching me so much), four adopted diabetics, and four fosters. Five were able to be “diet-controlled” (no requirement for insulin), the other four need/needed small doses of insulin along with an appropriate diet. (Two or three of those four had temporary bouts of remission.) As many caregivers ask my thoughts on feline diabetes, I thought I’d summarize my “personal beliefs” as they presently stand regarding effective treatment. I am always studying and learning new things when it comes to diabetes mellitus, so I expect as I learn more I’ll fine-tune my beliefs further.
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Gotta Have Faith

I gotta have faith… or do I?

Faith in veterinarians, that is.  Something foremost in my mind again, because of a couple of comments/emails lately.  One from a woman inquiring about raw diet and feline hyperthyroidism who said something to the effect of “I feel like I learn everything from an [internet forum] and you guys, and then have to turn around and teach my vet!”

I’ve sometimes felt the same.   For years, I just blindly followed the vet’s advice.  They went to school for years to learn just how to care for my cat, right?  Well, that was pretty naive of me.  First of all, we all know professionals in every industry imaginable that just aren’t that good at what they do.  Ergo, there must be veterinarians who aren’t the best as well – and how do we, the lay people, know whether our vet is the best or the worst or just somewhere in the middle?  If we’re not proactive and do some of our own research, we’re relying entirely on their “bedside manner”.

Secondly, vets generally get a four-year Bachelor’s degree in biology, then attend four years of veterinary school.  Do we really think they can learn absolutely everything about every animal species in four years?  Really?  As I often say, I’m sure I have less than 5% of the knowledge of most vets – I know next-to-nothing about any animals other than cats.  (Cows are the ones that say “moo”, right?)  I know little about feline parasites and next-to-nothing about surgeries and probably can’t name more than one or two bones in their little furry bodies and struggle with most terms, and have to think (hard) to remember which end is proximal versus distal.
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