Talk:Diabetes in cats

Is caninsulin the only *exclusively* vetrinarian insulin?
I realize there are many brands of insulin that may be used with cats and dogs. But I am asking if Caninsulin is the only one designed for cats and dogs, and exclusively available through vets. I worded the article to say its different than most insulin brands. However, I think better wording would be its the only purely vetrinarian insulin. However, I just don't know at the moment. If there are others, I would want the article to mention all of them. --rob 04:36, 23 August 2005 (UTC)


 * No it's not the only one.  PZIVet is also vet-only, although the IDEXX product does not have full FDA approval.  I don't know if they were all designed for vet-only use, but that's what they are now.  Caninsulin is known as Vetsulin in the USA.   Steve Rapaport 19:24, 2 September 2005 (UTC)


 * Caninsulin was originally devloped for humans!

Dosage and regulation
I'm a little uneasy about giving such detailed medical advice. We should definately mention common approaches, but not a step-by-step guide. Otherwise, there are so many caveats to put in, such as:
 * home testing doesn't work for many cats (thought micro-sampling is getting better)
 * Those who try it for a week or two generally succeed. Micro-sampling is down to 0.3 microlitres and quite reliable these days.  What kind of cats does it not work for?  What's your source?


 * home testing is risky if done to the paw which can get dirty/infected. Other place (like ear) could cause injury, and stil get dirty/infected.
 * I suppose it could, but I've been reading a very active forum with over 400 people posting dozens of postings daily.  The majority home test,  and this hasn't been a problem in the last 6 months, even for the newcomers. Searching for "ear infection" or related terms gives no search results for the last year. Ears are generally preferred to paws for hometesting in cats.  Lips in dogs.


 * glucose levels in-home and in-clinic are not easily compared due to stress
 * True. But nobody's comparing them in this article.   See next point.


 * stress, and therefore glucose readings, vary by cat, and hence the meaning of a number isn't so standard and simple as suggested
 * Stress affects glucose readings, but glucose readings don't become inaccurate due to stress. This doesn't change the meaning of the numbers.  Whether a high glucose number is caused by inadequate insulin, too many carbs, or stress, (or Somogyi Rebound) doesn't affect the damage caused by hyperglycemia.


 * some cats never give decent curves due to stress, and other approaches must be used, and can be successful
 * Curves done at the vet's are definitely prone to this problem. Curves done at home, once the cat gets used to them (a week or two) are quite accurate, not very stress-affected, and much more useful for finding a correct dosage than urine testing.  What other approaches did you have in mind?


 * very minor point: despite what the article says, home testing kits are initially cheap, but supplies can be expensive if used frequently
 * True, and worth mentioning.

Now, I didn't "fix" this, since I don't pretend my knowledge is better than anybody elses. I'm no vet. I just think we should avoid giving medical advice, talk of general approaches, and direct people to sites that give more detailed information, ideally vetrinarian web sites. Maybe with the best of intentions, we've gone a little to far. --rob 13:30, 2 September 2005 (UTC)


 * Rob, I'm sure there are plenty of caveats, but most of those don't ring true for me. I've run this article past the 400 or so most active users on the Feline Diabetes Message Board, which I read and post to daily ( http://www.felinediabetes.com/phorum5/list.php?8 ) and collected caveats and changes for 4 months now.  This board gets over 200 postings daily, includes at least one vet, several old-timers who have successfully cared for multiple diabetic animals, and is generally right more often than any given veterinarian on this one topic they know best.
 * If you want to delete large portions of hard-earned experience based on your own experience, please run your changes past these guys too.
 * Now I'd love to try directing people to veterinary web sites with more detailed information, if you can find them. But those I've seen are either vague or dangerously incorrect.  Do you have any suggestions?
 * Do any of the links I included at the bottom help?


 * This article is information, not advice. If you see  missing info, please add it in.  If you see information that seems questionable, challenge it.  But this information is important and needs to get out.   None of it should be hidden.
 * Steve Rapaport 19:22, 2 September 2005 (UTC)

Obviously, I didn't delete anything based on just my own experience, that's why I put it on the talk page. I have no plans to act unilaterally. That's what a talk page is for. You have stepped over the line, and are in fact, acting as a vetrinarian giving specific directions. Saying what's "recommended" or "necessary" is medical advice. Please tell me what more you would have to do, before it became medical advice? Even, a vet's assistant wouldn't go as far as you. Message boards don't make you a vet. Your comment that they are "right more often than any given veterinarian on this one topic they know best" pretty much shows you've decided that you know more than vets, and will now act in their replacement. I think your motives may be good, but you dangerously oversimplify, when you don't realize what exceptions exist. I won't make a big deal in this specific article, since there seems to be a larger issue of how does wikipedia make clear it's not a source of medical advice on medical issues. I will not address each of your points defending your medical advice, since I'm at least as unqualified to dispense medical advice as you. --rob 22:09, 2 September 2005 (UTC)


 * Rob, I'm interested in making this article neutral, but I don't want to remove the information painstakingly gathered from numerous websites (not to mention at least 2 vets) in the interest of "not giving medical advice". I also see postings like this about twice a week:
 * When I first found this web site two years ago, I thought it was overkill to test one's cat at home. Perhaps even a little crazy. After my experience and seeing what others are experiencing, I am now convinced it is the BEST and most sane thing one can do to help manage this disease. If I strictly followed the ER's vet's advice Andy would no doubt have hypo'ed big time and perhaps even died. Can you imagine what could have happened if I gave him his injection with a BG of 77? Yikes! I don't even want to know. --Dave & Andy




 * So I'm pretty keen on making sure people know how to test at home. That means, at minimum, giving them information on how it's done, what the general outlines of blood glucose levels mean, and what common problems they might encounter.  They should of course be encouraged to consult their veterinarians both before and after reading these things, but having a vet doesn't replace knowing the facts.  213.114.134.90 12:17, 6 September 2005 (UTC)

Comments on Somogyi re-bound
NOTE: I am new to Wikipedia. I have some information that is contrary to that presented in the article. Mis-diagnosis of a Somogyi re-bound prevented me from controlling my dog's diabetes for 6 months. My intent here is to start a discussion - that's what this is for, right?

(DISCLAIMER: I test my dog's blood sugar alot (sometimes every 30 minutes when exercising). The technique described below is a way of maintaining very tight control of BG and as such it can increase the risk of hypoglycemia. This method may not be suitable for any other dogs anywhere.)

I have been working with a diabetic dog for the last year using Dr. Richard K. Bernstein's book "DIABETES SOLUTION A Complete Guide to Achieving Normal Blood Sugars" modified for use with dogs (basically, my dog is on a no-carbohydrate diet). Dr. Bernstein flatly says that the Somogyi re-bound does not occur (in humans). He cites more recent research that indicates only mild insulin resistance occurring after periods of very low blood sugar. Re-bounds are caused by incorrect treatment of low blood sugar - i.e. too much carbohydrate being given.

One of Dr. Bernstein's rules-of-thumb is that 1g carbohydrate raises the blood glucose of a 140 lb human by 5mg/dL. For my 70 lb dog, it raises BG by 10mg/dL (I think this is just based on total blood volume which must be similar for canines and humans). One tablespoon of corn syrup will raise my dogs BG 160-170 mg/dL. For a 35 lb dog this would be 320-340 mg/dL. Since corn syrup is mostly fructose it is also slower than pure glucose (or dextrose) in raising blood glucose - fructose must be converted by the liver into glucose. Also, glucose can be directly absorbed into the blood stream - I don't know if this is true of fructose or not.

Dr. Bernstein recommends correcting low blood sugars with pure glucose. There are many forms of glucose available for humans. The solid forms are not especially good for dogs because even if you can get your dog to eat them (which I did fairly easily even though the flavors are not what a dog would typically like - orange,grape etc.) they do not chew them enough to rapidly absorb them (my dog crunches the wafer once and swallows the pieces). There are gel glucose products available (like Glutose) that work well but are expensive. I carry Glutose for emergencies because it is well preserved - it doesn't spoil.

I correct low BG in my dog with a solution of diluted chicken stock and dextrose (available as corn sugar at my local brewing supply supply for $1/lb). Dextrose is functionally equivalent to glucose (it is also known as D-glucose). I am careful about preparation (I boil the solution, disinfect the storage bottle with boiling water and do not keep it for more than 1 week) since it's is basically a growing solution for bacteria (this is why products like Glutose have snap off tops - they must only be used once). I prepare a 1L bottle containing 100g of corn sugar. 100 mL of this solution will raise my dogs BG by 100 mg/dL.

One disadvantage to pure glucose is that the effect only lasts for 45-60 minutes so if you are correcting for an insulin overdose you need to test BG and correct again about every hour.

My main use for this method is to correct low BGs that occur during exercise. I have corrected BGs as low as 17mg/dL without any re-bound. I also use it in advance of exercise to prevent low BGs from ocurring - for example the 17 mg/dL reading happened after a hike out of a steep canyon - I now give my dog doses before and during strenuous exercise.

Jgodwin4 19:16, 21 August 2006 (UTC)


 * This is fascinating but I don't see how this conflicts with the information given on Somogyi rebound. Somogyi is listed as one possible cause of high blood sugar.  Your information on correcting low blood sugar with pure glucose is fine, but doesn't relate in any way I can see to Somogyi rebound.  --Steve Rapaport 19:56, 3 July 2007 (UTC)

wide discrepancy in remission numbers/Tone and detail
"Remission can be induced in 20, 30, or even over 70 percent of type-2 diabetic cats who are properly regulated quickly." I found this statement very confusing in the absence of any explanation of this huge range in percentages. It could use a sentence or two about where are the numbers derived from and is this discrepancy related to some difference in cats' condition or treatment.

General comment: I know I have just suggested that more information to explain a confusing statement, but in general I wonder if this article may not have too much information. It contains SO many details, sometimes addressed in a personal style ("your pet"),that it reads less like an encyclopedia article than a manual or website for people who have diabetic pets--and ends up seeming like it attempts to replicate or substitute for such sources. Maybe it is beneficial to have this information, which the author notes was collected with a good deal of effort, assembled in one place, if the other sources do not have something comparable. The question would still remain, is an encyclopedia the right place?

However I am pretty inexperienced here and I perhaps do not fully understand all the policies and purposes. There are other articles that are very detailed and longer than this. And it's hard to say exactly how much is too much. But it seems to me that sometimes in an attempt to write an article that is the definitive source about a subject its author cares and (hopefully) knows a lot about, it is easy to get a bit carried away (I'd better admit here that I may not always keep my own tendency toward excess under a tight enough rein.) and the result is something more like a long journal article or some other type of publication or dissertation, than a typical encylopedia article. But then, this is not a typical encylopedia. Wichienmaat 05:10, 26 October 2006 (UTC)

Removal of Spam Tag in External Links
I did a cleanup of the external links section.
 * removed a couple dead links
 * also removed all links to message boards/forums including the Forums and communities section.


 * These edits are in line with WP:EL which states that there ought not be links to message boards. Any questions/issues feel free to contact me.  Thanks and happy editing! eLeigh33 17:21, 17 March 2007 (UTC)

Remission
"Remission can be induced in 20, 30, or even over 70 percent of type-2 diabetic cats who are properly regulated quickly" This sentence doesn't make any sense to me. Firstly because the 70 figure doesn't jibe with anything I've heard about remission and secondly because, well the sentence just doesn't make any sense. Percentages just don't work like that. If 70 percent of cats can have remission induced (and I doubt that figure) then mentioning the 20 or 30 percent is irrelevant. If there's some dispute over the numbers (and there is definitely some gray areas about remission) then I think the numbers have to be sourced and only ones that can be sourced should be used. Believe me, I wish it were 70 percent, but without a source, I think that figure needs to go. Cheers Dina 20:21, 8 April 2007 (UTC)
 * Since no one has responded I altered the sentence in question to read "about 20 percent of cats", which is what my online research indicates. Since we are presently trying to induce remission in one of our cats, I am quite personally aware that there is simply not enough research into this phenomenon to say much conclusively about it. As more data is gathered, it is possible that these numbers may change.  I sincerely hope that they do. Since my conversations with my vet are obviously not suitable resources for a Wikipedia article, we must go with published general wisdom, and my research indicates that the 20 percent figure is the most generally quoted, conservative figure.  I believe that that is what is appropriate for this article.  Cheers. Dina 18:47, 14 April 2007 (UTC)


 * Dina, the confusing figures are from different sources, which haven't been provided so I agree should not be cited. The "70%" figure comes from taking the Rand study from Univ of Queensland, which showed remission in 100% of 8 treated cats, and noting that with a sample size of only 8, the best possible claim with a good confidence is about 70%.


 * Since that analysis would be original research, I've removed it as you have, and instead simply quoted Dr. Rand's assertion that remission is a realistic goal for treatment in type-2 diabetic cats. I of course included her article as source for this citation.  Hope that satisfies!  --Steve Rapaport 16:07, 3 July 2007 (UTC)
 * I finally checked back and I like your changes. Thanks! Dina 21:23, 16 July 2007 (UTC)

With regards to remission, is it not worth mentioning that in dogs, if a female dog is entire (not neutered), the diabetes may develop after a season. If you spay (neuter) them soon enough, the diabetes may go away.Briony99 (talk) 23:15, 16 February 2010 (UTC)

Opinion about quality
This article makes me uncomfotable. It definitely NOT an encyclopedian article. One thing it lumps dog and cat diabetes together, although they are different TYPES of diabetes - most of the time (diabetes I vs. II). Therefore cat (easiest) focus is overepresented. This article is supposed to be of high priority because LOTS of pets suffer from diabetes. I'm proposing to separate dog and cat diabetes. They are different - most of the time they have different etiology, consequenses and prognosis. In addition, they require diff BG measurment techniques, have diff systemic reactions to high BG, etc. Please, whoever authorizied do something! —Preceding unsigned comment added by Ba dust (talk • contribs) 00:42, 14 June 2009 (UTC)

Very partial article
While there are limited authoritative sources, the way some sources are presented rather extensively makes me uncomfortable. There are e.g. advocates that Glargine should always be used to hold the blood sugar concentration in the physiological range (50-100mg/dL) and not above 100mg/dL as suggested in the article. The reason for this is quite clear, it's actually much harder - according to some studies - to hold the daily range between 100-180 than in the normal, healthy range. The chances of "undersugar" (below 40) with Glargine is minimal at a BID treatment.

The above is just one opinion held by some vets, the problem is that the other opinion is presented as gospel in the article without giving much regard for other ways to treat diabetes in cats. Oh, and I agree, the article should be separated in one for cats and one for dogs. 77.118.231.222 (talk) 09:44, 5 November 2009 (UTC)


 * I've fixed some of these complaints and updated the references to point to the most recent and successful methods of regulating rather than outlining them here. Steve Rapaport (talk) 11:54, 13 June 2010 (UTC) from Petdiabetes Wiki

Trying to split page
http://en.wikipedia.org/wiki/Diabetes_in_dogs

Trying to split this page into one for canine diabetes leaving this to become feline diabetes information.

We hope (talk) 04:15, 17 March 2010 (UTC)

Removing canine diabetes information as the canine information is now on the new Diabetes in dogs page.

We hope (talk) 01:37, 22 March 2010 (UTC)

Moved page
Changed title to Diabetes in cats to reflect the split of information into two pages.

We hope (talk) 02:02, 22 March 2010 (UTC)

Removed project dogs tags.

We hope (talk) 02:16, 22 March 2010 (UTC)

Clean up / article reads like a how-to
I just finished a ton of edits on the article. It was not encyclopedic at all and read like a how-to guide. Although I had a diabetic cat myself (RIP), it is important to remember that Wikipedia is not a set of instructions or a how-to. I tried to keep important information (especially that unique to cat diabetes vs human diabetes) while reducing the personal tone the article had ("your pet", "you should", etc). I would like to put more medical information in the article such as causes and pathophysiology (that isn't repeated in the diabetes article) since there is evidence that diabetes in cats is a bit different than in humans. The article probably needs a bit more cleaning up too. Sabar Cont 08:34, 28 July 2014 (UTC)


 * It's been a while since the previous comment, but I've done the same today - removed references that linked to pages which no longer exist, or to blogs, and also updated some references with more complete information. The page is still short on reliable citations, and the issues raised previously (lack of background, and reading like a "how-to" manual) are still there. Perhaps the page could be reorganized to reflect the sections listed in Manual of Style for Medicine-related articles which may aid in attempts to improve the content? DferDaisy (talk) 22:42, 21 January 2017 (UTC)

Renaming to "Diabetes mellitus in cats"?
Manual of Style/Medicine-related articles says: "The article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources, rather than a lay term (unscientific or slang name) or a historical eponym that has been superseded. These alternative names may be specified in the lead."

Given this, it would seem reasonable to change the article title? There are other types of diabetes other than diabetes mellitus, none of which are dealt with in this article. DferDaisy (talk) 16:32, 17 July 2016 (UTC)

Advert?
The part about the Vetmate glucometer just reads like an advert to me. Does that need to be edited, or perhaps completely removed? 194.176.105.133 (talk) 12:46, 24 October 2016 (UTC)

I agree this does not seem relevant to this article and looks like advertising. DferDaisy (talk) 17:54, 15 January 2017 (UTC)


 * I have deleted this advertising text. DferDaisy (talk) 21:40, 21 January 2017 (UTC)