Diabetic Cat France 2

 

France Information

This article provides information on Meters & Test strips, Syringes, Low Carb wet food choices, insulin and supplements for France.

La langue principale utilisée sur DCI est l’anglais, cependant, nous avons un membre qui parle français.

Si vous avez des questions, n’hésitez pas à les poser directement sur le site en anglais ou en français.  Nous ferons de notre mieux pour vous répondre et vous aidez!

METERS & TEST STRIPS

Few – if any – vets will suggest home testing. All however seem accepting (if surprised) – and appreciate the extra information testing provides.

While all major brands of glucometers are available in France, most pharmacies tend to only stock one brand. Some models:

• Accu-Check:  Performa or  Performa Nano
• Bayer:  Contour XT
• Glucofix:  Mio  or Glucofix Premium
–  The Premium has a larger and much more legible screen and also will test for blood ketones (using separate strips)
–  Both use the smallest blood sample on the market (0.3ml)
• OneTouch:  Vita  or Verio
– The Verio has a much clearer, backlit screen than the Vita

To note: The Freestyle Lite, while widely available, has shown to give falsely lower than real numbers in mid-high range BGs for some cats. For this reason, it is recommended that you choose another Brand.

Buying a meter from a pharmacy is expensive (in general around 75€ minimum for the meter, a lancet pen, 10 lancets and 10 test strips).

It is well worthwhile using an on-line price comparer such as prixmoinscher  to check for lower options on line.

Very good prices can also be found on EBay at times. Do note that you can only buy meters (and test strips) from EBay France. Due to restrictions on the shipping of certain medical supplies and medications across border, they block the entire health category of sites outside of your own market.

You may also be able to request a free meter from some companies if you contact their customer service and simply say that you would like to try their meter (do NOT mention that you want to use it on a cat – they will tell you that their meters are only for humans). The companies make their money by selling the test strips, so are often happy to send the meter for free.

One company that has done so is Menarini Diagnostics, makers of the Glucofix meters. You may write to their customer service on their site here: http://www.menarinidiagnostics.fr/Contactez-nous

Test strips cost approximately 35-40€ for 100 strips in a pharmacy. While availability is quite limited and you have to be a bit lucky to fall on an offer at the right time, EBay France can be a source for more reasonably priced strips.

Amazon France may also on occasion have some strips on offer for a better price than in pharmacies.

SYRINGES

The only brand of 0.3ml U100 syringes to come with half unit markings in Europe is BD Micro + Demi  (the + Demi is the half unit markings). The half unit markings are necessary to allow you to dose small increments of insulin accurately.

There is no good on-line source for these, if it is possible occasionally to come across a good buy. In general, you will need to buy them from your local pharmacy. As the use of pens to administer insulin is more and more widespread, the pharmacy may need to order them for you (simply to keep in mind and so to not run out completely!).

FOOD

Important: If your cat is on high carb wet or dry food, please see the sticky Detoxing your Cat from High Carb Food under Starting TR for information on how to transition your cat to 100% low carb wet food safely.

Below is a list of some appropriate low carb foods available in France. Pet Food companies do change food frequently, so it is good to double check ingredients and carbs before you purchase.

As is the norm in Europe, figures are based on Nutritional/As Fed Analysis.

Please see the information in the stickies Calculating Carbs – Carb Calculator under Starting TR, and Choosing the right low carb canned food under Food & Felines in the Knowledge Centre for more information on selecting the best food for your cat.

 

AVAILABLE IN SUPERMARKETS:

Carrefour
• Terrines Junior ……………………..……………………………..3.3%
   – Contains sugar as last listed ingredient

Felix
• Terrines ……………………..………………………………………7,0%
– Contains sugar as last listed ingredient
• Tendres Effilés Gelée…………………………………………..….6.5%
– Contains extract of vegetable proteins and sugar as last ingredient

Gourmet
• Gourmet Gold Les Mousselines ………………………………..8.8%
– Contains extract of vegetable proteins and sugar as last ingredient
• Gourmet Perle Filettines en Sauce…………………………..….8.6%
– Contains extract of vegetable proteins and sugar as last ingredient

Sheba
• Duo Emincés en Fine Terrine………………………………..…..5.2 %
• Finesse Delicate mousses………………………………………8.2%
• Plaisir en gelée……………………………………………….……5.0%
• Terrines Classiques……………………………………………….3.9%
– Coffret Gourmand, Cocktail de Volailles, Canard, Oie

AVAILABLE ONLINE (Zooplus – see note below)

Animonda
• Pouches – Exotic: Buffalo, Kangaroo or Ostrich………………..3,7%
• Pouches – Classic: Poultry & Veal, Turkey & Lamb or Beef & Turkey Hearts…………………………………………………………………5,8%
• Senior Trays: Beef, Poultry or Lamb……………………………..7,1%
• Adult Trays: Poultry & Veal, With Turkey Hearts, Multi-Meat Cocktail, Turkey & Rabbit or With Chicken Liver…….5,8%

Bozita
• 400g Tins: Poulet, Boeuf, Saumon, Crevettes.……………….5.5%
• Tetrapaks: Bouchées in Jelly…………………………….….…..7.1%
• Tetrapaks: Bouchées en Sauce…………………………………7.1%

IF YOUR CAT HAS RENAL PROBLEMS/LOWER PHOSPHOROUS

Integra Protect Diabete
• Available from zooplus (0.9% phos.)…………………………..7,2%

Specific FXW
• Available from Zubial (0.74% phos.)………..…………..……..7.4%
• Does contain psyllium and some rice

TREATS: Zooplus (see note below)
Thrive freeze dried treats
Cosma freeze dried treats (less expensive) : Regular or XL, do NOT buy THAI (which contain rice)

ZOOPLUS

Zooplus is an excellent source for food, treats, scratching posts, litter boxes, litter, etc.

The zooplus.de site is significantly less expensive than the zooplus.fr site. You do not need to speak German to use it: it is set up identically to the French site so it is very easy to find your way around, if it can be helpful to have the French site open at the same time to check back and forth quickly.

The german site has recently changed policy, and there is a flat 7.99€ delivery charge no matter how much you are ordering from them (it used to be free over 100€).  Nontheless, the difference in price is such, that if you are bulk buying and ordering 80€-100€ at least through them, you will still come out ahead.  On certain items, even a smaller order will probably still be less expensive on .de as the product is sold for very much less there.

It is very worthwhile checking both .fr and .de to find which is the least expensive for the order you want to place!

Note also that on both the .fr and .de sites, there is a discount for a bulk order of 100€ or more. The german site has recently dropped that to 2%, on the french site it remains at 3%.  You need to enter the following discount code:

- On zooplus.fr: COMMANDE-GROUPEE
– On zooplus.de: SAMMELBESTELLER

Again, do check the cost on both sites before placing your order!

INSULIN

Please see Insulins, Starting Scales & Dosing Criteria under Starting TR in the Knowledge Centre for full information on the different insulins.

As of 2016 there are now two vet insulins available in France:  Caninsulin and the new on the market ProZinc. Your vet does need to prescribe one of the two first. Only if your cat is not doing well on it will it be possible to move to another insulin. Both Lantus and Levemir are available in France. It is also possible, if your vet is willing, to import Hypurin Bovine Protamine Zinc from the UK.

The ease with which you will be able to get a prescription for an insulin other than Caninsulin or ProZinc (particularly Hypurin as it is not on sale in France) depends very much on the vet: some are very open, others not at all. In all cases, you will have to give it a “good try” and prove that your cat is showing poor results, for a switch to be considered. Maintaining a good test log can make a big difference!

Caninsulin

Caninsulin is a U40 vet insulin, used on both dogs and cats.

Caninsulin is available in vials or increasingly in a pen form. The lowest dose on the pen is 0.50u. It is strongly recommended that you use 3/10cc-0.3ml syringes with half unit markings to dose, even if you have the pens in order to be able to dose small increments. The top of the cartridge is clearly visible when you remove the cap – you simply stick the needle of the syringe into the stopper.

Please note that a conversion is necessary to dose U40 insulin with U100 syringes. See Converting U40 insulin to U100 syringes under Useful Tools & Tips in the Knowledge Centre for more information on the conversion.

ProZinc (available as of 2016)

ProZinc, like Caninsulin is a U40 vet insulin; however unlike Caninsulin it is specifically made for use on cats.  It was created in the US to replace the previously available manufactured PZI bovine insulines.  Those insulines became difficult to manufacture as sources of beef pancreas dried up over the Mad Cow disease.

ProZinc is available in vials only to date.  It is strongly recommended that you use 3/10cc-0.3ml syringes with half unit markings to allow you to dose accurately and consistently, given the difficulty in finding U40 syringes with half unit markings (they will appear on the market from time to time…. to then disappear).

Please note that a conversion is necessary to dose U40 insulin with U100 syringes. See Converting U40 insulin to U100 syringes under Useful Tools & Tips in the Knowledge Centre for more information on the conversion.

 

Hypurin Bovine Protamine Zinc

Hypurin Bovine PZI, made in the UK, is the only manufactured Bovine PZI available in the world today. As it is a bovine insulin, it is only one amino acid away from a cat’s own insulin.

Hypurin Bovine PZI is a U100 insulin available in vial form only.

You can order and import Hypurin into France from Masters Global. The contact is Julie Emms. She is very experienced in handling overseas shipments and is very helpful (she also is, incidentally, a cat lover!). Her email address is: julie.emms@mastersglobal.com

Hypurin is available in 100ml vials, and Masters Global do require that the original prescription be mailed to them. They will prepare the order with a faxed or scanned copy to speed things up, but will not mail it out before receiving the original prescription. The insulin is overnighted in a cold pack, and must be delivered to your vet (EU regulations do not allow delivery directly to you). It is sent in a large Styrofoam pack, and the insulin is kept very well protected during the trip.

Make sure that your vet has checked “renewable/ à renouveller” at the bottom of the prescription: the prescription will be kept on file for a year so you can order refills without having to go back through your vet each time.

Make sure also that the prescription is for Bovine Protamine Zinc: Hypurin does exist in several other forms.

It is worthwhile ordering several vials at a time:

1. It is always good to have at least one back-up vial in case you drop and break yours (especially in the case of an insulin that you cannot replace at the local pharmacy!), or if for some reason it becomes damaged.
2. The shipping cost is the same for one or several vials (check with Julie as to the current costs and number of vials you can include in one shipment). Hypurin is very stable as it is manufactured, and can be stored in the fridge and used for a long time (members have even used it well after its official expiration date).

Lantus (Glargine) & Levemir (Detemir)

Both Lantus and Levemir are available for human use in France and can be prescribed by your vet and purchased in any pharmacy. While both are unknown to most vets (you will need to specifically ask for them by name), they are becoming more well known as alternatives when a cat is getting nowhere on Caninsulin.

Which one your vet is more open to will depend on where he or she went to vet school in most cases: Maisons Alfort is a “Lantus” school; Nantes is a “Levemir” school, for example.

Lantus is available in vial, cartridge (5 cartridges/box) or pen form. The cartridges are more cost effective as there is less chance of the cartridges losing potency before you have finished one vs. the usual 10ml vial.

Levemir comes in pen form only. It is possible (and necessary) to use a syringe with these – they only dose in full units (1u, 2u, 3u).

SUPPLEMENTS

Few supplements are available in pharmacies; some can be purchased on French websites, others via other European or US sites. When it comes to European sites, it is better to find non-UK sites if possible – simply as continental shipping takes 2-3 days, whereas from the UK it seems to take 5-7 days.

Iherb.com is a very good source for supplements: the prices are good and above all the shipping prices to Europe are excellent.  Shipping does take about 10 days – 2 weeks usually (and may take longer), so do plan ahead and don’t let yourself run out of an important supplement for your cat.

Many supplements do contain fillers that are not appropriate for diabetic cats, such as rice powder or hidden sugars. Please check the ingredients carefully before purchasing, and post in Introductions & Questions if you would like some help in choosing the best supplement.

Appetite Stimulants:
• Periactin ( Cyproheptidine): available in any pharmacy

B50 Complex:
• B50 Complex:   NOW B50 Complex – iherb

Cancer aid/support:
• IP6 Gold:  IP6 Gold – iherb
• Curcumin (and excellent anti-inflamatory): Jarrows Curcumin – iherb
• CQ10 (also good for heart issues:  Doctor’s Best Ubiquitol – iherb

Digestive Issues:
• PepsidAC has unfortunately been taken off the market in France. Famotidine (the molecule in PepsidAC/generic) is available, but only in 20mg tablets and only by prescription. The tablets are small, and it is virtually impossible to cut them into 1/8s to give the correct dose of 2.5mg/BID. If your cat is suffering badly from acid/burning you can give half a tablet of the 20mg Famotidine for 1-2 weeks maximum if your vet will give you a script.
• Slippery Elm Bark: from the UK at  G Baldwin & Company

Immune System Boosters:
• Agaricus Blazeii: Doctor’s Best Agaricus – iherb
• Mushroom Optimizer (7 Mushroom blend):  Jarrows Mushroom –  iHerb

Neuropathy: Methyl Cobalamin B12
• Zobaline (Methyl B12 for FD cats): Lifelink
–  Note: Shipping to Europe is very expensive

Omega 3:
• Krill Oil:  NOW Krill Oil – iherb

Pancreatitis Supplements:
• L Carnitine (must be pure L Carnitine, not acytel or D variety ): NOW  L-Carnitine from iherb
• Milk Thistle Powder: Jarrows MT  –  iHerb
• SamE – Denemarin Tablets: Vet UK

Note: It is important to buy extract of Milk Thistle and not simply “100%” MT – the full plant does not have a high enough % of silymarin. Therefore, the Arkopharma gelules, for example, that you find in many pharmacies are not the right choice (only 1,4% silymarin).

Taurine:
• Taurine:  My Protein Company
:

Exams (Blood work)

Thyroid:
The basic thyroid test done seems to be usually Free T4. You will need to request T4 and T3 suppression test to definitively confirm diagnosis of Hyperthyroidism.

Pancreatitis:
A number of vets do not seem to want to do the Spec fpl1test so some pushing may be needed.

Here is link to information about the test in French that can be shown to your vet. In the sidebar is some very good information about pancreatitis in general:  IDEXX Pancreatitis/Francais

 

Last updated Sep16

 

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