How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 28533
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
Type Your Cat Veterinary Question Here...
Dr. Michael Salkin is online now
A new question is answered every 9 seconds

Salkin, It's Zolezio, caretaker of Sami, the constipated

Customer Question

HI Dr. Salkin, It's Angela Zolezio, caretaker of Sami, the constipated kitty with diabetes you helped me with a couple of months ago. I was just researching bitter melon for human diabetes and got the idea that maybe this would help Sami? She is currently on PZI insulin.
JA: I'm sorry to hear that. I'm sure the Veterinarian can help with the diabetes. What is the kitten's name?
Customer: Sami
JA: Is there anything else the Veterinarian should be aware of about Sami?
Customer: Her bs is in the low 300's in am, and is in the 200's during the day.
Submitted: 11 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 11 months ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply.

Customer: replied 11 months ago.
very good! nice to "talk" to you again
Expert:  Dr. Michael Salkin replied 11 months ago.

Hi Angela, I'm not aware of any studies concerning bitter melon and diabetes in cats. It's not harmful, however, so I think you should offer it to Sami and then publish a paper in a scholarly journal! I read that it contains a chemical that acts like insulin to help reduce blood sugar levels but how in the world are you going to get it down Sammi? I'm not happy with 300 in the AM and 200s during the day. How about a bump in the dose of the PZI?

Expert:  Dr. Michael Salkin replied 11 months ago.

Angela, I regret that my state board of veterinary examiners doesn't allow me to speak to customers by phone in this venue but other experts in this category may be able to assist you in this regard. Please let me know if you'd like another expert to do so and I'll opt out of this conversation. Please stay in the conversation if you wish.

Customer: replied 11 months ago.
Hi Dr. Salkin, sorry to hear! Yes, I would like to get some assistance regarding the issue with her bs levels and a holistic approach - it's been a trial and error, changing to different insulins several times over the year. Numbers start out well, but insulin doses go up to 10u per day!
Customer: replied 11 months ago.
we can discuss by email though??
Expert:  Dr. Michael Salkin replied 11 months ago.

We can stay here, Angela. What does Sammi currently weigh, please? Insulin doses should never go up that high. When doses approach 1 IU/lb I suspect that the Somogyi effect has prompted such increases. The Somgyi effect describes wide swings in the BG and if a vet only sees the rebound effect to an overdose of insulin (an overdose makes the BG plunge and the body reacts by rebounding the BG too high) a vet thinks even more insulin is necessary when, in fact, the dose needs to be reduced. This isn't something I can manage from here and so referral to a specialist veterinary internist (please see here: or, at least, to another vet who understand feline diabetes better should be considered. "Holistic" means addressing the entire body when addressing just a part. Did you mean homeopathic, instead? Good holistic care would involve feeding Sammi a prescription diabetic diet which can be very helpful in managing cats. In fact, many can normalize on the proper diet alone.

Customer: replied 11 months ago.
I'm sorry - homeopathic!
So, Sami is 10 pounds. Yes, I suspected the Somagi effect, but I don't think my vet is up to speed with feline diabetes. We started with human insulin, after 3 mo. Lantis, and after another 3 months PZI. Each time, numbers looked good, but then creeped up, requiring more insulin - when each insulin was up to 10u, I switched again. Sami has been on low carb wet food exclusively since her diagnosis a year ago. Thank you for the referral - love my vet, but I will probably seek out a specialist.
Expert:  Dr. Michael Salkin replied 11 months ago.

How can I say this, Angela...I think homeopathy is akin to snake oil. There, I've said it. Yes, please get the best help for Sammi. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.