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2013 vs. 2012 Cats on TR

2013 vs. 2012 Cats on TR. Table of Contents. Preface /Notes …………………………………..……. Page 3 2013 In Numbers ……………………..…….......…Page 4 Overall TR Results …………………….………………….Page 6 Overall Results by Type of Insulin …………………Page 15 Zoom on Bovine PZI ……………………………..……..Page 24

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2013 vs. 2012 Cats on TR

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  1. 2013 vs. 2012 Cats on TR

  2. Table of Contents • Preface/Notes …………………………………..……. Page 3 • 2013 In Numbers ……………………..…….......…Page 4 • Overall TR Results…………………….………………….Page 6 • OverallResults by Type of Insulin…………………Page 15 • Zoom on Bovine PZI ……………………………..……..Page 24 • Zoom on ProZinc ……………………………………..……Page 26 • Zoom on Hypurin …………………………………..………Page 28 • Zoom on Lantus ……………………………………….…….Page 30 • Zoom on Levemir ………………………………..………..Page 34 • Zoom on Canininsulin …………………………………….Page 36 • Zoom on NPH ………………………………………………… Page 38 • Appendix ………………………………………………………..Page 40

  3. Preface/notes • This document isbased on the tracking of cats with logs set up in Names & Numbers on DCC in 2012 and 2013 (Data collection through 31.12.2013) • The number of logs for 2013 isdifferentfromthatfound in the 2013 New Membershipstatistics as thatonlytakesintoaccount the activity of memberswhojoined in 2013; included in 2013 TR logs are memberswhojoinedbefore 2013 but did not set up a log till 2013 and thosewith more than one log up • Cats who have gone OTJ and thenrelapsed are counted in the OTJ figures, and as a new log/TR cat whenthey go back on insulin • Exception: Puddin/Lisa wasonly OTJ for 28 days, sois not included in the OTJ statistics • Seeappendix for cats concerned • Cats who switch insulin are included in the last insulinusedonly as one of the purposes of the trackingis to following the number and percentage of cats per insulinwho do – or do not – go into a dietcontrolledremission • A table of such cats maybefound in the Appendix • « Active Cats » refers to Cats that are OTJ or stillfollowed on forum (Total logs – GA and MIA cats) • 2012 figures includethree cats whowent OTJ and one whowent GA in 2013, as well as thosewhowent MIA during 2013

  4. 2013 in a few numbers …… 72logs set up by membersfrom12different countries in 2013… a 31%increase vs. 2012 55Active cats at the end of 2013 25cats whowent OTJ using6 differentinsulins

  5. ……but 2013 isalso Only 46% of cats starting TR in 2013 went OTJ… a drop of 22,2 points vs 2012 (base Active Members)

  6. Overall TR Results

  7. New TR logs in 201268% of Active Cats OTJ

  8. New TR logs in 201346% of Active Cats OTJ

  9. Number of logs started • A strong and encouragingincrease (16) in the number of logs started in 2013 vs. 2012…. If to note, total DCC membership rose by 52.4% over the sameperiod

  10. Status of Cats • While in total numbers, more cats went OTJ in 2013 than in 2012, a lessoptimisticviewthough, when the percent of cats going OTJ isexamined…. The percentage of cats going OTJ isdropping and the percentage of cats still FD has sharplyincreased • Some 2013 Cats willhopefullybecome OTJ in 2014…. And somewillbecome MIA/GA… so over the followingmonths, thesepercentageswillevolve

  11. Zoom on Active Cats • At the end of 2013, thereis an increase of 30,9% in the number of logs started vs. 2012, and of 71.9% in Active members (a percentagewhichwillcertainly have dropped by end 2014 due above all to MIAs over time) … However, the % of cats thatwent OTJ is not keeping pace – only 4 more cats went OTJ in 2013 than in 2012 – an increase of 19% • Overall, on the base of Active Cats, thereis a drop of 22 pts in the % of cats that are OTJ in 2013 vs. 2012: only 45,5% vs. 67,7%

  12. Seasonality • AsidefromFeb-April, no clearseasonality trends in terms of membersstarting logs • Note: the high number of logs started in October 2013 includes 5 membersbrought over from YDC

  13. Geography/ 2012 • While N. Americaaccounts for just over half of all logs set up in 2012, the US onlyaccounts for 44% - low vs. the total number of membersfrom the US • Verystrongpresence for the UK

  14. Geography/ 2013 • An increase in membersfrom the US setting up logs vs. othermarkets in 2013 • The appearance of South Americans • The samenumber of UK membersstarted logs (16) – but a lowershare due to the increase in total logs • FewerEuropeans and few Europen countries represented vs. 2012

  15. OverallResults by Type of Insulin

  16. Insulinused: Nb of Cats • Lantus is the mostusedinsulin in both 2012 and 2013 • A switch though for otherinsulins: • Use of PZI – whether Bovine, ProZinc or Hypurin – droppedsharply in 2013: in the case of Hypurin the drop canbelinked to good results for cats on Caninsulin in the UK which has meantthatitis no longer suggested (unlessresults on Caninsulinmerit) thatmembers move to it • Good increase in use of Levemir as good resultswith the few membersusingitled to more switching to its use: Levemirhas only been used as the first insulin for one cat • Increased use of Caninsulin for the reasonmentionedabove

  17. Insulinused: Percent of Total • In terms of the percent of cats using a giveninsulin, use of Lantus, Caninsulin and Levemir has increasedsubstantially • To note the verysharp drop in Hypurin cats: 22% of 2012 logs and only 3% of 2013 logs… • The use of PZI unsulin (US PZI and Hypurin) droppedfrom 51% to only 17% of cats…. With Lantus and Levemirnowaccounting for 50%

  18. Status per Insulin 2012 • In pure numbers, Lantus had the best success in 2012 with 7 cats usingit OTJ • Lantus isfollowed by Caninsulin and Hypurin. • US PZI (bovine or ProZinc) results are quitemedicore • Levemirwasonlyused by 2 cats, and NPH by 1 • A highnumber of MIAsamongstHypurin cats

  19. Status per Insulin 2013 • A change in 2013 as Caninsulinbecomes the veryclear « success story » of the year – 12 cats went OTJ on itwhileonly 4 remain FD (includingPuddin/Lisa whowas OTJ for 28 daysbeforeneedinginsulinagaindue to thyroid issues). • Lantus drops to second place… above all the number of OTJ cats on itissurpased – by 2 to 1 – by the number of cats thatremain FD.... With the samenumberdropping off forum • With one exception Levemir has been a replacement insulin – oftenfor longer term FD cats, whichmayexplainitslow OTJ number – the only cat to go OTJ on itstarted TR on itwhennewlydx’d

  20. % of Total Cats OTJ/Insulin • In terms of the percentage of cats who have gone OTJ , Lantus has lostitssuccess leader status to Caninsulin… whichaccounted to close to half of all cats thatwent OTJ in 2013 • Hypurin didwell in 2012 … but has dropped back in 2013 as it has dropped out of use by cats on forum • No cats have gone OTJ on Bovine PZI in the last twoyears (if few cats have usedit) Reminder % total logs

  21. % Active Cats OTJ / Insulin • A look at the % of Active Cats (removing MIA, whosestatusisunknown, and GA from the total figures) provides a more accurateway to look atsuccess rates • The total number of Active Cats using the insulindoes, however, need to betakenintoaccount - a 100% success rate for Levemir or NPH in 2012 or Hypurin in 2013, whenthereisonly 1 Active Cat, is not significant…. • Overall, the strong performance of cats usingCaninsulinisconfirmed • Again, the strong drop in success rates for Lantus cats in 2013 vs. 2012 isunderscored

  22. OTJ Index Active Cats • Anotherway to betterunderstand the performance of differentinsulinsis to look at an index calcuated by dividing the % of Active cats OTJ on the insuin vs. the % of Active cats usingthatinsulin • For example, if 4% of Active Cats are on insulin X, and 8% of OTJ cats are on insulin X, the index is 4%/2% or 200 • An index over 100 meansthat a relatively high proportion of cats on thatinsulin are going OTJ : a higherpercentage of cats usingthatinsulin are going OTJ vs. the percent of cats using the insulin • Again, caution needs to beusedwhenonly 1 Active cat isconcerned

  23. OTJ Index Active Cats (Cont.) • Takingintoaccount the only 1 active cat on Levemir/NPH in 2012 and 1 on Hypurin in 2013, once againCaninsulinprovesitself to be the mostsuccessfulinsulinusedwith TR eitheryearwith an index of 127 in 2012 and 165 in 2013 • Despite good results in terms of pure numbers, Lantus underperformswith indices under 100 bothyears – cats are going OTJ on it, but not in proportion to the number of cats on Lantus • US PZI insulins (both Bovine and ProZinc) have verylow indices – no cats have gone OTJ on Bovine PZI over the last 2 years (if few have useditand ProZinc has a low – and decreasing index • Interesting to note is the index of 132 for NPH in 2013 – with 5 active cats using the insulin • Caninsulin and NPH – usuallyconsidered « to beavoided » insulins have the best sucess rates …. The US PZI insulins on which TR isbased, are the least successful in getting cats OTJ

  24. Zoom on Bovine PZI Cats in 2013

  25. 2013 Bovine PZI Cats • Onlytwo 2013 Active cats on BCP at the end of 2013, bothremain FD • Mandy/Lisa was OTJ from Jan-Aug 2013 (afterbeingdx’d in Dec 2012)

  26. Zoom on ProZinc Cats in 2013

  27. 2013 ProZinc Cats • One cat went OTJ on ProZinc in 2013: Bubba, a a cat whowas OTJ (on Lantus) sinceFeb 2011, and came out of remission due to steroids • The last 3 cats all are end of 2013 arrivals, post veryinfrequently and are receivinglittle if any help on forum

  28. Zoom on Hypurin Cats in 2013

  29. 2013 Hypurin Cats • A huge drop in the number of cats on Hypurin in 2013 • One quick success story • One memberwhois no longer involved on forum, and whoswitchedfromCaninsulin to Hypurin only a short time beforeleaving

  30. Zoom on Lantus in 2013

  31. 2013 Lantus Results • 2013 OTJ rates for lantus are down sharply vs. 2012….. • 2012 : • 7 Lantus Cats OTJ • 37% of Total Lantus Cats (15 Cats) • 70% of Active Lantus Cats ( 10 Cats) • 2013: • Again 7 Cats OTJ…. But thisnumberrepresentsonly • 24% of Total Lantus Cats (29 Cats) • 33% of Active Lantus Cats (21 Cats)

  32. 2013 Lantus Cats

  33. 2013 Lantus Cats • Taking a closer look at the FD cats, there are some possible explanations…… • Several are quite long term FD cats (and arrivedtowards the end of the year): Tomas, BooBoo, Jesse • Members have not (or could not) alwaysfollowTR closely in terms of testing, optimal dosing times: Harlem, Jefferson • Several are not very active on forum, so not receiving on-goingadvice: Atreyu, Mikey, Raven, Winston, Jesse…… though a question iswhythey are not more active. • One, Little Bit, switched to Levemir in Jan 2014 (if wasdoingverywell on Lantus at the time withseveral 80 or sohourruns)

  34. Zoom on Levemir in 2013

  35. 2013 Levemir Cats • Heightenedinterest in Levemir in 2013 led to more cats moving to it • Many are longer term FD, explaininglow OTJ rates to date • Carl/Beth moved to Levemir in Nov 2013 • Baby/Elana isverywellregulated, withruns of 40-50 hours • JJ, the only OTJ cat, wasnewlydiagnosed and switchedfrom NPH starting TR on Levemiralmostimmediately

  36. Zoom on Caninsulin in 2013

  37. 2013 Caninsulin Cats • Excellent results for Caninsulin – the mostusedinsulin in 2013 behind Lantus • Of the remaining FD cats: • Mandy isdoingverywellwithextended durations – but has somehealthproblems • Sukiisalsodoingwell, if not 100% regulated • Streepje and Cloe (sameowner) are not beingdosedconsistenly, whichisaffectingresults

  38. Zoom on NPH

  39. 2013 NPH Cats • Excellent results for anotherfaster acting insulinalso: NPH • Alex when OTJ in May 2013, and has neededinsulinagainsince 30.12 followingsurgery to remove a tumour • Bandit is about to move to Levemir

  40. Appendix:Total Overall Figures since NWO (Stayed & New Cats)Cats who have switchedInsulinCats who have relapsed

  41. Overallnumberssince NWO51% of Cats OTJ

  42. Cats who have changedInslulin • Cats are included in last insulinusedonly in the statistics

  43. OTJ cats who have relapsed • Cats are included in OTJ statistics and re-entered as new logs whenrelapsed

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