My head is spinning! Suggestions/advice please!

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jillmerg

jillmerg

Member Since 2015
I have an appt with the vet this Thursday( tomorrow ) for Princess & wanted to possibly change from N to another insulin . I've been looking at all insulin's and I'm still up in the air on which one to go with! Brain overload!!! Princess has ok numbers except am/pmps since N just doesn't last long enough. I've been working on her SS for the past month to get a good idea of how she's doing. I'm a stay-at-home mom of 4, so even though I'm busy, I am able to monitor princess' BG throughout the day. However, I'd feel more comfortable keeping her at a 'safe' range where I don't have to constantly monitor her& change dosage (which seems like the TR protocol?) . I've been looking into pzi/pro zinc, lev, lan, vetsulin, pens vs. vials price and now I'm just ready to go bonkers! If anyone can please help point me in the right direction or help in anyway I'd really, really appreciate it! I know ECID, but I'd love if someone can give any insight on a good fit for her & me. Thanks!
Also, if she stays under 300 is that considered ok?
 
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Hi Jill,

The longer lasting insulins, Prozinc/PZI, Lantus and Levemir, are generally better for cats because of the longer duration.
But nobody knows in advance which particular insulin will work best for their cat (there's never a crystal ball around when we need one...)
Most folks here using Lantus find that it works best if given (as close as possible to) exactly 12 hours apart. So, if that's not possible for you then one of the other insulins may be a better choice. If you can shoot regularly at 12 hour intervals then, theoretically, you could use any of the insulins, and your choice may come down to cost.

I think Kay @KPassa has written some useful comparison info on the various insulins.
And I seem to recall that BJ @BJM has written a few posts recently about comparing the costs of insulin.
Have tagged them both in hopes that they can help.

Good luck, Jill :bighug:

Eliz
 
I will definitely say no to the vetsulin. Vetsulin is VERY similar to N. I had Hidey on vetsulin for a month when he was diagnosed (not by my choice) and after a month of numbers going up and up, I DEMANDED prozinc. Within a month of new insulin, diet change and a dental Hidey went into remission and I'm happy to say he's been in remission for a year thanks to this site. He had great success with prozinc, and I'm glad I picked it. I liked the fact that prozinc isnt a depot insulin and that I didnt have to consider that when dosing, or checking his bg. BUT like you mentioned, ECID as is the person caring for them.

As to your question for staying under 300 being ok......not really. You want them under 150, most prefer under 100. When your close to 200 and up you have to worry more about ketones.
 
Although I am far from an expert. I can tell you we started with the vetsulin with very disappointing results. I recently changed to prozinc. If I could have afforded the costs I would have tried the lantus.
 
jillmerg said:
Also, if she stays under 300 is that considered ok?
Click to expand...
Hi again, Jill,

There's some info here from the FDMB FAQ's that may be helpful (and I apologise in advance for copying/pasting a huge chunk of text (it seems kinda impersonal...))

"Q6.1. What is regulation?

A6.1. There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":
  • Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
  • Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
  • Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
  • Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
  • Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin]
  • Normalized [60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin]
There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a home glucometer. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.

Q6.2. Which definition of regulation should be my goal?

A6.2. That depends on your individual situation. Generally, it's thought that a cat will suffer less long-term organ and nerve damage if his average blood glucose is lower rather than higher. However, because preventing hypoglycemia is a top priority, it may not be practical to try for normal numbers. The ability of your cat to respond to food and insulin in a consistent manner and your own ability to monitor your cat are both important factors in setting your goal. For most cats who are receiving insulin, "regulated" is a reasonable first goal, after which you can try for "well-regulated". For the lucky minority who can be diet-controlled, normalization is often achievable. It’s important to realize that some cats never consistently stay in regulation range in spite of all efforts, and yet they can be happy and healthy anyway. Ultimately, you should tailor your goals to your cat's individual situation, and you should always consider your cat's quality of life as well as the numbers as you evaluate how well your treatment protocol is working."

The above info comes from this document:
http://binkyspage.tripod.com/faq.html#regulation

Eliz
 
Elizabeth and Bertie said:
  • Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
Click to expand...

So, Princess tends to be around upper 200's-low300's PS w/ her nadir around 100 (give or take). She has the lowest #'s between +3-7 hrs of her insulin cycle. She has never had ketones, knock on wood. Her bg drops at least a 100 within the first few hrs after her shot. Then 8+ starts climbing upper 200's. Would that be considered somewhat regulated then? Hopefully with a change she can maintain her lower #'s longer.
For the most part she does stay on a consistent schedule but there has been times that where I've been late, within the hour.

Thank you all for your responses!
 
The up front cost of Lantus and Levemir results in sticker shot for lots of folks.
The way to look at it, though, isn't just that up front cost, it is the cost per unit of insulin. That is the best way to compare the costs of the insulins against each other.

So, I popped out to Google, and searched their shopping links for some examples of the various insulins available in the US.

And, here are some example costs per unit.

These are just examples. The numbers change all the time. And, ordering from Canada can be much less expensive than these US numbers. And costs will be different in other countries.
 
THANKS! I have a few coupons too. If I'm reading it correctly its $25 for 2yrs from Novo Nordisk instant savings card(levemir) & 1 free needles. Seems too good to be true, I have to look into it.
 
And the Savings Card no longer works as of the first of this year (at least in the state of California) due to everyone now being covered by Obamacare so the coupon is invalid because there are no uninsured. At least that's how they explained it to me when they revoked mine.

Canada is your best bet now.
 
You also don't want the needle tips that come with the pens. You want to use syringes with the pen as if it's a mini vial. The needles work with the "dial-a-dose" feature that only dispenses in whole units and most of the time, our cats need fractions of units instead.
 
KPassa said:
And the Savings Card no longer works as of the first of this year (at least in the state of California) due to everyone now being covered by Obamacare so the coupon is invalid because there are no uninsured. At least that's how they explained it to me when they revoked mine.

Canada is your best bet now.
Click to expand...
I just checked both the Lantus and Levemir websites and they still have the discount cards available. On both sites I did not see any restrictions for California, however, on the Levemir site, it looks like the discount is no longer available for the pens. It may still work with vials.
 
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