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Shani

Member Since 2015
Hi! I found this place through catinfo.org
My 10yo cat has just been dx'd with diabetes a couple of days ago, but we're still waiting for the vet to prescribe insulin, which won't happen until our next appointment on Monday.
 
Welcome.
Good insulin are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI. For those two human insulin it is best to get the 5 pack of 3 ml disposable pens via a 10 ml vial. Although per ml the vial is less expensive most cats will not use up a 10 ml vial before the insulin goes bad/becomes ineffective. The human insulin N/NPH is sometimes prescribed but only lasts 8-10 hours. Same for the pet insulin Vetsulin/Caninisulin.
Most of use here test or cats blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
What are you feeding? A low-carb canned is best. Not reason for a prescription food. Here is a list of commercial low-carb canned
http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/
 
Welcome to FDMB.
Changing to low carb food now may reduce glucose levels from 100-200 mg/dL. One cat even dropped 300 mg/dL. Also, vet stress may elevate glucose 100-180 mg/dL, so home testing is imperative for safety.
See my signature link Secondary Monitoring Tools for additional methods of evaluating your cat.
 
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Hi Shani and Welcome to you and your Sugar Kitty :cat:
I am new here myself! It is alot to take in, very quickly. I was feeling quite overwhelmed by the time I even got here.
Read the very important and helpful links that Larry and BJM provided above to start out, in small bites!! The food chart is most important, as it just may reduce your kitty's sugar significantly. Results will be very noticeable in the litter box department! And not as much water drinking as the sugar is lowered.
I chose to change ALL my cat's over to low carb wet. We use Fancy Feast Classics, and I buy it by the case at Walmart. Be sure to let the vet know you have switched, and you won't be needing any high dollar prescription food. ;)

How do you feel about the home testing? I can tell you that it is only difficult for a very short period of time. In the beginning, I was like, "Oh my god, he won't go for this at all!" But it became routine for both of us within the week. By the next week, he was coming to the testing area on his own!!
Just ask any questions you have, right here on the forum, at any time. We have all been exactly where you are, and there is a wealth of knowledge and experience behind all that.
Just a quick word about insulin.
I didn't know anything about insulin! I didn't know the many types, nor what they did! I had no idea.
What I did know, was that my little one needed some and Mom had a slim budget. I chose the insulin I could afford to at least, begin him on something. Novolin N. It wasn't lasting long enough and was very harsh. Long story short, 2 weeks later I changed to ProZinc anyway. I kick myself for not doing the proper research first.
Please check back in and let us know how we can help you and your kitty.
All the best
-Brenda
 
Welcome.
Good insulin are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI.
What are you feeding? A low-carb canned is best.

Thanks!
How would I get human insulin anyway? I don't think the vet would prescribe it and I don't think many places give it over the counter.
I switched him to Fancy Feast Classics and he loves it! However, I plan on eventually making my own cat food, following Dr. Pierson's recipe.

Welcome to FDMB.
Also, vet stress may elevate glucose 100-180 mg/dL, so home testing is imperative for safety.

I do plan to start home testing ASAP!

Hi Shani and Welcome to you and your Sugar Kitty :cat:
I am new here myself! It is alot to take in, very quickly. I was feeling quite overwhelmed by the time I even got here.
Read the very important and helpful links that Larry and BJM provided above to start out, in small bites!! The food chart is most important, as it just may reduce your kitty's sugar significantly. Results will be very noticeable in the litter box department! And not as much water drinking as the sugar is lowered.
I chose to change ALL my cat's over to low carb wet. We use Fancy Feast Classics, and I buy it by the case at Walmart. Be sure to let the vet know you have switched, and you won't be needing any high dollar prescription food. ;)

How do you feel about the home testing? I can tell you that it is only difficult for a very short period of time. In the beginning, I was like, "Oh my god, he won't go for this at all!" But it became routine for both of us within the week. By the next week, he was coming to the testing area on his own!!
Just ask any questions you have, right here on the forum, at any time. We have all been exactly where you are, and there is a wealth of knowledge and experience behind all that.

Thanks. I'm hoping changing his diet will significantly reduce his sugar, right now it's at a pretty scary level! x_x

The difficulty of home testing isn't what has me worried, tbh; it's the routine. I happen to have a circadian rhythm disorder and I have no idea how I'll manage to do everything on time.

Question: I saw that this one was a #1 best seller, but is it good? http://www.amazon.com/TRUEResult-Blood-Glucose-Starter-Kit/dp/B002CGT08S/?tag=felinediabetesfdmb-20
Or should I get a different one instead, like Relion Confirm or Arkray Glucocard?
 
How would I get human insulin anyway? I don't think the vet would prescribe it and I don't think many places give it over the counter.
In most places one can purchase N/NPH insulin over the counter. However, it only lasts 8-10 hours and is not optimum. Getting it from Walmart is the least expensive. Next would be to Novo Nordisk's Novolin N. The most expensive is Eli Lilly's Humulin N
 
I would go with the Relion confirm or the relion Micro, as the test strips are much more affordable.. ie cheap! and welcome to the best place you never wanted to be at!
 
Hi Shani, and welcome to you and your kitty. :)

I don't know what you're feeding at the moment but if you start insulin before changing to a lower carb diet, it is vital that you should be home testing before initiating the food transition in order to keep your kitty safe (as Dr Pierson advises on catinfo.org). If you're switching to a diet lower in carbs your kitty's blood glucose levels may start to drop very quickly in which case the insulin dose would need to be reduced as his carbohydrate intake decreases.


Mogs
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Switching to Fancy Feast was a wise choice. You are already headed in the right direction. Dr. Pierson has some excellent low carb recipes so I am sure your cat will appreciate home-cooked meals.

A lot of us use Walmart's ReliOn Micro or Confirm glucometers and strips. The kits usually come with a 30 or 31 gauge/lancet. Starting out, we recommend using a 26 or 28 gauge/lancet. Any brand will do.

Now is the time to learn to home test, before you see the vet and start on insulin. A change to a low-carb diet can substantially lower BG (blood glucose) #'s. It did for my cat, CJ and now she is in remission.

There are handy tips on the home page and at this link for home testing. Plus members here will be very happy to help questions.

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Glad you found us. Welcome!
 
Ok, I'll get the ReliOn Confirm! Thanks for the advice.

The vet is going to prescribe us Vetsulin, it seems like.
 
Vetsulin is not the one we use much here. See the Vetsulin primer here: http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/
Note under Tip #1 in the primer about the insulin's duration. Very few cats get more than 8-10 hours of benefit from this insulin because it is fast acting and can be harsh.

It will be a good idea to wait at least a week before starting insulin while you're transitioning your cat to a low carb diet. That way you'll see how much of an impact the diet has on your cat's BG (blood glucose) levels.

I'd suggest you look at the "sticky notes" and primers for the different insulins in the Insulin Support Groups in the forum. Lantus is a popular insulin used by many members here. It is longer lasting and more gentle on a cat than Vetsulin. ProZinc is another popular insulin many here use. It's helpful to research the different insulin options before you start. Ask any questions; we're here to help.

Let us know how home testing goes. What is your kitty's name?
 
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Hi Shani,

When you're at the vets please ask them to check your kitty for ketones. It's also a good idea to have some urine test strips at home (e.g. Ketodiastix).
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So long as there are no ketones and other than the excessive urination, hunger, and weight loss, nothing else is wrong, its OK to change the food first. Switch about 20-25% per day to reduce the chances of food refusal, vomiting, and diarrhea which may happen with sudden food changes.
 
Vetsulin is not the one we use much here. See the Vetsulin primer here: http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/
Note under Tip #1 in the primer about the insulin's duration. Very few cats get more than 8-10 hours of benefit from this insulin because it is fast acting and can be harsh.

Let us know how home testing goes. What is your kitty's name?

Is it possible for me to convince the vet to prescribe Lantus or ProZinc instead? I'd rather not give him such a harsh insulin. I'll try asking about it.

His name is Stripes or Stripey. He belonged to my SO's mom before we moved out, and we kept the name, even though he's more orange than striped.

Hi Shani,

When you're at the vets please ask them to check your kitty for ketones. It's also a good idea to have some urine test strips at home (e.g. Ketodiastix).
.

Will do!

So long as there are no ketones and other than the excessive urination, hunger, and weight loss, nothing else is wrong, its OK to change the food first. Switch about 20-25% per day to reduce the chances of food refusal, vomiting, and diarrhea which may happen with sudden food changes.

We changed the food rather suddenly, but luckily he hasn't experienced any diarrhea or vomiting, and he likes the food much more than the kibble he used to eat.
 
Is it possible for me to convince the vet to prescribe Lantus or ProZinc instead? I'd rather not give him such a harsh insulin.

Like the rest of us, vets frequently prefer to use treatment protocols with which they are familiar. Should it be the case that your vet If it is the case that your vet is not yet familiar with the likes of Lantus, then providing him with peer-reviewed, evidence-based documentation of how and why to treat with an alternative insulin it may help you to make your case.

Here is a copy of the published Roomp/Rand study, Management of Diabetic Cats with Long-acting Insulins. Included in the document are full instructions on starting doses and dose adjustments which should be reassuring to any vet not yet familiar with the use of Lantus and other long-acting insulins.

In the event your vet has reservations about treating Stripey with one of the longer-acting insulins, discussing the document may help you to negotiate with your vet to get the insulin treatment you prefer.


Mogs
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Hi Shani..Quick word here on the insulin..
As I've said before,I switched insulin within 2 wks. My vet was very resistant to home testing already, so I knew I had to present a strong case, or find a new vet..
I emailed him 3 options that I would be cool with, listing sites and all pertinent info, prior to my visit. I asked that we be able to resolve this by end of day.
You are Stripey's best and only advocate. Stand your ground.
Emailing prior to the visit, gave Dr. a little "breathing" room.
 
If you want to email your vet that document for review, Shani, download a copy from here and then attach it to an email for your vet to review. (Very politically astute approach, Brenda (@Tucker&Me). ;) )

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First of all. thanks for the PDF!

Okay, so I just got back from the vet and he was actually fine with Lantus, saying that it was considered the best insulin. He said that it was their #1 insulin before they switched to Vetsulin, and that they had to switch because Lantus went up in price - a lot! He says it would cost us ~$300 (and that the only patient of theirs who found it for $100, had to order in bulk from Canada.)
Then I asked about ProZinc and he said that it's the exact same thing as Vetsulin, and that ProZinc would not be longer lasting. So now I am thoroughly confused.

He said that once I decide on the insulin I want, provided I can find it in an online pharmacy, I can refer them to my vet and get a prescription for it. Or I can come back to the pharmacy for Vetsulin.
So, what do I do? :confused:

P.S. Stripey's BG has gone down from over 570 to 328 after 5 days of FF.
 
Hi Shani,

I'm glad you had such a positive consult with the vetty bean. If finances weren't a factor I'd go with the Lantus. You can get tips on where to buy from members here. Many order from Canada, and I have read that some members have had success on occasions persuading a pharmacy one pen cartridge at a time. Also check out the Supply Closet on this forum to see if you can get a deal there.

Good news about how the diet change is helping Stripey down to lower BG levels already. :)



Mogs
.
 
Eesh, finances are a bit of a factor. We're kind of living paycheck to paycheck and wouldn't be able to afford $300 insulin. I guess I'll check out the Supply Closet. Thanks.
 
You can get Lantus for a good price from Mark's Pharmacy: https://rxcanada4less.com/shoppingcart.php
Just type in Lantus in the "Enter Product Name Here" box and you'll see the price for a vial and a price for the pens. $144.99 in U.S. dollars for a box of 5 pens is a bargain.

You'll get a lot of help here from Lantus members. Be sure to check out the information and protocols in the Lantus forum.

It is encouraging to see improvements in the BG #'s since you switched to FF. You were wise to do the diet change before starting insulin.

You can buy Ketones strips anywhere diabetic supplies are sold (i.e. Walmart, Target, Rite Aid, etc) and test for ketones at home.
 
How long would a box of 5 pens last? I'm worried they might expire before I use them all.

And is it true that there is no difference between Vetsulin and ProZinc? If so, why do some people prefer ProZinc?
 
Vetsulin (Caninsulin in Canada) is too short acting for cats. it is formulated for dogs. ProZinc is for cats only and has sufficient duration to be good for cats
 
If you want to email your vet that document for review, Shani, download a copy from here and then attach it to an email for your vet to review. (Very politically astute approach, Brenda (@Tucker&Me). ;) )

.
Why thank you dear. God knows we wouldn't want to upset the ego-challenged applecart. ;)
 
First of all. thanks for the PDF!

Okay, so I just got back from the vet and he was actually fine with Lantus, saying that it was considered the best insulin. He said that it was their #1 insulin before they switched to Vetsulin, and that they had to switch because Lantus went up in price - a lot! He says it would cost us ~$300 (and that the only patient of theirs who found it for $100, had to order in bulk from Canada.)
Then I asked about ProZinc and he said that it's the exact same thing as Vetsulin, and that ProZinc would not be longer lasting. So now I am thoroughly confused.

He said that once I decide on the insulin I want, provided I can find it in an online pharmacy, I can refer them to my vet and get a prescription for it. Or I can come back to the pharmacy for Vetsulin.
So, what do I do? :confused:

P.S. Stripey's BG has gone down from over 570 to 328 after 5 days of FF.
Tell your vet I said that a bunch of hooey. I'm NEW and I know better than that!
Just Google it for yourself and you'll see.
Or read here
http://felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/
 
Each pen hold 300 units. At 1 unit twice daily that would be 150 days. About 2 years for 5 pens. Each pen is good for at least 6 months before it loses effectiveness.
 
Vetsulin (Caninsulin in Canada) is too short acting for cats. it is formulated for dogs. ProZinc is for cats only and has sufficient duration to be good for cats

It is really weird then that the vet told me they're the same, and even that ProZinc isn't as long lasting and that Vetsulin is formulated for cats... maybe he got the two confused.

I guess I'm leaning more towards ProZinc, cause he can at least prescribe it for a lower price than Lantus. (He also mentioned that Lantus will become cheaper next year or so, when their patent runs out. Not sure how true this is.)

Each pen hold 300 units. At 1 unit twice daily that would be 150 days. About 2 years for 5 pens. Each pen is good for at least 6 months before it loses effectiveness.

Ah, then would buying a box of 5 be wasteful? Or is that 6 months only after opening?
 
You can try buying a single Lantus pen from someone in the For Sale section of the forum or see if a hospital, nursing home or pharmacy will sell you a single pen.
Or you can buy from Mark's Pharmacy in the link I gave you above and sell or donate the unused ones. Overall, Lantus is the most popular insulin used here. But there are quite a lot of members here who use ProZinc as well.

You want to use the insulin that will best work for your cat. From a cost perspective, the price of ProZinc vs Lantus is not that much different. Maybe up front but overall, no.


Yes, your vet got Vetsulin and ProZinc mixed up.
 
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Thanks for all the help and support, everyone!

What kind of syringes should I use? The vet wanted me to buy some from them, but I could probably get them cheaper at a pharmacy. And I wasn't sure whether to go for U40 or U100 until I decided on an insulin first, cause they said it mattered what kind of insulin it was.
 
Thanks for all the help and support, everyone!

What kind of syringes should I use? The vet wanted me to buy some from them, but I could probably get them cheaper at a pharmacy. And I wasn't sure whether to go for U40 or U100 until I decided on an insulin first, cause they said it mattered what kind of insulin it was.

@Larry and Kitties, can you advise which needles go with which insulin? U40 for the ProZinc and U100 for the Lantus, Levermir and NPH insulins?

Shani, yes, you can likely get the needles cheaper at a pharmacy. You'll probably need an RX from your vet.
 
With a conversion chart, it is possible to use U-100 syringes with a U-40 insulin.
If you are in the US, ordering Lantus or Levemir from Canada will be much less costly than buying it in the states.
 
So, I started trying to home test, but no luck so far :(
He doesn't like his ears being touched at all, folding them back, and he won't sit still. Gentle restraint doesn't work cause he tries to run away. I even tried a cat burrito, and getting someone else to hold him, but he stuggles and cries constantly.
At least reading about others' difficult cats makes me hopeful that it'll get easier over time.
 
Shani, it takes time but it does get easier. What is your kitty's name? We'd like to see a photo of him!

It will be helpful to put in your signature line your cat's name, date of diagnosis, insulin (once you get it) and dose, meter using, any other medical conditions, if applicable, and food you are feeding. Click on your profile, then signature to update this information. It will help other members help you more quickly.

I'd suggest not folding your cat's ears. If you can, try poking from the outer ear, not inside. If you can't see the vein and "sweet spot", a flashlight is useful. Pet him a lot, praise and massage the ears very gently. Then reinforce with a low carb treat and lots of praises afterwards. Equally important is being calm.

Poking does not hurt your cat at all. Cats have few nerve/pain receptors in their ears so the more you poke, the easier the ear will "bleed" and form new capillaries.

What size lancet gauge are you using? Starting out, we suggest using 26 or 28 lancet gauges. The lower the number, the thicker the needles. Higher gauges are thinner but take longer for blood to bleed. Most glucometer kits come with a 30 or 31 gauge. For now, start with the lower # gauges.

The next step is warming up the ears. I use a terry cloth headband or small wash cloth, add water and microwave it for about 20 seconds or so and then I put it in a ziplock bag. I test it on my arm to make sure it's warm, not hot, and then apply it gently to CJ's ear briefly. A lot of members here use a sock filled with oats or rice and warm it up in the microwave.

A key to getting the blood on the ear to bead up is to apply a very tiny amount of ointment such as neosporin, polysporin or even vaseline with a q-tip before you poke. Be sure to put a very tiny amount; too much will cause an error message on your meter.

Another key is to aim for the "sweet spot" area between the vein and the outer ear. See this link, first post for a picture for the sweet spot: http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/

You will find a technique that works best for you and your cat. Starting out, it can help to test while your cat is napping and more relaxed.
 
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Another insulin choice, since money is an issue, is BCP PZI. It is similar to ProZinc, dosed like it. It is a compounded form of PZI. Your vet can order a vial from the compounding pharmacy; the last price I heard was under $100 including postage. We have people using it here and it seems to work just like, and as well as, ProZinc. It can be ordered in U100 strength so you can use U100 syringes with it. (Less expensive than U40 syringes and available at the drug store instead of only through your vet.)
 
Shani, it takes time but it does get easier. What is your kitty's name? We'd like to see a photo of him, too!

It will be helpful to put in your signature line your cat's name, date of diagnosis, insulin (once you get it) and dose, meter using, any other medical conditions, if applicable, and food you are feeding. Click on your profile, then signature to update this information. It will help other members help you more quickly.

I'd suggest not folding your cat's ears. If you can, try poking from the outer ear, not inside. If you can't see the vein and "sweet spot", a flashlight is useful. Pet him a lot, praise and massage the ears very gently. Then reinforce with a low carb treat and lots of praises afterwards. Equally important is being calm.

Poking does not hurt your cat at all. Cats have few nerve/pain receptors in their ears so the more you poke, the easier the ear will "bleed" and form new capillaries.

What size lancet gauge are you using? Starting out, we suggest using 26 or 28 lancet gauges. The lower the number, the thicker the needles. Higher gauges are thinner but take longer for blood to bleed. Most glucometer kits come with a 30 or 31 gauge. For now, start with the lower # gauges.

The next step is warming up the ears. I use a terry cloth headband or small wash cloth, add water and microwave it for about 20 seconds or so and then I put it in a ziplock bag. I test it on my arm to make sure it's warm, not hot, and then apply it gently to CJ's ear briefly. A lot of members here use a sock filled with oats or rice and warm it up in the microwave.

A key to getting the blood on the ear to bead up is to apply a very tiny amount of ointment such as neosporin, polysporin or even vaseline with a q-tip before you poke. Be sure to put a very tiny amount; too much will cause an error message on your meter.

Another key is to aim for the "sweet spot" area between the vein and the outer ear. See this link, first post for a picture for the sweet spot: http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/

I put CJ between my legs, her face away from me, and use my legs to gently cushion her and keep her from escaping. I also use my left arm under her chin to hold her steady while I poke. She doesn't like being held but she craves attention and praises. You will find a technique that works best for you and your cat. Starting out, it can help to test while your cat is napping and more relaxed.

I'm using 26 gauge lancets. Also, I meant Stripey is folding back his own ears, I'm not folding them XD

Finally! After much struggling, I got a reading. It's 268 on the ReliOn Confirm. As I understand it, I add 30%-40%, so it's actually 348-375? What number should I put down on Stripes' SS?

Another insulin choice, since money is an issue, is BCP PZI. It is similar to ProZinc, dosed like it. It is a compounded form of PZI. Your vet can order a vial from the compounding pharmacy; the last price I heard was under $100 including postage. We have people using it here and it seems to work just like, and as well as, ProZinc. It can be ordered in U100 strength so you can use U100 syringes with it. (Less expensive than U40 syringes and available at the drug store instead of only through your vet.)

Thanks, I'll ask my vet about it.
 
You don't need to add anything or convert numbers. We are all used to using human meters, so those are the number we relate to. Just put the number you get on the SS.
 
Stripes usually doesn't like belly rubs! It was a rare moment when he wanted my attention, and jumped on the bed between/on my tablet and keyboard (the black thing is my tablet). He'll also sit next to me, with his back turned, when he wants me to pet/groom him.
 
Just my luck. My vet is on vacation and won't be back till next week. I won't get a prescription for Lantus until then. :S
 
Oh wow, YOU ARE DOING GREAT! Congrats on the first successful poke! I remember how thrilled I was!! Small victories..we'll take 'em! Bummer about your vet-he hasn't left a back-up? The good news is you're feeding low carb now, and that's going to help. Keep on those ears, and praise praise praise!!
 
Is there another vet at the clinic who can prescribe the Lantus? If not, perhaps you can get it from someone selling it in the For Sale section in the forum.
 
I don't think he left a back-up. We asked if anyone else could prescribe it for us and were told we had to wait.

Will anyone sell me some from the For Sale section if I don't have a prescription yet, though?
 
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