From Hypo To Serial Poker, Figuring Bear Out

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With the Lantus... depending on the dosage... 1 pen could last many months... I usually get about 3 months out of one pen... so it could work out to be only $10 to $15 a month (or something like that)... something to consider :)
 
Yong said:
Lantus in the states is expensive (I've heard $300) so most buy it from Canada https://rxcanada4less.com/ where you can get 5 pens for $150 + S&H. You use syringes to draw from each pen vial (mini vial).
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Interesting. $150 is still high for us, but it is much better than the $300+ here in the states. My husband used Lantus pens for a while and even with his insurance it was still over $100. Well have to see, because I would prefer to him be on something calmer.
 
You can also check out the Supply Forum here on FMDB. I can personally vouch for buying Lantus from Alan. Have bought from him twice and most reliable! Others on the board have bought from Alan and there are other sellers also that members have purchased from. Good luck! My cat started out on Novolin N and was doing okay on it for 4 months, then suddenly hypoed and almost died! I strongly urge you to find a way to get off of Novolin N or reduce the dose!

Link: http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/
 
JohnZ said:
With the Lantus... depending on the dosage... 1 pen could last many months... I usually get about 3 months out of one pen... so it could work out to be only $10 to $15 a month (or something like that)... something to consider :)
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How many units does your cat get a day? If you don't mind me asking, so I can estimate.
 
Fancy Feast is a good low carb food, but to save some money, you could switch to Friskies Pates which are much cheaper. Just stay away from the indoor ones(green lid) and any with gravy.

I've bought from Alan in the Supply Closet Forum too, and he is very reliable.
 
Shoeskitty said:
You can also check out the Supply Forum here on FMDB. I can personally vouch for buying Lantus from Alan. Have bought from him twice and most reliable! Others on the board have bought from Alan and there are other sellers also that members have purchased from. Good luck! My cat started out on Novolin N and was doing okay on it for 4 months, then suddenly hypoed and almost died! I strongly urge you to find a way to get off of Novolin N or reduce the dose!

Link: http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/
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Wow. I'm sorry to hear that. Bear started off on an insulin that was supposed to be good for remission, but he didn't take to it. Then came Humilin N, which was increased and increased, then Novalin N (the "off brand") and a final increase to 8. He was good for about a month and then last night/this morning happened. And thank you for the link. I'll be sure to check it out.
 
Sharon14 said:
Fancy Feast is a good low carb food, but to save some money, you could switch to Friskies Pates which are much cheaper. Just stay away from the indoor ones(green lid) and any with gravy.

I've bought from Alan in the Supply Closet Forum too, and he is very reliable.
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Yeah. Bear has two brothers (Ninja and Tails) and they all have to eat together and the same thing or its like I gave someone th better toy and they each want what the others have, so it's expensive to feed them now, let alone going from a total of e cans a day to 9 of the Fancy Feast.
 
EllieAviles said:
Interesting. $150 is still high for us, but it is much better than the $300+ here in the states. My husband used Lantus pens for a while and even with his insurance it was still over $100. Well have to see, because I would prefer to him be on something calmer.
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You could just get 1 pen (although it's more cost efficient to get the 5) from CVS for about $80
EllieAviles said:
How many units does your cat get a day? If you don't mind me asking, so I can estimate.
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It varies... but he averages 1 unit twice a day... I always draw up a little extra... and then measure the amount...
 
JohnZ said:
You could just get 1 pen (although it's more cost efficient to get the 5) from CVS for about $80


It varies... but he averages 1 unit twice a day... I always draw up a little extra... and then measure the amount...
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Interesting. Thank you for sharing. I'm definitely going to talk to the doctor about it.
 
JohnZ said:
You could just get 1 pen (although it's more cost efficient to get the 5) from CVS for about $80


It varies... but he averages 1 unit twice a day... I always draw up a little extra... and then measure the amount...
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Another quick question since your signature says you switched from Humulin to Lantus. Did his dosage stay the same and was it difficult to switch?
 
EllieAviles said:
Another quick question since your signature says you switched from Humulin to Lantus. Did his dosage stay the same and was it difficult to switch?
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No... not difficult at all to switch...

Switched over 2 years ago.

He was on 6 units of Humulin... and went hypo 1 night... we immediately switched him to 1 unit of Lantus (a big difference)!...

Since then his dosage has varied somewhat... from just 1/2 unit to 1 1/2 units...
 
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Someone has posted in the Supply Closet that they have Lantus vials for sale, I believe they are less than $100, and at least one member has made a successful purchase from him.
 
Just got home from work and checked in to see how you made out with Bear as he seemed to be in a lot of trouble early this morning. Seems he made out OK. Congratulations, your quick attention may have just saved Bear's life this morning.

As for feeding Bear at a low cost, you need a food he will eat. As an example, most of the brands that are lower cost than the 5.5 oz cans of Friskies pate don't seem to agree with my cats, they get diarhea. So the Friskies 5.5 oz cans are the lowest feeding cost I can get, however grocery store or WalMart brand pate may be a lower cost for you if it agrees with him. I generally feed 3 of those cans to my 2 cats per day. One cat is 12 lb the other 19 lbs. So the lightest is getting less than 1 1/2 of those cans per day, and Boo the heavier cat is getting a bit more than 1 1/2 cans.

When I started dosing insulin I figured 100 test strips would last me many months if I just did a curve once every week or two. Now I more willingly buy 100 strips every two weeks just knowing that its keeping him safe.
 
Just as a small update, Bear is doing fine so far. We skipped his morning shot yesterday. At 4:17 PM yesterday he tested at 572. When Dr. Haddix called she didn't want him to stay so high all day so she had me give him 4 units of his Novolin N (which is half of what he was taking) and offer him a full can of food. He wasn't interested in the food, but I gave the shot anyways. It gradually decreased throughout the rest of the evening. His AMPS was 414. I was told if it was over 250 to feed him again and give another 4 units. He ate a whole can of Fancy Feast Classic. I've been checking him every two hours. At +2 he was 365, at +4 he was 198, at +6 he was 105, and at +8 he was 96. He's up and moving around and his little nose is wet, which (with him) is my first sign of him feeling either good or yucky. He even played with his brother late this morning. I'm sure you guys understand that when you see your sick baby up and playing it's one of the greatest moments ever.

My only worry is that he's at 96 and he still has 4 hours until his next shot. I do plan on doing another test in 2 hours at 3:00 PM (+10) and, of course, again one before his shot at 5:00 PM. The good news is his vet is open until 6:00 PM, so if I'm unsure of myself, I sure as heck am going to call Dr. Haddix and see how she wants me to proceed. What would you guys normally do if he is under 200 before shot? Wait an hour and test again? Feed him? Don't feed him? I'm going to ask his vet either way, I just wanted some other opinions (especially in case I ever find myself in a similar situation when his vet is closed). I also understand that he may go up before his shot, but I just want to be prepared.
 
Good to hear that Bear has recovered from his episode! No dosing advice from me however. Thanks for letting us know how Bear is doing!
 
My thoughts here... seems that the dosage of 4 units may still be to high... since it took him from 414 AMPS to 96 (+8)... which is late in the cycle for Humulin.
You might want to further reduce the dose... maybe to 2 units.
Due to limited history/data... it's probably best to not shoot if he's under 200.
I would also skip the shot if he doesn't eat.
 
JohnZ said:
My thoughts here... seems that the dosage of 4 units may still be to high... since it took him from 414 AMPS to 96 (+8)... which is late in the cycle for Humulin.
You might want to further reduce the dose... maybe to 2 units.
Due to limited history/data... it's probably best to not shoot if he's under 200.
I would also skip the shot if he doesn't eat.
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I agree with this.
 
JohnZ said:
My thoughts here... seems that the dosage of 4 units may still be to high... since it took him from 414 AMPS to 96 (+8)... which is late in the cycle for Humulin.
You might want to further reduce the dose... maybe to 2 units.
Due to limited history/data... it's probably best to not shoot if he's under 200.
I would also skip the shot if he doesn't eat.
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Good advice here!!!
 
I also can't help on dosing (esp. for Novalin N), but as a general guideline, if the pre-shot number is below 200 but not wildly so, you can stall a bit to see if it comes up. Don't feed (you don't want food influencing the BG), test again in 20-30 minutes. Other than that, I agree with the previous posters-- a reduced dose is probably indicated given the 96 today, and skip altogether if he doesn't eat a meal before a shot. Safety first!
 
JohnZ said:
My thoughts here... seems that the dosage of 4 units may still be to high... since it took him from 414 AMPS to 96 (+8)... which is late in the cycle for Humulin.
You might want to further reduce the dose... maybe to 2 units.
Due to limited history/data... it's probably best to not shoot if he's under 200.
I would also skip the shot if he doesn't eat.
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I'll be sure to ask his vet about decreasing it some more. Thank you for the advice. I'm keeping a close eye on him until I test for his +10 at 3:00 PM. I have to leave the house to drop my husband off at work then, so I'm worried about leaving him if it has dropped even more. I'm never sure if I'm being hyper-protective or not.

Nan & Amber said:
I also can't help on dosing (esp. for Novalin N), but as a general guideline, if the pre-shot number is below 200 but not wildly so, you can stall a bit to see if it comes up. Don't feed (you don't want food influencing the BG), test again in 20-30 minutes. Other than that, I agree with the previous posters-- a reduced dose is probably indicated given the 96 today, and skip altogether if he doesn't eat a meal before a shot. Safety first!
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That makes sense. I'm making notes and trying to put together a small hypo kit for emergencies. Thank you and I agree. Safety first! :)

That's another question I had. In the hypo kit thread, it was suggested to keep high carb wet cat food for emergencies and the Fancy Feast Grilled with Gravy Flavors was suggested. Bear won't eat any soft food unless it's pate for some reason. Is there a high carb wet food that comes in pate?
 
Nan & Amber said:
Will he eat the gravy alone? That's where all the carbs are, so we often just use the gravy part for a high-carb boost.
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I'm actually not sure because I've never tried. Do they make just gravy packets (like as a food enhancer?) or will I need to but a can of food with gravy in it?
 
EllieAviles said:
I'm actually not sure because I've never tried. Do they make just gravy packets (like as a food enhancer?) or will I need to but a can of food with gravy in it?
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Hmm, there might be such a thing out there, but usually we just use the gravy-containing foods and squeeze out the gravy we need. Somewhat wasteful, I guess, but hopefully you won't be needing to do it too often!
 
Kris & Teasel said:
You can try adding a little honey to pate wet food. That works well with my guy. The gravy foods seem to upset his tummy.
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That would be an interesting idea. I'm going to make a note of that in case he won't eat the gravy food if he hypos again.
Never. I will never be unprepared again.
 
Whenever you aren't sure of a dose you are better off going a little lower to be safe. Feel free to post the pmps here and we can advise on dosing. I'd probably go with 2-3 units myself for a few days and see what happens. If you hold it at 2 units for two or three more days we can see if it needs to be raised.the raising of the dose should be done in small 0.25-0.5 increments.
 
I am not a vetsulin user so I am not too sure of the differences between it and lantus but from reading a bit in the past about others using it, I think I remember it being very necessary for the cat to eat about one hour before the shot, which is a big difference from lantus which is usually done just prior to the shot.
This is from the sticky in the vetsulin forum:

----- http://www.felinediabetes.com/FDMB/threads/humulin-n-primer.303/

1. FOOD. Always make sure kitty eats about an hour before his/her shot. This will insure that kitty has food on her stomach to counteract the typical fast drop of the bg's caused by N (some cats do not drop fast on it, which is, again, why hometesting is so important!).

Feeding an hour ahead also leaves you relatively sure the cat is going to keep the food down. Warning: We are dealing with cats here, which means nothing is guaranteed. Bunny vomited at peak, while we were asleep, and that is how we had our first hypo in over 5 years of treating diabetes.

NOTE: Bunny free fed and seemed to know when he needed to eat, so we did not have to worry about his eating before hand. However, kitties getting timed feedings should be fed as stated.
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Okay. Just got home from dropping the husband off and took a PMPS at 4:45 PM, his shot is due at 5:00 PM with his food and it was 121. I'm on hold with the vet, Dr. Haddix, now to see what she wants to do. What is your guys' opinions?
 
babyBoo said:
I am not a vetsulin user so I am not too sure of the differences between it and lantus but from reading a bit in the past about others using it, I think I remember it being very necessary for the cat to eat about one hour before the shot, which is a big difference from lantus which is usually done just prior to the shot.
This is from the sticky in the vetsulin forum:

----- http://www.felinediabetes.com/FDMB/threads/humulin-n-primer.303/

1. FOOD. Always make sure kitty eats about an hour before his/her shot. This will insure that kitty has food on her stomach to counteract the typical fast drop of the bg's caused by N (some cats do not drop fast on it, which is, again, why hometesting is so important!).

Feeding an hour ahead also leaves you relatively sure the cat is going to keep the food down. Warning: We are dealing with cats here, which means nothing is guaranteed. Bunny vomited at peak, while we were asleep, and that is how we had our first hypo in over 5 years of treating diabetes.

NOTE: Bunny free fed and seemed to know when he needed to eat, so we did not have to worry about his eating before hand. However, kitties getting timed feedings should be fed as stated.
-----
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I was told to give him his shot with his food. I normally make sure he's eating and just give him a quick poke when he's halfway (it also helps because he's distracted).
 
Nan & Amber said:
What dose did the vet recommend? [I'm in the "skip" camp, by the way, but just to know]
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Just got off of the phone with Dr. Haddix.

She doesn't understand why he didn't peak higher at the end of his curve, but his numbers were so high yesterday. I did remind her that yesterday he had an off brand hard food that was very high carb and bad for him to help bring up his levels during his hypo and she had me leave a bowl down for him to munch on as needed. We also skipped a shot and he went nearly 17 hours without insulin.

Once I gave him his shot, he did have a curve, but it was in the high numbers. This morning he ate a full bowl of Fancy Feast Classics (his normal food and much better for him) with his 4 units. His numbers dropped pretty quickly from the beginning, but seem to be staying in the same range instead of spiking more at the end. I've updated his spreadsheet.

She wants me to wait two hours, check him at 7:00 PM and if he is at or close to 250 give him 3 units instead of the 4. I'm now getting dirty looks from Bear because he heard his medicine and food alarm go off on my phone and I haven't made a move to put down the goods for him. :p
 
Can you shift your testing/shooting schedule by those 2 hours going forward?... If not you should probably just skip the shot and start anew tomorrow morning.
 
If it's going to be two hours, I think you could give him his dinner-- we usually say that we want to keep the 2hr pre-shot window free of food influence, so that's about right. If I were you, I'd give him his meal now, and then re-assess (and probably skip). I definitely wouldn't give 3 units, though.

The high numbers after the hypo are likely due to what we call a "bounce"-- basically, the cat's body reacts to the low by dumping as much stored glucose into the bloodstream as possible. It can last a few days, it's actually surprising that Bear got back down to green numbers so quickly.

More thoughts in a bit...
 
JohnZ said:
Can you shift your testing/shooting schedule by those 2 hours going forward?... If not you should probably just skip the shot and start anew tomorrow morning.
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Yes. It's actually preferred. We had him at 10 AM and 10 PM because that's when my husband always took his medicine, so I would dose both my guys at the same time. Lol. Because of the hypo incident and Dr. Haddix wanting him to have 4 units right then, it completely shifted his schedule to 5 AM and 5 PM. I managed to get up this morning with very little sleep (we've had another emergency where my mom's cat was attacked the night before Bear went hypo, so I had been operating on only 4 hours of sleep over the course of two days) and test him then feed him with his shot of 4 units. I then continued to test him every 2 hours because that's what they did when he went for his curves at the vet's office. I'll eventually, and very slowly, move him back to an easier time, but 7:00 is much easier for us than 5:00.
 
Nan & Amber said:
If it's going to be two hours, I think you could give him his dinner-- we usually say that we want to keep the 2hr pre-shot window free of food influence, so that's about right. If I were you, I'd give him his meal now, and then re-assess (and probably skip). I definitely wouldn't give 3 units, though.

The high numbers after the hypo are likely due to what we call a "bounce"-- basically, the cat's body reacts to the low by dumping as much stored glucose into the bloodstream as possible. It can last a few days, it's actually surprising that Bear got back down to green numbers so quickly.

More thoughts in a bit...
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I agree... I definitely wouldn't give 3 units...
 
Ellie - I like how you're learning to take care of Bear's diabetes better. Did you know that you can decide how much insulin, when to reduce, when to raise, what to feed, etc all by yourself? Many of us make those decisions after learning what works when for each of our kitties. The experience here is WAY beyond amazing. You're already taken so many steps toward understanding - good job!

Using your particular insulin, I'd skip this one too....

HUGS!
 
Nan & Amber said:
If it's going to be two hours, I think you could give him his dinner-- we usually say that we want to keep the 2hr pre-shot window free of food influence, so that's about right. If I were you, I'd give him his meal now, and then re-assess (and probably skip). I definitely wouldn't give 3 units, though.

The high numbers after the hypo are likely due to what we call a "bounce"-- basically, the cat's body reacts to the low by dumping as much stored glucose into the bloodstream as possible. It can last a few days, it's actually surprising that Bear got back down to green numbers so quickly.

More thoughts in a bit...
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I am leery about it because that night absolutely terrified me. I'm sure you guys understand with your own kitties that he's my lil' love.

So I should give him his (and his brothers') dinner now and then check again in 2 hours?

I was surprised at his numbers as well, but I'm not nearly as experienced as you all are. It doesn't matter that I'm using a human monitor (ReliOn Prime), does it?
 
EllieAviles said:
I am leery about it because that night absolutely terrified me. I'm sure you guys understand with your own kitties that he's my lil' love.

So I should give him his (and his brothers') dinner now and then check again in 2 hours?

I was surprised at his numbers as well, but I'm not nearly as experienced as you all are. It doesn't matter that I'm using a human monitor (ReliOn Prime), does it?
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I wouldn't feed him now... if you think you may still do the shot in 2 hours... still think it's it's best to just skip the shot...
 
Squeaky and KT (GA) said:
Ellie - I like how you're learning to take care of Bear's diabetes better. Did you know that you can decide how much insulin, when to reduce, when to raise, what to feed, etc all by yourself? Many of us make those decisions after learning what works when for each of our kitties. The experience here is WAY beyond amazing. You're already taken so many steps toward understanding - good job!

Using your particular insulin, I'd skip this one too....

HUGS!
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Thank you, that means a lot.

I'm worried I'll make the wrong call, but I'm much more comfortable with taking samples and reading the spreadsheet.

I've also known his moods like the back of my hand, that's how we found out he was diabetic. I told my husband something was off, it wasn't right, but he wasn't acting strange or "sick", so he pushed it off. A week later he passed out in the water bowl and my husband called me at work. I left early and we rushed him to the vet. Diagnosed as diabetic. We may have fought, but he doesn't second guess me any longer when it comes to Bear.
 
EllieAviles said:
Yes. It's actually preferred. We had him at 10 AM and 10 PM because that's when my husband always took his medicine, so I would dose both my guys at the same time. Lol. Because of the hypo incident and Dr. Haddix wanting him to have 4 units right then, it completely shifted his schedule to 5 AM and 5 PM. I managed to get up this morning with very little sleep (we've had another emergency where my mom's cat was attacked the night before Bear went hypo, so I had been operating on only 4 hours of sleep over the course of two days) and test him then feed him with his shot of 4 units. I then continued to test him every 2 hours because that's what they did when he went for his curves at the vet's office. I'll eventually, and very slowly, move him back to an easier time, but 7:00 is much easier for us than 5:00.
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Here's a suggestion... why don't you just wait until 10 PM... that would get you back on your preferred schedule... and give his numbers a chance to rise...?
 
JohnZ said:
I wouldn't feed him now... if you think you may still do the shot in 2 hours... still think it's it's best to just skip the shot...
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Okay. That makes sense, but I do have a question.

This is hypothetical, so I know what I may do. If I don't feed him now and test in two hours and he is still below 250, should I go ahead and feed him, don't give him the shot, then continue to test him every two hours to keep track of his curve and see where his numbers go? That's what I feel I should do, but I'm second guessing myself.
 
JohnZ said:
Here's a suggestion... why don't you just wait until 10 PM... that would get you back on your preferred schedule... and give his numbers a chance to rise...?
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But should I wait to feed him until 10 PM, too? Would feeding him mess with the numbers I'm getting because of the food?
 
JohnZ said:
I wouldn't feed him now... if you think you may still do the shot in 2 hours... still think it's it's best to just skip the shot...
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I'm going to have to disagree with this-- I say go ahead and feed, two hours is enough time to let the immediate food influence fade, and waiting that long without feeding all day can cause numbers to drop even further, so you'd be skipping anyway. I say, let him have his meal and his meds!

EllieAviles said:
Okay. That makes sense, but I do have a question.

This is hypothetical, so I know what I may do. If I don't feed him now and test in two hours and he is still below 250, should I go ahead and feed him, don't give him the shot, then continue to test him every two hours to keep track of his curve and see where his numbers go? That's what I feel I should do, but I'm second guessing myself.
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If you don't feed and end up skipping, I think you can give him a break on testing for the night. It's good information to have, but not critical-- he's not going hypo if he doesn't have insulin on board.

Based on your story and the numbers you've gotten in the past couple days, I am going to make a guess that Bear is one of those cats who is very food-sensitive, and that the recent changeover to Fancy Feast has had a dramatic effect on his insulin needs (not uncommon at all). It took a while for him to hypo symptomatically because of the "bouncing" kind of reactions I described above-- for a while, anyway, his body could compensate by dumping glucose into the bloodstream and get his numbers back into a safer area. Until the other day when he slipped below the line (which, yeah, I'd be terrified of it happening again, too! Thank goodness you were able to get to him in time).

I really think skipping tonight and re-starting the whole process tomorrow "fresh" is the best move...
 
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