Trying to Determine Next Steps

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Fit_Jan

Fit_Jan

Member Since 2017
Linus is getting increasingly lethargic.

I am going to call the vet tomorrow and ask if they will just give him the simple BG test which is $22.00 and ask that she write the prescription for the insulin. I am going to ask that she not do the Fructosamine test which is 88.00 and the other test they were recommending. I mentioned in my into thread that my costs have been extremely high since he was diagnosed.

My other challenge is that if I am able to get him started on insulin this week, I have to go out of town this weekend, and I only have someone who can feed him. The neighbor surely will not be able to give him insulin shots while we are away. If this is the case, would it be better to get him started on the insulin after we return next Sunday so we can be her to monitor him?

I have no idea if the vet will be willing to cooperate with my request for the regular BG test or if she will just write an Rx for Linus.
 
Update:

I just spoke with the doctor, she is just going to write me the prescription. No testing required.

I mentioned that I plan on learning about how to do the curves testing so that I can do it, she told me I didn't need to buy all that equipment, they only do curves testing when there is complications. She said I shouldn't have to stick the kitty so much. They would just have him come in for a BG test in about 3 weeks, which would cost about $22.00. She said most of my expenses are behind me.

I told her I was going out of town this weekend, leaving early Saturday and returning Sunday afternoon and she said it would be okay to start him on the insulin before I leave.

She told me to just make an appointment to come by and they will show us how to give the injections.

I'm going to pick up the prescriptions this afternoon. The insulin is Lantus.

Thoughts?

ETA: It can't be that simple, right?
 
Last edited:
Fit_Jan said:
Update:

I just spoke with the doctor, she is just going to write me the prescription. No testing required.

I mentioned that I plan on learning about how to do the curves testing so that I can do it, she told me I didn't need to buy all that equipment, they only do curves testing when there is complications. She said I shouldn't have to stick the kitty so much. They would just have him come in for a BG test in about 3 weeks, which would cost about $22.00. She said most of my expenses are behind me.

I told her I was going out of town this weekend, leaving early Saturday and returning Sunday afternoon and she said it would be okay to start him on the insulin before I leave.

She told me to just make an appointment to come by and they will show us how to give the injections.

I'm going to pick up the prescriptions this afternoon. The insulin is Lantus.

Thoughts?

ETA: It can't be that simple, right?
Click to expand...
That's great that you are going to start Lantus.

I agree you don't need more testing at the vet. I disagree that you don't need to test at home.
 
Glargine Insulin u100
Give 2 units subcutaneously twice a day.
She said it would be okay for him to miss 3 doses it might make him feel better before I leave.

It is going to be a challenge to find the insulin before the end of the week. I was out of the office with a doctor's appointment today, I was out in training all last week. Work is going to be strenuous for the rest of this week.
Can I vent, I should be happy to be going to see my family... but this is a bit much right now.
 
Fit_Jan said:
Glargine Insulin u100
Give 2 units subcutaneously twice a day.
She said it would be okay for him to miss 3 doses it might make him feel better before I leave.

It is going to be a challenge to find the insulin before the end of the week. I was out of the office with a doctor's appointment today, I was out in training all last week. Work is going to be strenuous for the rest of this week.
Can I vent, I should be happy to be going to see my family... but this is a bit much right now.
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Vent away ... we all understand the extra burden FD puts on top of everything else in life. I, personally, wouldn't start with a 2 u dose, especially just before going away and with no BG testing routine in place. Give the issue some thought, read more on the forum and see what you'd be most comfortable with. You can probably predict what we'll say. You have to decide if it's the way you want to proceed. :)
 
I agree with starting with less than recommended for certain, just based on my personal experience with medicine. We want just enough to get us back to normal, we don't want to swing in the wrong direction. I'm concerned with the usual 12 hour gap in time that I am away from on week days, not to mention being gone for 40 hours straight. I cut the trip way short. The reunion starts Friday, we are waiting until Saturday morning to leave and then we are turning around and coming back Sunday morning. it's about a 6-7 hour drive.
 
Fit_Jan said:
I agree with starting with less than recommended for certain, just based on my personal experience with medicine. We want just enough to get us back to normal, we don't want to swing in the wrong direction. I'm concerned with the usual 12 hour gap in time that I am away from on week days, not to mention being gone for 40 hours straight. I cut the trip way short. The reunion starts Friday, we are waiting until Saturday morning to leave and then we are turning around and coming back Sunday morning. it's about a 6-7 hour drive.
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I think you'll have more peace of mind if you wait to give insulin after your return. A few more days of high BGs isn't going to make much difference in the long run but one episode of too low when you aren't aware can be a huge problem.
 
Fit_Jan said:
No testing required.
Click to expand...
I totally agree with Kris and Janet's disagreements :D. One way we like to look at it here is, we wouldn't blindly dose a human child with insulin without daily testing, our fur babies are no different. My Aunt's guilt me with the same thing "Aww his poor ears, you shouldn't stick him so much". My Spreadsheet is just one, where if I wasn't home testing and just kept giving him full doses, I would have sent him hypo. If anyone saw Maury right now, you can't even tell his ears have been poked once! :smuggrin:. Home testing also lessened my anxiety with worrying how his BG was doing, of course it's still there (especially when I have to be gone all day - 9/10 hours) but if he acts like he's going low, I can spot check him and know his BG right there.

In addition to your Vet saying to start and then skip 3 doses, Lantus is a depot insulin, it can take a few days just to get that going. So if you were to start, build it up some, then skip 3 doses it will make the depot kind of wonky. Given I haven't used Lantus yet, we are making the switch. There is lots of information in the "Sticky's" in the Lantus thread.

Lastly, keep in mind the management of diabetes is a marathon, not a sprint. It still may take time for Linus to get back into normal ranges and there is no 100% guarantee he'll go into remission.

With that, I hope you can enjoy your trip and if you're not starting insulin before you go you might be able to relax a little more. Linus should be OK for another couple days. We're here to support Linus and YOU :bighug:
 
Linus was in good spirits and getting around yesterday, and now this morning he won't eat. This is the first time this has happened. I may have to get him started ASAP! I don't know what else to do at this point.
 
Have you tested him for ketones? You can pick up test strips at any pharmacy. This is important, ketones can be very serious.
 
Sharon14 said:
Have you tested him for ketones? You can pick up test strips at any pharmacy. This is important, ketones can be very serious.
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I am at work now. Plan to go to the Pharmacy at lunch if I can get away. This is why I'm thinking I need to find someone who can adopt Linus. I am just not physically, or mentally available for him when he needs me the most it seems.
 
Fit_Jan said:
I am at work now. Plan to go to the Pharmacy at lunch if I can get away. This is why I'm thinking I need to find someone who can adopt Linus. I am just not physically, or mentally available for him when he needs me the most it seems.
Click to expand...
Post another thread on this forum asking for information about rehoming Linus if you aren't able to care for him. There are a number of members here who have adoptees from people who couldn't look after their FD kitty for one reason or another.
 
Fit_Jan said:
What would we do if there is Ketones? give insulin?
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If ketones are trace when you test, call your vet for advice. Anything more than trace needs immediate vet attention because there's a risk of diabetic ketoacidosis (DKA) setting in and that's a very serious complication.
 
Fit_Jan said:
I am at work now. Plan to go to the Pharmacy at lunch if I can get away. This is why I'm thinking I need to find someone who can adopt Linus. I am just not physically, or mentally available for him when he needs me the most it seems.
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I have two things to offer you:
  1. Treating FD seems an insurmountable obstacle at first but does get much easier over time as you learn the skills and build a new routine. It's not as onerous as it feels to you right now when you're facing an avalanche of new information and things to do. There are many people here who successfully fit it in while working full time outside the home or dealing with other complex family/health issues. I know we all have different levels of tolerance for things like this and I certainly don't want to make you feel bad if you decide that you can't help Linus.
  2. You can post on this forum asking for information about rehoming him if, after more thought, you decide this won't work for you. There are several members on FDMB who have taken in kitties from owners who can't care for their FD for one reason or another.
Take some time to think more about it. Ask questions here. We can help you learn to look after him while still having your own life. :)
 
Can someone please post the ketone testing kit that we can purchase from Walgreens or Walmart? I'm trying to get someone to help me while I am at work.
 
My cat let's me stick a spoon under him while he pees. Others have had success using some plastic wrap in the litter box catching urine in the folds. Still others simply hold the test strip in the urine stream. You only need a tiny amount of urine. Be sure to time the test exactly as the directions state to get accurate results.

ETA most use a long handled spoon
 
Sharon14 said:
My cat let's me stick a spoon under him while he pees. Others have had success using some plastic wrap in the litter box catching urine in the folds. Still others simply hold the test strip in the urine stream. You only need a tiny amount of urine. Be sure to time the test exactly as the directions state to get accurate results.

ETA most use a long handled spoon
Click to expand...
My cat goes in the same spot all the time perhaps we can put something in his favorite spot that can catch some of his urine... I'm trying to brainstorm about cat pee while in a meeting at work...

Life is funny.
 
If your kitty isn't shy about you looking at him while he's in the box, slipping a shallow, long-handled spoon under his backside to catch some urine works really well. You only need enough to wet the end of the test strip. Make sure you time it properly (usually 15 sec) so the colour develops to the correct point. View it under a good strong light.
 
Kris & Teasel said:
If your kitty isn't shy about you looking at him while he's in the box, slipping a shallow, long-handled spoon under his backside to catch some urine works really well. You only need enough to wet the end of the test strip. Make sure you time it properly (usually 15 sec) so the colour develops to the correct point. View it under a good strong light.
Click to expand...
I am not home, was hoping to get someone to help. Does the urine have to be fresh out of the kitty or can we create a "reservoir" in the litter box and collect from a not fresh sample?
 
Honestly just work on one hurdle at a time!! My Tribby was just diagnosed last February and it was very overwhelming!

I'd worry just about starting the insulin and home testing first. Don't worry about other things right away unless you have to! One step at a time.
Many pharmacies will give you a BG meter for free if you buy a certain amount of test strips. My pharmacy is great about holding expired test strips and lancets for me because they know it's for a cat. Great help!
Wait until you get back and start giving insulin and BGT's. See how it goes for a few weeks. It's eazy peazy now to test and give insulin to my cat. Under 5 minutes and she even wakes me up in the morning when it's time.
Just focus on one thing at a time! Otherwise it's overwhelming!
I work crazy hours as well. I treat her right before I leave and usually as soon as I get home.
Can the clinic keep your kitty over the weekend and start the insulin for you or would that be horribly expensive? Don't assume they know how to do ear pricks for BGT though. Lol. We reside in a special world of special talents us diabetic kitty caretakers.
Reasses in a few weeks and see how you feel. If its still too much it's fair to find a new home but look carefully. Many people with a diabetic cat would take another no problem.
It does get easier I promise.
 
CassWTribby said:
Honestly just work on one hurdle at a time!! My Tribby was just diagnosed last February and it was very overwhelming!

I'd worry just about starting the insulin and home testing first. Don't worry about other things right away unless you have to! One step at a time.
Many pharmacies will give you a BG meter for free if you buy a certain amount of test strips. My pharmacy is great about holding expired test strips and lancets for me because they know it's for a cat. Great help!
Wait until you get back and start giving insulin and BGT's. See how it goes for a few weeks. It's eazy peazy now to test and give insulin to my cat. Under 5 minutes and she even wakes me up in the morning when it's time.
Just focus on one thing at a time! Otherwise it's overwhelming!
I work crazy hours as well. I treat her right before I leave and usually as soon as I get home.
Can the clinic keep your kitty over the weekend and start the insulin for you or would that be horribly expensive? Don't assume they know how to do ear pricks for BGT though. Lol. We reside in a special world of special talents us diabetic kitty caretakers.
Reasses in a few weeks and see how you feel. If its still too much it's fair to find a new home but look carefully. Many people with a diabetic cat would take another no problem.
It does get easier I promise.
Click to expand...
I was willing to wait until I return from my trip but today for the first time, Linus did not want to eat. He has been begging for food non stop. That has me really worried. It's just Tuesday, that means we won't be able to start him until Sunday afternoon / early evening.

I'm a mess, totally not focused on my job, which is going to get me into huge trouble.
 
Ps. You can get a ketones test kit with hydromorphic sand at most pet stores. I personally don't test for ketones regularily but I have the kit just in case I need to.
The kit comes with the sand to substitute for your litter, and test strips. Plus a nozzle thingy to suction up the urine.
 
I'm a mess, totally not focused on my job, which is going to get me into huge trouble.[/QUOTE]

I know right?! The first few days after diagnosis are a blur for me. My first blood tests didn't work either but we got there with practice. With insulin less is better to start off with I agree.

Can the vet clinic board him for the weekend and treat him or do they have a vet tech willing to cat sit and start him? Do you know any nurses? They are great at giving insulin.
Call and ask because you never know!
 
CassWTribby said:
I'm a mess, totally not focused on my job, which is going to get me into huge trouble.
Click to expand...

I know right?! The first few days after diagnosis are a blur for me. My first blood tests didn't work either but we got there with practice. With insulin less is better to start off with I agree.

Can the vet clinic board him for the weekend and treat him or do they have a vet tech willing to cat sit and start him? Do you know any nurses? They are great at giving insulin.
Call and ask because you never know![/QUOTE]
My Vet doesn't board, and she is expensive! We are doing good to have someone come and feed the cats while we are away.
 
The urine should be fresh, Within an hour according to the Relion instructions. What are you feeding now, still Purina DM?
 
Sharon14 said:
Do you have some other food to try, maybe Fancy Feast Classic, or Friskies Pate? Some cats get tired of the DM and quit eating it.
Click to expand...
Oh my gosh, that expensive $2.00 per can food!!
I am going to the pharmacy today, I will pick up some Fancy Feast Classics and see if that helps!

I just found out that Walmart has an OTC insulin
- Novolin N and R ...

I'm trying to see if I can get a deal on Lantis. Walmart said they will not break a 5 pen box. So that's a no go. It's $288.02 per vial.
 
Novolin is not a good insulin for cats. It's too fast acting and doesn't last long enough. Many of us buy Lantus from Canada, not sure how long it takes to get it, but in the meantime you can call around to find a pharmacy that will sell a single pen, or check out the Supply Closet forum. Many of us have bought from Alan and he will often sell singles. http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

ETA The pens are a better deal than the vial. They will last a long time if kept properly, while the vial will often lose effectiveness before its used up. You'll need syringes to draw the insulin from the pen rather than using the pen needles.
 
Sharon14 said:
Novolin is not a good insulin for cats. It's too fast acting and doesn't last long enough. Many of us buy Lantus from Canada, not sure how long it takes to get it, but in the meantime you can call around to find a pharmacy that will sell a single pen, or check out the Supply Closet forum. Many of us have bought from Alan and he will often sell singles. http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

ETA The pens are a better deal than the vial. They will last a long time if kept properly, while the vial will often lose effectiveness before its used up. You'll need syringes to draw the insulin from the pen rather than using the pen needles.
Click to expand...
So the Pens are better than the Vials. No one I called so far wants to break the box. ..oy!
 
If you do plan on getting Lantus from the Supply Closet or from Marks in Canada, you should do it soon. While all Lantus is shipped express in special boxes to try and keep it cool, Marks will not ship when the weather gets too hot.
 
Thank you @Yong and @Red & Rover (GA) and @sharon and @CassWTribby @Kris & Teasel I appreciate each and every one of you.
I went to my pharmacy and got a vial of Lantus because Linus is getting worse not better. I am going to start him on it tonight, I am going to see if I can find someone to administer while we are gone (if we go)
I could not find a pharmacy to break a box of pens. I couldn't take up more time at work to figure that out today.

Can you please point me to a YouTube of the best way to administer the insulin? I have looked at some YouTubes with demonstrations that conflicts with what I have read here.
Also the best way to preserve the insulin.

ETA: I pray I will be in a better position to take advantage of deals, and Canada, etc at a later time.
 
Fit_Jan said:
Thank you @Yong and @Red & Rover (GA) and @sharon and @CassWTribby @Kris & Teasel I appreciate each and every one of you.
I went to my pharmacy and got a vial of Lantus because Linus is getting worse not better. I am going to start him on it tonight, I am going to see if I can find someone to administer while we are gone (if we go)
I could not find a pharmacy to break a box of pens. I couldn't take up more time at work to figure that out today.

Can you please point me to a YouTube of the best way to administer the insulin? I have looked at some YouTubes with demonstrations that conflicts with what I have read here.
Also the best way to preserve the insulin.

ETA: I pray I will be in a better position to take advantage of deals, and Canada, etc at a later time.
Click to expand...

Usually you get a "how to inject insulin" tutorial from a vet tech at your vet's clinic. They often tell you to use the scruff of the neck and that can work until you build your skill level. Basically, regardless of shot location, you grasp some skin firmly between thumb and index finger and lift it up high enough to form a "tent". Feel for the depression that is the "tent door" and that's where you poke the needle in using a forward but very slightly downward direction. Use a spot that's in the middle of the "tent door".

If I recall, a dose of 2 units twice a day was prescribed. We would strongly recommend starting at 1 unit twice a day for safety's sake. It's also best to keep the two doses as close to 12 hours apart as you can. Lantus is a depot insulin in that a part of each dose goes to filling a depot under the skin that acts as a sort of time release mechanism. It takes a few doses for this depot to fill properly. The insulin works best when the depot is full and stable in size (its size depends on how large the dose is). Varying the dose AM to PM or varying the timing of the shots can alter the depot and that can lead to some unpredictable responses.

The Lantus vial should be stored in your fridge on a main shelf, not in the door. Put it in some sort of small container that protects it and keeps it from getting knocked around. Lantus, like all insulins, can be affected by heat and being dropped or banged around. Be careful not to drop it when it's out for use - very $$$ accident.

Does this help? Maybe you can let us know what confusion you have regarding how to inject. Are you planning to tackle testing blood glucose at home? We think it's the single most important tool in keeping kitty safe, monitoring his response to insulin and helping you take the steps that will get him regulated sooner.
 
Kris & Teasel said:
Usually you get a "how to inject insulin" tutorial from a vet tech at your vet's clinic. They often tell you to use the scruff of the neck and that can work until you build your skill level. Basically, regardless of shot location, you grasp some skin firmly between thumb and index finger and lift it up high enough to form a "tent". Feel for the depression that is the "tent door" and that's where you poke the needle in using a forward but very slightly downward direction. Use a spot that's in the middle of the "tent door".

If I recall, a dose of 2 units twice a day was prescribed. We would strongly recommend starting at 1 unit twice a day for safety's sake. It's also best to keep the two doses as close to 12 hours apart as you can. Lantus is a depot insulin in that a part of each dose goes to filling a depot under the skin that acts as a sort of time release mechanism. It takes a few doses for this depot to fill properly. The insulin works best when the depot is full and stable in size (its size depends on how large the dose is). Varying the dose AM to PM or varying the timing of the shots can alter the depot and that can lead to some unpredictable responses.

The Lantus vial should be stored in your fridge on a main shelf, not in the door. Put it in some sort of small container that protects it and keeps it from getting knocked around. Lantus, like all insulins, can be affected by heat and being dropped or banged around. Be careful not to drop it when it's out for use - very $$$ accident.

Does this help? Maybe you can let us know what confusion you have regarding how to inject. Are you planning to tackle testing blood glucose at home? We think it's the single most important tool in keeping kitty safe, monitoring his response to insulin and helping you take the steps that will get him regulated sooner.
Click to expand...
Is rolling the vial appropriate?

I plan to test. I bought a meter and some strips. The vet keeps advising me to just get him on the insulin. They offered to show me how but I could not get to their office before they closed. I left work early to get the insulin, I could not do that and make it to the vet in time.
 
Fit_Jan said:
Is rolling the vial appropriate?
Click to expand...
You don't really have to do that with Lantus. It's a solution, not a suspension like some other types of insulins are. Always check it for clarity before use. It should be crystal clear throughout with no floaties or little "snowflakes" in it.
 
Fit_Jan said:
Is rolling the vial appropriate?

I plan to test. I bought a meter and some strips. The vet keeps advising me to just get him on the insulin. They offered to show me how but I could not get to their office before they closed. I left work early to get the insulin, I could not do that and make it to the vet in time.
Click to expand...
A huge YES! to the testing. Never mind what the vet said. Do you feel as though you have enough info to give a shot tonight? Ask anything else that comes to mind.
 
Kris & Teasel said:
A huge YES! to the testing. Never mind what the vet said. Do you feel as though you have enough info to give a shot tonight? Ask anything else that comes to mind.
Click to expand...
My son and I gave him the shot at 7:30 pm and he ate a good bit of Fancy Feast Classics. I will keep reading and will start testing soon, I'm just exhausted at the moment with all today's activities. Work was crazy busy, but I was so distracted by my worry about my baby! I did some reading about how to avoid Ketones I will work diligently to make sure Linus eats and drinks. I got him to drink by putting water in a big coffee mug and sloshing it around with my finger. That is hard for him to resist!
 
Fit_Jan said:
My son and I gave him the shot at 7:30 pm and he ate a good bit of Fancy Feast Classics. I will keep reading and will start testing soon, I'm just exhausted at the moment with all today's activities. Work was crazy busy, but I was so distracted by my worry about my baby! I did some reading about how to avoid Ketones I will work diligently to make sure Linus eats and drinks. I got him to drink by putting water in a big coffee mug and sloshing it around with my finger. That is hard for him to resist!
Click to expand...
Whatever it takes! Many of us add some warm water to all the wet food meals to make a sort of "stew". It's a really good way to boost hydration, flush out their bladder and ketones if they're there and can help with constipation too.
 
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