Insulin?

[CassWTribby]

Hi everyone. Tribby has been on Caninsulin 3 x a day for 10 months. It worked ok the first half but lately has not been working as well. She has had high BGL and hypos following those. She never gets more then 1 unit.
I'm wondering what type of insulin change I should try and what everyone uses.
She's 15 and has diabetes IBD and CKD. She takes prednisolone every other day and tylosin as well as s boulardii and slippery elm.
Her appetite can be sluggish so I rotate between raw, cooked and canned foods . She cannot have carageen or guar gum so I can only chose A few brands. Low carb options of course

What would be an option of insulin to switch to?
I cannot afford anything expensive.
Thanks everyone!

 

[Chris & China (GA)]

Lantus or Levemir are two of the best insulin's for cats

They're available at any human pharmacy and since you live in Canada, you can get them OTC!!

Lantus is around $90 I think for a 5 pack of pens, but that's enough to last most cats at least a year, so it doesn't end up being too expensive.

The pens are the better buy instead of a 10ml vial.....each pen holds 300 units and you can use them down to the last drop, where the vial will start to lose efficacy in 4-6 months and you could end up throwing a lot of it away.

 

[JanetNJ]

Hi everyone. Tribby has been on Caninsulin 3 x a day for 10 months. It worked ok the first half but lately has not been working as well. She has had high BGL and hypos following those. She never gets more then 1 unit.
I'm wondering what type of insulin change I should try and what everyone uses.
She's 15 and has diabetes IBD and CKD. She takes prednisolone every other day and tylosin as well as s boulardii and slippery elm.
Her appetite can be sluggish so I rotate between raw, cooked and canned foods . She cannot have carageen or guar gum so I can only chose A few brands. Low carb options of course

What would be an option of insulin to switch to?
I cannot afford anything expensive.
Thanks everyone!

If she's having hypos clearly 1 unit is too much. You are sending her too low so her body is over reacting and bouncing to high numbers. Why are you giving it 3 x a day? Can you post a log of spreadsheet of the readings for the past month or so? What was the original dose at diagnosis? How did the vet come to the conclusion 3x a day would be better?

 

[Elizabeth and Bertie]

It worked ok the first half but lately has not been working as well. She has had high BGL and hypos following those. She never gets more then 1 unit.

Hi Cassandra,

As Janet has said in the post above it sounds like the dose is causing Tribby's blood glucose to drop too low and then bounce up to high numbers. She could be caught in a pattern of hypos and bounces. If the insulin dose is causing her to hypo like this it is too high...

How often are you testing Tribby's blood glucose, Cassandra? And have you kept a record of Tribby's test data?
It would be super duper if you could put some of that recent data onto a Google spreadsheet. Someone here can set one up for you if you wish. And once it's up and running it's easy to maintain.

Tribby has been on Caninsulin 3 x a day for 10 months

Can you clarify how often you're giving the insulin shots? Was the '3' just a typo in your post? (Your signature says you're giving insulin twice a day).

Eliz

 

[CassWTribby]

Hi everyone,

I'm actually wondering if the Caninsulin went off. It's turned a bit cloudy. I would like to try a different insulin now because it's not lasting Tribby very long and I find her with a high BGL as early as 8 hrs post injection. She's been on Caninsulin since her diagnosis and I've never been that happy with it although my vet think it's fine.
I test at least 2 x daily and she gets units depending on her bgl. She never gets more then 1 unit.
She also has IBD and CKD so those meds also affect her bgl.
I would really like to try a different insulin instead of buying more caninsulin.
It would be fantastic if someone could set me up a Google spreadsheet. I have recorded all her levels and can upload tonight. I have a Google account. I'm hoping to pick up insulin today because I did not give her any this am.

Thanks everyone!

 

[CassWTribby]

Lantus or Levemir are two of the best insulin's for cats

They're available at any human pharmacy and since you live in Canada, you can get them OTC!!

Lantus is around $90 I think for a 5 pack of pens, but that's enough to last most cats at least a year, so it doesn't end up being too expensive.

The pens are the better buy instead of a 10ml vial.....each pen holds 300 units and you can use them down to the last drop, where the vial will start to lose efficacy in 4-6 months and you could end up throwing a lot of it away.

Thank you. I'm going to Wal-Mart pharmacy tonight.

 

[Kris & Teasel]

She never gets more then 1 unit.

Do you give 1 unit twice a day or three times a day? That's key information for us to have. I agree with the suggestion to try Lantus. It's available in a human pharmacy without a prescription here in Ontario. You can buy both the 5 pack of pens or the 5 pack of cartridges here. Just buy the cartridges. They can be used like a mini vial. You'll need U100 syringes with half unit marks on them. I buy mine from my vet.

It's great that you're willing to set up the spreadsheet we use here. There are folks here who will help:
@Chris & China
@Marje and Gracie

 

[CassWTribby]

If she's having hypos clearly 1 unit is too much. You are sending her too low so her body is over reacting and bouncing to high numbers. Why are you giving it 3 x a day? Can you post a log of spreadsheet of the readings for the past month or so? What was the original dose at diagnosis? How did the vet come to the conclusion 3x a day would be better?

I do not give her 1 unit each time. I always BGT and adjust the level. I'm having a hard time keeping her level stable. The past few weeks it has been higher then normal but I'm thinking her caninsulin has gone off then yesterday she had a hypo after 1/2 unit and she was eating.
Time to find a new insulin. I have never been that satisfied with caninsulin other then it's affordable.

 

[Kris & Teasel]

I do not give her 1 unit each time. I always BGT and adjust the level. I'm having a hard time keeping her level stable. The past few weeks it has been higher then normal but I'm thinking her caninsulin has gone off then yesterday she had a hypo after 1/2 unit and she was eating.
Time to find a new insulin. I have never been that satisfied with caninsulin other then it's affordable.

At a low dose like she gets, a 5 pack of Lantus catridges will last you almost a year - cheaper in the end than Caninsulin.

 

[CassWTribby]

She gets insulin 2x a day. That was a typo. In actually dealing with my own health problems right now which sucks

 

[Elizabeth and Bertie]

n actually dealing with my own health problems right now which sucks

So sorry to hear that, and really hope you're feeling better very soon.
.

 

[Elizabeth and Bertie]

I'm actually wondering if the Caninsulin went off. It's turned a bit cloudy

Caninsulin should look a bit milky when mixed.
And the fact that Tribby had that hypo would seem to suggest that the insulin does still have some potency...

I see Kris has tagged some folks to get a spreadsheet set up for you. That's great! Things may become a lot clearer when we can see some of Tribby's recent test data.
.

 

[CassWTribby]

Lantus or Levemir are two of the best insulin's for cats

They're available at any human pharmacy and since you live in Canada, you can get them OTC!!

Lantus is around $90 I think for a 5 pack of pens, but that's enough to last most cats at least a year, so it doesn't end up being too expensive.

The pens are the better buy instead of a 10ml vial.....each pen holds 300 units and you can use them down to the last drop, where the vial will start to lose efficacy in 4-6 months and you could end up throwing a lot of it away.

Just wondering where you got your lantus.. the pens are way more expensive at my Wal-Mart I can get the 10 ml vial for $80. I really cannot afford more then that right now.

 

[Kris & Teasel]

Just wondering where you got your lantus.. the pens are way more expensive at my Wal-Mart I can get the 10 ml vial for $80. I really cannot afford more then that right now.

I've bought Lantus at Shoppers Drug Mart for $125 for 5 pens. I think others in Ontario have found it for a better price at other pharmacies but around $100-$110 CAD for a 5-pack is about the cheapest. You could call around to different pharmacies in your area. As Chris said, the problem with the 10 mL vial is that it'll expire in about 6 months (or less) and you'll be no where near finishing it. That's a lot of waste. Each cartridge is only 3 mL and it's possible to use every last drop while it's still potent. The other unopened cartridges will keep in the fridge until their expiry date, usually 2 years down the line.

 

[CassWTribby]

So I'm doing my research on lantus and where to buy it. A bit of budgeting is needed as well. I'm hoping to get the pens this week. If not I will get a vial and use it until I can afford pens.

Once I have it do just stop using the Caninsulin and start using the lantus?
She's around 5lbs. Is getting 1u caninsulin 2 x daily but the 1 unit is too much for her when her bgl is low so she gets 1/2 or even 1/4 unit. She's been caught in a cycle of highs 18 then crashing to a low of <5 which is scarey. She has IBD and CKD so if really like to figure this out. Caninsulin only seems to last 8-10 hours for her which is another issue. I have never been thrilled but my vet doesn't agree.

Unfortunately I'm dealing with some health issues of my own so I'm trying not to be overwhelmed! So much to know!

Thanks

 

[Chris & China (GA)]

Once I have it do just stop using the Caninsulin and start using the lantus?

Yes, you can shoot one in the morning and the other at night (or vise versa) Caninsulin doesn't have any "carry-over" ....once it's out of the body, it's out.

If she's only 5lbs, her starting dose on Lantus would be 0.5

Don't forget..Caninsulin is a U40 insulin....Lantus is U100 so you'll need U100 syringes

 

[Juliet]

Lantus or Levemir are two of the best insulin's for cats

They're available at any human pharmacy and since you live in Canada, you can get them OTC!!

Lantus is around $90 I think for a 5 pack of pens, but that's enough to last most cats at least a year, so it doesn't end up being too expensive.

The pens are the better buy instead of a 10ml vial.....each pen holds 300 units and you can use them down to the last drop, where the vial will start to lose efficacy in 4-6 months and you could end up throwing a lot of it away.

I wish it was only $90 for the pens. It’s about $90 just for the vial which is what I get. Five pens more like $200 last time I asked.

 

[Chris & China (GA)]

I wish it was only $90 for the pens. It’s about $90 just for the vial which is what I get. Five pens more like $200 last time I asked.

That's why I said "I think" when I mentioned a price.....I know it's cheaper than it is here in the US, but since I'm not in Canada, I don't really know. I do know that a 5 pack of pens shouldn't cost you $200 though!! They don't even cost me that much when I buy from Canada ($165) and we pay more than Canadian citizens do

The pens are still the better buy though unless you have a high dose cat. A vial is 1000 units....on an "average" of 2U per shot, that's 250 days worth.....Most of the time, the vial starts to lose efficacy at 4-6 months (120-180 days), so you could end up throwing half a vial away.

The pens only contain 300 units in each pen so you can usually use every drop from the pen before it starts to lose it's punch. The pens are usually good for at least 2 years from the date of purchase, so most of us will save money in the long run by using the pens instead of throwing a bunch of insulin in the trash

 

[Juliet]

I guess it’s better for the pens. Personally I never have that much at one time. I buy my strips specially order d from my pharmacy as she’ll order me 50 at a time instead of packs of 100 that they all sell. That way I pay $50 instead of $80 at a time.

 

[CassWTribby]

Thanks everyone. I'm picking up 5 cartridges for $125 At Shoppers. I'm hoping to start her today. I have her caninsulin last night and she didn't seem to feel well after. Her bgl was fine, but she just felt icky.

From what I've researched she should get a 1/2 u from a u100 syringe to start? In my readings I also saw it may take 24 hrs to bring her bgl down?
I'm hoping to do a bgl curve this weekend.
I've tried several times to start a spreadsheet and have had no luck on my phone or tablet! It's an end user problem though. I'm not that familiar with Samsung yet. I may try to go to the library and start one there on a computer.

Thanks again everyone. Its been an awful week with my own health issues and everyone here helps me keep my sanity!!

 

[Kris & Teasel]

Thanks everyone. I'm picking up 5 cartridges for $125 At Shoppers. I'm hoping to start her today. I have her caninsulin last night and she didn't seem to feel well after. Her bgl was fine, but she just felt icky.

From what I've researched she should get a 1/2 u from a u100 syringe to start? In my readings I also saw it may take 24 hrs to bring her bgl down?
I'm hoping to do a bgl curve this weekend.
I've tried several times to start a spreadsheet and have had no luck on my phone or tablet! It's an end user problem though. I'm not that familiar with Samsung yet. I may try to go to the library and start one there on a computer.

Thanks again everyone. Its been an awful week with my own health issues and everyone here helps me keep my sanity!!

Yes, start her on a half unit measured on the U100 syringe. Do yours have half unit marks? There are people here who will set up a spreadsheet for you:
@Chris & China @Marje and Gracie

 

[CassWTribby]

Yes the needles I have have 1/2 units. Thank you!!

This is the exact problem I'm having with caninsulin. I gave her 1/2 unit at 9:30pm last night. I just checked her and she's 17.8!! Should I give her some caninsulin while waiting to see when her bgl comes down? Ugh that scares me to death. She did eat and drink ok just before. Seems a bit yucky feeling.

 

[CassWTribby]

Caninsulin should look a bit milky when mixed.
And the fact that Tribby had that hypo would seem to suggest that the insulin does still have some potency...

It actually looked as though it separated. I mixed it with my palms but still looks iffy.
I see Kris has tagged some folks to get a spreadsheet set up for you. That's great! Things may become a lot clearer when we can see some of Tribby's recent test data.
.

 

[Marje and Gracie]

I’ll send you a private message to set up a Spreadsheet for you. Just check your “inbox” in the upper right corner of this page in a few minutes.

IMHO, if I had a choice on which insulin to start her on, with her health issues, I’d choose Levemir. And it’s also a bit less expensive.

However, you need to understand the difference between them because they have different onsets and nadirs which might not fit into your lifestyle.

Lantus generally onsets at about +2 and the nadir (or lowest point in the cycle where the peak action of the insulin occurs) is around +6 (every cat is different so that might vary).

Levemir generally onsets at about +4 and the nadir is between +8 and +12 so users of Levemir need to learn to shoot the lower numbers sooner than Lantus users generally do.

 

[JL and Chip]

I replied to your other post before I saw this one.

My Charlie was a steroid-induced diabetic and was SUPER sensitive to insulin. He could go from the 400s to hypo territory on 1/4 unit of Lantus. He also had severe IBD, CKD, and other health problems.

I suspect that the prednisolone might be contributing to the erratic numbers you're seeing. Charlie couldn't handle prednisolone without being thrown into diabetes, so we tried him on budesonide, which theoretically has more focused impact on the GI tract and fewer systemic side effects. Have you tried budesonide? It also caused Charlie's BG to skyrocket so we had to pull him off of it as well. I believe we went to Chlorambucil after that. Charlie's BG would spike while on steroids and we'd have to start insulin, then as soon as we pulled him off steroids, his BG would settle down back into non-diabetic ranges and I'd have to stop the insulin. Thankfully I was hometesting so we caught the changing needs and avoided hypo. In the end, our Internal Medicine specialist wanted to avoid adding diabetes to his laundry list of medical issues so we avoided steroids entirely.

Charlie was on tylosin as well and could eat only one flavor of Merrick canned food mixed with canned pumpkin or else he'd have a massive blowout. So I've walked a very similar path to what you're on right now and I feel your pain. Unfortunatly, I'm not sure you'll be able to get consistent numbers with prednisolone on board very other day (steroids can spike BG), but Caninsulin can be somewhat harsh and difficult to work with in cats, and as others have said, Lantus or Levemir tend to be much better options. Just know that you do NOT want to use a sliding scale with Lantus or Lev.

Charlie also had chronic pancreatitis. Have you tested for that? It can make them feel very punky even when the BG is good and is relatively common in diabetics. The test is called an fPLI.

 

[CassWTribby]

I'm actually in the process of weaning Tribby off of prednisolone thankfully. I started her on CBD oil and it has had an amazing affect on her. Way better then the pred did. She used to have a major blow out if she got any of our other cats food at all with carageen or guar gum in it. Now with the cbd oil I can actually use a bit of fancy feast as a topping with no issues. She's getting it every third day now. hoping to give even less next week and fingers x stop it after that. Bude had no effect sadly.
Thanks for the suggestions though. It's been over a year since all of this began and she's been having solid poops for a month or so now.
Does tylosin raise bgl did you notice?
She gets that daily. Hard to day what's causing it but yes pred does raise her bgl.
We have tested and she was negative for pancreatitis. Lots of blood work has been tested.
She was 20 this am but that was my fault - fur shot last night. Ugh I hate that! She's getting such a tiny amount too. Still at .25
She seems happier and perkier in lantus already. Caninsulin was very hard on her system. I wished I had pushed onto lantus much earlier.

 

[Juliet]

Tylosin and Pred got Silver out of remission so I would imagine they both raise BG.