? Need some help please

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If Pepper were my cat:

- I'd get hold of the vet as soon as they're open and try to get an anti-nausea treatment that I could administer at home as needed, e.g. generic ondansetron (the branded Zofran version is hideously expensive but the generic is much more affordable - it's a human medication so if your vet doesn't carry the generic you could ask for a written Rx and get it filled at a regular pharmacy. Ondansetron's an anti-emetic so it could help with both vomiting and also reluctance to eat due to nausea. If you tackle the nausea the appy stimulant might not be needed, and Pepper might eat more steadily and predictably for you.

- I'd look to switch to an insulin known to typically have a longer duration in cats, i.e. Lantus, Levemir or Prozinc. Looking at Pepper's spreadsheet, for a Novolin kitty she's getting a relatively good duration for this insulin type with nadir around the +6 mark but it's completely petered out by the time the next dose is due. Word of caution: You might end up with similar results on Vetsulin. Also, the Novolin N is producing relatively wide swings in BG between the PS and nadir levels. That can make some cats feel really cruddy. An insulin with a 'gentler' action profile might even Pepper out and make her feel a lot better in general (for Saoirse the difference between being treated with Vetsulin (aka Caninsulin) and Lantus was like night and day; she was getting wide swings on the former and it made her miserable most of the day.

Pepper's not on a high dose of insulin at the moment. If you're in the US and you were to order Lantus or Levemir from Marks Marine Pharmacy in Canada it would make those choices much more affordable - and possibly comparable to the cost of the Vetsulin. (See the main FDMB FAQ section for more info on ordering from Canada.)

I don't know whether this might be of a little bit of comfort to you: looking at Pepper's PMPS values over the last few days they're starting to show a bit of a downward trend, and that's encouraging.

I feel for you: I fully understand the frustration and fear that comes from feeling all alone with FD. Please know that you're not alone; we're all here for you and we'll do all we can to help and support you both.

:bighug:


Mogs
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I'm here. I'm trying to take this all in. The vet still hasn't called to talk to me. I'm still wondering on whether or not an insulin change will be good for Pepper, since what I am getting from here is that Vetsulin poops out around +8. That sounds like what we are dealing with now with Novulin. I just can't spend an arm and a leg on insulin and vet visits. I am a one income household supporting 3 people. I was just looking at being able to help Pepper on a budget and so far that doesn't seem possible.
 
Critter Mom said:
If Pepper were my cat:

- I'd get hold of the vet as soon as they're open and try to get an anti-nausea treatment that I could administer at home as needed, e.g. generic ondansetron (the branded Zofran version is hideously expensive but the generic is much more affordable - it's a human medication so if your vet doesn't carry the generic you could ask for a written Rx and get it filled at a regular pharmacy. Ondansetron's an anti-emetic so it could help with both vomiting and also reluctance to eat due to nausea. If you tackle the nausea the appy stimulant might not be needed, and Pepper might eat more steadily and predictably for you.
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I've asked the vet at her last appointment and again on the phone right before Christmas, and she will not give me an anti nausea medication.
 
Re cost of insulin, it is worth keeping watch on the FDMB Supply Closet for offers of Lantus/Levemir.

Peppersmom72 said:
I was just looking at being able to help Pepper on a budget and so far that doesn't seem possible.
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Please don't lose heart: the early days can be so tough but with a little time you'll hopefully get all your ducks in a row re cost of food/supplies, etc.

:bighug:


Mogs
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No, after her appointment the vet tech came in to give Pepper her anti nausea shot and to give me a prescription for the appetite stimulant, I then asked am I getting a prescription for anti nausea meds and she said "no, she doesn't need it". Then I called before Christmas and told her that she was throwing up and not eating and I asked again if I could get a prescription for anti nausea and she just ignored the question and started talking about how we should raise her dose to 2.5 from 2.o. And not to do a curve until the weekend of New Years eve.

Then she stated that should would like in the near future to do an ultrasound to see if something else is going on (why she is vomiting). There goes more money. $350 for an ultrasound.
 
Also are there any other vets at the practice? If yes, could you ask for a second opinion on treatment for the eating difficulties from one of them?

(Brainstorming here.)


Mogs
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Peppersmom72 said:
I called before Christmas and told her that she was throwing up and not eating and I asked again if I could get a prescription for anti nausea and she just ignored the question ...
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:mad::mad::mad:

[Insert very rude words here.]

Vets like that are a total head-wreck. I've been in that position myself and it makes me SOOOOOOOOOOO ANGRY to see it happening to other people and their little ones!!!! I'm so sorry that you're not getting adequate and appropriate veterinary support; makes things a lot harder - unnecessarily.

Have another :bighug:.


Mogs
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Critter Mom said:
Also are there any other vets at the practice? If yes, could you ask for a second opinion on treatment for the eating difficulties from one of them?

(Brainstorming here.)


Mogs
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There are not any other vets in the practice and the vet seems like she is genuinely caring. It seems like the vet tech intervenes. Also, because of being a new sugar mom, when I call they say "Oh she's busy, she'll call you back" and I feel like I'm pushed aside. Thank God there has never been a REAL emergency.
 
Regarding the ultrasound: when important/expensive tests or procedures are in the possible future, the question I always ask is "how will the outcome of this test change our course of action". What is she hoping to find (or not) with an ultrasound? (350 sounds expensive, it's about 100 here and Switzerland is supposed to be twice as expensive as everywhere else). What might happen without the ultrasound is that one has to guess certain things, and "treat and see", and possibly be treating "for nothing". So it depends what the treatment is, and how you feel about it. I'd say it would be an interesting discussion to have priori to the test. And also: you're having trouble getting the vet on the phone (which can be expected), but she seems caring, maybe it's worth paying for a consultation (maybe even without the cat) to talk through all these issues.

Am I right that there have not been any curves done recently? When was the last?
 
Peppersmom72 said:
Now with everything being said, should I still give her her shot early tonight and should I still give her the shot if she doesn't want to eat or throws up her food?
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I would give the shot. Or at least a half-shot, depending on how anxious I am, and whether I feel up to monitoring her post-shot, and sticking out through possibly (but unlikely) low numbers.
 
Stephanie & Quintus said:
Regarding the ultrasound: when important/expensive tests or procedures are in the possible future, the question I always ask is "how will the outcome of this test change our course of action". What is she hoping to find (or not) with an ultrasound? (350 sounds expensive, it's about 100 here and Switzerland is supposed to be twice as expensive as everywhere else). What might happen without the ultrasound is that one has to guess certain things, and "treat and see", and possibly be treating "for nothing". So it depends what the treatment is, and how you feel about it. I'd say it would be an interesting discussion to have priori to the test. And also: you're having trouble getting the vet on the phone (which can be expected), but she seems caring, maybe it's worth paying for a consultation (maybe even without the cat) to talk through all these issues.

Am I right that there have not been any curves done recently? When was the last?
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I did a curve on 12/9/17 before the increase to 2.5
 
Pepper's spreadsheet does look a lot better now than when you started. She has some yellows and blues. That's an improvement. If you are serious about changing insulin, you might consider Prozinc. It was made just for cats. A vial should last a long time. When my Callie was on 3 units per dose, it would last 3months. I get from a mail order pet pharmacy. I pay about$130/vial, included shipping. That works out to $43.34/month. You just have to talk the vet into it.
 
Just a heads-up that I'm signing off for the night. Hope all goes well with Pepper and you find a decision you're comfortable with. Look forward to catching up with what happened my tomorrow morning.
 
Peppersmom72 said:
Thank you. I said to Pepper "come on lets get your shot and feel better" and she immediately came in the kitchen and laid down for me to give her her shot. Then I got kisses on my hand after her shot was given, like she was saying "thanks mommy"
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See now there's your reason to keep chugging along.

When she throws up is it on an empty stomach... Like bile... Or is it food she's puking
 
I'd really suggest a different insulin like Lantus.....If you buy it from Marks in Canada it can be quite affordable.

One pen ($49.99 + 20 shipping) at 3U twice a day (which is a pretty high dose) would last you 50 days, so about $1 per day, but if you could afford to buy a 5 pack, that's 1500 units for $165 + $25 shipping) ...that would be about .75 cents per day and last you about 250 days.

If you ended up on less than 3U, it would last even longer.

Also, if you could get a script from your vet, you could apply to DCIN and we could help you with the insulin.
 
Chris & China said:
I'd really suggest a different insulin like Lantus.....If you buy it from Marks in Canada it can be quite affordable.

One pen ($49.99 + 20 shipping) at 3U twice a day (which is a pretty high dose) would last you 50 days, so about $1 per day, but if you could afford to buy a 5 pack, that's 1500 units for $165 + $25 shipping) ...that would be about .75 cents per day and last you about 250 days.

If you ended up on less than 3U, it would last even longer.

Also, if you could get a script from your vet, you could apply to DCIN and we could help you with the insulin.
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If the vet calls me back, I will discuss whatever insulin would be best for Pepper. Long lasting and easy on her system. That would allow me to be away for 11-1/2 hours a day and not have to worry so much. That's why I asked which insulin would possibly be easiest on her little body.
 
Peppersmom72 said:
Thank you. I said to Pepper "come on lets get your shot and feel better" and she immediately came in the kitchen and laid down for me to give her her shot. Then I got kisses on my hand after her shot was given, like she was saying "thanks mommy"
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Aw. She has a lovely face and you're the best Pusscat Mum.
I'm not even going to try to make suggestions as I'm far too new myself. You 'n Pepper hang on in there with this lot here in this group.
They'll get you sorted & help you train the vet .

Anyway. I think you need a hug. :bighug: So very hard.
 
The Supply Closet has different ones selling insulin, some sell Lantus. I think that sometimes you can get 1 Lantus pen at a time. It might be worth your while to take a look and see what you could find.
 
Peppersmom72 said:
Whats the "scratch record" technique?
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Just asking over and over. At some point they get tired of you asking and they actually listen and pay attention -- or give you what you want to have peace.

Hope this cycle went well! Going to see if there is news in another thread.

Pay attention to what @Chris & China said regarding the "shot cost" of Lantus and possibility to get help from DCIN (Diabetic Cats In Need) if Lantus is out of your budget.

Lantus vs ProZinc, from what I understand: amongst other things Lantus requires pretty strict 12h shots, ProZinc is a teensy bit more flexible. (Take that into account regarding your schedules.)
 
I am to pick up her prescription after work and order it from Allivet. I'm sure it won't be until next week before I get it, so I will use the Novulin until then.

The vet said I have to start over with Prozinc at .5u.

Can I go from one insulin to another that fast?
 
Peppersmom72 said:
I am to pick up her prescription after work and order it from Allivet. I'm sure it won't be until next week before I get it, so I will use the Novulin until then.

The vet said I have to start over with Prozinc at .5u.

Can I go from one insulin to another that fast?
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since novolin is out of the system after a cycle, yes you can start the prozinc right away. I'm surprised she's saying start at .5 and not 1 unit. If it were me I'd say start at 1 since Pepper's numbers are so high, but I'll defer to the expertise of ProZinc users.
 
Peppersmom72 said:
I just wanted to give everyone an update. Pepper's vet has agreed to change Pepper's insulin to Prozinc. She is going to write a prescription so I can order it online for $96, since the vet office charges $170 for a 10ml vial. I'm hoping this will give Pepper better ps numbers and better nadirs.
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This is great news! If you look at the forum list there is one devoted to ProZinc with people there who are experienced with this insulin. I hope it will work better for Pepper!
 
FurBabiesMama said:
I would think so as well. 1u is the 'normal' starting dose. Of course, I would rather see someone start too low than too high.. at least the vet has enough sense not to say to start her at 2 or 2.5. :eek:
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Lets hope she keeps to what she says. I have to pick up the prescription after work, and she likes to change her mind on dosages...... so we will see what she says when I pick it up. :p
 
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