New member needing advice on cat not eating after diagnosis

[Miimi and Velvet Mirth]

Hello,
My 13 years old Mimi was diagnosed with diabetes a few days ago. Unfortunately, after the first dosage of 2 unit she became hypoglycemic with a drop from 460 to 55. At the hospital they discovered she had a UTi and her ketones levels were very high. She was in the hospital for three days as they struggled to regulate her levels and she started to refuse food.
We took her home last night and she is just not eating. She is on 1 unit of Lantus every 12 hours but her levels do not seem to remain stable and after 4 hours she went from 156 back to the 400s. The vet instructed us that she has to eat wet food before the injections but she is barely touching it.
This is happening so fast. She was fine 3 weeks ago and now she has lost 4 pounds and barely has any energy. I am so concerned and I do everything the vet says to do, but I don't think she is getting better.
I read of cats always being hungry when they are diabetic, so why won't my Mimi eat anymore?
Any help or sharing would be most appreciated.

 

[AliceMeowliss (GA)]

Welcome to the group. It can be very overwhelming at first, but this place is a great resource for info and support. I am sleep-deprived so this may be a bit disjointed. My Alice had DKA (diabetic ketoacidosis) a month ago. Since then she has had a few bouts of anorexia, nausea and vomiting. In those cases I often try multiple food types, and sometimes I even feed by hand if she is feeling too weak. Is Mimi continuing antibiotics for the infection? Sometimes those can bother their tummies.

I keep a supply of nausea medicine and appetite stimulant. You may want to ask your vet about that.

I should have more to say but I am so tired right now. Someone better equipped will come along with more coherent info. In the meantime, there are great basic articles on the home page and stickies in each forum.

For tonight, I would keep trying to encourage fluids and if she won't eat low carb maybe just a bit of moderate carbs to entice her would help. Ketones mean the body is destroying muscle and fat to sustain itself. It's important she eats and continues to get her insulin and that she is well-hydrated to help her body clear those ketones out. Infections in a diabetic cat can wreak havoc. So the loss of appetite may be related to that in part.

Have you read up on the Lantus depot yet?

I hope you get some better responses but I know sometimes it helps just to have any supportive response at all, as quickly as possible! I hope Mimi is feeling better soon.

 

[Julie and Honey]

Hello,
My 13 years old Mimi was diagnosed with diabetes a few days ago. Unfortunately, after the first dosage of 2 unit she became hypoglycemic with a drop from 460 to 55. At the hospital they discovered she had a UTi and her ketones levels were very high. She was in the hospital for three days as they struggled to regulate her levels and she started to refuse food.
We took her home last night and she is just not eating. She is on 1 unit of Lantus every 12 hours but her levels do not seem to remain stable and after 4 hours she went from 156 back to the 400s. The vet instructed us that she has to eat wet food before the injections but she is barely touching it.
This is happening so fast. She was fine 3 weeks ago and now she has lost 4 pounds and barely has any energy. I am so concerned and I do everything the vet says to do, but I don't think she is getting better.
I read of cats always being hungry when they are diabetic, so why won't my Mimi eat anymore?
Any help or sharing would be most appreciated.

Welcome to you and Mimi!

Sounds like you need some help quickly. There are several issues going on, ketones is a big one, do you have ketone strips at home? The fact she had them at the hospital means you will need to check for those at home. You can get these at your local pharmacy or Walmart. Need to test Mimi’s urine as high ketones can be a time critical issue, you want to keep a close eye on that.

Sounds like you are testing her blood sugar at home? That is great and very important. The fact she shot up from 156 to 400s is not unusual it could be bouncing, where her body is trying to adjust to insulin. When they get a lower number than their body is used to, many times their liver will put out sugar because their body thinks it is too low and then they will shoot up, this is nothing to worry about and will even out once their body sees it is okay to be in lower (normal) range. This does NOT necessarily mean the cat needs more insulin, a mistake many vets make.

We monitor blood sugar levels here on a current dose and make adjustments only when we know what the current dose is really doing. We can help you get set up with a spreadsheet once you get through this current situation.

Original insulin dose was higher than normal starting dose, good it was reduced. The UTI may have artificially raised sugar levels and once that is treated, they will drop.

Cannot be giving insulin without food. Lantus is a slower acting insulin, so they usually drop lower several hours after shot time. There will be time to learn more, but let’s get you some help first to help your kitty as quickly as possible.

I am tagging a few people to get you some help quickly as I am concerned with recent ketone issues and the not eating.

@Idjit's mom
@Wendy&Neko
@Gill & George
@Bobbie And Bubba

 

[Julie and Honey]

Plain chicken, turkey or beef baby food (not ham, too salty) are often given to kitties that are sick or have little appetite. If you are in the states, these are readily available, Canada not so much for some reason. This is not a long term solution because does not have all nutrients cats need, but is good short term just to get some food in them. Or a plain cooked chicken breast chopped up in tiny pieces (no salt or spices).

 

[Bobbie And Bubba]

Hey there and welcome to the best place you never wanted to be.

Cassandra and Julie both gave some good advice. The no eating could be due to nausea so getting some anti nausea meds is a really good idea. Baby food is a go to for when either of my kitties won't eat. What ever you have to do to get food into her even if it's higher carb food than 10% . We recommend keeping the carbs under 10% but that goes out the window when a recent DKA kitty won't eat.

The recipe for a DKA event is = not enough insulin + a systemic infection ( UTI) and in appetence. You want to get some ketone strips at the pharmacy ( the kind humans use ) and test her urine to make sure there is no ketones. If she is throwing any and not eating, it would be very wise to have her seen at your vet ASAP.

At shot time if she is not eating, you have about 2 hours before the onset of the insulin so you can continue to try and get some food into her. Skipping shots with a cat that has had DKA is not a good option. You might have to water down the food and put it into a feeding syringe and assist feed her. You can try topping her food with some of the following toppers which entice kitties to eat when they won't.

Sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. There are a couple low carb / grain free brands -- EVO and wellness core. I have added Young Again Zero carb.

-make a buffet to give him/her choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

If enticements don't work, you should consider:
-assist feeding ( syringe or make little meatballs and place in mouth)
-and/or talking to your vet about appetite stimulants ( mirtazapine or cyproheptidine)

and if those fail talking to your vet about feeding tubes.

If you can set up a Spread sheet and create a signature and attach the SS to it, we can help you better by seeing the numbers. If you need any help setting it up, let us know and someone will assist you.

Please keep us posted.

 

[Gill & George]

She is on 1 unit of Lantus every 12 hours but her levels do not seem to remain stable and after 4 hours she went from 156 back to the 400s

It's great you are home testing do you think you could set up the spread sheet and put in all the data you have, it will really help us help you.
Instructions here http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Unfortunately, after the first dosage of 2 unit she became hypoglycemic with a drop from 460 to 55.

Was she symptomatic? Are you using a pet or human meter?

She is on 1 unit of Lantus every 12 hours but her levels do not seem to remain stable and after 4 hours she went from 156 back to the 400s.

After a symptomatic hypo event kitties can be more sensitive to insulin so that may be why you are seeing the swings.

At the hospital they discovered she had a UTi and her ketones levels were very high. She was in the hospital for three days as they struggled to regulate her levels and she started to refuse food.

Is she still on antibiotics? With DKA it's important that any infection is addressed as a matter of urgency.

I read of cats always being hungry when they are diabetic, so why won't my Mimi eat anymore?

Cat's with DKA get lethargic, sick, feel nauseous and stop eating. Sounds like this might be what you are going through.

Do you think you could check for ketones? You can do this at home with urine strips (ketostix) you can get those from any pharmacy. You just need human ones. If she is showing high levels of ketones again you may need to take her back to vets. If she is not then it's possible to manage things at home, folk here can help you with than. Here's an example of what I am talking about.
https://www.amazon.com/BAYER-HEALTH...trips/dp/B01IF54RKA?tag=felinediabetesfdmb-20

It's really important that you get her to eat, you may need to assist feed. Bobbie has given you some great tips on how you might be able to entice her. When I've had to do that I blend the cat food into a smooth consistency added a little water and used a feeding syringe to get some food into kitty.
Have you just swapped her to wet food? It is better for her, but I'm just wondering if she is refusing food because she's a kibble addict?

 

[Idjit's mom]

Hi and welcome Velvet and Mimi. I am sorry that Mimi has had such a rough time and hopefully with the advice you have received from Julie, Cassandra, Bobbie and Gill you can get a clearer idea of how to handle her care at home. Gill has provided you with the link to the instructions for setting up the spreadsheet and recording the insulin and testing data. This is a link on understanding the spreadsheet if you aren't familiar with how a spreadsheet looks and how it displays information.
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Here is how to create the signature with Mimi's information that will display with each of your posts (light grey text under a post). This provides all the pertinent information in one place so that advising members can review this quickly as well as the spreadsheet info which can be linked to the signature. Then you won't have to continually answer the same questions about her insulin, dose, meter type, food etc.

click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters) Be sure to SAVE when you are finished.

A huge hug to you for caring so much about Mimi and we will do everything we can to help her and you get through this and get Mimi feeling better.

 

[AliceMeowliss (GA)]

So glad to see more coherent advice has come along! It may feel scary and confusing in the beginning and you may miss some sleep, but these things can often be managed well. Kitties can go into remission from diabetes!

Do please keep us updated when you're able.

 

[Miimi and Velvet Mirth]

Have you read up on the Lantus depot yet?
Hello,
thanks for answering to my post. I have started to read about the Lantus depot. Because she was taken off Lantus after her hypoglycemia episode, she was in ICU for three days and they only gave her short acting insulin. A couple of days ago we started the 1 unit and because she is so sensitive to it, we were told to test every two hours and do not administer insulin unless she is at 300. I have attached the spreadsheet. Her values swing wildly and she drops very quickly. I hope that we can find a pattern because I am not sure that withdrawing insulin is the way to go either..
Her ketones have dropped from 80 to 6 but she is still fighting the UTI. we have strips to test her now.
Thanks so much!

 

[Miimi and Velvet Mirth]

It's great you are home testing do you think you could set up the spread sheet and put in all the data you have, it will really help us help you.
Instructions here http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/


Was she symptomatic? Are you using a pet or human meter?
I am using the trek 2 for pets. She was symptomatic and was hospitalized for three days with values around 55 that would not go up even with food. Scary. that was her first injection of insulin.


After a symptomatic hypo event kitties can be more sensitive to insulin so that may be why you are seeing the swings.


Is she still on antibiotics? With DKA it's important that any infection is addressed as a matter of urgency.
She is still on antibiotics and she gets Verafloz once a day for another 3 weeks. She is now peeing ok and her appetite is a bit better.


Have you just swapped her to wet food? It is better for her, but I'm just wondering if she is refusing food because she's a kibble addict?

Mimi has always refused any human food or wet food or treats. She would only eat one type of dry food - Nutro Essentials. We tried everything.
Since the infection started to clear and she is figuring out that wet food is her only choice, she is starting to accept it, but we have to blend it into a warm soup and she takes ages to drink it, so before insulin we have to use a baster to make sure she has enough in her system.

Taken time off work as the vet wants her blood work checked every two hours and to call the values in before giving insulin.
A funny thing just happened. we put the phone on speakerphone and Mimi who was chilled at the window, heard the voice of the vet and ran to hide under a blanket. She recognized her voice!! Poor Mimi.

Right now we just want her to get better, but at some point we will need to work out where to buy affordable Lantus insulin and test strips. We spent close to 6K in four days and cannot sustain it, so any suggestions on where to get supplies will also be appreciated.

WE ARE SO grateful for all your advice and help and information. We are so sleep deprived and worried that you have provided us with a safety net. We have already adopted a special need cat called Velvet Mirth so we hope to be able to put them on the same schedule for meds!

 

[Miimi and Velvet Mirth]

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

If enticements don't work, you should consider:
-assist feeding ( syringe or make little meatballs and place in mouth)
-and/or talking to your vet about appetite stimulants ( mirtazapine or cyproheptidine)

and if those fail talking to your vet about feeding tubes.

If you can set up a Spread sheet and create a signature and attach the SS to it, we can help you better by seeing the numbers. If you need any help setting it up, let us know and someone will assist you.

Please keep us posted.[/QUOTE]

Thanks so much for the information. We are trying some of the suggestions and maybe she is starting to accept the new routine. Mimi has always been a small meal few times a day kind of gal and now it is hard to feed her before insulin shot is due.
My questions would be: how much wet should should be truly be eating in a day? the vet said half can twice a day, but as we have to use a syringe, there is no way I can force her to eat half a can.. so we are leaving some of the wet food out in her usual places and she goes back and forth. Not sure if the food intake is enough. She lost 4 pounds very quickly when she was (mis)diagnosed at first and now her weight seems stable at 9.7. She is 13.5 years old.
Thank you!!!

 

[AliceMeowliss (GA)]

Have you read up on the Lantus depot yet?
Hello,
thanks for answering to my post. I have started to read about the Lantus depot. Because she was taken off Lantus after her hypoglycemia episode, she was in ICU for three days and they only gave her short acting insulin. A couple of days ago we started the 1 unit and because she is so sensitive to it, we were told to test every two hours and do not administer insulin unless she is at 300. I have attached the spreadsheet. Her values swing wildly and she drops very quickly. I hope that we can find a pattern because I am not sure that withdrawing insulin is the way to go either..
Her ketones have dropped from 80 to 6 but she is still fighting the UTI. we have strips to test her now.
Thanks so much!

It can take some time to regulate on Lantus but its typically one of the ideal ones because once regulation is achieved, it's known for not taking kitty on a sugar roller coaster, but rather a nice gentle ride through meadows with the occasional small hill. Lol.

You're doing great, you're here!

Glad to hear ketones have decreased. You do not want a DKA episode! Scariest thing I ever saw.

Re: food intake. http://www.felinediabetes.com/FDMB/threads/feed-kitty-as-much-as-they-want.205170/

 

[Gill & George]

Nutro Essentials. We tried everything.
Since the infection started to clear and she is figuring out that wet food is her only choice, she is starting to accept it, but we have to blend it into a warm soup and she takes ages to drink it, so before insulin we have to use a baster to make sure she has enough in her system.

When did she last have dry food?

Dry food is super high in carbs, taking that out of the equation can make a big difference to her insulin requirement, if the infection is cleared up that will also affect the insulin requirement.

We have known a number of cats who go straight into remission with just a food change.


How much does she weigh?
If she is on wet food only and if you chose to do TR there is a formula for determining a BID starting dose (twice a day).
How to determine an initial starting dose for glargine or detemir when following the Tight Regulation Protocol:

• the formula is 0.25 unit per kg of the cat's ideal weight
• if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
• if the cat was previously on another insulin, the starting dose should be determined by taking prior data into consideraion

On SLGS the following starting doses are used depending on what sort of diet the kitty is on
Starting Dose: on SLGS

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

Link to info on both protocols http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

A 2u starting dose (unless Mimi was 8kg) was too high of a dose to start Mimi on, sadly, it's not unusual for vets who are not that familiar with lantus to start cats on too high of a dose. If we combine that high starting dose, with change of food and infection clearing up it's easy to imagine how she hypoed after just one dose of 2u.

I've taken a look at the SS and numbers, given the DKA/ketones/her reluctance to eat I have some concerns.

1. Lantus only stays in the system for 12 hours (give or take) it's a human insulin, in humans, with our slower metabolism it lasts for around 24hrs and so is dosed once a day. Cat's with their faster metabolism, need to be dosed twice a day, only this way are you going to be able to get her (eventually) in a consistently nice flat cycle in near normal numbers (take a look at my Georges SS, he's a well regulated cat on only a small amount of insulin. If you look back to when he was first diagnosed in 2015 you can see how this is something we achieved over about 6 months. He actually went into remission and is only back on insulin now after a steroid shot sent his blood glucose through the roof.
2. Shooting just once a day is possibly leaving her without insulin for many hours, this is increasing the risk of the DKA recurring and another costly visit to the ER.
3. She is dropping very fast and quite low when you shoot, this makes me worry that 1u would be too much of dose to shoot BID. It would be good if you could find a dose that you could shoot BID.
4. If she is not getting enough calories, this can also be contributing to those lower numbers, and more importantly increases the risk of a recurrence of DKA. How many calories is she getting?

Where do you go from here??
It's tricky, because of the DKA, I wouldn't want to reduce the insulin dramatically because of the risk that would entail, but equally looking at the numbers, I think that shooting 1u BID would be risking a hypo situation, which with a kitty that is not eating well is pretty scary.
In the back of my mind I am also thinking that the food change and infection clearing is impacting things too. So overall it's hard to see the wood for the trees.

Did you get the ketostix? they are human ones and not expensive.
If you could monitor her ketones and tell us what you are getting with that it will help us go forward. If she was negative on ketones I would probably suggest taking the dose down to 0.5u BID. However if ketones are present we may need to try another approach.
I am going to ask some other experienced members to take a look and give you some more input.

Cutting out the dry food is a great idea, but if you still have some, and she will gladly eat that, then it's a good tool to have if you find yourselves in a situation with her numbers plummeting. As a general rule we avoid using dry because it can take too long to clear the system and can complicate dosing decisions, but if needs must.....

I would strongly suggest you read the following info posts on how to handle a hypo situation, the third is more specific to Lantus.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

http://www.felinediabetes.com/FDMB/threads/dont-panic-or-how-to-handle-low-numbers.210109/

 

[AliceMeowliss (GA)]

@Gill & George OP did note ketones dropped from 80 to 6, last night.

0.75u 2×/day maybe? @Velvet Mirth do not take my dosing advice without agreement from a more experienced member please. You will find a lot of info here do arm yourself with knowledge and keep browsing the site. Always ask questions when you have them. I saw someone say, "the only silly questions are the ones you don't ask."

 

[Gill & George]

My questions would be: how much wet should should be truly be eating in a day? the vet said half can twice a day, but as we have to use a syringe, there is no way I can force her to eat half a can.. so we are leaving some of the wet food out in her usual places and she goes back and forth.

It's fine to let her graze, with lantus we usually recommend that she has several small meals a day, with lantus being a gentle insulin it works better this way. Fro the moment letting her graze will be fine, many folk do that anyway.
As an example:
George gets 3ouces just before shot time am and pm and then he gets snacks (about an ounce) every 3 hrs. This is something I fine tuned and tweaked over time based on the BG data.
The one thing I would suggest that you do is pick up all her food two hours before shot time. The reason for doing this is that you want to make sure that the test you get just before the insulin shot is not influenced by food, so you know that it is safe to shoot.

Her ketones have dropped from 80 to 6 but she is still fighting the UTI. we have strips to test her now.

I missed this sorry for asking the question again. That's great news.

Right now we just want her to get better, but at some point we will need to work out where to buy affordable Lantus insulin and test strips.

A big saving can be made by using Human meters, if you are in the US I believe a lot of folk go to walmart and use the Relion meter and strips, much cheaper than the pet meter strips. I'm in Spain so I can't help you with that. Both protocols were developed using human meters, and as such it's encouraged to use Human meters as it makes following the protocols simpler, since there is no conversion possible from pet to human.
As for Lantus, a lot of folk in US use Marks Pharmacy in canada for a much more economical supply of lantus.
@Bobbie And Bubba
@Judy and Boomer
could you please advise on purchasing affordable supplies? Thanks.

Also I forgot to add
Thank you for getting the Spread Sheet (SS) that's been really helpful. In the remarks you can record the Ketone tests when you get them, I'd continue getting them twice daily in light of still seeing high numbers, iffy food intake and infection. They can change really quick.

These are for you
I still remember how overwhelming and exhausting it first was when BFG was diagnosed.
It gets easier, just hang in there

OP did note ketones dropped from 80 to 6, last night.

I just saw, thanks.

0.75u 2×/day maybe? @Velvet Mirth do not take my dosing advice without agreement from a more experienced member please.

I do think a BID dose needs to be less than the 1u, not sure if the 0.75 would still be too much, going to get some more eyes on this especially those with DKA experience, there are complicating factors, with food change, infection, appy, DKA. Normally I would go for a lower option and work up, but the DKA makes that tricky. So we need to come up with a safer approach. We don't want a hypo, but provoking a return to DKA is even more worrying.
Recipie for DKA
Not enough insulin
Not enough food
Systemic Stress/infection

With the ongoing infection and the reduced appy, taking the insulin down could be the tipping point for DKA, equally, not dosing BID, is leaving kitty without insulin for a significant portion of the day.
INFO post on DKA
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/

ETA
Are you using pen needles or syringes?

 

[Gill & George]

@Velvet Mirth
You may want to think about creating a new post on the Lantus forum, there are a lot more folk on that forum regularly, so you will get more help when you need it.
When you do post, please create a link for this post in your new Lantus frorum post.

Thank you.

 

[Judy and Boomer]

Welcome to the FDMB!
You were asking about the best places to buy supplies.....where are you located? I'm in Canada (Ontario) so if you happen to be in Canada tag me and I'll give you my go-to spots!

 

[Jill & Alex (GA)]

@Velvet Mirth welcome to the FDMB!

This is just a forum for introductions and getting acquainted. Follow up your intro by posting in the Feline Health - (The Main Forum) for suggestions and general advice. More members frequent that forum so you'll receive more responses to basic questions you may have. Once your basic questions have been answered you may want to move on to the Lantus / Basaglar (glargine) and Levemir (detemir) Forum where you'll find others using Lantus with their diabetic kitties.

Again, welcome and I hope to see you posting often!

 

[Miimi and Velvet Mirth]

I have posted a new thread on the Lantus forum as suggested so I am hoping I will get some help there too soon.
Mimi is so stubborn it makes me cry. She begs for dry food and will not touch wet food even one week after diagnosis. So the force feeding continues prior to her shot being administered. Her values are all over the place which means that we cant keep a proper schedule as I can't give her insulin when she is below 200 and last night even with only .5 unit she went from 400s to 54!
The first time it happened we let her have some dry food and retested 20 mins later to make sure BG went up and it did.
I still dont know if feeding her and how much is needed before a shot because she refuses to eat when she needs to and then begs for food 3 hours before her shot is due. I am taking a leave of absence from work as i am not able to set her 7am and 7pm schedule, but I am not sure it is good for her not to have a proper schedule.
thankfully her ketones are negative and her UTI seems resolved though she is still on antibiotics for another two weeks.
She weighs about 9.7 and has not lost any more weight, but the force feeding is heartbreaking for all of us..

 

[Miimi and Velvet Mirth]

Welcome to the FDMB!
You were asking about the best places to buy supplies.....where are you located? I'm in Canada (Ontario) so if you happen to be in Canada tag me and I'll give you my go-to spots!

I am located in the San Francisco Bay Area. Walmart charged me $380 for the vial we needed, but had no choice as CVS ran out, Sams Club ran out and even my vet didn't have any on hand. I hear about buying pens and then using syringes to draw the insulin, but I am worried about the air bubbles as 0.5 unit is so hard to see..

 

[Idjit's mom]

If you would consider ordering the Lantus from Marks Marine in Canada you can save some $$ down the road.
https://rxcanada4less.com/
http://www.felinediabetes.com/FDMB/threads/buying-insulin-from-canada.203498/

Many members use the pens and syringes because there so much less waste of that precious and very expensive insulin. I have read that you can use the pens as a vial and use it to the last drop.
From the Lantus forum: http://www.felinediabetes.com/FDMB/...info-proper-handling-drawing-fine-dosing.151/
Using syringes with a pen, cartridge, or vial:

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Basaglar, or Levemir from vials, cartridges, and pens.
• BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
• Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
• Full and half-unit syringe scales:

Here is a video on how to draw insulin from the pens:

There is other information about fine dosing, and using calipers for fine dosing.
I know you will get more input from the Lantus users, but I hope this helps a little.