Disco 12/22 Update

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Teri & Disco NoFurNo (GA)

Teri & Disco NoFurNo (GA)

Member Since 2019
Starting a new thread for Disco, even though we haven't yet made the change from Vetsulin.

His SS is up-to-date and the past 6 days, he has had lots of 'yellow' readings, a few 'purples' and only 1 red. I had hoped to have time to do some curves to track how fast he was 'burning' through the Vetsulin, but Thanksgiving prep and spending more time over at my new house unpacking had me away from my mom's house and Disco for the better part of each day. But this week I will get back to being diligent about it so I have the data to revisit changing insulins with his vet again.

That being said, this morning, his AMPS was 276 and his +4 was 92. I didn't feed him as he was just over the 'feed him high carb snack if he goes below 90' but retested 30 min later and he was at 261. His +5 was 219. Not sure what that will do to the rest of his readings today, but I will be home for another few hours so will do a +5 (219) and +6 (250) and try and try to be home to do a +8 if I can.
 
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I heard from Disco's vet on Wed 12/4 and had told her I would be more diligent about doing curves this week and she replied: His current dose of Vetsulin appears to be maintaining his glucose more reliably. Since 11/27 he appears to stay within the "green" 300-200 range, which is more ideal. I saw his dip into the 90 range on 12/2. If he continues to have such fluctuations and burning through the Vetsulin, let's consider the Lantus or ProZinc. Please keep me updated after his curves this week.

His SS is up-to-date and we still aren't getting any numbers less than 200 (except for that +3 dip on the 2nd to 92) and always the 300's in the PMPS, and his +5's and +6's have been all over the 200's until just now at 321. I have made the time to look at a few SS of cats on Lantus in the support group and while the hypos scare me, I sure would like to see more 'blues' and have no glucose in his urine (which hasn't happened on Vetsulin). He is still urinating big clumps and drinking a lot, though his appetite doesn't seem ravenous (although that's debatable as he has always been food motivated, kind of like that Sphynx video of a cat trying to tear a package of food from it's owner's hands, LOL).

I gave his vet the info from Mark's Marine including cost differences and wanting to use the pens for the reasons explained in this group and that it may take a week for it to arrive, so that based on his readings, I would like to move ahead with changing to Lantus. If there is anything else I can add to the email I will send to the vet this afternoon (like what would be good numbers I might expect on Lantus?) Everyone in my family says he acts like a normal healthy cat-interactive, eating, not lethargic and I am so glad I didn't put off his senior exam visit in October as even though he hasn't come around on Vetsulin to my liking, he has improved from the 400-500 readings he was having in the beginning.

Thx again to all his 'nurses' and followers!

 

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The article I attached is the published article by Roomp & Rand (2009) on the Tight Regulation Protocol I'd also suggest you refer your vet to the AAHA guidelines on the treatment of diabetes. You'll have to go through a couple of links to get to the pdf to download the AAHA guidelines.
 

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Sienne and Gabby (GA) said:
The article I attached is the published article by Roomp & Rand (2009) on the Tight Regulation Protocol I'd also suggest you refer your vet to the AAHA guidelines on the treatment of diabetes. You'll have to go through a couple of links to get to the pdf to download the AAHA guidelines.
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Oh boy, she has the AAHA Guidelines (I gave her the link, and she’s referred to it numerous times, picks and chooses parts of it, but seems to skim over other important parts). I am her first client who home tests! She is learning and that’s hopeful. I will send her the article, too.

12/7 Update: Tech from vet called, said Dr got my emails and requests and article and will review it all over the weekend and get back to me on Monday, said she wasn't sure her Oregon license permits her to use the Canada pharmacy (I didn't go into that with the tech but as I am her first client using Lantus and probably the first to requesting to use a Canadian pharmacy, if she follows the link to Mark's, she will see how it's done etc).
 
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You can let the vet know that Lantus is sold over the counter in Canada. If you physically crossed the border, you wouldn't need the Rx. It is for the phamacy's protection that they ask for an Rx. It's not a matter of your vet prescribing across state/country lines. It would actually be a problem in the state where the Rx is filled if they honor an out of state Rx. (Usually, in the US, the pharmacy will call the MD.) FWIW, I used a compounding pharmacy that's in Arizona for one of Gizmo's medications. My vet is in Ohio. They honor the Rx.
 
Your vet wouldn’t be using Marks pharmacy, you would. Your vet writes out the Rx for you, you send a copy to Marks. If it helps, I live about 25 minutes away from Marks Marine. They are a genuine bricks and mortar pharmacy. And making a decent profit as their prices are higher than what we pay OTC in Canada.
 
Wendy&Neko said:
Your vet wouldn’t be using Marks pharmacy, you would. Your vet writes out the Rx for you, you send a copy to Marks.
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I wonder if she will cite the AVMA guidelines on this:

Q: Can my client obtain needed prescription drugs from pharmacies in Canada?

A: No. Drugs from Canada are not approved by the federal government for use in the United States. If your client asks you to help them obtain veterinary drugs from Canada, you should refuse on the grounds that it is illegal to ship prescription drugs from Canada into the United States. In the past, and under very unique circumstances, the FDA has allowed the temporary importation by veterinarians of non-FDA-approved drugs under medical emergency conditions when an FDA-approved product was not available in the U.S. However, personal importation of non-FDA-approved animal drugs is not allowed.

Both cat veterinarians that I worked for previously used Canadian pharmacies all the time. Guess I will have to seek out the other veterinarian I have been to if she refuses.
 
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Just tell the vet you want the script to go pharmacy shopping yourself. No need for them to get involved in your choice of pharmacy that is convenient to you. Make sure the script says "pens", not vial.
 
I wouldn't get into a discussion about where you're buying your insulin. Given the price of Lantus, these days, you're smart to call around to find the best price. Even when I first started out with this 10 years ago, the ER vet handed my a prescription for Humulin N. He had no clue where I was going to fill the Rx.
 
@Sienne and Gabby (GA) @Wendy&Neko Thanks so much for the advice! I will have a better idea on how to proceed now when the vet calls, although in my last email to her I did give her Mark's Marine info and a couple of prices of Lantus that I found both locally and online with US pharmacies, but I can backpeddle a bit and just say I want to shop around so would like the written prescription sill even if I just get 1 pen through a local pharmacy to start.

Yesterday I made a 3-ring bind with all the 'sticky' files/docs so I have everything right at hand. The TR sticky is both awesome and overwhelming, but I am so glad for two things--1) that I am retired and can test frequently and it will be even easier when I am finally in my own home and not running back and forth unpacking. And 2) that Disco is so amenable and easy to 'prick'! I am still using his paw pads, warming the pad, using a rubber band tourniquet and neosporin ointment (am thankful also that he doesn't have furry paws, HaHaMeow!).

I'll update when I hear from the vet, today I hope. I didn't want to do it without asking, but is it allowed to share the SLGS and TR Stickies with the vet? I assume it is just for members, but it would be nice if she knew how I was proceeding as she has not any experience with cats on Lantus it seems. Also, do I start out with SLGS and not the TR?
 
Attached to the dosing method Sticky Note is a copy of the published article describing TR. that will likely have more weight than printing off the Sticky Note itself. The notes are open to any viewer, you don’t have to be a member to see them. If you started sith SLGS and moved to TR, you wouldn’t be the first. Just switch when comfortable doing so, as long as you are feeding low carb wet or raw.

Good plan to have a printed copy of the notes, especially on handling low numbers. Power outages can pick the most inconvenient of times. Ask me about poking by candlelight. Been there, done that. :rolleyes:
 
Wendy&Neko said:
Attached to the dosing method Sticky Note is a copy of the published article describing TR. that will likely have more weight than printing off the Sticky Note itself. The notes are open to any viewer, you don’t have to be a member to see them. If you started sith SLGS and moved to TR, you wouldn’t be the first. Just switch when comfortable doing so, as long as you are feeding low carb wet or raw.

Good plan to have a printed copy of the notes, especially on handling low numbers. Power outages can pick the most inconvenient of times. Ask me about poking by candlelight. Been there, done that. :rolleyes:
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Thx! I have a headlamp that has come in useful under many 'dark' situations. I used to use it when birthing kittens in the middle of the night and will keep it handy for Disco's dark episodes if that ever happens! And he is on raw and FF Classics, no kibble even as a treat any longer...
 
@Sienne and Gabby (GA) and @Wendy&Neko
Just wanted to update everyone that Disco's vet has a written Rx for me to pick up so I can order the Lantus from where ever I like. She wants me to start at 1u BID, and I am going to post this in the Lantus group, too, as I recall reading (and having a message that once I'm ready to start that they can advise on starting dose etc). I'll let everyone know what happens next...
 
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