New Member; Tazzy. Steroid induced Diabetes

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Nicole M

Nicole M

Member Since 2020
Hello!
I can't say how happy I am to have found this forum, I am so grateful for all the wonderful resources and articles. Just reading your stories and educating myself has done wonders to calm me down.

I found out yesterday my little girl kitty Tazzy is officially diabetic and i'm feeling somewhat panicked and overwhelmed. She was diagnosed via blood glucose and confirmed with a urine test. She recently turned 13 and has multiple health issues, this new onset diabetes is a side effect of her other medications. I am a Nurse so I understand diabetes when it applies to people, but the idea of poking my baby for blood sugar checks and insulin injections twice a day for the rest of her life is awful, she HATES being poked and hides from me for hours after I give her her weekly B12 shot.
I'm not sure of the name of her preexisting chronic illness, its kind of a grey area according to our vet, but basically Tazzy has difficulty absorbing the food she eats due to an autoimmune disorder. In August 2019 she was on her way to dying and weighed 7 lbs, I had to syringe feed her to keep her alive. Almost 6,000$ later, miraculously she survived. We increased her calorie intake, and she now weighs 13 lbs. She is on a liver support drug called Ursidiol, a B12 shot once a week, and a daily steroid Prednisolone. Unfortunately the rapid weight gain the the need for chronic steroids has lead to diabetes. Her goal weight is now 10lbs.

The vet has decreased the steroid dosage as of yesterday, but she cant come off them completely. Unfortunately Tazzy needs to be on a steroid or immune suppressant, the alternatives to steroids are basically chemotherapy. I have started her on low carb wet food, and cut out dry food snacks completely. I was hoping to control her diabetes through diet/weight loss alone... but the vet said that is unlikely.

I've started her on Fancy Feast Shredded Wild Salmon 3oz can at 7am with 88 calories and 9 carbs, and Authority Turkey and Giblets 5.5oz with 186 calories and 7 carbs at 5pm. These are within my budget of 50$ a month for food. Are these appropriate low carb wet foods?

Does anyone else have a cat who needs to be on chronic steroids? My vet suggested a few alternatives each with pros and cons. I can switch her to Chlorambucil every other day with a CBC every 3 weeks, the drug being 75$ a month plus blood test costs, about 170$ every three weeks. I could also try a modified cyclosporine Atopica, which requires monitoring her liver values and is crazy expensive at 330$ a month plus blood tests. Very different and VERY scary numbers. Does anyone have suggestions for medications at a cheaper rate? I'm in so far over my head.

How much do insulin/syringes/needles cost? What I've seen says about 100$ a month for insulin and syringes. I've looked on Chewy and it looks like for the lancets/strips its an additional 70$ a month to check her twice a day.

I'm so overwhelmed. I don't want to start insulin, but what other choice do I have? As a nurse I'm gone for 14 hours a day... What if she goes hypoglycemic while i'm gone? I don't have any family where I live, and no roommates. Is it even safe to give her insulin? I can take a couple days off next week to try and get her stabilized and find a routine but with COVID I cant take any significant time off from the hospital.

This post got away from me, its so long. Thank you to anyone who takes the time to read it. <3
 
Hi Nicole,

Welcome to the forum. I am a newbie myself, and therefore can't help you with many of your questions, but wanted to point you to some food guides:
https://www.felinediabetes.com/glutenfree.htm
https://www.felinediabetes.com/diabetic-cat-diets.htm

You do not say which country you are based in, but if you are in the UK, Feringa cans from zooplus comes out quite reasomable.

Anyway, just wanted to let you know that I know how you are feeling, because I am still trying to learn the ropes a month in, but injecting insulin and monitoring blood glucose has gone from nerve racking to routine very fast. So fingers cross, you and tizzy get used to a new routine as easily! :)
 
WELCOME TO FDMB We are glad you found us! I have to say I dont have any experience with these issues Tazzy has. To get more specific responses you may want to edit your title including the words steroid induced diabetes. While you are waiting for more responses you might want to start here:
New? How You Can Help Us Help You!
Theres a wealth of information here at your finger tips. We are a community of dedicated cat lovers that are bound together by this disease called diabetes. We welcome any and all that need answers and advice
WELCOME TO THE BEST SITE ON THIS PLANET to learn everything you need to know about feline diabetes!
jeanne
 
Hi Nicole what a beautiful kitty Tazzy is.
You have found the best place you can be
I see you live in Chicago, you can go to Walmart and get a human meter , the Relion Prime which most of us use for 9 bucks, the strips are 17.88 for 100 strips
Lancets a couple of bucks for 100
You can buy the syringes there also, just make sure they give you the ones with half unit markings
Get the 28 gauge lancets they will make her ears bleed better, as you test more cappliaries will grow and will make it easier.
Pick up some cotton rounds also to hold behind her ear so you don't stick yourself
Warm his ear first with a rice sock put it in the microwave just to get it warm and hold it on his ear until more capillaries grow

Can't tell you how much the insulin costs, what is the vet planning on prescribing
If he prescribes Vetsulin which some vets do because it's cheaper, it's actually intended for dogs. Vetsulin is harsh insulin which can it hard and fast. Can drop a cats BG very low , very early and you would have to be around to monitor her and see how low she drops. That's why we like Lantus it's more gentle
Let us know and we can tell you where you can get the best price
So sorry your expenses are so high, poor Tazzy has a lot going on

Most of us use Lantus insulin, You can save a lot of money buying it from Marks Marine in Canada.

Many members buy it from Marks Marine Pharmacy in Canada.
This will save you a lot of money
These 5 solorstar pens will last you a year depending on the dose you will give
The expiration date is on them , keep in the fridge and they will be good until you start to use them probably has an expiration date of 2022 or 2023 Lantus Solostar CARTRIDGE 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100iu/ml 15 ml $159.99 USD

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Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

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Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

rx.gif
Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


They will just need a script from your vet, check out their website

I would buy the 5 Solostar Pens
We use syringes with half unit markings U-100 it makes it easier to increased or decrease by 0.25 units.
With the pen you can only increase or decrease by full units
You would take the top off the pen and stick their syringe in the small gray rubber stopper and draw from there

Most of us feed Fancy Feast Classic Pates, most are around 2 or 3 carbs
I will give you a link to the food chart. We like to stay under 10 % carbs
I wouldn't feed Tazzy fish every day
What you are feeding isn't that bad but maybe you can lower the carbs
Since you work 14 hours a day you can look into an automatic feeder and set times for her to eat

We usually feed larger meals at shot times AM and PM, then smaller meals maybe two times during each 12 hour cycle, it's easier on the pancreas.

I know I hit you with a lot of info but believe me we were all overwhelmed in their beginning.
You will be a pro in no time
Just keep asking questions that's what we are here for.
Stay safe Nicole :cat::cat:
 
Oh my goodness thank you so so much! I didn’t even think to look at human glucometers that’s such a good idea So much wonderful information. I have a phone meeting with my vet tomorrow to sort out a plan, So I’ll know more what she which insulin to buy. I’ll also order some fancy feast pate today.
This community is already so wonderful! Thank you again
 
Nicole M said:
Oh my goodness thank you so so much! I didn’t even think to look at human glucometers that’s such a good idea So much wonderful information. I have a phone meeting with my vet tomorrow to sort out a plan, So I’ll know more what she which insulin to buy. I’ll also order some fancy feast pate today.
This community is already so wonderful! Thank you again
Click to expand...
You are welcome Nicole :cat:
 
You might want to pick up a few cans of these just in case she drops too low and you might have to raise her BG or leave some out for her while you are at work

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs
 
Welcome. It sounds like she might have EPI as she’s not absorbing nutrients and possibly chronic pancreatitis? Do you have a copy of her most recent labs you could post? If not ask for your vet to email them to you. There’s a wealth of knowledge here on lots besides FD. Lots have needed steroids for IBD and other issues. You will be surprised how these cats adapt to ear poking. Treats really help. Just make sure 100% protein.
 
Once you have a plan and know what insulin and meter you will be using, etc If you could set up you signature that would be great
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Tiffmaxee- I will email my vet for a copy of Tazzy's most recent labs and post it. EPI sounds right, I remember pancreatic problems were in the diagnosis when she was first in trouble last year, the symptoms and ultrasound indicated either pancreatic inflammation or cancer. I refused a diagnostic biopsy due to cost and pain to Tazzy at that time, and we chose to treat with liver support meds, diet changes, and steroids. Which treats do you use? I'd love a recommendation :)

Diane- Ill add some to my signature now and more as soon as I know Tazzy's plan. Thanks again! :)
 
[QUOTE="Nicole M, post: 2615027, member: 30850"Which treats do you use? I'd love a recommendation :)
I used freeze dried 100% protein. There are lots available. I even bought human freeze dried by the pound as it was cheaper. Pure Bites I’ve used. With my two young ones I feed raw so they get Primal or Small Batch.
 
Tazzy is on Prednisolone. Is one better then another to manage diabetes?
And thanks for the recommendations on protein treats! I’ll get some ASAP.
No word back from my vet yet today.... hopefully she calls soon!
 
Critter Mom said:
Hi Elise,


I'm a bit rusty on stuff. Could you remind me which can be better for feline diabetics, please?


Mogs
.
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Budesonide often is better for a diabetic but even that can cause the bg to rise. Not all cats on pred become diabetic. I had one years ago that was on prednisolone for unknown reasons for a very long time and she never became diabetic. It makes me wonder if some are just prone to it. I don’t know.pred works better for small cell lymphoma as well as large cell and intermediate. Max had “just “ chronic pancreatitis and was never on steroids. He was controlled by treating his symptoms. With IBD a steroid is often needed and tge one vets usually try first is budesonide.
 
Nicole M said:
Tiffmaxee- I will email my vet for a copy of Tazzy's most recent labs and post it. EPI sounds right, I remember pancreatic problems were in the diagnosis when she was first in trouble last year, the symptoms and ultrasound indicated either pancreatic inflammation or cancer. I refused a diagnostic biopsy due to cost and pain to Tazzy at that time, and we chose to treat with liver support meds, diet changes, and steroids. Which treats do you use? I'd love a recommendation :)

Diane- Ill add some to my signature now and more as soon as I know Tazzy's plan. Thanks again! :)
Click to expand...
I have heard on the radio while driving about pancreatic insufficiency, I noticed it because my cat Buddy has so much trouble with pancreatitis. One other person on the board has a cat that takes pred for his pancreatitis and it helps that kitty. Would you mind telling me how much pred your kitty takes, does he see a specialist and does he have pancreatitis.
 
tiffmaxee said:
@Teresa & Buddy Prednisolone is not usually given for pancreatitis. It is often given for IBD but budesonide is more commonly tried.
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I know usually pred is not given, but sometimes with chronic pancreatitis they cannot get their diabetes under control because of the inflammation in the pancreas, so sometimes Pred is given to control the inflammation. I do know of 1 person on this board who is giving pred to their diabetic kitty.
 
Thank you all so so so much!
Sorry I haven’t checked back in a couple days, I’ve been waiting for the vet to reply with labs and getting supplies delivered. I finally have everything set up and will start insulin tomorrow! I took the rest of the week off work so I can be home with Tazzy and watch her closely.
I’m going to be giving her Lantus, 1 unit with breakfast and 1 unit with dinner for one week, then do a blood sugar curve. I’ll be giving her the low carb fancy feast in small portions three times a day to reach her calorie goal of 270-320calories/day. I have high carb/calorie cans ready incase she is hypersensitive and gets hypoglycemic. I also have honey ready to rub on her gums if it gets really scary.

The pharmacist told me that the Lantus can be unrefrigerated but I have to throw it out after 28 days. But that feels like such a waste... does anyone keep it refrigerated and use it longer? It was SO expensive... I’m ordering from the Canadian pharmacy for the next vial but this one I bought from Walmart cause she couldn’t wait 3 weeks for delivery.

Any tips for my first week? I’ll post the lab results shortly.
Thanks again,
Nicole & Tazzy
 
Nicole M said:
The pharmacist told me that the Lantus can be unrefrigerated but I have to throw it out after 28 days. But that feels like such a waste... does anyone keep it refrigerated and use it longer?
Click to expand...
28 days is the recommendation for human use. Humans carry the vial around with them. The company only asks the FDA to test for 28 days. In the fridge (not in the side of the fridge) your vial on Lantus will last for months.

Still, do order from Marks. It is always good to have a back-up vial in case you drop it on the floor and it breaks (it has happened).
 
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Red & Rover (GA) said:
28 days is the recommendation for human use. Humans carry the vial around with them. The company only asks the FDA to test for 28 days. In the fridge (not in the side of the fridge) your vial on Lantus will last for months.

Still, do order from Marks. It is always good to have a back-up vial in case you drop it on the floor and it breaks (it has happened).
Click to expand...
Oh my gosh what a relief, I’ll 100% order from marks next time! I just wanted to start her ASAP. Thank you!!
 
Hi.

I have a cat with chronic pancreatitis and Prednisolone is actually very commonly & routinely prescribed for cats with a primary diagnosis of chronic pancreatitis. While Budesonide can certainly be tried, the reason for its trial—it generally has less systemic effect vs Prednisolone—is often the very reason that it may not work well for cats with a primary diagnosis of chronic pancreatitis vs a secondary issue with the pancreas caused by a GI disease. Budesonide is going to have a localized effect in the GI tract which is often very effective for GI issues, but if you need control of the inflammation elsewhere, even within the lower end of the GI tract, it is often not very effective. With that being said, it still does have some systemic effect and the extent of that effect will differ from one cat to the next.

One of the leading researchers & thought leaders with respect to treating chronic pancreatitis is at TAMU & he is currently studying adding cyclosporine to Prednisolone with cases where the Prednisolone is no longer controlling the issue. The recommendation from him, as well as other specialists from a few universities my vet and I consulted with when my cat was first diagnosed with DM was, knowing that we had what is most likely an autoimmune mediated pancreatitis vs pancreatitis driven by GI issues, continue with Prednisolone and maximize its dose before adding chlorambucil or cyclosporine. The consensus was that both are add on drugs and are not best for use as first line treatment. I will also share that one internal medicine specialist and I decided to attempt one last try to lower the Prednisolone dose since we hadn’t tried it in awhile, with the thoughts of possibly trying Budesonide IF he did well on a tiny every other day dose of Prednisolone (tiny=2.5mgs)—again, keeping in mind that the Budesonide was NOT going to do much outside the GI tract. The result was similar to previous attempts to reduce Pred—increase in inflammation of the pancreas and a very sick & miserable cat—and an increase in BG. Since that time, my cats blood glucose is well controlled and a big reason for this is that the inflammation is well controlled. All of the consultants spoke to the fact that inflammation will cause DM to be unregulated & a challenge to manage, so find the least effective dose of the most effective drug and use it.

In addition, as already mentioned in a previous post, the steroid may not have caused the DM. There are quite a few studies and also specialists who use it routinely and generally it is not a problem. There is the belief that there is an underlying predisposition, just like with people.

In the end, my choice is a happy, healthy cat enjoying life taking Prednisolone and getting 2X/Day insulin OR a miserable cat who is nauseated, in pain, unable to eat or live a quality life.

Please give yourself and your cat time to adjust to some of the changes :). It does seem overwhelming at times in the beginning but it is more manageable than you think. One other suggestion that I did not see mentioned in prior posts was to buy a timed autofeeder. Since you will be at work, an auto feeder with ice packs that opens at set times will help. There are also options for insulins and options for management that can work for what will work best given your particular situation. While some people tightly regulate their cats similar to what is done with humans , there are also various looser regulation protocols that work as well. I just do not want you to think this can’t be done/managed with your work schedule &/or additional responsibilities :).....take one step at a time and people are here (as well as you vet hopefully) to help you. A plan that works best for you and Tazzy will come together with time :bighug:.
 
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@Tomlin -

Thanks for a post packed with really valuable information and experience.

I have a favour to ask: when you have a spare minute is there any chance you might edit the post and add a few paragraph breaks, please?. The solid block of text is quite hard to read. It's a post I'm bookmarking so that I might be able to refer other members to this information in the future. :)


Mogs
.
 
Critter Mom said:
@Tomlin -

Thanks for a post packed with really valuable information and experience.

I have a favour to ask: when you have a spare minute is there any chance you might edit the post and add a few paragraph breaks, please?. The solid block of text is quite hard to read. It's a post I'm bookmarking so that I might be able to refer other members to this information in the future. :)


Mogs
.
Click to expand...

Sorry about that! I was on my cell and running late so I typed quickly and posted :rolleyes:. Hopefully it works better now but let me know if it doesn’t :cool:!
 
Nicole M said:
View attachment 55828 View attachment 55829 View attachment 55831
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Did they happen to do what is called a full TAMU GI Panel in the past &/or also repeat it during this visit? There would be 4 labs within the panel: 1) Spec fPLI which is the gold standard test for diagnosing pancreatitis & it is also used for evaluating improvement or worsening of chronic pancreatitis 2) TLI which is used to diagnose EPI (exocrine pancreatic insufficiency) 3) Cobalamin (B-12) and 4) Folate
 
Tomlin said:
Did they happen to do what is called a full TAMU GI Panel in the past &/or also repeat it during this visit? There would be 4 labs within the panel: 1) Spec fPLI which is the gold standard test for diagnosing pancreatitis & it is also used for evaluating improvement or worsening of chronic pancreatitis 2) TLI which is used to diagnose EPI (exocrine pancreatic insufficiency) 3) Cobalamin (B-12) and 4) Folate
Click to expand...
I’m not sure, I don’t think those have been run. I’ll ask! Thank you
 
jayla-n-Drevon said:
Hi Nicole
Im sure you are overwhelmed right about now -- lots of wisdom going your way and the members are awesome.
Take your time and give yourself a breather now and then:bighug:
Click to expand...
Tomlin will answer this, but I believe Budesonide is for IBD and Pred is for pancreatitis. I am really interested in this because Buddy has chronic pancreatitis and if I could give him a dose of pred to see if it helped I would do it, but I am afraid of out of control diabetes. Buddy, was given pred for allergies one year at Christmas time when no vets were in and he became diabetic from the pred. By the time I could get him in to the vets he was a mess and had to be hospitalized for days, this is why I am afraid to give the pred without supervision. If you have supervision from your vet I would not be to worried, look at Tomlin.
 
Hi,

Please look back on the long post I sent last week for more details. You can try to use Budesonide In hopes that the systemic effect for your specific cat is minimal. Again, Budesonide targets the GI tract and therefore, it typically does not raise blood glucose but this is not true for all cats. It does have some systemic effects vs none and how much will differ from cat to cat. With that being said, the general lack of systemic effect is why it is often ineffective in managing what is a primary diagnosis of chronic pancreatitis vs pancreatitis caused by a GI issue. If a cat does have an undiagnosed underlying GI issue & it leads to the pancreatitis, sometimes the Budesonide will actually help. These are the cases you here about Budesonide working. The fact that it worked clearly indicates that there was a problem beyond the pancreas vs just chronic pancreatitis. It is worth trying, but you need to know that it may not work if it is pancreatitis and again, it is not being caused by a GI issue. It also may not help if the GI issue if it in the lower end of the GI tract or if the GI issue is more severe.

In cases where there has not been endoscopy or open surgery to get biopsies to determine the diagnosis (i.e. confirming that there is no GI issue or small cell lymphoma) or if the cat has had symptoms indicative of a GI issue, you can always try Budesonide & see if it works. If it works, it indicates there was a GI issue driving the problem because again, the Budesonide is not going to have enough of a systemic effect to manage a primary and more chronic issue of inflammation of the pancreas & this is why Prednisolone is used as the primary treatment.
 
Sorry for 2nd post but I am hoping it may help.

When the word systemic is used, the drugs effects are going throughout the body. So, Prednisolone is able to effect the intestine, the pancreas, the immune system. This is why it is very effective. However, it also effects the adrenal axis and glucose etc & this can be an issue.

When a drug is localized it is going to manage a specific area. Budesonide manages upper GI but it’s effects beyond that particular and more specific area are extremely limited so it is not going to do much for organs outside of the GI tract or even for the lower GI tract because it just doesn’t reach that far very well. Even for GI issues in cats, it has been hit or miss. Again, worth a try in selected cases, but not always effective.

Every cat is different & the symptoms and management will be based on the specific cat and of course, the diagnosis & course of the disease.

Best of luck. My hope is whatever treatment is chosen is effective :).
 
Hey all,
Have any of your kitties experienced nausea/vomiting with newly started insulin and going low carb?

The first 10 days I had Tazzy on Lantus went really well, 1 unit with breakfast and 1 unit with lunch. On the Fancy Feast Classic Pate that was recommended on here. Our first glucose curve was practically perfect according to my vet. Then on Sunday 9/6 she vomited yellow water twice and had a low appetite/energy. That night I gave her her old regular higher carb food and didn’t give insulin that night to avoid hypoglycemia. When I restarted low carb and insulin Monday morning we were back on track, and she didn’t vomit. Tuesday she again started vomiting, she vomited water 6 times and I was so close to taking her to the ER. She was drinking water and using the litter box and her blood sugar was consistently 150s-170s, so we stayed home and didn’t give insulin again.

I’m nervous to restart her on the low carb food and Lantus. It’s been about 48 hours now without insulin on regular old higher carb food and her blood sugar is 182, a little high but not crazy. She’s eating all her food, and playing and using the litter box as normal. How can her blood sugars be so good? Should I switch back to low carb? I’m hoping it was just a little stomach bug. Can Lantus cause nausea? My plan right now with my vet is to check her glucose at meal times and to give her 0.5units if her blood sugar went over 200.
Has anyone else experienced something like this?
Thank you in advance!
 
Diane Tyler's Mom said:
Hi Nicole what a beautiful kitty Tazzy is.
You have found the best place you can be
I see you live in Chicago, you can go to Walmart and get a human meter , the Relion Prime which most of us use for 9 bucks, the strips are 17.88 for 100 strips
Lancets a couple of bucks for 100
You can buy the syringes there also, just make sure they give you the ones with half unit markings
Get the 28 gauge lancets they will make her ears bleed better, as you test more cappliaries will grow and will make it easier.
Pick up some cotton rounds also to hold behind her ear so you don't stick yourself
Warm his ear first with a rice sock put it in the microwave just to get it warm and hold it on his ear until more capillaries grow
......
Stay safe Nicole :cat::cat:
Click to expand...

Diane, I wish we could make your reply a sticky. All of this is info I had to put together -- I just wish the vet had handed me a list like this: get this meter, get this food, get these syringes, this insulin. It's perfect!
 
Nicole M said:
Hello!

How much do insulin/syringes/needles cost? What I've seen says about 100$ a month for insulin and syringes. I've looked on Chewy and it looks like for the lancets/strips its an additional 70$ a month to check her twice a day.

I'm so overwhelmed. I don't want to start insulin, but what other choice do I have? As a nurse I'm gone for 14 hours a day... What if she goes hypoglycemic while i'm gone? I don't have any family where I live, and no roommates. Is it even safe to give her insulin? I can take a couple days off next week to try and get her stabilized and find a routine but with COVID I cant take any significant time off from the hospital.

This post got away from me, its so long. Thank you to anyone who takes the time to read it. <3
Click to expand...

Hi Nicole and welcome, sounds like you already realize this forum is the place to be. So sorry your furbaby is going through so much. Ordering from Canada may not be an option if you want to start insulin ASAP, so here's my story: I called 8 pharmacies to get the "cash price" for Lantus, and price quotes ranged from $357 to $313. CVS ended up being the most helpful and best price, because they told me to enroll for a free online prescription discount card from GoodRX to get a discount. Note that the GoodRX site will make you promise the prescription is for a human, so I ended up using SingleCare. These cards offer discounts to get the price down to $231 a vial. A vial can last 6 months (so I have read) though they say they will expire after 30 days. You have to refrigerate it and not shake it. When I finally got to CVS, the tech said there was a promotion and the price was $99. Other people on this forum have not been able to get that price because some techs won't give the promotion to pets, evidently. But I got lucky and I hope you will, too. I don't know if the promo is still happening, but it was only 2 weeks ago that I got it, so you can call and ask.
 

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