Asking vet to change insulins and food - follow up | Feline Diabetes Message Board - FDMB

Asking vet to change insulins and food - follow up

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Librarianista

Member since 2021
Chloe has a vet appointment on Friday, and I want make sure I'm prepared with good questions.

Chloe is currently on Vetsulin and is not responding to it (dosage history here in my intro post). We will be discussing switching to Lantus. I only JUST started home testing, but all her numbers are pretty high (usually >500), as were her recent vet tests. I am wondering what I should expect in terms of a starting dose for switching to Lantus?

I am also going to ask about switching her food to FF since the DM Savory Selects are too high in carbs (and she doesn't like the pate). I know that switching foods in addition to switching insulins could cause some very different numbers. In your experience, what advice should I expect to receive about making these changes safely and smartly?

Thank you!

Also, I know I am missing her AMPS for this morning. I could *not* get her to settle long enough to get a draw.
 
Her numbers are very high so you have some wiggle room. If it were me, I'd transition diet while you wait for Lantus to come. I'd start by swapping in 2oz of new food every other day to avoid tummy upset - but while you're doing it, please please be sure to test at +1 and +2 every cycle; if you see a big drop from PS then test until you see her going up. Do this every cycle until she's completely transitioned; any number below 90 is an immediate reduction of 0.25U.

Where she's at after diet change will determine Lantus dose. When you're ready we'll get some Lantus experts to weigh in on dose.

Also be sure to get U100 syringes! With half unit markings

Edit: reading previous post, if you decide to do a dental that will be critical info as well, so be sure to let us know
 
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If you switch to Lantus we can tell you where to get it, Marks Marine in Canada



Most of us use Lantus, . Lantus is expensive in the US so we buy it from Marks Marine in Canada
We buy the 5 pack of pens they will probably last you for over a year
With Lantus you use U-100 syringes with half unit markings
so you can increase or decrease by 0.25 units

With the pen you can only adjust by whole units, that's why we use syringes to insert in the little gray rubber stopper and draw out the insulin from there
The expiration dates will probably be 2022 or 2023 just keep them in the middle shelf in the fridge. You can call them to contact your vet to get in touch with your vet to send over a script.
After that you will not need another script to reorder
 
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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

rx.gif
Lantus Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

rx.gif
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

https://rxcanada4less.com
 
I’m not sure the vet will be able to help you with a suitable food. They mostly like you to use the prescription foods that are expensive and high in carbs.
As has been mentioned above, when swapping to a low carb food you need to be monitoring BGs closely as a switch to low carb can drop the BGs quite a bit.
I would look at the lists here and try and find a suitable food which Chloe likes.
Here is a linkhttps://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf


Where she's at after diet change will determine Lantus dose, usually it's 1U or about half the current dose.
When swapping from one insulin to another, the current dose of the previous insulin is taken into consideration.
We do not recommend reducing the dose to 1 unit or about half the current dose.
In a lot of cases we use the current dose when swapping.
An exception is swapping from Lantus to Levemir....where we recommend starting at 70% of the current dose.
Alex, I would try and get a few more test in during the pm cycles if you can so we can see how she is during that cycle. The more data we can have when swapping over to Lantus, the better.
Good luck with the vet apt. I would definitely recommend swapping to Lantus or Levemir.
 
I’m not sure the vet will be able to help you with a suitable food. They mostly like you to use the prescription foods that are expensive and high in carbs.
As has been mentioned above, when swapping to a low carb food you need to be monitoring BGs closely as a switch to low carb can drop the BGs quite a bit.
I would look at the lists here and try and find a suitable food which Chloe likes.
Here is a linkhttps://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf



When swapping from one insulin to another, the current dose of the previous insulin is taken into consideration.
We do not recommend reducing the dose to 1 unit or about half the current dose.
In a lot of cases we use the current dose when swapping.
An exception is swapping from Lantus to Levemir....where we recommend starting at 70% of the current dose.
Alex, I would try and get a few more test in during the pm cycles if you can so we can see how she is during that cycle. The more data we can have when swapping over to Lantus, the better.
Good luck with the vet apt. I would definitely recommend swapping to Lantus or Levemir.
Whoops sorry! Not really sure where my head was at.


I'll edit previous post just to avoid confusion.
 
I mixed in some FF flaked fish with her other food tonight and got some freeze dried chicken treats. +1 hr, her BG is so high the meter just says HI, so it’s at least 750. I will keep monitoring tonight.
 
Regarding Lantus pricing, I wanted to add that I was able to get a 10 mL vial of Lantus from my local CVS for $99 last week with a discount they found and applied. Otherwise it would have been $314 at CVS and $340 at Walmart or Costco. I think $99 is an okay price, correct, for one of the better insulins? Plus not have to worry or wait for the insulin to be shipped from Canada. Not saying that's a bad thing. I used to order inhaled meds for my asthma Kitty from Canada.
 
Regarding Lantus pricing, I wanted to add that I was able to get a 10 mL vial of Lantus from my local CVS for $99 last week with a discount they found and applied. Otherwise it would have been $314 at CVS and $340 at Walmart or Costco. I think $99 is an okay price, correct, for one of the better insulins? Plus not have to worry or wait for the insulin to be shipped from Canada. Not saying that's a bad thing. I used to order inhaled meds for my asthma Kitty from Canada.

Was this a discount through insurance or just a special they were running? I'm not personally on any prescription meds, so looking for discounts is a new concept for me.
 
I do not have insurance for my cats. This was just a discount CVS has. They did the same thing for me 2 years ago with progesterone. Searched and found a "deal" which was better than my prescription insurance. I just looked at all of the paperwork that came with the Lantus receipt. There is no mention of the discount. Perhaps I got it due to being a senior? You'd just have to call and ask. Good luck and hugs.
 
Okay, post-vet update. She was there from a half hour after her AM shot until about a half hour ago - so 6 hours that I don’t have any readings for today (and I’m currently in the pharmacy so I haven’t tested her since dropping off at home). I imagine it’s HIGH from the stress of the vet stay.

We are switching to 2U of Lantus BID, except tonight she just wants me to give 1 to make sure the Vetsulin is out of her system. Does that sound right?

Didn’t get a full dental exam but she has 1 broken tooth she could see. She didn’t flinch when the dr was poking around that area so she doesn’t think it was an emergency. There’s plaque buildup on some back teeth that might be painful. They gave me some Onsior pills to see if that affects whether she’ll eat on both sides of her mouth or try some dry food. I know that pain might affect her BG levels, but I’m not sure what new insulin + new meds will do and which should take precedence.
 
Didn’t get a full dental exam but she has 1 broken tooth she could see. She didn’t flinch when the dr was poking around that area so she doesn’t think it was an emergency. There’s plaque buildup on some back teeth that might be painful. They gave me some Onsior pills to see if that affects whether she’ll eat on both sides of her mouth or try some dry food. I know that pain might affect her BG levels, but I’m not sure what new insulin + new meds will do and which should take precedence.
As a newbie to all of this insulin stuff, and not yet testing, I can just send you hugs. :bighug::bighug::bighug:
I will say I don't understand how any of you can hold down jobs and do all this testing.
 
As a newbie to all of this insulin stuff, and not yet testing, I can just send you hugs. :bighug::bighug::bighug:
I will say I don't understand how any of you can hold down jobs and do all this testing.

Thank you for the hugs! Right back at you! I’m still working from home, though I’ll be heading back to the office part-time in a couple of weeks. If I hadn’t been home and had a direct line of sight to her water dish and litter box over the last year+, I’m not sure how soon I would have caught it.
 
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