New Member: Mike and Shannon

[MikesMom]

Hi all.
I’m Shannon.
My cat is Mike Teavee, or just Mike for short. Male, tuxie. He’s been an overweight cat for a few years and trying to get his weight down has always been a struggle (I have another cat; very hard to regulate food with more than one!). Edited to add: Also, Mike is on phenobarbital to prevent seizures, and that has a tendency to make cats lazy, which adds to the difficulty with weight loss.
When he started drinking a lot of water, urinating quite a lot, and then dropped a lot of pounds rapidly, I was concerned that he had diabetes, and unfortunately that was confirmed by a vet visit last week. I’m brand new to this; today I pick up his insulin and go to the vet to learn to give injections.
Right now, my main concern is how to keep costs of insulin down. I suppose like a lot of people who haven’t had to deal with it directly before, I was basically aware that they were high enough to exclude some people with diabetes from getting needed treatment. I wasn’t aware that costs were about as much as a car payment. He’s been prescribed Lantus U-100 for now, and the pharmacist advised me to gather a lot of coupons since not all can be accepted for pets (?), but so far that’s all I know. In terms of affording it - I can, but obviously it would be preferable to reduce costs.
I do have pet insurance through Healthy Paws, but this is going to be my first major test of his insurance, I have no idea how much they’ll cover.
Many thanks,
Shannon

 

[Sienne and Gabby (GA)]

The quickest answer to keeping costs down for Lantus is to:

• order from Canada. Many people here order from Mark's Marine Pharmacy. The cost is about 1/3 of what you will pay at a US pharmacy
• get a biosimilar (generic) of Lantus which are now available. Semglee is the least expensive (the other biosimilar is called Basaglar). Semglee costs about the same as if you were buying from Canada. You may need to call around since not all pharmacies stock it. (Your pharmacist should have told you this.)
• If you need to use the manufacturer's website for a coupon, don't say it's for your cat!

The good news is that your vet prescribed a very appropriate insulin for your cat!

You will also want to consider getting Mike on a low carbohydrate diet if you've not already done so. We strongly encourage a canned food diet that is less than 10% carbohydrate. Most members here feed their cat in the neighborhood of 5%. The lesser expensive options are Fancy Feast and Friskies in their pate style variety. This is a chart that contains most of the canned cat foods available in the US along with the amount of carbs.

If you are interested in taking advantage of the support offered here, I'd encourage you to take a look at this post on helping us to help you. It provides a good deal of general information for new members along with how to set up your signature and a spreadsheet. We are huge advocates of home testing and a spreadsheet will allow you to track Mike's progress and will allow us to follow along.

 

[MikesMom]

Thanks so much for the information. How long do shipments from Mark’s Marine Pharmacy normally take to ship to the US? I’m in the Chicago area.
Right now Mike eats Fancy Feast Classic Pate morning and evening, and free feeds dry Hill's Prescription Diet w/d Multi-Benefit Digestive, Weight, Glucose, Urinary Management. My vet recommended this dry food for UTI management and weight loss, it’s a high-fiber and high-protein dry food, but based on the info I’m seeing here, I’m going to discuss transition to a high- or exclusive-wet food diet.
I’ll check out the info you linked, I really appreciate you helping me get started here on the forum!

 

[Diane Tyler's Mom GA]

Here is a coupon below
Just call any pharmacy to see if they have the 5 pens, they will last you a year or more
Type in where you live and you will see where you can buy it
Lantus is expensive if you live in the US
https://www.goodrx.com/semglee?dosa...rride=Semglee&quantity=1&sort_type=popularity
Semglee, it is a generic Lantus, and was approved by the FDA last June. The cost is compatible with Lantus from Canada.

 

[Sienne and Gabby (GA)]

The dry Hill's is VERY high in carbs. There is also nothing "prescriptive" about it. In fact the pet food manufacturers were subject to a class action suit for calling their food prescription. They lost. With urinary tract issues, it's more important to make sure your cat is well hydrated and dry food contains almost no moisture. I routinely add water to my cats' canned food -- it's good for their kidneys. You might want to take a look at this information on feline nutrition. It's from a vet who has put a huge amount of time and energy into studying feline nutrition. If you look at the menu bar on the right side of the page, there's a section on prescription food.

If you transition your cat to a low carb, canned food diet, it's highly likely that your cat will lose weight. What we encourage is a species appropriate diet. Cats are obligate carnivores -- they can't process carbs. Essentially, a diabetic needs to be on the Atkin's diet!!

I've not ordered from Mark's. They are very good about customer service and if you call, I'm sure they can tell you how long it typically takes. I'm also tagging @Chris & China (GA) who can answer any of your questions about ordering from Mark's. I used to live in Chicago -- their mail service is notoriously bad!!

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
What dose of insulin has your vet prescribed.?
Don’t forget to get the hypo kit set up as soon as possible. The link is in the ‘Help us help you’ link Sienne sent you.
Have you thought about home testing the blood glucose.. ? It’s the best way to keep Mike safe.
The ReliOn Premier meter from Walmart is inexpensive at $9 for the meter and $17.88 for 100 test strips. You will also need some lancets to prick the ears …get size 26 or 28 gauge and some cotton rounds to put behind the ear when testing
HOMETESTING link here

 

[MikesMom]

Mike’s dose is 2 units morning, 2 units at night.

For home testing, I do have an AlphaTrak meter. The vet didn’t make specific recommendations for testing prior to injections, but it sounds like a lot of people do that. Do you recommend testing after meals and before the shot? Or before meals? Reading the sticky, I see that below 50 mg/DL means do not give insulin, but what’s considered the safe or ideal range? I’d love some guidance, because I’m sure a BG of 60 wouldn’t make me feel reassured. Also, what is the TR protocol? I couldn’t find it in the Glossary, but I keep seeing it referred to.
Finally, I’ve got him fully on wet food now and plan to stay there as long as he doesn’t have any issues with it. Only problem - the vet recommended two meals daily, each right before insulin. That’s a lot of canned food all at once. To avoid a scarf and barf situation, I’ve been feeding him each meal in “courses”, over the space of an hour (meaning I give him a little food and then give him 10 or 15 minutes to digest it, then a little more food). Still. It is a lot at once. He tends to want to be fed about 2 hours before I start mealtime, and I think some of that is habit related to when I tended to feed prior to switching to mealtimes, but I also suspect he’s actually hungry around that time. I’d like to hear thoughts on meals.

I edited this down a lot because I was in a bad mood when I posted yesterday, mainly from feeling uninformed by my vet. I talked to her and feel somewhat better. Sorry if it came off as a rant.

 

[Diane Tyler's Mom GA]

Also, what is the TR protocol? I couldn’t find it in the Glossary, but I keep seeing it referred to.

Here are the 2 dosing methods for lantus
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

 

[Katherine&Ruby]

Hi there, we recommend testing at minimum before each shot to make sure the cat is not too low. Then we recommend at least one test between each cycle (one cycle is the 12 hours between the shots, two cycles in a day). Here's a link to my Ruby's spreadsheet so you can get an idea of how much to test (you can look at everyone else's spreadsheets through a link in the signature): https://docs.google.com/spreadsheet...JUiVX87H-YOj5-lZYu3yHgXosQudHNFRKd6T-/pubhtml

We recommend testing before feeding. Since you're new, a two hour fast is recommended to make sure the number you get isn't influenced by food, and don't shoot any number below 150.

Here's a link that may answer a lot of your questions: New? How you can help us help you!

 

[Bron and Sheba (GA)]

Hi Shannon, with feeding the food…..We recommend feeding a meal before the shot. So you test first, then feed, then shoot.
Then we recommend feeding a few snacks during all the cycles. So for example you could give a snack at +3 and +6. You might find you want to give another small snack but try and keep it closer to the half way mark in the cycle because that is when the insulin is strongest and if you give the snack later in the cycle it can shorten the action of the insulin a bit. It’s trial and error and we can help you. I would start with the main meal and 2 snacks each cycle and see if that is enough for Mike.
Also don’t feed for the two hours before the preshot test as we don’t want the BG to be food influenced.
My cats are all used to smaller meals….if I fed all their food at once, they would vomit. Just feeding twice a day is old thinking and with the newer insulins feeding more often is good and better for the pancreas.

Have you thought about setting up our spreadsheet to add your BG data to?
Here is the link SPREADSHEET

 

[MikesMom]

Hi Shannon, with feeding the food…..We recommend feeding a meal before the shot. So you test first, then feed, then shoot.
Then we recommend feeding a few snacks during all the cycles. So for example you could give a snack at +3 and +6. You might find you want to give another small snack but try and keep it closer to the half way mark in the cycle because that is when the insulin is strongest and if you give the snack later in the cycle it can shorten the action of the insulin a bit. It’s trial and error and we can help you. I would start with the main meal and 2 snacks each cycle and see if that is enough for Mike.
Also don’t feed for the two hours before the preshot test as we don’t want the BG to be food influenced.
My cats are all used to smaller meals….if I fed all their food at once, they would vomit. Just feeding twice a day is old thinking and with the newer insulins feeding more often is good and better for the pancreas.

Have you thought about setting up our spreadsheet to add your BG data to?
Here is the link SPREADSHEET

I’m setting up his spreadsheet tomorrow, when I do his first Curve. I haven’t been regularly testing which is why I haven’t set up the spreadsheet.

Also I have ADHD, and the spreadsheet instructions aren’t easy for me. Yes I’ve followed the setup link and looked multiple times, but they weren’t very clear. It took a lot of replies to my questions and looking at other people’s spreadsheets to make sense of it.

Thanks very much for your thoughts on giving the cat snacks - Twice a day feeding seems to mean that he’s extremely hungry 2 hours prior to meal time, but then by the end of the meal, it’s too much for him to finish. He should ideally be eating 3 cans of FF total in a day. He can easily eat one can at a meal, but anything more than that is a struggle. But you said you do snacks at +3 and +6: his insulin is at 8 a.m. and p.m., I can do a snack 3 hours later at 11 p.m. but I’m asleep 3 hours after that.

 

[Bron and Sheba (GA)]

For snacks when you are asleep I would suggest looking at buying an automatic timed feeder. A lot of us here use them and they are invaluable. If you can’t afford a timed feeder the swap the times around a bit at night to for two snacks in before bed.

I am going to ask @Bandit's Mom to assist you with the SS if you are having trouble with it. I needed assistance too!

 

[Bandit's Mom]

I’m setting up his spreadsheet tomorrow, when I do his first Curve. I haven’t been regularly testing which is why I haven’t set up the spreadsheet.

Also I have ADHD, and the spreadsheet instructions aren’t easy for me. Yes I’ve followed the setup link and looked multiple times, but they weren’t very clear. It took a lot of replies to my questions and looking at other people’s spreadsheets to make sense of it.

Hi and welcome!
I can help you set up your spreadsheet. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

[Hendrick Cuddleclaw]

Hi and welcome to the best club you never wanted to join. I am new to this whole thing myself, my buddy Hendrick was diagnosed 1/5/22

A couple tips for home BG testing, that helped me a ton:

I could not get the hang of poking his ear with the lancet device that came with the AlphaTrak. The loud click, right at his ear no less -- no good. Then I tried just freehand using the little mini-lancets that go into the device. This also did NOT work for me or my wife.

What finally got us going was buying a box of lancets like these: https://www.amazon.com/gp/product/B07VRZ88Q3/?tag=felinediabetesfdmb-20

Yes they are much longer than you need but it helps me a ton to get that right 45 degree angle and see what I'm doing. I also wear an LED headlamp and my readers. Additionally, initially I didn't know that the trick is to touch the tiny little triangular protrusion on the SIDE of the Alpha Trak test strips (either side) to the blood drop and it should just suck it up on the strip immediately. This picture shows it. And Vaseline is KEY for us or the blood just goes right into the fur. We never had a successful test until we used Vaseline. Should have used it from the beginning, d'oh

It seems about 99% of vets know very little about how to care for a diabetic cat properly and potentially help them go into remission. Every new post here, just about, has someone mentioning that their vet said only feed every 12 hours.

Also, I know how overwhelming this all is but hang in there. There's a learning curve but you'll get it. I remember the first time I looked at one of these spreadsheets, my mind boggled. It was like a foreign language and it seemed daunting. But just a week or two later and I'm getting it.

you will too!