? Pickles just relapsed :( Need advice

[picklesmom]

My 8 year old kitty, Pickles, was diagnosed with diabetes 2 years ago. He was put on 2 units of vetsulin 2x a day. We did that for a month and a half plus I switched him to a zero carb diet (young again kibble and fancy feast pate) and he went into remission. We stopped the insulin and he's been fine for the past 2 years.

Recently i noticed a big weightloss, his coat was unkempt and he had loose stool. But he wasn't drinking or urinating excessively (which is what alerted us last time to an issue). I just took him to the vet this AM and they called to say all they could find after doing bloodwork and xray is moderately high glucose (350). He wants to put him on 1-2 units of vetsulin again.

First question - should I try removing the young again kibble from his diet and only do fancy feast and see if that helps?

Second question - Is there a better option than vetsulin? I know it's the cheapest, but I'd pay for something better.

I'm so stressed because it was so hard to get him to let me test him. I never figured out the ear so I always had to do paw and it required both me and my husband to get it done. I was really hoping he'd stay in remission :'(

 

[Bron and Sheba (GA)]

Hi and welcome back although I sure you would rather not be here.
My kitty Sheba relapsed after 2 1/2 years so I understand the stress and disappointment.
Yes there is a much better insulin for your kitty than vetsulin which is shorter crafting and is really a dogs insulin.
Ask for Lantus insulin. It is a longer acting, more gentle insulin.

If the dry is low carb, it is unlikely to be causing the higher BGs but I have heard some cats have got a higher Bg from it so it would be worth a try. But it does sound as if you may need to restart insulin.
Do you know if they did a fructosamine test or just an ordinary blood test for the glucose.
The starting dose for Lantus is 1/2 to 1 unit twice a day.
Once you have the insulin, post again and we can help you with the dosing.
I would suggest feeding the pre shot meal and then a couple of low carb snacks during both cycles. There is no need to wait after feeding with lantus. You test/feed and shot one after the other as the onset of insulin is not for about 2 hours, unlike vetsulin

 

[picklesmom]

Hi and welcome back although I sure you would rather not be here.
My kitty Sheba relapsed after 2 1/2 years so I understand the stress and disappointment.
Yes there is a much better insulin for your kitty than vetsulin which is shorter crafting and is really a dogs insulin.
Ask for Lantus insulin. It is a longer acting, more gentle insulin.

If the dry is low carb, it is unlikely to be causing the higher BGs but I have heard some cats have got a higher Bg from it so it would be worth a try. But it does sound as if you may need to restart insulin.
Do you know if they did a fructosamine test or just an ordinary blood test for the glucose.
The starting dose for Lantus is 1/2 to 1 unit twice a day.
Once you have the insulin, post again and we can help you with the dosing.
I would suggest feeding the pre shot meal and then a couple of low carb snacks during both cycles. There is no need to wait after feeding with lantus. You test/feed and shot one after the other as the onset of insulin is not for about 2 hours, unlike vetsulin

Thank you for the reply. They did an ordinary blood test. I’ll ask for Lantus. Can I have them send the script to a regular pharmacy? I see generic lantus is $90 at rite aid without insurance.

 

[Bron and Sheba (GA)]

Thank you for the reply. They did an ordinary blood test. I’ll ask for Lantus. Can I have them send the script to a regular pharmacy? I see generic lantus is $90 at rite aid without insurance.

I live in Australia but I think so. The generic landis is fine.
If you are not going to be able to start insulin for a few days, I would buy some Ketostix and test the urine for ketones.
When you get the lantus, list and ask about the dose to start.

 

[Diane Tyler's Mom GA]

I’ll ask for Lantus. Can I have them send the script to a regular pharmacy? I see generic lantus is $90 at rite aid without insurance.

Generic is fine you are better off getting the pens and not the vials
Basaglar

Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year

Basaglar is also Insulin Glargine, it acts the same way.

Here is a saving card for basaglar for 5 pens
Check it out just put in where it says set your location
https://www.goodrx.com/basaglar

I see some members will call CVS, Rite Aid, Costco to get the price for 5 pens

You will need U-100 syringes with half unit markings for lantus , just insert the syringe into the pen and draw out the insulin.

https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

 

[picklesmom]

Generic is fine you are better off getting the pens and not the vials
Basaglar

Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year

Basaglar is also Insulin Glargine, it acts the same way.

Here is a saving card for basaglar for 5 pens
Check it out just put in where it says set your location
https://www.goodrx.com/basaglar

I see some members will call CVS, Rite Aid, Costco to get the price for 5 pens

You will need U-100 syringes with half unit markings for lantus , just insert the syringe into the pen and draw out the insulin.

https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

Thanks for the info - I didn't know you could get the pens! According to the first link you sent I can get five 3ml pens for $91 of a 10ml vial for $71. I'm assuming the pens are better due to the vial expiring after a certain amount of days and not being able to be fully used. Is this right? I called my vet and they said they're willing to call in a prescription to my pharmacy of choice. Should I specifically ask for the pens? Or can I make that arrangement at the pharmacy. My vet overall seems useless and clueless.

 

[Diane Tyler's Mom GA]

Get the 5 pens they will last you at least a year
Even though both the pens and vials say they are only good for 28 dayts that's for human use.
Just keep the pens in the fridge middle shelf
Get U-100 syringes with half unit markings because if you use the pen with the needles that would go in them you can only adjust doses by whole units
So that's why we use the U-100 syringes half until markings , we adjust the doses by 0.25 units at a time
Yes tell your vet to call the pharmacy and ask for 5 pens and tell her to say generic lantus is fine.

Like Bron said above once you are ready to start the lantus post again and the members can help you with dosing. I'm not experienced enough to advise about doses
Just a suggestion to save you money
I see you are using the Alpha Trak . I know the strips are very expensive, I used that in the beginning.
Some of the members suggested that I switch to a human meter which I did, plus our numbers are based on human meters anyway
You can get the Relion Premier Classic from Walmart or order it on their web site
It's 9 dollars
17.88 for 100 test strips
The members will help you get used to human numbers
I know that on human meters normal number are 50-100
Thought I'd just let you know


Human meters tend to read lower than a pet meter like the AlphaTrak. That is why in this forum we say the normal range on a human meter is 50-100....on a pet meter while it is 68-150.

On a human meter, 50 is your “take action” number compared to 68 on the AT2.
Meaning you will need to intervene with food to bring the BG number up
Human meters tend to read lower than a pet meter like the AlphaTrak.

If you do ever decide to switch to a human meter let us know , the last 2 color codes up top of the spreadsheet would need to be changed

You can read all about Lantus here
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

 

[picklesmom]

Get the 5 pens they will last you at least a year
Even though both the pens and vials say they are only good for 28 dayts that's for human use.
Just keep the pens in the fridge middle shelf
Get U-100 syringes with half unit markings because if you use the pen with the needles that would go in them you can only adjust doses by whole units
So that's why we use the U-100 syringes half until markings , we adjust the doses by 0.25 units at a time
Yes tell your vet to call the pharmacy and ask for 5 pens and tell her to say generic lantus is fine.

Like Bron said above once you are ready to start the lantus post again and the members can help you with dosing. I'm not experienced enough to advise about doses
Just a suggestion to save you money
I see you are using the Alpha Trak . I know the strips are very expensive, I used that in the beginning.
Some of the members suggested that I switch to a human meter which I did, plus our numbers are based on human meters anyway
You can get the Relion Premier Classic from Walmart or order it on their web site
It's 9 dollars
17.88 for 100 test strips
The members will help you get used to human numbers
I know that on human meters normal number are 50-100
Thought I'd just let you know


Human meters tend to read lower than a pet meter like the AlphaTrak. That is why in this forum we say the normal range on a human meter is 50-100....on a pet meter while it is 68-150.

On a human meter, 50 is your “take action” number compared to 68 on the AT2.
Meaning you will need to intervene with food to bring the BG number up
Human meters tend to read lower than a pet meter like the AlphaTrak.

If you do ever decide to switch to a human meter let us know , the last 2 color codes up top of the spreadsheet would need to be changed

You can read all about Lantus here
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

thank you!! I'll look into a new monitor. My worry is the one you mentioned requires a 0.5 sample while the alpha trak only requires 0.3. I already struggle to wrangle him for testing, is .2 a big difference?

 

[Diane Tyler's Mom GA]

thank you!! I'll look into a new monitor. My worry is the one you mentioned requires a 0.5 sample while the alpha trak only requires 0.3. I already struggle to wrangle him for testing, is .2 a big difference?

I used to use the Alpha trak yes I know it requires less blood but I had no trouble getting enough blood with the Relion . you can try putting a thin layer of Vaseline on Pickles ears so the blood with bead up , you can even put the blood on a clean finger nail and test it from there.
Are you giving Pickles a freeze dried treat before and after you test so he associated getting a treat for testing?

 

[picklesmom]

I used to use the Alpha trak yes I know it requires less blood but I had no trouble getting enough blood with the Relion . you can try putting a thin layer of Vaseline on Pickles ears so the blood with bead up , you can even put the blood on a clean finger nail and test it from there.
Are you giving Pickles a freeze dried treat before and after you test so he associated getting a treat for testing?

I'll try the vaseline. Yes, I gave him a few pieces of young again zero carb kibble AFTER i did it. Is it okay to give before/during? I was worried it could impact the test result. But I guess that's crazy to think it would impact that quick haha

 

[Diane Tyler's Mom GA]

When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
Looking at the pic of Pickles he looks like such a fluffy handsome boy

 

[Diane Tyler's Mom GA]

I'll try the vaseline. Yes, I gave him a few pieces of young again zero carb kibble AFTER i did it. Is it okay to give before/during? I was worried it could impact the test result. But I guess that's crazy to think it would impact that quick haha

I'm sure that would be fine it wouldn't impact his BG that quickly