? New member & some questions on switching to Glargine

[RedCedar]

Hello everyone,

Nice to meet everyone - I found this forum via the Facebook group. Thanks so much for the admins/moderators over there being so kind and patient in helping me out with newbie questions and a scare with a mild hypo episode

Background: We are located in the United States. My kitty, Bart, is 14 years old and roughly 15 pounds (he is a very large cat but also a bit overweight). He was diagnosed on 2/20. At his previous exam 6 months before his BG was 180 and was not considered significant. In February it was 470; no ketones found in the urine. His symptoms are increased thirst and urination along with neuropathy of hind legs. He also had lost about 2 pounds.

Per the vet's recommendation we started on Vetsulin at 1 unit, did a BG curve at the vet's office after which they switched him to 2 units; we were then asked to increase to 3 units following at-home +6 BG tests in the 300 range. We did a week at 2.5 because I was nervous with the increase, and after increasing to 3 we figured out a good way to test him without him freaking out, so we decided to try a full curve at home.
When doing the full curve we found he was going hypo at +4 (61 with pet meter), with mild symptoms (hunger). Thankfully we had provisions at home and got it back up to over 100 right away.

Needless to say, it is now clear to me that the reason why his +6 values were still high is because his nadir was way earlier. Given this, I want to switch him to glargine as soon as I can get a prescription for it (hopefully tomorrow!)

Given the price of glargine in the US, I'm leaning towards purchasing one full price pen immediately and then order the rest from Canada. I assume that once we switch we should start from starter dose and work our way up from there. I read the info on the various sticky posts and I understand we should give it a week for the depot to fill before starting to test again.
Sanity check, does this all sound correct/accurate?

And, is there any recommended U100 syringes I could grab online in preparation that have 1/4 measures?

Apologies my spreadsheet is very barebones but we just figured the home testing situation.

EDIT: forgot to mention - he was diagnosed as very early phase kidney disease because of low urine concentration. We also have another 14 years old kitty at home that has stage 3-4 CKD. So the diet situation in the household is fun

 

[Ale & Bobo & Minnie (GA)]

Hi and welcome!!

it sounds like you did your homework and are very prepared! I’m tagging @Diane Tyler's Mom who has info on coupons you can use for glargine here in the us. I always ordered my Lantus from Canada because it was 1/3 of the cost and never had an issue. I would think starting at 1 unit would be smart given the hypo scare and also because you’ll now be testing and able to monitor what the dose does but I’ll defer to any other more experienced members who may have a different opinion

I always got my syringes from Walmart because it was the best priced ones and 1/2 unit marked but you can’t order them online. They only sell it at their in store pharmacies. I never needed a prescription for it and I always called first to make sure they had them in stock.

 

[Ale & Bobo & Minnie (GA)]

You mean 1/4 or 1/2 units? There no 1/4 unit syringes for insulin that I know of

 

[Diane Tyler's Mom GA]

Hi and welcome
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

Tap on your name up top and tap on signature and add the information that is asked in the blue link

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

 

[Diane Tyler's Mom GA]

Here is some info
Check this out
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
One pen would last me about 3 -4 months . we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

We don't use the pen because you can only adjust the dose by full units, we adjust the dose by 0.25 units at a time. You would need U-100 syringes have half unit markings


Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!

If for some reason you can't get to a Walmart you can order these
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct
You might need your vet to fax over a script for them to ADW Diabetes. Just call them and tell them what syringes you want and they will contact your vet. Give your vets office a hesfs up and ask for refills so you can go to their web site and order them.
Set up an account with them

 

[Diane Tyler's Mom GA]

symptoms are increased thirst and urination along with neuropathy of hind legs.

You can order this for neuropathy, you can start giving it now but you will see a better improvement once he's better regulated . Just mix one capsule every day in the wet food ,
You can order this Methyl B-12 . I have used it for years and a lot of other members use this Methyl B-12 , just open up the capsule mix it in with the wet food add some water, it's tasteless.
Tyler had neuropathy and I started to see an improvement in about a month or 2 , but each week he seemed to be walking better. He's back to jumping all over the place



https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
14.49 for 100 capsules
Give one a day

 

[Diane Tyler's Mom GA]

If you need any suggestions on what food is available for diabetes and kidney disease low carb and low phosphorus just ask me
Also I see you are using the Alpha Trak which I know how expensive the test strips are , I used it in the beginning and then switched to a human meter , our numbers are based on human meters but if you want to use the Alpha Trak that's perfectly fine
I can give you the name of a human meter that most of us use if you would like

 

[RedCedar]

Thank you so much for the welcome and for all the advice!!

I updated my signature with more info. I had got as far as setting up the spreadsheet but had completely missed the rest of the info I should have been putting in there!

@Diane Tyler's Mom this is all amazing information, thank you so much! I hadn't realized that there are generics for Glargine as well. The cost is much more reasonable, and I have access to most of those pharmacies around here so I will absolutely leverage those coupons.

And thank you SO much for the link for the vitamin! Is there any concern if my other kitty with no neuropathy gets into the food it's mixed in?

For food: I got a list from the Facebook group and so far I am trying the following:
- Weruva low phosphorus line - just got those yesterday from the store - still going through 'taste test'
- Weruva BFF (which are a bit hit and miss with my boys)
- Some of the Tiki cat flavors
-Dr Elsey's chicken dry for occasional snacks (I know dry is not ideal but both of them love kibble and it helps a lot with trying to keep the weight for the CKD boy)
Both of them are quite picky with canned food - I currently feed them 5 times at 4 hours intervals and they split 3 ounces cans every time. They will not eat opened cans most of the time -_- They also will not eat the same food if I offer it too often. I occasionally feed different foods to each of them, but since they never eat all of it at once, I can't do that too often.

 

[Sienne and Gabby (GA)]

With respect to the price for Lantus, it is now available as a generic/biosimilar. It is a fraction of the price of the name brand. It will cost about the same as getting Lantus from Canada. There are several people who use the biosimilar successfully. Make sure the vet writes the prescription for glargine (not Lantus). You may need to call around to pharmacies in your area to make sure where it's available.

 

[Diane Tyler's Mom GA]

And thank you SO much for the link for the vitamin! Is there any concern if my other kitty with no neuropathy gets into the food it's mixed in?

I don't think so at all. I used to give it to Tyler's brother who was not diabetic but did have kidney disease , it was recommended to give it to him by a kidney disease group I had joined
Make sure you add water to the food and mix it up good
They are picky not eating opened cans most of the time lol, what if you warm it up in the microwave for them? These cats can drive us crazy
I think you will really like glargine
What a gorgeous boy Bart is Angela !
Methyl B-12

• Vitamin B-12 (cobalamin) is a water-soluble B vitamin that’s vital for carbohydrate metabolism and energy production. It also plays an important role in the formation of healthy red blood cells.

 

[Jacques and Pumpkin]

Water soluble means that excess can get excreted away by urine, so it's a relatively safe vitamin and shouldn't cause issues for your non-diabetic kitty.

 

[RedCedar]

Thank you both! We'll definitely give the Methyl B-12 a try

They are picky not eating opened cans most of the time lol, what if you warm it up in the microwave for them? These cats can drive us crazy

They don't seem to like having their food warmed at all! With that said, as of today I still don't know if it's actually the opened can they mind, or if they simply object to having the same food twice in the same day, haha. The only way I have found to make both eat more wet is by feeding them a different food every time, many times a day.

And thank you! He is a handsome boy and also very sweet <3 I am hopeful that the glargine will get him in a good spot.

 

[Diane Tyler's Mom GA]

Thank you both! We'll definitely give the Methyl B-12 a try



They don't seem to like having their food warmed at all! With that said, as of today I still don't know if it's actually the opened can they mind, or if they simply object to having the same food twice in the same day, haha. The only way I have found to make both eat more wet is by feeding them a different food every time, many times a day.

And thank you! He is a handsome boy and also very sweet <3 I am hopeful that the glargine will get him in a good spot.

I'm sure the glargine will get him in a good spot
I think you should add vetsulin to your signature then when you switch to glargine you would add that to your signature like this
Vetsulin/Glargine then the date so members know. Do this on your spreadsheet also up top and then put a blank line above the date you start the Glargine and highlight it.
If you don't know how to do this I can ask someone to do it for you