? AMPS 154 +2 174 +4 281 +6 285

[Basic's Mom]

I'm doing Basic's curve today. Before I increase his dosage to 3.25, I want someone to review his info and let me know what they would do.

I'm currently making the switch from high carb kibble to low. It is going well and they (I'm switching both cats so there is no high carb food he could possibly get into) aren't having any adverse reactions.

Before I increase his insulin, should I wait a few more days to see what happens to his BG once the high carb is completely eliminated? He currently is getting ⅛ C of high and ⅛ C of low mixed. Tomorrow morning it will be a little more and Tuesday will be all low carb. I did this over 7 days so that they could adjust accordingly. There isn't a huge difference in calories between the 2 foods. Only 15 calories less per serving, which is fine. I'm posing this question because I do not want him becoming hypo. While his numbers don't reflect that is really possible, I want to prevent it at all cost.

Which brings me to my next question, I have read a few things regarding caloric intake for your cat. I want to make sure I'm feeding him the correct calories. I've seen very complicated formulas and I recently read multiply their weight by 20. Can someone advise me on the method they use or attach a link? He weighs 22.4 lbs. He is heavy and has always been, but I'm willing to work on his physique once his BG is under control, but understand this has to be a super slow process for cats.

Also, I asked his vet for generic insulin (biosimilar glargine) because I'm paying over $100 for a Lantus pen. She said generic isn't really tested on cats, but should work the same. She also stated she could never give me a prescription for 5 pens because they would go bad, even in the fridge. Is there any information (links) I would send her to show her this is being done and has been done for years (using generic Lantus and keep 5 pens in the fridge)? I can get 5 pens for less than the price of one Lantus pen with GoodRx.

He is going in for a full blood panel tomorrow. If anyone thinks there is anything that isn't usually tested that could help us, please let me know.

His vets office was supposed to call his ondansetron into my pharmacy because it is $50 cheaper and they didn't. He hasn't had any today. I only have 1 pill left. Should I attempt to wean him off again?

Thanks in advance for your help on any of these topics.

 

[Jason - Kona's Dad]

Also, I asked his vet for generic insulin (biosimilar glargine) because I'm paying over $100 for a Lantus pen. She said generic isn't really tested on cats, but should work the same. She also stated she could never give me a prescription for 5 pens because they would go bad, even in the fridge. Is there any information (links) I would send her to show her this is being done and has been done for years (using generic Lantus and keep 5 pens in the fridge)? I can get 5 pens for less than the price of one Lantus pen with GoodRx.

I don't have links.. but that is nonsense. My vet wrote me a script for Lantus and when I went to the Walmart pharamcy the pharmacist handed me a pack of 5 Mylan insulin glargine-yfgn. I was confused and she said the script had "generic okay" on it so the pharmacist said, you want to pay over $100 for ONE Lantus? I recommend you use the bio-similar "glargine-yfgn) and you get 5 pens. It is FDA-approved interchangeable biologic!!!

They last forever in the fridge... I got the 5 pack of pens back in September I think, but I'll post the expiration date for you, for reference.

I keep the pen I'm using in the fridge, despite the manufacter saying not to and to discard after 27 days. I use the pens for at least a couple months, if not more and they are fine.

 

[Jason - Kona's Dad]

 

[Basic's Mom]

I don't have links.. but that is nonsense. My vet wrote me a script for Lantus and when I went to the Walmart pharamcy the pharmacist handed me a pack of 5 Mylan insulin glargine-yfgn. I was confused and she said the script had "generic okay" on it so the pharmacist said, you want to pay over $100 for ONE Lantus? I recommend you use the bio-similar "glargine-yfgn) and you get 5 pens. It is FDA-approved interchangeable biologic!!!

They last forever in the fridge... I got the 5 pack of pens back in September I think, but I'll post the expiration date for you, for reference.

I keep the pen I'm using in the fridge, despite the manufacter saying not to and to discard after 27 days. I use the pens for at least a couple months, if not more and they are fine.

I don't think a lot of vets have the knowledge that this group does. When a patient comes in with all of this knowledge and it iisn't what they were taught or practice, I think it can be overwhelming and even triggering sometimes. I'm just trying to provide her with facts other than simply saying, "people in the Feline diabetic group do this and have for years." I did explain to her that I'm not experimenting with insulin on my cat. I know people that use generic insulin and also keep 5 pens in their fridge. I'm just hopeful I don't have to switch vets. I will do what I have to for my cat and my bank account though.

Thanks for replying. I'm hopeful to have some of my other concerns addressed before said time.

 

[Angela & Cleo]

It looks like the ration of HC to LC is 50:50. How long have they been on 50%HC 50%LC? I might increase the ratio to 25% HC and 75% LC.

Can someone advise me on the method they use or attach a link?

Dr. Lisa Pierson has this http://catinfo.org/?link=felineobesity#How_Much_Do_I_Feed on her website. Its what I have gone by.

Also, I asked his vet for generic insulin (biosimilar glargine) because I'm paying over $100 for a Lantus pen. She said generic isn't really tested on cats, but should work the same. She also stated she could never give me a prescription for 5 pens because they would go bad, even in the fridge. Is there any information (links) I would send her to show her this is being done and has been done for years (using generic Lantus and keep 5 pens in the fridge)? I can get 5 pens for less than the price of one Lantus pen with GoodRx.

Maybe show your vet the AAHA guidelines (see page 6 about storing in the refrigerator and insulin lasting 3-6 months).

He is going in for a full blood panel tomorrow. If anyone thinks there is anything that isn't usually tested that could help us, please let me know.

I would ask for a senior blood panel. Are there any issues of concern you would want to address?

His vets office was supposed to call his ondansetron into my pharmacy because it is $50 cheaper and they didn't. He hasn't had any today. I only have 1 pill left. Should I attempt to wean him off again?

Sorry I don't have any experience with this. Perhaps Elise (she should be on later today) @tiffmaxee can help.

 

[tiffmaxee]

It looks like the ration of HC to LC is 50:50. How long have they been on 50%HC 50%LC? I might increase the ratio to 25% HC and 75% LC.


Dr. Lisa Pierson has this http://catinfo.org/?link=felineobesity#How_Much_Do_I_Feed on her website. Its what I have gone by.



Maybe show your vet the AAHA guidelines (see page 6 about storing in the refrigerator and insulin lasting 3-6 months).


I would ask for a senior blood panel. Are there any issues of concern you would want to address?


Sorry I don't have any experience with this. Perhaps Elise (she should be on later today) @tiffmaxee can help.

You do not need to wean off ondansetron. Can you get a written RX tomorrow and buy it at Costco?

 

[Staci & Ivy]

I got a script for 30 pills from my vet and filled at my local pharmacy for a very inexpensive cost:

 

[Basic's Mom]

It looks like the ration of HC to LC is 50:50. How long have they been on 50%HC 50%LC? I might increase the ratio to 25% HC and 75% LC.

The transition started 4 days ago. His next kibble feeding portion will be 75% lc and 25% hc. The complete transition will be completed Tuesday morning with 100% lc. I was asking more about increasing his insulin before he is completely off the hc.

Dr. Lisa Pierson has this http://catinfo.org/?link=felineobesity#How_Much_Do_I_Feed on her website. Its what I have gone by.

Thanks. There is a lot of options there. Just added to my confusion of which method to be use.

Maybe show your vet the AAHA guidelines (see page 6 about storing in the refrigerator and insulin lasting 3-6 months).

She has mentioned to me it will only last a few months. If that link only confirms that, she will be even less likely to write me a script for 5 of them.

I would ask for a senior blood panel. Are there any issues of concern you would want to address?

He's 10. I'm not sure when they are considered seniors. I don't have any, but this is all new territory to me. I don't know what to be looking for. I don't think anyone has really ever reviewed his labs from this group from the first time.

Thank you for helping us. I truly appreciate your response.

 

[Basic's Mom]

You do not need to wean off ondansetron. Can you get a written RX tomorrow and buy it at Costco?

I can get a script tomorrow, but I'm not a member of Costco. I didn't want to stop cold turkey with him again. Last time he wasn't ready. The vets office left me with no other choice temporarily though. Thought I'd try to see if he is ready to be off of them again, unless you don't think it is a good idea. He's been off the miratz for at least a week. His old appetite has completely returned. That's why I'm thinking he may not be nausea anymore. If you don't think this is a good idea, please advise.

 

[Basic's Mom]

I got a script for 30 pills from my vet and filled at my local pharmacy for a very inexpensive cost:
View attachment 68012

Wow. That is incredibly inexpensive. I have the 8 mg, but that shouldn't be that much of a difference in price between the 2. When I looked it up for my pharmacy with the goodrx discount, it was $60 at kroger. I checked goodrx again and I can get it for $7 at meijer. Thank you for sharing that. I didn't realize the goodrx discount changes per med per store.

Thanks again.

 

[Staci & Ivy]

I know one time I got a script for myself at Costco and I’m not a member. You could call and see if that is still possible.

 

[Staci & Ivy]

Wow. That is incredibly inexpensive. I have the 8 mg, but that shouldn't be that much of a difference in price between the 2. When I looked it up for my pharmacy with the goodrx discount, it was $60 at kroger. I checked goodrx again and I can get it for $7 at meijer. Thank you for sharing that. I didn't realize the goodrx discount changes per med per store.

Thanks again.

It’s a generic med so very cheap.

 

[tiffmaxee]

You do not need to be a member to use Costco pharmacy check good RX to see where ondansetron is least expensive.

 

[Angela & Cleo]

The transition started 4 days ago. His next kibble feeding portion will be 75% lc and 25% hc. The complete transition will be completed Tuesday morning with 100% lc. I was asking more about increasing his insulin before he is completely off the hc.

Since you haven't fully transitioned to all LC, I would hold the dose for a couple of cycles. I say this because you have gotten some low blues on this dose with the transition.

Thanks. There is a lot of options there. Just added to my confusion of which method to be use.

I use this formulas from the website
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70.
To know optimal lean body weight, I would ask my vet.

He's 10.

That makes him a senior

 

[Basic's Mom]

Since you haven't fully transitioned to all LC, I would hold the dose for a couple of cycles. I say this because you have gotten some low blues on this dose with the transition.

Okay. That is what I was thinking regarding dose increase. He's been on this for 16 cycles now. I also understand that removing that hc food completely will absolutely change his bg for the better.

I use this formulas from the website
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70.
To know optimal lean body weight, I would ask my vet.

I used the 20 X weight today to see what the average would be. I'm already reducing his calories from before his dx. His vet said she didn't want him losing weight until his bg has stabilized. I will check with her again because with the 13.6 calculation, I would be reducing by another 100 calories. This is what I was afraid of though. I need to know the correct amount of calories for him at his current weight. I get different numbers depending on which method I use. I will ask her which method she is using so we can be on the same page.

That makes him a senior

I won't tell him that. Thank you. I'll ask for that panel too.

 

[Basic's Mom]

Thank you @tiffmaxee and @Staci & Ivy for the heads up on Costco. Had no idea.

 

[Staci & Ivy]

Thank you @tiffmaxee and @Staci & Ivy for the heads up on Costco. Had no idea.

Glad we could help. I think it’s not commonly known information, so it’s good to share it

 

[Jason - Kona's Dad]

She has mentioned to me it will only last a few months. If that link only confirms that, she will be even less likely to write me a script for 5 of them.

Just to be clear... the insulin pen while in use/opened should last a few months in the fridge. I think that's what she is referring to and you'll want to double check. NEW, unopened insulin pens should last about a year. From my photos I posted above, the expiration is 9/2024. I'm pretty sure I purchased them sometime back in August of this year.

At the end of the day, the vet should not be concerned with that... if it costs you $100 for 5 pens versus 1 pen, who cares if you don't end up using the last one or two before they all expiry It's your money!!!

Sorry I'm venting and going back to this, but I see soooo many people on here struggling with their vets to get the scripts they want or need.

 

[tiffmaxee]

I used every pen to the last drop. The vial opened lasted me 5-6 months. As long as it’s stored in the fridge there’s no reason to suspect yours won’t last as long or longer. If you buy a box of 5 there will be an expiration date on it which is when unopened pens will expire. I believe my boxes were good for 2 years but not sure on that as a box lasted me a year.

 

[Staci & Ivy]

Just to be clear... the insulin pen while in use/opened should last a few months in the fridge. I think that's what she is referring to and you'll want to double check. NEW, unopened insulin pens should last about a year. From my photos I posted above, the expiration is 9/2024. I'm pretty sure I purchased them sometime back in August of this year.

At the end of the day, the vet should not be concerned with that... if it costs you $100 for 5 pens versus 1 pen, who cares if you don't end up using the last one or two before they all expiry It's your money!!!

Sorry I'm venting and going back to this, but I see soooo many people on here struggling with their vets to get the scripts they want or need.

I agree 100%%%%