New Member, Intro & Questions

[Emma’s Mama]

Last Wednesday I found out that Emma has diabetes. It wasn’t a huge surprise - I brought her to the vet after noticing that she had started drinking a ton of water and peeing a lot more than usual. I recognized the signs because I have had two other diabetic cats. Smokey was diagnosed back in the late 90s or 2000. He was on “human” insulin that we got at Rite Aid, and he actually went into remission for the last few years of his life. My cat Flopsie was diagnosed in about 2012, and that was when I first found out that there were now insulins specifically for veterinary use. She was on ProZinc until she died in 2015 at 17 years old.
So, now there is Emma. The vet said that her blood test results all looked good except for her blood glucose, which was 456. She said I didn’t need to come in for an orientation-type visit since I was already familiar with how to administer insulin, so I could just go and pick it up, which I did last Thursday. My first issue is that they gave me Vetsulin, which doesn’t really seem like the best first choice for a newly diagnosed cat, does it? They made an appointment for this Thursday for her first follow up. The office staff said that they would be doing a fasting blood glucose test. I should feed her Wednesday night, and give insulin. Then on Thursday I should withhold food, but give her insulin one hour before the appointment. I am going to call to clarify that because they seemed uncertain if that’s what the vet wanted, but told me to do that. But isn’t that just asking for hypoglycemia (although I don’t think the dose is high enough anyway, as she’s still drinking and peeing just as much)? I am going to ask for an rx for Lantus, I think…
Anyway, I found this site years ago, not long before Flopsie died, and thought if I ever had another diabetic cat I would do things differently. My vets had never suggested testing at home, but I ordered a meter. I will start a spreadsheet once I start testing Em. Thank you all for any feedback and for this resource!

 

[Larry and Kitties]

My first issue is that they gave me Vetsulin, which doesn’t really seem like the best first choice for a newly diagnosed cat, does it?

Correct, Vetsulin us not really suitable for cats. Prozinc is good as is the human insulin glargine (Lantus is the major brand).

I am going to ask for an rx for Lantus, I think

Yes, do that

The office staff said that they would be doing a fasting blood glucose test. I should feed her Wednesday night, and give insulin. Then on Thursday I should withhold food, but give her insulin one hour before the appointment. I am going to call to clarify that because they seemed uncertain if that’s what the vet wanted, but told me to do that. But isn’t that just asking for hypoglycemia (although I don’t think the dose is high enough anyway, as she’s still drinking and peeing just as much)?

Agree that does not seem right. Taking a BG before eating and inject is right.

Most of use here test our cars BG using a humane BG meter like one of Walmart's Premier series of meters.. We enter the number is a spreadshee:
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[Ale & Bobo & Minnie (GA)]

You don’t want to fast a cat on Vetsulin. It’s a harsh fast acting insulin, in fact you always want to make sure it’s eaten at least 30 minutes before you give the shot. I don’t know what your vet is doing but this is nuts. Tagging a few others @Sienne and Gabby (GA) @Suzanne & Darcy

 

[Ale & Bobo & Minnie (GA)]

If you’re willing to learn how to home test, you can do all the curves at home.

With a diabetic cat you need:

• A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
• A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
• We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
• HELP US HELP YOUhas information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

 

[Emma’s Mama]

I called the vet’s office and they want me to feed her tonight and give her insulin, then no food or insulin until her appt. tomorrow. I’m supposed to bring her insulin and food with me to the vet’s.

Unfortunately, my cats - I have three others - are all used to free feeding on dry food. I know that wet food is better for them, and I have tried! Obviously now I am even more aware of how important it is, but they don’t seem to agree! I’ve had had all the usual issues; they don’t seem to realize that canned food is actually food, two are a healthy weight and graze throughout the day, while the other two including Emma basically freak out if the food dish isn’t there. Then when I put food down they “scarf and barf” as a vet once described it. I don’t quite know how to make sure each of them gets enough but not too much. Again I’m working on it!

Sorry for rambling, I guess I’m just processing the situation. If anyone has any thoughts on helping a diabetic cat and an obese cat get to a healthy weight while also helping healthy weight cats who eat small amounts throughout the day not go hungry, please let me know.

 

[Ale & Bobo & Minnie (GA)]

There are two low carb dry foods you could try. They’re not cheap but they’re the low carb dry options for diabetic cats. Dr. Elseys and Young Again Zero Carb.

the ordeal of having curves done at the vet is stressful to most cats which means the bg numbers you’ll get will likely be elevated. This is one of the many reasons we encourage home testing. Your vet may recommend a dose increase based on street influenced numbers when one is not in fact needed. I know it all feels overwhelming but I didn’t feel like I had the support I needed and didn’t feel I had a handle on the diabetes until I found this forum and followed the guidance here. I thought I’d never be able to home test but it quickly became second nature and I was some days testing every 30 minutes many many times.

 

[Sienne and Gabby (GA)]

Maureen:

The problem with the recommendation from the vet's office is that it is likely to throw you off of your shot schedule. At least for me, my cat's shot schedule was tightly tied to my work schedule. Holding off on food and insulin in order to accomodate a vet appointment would not have been possible. While a vet appointment may be important, it's a once in a while thing. At least in my opinion, keeping Emma on a 12 hour schedule for insulin would be far more important. Frankly, if you're home testing you don't need the vet to do a curve -- it's something you can do at home. And, as Ale suggested, the results you get at home are likely to be more accurate given the Emma is in a less stressful environment.

 

[Emma’s Mama]

I just got home from the vet, and I think I might need to find a new veterinarian.

Emma’s blood sugar was 389 about 12 hours after her shot, so they recommended increasing her Vetsulin dose from 2 units to 3. Well, that’s when I asked about switching her to Lantus or ProZinc and (nicely) asked why they started her on Vetsulin as the first choice. Apparently they basically give all of their diabetic cats and dogs Vetsulin and only switch to Lantus if Vetsulin isn’t working. And they said they haven’t dispensed ProZinc since 2013 or 2014 (which I know isn’t true because my cat Flopsie was on it, from the same office, until she died in July 2015).

***Dramatic eyeroll***

I was actually speaking to the vet tech who was going back and forth to the vet, who was finishing a surgery. I was told the vet will “have to do some research” and will call me. The tech really couldn’t answer why they don’t use ProZinc at all, why they prefer Vetsulin for cats, and the options on the table seem to be Lantus or glipizide tablets? I’m not even sure how glipizide came into the conversation!

Anyway, I did get to watch her prick Emma’s ear to test, and the meter I ordered arrived so at least I’ll be able to start doing that for her. And I guess I’ll be researching vets who are more knowledgeable about this while waiting for her current vet to call.

 

[Emma’s Mama]

Update: They are sending an rx for Lantus to CVS, I checked for Good RX-type discounts and it should be about $35. I think I will have to ask for U100 syringes, because it sounds like they are doing the Solostar pen, and the vet tech mentioned needing pen needles and turning the dial to get the dose (she said hopefully the pharmacy would help with that… I don’t think she was that familiar with it). Fingers crossed that this goes smoothly!

 

[Larry and Kitties]

I checked for Good RX-type discounts and it should be about $35.

Just note that some caregivers hve been unabe to use the GiidRx couoon sunce aooearentky ut requires an NPI (National Provider Identification) number and veterinarians can't get one. If you can't use the Lantus GoodRx coupon getting a generic/biosimilar glargine insulin vice the Lantus which is the name brand glargine.

 

[squeem3]

Update: They are sending an rx for Lantus to CVS, I checked for Good RX-type discounts and it should be about $35. I think I will have to ask for U100 syringes, because it sounds like they are doing the Solostar pen, and the vet tech mentioned needing pen needles and turning the dial to get the dose (she said hopefully the pharmacy would help with that… I don’t think she was that familiar with it). Fingers crossed that this goes smoothly!

Yes, you do need U100 insulin syringes with the Lantus pen (any insulin pen really). You do not need the pen needle or mess with the dial thing like Human diabetics do. Treat the pen just like any insulin bottle. See this for pictures of how to use a pen and general info: https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

The ideal insulin syringes to use are 3/10cc (30 unit) with half unit markings. The link above has pictures of what the half unit markings look like compared to a regular whole unit markings. You can use whole unit marked insulin syringes but measuring half and quarter doses (which some cats do need) is harder since you have to eyeball in between the lines to guess where half or quarter unit is. There are different brands of half unit marked insulin syringes available. People have their "go to" brand. There are pet / veterinary insulin syringes with half unit markings available online but the Human ones work just the same and generally cost less. Plus you can buy Human insulin syringes at any pharmacy if needed.

 

[Ale & Bobo & Minnie (GA)]

Tagging @Diane Tyler's Mom who has lots of info on discounts for Lantus and it’s biosimilars.

I used to order mine from Mark’s pharmacy in Canada since it’s 1/3 of the cost but you’d need to send them the prescription.

home testing is not that hard and a lot easier at home when you can warm up her ear to get more blood out. We have lots of tips like always aiming for the sweet spot

 

[Diane Tyler's Mom GA]

Tagging @Diane Tyler's Mom who has lots of info on discounts for Lantus and it’s biosimilars.

Tap on this blue thread and read post # 11 and 12 , post numbers are to the right
I gave this info to one of our members
https://felinediabetes.com/FDMB/threads/new-to-this.285187/#post-3138880

Also tap on this link ,read post #27 about home testing tips
https://felinediabetes.com/FDMB/threads/hello-from-ronnie-hank-the-cat.286452/#post-3151963

I see you have a meter already is it a human or pet meter? Can you add that to your signature please. Tap on your name above ,tap on signature ,add it then tap save . I see you were given the link to set up our spreadsheet ,if you need help with it just ask. We have a member who will be glad to set it up for you.
If it wasn't for this group and me taking their advice I know that Tyler wouldn't be in remission for 3 years already ( knock in wood)
@Emma’s Mama

 

[Emma’s Mama]

I don’t remember the last time I was this aggravated by anything, truly.

Got the Lantus pens at CVS last night, paid $105 for the box of 5 pens. Should be all set for the next year plus. Terrific.

However, they said they had not received a prescription for syringes, or even the pen needles, and they don’t sell syringes without an rx at all. Okay, I have the insulin, I’ll just order syringes online. Found what I need on ADW Diabetes (3/10 cc, half unit markings, etc). Placed an order, they needed my vet’s info to get approval from them, seems good.

Then today I get a call from ADW saying my vet wouldn’t approve it as I was already getting the needles somewhere else, and when I call the vet they say they don’t know what ADW is, haven’t heard from them, and that they sent an rx for pen needles to CVS.

I give up. Walmart is a little bit of a distance away, but tomorrow I will head over there as it seems lots of people here have had good luck there. For now, I’ll continue giving Em 3 units of Vetsulin and hope she does okay with that.

I’m so glad that the internet generally and this place specifically exist! If I was just depending on the expertise of the vet’s office…

 

[Sienne and Gabby (GA)]

Maureen --

Depending on which state you live in, you may need a prescription for syringes. (Given that you've been through feline diabetes treatment before, you are likely to know whether this is the case.) Your vet clinic sounds disorganized at best. If there's a cat only vet in your area, that may be a good alternative. You can also post a note here asking if anyone has recommendations for a vet in your general area.

 

[Diane Tyler's Mom GA]

Got the Lantus pens at CVS last night, paid $105 for the box of 5 pens. Should be all set for the next year plus. Terrific.

Hi that's great, you can get the U-100 syringes with half unit markings without needing a vets script which state do you live in?
I was googling and they mentioned they don't ship syringes without a script from a vet, I would call Amazon and ask them
I used these for Tyler before he went into remission and I liked them
You can get the U-100 syringes with the half unit markings here
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

@Emma’s Mama

I found another post by one of our members who lives in Calif and she said
It depends on the state. Here in California, I can buy the Walmart syringes without a prescription
So I guess it depends on where you live
Let us know how you make out ok

Amazon phone number
888-280-4331

If you go to Walmart I showed you the 2 pictures of the boxes of the U-100 syringes with the half unit markings, either box if fine

 

[squeem3]

State law varies on prescription requirement for insulin syringes. I don't need a prescription or provide a doctor's phone number to buy insulin syringes online. I haven't bought insulin syringes from a store pharmacy since the early days of Squishy but I think I had to provide a prescription (haven't moved states).

You don't need the pen needles. Ask the vet for a prescription for U100 3/10 cc insulin syringes with half unit markings. You can tell the vet that you have done some research on using insulin pens for cats and the best way to get the insulin out is to use insulin syringes. Get a written prescription so you can take it to any pharmacy to fill.

 

[Dyana]

Walmart is a little bit of a distance away, but tomorrow I will head over there as it seems lots of people here have had good luck there.

If you go to Walmart: In my state you need a prescription for insulin syringes, if you want to buy a box, but Walmart will sell a pack of 10 insulin syringes to you (in New Jersey anyway) without a prescription. Their Relion brand is $1.14 for 10, I think.
At least that would hold you over for a few days until you can get a box of syringes.

 

[Ale & Bobo & Minnie (GA)]

As Diane already said, not sure what state you’re in, but here in California I don’t need a prescription for syringes not online and not at a store. Call Walmart first so you don’t waste your trip and also to make sure they have it in stock as sometimes they’ve been out by me. If you were local, I’d just give you a box. I have 2 extra ones. Also always check our supply closet forum. I got 2 Lantus pens from someone who also lives in Los Angeles last year. Here’s the pic again

 

[Ale & Bobo & Minnie (GA)]

I meant to add, take a deep breath. I know how frustrating dealing with vets can be. You’re doing all the right things and once you figure out these little bumps on the road, you’ll be a lot easier.