Vet Visit Tomorrow (Might be Back on Insulin)

Hello everyone! I'm back after my last post. (Am I freaking out over nothing?)

So I was really hoping that his BG would stabilize to what it used to be after stopping the medication. Unfortunately, it's been pretty high. Tomorrow morning I have an appointment with the vet and I'm thinking I may have to start him on insulin again. I haven't seen him drinking water like he did when he was first diagnosed so I was unsure. Lately though, he's been more vocal. I thought it was a cry for attention as I've had a lot on my plate, but after seeing him paw at his bowl I realized it might be hunger.

When he was first diagnosed he was put on Novolin (and at units that people felt were too high for a cat only just starting insulin). (Just Diagnosed) He only ever had one shot of it because when I changed his food (Friskies Pate, wet food only), his BG went into the green.

Is Lantus the best insulin I could get him? Any other that's equal to it? Could he go back into remission if we start insulin soon? I can't afford full price for Lantus, if we end up going with that, so how can I afford it or another good insulin longterm? Are there any questions you would recommend I ask the vet?

There's a way to get a box of five Lantus / glargine pens for $35 in the US: Info - Sourcing Insulin More Economically

Some pharmacies will sell a single pen at their discretion.

ProZinc is another good choice. It's made just for pets. Chewy has the 10 ml bottle for $131.69. That seems to be roughly the price at other online pet supply related web sites.

squeem3 said:

There's a way to get a box of five Lantus / glargine pens for $35 in the US: Info - Sourcing Insulin More Economically

Some pharmacies will sell a single pen at their discretion.

ProZinc is another good choice. It's made just for pets. Chewy has the 10 ml bottle for $131.69. That seems to be roughly the price at other online pet supply related web sites.

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Thank you! Is there anything I should keep in mind if the vet writes the prescription? Like anything that would keep the pharmacy from filling it?

No, it just needs to have "Lantus Solostar pens 3ml x 5" or something like that and a dose. Lantus is the brand name. Glargine is the name of the insulin so you may get a generic brand if the pharmacy doesn't have Lantus. A pharmacy will be able to fill a prescription. Whether the $35 coupon works or not is a different issue. You can read the Sourcing Insulin thread for tips on how to get a coupon to work.

Okay so here's the update. They did a fructosamine test and other bloodwork. Everything else in his bloodwork came back great except for his glucose. I have to collect a urine sample and take it to them for further testing, but I haven't been able to catch him at the litter box yet.
They said they don't necessarily worry until a cat's glucose is higher and don't want to make him dependent on medication or insulin until we've tried other things.
I got a call from the vet today saying that the results of the fructosamine test show that his glucose has been high and she wants me to try the glycobalance wet food for a while, bring in the urine sample, and then we can discuss possibly medicating him. She thinks that if I switch over to that food from the Friskies that it should help get everything under control without resorting to insulin.
She also told me that I need to use a pet meter for better results, although I've already explained my reasoning for wanting to stick with my human meter.

Any thoughts? I'm waiting on the office to send me the fructosamine results.

There's nothing in the Glycobalance food that makes it better than commercially available canned food that is low carb. Just agree to disagree with the vet about food. The vet can't force you to feed it.

Give a low carb canned food only diet a try for a week, maybe two. Test your cat's blood glucose levels during this time, one at breakfast time and one at dinner time and maybe one or two in between checks. Normal blood glucose levels is roughly 60 to 150 mg/dl in cats. Over 200 is a good indicator that insulin is needed. The sooner a cat starts on insulin and diet, the greater the chances of remission are although there are oddball cats who never go into remission.

Veterinary studies done on diabetic cats and their blood glucose levels were done on Human meters up until maybe within a decade ago when the first pet meters were made (AlphaTrak for one). FWIW, CGM meters which some vets are putting on new diabetic cats are actually made for Human diabetics. There is no pet CGM meter. There is no reason at all to buy an expensive pet specific meter. Test strips are not sold in stores so you have to plan ahead to buy online or set up an online autoship somewhere. Agree to disagree with the vet about meters.

What does your vet need the urine sample for? Urine glucose levels are always high in a diabetic because glucose just builds up in the urine until the cat pees. Bacteria love glucose so there'll probably be a presence of that in urine. It does't necessarily mean your cat has a urinary infection or anything. Ketones can be tested with a (Human) urine test strip you can get at any pharmacy.

Thanks for the insight! I try to defend myself and Mus at the vet where I can, but I admittedly don't know enough to put my foot down on certain things.

He's been on a low carb diet with Friskies Pate a little after he was diagnosed and I discovered the forum. That's why I'm so worried now. I haven't changed anything besides those few days that he was required to take medication to prevent an ear infection after a bad scratch. At that time his BG levels did go up and I went to the vet with my concerns. We took him off the medication as soon as we could and I thought his BG might stabilize. But recently, as shown in my spreadsheets, he hasn't gone back down to green much at all.

The human meter thing is something that I have refused to budge on.

As far as I know, she's wanting to test his urine for glucose, but it's possible she'll check more like with the blood work yesterday. I have ketone strips, but it's been a while since I've tested him as he seems to pee most when I'm not around to catch it.

Edit: If the issue is food, I'm willing to try something like Tiki Cat if need be. I settled on the Friskies Pate because he did well on it and it's still more affordable for me. Can anyone advise?

Update: I was able to get a pee sample after many tries, but there seems to be a little sediment from the litter (a very small amount to where I almost didn’t notice). Does anyone know if this will affect the urinalysis? Also tested for ketones and still nothing.