11/28 Tessa AMPS 400+ - Food question?

[tessa's mom]

I hope I did the title right, please correct me if I messed it up!

I'm new here so this is my only previous thread: https://www.felinediabetes.com/FDMB...verwhelmed-and-disappointed-in-myself.271079/

I was warned in the thread to not switch to low carb just yet because it might drop her BG too quickly so I've been feeding part high carb canned and part low carb canned.

Based on how her numbers are still staying high, is it safe to switch her fully to low carb canned?

Sorry I haven't bought a regular glucometer yet, I was sick over the weekend. I'm ordering one for pickup today. The Libre maxes out at 400 so anything in my spreadsheet marked as HI is something over 400. I wasn't sure how to mark that so the colors would show up so I just did HI because that's what the app tells me.

I just sent in the Libre reports to the vet this morning, I should hear back on her thoughts on increasing the dose soon. I also requested a script for the generic glargine pens.

EDIT: I forgot to add that the vet sold us repackaged insulin. As soon as we get the script for the pens, I'll be switching to new insulin. I'm not sure if that's relevant for the food question but I figured I'd add that!

 

[Bandit's Mom]

Hello and welcome to the LBL forum

The way you have filled in the spreadsheet is fine. Her numbers are indeed pretty high and you could switch her to LC faster. Will you be around to monitor her numbers over the next 2-3 days?

I would not increase the dose till the food transition is complete. We have seen cats go off insulin after a food change to a low carb diet!

 

[tessa's mom]

Hello and welcome to the LBL forum

The way you have filled in the spreadsheet is fine. Her numbers are indeed pretty high and you could switch her to LC faster. Will you be around to monitor her numbers over the next 2-3 days?

I would not increase the dose till the food transition is complete. We have seen cats go off insulin after a food change to a low carb diet!

Thank you! Yes, I work from home so I can monitor her all day. She does have a grooming appointment on Thursday (about 1 hour after her AM insulin dose) but it's a mobile groomer who will be parked in my driveway. Tessa has been groomed by her several times in the past with no issue so I think she'll be fine but I'll ask the groomer to please notify me immediately if she notices anything off.

 

[tessa's mom]

The vet called me tonight to talk about Tessa's Libre graphs. She's on board with not increasing her insulin just yet and seeing what the food change does. I'm already seeing lower numbers and I'm hoping that keeps up!

The vet questioned my request of glargine pens instead of buying from them. She said they get their insulin "compounded" into 2mL vials so there's less waste but after reading on here, I do not trust compounded/repackaged insulin. She said there's no such thing as generic glargine pens so I might be forced to buy the Lantus Solostar pens which are really pricey. If that's the case, I suppose I'll be ordering from Mark's pharmacy in Canada since it's wayyyyy cheaper there than anywhere in the US.

My husband's day off is tomorrow and he's going to pick up the script and we'll go from there. I really want to buy my own insulin as soon as possible because there's a chance that this "compounded" insulin isn't as effective as it should be.

I have a pickup scheduled at Walmart for a ReliOn meter, BG test strips, ketone test strips, lancets, and a lancing device. I ordered other supplies (syringes, sharps container, etc.) from ADW online and they've already shipped. The only thing I still want to get is the Illumavein but their website keeps giving me an error.

 

[Bandit's Mom]

The vet questioned my request of glargine pens instead of buying from them. She said they get their insulin "compounded" into 2mL vials so there's less waste but after reading on here, I do not trust compounded/repackaged insulin. She said there's no such thing as generic glargine pens so I might be forced to buy the Lantus Solostar pens which are really pricey. If that's the case, I suppose I'll be ordering from Mark's pharmacy in Canada since it's wayyyyy cheaper there than anywhere in the US.

You do not want repackaged insulin. Nor do you want the 10ml vial. A vial holds 1000 units and not many cats can use that much before it starts to lose efficacy and you end up throwing a lot of it away. It's actually a better buy to get a 5 pack of pens. A 5 pack of pens is a total of 1500 units, but each pen only holds 300 units so you can use each one down to the last drop while the other pens stay safely in the fridge and are good until the expiration date on the box (usually at least 2 years). And if you drop a pen, you're much less likely to break it, but even if you did, you'd have extras! If your vet writes for a vial, all you have to do is call Marks and tell them you want pens instead.

There is generic glargine available - it used to be called Semglee but it's now called something else, I think. Just ask your vet to write a prescription for Insulin Glargine pens.
https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

Some people here have gotten great deals on Lantus with GoodRx coupons. So you might want to look at that as well.

 

[tessa's mom]

You do not want repackaged insulin. Nor do you want the 10ml vial. A vial holds 1000 units and not many cats can use that much before it starts to lose efficacy and you end up throwing a lot of it away. It's actually a better buy to get a 5 pack of pens. A 5 pack of pens is a total of 1500 units, but each pen only holds 300 units so you can use each one down to the last drop while the other pens stay safely in the fridge and are good until the expiration date on the box (usually at least 2 years). And if you drop a pen, you're much less likely to break it, but even if you did, you'd have extras! If your vet writes for a vial, all you have to do is call Marks and tell them you want pens instead.

There is generic glargine available - it used to be called Semglee but it's now called something else, I think. Just ask your vet to write a prescription for Insulin Glargine pens.
https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

Some people here have gotten great deals on Lantus with GoodRx coupons. So you might want to look at that as well.

Thanks! Yeah, I definitely want pens. Vials seem like a massive waste of money when you can just use the pens like mini vials and actually use it all up.

My husband is informed on what I want and will ask them to re-write the prescription if it's for anything other than what I want. He looks like a big tough guy (despite being basically the opposite) so I don't think they'll argue with him lol.

 

[Diane Tyler's Mom GA]

@tessa's mom

many members use the generic lantus

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
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.

 

[Wendy&Neko]

Hello and welcome to the LBL forum.

For the spreadsheet, although you've put "Hi" for the 400+, you might want to change it to just 400 or something like that. For most other meters, "Hi" means over 600. You are right they are just "too high" at that point, but I tend to react strongly to black numbers on the spreadsheet.

I hope you are testing her regularly for ketones. Always a good practice when kitty is in high numbers.

I'm glad you are going to ditch the repackaged insulin - I've seen far too many cats do poorly on repackaged. As Sienne said, it's just too risky. In addition to insulin glargine, there is also Basaglar, which is also a biosimilar Lantus. One pharmacy may sell one vs. the other. I think that's what Mark's generally sells you now if you go that route.

 

[tessa's mom]

@tessa's mom

many members use the generic lantus

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
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.

Thank you! I think you posted on my other board because this is why I wanted the glargine pens locally, I can get them for $125 at Meijer according to this.

 

[Diane Tyler's Mom GA]

Thank you! I think you posted on my other board because this is why I wanted the glargine pens locally, I can get them for $125 at Meijer according to this.

Oh yes now I remember

 

[tessa's mom]

Hello and welcome to the LBL forum.

For the spreadsheet, although you've put "Hi" for the 400+, you might want to change it to just 400 or something like that. For most other meters, "Hi" means over 600. You are right they are just "too high" at that point, but I tend to react strongly to black numbers on the spreadsheet.

I hope you are testing her regularly for ketones. Always a good practice when kitty is in high numbers.

I'm glad you are going to ditch the repackaged insulin - I've seen far too many cats do poorly on repackaged. As Sienne said, it's just too risky. In addition to insulin glargine, there is also Basaglar, which is also a biosimilar Lantus. One pharmacy may sell one vs. the other. I think that's what Mark's generally sells you now if you go that route.

Thank you! I changed the HI to 400+ per your suggestion. I was only entering HI because that's the app said. I had a feeling that wasn't the right thing to do since the spreadsheet says black is 500+ and I don't think she's getting quite that high. Even at the vet, she was only at 428.

I should have a ReliOn meter by this afternoon so I'll be able to get actual numbers for her preshots at least. Now I just have to pray that she stands me poking her ear with a lancet. She's been doing OK with getting her insulin shots but I think her ears are an entirely different story.

I have not tested her for ketones yet but I will have a pack of ketone testing strips by this afternoon. I'm not sure how I'm going to pull off testing her since she's VERY skittish in the litterbox (vet has cleared any medical reason for this). She's been this way for the entire 2 years we've had her.

 

[Diane Tyler's Mom GA]

Now I just have to pray that she stands me poking her ear with a lancet. She's been doing OK with getting her insulin shots but I think her ears are an entirely different story.

I can even test Tyler when he's sleeping
This might help for testing
Here's the post with testing tips:
https://www.felinediabetes.com/FDMB/threads/9-9-bailey-amps-117-5-62.252712/#post-2851043

Also
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
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
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops

 

[tessa's mom]

I can even test Tyler when he's sleeping
This might help for testing
Here's the post with testing tips:
https://www.felinediabetes.com/FDMB/threads/9-9-bailey-amps-117-5-62.252712/#post-2851043

Also
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
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
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops

Thank you! I'm mostly worried about getting her to sit still that long and letting me mess with her ears. I normally give her insulin while she's eating (and she LOVES to eat lol) so that doesn't bother her too much. I guess a treat while lancing would help though.

 

[Diane Tyler's Mom GA]

Thank you! I'm mostly worried about getting her to sit still that long and letting me mess with her ears. I normally give her insulin while she's eating (and she LOVES to eat lol) so that doesn't bother her too much. I guess a treat while lancing would help though.

Try and start rubbing her ears every now and then now to get her used to you touching her ears then give her a treat.

Forgot to mention, look at the lancet under a light ,you will see that one side is pointed upward, that's the side you want to poke with. The side of the lancet looks like it's curved upward

 

[tessa's mom]

Try and start rubbing her ears every now and then now to get her used to you touching her ears then give her a treat.

Forgot to mention, look at the lancet under a light ,you will see that one side is pointed upward, that's the side you want to poke with. The side of the lancet looks like it's curved upward

Good idea, thank you! I have been messing with her ears more when she comes to snuggle with me when I'm watching TV and adding a treat to that is a good idea.

 

[tessa's mom]

Update on getting the insulin. It's been a fight trying to get this done. My husband picked up the script before lunch and went to Meijer. The pharmacy tech said she could do the generic and then a few minutes later came back and said they couldn't because the vet had put Lantus on there and put dispense as written at the bottom. So he went back to the vet after lunch and got a script that didn't say Lantus on it. Then he waited at the pharmacy for over an hour and they tried to give him Lantus and make him pay $400 for it. He's currently trying to get them to switch it to the generic but this pharmacy seems pretty braindead so IDK if that's going to happen. They can't give us our paper prescription back, they can only transfer it to another pharmacy. UGH. Why can't these things just be simpler?

I feel bad for him, he's spent like 3 hours of his day off just trying to do this.

 

[Diane Tyler's Mom GA]

That's just ridiculous! They have the genetic and you have a new script and it doesn't say Lantus on it so what's their problem.
Your poor husband . I have never heard of a pharmacy not giving you your prescription back. Let us know how you make out

 

[tessa's mom]

That's just ridiculous! They have the genetic and you have a new script and it doesn't say Lantus on it so what's their problem.
Your poor husband . I have never heard of a pharmacy not giving you your prescription back. Let us know how you make out

We got it! Apparently it was a weird system glitch. There are multiple manufacturers for the generic and their system was set up for one but they were out of stock on that so it kept trying to switch to the brand name. The pharmacist did something to make the other one show up and they were able to sell it to us. So we have a box of 5 pens and it was only $122. Thankfully that should last a long time so we won't have to deal with this for awhile!

 

[Diane Tyler's Mom GA]

We got it! Apparently it was a weird system glitch. There are multiple manufacturers for the generic and their system was set up for one but they were out of stock on that so it kept trying to switch to the brand name. The pharmacist did something to make the other one show up and they were able to sell it to us. So we have a box of 5 pens and it was only $122. Thankfully that should last a long time so we won't have to deal with this for awhile!

Great! That's such a really good price!
Best of luck with the testing