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neoncat.marian

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Hi all!

My cat Chip was found to have diabetes last Sat., 2-4-12. At time of visit he was at >700 on his glucose test. Some kidney impairment. He's been at the vet's eating W/D (a change from his normal Iams dry chicken); they are feeding him often and a lot, as in all day. He was 320 the first day in-hospital on 5 units of unknown to me insulin (short acting). When I asked the vet the next day I was told he was stable and in range. However, on my next visit I was told by helper he'd never been normal and was running 320+ on their twice daily checks. They were to have gone to 6 units on Tuesday evening. Yesterday his morning reading was 363 and the evening reading 404. When I took him in he was basically himself just drinking tons of water and thinner over the last 2 weeks previously than normal, also with poorer coat (thinning). He's been his loving self on visits but has an eye for every scrap of food around. Anyway, the vet cannot provide me with an idea of my veterinary costs and after some talks with my friend who has diabetes herself, she and I think I should bring him home and care for him here and find another vet. I could at least run a daily curve or two and surely attempt regulation as well as it is being done at the vet's now. I have been reading articles (feline diabetes is new to me) and I am a breeder of 20 plus years so I am not unfamiliar with cat care. Is this an unreasonable goal or request? When I talked to the vet's office yesterday trying to get some idea of expenses already incurred I was told they had not yet generated a record and could not tell me. Nor would they set up an exit appointment so I could talk to the vet and find out what they recommended I get for on-going care. They do not sell meters there and the staff said I should go to Wal-Mart for meter, strips, glucose, andd lancets. I asked the office manager to check on AlphaTrak pricing for me. I was to talk to the vet last night -- this didn't happen. I only got to say, in passing, I'd like to bring Chip home soon. Surely I could do as well, not withstanding we may not investigate any possible underlying conditions at this vet's office. I also understand, in part, that Chip may not be able to be regulated using this vet's program or any. But I'd like to try. Funds are limited so I need to make what I do count for Chip. And yes, I am stressed, but is my plan reasonable?

Chip is a whole male. I did tell the vet I'd like to have him neutered. It has not been discussed further. Chip will be 8 years old 2-15-12 and has been in good health up until about two weeks ago.

Any ideas would be most welcome.
Thanks!

Marian
 
Welcome Marian and Chip to the FDMB Family,

You most certainly can manage Chip's diabetes at home, in fact you can do it far better at home than they can at a vet's office where he is more than likely stressed out and that stress is raising his blood sugar readings.

There are 3 keys to managing feline diabetes at home.

FIrst is diet: You don't need the fancy prescription stuff as there is plenty of stuff out there that is better both carb and ingredients than the prescription stuff. We highly recommend a low carb/high protein canned or Raw diet. Binky's List This is a chart that a lot of us use when picking out foods for our diabetics, you will want to stay under 10% carbs (3rd column). Many of us feed Classic Fancy Feast, Pate Style Friskies, and even Wellness, Merrick or Evo. Almost all dry is too high in carbs for a diabetic.

Second is testing at home. Again you don't need the AlphaTrac pet meter, any human meter that takes a small sample of blood and has strips that 1) fit you budget, & 2) sip the blood rather than having to have the blood dropped on the strip will work just fine. Since I have 2 diabetics I have two different meters both of which are excellent, one is a Relion Micro from Walmart and is about the cheapest strips around, the other is a Bayer Contour and is a little expensive on the strips, but both work equally well. Testing at home at first can be a little frustrating but once you find your groove it becomes like brushing your teeth.Testing links Here is where you will find lots of tips and tricks as well as videos on how we test at home.

And Lastly Insulin: Three of the best insulin to use in a cat are Lantus, Levermir or PZI, all 3 are long lasting gentle insulin and these are the ones that you want to request from your vet for Chip, you will want to stay away from NPH/Humulin N as this one works very quickly and doesn't have the duration that a cat needs, as they metabolize insulin twice as fast as either a human or a canine. Also if you are prescribed either one of the Ls you will want to ask that the script be written for the Solostar/Flex pens rather than a vial, since cats take very small doses you will be able to use the pens up before they lose their punch, but with a vial you will end up throwing a lot of it away.

You will also want to start out on a very low dose and slowly adjust the dose up as needed. We recommend that you start no higher than .5u to 1u b.i.d. or twice daily 12 hours apart.

And of course ask as many questions as you may have there is usually someone around that can answer just about anything and if they can't they will find someone that can. The only silly or stupid question around here is the one that goes unasked.

Mel, Maxwell, Musette & The Fur Gang
 
I would most certainly bring your cat home and treat there. A vet is not going to be able to regulate him in the office--regulation takes time and daily monitoring where the cat is not stressed out. Diabetes is best treated at home just like with people. One huge red flag to me is that you said your vet is giving him six units of a fast acting insulin (I'm assuming Humilin-R or N)! That is an extremely high dose for a cat and if your cat is not being tested frequently (more than just twice a day!), it can cause a deadly hypoglycemic incident. Likely, the W/D that your vet is giving him is keeping his blood sugar high enough so that he doesn't severely hypo--W/D is very high in carbohydrates and just about the worst food you can give a diabetic cat. If it were me, I would pull him out of there immediately. They obviously are not up to date in their treatment and that is very dangerous for your cat. If they are only testing twice a day, it is also unlikely they would detect rebound from a hypoglycemic incident that your cat may have already experienced (when cats' blood sugar drops too low, their liver releases sugar into the blood stream, so a few hours after the hypo their numbers will be sky high, which is why we test more frequently than twice a day).

One very important question to ask is whether or not your cat has ketones. A cat with ketones will need to be monitored and possibly admitted to a different hospital (one that is not so out of date with diabetes). To give you an idea on the correct treatment, here's a link to the current treatment guidelines issued by the AAHA: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

As Mel mentioned, you don't need to feed prescription food. You just need a food that's canned, and under 10% carbs. The ingredient quality of prescription is about the same as the cheaper canned foods like Special Kitty, Friskies, or Sophistacat, and they charge an insane amount of money for it. You can get a premium, low-carb cat food with human-grade meat for less than what you'll pay for the prescription food, or a grocery store brand that's the same quality for a fraction of the price. As I mentioned, W/D is a horrible food for a diabetic cat as its carb content is through the roof--it's like feeding a type-2 human diabetic fast food for every meal. One good place to start if you want something reasonably priced and decent quality is the grain-free flavors of Fancy Feast: http://www.felinediabetes.com/glutenfree.htm.

You can use any human glucometer to test at home--many people here use the Walmart meters and like them alot. The Alphatrak isn't necessary--the dosing protocols for cats are adjusted to account for the difference in values using a human meter.

So (if there are no ketones) what I would do is insist you want to bring your cat home. Change the diet to a low carb canned food and get a prescription for a slow acting insulin like Lantus or Levemir, or Prozinc. Then with your home meter, you start testing and start with a low dose (1u or less). Some lucky cats immediately go into remission when the diet is changed (which is why we monitor at home and start with a very low dose), but most cats need insulin for a period of time (Bandit was on Lantus for a year). The good news is that the large majority of cats go into remission with the right diet, the right insulin, and regulation via home monitoring.
 
neoncat.marian said:
Hi all!

My cat Chip was found to have diabetes last Sat., 2-4-12. At time of visit he was at >700 on his glucose test. Some kidney impairment. He's been at the vet's eating W/D (a change from his normal Iams dry chicken); they are feeding him often and a lot, as in all day. He was 320 the first day in-hospital on 5 units of unknown to me insulin (short acting). When I asked the vet the next day I was told he was stable and in range. However, on my next visit I was told by helper he'd never been normal and was running 320+ on their twice daily checks. They were to have gone to 6 units on Tuesday evening. Yesterday his morning reading was 363 and the evening reading 404. When I took him in he was basically himself just drinking tons of water and thinner over the last 2 weeks previously than normal, also with poorer coat (thinning). He's been his loving self on visits but has an eye for every scrap of food around. Anyway, the vet cannot provide me with an idea of my veterinary costs and after some talks with my friend who has diabetes herself, she and I think I should bring him home and care for him here and find another vet. I could at least run a daily curve or two and surely attempt regulation as well as it is being done at the vet's now. I have been reading articles (feline diabetes is new to me) and I am a breeder of 20 plus years so I am not unfamiliar with cat care. Is this an unreasonable goal or request? When I talked to the vet's office yesterday trying to get some idea of expenses already incurred I was told they had not yet generated a record and could not tell me. Nor would they set up an exit appointment so I could talk to the vet and find out what they recommended I get for on-going care. They do not sell meters there and the staff said I should go to Wal-Mart for meter, strips, glucose, andd lancets. I asked the office manager to check on AlphaTrak pricing for me. I was to talk to the vet last night -- this didn't happen. I only got to say, in passing, I'd like to bring Chip home soon. Surely I could do as well, not withstanding we may not investigate any possible underlying conditions at this vet's office. I also understand, in part, that Chip may not be able to be regulated using this vet's program or any. But I'd like to try. Funds are limited so I need to make what I do count for Chip. And yes, I am stressed, but is my plan reasonable?

Chip is a whole male. I did tell the vet I'd like to have him neutered. It has not been discussed further. Chip will be 8 years old 2-15-12 and has been in good health up until about two weeks ago.

Any ideas would be most welcome.
Thanks!

Marian
Click to expand...

Hi Marian,

Yup, bring Chip home right away.... there's not much of much that you can't do at home for him... you can test him, and feed him better food than the vet, and I am betting you will see better numbers because stress at being in the vet office is often contributing to a cat's higher numbers.

Whoa that's alot of insulin.... not sure what the vet is trying to do but that's not the way to go! Get info on what insulin was given, how much each time, and also the times and resulting BG numbers. If the vet has been giving N or R insulins, they are of no use to you at all because they are poor insulins for you to use at home, and R is used more as an exception, in only certain circumstances.
I prefer Levemir as a good insulin but Lantus is good as well. Some people use PZI but I prefer the other two because you don't need to rely on getting the PZI insulin and U40 syringes from a vet. With Lantus and Levemir, you can get the insulin and all supplies much cheaper online or at a pharmacy than going through a vet.

All you need to pick up is a BG meter from the pharmacy, test strips and lancets for that meter, and also pick up a box of KETOSTIX to test urine for ketones. As for food, dump all the dry food and treats and feed wet low carb pate type foods, like fancy feast or friskies.... they are better in the carbs and alot cheaper than what the vet charges for foods.

A vet is NOT going to get any cat 'regulated' at the vet office. All that will result from the cat's stay at the office is unstable crazy numbers, a poor stressed out cat, and a nice juicy vet bill for YOU.

So yeah, get the RX for insulin from the vet, take your Chip home, and then pick up all you need to take care of him in the comforts of his own home.
 
Hello Marian & Chip! We are glad you found us. You will be so happy you did.

Everyday Chip is at the vet you are being charged for BG testing plus the fees for food & time there. I am sure they are also testing his urine, thats another test. What kind do kidney impairment did they discuss with you? My vet charged me $36 to run a couple of BG test. Something you can do right home home with your own meter. You can do your own curve. Alpha Trak is around $200. Many of the meters used by members here are the Relion meters purchased at WalMart. The testing strips are less expensive then other meters.

If Chip was my cat. I would go into the vet & tell them I need a total bill before they do anymore BG test, urine test, adminstering insulin etc. I am going to warn you it's going to be sticker shock. At that point very nicely ask them what can I do at home? If they tell you nothing you can really do....RED FLAG....find a new vet. If the vet is not supportive of home testing....another RED FLAG....find a new vet. Tell them you finically can't afford to continue to keep him there, purchase the insulin & take Chip home. Chip will be less stressed, you will get a better idea of his BG #s. They might not be that high.

Oh & I won't purchase Science Diet W/D.

Everything is going to be just fine. You have us now. It's going to feel a little overwhelming at times with all the new knowledge, but just breathe. You are going to get through this & Chip is going to love you even more.

Now go get your boy & bring him home!

Jenn & Baxter
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I forgot to add--not only is home treatment the best way to treat your cat in terms of control, but it's also FAR less expensive. Apart from his initial diagnosis, Bandit has never had his blood glucose tested at the vet--no curves, no fructosamines, no spot checks. My vet was very adamant that I needed to test him at home. My only vet bills for him have been regular, semi-annual office checks. He did need some teeth pulled to get his diabetes under control (dental problems can keep cats from regulating), but that's it. So my total vet bills for the past 3 years for just for the diagnosis and the extra yearly vet check are $230.

As for the expenses for home treatment--they are very, very doable. I don't make much money, and I was able to manage just fine. The biggest initial expense is going to be insulin. If you get Lantus or Levemir, ask for a prescription for the PENS. You'll never go through an entire 10ml vial of insulin before it goes bad, and the pens act like mini 3ml vials, so there is practically no waste. You just use a syringe with them just like you would a vial. The cost of a pack of Lantus pens is going to be about $220 with this coupon: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=36964. That seems like a lot but keep in mind that the pack of pens will last you at least 6 months, but more likely over a year if you handle them right. A vial will cost around $150, but it will need to be replaced at most in 28 days, and at least 3 or 4 months if you're very lucky.

Get a prescription for 31g, .3cc, 5/16 in. syringes with half unit markings. A box of these is only about $13 at Walmart.

Finally, the meter--the big expense with meters is the strips. If you want to buy your strips in a store, get the Walmart Relion Confirm, or the Relion Micro--they are good meters and their strips are the most inexpensive you can get. If you don't mind buying online, the Arkray Glucocard at American Diabetes Wholesale is the exact same meter as the Relion Confirm, but without the Walmart brand so the strips are even cheaper. You can also get a meter like the Aviva AccuChek, and even though the strips are very expensive in the store, you can order your strips through amazon or ebay for only a little bit more than what you would pay for the Relion strips in the store.

All in all, I spent about about $30-$50 a month in test strips, and I only purchased one box of Lantus pens before Bandit went into remission.

And going through these steps and doing the correct treatment also pays off--now that Bandit is remission I only spend about $3 a month on test strips, and spend nothing on insulin.
 
I am breathing easier and am going to call and tell them to get Chip ready to bring home.
You all are great!
My human diabetic friend also called this morning, she has an excellent vet in Dallas (kitties and I are in Fort Worth) and asked him -- Chip should come home. I already have lots of suitable canned food (Fancy Feast and Friskies, low carbs). I can shop today for meter and things.
Last night I was freaking and kept getting the prompt to sign up and ask here -- same this morning, and I am so glad I did.

As to kidneys, vet said he was about 60% -- BUN, I think, was somewhat high. 70 or something. But Chip and I had waited over 2 hours before being seen, so both of us were half crazed by the time we were seen (this with a set appointment). Chip schmoozed a waiting Yorkie girl dog and someone snapped a photo, and he entertained the other waiters while sitting on my lap, but clearly he was as ready to be gone as I was when seen. He peed on the floor and I fidgetted. I do not think well under stress. So, the kidney-deal at this point is a bit of a mystery to me. I will ask more and hope for answers when I go for Chip. Not much has ever happened over the course of 20 years breeding and owning cats, so there is lots I have not experienced with mine first hand.
A new vet might be perfect.
I am grateful to know that we need to address diabetes.
The how was what was getting me. And the wisdom (or not) of letting him continue to stay at the vet's.

Are the two insulins mentioned (Levemir and Lantus) to be had without prescription? My friend early this morning was saying she found that certain types need no script. I am not optimitic about getting a script from this vet for these, he was pretty adamant about short-acting alone when I tried to ask about long-acting and short-acting at my friend's prompting days ago.

What started this was a kitty fight amost two weeks ago -- we have a fight about every 7 years. I broke it up quickly but Chip had some facial wounds that didn't seem to heal (nothing deep). And he started losing weight. The morning we were to go to the vets I watched in amazement at the sheer volume of water he drank. He was active and pretty much OK except for his coat, the fur just did not seem to be "perky". The vet said he should be comatose or dead with his high reading. I caught Chip's eye about this time and it was as if we were both thinking "really?" So, our first visit with Chip was all-around a head-trip for me. Probably for Chip, too.

I make ceramic art from home so I am almost always about. This all seems quite do-able to me now. There are no solid doors (screened instead) so everyone is always pretty much in viewing range as I go about the house. Chip will be well attended my me.

Chip is a chocolate & white Devon Rex -- they eat about three times as much as other cats, so I have been thinking on how much wet food to feed. He has seemed ravenous up at the vets. I have been feeding wet food to adults as a treat maybe once or twice a week. Otherwise they free feed dry (none but fat Sunshine are over weight; she has saggy-belly). Kittens eat dry and wet food. They are big food eaters, too -- little piglets. I will re-evaluate our feeding program here while I am at it -- those are nice food guides you all have.

I gotta call and go rescue him...and shop. The shopping tips are great -- just what I need to know including pricing.
I'll check the board and post back later to let everyone know how he's doing and what we are up to.
If someone gets a chance, please help with the question on scripts or not for insulin in case Chip needs some.
Thanks bunches, everyone!!

Marian
 
Hello and welcome from a fellow newbie (1 month or so). Hoping you have Chip home in his comfy environment soon!

Once you bring him home and begin testing, you'll probably be testing him A LOT to start out with. I bought a Relion meter at wally world, which uses considerably less expensive strips ($36/100). Our store is closeby and 24/7 which makes it convenient if I run out of supplies. Keep this in mind if you're in a more remote location or if you mail order, and plan accordingly when supplies get low.

Because I was trying to test very frequently, still working out the kinks of getting blood from my little turnip Grayson's ear, and sometimes not having enough blood for the test, I went through strips VERY quickly. From an economic standpoint, the choice of meter was a good one for me, and it appears to be more accurate/consistent than the another that I picked up at a drugstore. As I was advised, and I now reiterate, be consistent with the meter you use... don't go from one to another if you have more than one. But I did check mine against Kim's and my vet's to make sure it was reading accurately (and know that there WILL be differences from one meter to another).

I think I paid the vet ~$120 for the ProZinc insulin, and probably about the same for the exam/initial bloodwork/etc. My supplies at home have been minimal, so not a big financial burden - and I feel REALLY good about testing, as it's given me a clear idea of how much insulin he needs (I don't support dosing blindly!!!). Grayson is only SIPPING (some might consider it "micro-dosing") .5u to 1.0u, so the insulin supply will probably last me a while.

Good luck and keep everyone tuned in to his and your progress. You'll find amazing support at this site... and know that although sometimes it feels very challenging, you WILL get the hang of it! Welcome -

Lu-Ann
 
neoncat.marian said:
When I talked to the vet's office yesterday trying to get some idea of expenses already incurred I was told they had not yet generated a record and could not tell me. Nor would they set up an exit appointment so I could talk to the vet and find out what they recommended I get for on-going care.
Click to expand...


This complete lack of communication and respect is more than I would be willing to put up with. It's ok to have minor differences and disagreements with your vet but diabetes is a disease that requires the vet and owner working together for the best health of the cat.

I definitely agree with your decision to go and get him today. I would also line up an appointment with the new vet ASAP. When you call the clinic to say you're coming to get him, let them know that you will also need a full copy of all of his medical records for his new vet.

Over the next few days, I would also draft a letter to the clinic owner, letting know why you are firing them as the veterinarian for your pets. I would also request copies of the records for any other pets that you have and tell them you will pick them up in 2-3 days. I would let them know that they need to have open lines of communication with owners who are concerned about their pet's welfare and they need to have some respect for an owner's concerns about the cat and also the costs. I had a cat who needed surgery last week and her vet was more than willing to get an estimate together for me in the space of an afternoon so I would know how I needed to proceed. (and then he personally called me the minute he finished her surgery to give me a full update and answer any of my questions.)

Veterinary clinics are a business and customer service is important. They need to understand that if they want enough clients to keep their doors open. My vet clinic has gained at least a dozen additional clients and probably over $10,000 per year due to my positive referrals. It isn't just about the animals--they have to know how to communicate with the owners too.

You do need to have a vet but I don't think this is the right one for you.
 
If chip has kidney disease, there are foods that are good for both conditions! My Gabby had early stage kidney disease and she did not need a prescription diet (despite the vet wanting to put her on one)--unless a cat is in the end-stages (late stage 3 and stage 4), there's no advantage to low protein/low phosphorus over just low phosphorus. 60% is still late stage 1/early Stage 2. Feeding a low protein diet long term can cause muscle wasting in cats, and it will be impossible to get the diabetes under control on a kidney diet.

You simply need a low carb, low phosphorus canned food, preferably without byproducts (higher quality protein sources are easier on the kidneys). Keeping your cat as hydrated as possible is key to managing the disease, along with low phosphorus foods. Mixing water in with the canned food is one good way to help with hydration.

Here's an updated food list with the values for several premium foods: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50. You're looking for something with less than 10% carbs and less than 250 mg/kcal of phosphorus. The foods I would suggest are Merrick's Before Grain Beef, Merrick's Before Grain Turkey, Merricks' Cowboy Cookout, Merrick's Surf & Turf, Wellness Turkey, EVO 95% Chicken & Turkey, and Blue Wilderness Duck.

If those are out of your price range, the next best thing to feed are the low carb Friskie's Special Diet flavors. These are Turkey & Giblets and Salmon Dinner--make sure they are the ones that say "special diet" on the can, though. PetSmart carries them, and some grocery stores. Here is an updated list of just the phosphorus values for many commercial foods. They can be cross referenced with Binky's chart for carb values if there's something on there that you want to feed. On this chart, you're looking for something that is less than 1% phosphorus (these values are on a dry matter basis, not mg/kcal): http://www.felinecrf.org/canned_food_usa.htm

While carb values don't change much over time, phosphorus values do, so don't use Binky's chart for phosphorus values because they are out of date.
 
Hi Marian,

I agree with everything everyone else said. I would never allow a vet to keep my baby so long for something like diabetes or to treat me like that. He/she had better answer my questions or my cat is out of there! I am so glad you are rescuing him.

The reason I am writing though is to answer your question about scripts. I think it depends on what state you are in. I live in VA and here we need a prescription for the Lantus that Racci uses. I really like Lantus. She was on PZI originally and it can only be gotten from the vet for one thing and is more expensive, and secondly it was not as good for Racci. She did so much better on Lantus.

By the way, that really is a huge dose. I'm not familiar with short-acting insulins but even Racci who was almost insulin resistant and would only eat dry DM, and is almost 20 lbs was at 5u lantus at her highest point. (She's come down now thanks to the Lantus high doses which got her more regulated ). Now she is coming down even more because she is switching to wet food & her doses have been dropping all along.

You're going to need a new vet right away anyway so if this current one insists he won't give you a script, I would have another vet already lined up and get in there if TX requires one. You can call your pharmacy to find out.

Melanie
 
Glad you are going to get Chip :RAHCAT . He is going to be so happy to come home. bcatrun_gif Poor little guy being a prisoner @ the vet office. grr_red

This reply is about Vets in the Dallas/Ft Worth area. I am from Dallas, but while living there I didn't ever need a vet. I have friends there whom have pets/vets. What area are you in?

Also, there is a member on the board who lives in Euless. Her kitty is currently in remission. I will message her to respond here about vet referrals. Her user name is "ohbell".

I hope this helps.
Let us know how Chip is.

Jenn & Baxter
cat_pet_icon
 
Are the two insulins mentioned (Levemir and Lantus) to be had without prescription? My friend early this morning was saying she found that certain types need no script. I am not optimitic about getting a script from this vet for these, he was pretty adamant about short-acting alone when I tried to ask about long-acting and short-acting at my friend's prompting days ago.
Click to expand...

I forgot to answer this question.

The 2 long-acting human insulins that are good for cats (Lantus and Levemir) do require a prescription. Cats need long-acting insulins because their metabolisms are twice as fast as humans and dogs. Lantus is a 24 hr insulin for people and dogs (one shot a day), but only lasts 12 hours in cats (you shoot twice a day). Short acting insulins that don't require prescriptions, like Humulin R and N, are NOT good for cats at all. They give very steep drops, and only last for 2-6 hours per shot cats, and it's only working to lower blood glucose for half the cycle--not the whole cycle like Lantus or Levemire. Keep in mind that N and R insulins last twice as long and are fine for use in dogs and humans, which is why your friend is advising you to get one, but they are the wrong insulin for cats.

If your vet will not give you a script for Lantus (glargine), call around to vets in your area and explain your situation until you find one that will. Usually the vet will give it to you if you insist hard enough, and provide them with the article I've attached. Print it out to take with you when you tell them you want a prescription for Lantus pens.
 

Attachments

OK, I am getting Chip in a little while -- the office manager seemed aggrieved and said she's ask the vet and 'try' to get his bill done.
I have the food lists printed and referenced to phosphorus and carbs (special thanks for notes on his kidneys and diet); I checked on pricing for the insulin pens, printed my coupons, got Chip on the special insurance plan at Walgreens (nice savings if the vet will go for Levimer) and can go to Wal-Mart for meter, strips, lancets, and ketone testers and still get Chip out of hock (I think). I've read all the info on hypo should we ever get there and have honey, syrup, etc.
I'll continue to learn your names when I am calmer. I have your kitty names and faces (where pics are available) down pretty well. I hope you will all tell yours how much they and your experiences with them have helped another kitty and give them a little hug from us. And to all who replied -- I am overwhelmed with gratitude for the out-pouring of help for Chip and me. I bet he'll be glad to come home. His buds miss him (as do I) and I have told them to expect him soon. It is kind of scary but you all make it seem OK. I don't shop much, so even the reminder of 24-7 stores was a help. I am close to everything here.
And yes, I have had vets and staff with good "bedside" manners. Maybe we will again...this clinic is rather new to us, but mostly I've only gone for kitty shots and basic check-ups.
This vet did recommend I check for info on-line:>)
I'd recommend you all any time!

Marian
 
Jenn & Baxter said:
Glad you are going to get Chip :RAHCAT . He is going to be so happy to come home. bcatrun_gif Poor little guy being a prisoner @ the vet office. grr_red

This reply is about Vets in the Dallas/Ft Worth area. I am from Dallas, but while living there I didn't ever need a vet. I have friends there whom have pets/vets. What area are you in?

Also, there is a member on the board who lives in Euless. Her kitty is currently in remission. I will message her to respond here about vet referrals. Her user name is "ohbell".

I hope this helps.
Let us know how Chip is.

Jenn & Baxter
cat_pet_icon
Click to expand...

Jenn, I'm in Fort Worth, Arlington Heights, my contact info is on my website (www.neon-cat.com) if ohbell would rather call to chat and buck me up. I'll be out awhile (off to wally world then to the vet's) but am here almost all the time. Or have her email me directly at neoncat@flash.net.
Many thanks!

Marian
 
Well if it helps at all to easy your worries on just how easy it is to treat a diabetic kitty at home....Both my Maxwell, and Musette (my avatar) were adopted by my husband and as diabetics when their former owners wanted them Put to Sleep for being diabetics. Now that might not sound like a big deal, except for the fact that at the time that we adopted Maxwell we had 10 healthy and happy cats at home (all rescues) later we added one more heathy rescue which made 12 cats in the household and then we adopted Musette so there are 13 cats here in total that are ours as well as a foster momma cat and her 2 newborn kittens.

We adopted both of our diabetics after our first diabetic girl Muse had to leave us for the Rainbow Bridge, so if it was difficult at all to care for a diabetic we certainly wouldn't have adopted not one but 2 when we had so many perfectly healthy fur kids at home. But because it requires so little extra care we just couldn't see these beautiful animals destroyed for being just a little extra sweet. With just a diet change and a short course of Lantus my Maxwell has been in remission and off insulin altogether for over a year now, and Musette is doing her level best to follow him..in the last 6 months she has gone from 1.25u twice a day to this evening having her dose reduced yet again to .5u twice a day. And neither of them have seen the vet for anything other than the normal kitty stuff, shots, wellness checks etc. Everything concerning their diabetes has been managed by myself and the support and help of this board.

If you have questions or problems with testing etc just give a shout. And someone will be right here with the answers. :-D

Mel, Maxwell, Musette & The Fur Gang
 
Julia & Bandit said:
Are the two insulins mentioned (Levemir and Lantus) to be had without prescription? My friend early this morning was saying she found that certain types need no script. I am not optimitic about getting a script from this vet for these, he was pretty adamant about short-acting alone when I tried to ask about long-acting and short-acting at my friend's prompting days ago.
Click to expand...

I forgot to answer this question.

The 2 long-acting human insulins that are good for cats (Lantus and Levemir) do require a prescription. Cats need long-acting insulins because their metabolisms are twice as fast as humans and dogs. Lantus is a 24 hr insulin for people and dogs (one shot a day), but only lasts 12 hours in cats (you shoot twice a day). Short acting insulins that don't require prescriptions, like Humulin R and N, are NOT good for cats at all. They give very steep drops, and only last for 2-6 hours per shot cats, and it's only working to lower blood glucose for half the cycle--not the whole cycle like Lantus or Levemire. Keep in mind that N and R insulins last twice as long and are fine for use in dogs and humans, which is why your friend is advising you to get one, but they are the wrong insulin for cats.

If your vet will not give you a script for Lantus (glargine), call around to vets in your area and explain your situation until you find one that will. Usually the vet will give it to you if you insist hard enough, and provide them with the article I've attached. Print it out to take with you when you tell them you want a prescription for Lantus pens.
Click to expand...

Good article. Nice remission rates!
I will check pricing while at wally world.
I printed a copy for the current vet and saved to files for me and future vets.
Thanks for sharing!
Marian
 
neoncat.marian said:
OK, I am getting Chip in a little while -- the office manager seemed aggrieved and said she's ask the vet and 'try' to get his bill done.
I have the food lists printed and referenced to phosphorus and carbs (special thanks for notes on his kidneys and diet); I checked on pricing for the insulin pens, printed my coupons, got Chip on the special insurance plan at Walgreens (nice savings if the vet will go for Levimer) and can go to Wal-Mart for meter, strips, lancets, and ketone testers and still get Chip out of hock (I think). I've read all the info on hypo should we ever get there and have honey, syrup, etc.
I'll continue to learn your names when I am calmer. I have your kitty names and faces (where pics are available) down pretty well. I hope you will all tell yours how much they and your experiences with them have helped another kitty and give them a little hug from us. And to all who replied -- I am overwhelmed with gratitude for the out-pouring of help for Chip and me. I bet he'll be glad to come home. His buds miss him (as do I) and I have told them to expect him soon. It is kind of scary but you all make it seem OK. I don't shop much, so even the reminder of 24-7 stores was a help. I am close to everything here.
And yes, I have had vets and staff with good "bedside" manners. Maybe we will again...this clinic is rather new to us, but mostly I've only gone for kitty shots and basic check-ups.
This vet did recommend I check for info on-line:>)
I'd recommend you all any time!

Marian
Click to expand...


This is wonderful! Levemir (detemir) and Lantus work pretty similar, so a prescription for either one is good. Both insulins are great with diabetic cats. I suggested Lantus only because there is the article to support your request to the vet, but if your vet will write you a script for Lev and it's cheaper, go for it!

If you need something to support asking for the Levemir, here is the Lantus/Levemir dosing protocol for cats, that shows it is dosed the same and was tested in cats: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

Don't forget to get a prescription for the syringes (31g, .3cc, 5/16in. with half unit markings) as well if it's required in your area.
 
Julia & Bandit said:
So (if there are no ketones) what I would do is insist you want to bring your cat home.
Click to expand...
forgive me if i have missed the response, but it's important to note... if chip is throwing more than trace ketones or is in diabetic ketoacidosis (DKA) bringing him home is not a good idea. DKA can be fatal and does require vet care.

more info here: Ketoacidosis.
 
neoncat.marian said:
Jenn & Baxter said:
Glad you are going to get Chip :RAHCAT . He is going to be so happy to come home. bcatrun_gif Poor little guy being a prisoner @ the vet office. grr_red

This reply is about Vets in the Dallas/Ft Worth area. I am from Dallas, but while living there I didn't ever need a vet. I have friends there whom have pets/vets. What area are you in?

Also, there is a member on the board who lives in Euless. Her kitty is currently in remission. I will message her to respond here about vet referrals. Her user name is "ohbell".

I hope this helps.
Let us know how Chip is.

Jenn & Baxter
cat_pet_icon
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Jenn, I'm in Fort Worth, Arlington Heights, my contact info is on my website (www.neon-cat.com) if ohbell would rather call to chat and buck me up. I'll be out awhile (off to wally world then to the vet's) but am here almost all the time. Or have her email me directly at neoncat@flash.net.
Many thanks!

Marian
Click to expand...


Ohbell is going to contact you via phone. I hope she will be able to help you with a vet.
 
At last!! Chip is home!!!!
We just got back. Our bill was not ready earlier and they wouldn't let me take him, so I went shopping and got stuff at wally world -- meter, lancets, strips, ketone strips, and Neosporin with pain relief ($60.00), explored foods at Petsmart after being baffled by foods at wally's place, and stopped to ask about phosphorus blocker at the health food store -- no go there. The vet had some, a powder called Epakitin ($32.95, mix with food morning and night).
Chip is relaxing a minute. He last had insulin at 7:15 this morning after eating. 8 units of Humulin N, his morning test reading 413. Apparently he ate all day. I looked at levemir at wally world ($230.00 pens, $130.00 for 100 ml vial). I did not get insulin tonight. The sweet gal who helped me could not find Lantus. I could go and get the Levemir. What do you think?
After Chip chills out I will try a reading and then feed (Friskies Special, I forgot my list of foods and it was all I could remeber -- darned if they don't all start to seem questionable if you are standing in front of row after row of choices.)
Chip seems himself and happy. He headbutted a few of his freinds. The vet wanted me to call after I do a reading and get an amount of Humulin to give. I would rather not.
So, for tonight -- anyone?
I will be up for awhile.
Ohbell was great to chat with. She mentioned the phosphorus blocker, so that would be good to expand affordable food choices. A Wysong canned venison was $5.19 per large can at the health food store. Wow! Looked pretty good though, I am starved.
But happy.
Now what? My mind is glazing over...

Marian
 
So good to hear Chip is home & happy.

Check the prices of insulin at Sams or Costco. You might need a script. Since he really doesn't have any insulin in him right now. I would test him at the time you would feed his pm meal. Then test him a couple of hours later. Then maybe 4 hrs after & again 6 hrs after his meal. Maybe get a reading before you go to bed. Kind of just follow as if you were giving insulin. So test again in the morning before his am meal. No dry food right? Is he eating the canned food?

Becareful with Vension it tends to higher in fat which can drive BG #s. Chicken, turkey, beef are all good. Fish you would only want to feed a couple of times a week.

I don't know anything about other insulines. I use ProZinc $130. 8 units of any insulin sounds like way to much insulin. Maybe that's why the vet was feeding him so much so his BG won't lower because of all the insulin. I don't really know.
It's better to feed diabetic 4 small meals with 2 shots am & pm. There are many who feed 12/12 2x daily with 2 shots daily am & pm.
 
I have no idea of the logic behind the vet's program. I do like the lessons I am learning here and in the articles on modern management.
Chip ate a can of the Friskies Special Diet and seemed to enjoy it. No dry. I just got him set up. Was hoping to try the ketone strips (they never go when you want them to). He seems fine, alert, happy and relaxed. I am settling down, will play with the meter and testing in a bit - I never did eat. My human diabetic buddy suggested seeing how he does tonight and test in the AM. The vet's office did say they would call in prescriptions. I left the article I'd printed for the vet to read (or not), his daughter checked us out.
Vet bill - from the evening of the 4th until tonight -- $333.68. Two glucose tests per day were $20.66. In-house stay, $16.00/night. Buck fifth per day for W/D. Insulin vial, $59.00. Nothing beyond first I-Stat EC-8 Blood profile ($34.46). No testing for ketones.

He gained 5 ounces, but is still under his normal weight.

Onward...I need to make an ear-warmer:>)

You all sure lightened and instructed my thought today. I will do some more pricing in the morning, for insulin.
And work on the glucose curve every 2 hours.
Chip should be safe for tonight. Let the carbs process out of his system and start fresh.

Marian
 
I have no idea of the logic behind the vet's program. I do like the lessons I am learning here and in the articles on modern management.
Chip ate a can of the Friskies Special Diet and seemed to enjoy it. No dry. I just got him set up. Was hoping to try the ketone strips (they never go when you want them to). He seems fine, alert, happy and relaxed. I am settling down, will play with the meter and testing in a bit - I never did eat. My human diabetic buddy suggested seeing how he does tonight and test in the AM. The vet's office did say they would call in prescriptions. I left the article I'd printed for the vet to read (or not), his daughter checked us out.
Vet bill - from the evening of the 4th until tonight -- $333.68. Two glucose tests per day were $20.66. In-house stay, $16.00/night. Buck fifth per day for W/D. Insulin vial, $59.00. Nothing beyond first I-Stat EC-8 Blood profile ($34.46). No testing for ketones.

He gained 5 ounces, but is still under his normal weight.

Onward...I need to make an ear-warmer:>)

You all sure lightened and instructed my thought today. I will do some more pricing in the morning, for insulin.
And work on the glucose curve every 2 hours.
Chip should be safe for tonight. Let the carbs process out of his system and start fresh.

Marian
 
Nice to chat with you as well.
Taking my lunch break and thought I would respond.
Glad to hear you got the home testing done with Chip! YOU GO MAMMABEAN!
He will thank you later. When I get home, I will do some board/forum searching on the blocker issue. As I said yesterday, I researched for Gumpy but I dont remember the sites.
Hugs to you and Chip and shout later! ;-)
 
I can't believe the vet bill was so low! :lol: Is it always that cheap in TX? Here it would be at least $1000. I also can't believe he never tested for ketones. You should probably do that the first time you get a chance to play it safe. You also will need another vet right away if he refused to give you that script. It won't hurt him to get cleaned out but you don't want to wait too long either. Good job!

Melanie

PS: Just holler if you need help.
 
Hi all!

Chip is doing really well!
(I seemed to be the worst for the wear but am feeling good today)
He is relaxed, happy, meowing up a storm for his girls, with coat looking good, leaping, jumping, and walking normally, drinking water normally, normal amounts of pee, good stools, and nor seeming ravenous. I've gotten to test ketones three times since he's been home -- all negative. He is hanging in the 280's just on Friskies Special Diet, no insulin. Considering his week from hell I am well pleased. I'll decide tomorrow our next plan of action. I guess I will find out other veterinary pratice price costs then. The costs at vets' in the Dallas-Fort Worth area are very varaiable for things like spay-neuter, but I can't much speak to disorders and the prices for their treatments. One example though -- echo cardiogram is $90.00 at Chip's old climic, at another place it was $575.00 with add-ons.

I never could get the tips to the lancing devices to work for him (Relion micro). So I just jab his ear inside where there is no fur or very little fur. He is OK with that, not flinching (I tried jabbing and testing myself a couple of times before moving on to Chip - no pain). Best places are near the edge of his ear. It doesn't seem to matter much whether I use Neosporin with pain med or not, a small, nice drop appears. I've gone through a number of strips dropping them, smearing the blood on the top of the strip, etc., but all in-all the Relion is very easy to use. I have been testing four times a day and feeding twice a day thus far. I may now go to a four times a day feeding plan.

Marian, with a paw-wave from Chip
 
That's great Marian! You're really doing a good job and he sounds like he's doing wonderfully and adjusting nicely to the testing. It's amazing that the vets are so different in pricing there. Here they're all about the same price with a small variance. I see that I missed where he said he will give you prescriptions above. Hopefully it will be for one of the appropriate longacting ones for cats. Keep us updated.


Melanie & Racci
 
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