Bad vet? panic confusion- argggg Need words of reason

Status
Not open for further replies.
Misty&Bast

Misty&Bast

Member Since 2012
history-
I noticed m cat had lost weight, had dandruff and lackluster hair and was peeing outside the box. bast was diganosed tuesday evening with diabetes- his sugar maxed the test at 700. They sent him home tues nite and I brought him back wed morning for the vet to keep him a few days and bring everything to normal. I am told sometime yesterday they tested him at 313 and gave one unit of insolin and it came down to 117. he ate yesterday (they seem to be giving him wet food with a little dry).

This morning they called early and said he had a fever and didn't eat last night. He was checked and he has a UTI and DKA. So they stuck in an iv and gave him fluids and antibiotics. I went to visit and he was under the kitty bed and blanket (hiding). I explained he normally sleeps during the day under a blanket on the bed so this is normal. We are home 7pm-10pm at night and awake till 3am. So he is more nocternal. I played with him for 1/2 hour and he drank water while i was there. He usally sleeps in the bed between myself and my BF at night so I am sure e was happy to see "mommy".

The vet is keeping him another night (they were going to send him home before the fever/uti/dka) so the can get the ketones out of the system and make sure he is hydrated and eating.

problems- the vet says they are using humulin! I tried to get a change to the others reccommended on this board but they don't carry it. I asked about a script for them after and he said he could write one for Glargine but it is very expensive. He was explaining they would send Bast home after instructions for shots 2x's a day & stips for his urine. I asked about glucose blood monitering and bloodsticks on the ear (I think they are using the nail on his hind foot now) and he told me i didn't need to do bloodsticks. This sounds wrong to me. He kept talking about the pee strips. Then he was talking about bringing Bast back in 2 weeks so they can do a curve with testing every 2 hours for 2 days. This might have to be done twice. I know from reading here that I can do that at home. I can even bring the cat to work so I can moniter all day. (family owned business- he can be in a playpen in back).

So how do i get a script for a differnt insolin? What is Glargine? I figure to let them take care of the DKA but then i want him home. He has been a dry food eater and I was planing to switch to wet but not in the first 2 weeks. Now that they are feeding him some wet- should i try to switch now?
Whn bast comes home should I keep the vet insolin first and then switch him (vet said not to change but i am not trusting that right now).
I am at a loss and upset.
 
Glargine is Lantus and it is a good insulin so if he will write you a script, I would definitely get it. Yes, it is more expensive than Humulin but in the long run, if you can get him regulated or in remission, it will be worth every penny - rather than struggling with Humulin and having to change at some point anyway.

I know you have read enough here to know we think testing blood at home is vital and the only way to keep him safe. We will also urge you to do ketone urine testing since he has had ketones (ketones) but urine testing for blood glucose levels is completely inferior to blood testing and only suggested by us as a last resort (like with a feral cat) Urine testing for glucose gives you a reading that is hours old - after the urine has made its way all through his body - and can't be used to determine whether it is safe to give a shot, for example.

If they are feeding wet, and you bring him home and start testing immediately, you can continue with the wet diet. (you'll want to do some research with the food charts to be sure it is wet LOW CARB, not just wet) Once you are testing, it would not make sense to have the vet do the curve. Too expensive and not likely to be accurate with vet stress figured in.

IMHO, it looks like time to put your foot down with your vet (as in This is how I plan to treat my cat; I would like your help.) or get a new vet. If you want to put your city and state in this thread and maybe in the Subject line, maybe we have a member who lives close by and could help you learn to test on the ear and suggest a FD friendly vet.

I am sorry you are going through all this worry over your kitty, and then having to worry about his treatment too. Just know that you have a support group now that is ready and willing to help in any way you need it. Now that you are part of the FD family, he is our kitty too.
 
Sue and Oliver (GA) said:
Glargine is Lantus and it is a good insulin so if he will write you a script, I would definitely get it. Yes, it is more expensive than Humulin but in the long run, if you can get him regulated or in remission, it will be worth every penny - rather than struggling with Humulin and having to change at some point anyway.
Click to expand...

It is more expensive than Humulin, however, have your vet write the prescription for either the pens or cartridges. If you can avoid it, do not get the script for the vial. Initially the cost is more for the pens or cartridges, however, you get 5 of them in the package. Because the insulin in the vial will become ineffective long before you can use it all, we recommend the pens & cartridges. Each one is a smaller quantity than the vial and usually you will be able to use almost every drop. The total package contains the same amount of insulin as one vial. With a vial, you may get 3-4 months out of it before it becomes ineffective and have to buy a new one. With a package of pens or cartridges, each one will last the about the same amount of time and you will use it all. With one package of pens, you will have enough insulin to last almost all year.
 
Right now, your kitty is exactly where he needs to be. If he's been diagnosed DKA and has a UTI, it's just about impossible to deal with that combination at home. Don't be alarmed that they are using Humulin right now. In order to treat DKA, they use a short duration, fast acting insulin. They deal with the drops that happen quickly from that insulin, usually by putting the cat on some sort of "sugar drip" to keep the numbers from going too low.

They will most likely be sending him home, once the ketones are gone, with an antibiotic for the UTI, and until the infection clears up, getting regular insulin doses and making sure he eats are critical so that the ketones don't reappear. However, Humulin is NOT a good insulin to use once this crisis is over. If you can afford the Lantus (glargine), by all means try to get some ASAP. And like Sue said, as long as it is a low-carb wet food, that's what you should be feeding him. Make sure it isn't anything made by Hill's. Their "M/D" formula is supposed to be a good food for diabetic cats, but it isn't. Your vet might insist that it is, but he'd be wrong. There are plenty of less expensive lower carb canned foods available at the grocery store. Friskees Pates and Fancy Feast Classics are just two of those, but those are perfectly fine to feed.

If you are able to home test, there is no reason you will ever have to bring him in for the vet to run a curve. You can email the vet your numbers if they want to know what they are.

Find out if the vet has any experience with treating feline diabetes with Lantus. That matters because if they don't, then they probably won't give you good advice as far as dosage goes. Let us know what they say, and what sort of dose they recommend. There are guidelines published by the AAHA that detail how insulin should be dosed for cats, and hopefully they are familiar with them. If I remember right, they are found on page 18 of this document:
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

Blood testing from the ear, and testing the urine with ketostix are two of the best things you can do from day one. DKA is very serious, and you want to monitor for ketones for sure. It's much easier, I think, to get blood from the ear, and once you do it successfully a couple of times, it's very easy to do.

You've found a very incredible place to help you with this!

Carl
 
Poor Bast! He is a sad little kitty ight now :cry:

The insulin he suggested after you pressured is a good one (Lantus) much better than Humulin and I would suggest starting it right away after the DKA is over rather than waiting to the end of the bottle- that is what i did and it put us over a month behind in Sneakers FD journey and and kept her in crappy numbers. If you can get a script make sure it is for the pens. Higher cost but they last longer and are better to use in the long run.

I would change his food, lower the dry and increase the wet while keeping an eye on his ketones (buy the ketone strips at the pharmacy- usually $6-9/50 depending on where you go. Test at least once a day if not more since he just went through DKA. DKA is the result of too little insulin, too little food, and an infection (his UTI). Keep adding water to the food to increase his water intake

And don't follow the vets orders if he gives you a starting dose of 2u BID (2x's day)- a normal starting dose is .5u or 1u BID and with his DKA I would start with 1u and see how he does with that while you check those ketones. I would see about getting a new vet as he isn't really up do date on FD at all but if you like him you need to be the belligerent/strong one starting with the words "This is my cat, I love him and I don't want you to kill him because you haven't got a clue. I will be needing the glargine prescription and I will be home testing and he will be eating a FD friendly diet." Be stern, be honest. We've all had to pull on those big girl (and boy) panties for our cats here as very few vets have the time to do research on FD when they have to learn about the latest fad pet diseases.

Don't pay for office curves as those numbers are stress induced and unusable for dosing.

Keep us informed! I hope you are at least getting some sleep even though you are worried.
 
I am ging to ask for the LANTUS for a scrip. I read i should get the pens. I don't see they do 1/2 doses. Right now he is on 1 unit at the vet but he is so skinny (8 pounds) I am worried I will need to be able to adjust.

I have been planning- with our scedule we will be doing shots 9/10 am and 9/10 pm (have to pin down the hour). I want to use the Lantus and am waiting for my kit to see what meter and such we have. i have also had offers from froms for moremeters. I started looking for the best price on the Lantus and see about $136-150 for 5 pens Is that good? Do I still need needles if I have the pens? Do I need a needle desposable box?

I am checking into food tomarrow at the store.
I am going to go visit him again now.

thank you for all the help and info!
 
themewedd said:
I am ging to ask for the LANTUS for a scrip. I read i should get the pens. I don't see they do 1/2 doses. Right now he is on 1 unit at the vet but he is so skinny (8 pounds) I am worried I will need to be able to adjust.
Click to expand...

You don't use the SoloStar pen the way a Human diabetic would. For cats, you can use insulin syringes :smile: When you uncap a pen, there is a rubber stopper. Just stick the insulin syringe needle into that and draw up a dose. There are pictures of how to do that here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151


I started looking for the best price on the Lantus and see about $136-150 for 5 pens Is that good? Do I still need needles if I have the pens? Do I need a needle desposable box?
Click to expand...


You do not need pen needles. All you need are insulin syringes. You need to use U100 insulin syringes with Lantus. The most ideal ones to use are 3/10 cc with half unit markings.

There is a $25 coupon for the Lantus pens here: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=36964

Where did you get those prices from? Those are pretty good prices. In some parts of the US, the price is closer to $225 for a box of SoloStar pens. You can use http://www.goodrx.com/ to get approximate prices on Lantus at the local pharmaices.

Some people buy their Lantus from online Canadian web sites; Here is a thread with info: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=11530

You can save additional money by using a free prescription card. Here is a thread with info: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=53397

Some people use a Sharps/biohazard container and return the filled container to the vet's office. Others use a sturdy plastic or metal container, like an empty coffee can or laundry detergent bottle, and throw the emtpy container away with the regular hosuehold trash. State laws vary so you should check with your local laws to see what the proper way to dispose of Sharps is. Sometimes pharamcies will take filled Sharps containers. Some cities/towns have hazardous waste collection days in which used medical supplies are accepted.

Some people use a needle clipper to remove the needle part of the insulin syringe. The plastic syringe part can be thrown away with the regular trash. The clipper holds some amount of needles and then you just throw it away. http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=7416
 
hey there, someone pm'd me to see if I were close enough to help at all and indeed I am. I'm just down the road from you literally :-)

first off, i second everything everyone has said about getting a scrip for lantus, etc.....

but double check that that price is for a 5 pack of solostar pens because i've found it to be around $200 plus for that box. it is obviously more expensive than a single vial but in all honesty, i get about a year out of one box of 5 pens because my cat takes such a small dose. and if by chance that's a stretch right now maybe we can split the cost of a box or something as i'm going to need some new insulin soon myself.

as far as meters go, i take it you ordered a kit from here? if by chance you want to get your hands on one sooner, walmart there off of the 91 & mckinley has one of their house brand meters, the Relion Prime, for $16.43 i think it is and a box of 50 strips for $9.00 which is the cheapest for strips locally. I switched to it just recently and it works great for us.

hometesting help. i can certainly help with that no problem. i can either come and bring my testing supplies and show you how it's done, perhaps even this weekend if your kitty is home then. or we can wait until you get a meter of your own. let me know about that.

ummmm....what else, as far as a vet. i drive down to orange county to see our vet but she's well worth the drive as she knows alot about diabetes, knows about hometesting, proper nutrition, and prefers lantus insulin. it's really not far, since she has saturday hours it only takes me about 15 minutes or so to get there so i haven't bothered finding a new one in riverside county since i moved out there.

i'll keep an eye on this thread in case you want to hook up for any of this k
talk to you soon
 
aww the price was for 3 pens http://www.goodrx.com/price/lantus/solo ... ll__Lantus
Ms LynnLee I would be interested in splitting an order.

LOL on me for thinking I could just use the pen like a people! (i have seen people at my work use them).
I live downtown in the wood streets but I can travel some.

I went to see Bast this evening (yes, I visited twice today) and as soo as he heard me he came out from the blanket and they got him fresh food and water and he drink some and ate a little which made the vet happier. So I have to visit to get him to eat- LOL- mama's boy! He did break his fever and it was down to 101.
I told my vet I was going to want a scrip for the Lantus (glargine), He didn't seem to know they were the same thing and I said I wanted the pens because the vials go bad so quickly. He tried to tell me they don't. I told him I would like the pens. So I think I need to bring him a paper on what I want to get the right script.

I told him we would be doing 9am/9pm shots and he said he could probably adjust Bast to 8am/8pm before he left- I think I could work from there.
He was feeding him all wet food when i left and i was surprised Bast ate about 1/2 cup before i left. Hoping he eats more tonight. He is on an IV so I am not so worried but they did add some potasim to it (i was reading the chart).

It will be a day or two before he probably can go home. I have a huge event at work sat and fittings for a wedding dress sun (I sew historical dresses among my other jobs) so I really need to buckle down and work. I have been up the last 3 days running aound all day and night and am tired. Funny how Bast is sleeping all day and I am gettting no sleep!

So much help on these boards and now i am not shaking so much ;-)

Now- to figure out how to feed him when I am gone (freezing the food sounds good) and keeping my other cat from getting mad we are switching food!
 
I'm so glad to read that Bast is eating and drinking some.....and glad to see you standing up to the vet and telling him what you want and need :thumbup Hopefully your boy will be home with you soon and feeling better. Knowledge is power and the more you learn and understand the easier it will become for you to take care of your boy.
 
Status
Not open for further replies.
Back
Top