Caution on Costco syringes- U40

[Ellen and Woody]

Hello forum,
A friend with a diabetic cat has been buying his syringes at Costco. Turns out they are U40, not U100, so he was dosing his cat 5 units Lantus twice a day instead of 2 units! The Costco pharmacy did not notice this, and his vet actually said that "Costco is killing cats"! Not sure if this applies to just his local Costco or whether all Costcos use U40 as their standard Lantus syringe without question. His vet was freaked out when she found out, but the cat is actually okay.

This is a friend that does not test, the cat is semi feral and goes outside all day, in a laundry room at night. Freaks ME out that he has no food access after shot but I cannot convince him to be more careful and the cat would be deceased if not for the minimal care.

Would love your comments, as this says to me that Lantus is really as gentle as they say. It makes me more confident to try and control Woody's BG tighter and not be afraid to dose him 2 units or even more (?) when he is in the normal range pre-shot. He's averaged 287 pre shot over the last 2 months but now has diabetic neuropathy, so I would love to better regulate him.

However, I do not want to test him more than 2x a day, except for occasional curves. Thoughts???

Ellen and Woody

 

[BJM]

What is the cat eating? That may be what saved him, if he isn't on low carb canned food.

 

[Elizabeth and Bertie]

Would love your comments, as this says to me that Lantus is really as gentle as they say. It makes me more confident to try and control Woody's BG tighter and not be afraid to dose him 2 units or even more (?) when he is in the normal range pre-shot. He's averaged 287 pre shot over the last 2 months but now has diabetic neuropathy, so I would love to better regulate him.

However, I do not want to test him more than 2x a day, except for occasional curves. Thoughts???

(Emphasis mine)

Hi Ellen,

Your friend's cat has been extremely fortunate in surviving this overdose of insulin (assuming it's not actually a 'high dose' cat...)

Hypoglycemia is caused by too much insulin, irrespective of the type of insulin used.

It may well be possible to get Woody "better regulated" but you really need more hometesting data in order to see what the current dose of insulin is doing.
Lantus dosing is based on the lowest number of the cycle, not the preshot number.

Have I understood correctly that you're only getting preshot tests (aside from occasional curves)?
If you're not getting some routine mid-cycle tests there is no way of knowing how low Woody's blood glucose may be dropping (and you will also not be able to see if his blood glucose is dropping low and then bouncing high in response to that.)
Occasional curves will not give you this information. They are a snapshot of what is happening on a given day, and no two days are the same.

Are you able to get some more tests...?

Regarding the neuropathy, many of us have found that methyl B12 (methlycobalamin) can speed up the recovery. Zobaline is a form that's actually made for cats!
Neuropathy-like symptoms can also be caused by potassium deficiency (if the kitty is peeing a lot they can lose potassium). If your vet confirms a deficiency then the potassium can be supplemented.

Hoping Woody feels better soon,

Eliz

 

[Vyktors Mum]

If you want tighter control, which would be great since obviously Woody's levels are high enough to be causing damage, then you need mid cycle tests. As Eliz says the lantus dosing is based on the nadir not the preshot. The only reason we test the preshot is to make sure it's safe to shoot.

Zobaline will do wonders with diabetic neuropathy, 1 tasteless pill crushed into food daily for about three months. My mums cat has come back from walking right down on his hocks and not being able to jump to 100% normal. However, we starting treating the neuropathy reasonably quickly and also got him well regulated. I don't think the Zobaline will work while Woody remains unregulated as the sugar that is causing the problem is still there causing more damage. Eventually the damage will be come permanent.

 

[Critter Mom]

If it were my cat, I would not aim for tighter regulation without getting mid-cycle tests to establish the nadir - at any dose.

 

[Ellen and Woody]

Thanks everyone! I know I need to do more testing but it is emotionally hard for me to stick him several times a day, as many of you do! What is the minimum number of tests recommended (eg every 2 hours, every 4 hours?) to find his nadir? When I increase his dose, he goes too low to shoot at the next test 12 hours later.
Thanks so much! I will also check the potassium and look into Zobaline.
The neurologist has him on L-Carnitine and Co-Q-100. Is Zobaline better?
Ellen

 

[BJM]

Zobaline is a different supplement which works on a different issue than the L-carnitine and Co Q 10.
When you say too low to shoot, what number are you using?
In addition to the pre-shot tests, get a mid-cycle test between +5 to +7 hours after the shot. This is the common nadir period, however, the nadir isn't the same every day. Change up the mid-cycle test time daily to cover that period. One day, check +5; the next day check +7, the next +5.5, etc.

 

[Ellen and Woody]

Zobaline is a different supplement which works on a different issue than the L-carnitine and Co Q 10.
When you say too low to shoot, what number are you using?
In addition to the pre-shot tests, get a mid-cycle test between +5 to +7 hours after the shot. This is the common nadir period, however, the nadir isn't the same every day. Change up the mid-cycle test time daily to cover that period. One day, check +5; the next day check +7, the next +5.5, etc.

Too low to shoot means that his pre-shot is 70 or 60, so I am scared to shoot him.