diabetes

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datcat56

Member Since 2013
Hello, I am new to this but my cat has just been diagnosed with diabetes. He is on 3.5 of lantus u 2x a day. I was shocked to find out that the cost is $170 a month. I can't afford this. Does anyone know if there is cheaper insulin out there? Please help Ted is only 7yrs old and I don't want to have to put him down.
Thank you.
 
1 vial of Lantus is 10 mL.
1 mL is 100 units
therefore, the vial contains 1,000 units
Example:
At 4 units per day (a somewhat high starting dose that may need lowering), that is 250 days, so long as you don't roll or shake the vial, drop it, keep it refrigerated.
Yes, you can use it longer than 1 month, despite the labeling. Most if not all of our Lantus users do that.

It is a steeper up front cost, but saves money in the long run, to get a prescription for 5 of the the 3 mL pens. We use them like a vial. each pen has 300 mL, lasting 75 days at 4 units per day. There is a coupon for them available from Lantus to get the cost down. Sometimes, you can purchase pens individually at warehouse clubs or pharmacies.

And it is much cheaper in Canada, if you happen to live anywhere near there to drive, or can get it shipped refrigerated.
 
Stress from being at the vet may raise the glucose 100-180 mg/dL. How did your vet diagnose diabetes? From an office glucose test? Urine glucose? Fructosamine?

If you have already started injecting insulin we strongly encourage you to get an inexpensive glucometer like the WalMart ReliOn Confirm, Confirm Micro, or WalMart ReliOn Prime. The Confirm models may be purchase from our shopping partner ADW (link at top of page) as the Glucocard 01 and 01 Micro.

These have the most inexpensive test strips and meters.

Testing will help keep your cat safe from overdose.

I am very concerned that the dose is too high. Please check the following calculation for safety.

How much does your cat weigh, and how much should your cat weigh? There is a formula for the starting dose, using the lower of these 2 weights, in kilograms (divide pounds by 2.2), multiplied by 0.25 and rounded down, for safety.

lean weight in kg * 0.25 = appropriate starting dose
 
If you have not yet started injecting insulin, work on diet change to low carb canned or raw food. It is cheaper than the prescription foods and just as good for the cat, plus has variety and adequate moisture.

Low carb food can bring down the glucose levels 100 points. Common inexpensive brands we use include the Friskies pates, Fancy Feast classic pates.

For more than you ever wanted to know about feline nutrition, go to thw vet written site Cat Info, for a printable food list, explanations of appropriate weight, how to safely slim your cat, and why wet food is best.

Make food transitions gradual to avoid GI upsets.
 
U-100 syringes are used to dose insulins like Lantus and Levemir.

U-100 means there are 100 units of insulin in 1 milliliter (mL)

Ideally, you have a syringe which has half units marked, as well as whole units.

If you are drawing up 3.5 on the syringe, this is 3.5 units of insulin. That could be way, way too much starting out.

Please reply to this post with your cat's weight and what his ideal weight is. We'll go from there.
 
I'm sorry the amount that ted is getting is just 3.5 of where the little lines are, not a full syringe.

Thank you.
 
datcat56 said:
Ted weighs 15lbs, My guess is that he weighed about 30 lbs back in march...
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So he has lost weight, then. Take a look at this Body Condition Chart. Which level does he most closely match?

If he is from a 1 to a 3, this applies:
15 lb = 6.8 kg
6.8 kg * 0.25 = 1.7 units

rounded down, give 1.5 units per shot.
 
Yes, he has lost a lot of weigh, He would be #3 on that chart. Should i still give him 2 shots a day? and if so how many units?
 
Source
"3 = Moderate
Ribs palpable without excess fat covering. Abdomen tucked up when viewed from side."

This would be ideal weight, so the previously calculated 1.5 units every 12 hours (called "BID" dosing) would be the correct calculation.

The shots need to be as close to 12 hours apart as you can get.
 
datcat56 said:
I'm sorry the amount that ted is getting is just 3.5 of where the little lines are, not a full syringe.

Thank you.
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That would be 3.5 units of insulin - way too much when feeding a low carb diet. So what are you feeding him right now? How much?
 
I feed him fancy feast, grilled tuna, or chicken, believe it or not he has been eating about 8 cans a day. He hardly drinks any water at all. So i should give him 2 shots a day 1.5 units 12 hours apart? I am so not happy with the vet, I asked her so many question about diabetes and most of the time she would reply that she is new to this. I later found out she just got out of school. Again I thank you for everything.
 
datcat56 said:
I feed him fancy feast, grilled tuna, or chicken, believe it or not he has been eating about 8 cans a day. He hardly drinks any water at all.
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Fancy Feast comes in the 3 oz cans, so 24 oz per day, roughly. Not surprising for a big cat with unregulated diabetes. As much as 50% more food can be needed for the unregulated diabetic. It can help slow him down by adding some water to each can to increase the volume. Also, spread it out across the plate so it takes him longer to eat it - just like with people, it takes the body a bit of time to start receiving calories from eating and recognizing that the need for food is being met.

datcat56 said:
So i should give him 2 shots a day 1.5 units 12 hours apart? ...
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Yup. Every 12 hours like clockwork.

datcat56 said:
I am so not happy with the vet, I asked her so many question about diabetes and most of the time she would reply that she is new to this. I later found out she just got out of school. ...
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Vets are supposed to be able to treat a variety of animals with numerous conditions; it would be impossible to be an expert on everything. The trick for the generalist is to know when to research something. Print out a copy of the American Animal Hospital Association Feline Diabetes Guidelines to read and share with her.
 
Its a little strange to me that he is eating a lot but not drinking much. Drinking a lot is a key sign of diabetes. I am concerned she is new and may have misdiagnosed or missed something.

When she was diagnosing - how did she do it?

1. did she mention "fructosamine" and send his blood to a lab?
2 . Did she test his pee for sugar?
3. Did she test his blood right there and then while you were there?

Let me know
thanks
Wendy
 
I will share that information with her. How long do you think it will take Ted to get better? The vet wants to do another curve test in 4 weeks.
 
We really need to be sure he IS diabetic.

How did the vet diagnose this?
1) glucose blood test in office
2) fructosamine blood test sent to lab
3) urine test in office

And what were the numbers?
 
When I first took him in she thought he had hyperthyroidism, She did a complete blood panel test on him. She said his sugar was a little high but was pretty sure he wasn't diabetic because he wasn't drinking a lot of water. About 2 days later she called and said his thyroid was fine but his sugar was a little high. So yesterday he had a blood curve test done and they started him on insulin. She wasn't there when I picked him up. The only thing the vet tech did was show me how to give a shot. I tried to call the vet this morning but she is off today?
 
OK i will do that. Should Teds second shot tonight be 1.5? or should i start that tomorrow? Did you say don't shake or roll the bottle.The tech said that after i insert the needle i should draw back to make sure there isn't any blood in it. Do i have to do that?
 
datcat56 said:
OK i will do that. Should Teds second shot tonight be 1.5? or should i start that tomorrow? Did you say don't shake or roll the bottle.The tech said that after i insert the needle i should draw back to make sure there isn't any blood in it. Do i have to do that?
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Yes, 1.5 units.

Most of us don't bothe drawing back to make sure there is no blood. If you pull up the fur, push the needle into the tented area, push in the plunger, and pull out the needle, you're usually OK.

OK. One of the things which can happen when giving insulin, is you may give too much. Or the cat doesn't eat/vomits and not enough calories go in. When this happens, the glucose level in the cat may go too low for safety. You should be prepared for that. Here are the instructions about what to have on hand, what to observe, and how to intervene. Please check your cat now, since this morning's dose was higher than the recommended amount. Please get what you need and put it somewhere you can find it quickly; also label the high carb foods so you don't feed them by mistake.
 
I have Ted here and he seems to be fine. He has eaten 3 cans of food since 4am. I do have syrup in the house.
Should I start to test his blood sugar soon?
 
If you've got lancets, a meter and test strips, go for it!

Maybe practice a couple times with a lancet on an apple or test yourself to literally get a feel for it.

A dab of neosporin ointment with pain relief may be applied to the ear for a few minutes before testing, and wiped off to test.

Have a low carb treat to give him after you test. This associates a positive treat with an annoying ear prick.
 
Hello again, well the vet just called me back and said that Teds sugar was 396 and then after they gave him 3.5 of insulin it dropped down to 176. The vet tech told me that ted didn't eat a thing yesterday, but the vet said he did, She also said that 396 wasn't that high a reading. I'm so confused.
 
datcat56 said:
Hello again, well the vet just called me back and said that Teds sugar was 396 and then after they gave him 3.5 of insulin it dropped down to 176. The vet tech told me that Ted didn't eat a thing yesterday, but the vet said he did. She also said that 396 wasn't that high a reading. I'm so confused.
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OK. So if any of that was due to vet stress, he could have been as low as 216, which is still higher than the normal of 40 -130 mg/dL.

How high is high?
- Lab equipment can read over 700 mg/dL
- Human glucometers read up to 600 mg/dL
- Pet specific glucometers read up to 700 mg/dL

When it comes to home testing, if the nadir - the lowest point between shots - is above 150 with a human glucometer, you take corrective action by following the Lantus protocol which explains how to correctly adjust the dose. It doesn't matter how high it is once its over the normal numbers - 300, 450, 600, HI - its all higher than you want. So don't get hung up on the numbers.

The 3.5 units was too much because Lantus is a depot insulin. This means the effects are cummulative and each shot builds on the preceeding shot.
 
BJM, Thank you so much for all this information, I will keep you informed on Ted's condition.
I'm so happy I found this site!
 
You know what, lets confirm the diagnosis yourself.. get the blood testing kit and we will know fast whats going on. Plus the testing kit will help you monitor him ( keep him safe) and give your vet more data (and us) for any dose changes etc. Plus you will be able to spot if/when he goes into remission.

Getting started shopping list
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast


Also can you tell me which types of fancy feast you feed? Is it the pates> Some of the others are to high carb and may impact your chance of remission

Wendy
 
Hi, Ted eats grilled tuna, chicken. He really doesn't like the pate. I haven't started testing him at home yet. One more thing Bjm told me tower his insulin from 3.5 units 2x a day to 1.5 2x a day but I noticed yesterday that Ted has started to drink a lot of water, Should I increase it a bit?

Thank you
Donna
 
datcat56 said:
Hi, Ted eats grilled tuna, chicken. He really doesn't like the pate. I haven't started testing him at home yet. One more thing Bjm told me tower his insulin from 3.5 units 2x a day to 1.5 2x a day but I noticed yesterday that Ted has started to drink a lot of water, Should I increase it a bit?
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We have a saying "Better too high for a day, than too low for a moment". Going hypoglycemic - too low of a glucose level - can kill very quickly. This is a big part of why we support home glucose testing - your cat's safety.

Are you completely switched to a low carb diet at this point? If not, that will result in some glucose elevation while you make the switch.

Also, remember that the Lantus is cummulative - it takes 5 full days (10 shots), to evaluate if the initial dose is enough because of this carryover effect. And anytime you see a glucose below 50 mg/dL on a human glucometer while on insulin, it suggests the dose could be too high. If you try to change it every time you shoot, you'll have great difficulty regulating him and may unintentionally overdose him.

That said, there is a protocol which uses indirect methods of water consumption, urine ketones & glucose, and so on ... it changes doses only every 2 weeks.
 
Hi BJM,Well I don't really know if the food he eats is low carb. I can tell you that he doesn't eat any dry food. He's full of energy today but is still looking to eat all the time. Should I keep the does of insulin at 1.5 2x a day?

Thank you
Donna
 
Donna, It's ok to be nervous. We all were in the beginning. That is why we are trying to help you with some of this now. Paying it forward.

Which "style" of the Fancy Feast is that Grilled tuna and chicken you are feeding? Gravy lovers? flaked? Sliced? Primevera? Roasted?
If the can says Grilled on it, it's too high in carbs.

Maybe try the Fancy Feast Chunky Chicken Feast, Chunky Turkey Feast, Chunky Chopped Grilled Feast for lower carbs.

All the Fancy Feast flavors that say "Flaked" on the can are chunkier and have <10% carbs.

Where do you live? State and city? Maybe we have someone near you to help you learn to home test.
 
datcat56 said:
Hi BJM,Well I don't really know if the food he eats is low carb. I can tell you that he doesn't eat any dry food. He's full of energy today but is still looking to eat all the time. Should I keep the does of insulin at 1.5 2x a day?...
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Printable food list here. Select any with 10% calories from carbohydrates of less.

Yes, for now, until you are testing or see signs of hypo, hold the dose for 5 days. Print out the hypo info and make sure you have the necessary supplies on hand so you're prepared. These can happen from not enough food, vomiting, lack of appetite and so on, not just too much insulin.
 
yes you should test his pee and blood. we need to confirm diagnosis as well as see how he is doing on the 1.5 units. You dont want to increase until we have the blood data in case you send him too low.
 
Hi Donna and welcome to our FD family! Wow--you are doing a great job!!! A lot of newbies are sometimes reluctant to start hometesting immediately--you've made the right decision to get started immediately. Hometesting will keep your cat safe. As was mentioned above, the insulin is cumulative and the "depot" will start to fill. Starting a spreadsheet will be very helpful; (other members--can someone provide the link with SS instructions? I don't have it). And we'd love to see a picture of your "sweetie"! It would be great if you could give us some information in your signature: Your & kitty's names, Diagnosis date, Meter used, Insulin used. You can add a picture as your avatar. If you need help setting that up, we can help you :-D

To introduce myself; I'm Kat, mom to Gobbles who is my BFFF (best fur friend forever); he's an 11 year old neutered shelter kitty and was diagnosed with diabetes back in November 2012. He is now in remission; his last insulin shot was May 16th of this year.

Feline diabetes is a new journey; we'll help you, support you, education you and hold your hand, if you'd like. It is a LOT to take in at once. Read the stickies and please ask ANY questions you have. The only dumb question is the one you haven't asked!!!
 
One other thing Donna: If you haven't purchased the Lantus yet, you may be able to get it in pen form, for $25 per pen. Lantus is a GREAT insulin--many cats on it go into remission. Gobbles did.
 
For those people home testing, we have a wonderful way to keep track of the test data and shots. There is a google spreadsheet template you can use so you don’t have to start from scratch and figure out what you want it to look like.

We have instructions on how to set one up. how to setup a SS and link to your signatureThe color coding is helpful to see trends over time in how the insulin is working. We even help set them up for people that may be technology challenged. Please ask if you need help.

Having a SS set up and linked to your signature is a great way to get some suggestions from the experienced people on FDMB. You can even share the spreadsheet with your vet, by email. It's totally optional but it can get you some great advice on how to manage your cat with his BG numbers.

What do you think? You can look at Wink's SS in my signature to see what one looks like. I found it invaluable.
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If you have problems setting it up, I can do that for you. Just ask. Or send me a PM.
 
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