? Freckles/Judy - 01/25 - AMPS 227, 230@+2, 232@+4, 239@+5, 225@+6. Lantus pens vs cartridges

[Judy and Freckles]

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No flinching with the Lantus this morning. Going to pick up new prescription and thought about trying pens instead of vial - I like the idea of having the insulin split up in case I drop the vial. Pharmacist asked if I maybe wanted cartridges instead of the pens, but I'm not sure what the difference would be. Is there a preference? I will still be using needles to draw out the insulin so which is better? (P.S. I'm in Canada)

Thoughts?

Wondering if @Wendy&Neko and/or @Marje and Gracie have any input?

Thanks!

 

[Judy and Freckles]

@Marje and Gracie wondering if you have a second if you can take a look at Freckles' labs that were done prior to the dental on January 10? That would be greatly appreciated. Feedback that I got back from the vet was some slight anemia.

 

[Wendy&Neko]

I used cartridges. Used less space in the fridge and cost less. My girl at one point went through one every couple weeks, so any savings helped. Some people like pens because it’s an extra layer if you drop them. I never dropped a cartridge. Smaller object made it easier to hold syringe and cartridge together. Cartridges aren’t available in the US, so they won’t have experience with them.

As for the labs, you are missing the column that includes the reference ranges for the lab. Check out Neko’s, we went to Idexx first, then changed later when she went to the specialty hospital, so I have two sets of ranges. The HCT shows as low of Freckles, and that gives the indicator of anemia, but without a reference, can’t tell by how much.

 

[Deb & Wink]

Lantus Solostar pens are available in the US. For future reference. Not sure if the 3ml cartridges can be purchased separately from the dosing pen.

Canadians are very fortunate in that you can purchase the lantus insulin in any drugstore/pharmacy without a prescription. And at much lower cost than the US. But I understand that meters and test strips can cost more north of the border.

 

[Wendy&Neko]

Not sure if the 3ml cartridges can be purchased separately from the dosing pen.

Not in the United States. I too am in Canada. From the Insulin Info Sticky:

Lantus is available in:

• a 10 mL vial
• a box of five 3 mL refill cartridges (no longer available in the USA)
• a box of five 3 mL prefilled SoloStar Pens

 

[Marje and Gracie]

@Marje and Gracie wondering if you have a second if you can take a look at Freckles' labs that were done prior to the dental on January 10? That would be greatly appreciated. Feedback that I got back from the vet was some slight anemia.

Yes the normal ranges would be very helpful. However, just going by what you have highlighted as high (thank you), the one that is a real concern is her phosphorus. It’s really high. Typically, we only see a P value that high with more advanced CKD. Her creatinine is a little higher than I’d like to see it but even if she were in stage 1 CKD (not saying she is as there is no proof of that), it’s rare to see a P that high. Do you give her bone broth because I have seen bone broth really raise the P in non-CKD cats. Or are you feeding a food that is really high in P? In hand with this, her Ca is on the borderline of high but I bet if the P came down, the Ca would. What does your vet say?

I steer away from offering thoughts on the CBC when WBCs are elevated. There are so many things that can cause that including teeth issues. It’s best to let your vet have input on that. The other thing that is a bit high is her bilirubin. Have you noticed if her pee is a dark gold?

 

[Sienne and Gabby (GA)]

Cartridges were available in the US when Lantus became available in pens but they were subsequently discontinued. I had a chance to. use both. Unlike Wendy, I preferred the pen over the cartridge. It really bois down to a matter of personal preference.

 

[Judy and Freckles]

Yes the normal ranges would be very helpful.

Awesome! Thanks @Marje and Gracie . Normal ranges have been entered in SS.

Do you give her bone broth

No bone broth.

Or are you feeding a food that is really high in P

The first blood panel (Sept. 24), Freckles was eating Meow Mix dry (Min.phosphorus guaranteed analysis .8% it says on their website). Second blood work (Jan. 10) she has been eating strictly Fancy Feast Pate with phos ranges of 267-481 mg phos per 100 kcal.

What does your vet say

Vet on Sept. 24 said thyroid was good but she has diabetes. Vet said Jan. 10 blood work Freckles showed a little bit of anemia but said it was likely because she is drinking more water. Nothing to worry about. (I rarely see her drinking water, but I do add water to her FF for every meal/snack).

Have you noticed if her pee is a dark gold?

No, not dark gold. Medium yellow in colour.

Different vets on Sept. 24 and Jan. 10 - neither said anything about kidneys.

 

[Marje and Gracie]

Well, jeepers. I was looking at her Sep labs. I did this with Olive the other day I always put Gracie’s most recent labs to the far left and so that was what I was thinking was most recent. Sooooo.....the high P was from Sep.

phos ranges of 267-481 mg phos per 100 kcal.

That’s really high phosphorus, especially as you get over 300. I wish they had rechecked it.

Her hematocrit is really low; not so low that she needs the big guns but pretty low. She’s correct that dehydration can cause the HCT to go up and drinking water can cause it to come to normal numbers but....hers is way past that. Your vet is missing something. Even my kitty with CKD who got fluids every day did not have an HCT that low.

 

[Judy and Freckles]

Thanks Marje!

Well, jeepers. I was looking at her Sep labs.

I was looking at some other labs and realized that the most recent is to the left... makes sense so you don't have to scroll to the end of the SS to see the most recent.

That’s really high phosphorus, especially as you get over 300. I wish they had rechecked it.

So I should be just feeding Freckles below 300 for phosphorus? 267 is the Salmon FF pate. I can just start feeding her that if it will help. I don't know why the vet didn't recheck the phosphorus.

Her hematocrit is really low

Maybe I'm giving her too much water in her food? I read somewhere that excess water intake can lead to anemia?

Any recommendations then?

 

[Marje and Gracie]

Thanks Marje!

I was looking at some other labs and realized that the most recent is to the left... makes sense so you don't have to scroll to the end of the SS to see the most recent.

So I should be just feeding Freckles below 300 for phosphorus? 267 is the Salmon FF pate. I can just start feeding her that if it will help. I don't know why the vet didn't recheck the phosphorus.

Maybe I'm giving her too much water in her food? I read somewhere that excess water intake can lead to anemia?

Any recommendations then?

I”ve always given my cats a lot of water and I’ve not seen a HCT that low when everything else was normal. I’m sorry but I do have a hard time with believing it’s because of water. I drink a ton of water in a day and my HCT is completely normal. I would try to feed lower P foods.

 

[Judy and Freckles]

I would try to feed lower P foods

Will do. Is there a recommended range or should I just shoot for below 300?

Thanks so much for your help with Freckles. These lab sheets require a person to have a specialized university degree on their own!

 

[Marje and Gracie]

Will do. Is there a recommended range or should I just shoot for below 300?

Thanks so much for your help with Freckles. These lab sheets require a person to have a specialized university degree on their own!

You’re welcome. Both of my cats are fairly young and healthy and I like to keep their P no more than 200 mgP/100 kcal. But they eat balanced raw so that’s easy to do. I’d shoot for less than 250. That’s not really lower P but it’s definitely lower than what she’s getting. Even 200 is not “low P” but it’s reasonable.

 

[Wendy&Neko]

Although a lot of people recommend Fancy Feast to new people here, most of their varieties are rather higher in phosphorus. You might have to look at other manufacturers. I also shot for a P below 250, but also fed raw so easier to achieve if I stayed away from raw with bone.

Did your vet send the blood out to Idexx? Kind of surprised you don't have any SDMA value which comes pretty standard with Idexx. It's a good early indicator of kidney disease.

 

[Ella & Rusty & Stu(GA)]

I live close to the US-Canada border and have bought both the pens and the cartridges in Canada. Like Wendy, I always preferred the cartridges: cheaper than the pens and easier to hold when drawing from them with a syringe.

I've been feeding my civvie, Gus, Sheba, Perfect Portions Patés lately (chicken; turkey): good balance between protein and fat, low in carbs, and in the 230 range in phos.

 

[Judy and Freckles]

Did your vet send the blood out to Idexx

No the vet has the IDEXX machine right in his clinic.

I also shot for a P below 250

Yes, have been having a look at different manufacturers. I'm beginning to think it would be easier if Freckles just started hunting mice!

 

[Judy and Freckles]

Kind of surprised you don't have any SDMA value

Couldn't find any of those letters (SDMA) on the labs sheet.

Thanks again for your help Wendy!

 

[Wendy&Neko]

No the vet has the IDEXX machine right in his clinic

That explains it, that's usually a subset of what the outside Idexx labs will test.

 

[Judy and Freckles]

Kind of surprised you don't have any SDMA value

Couldn't find any of those letters (SDMA) on the labs sheet.

Thanks again for your help Wendy!

 

[Diane Tyler's Mom GA]

last post

No flinching with the Lantus this morning. Going to pick up new prescription and thought about trying pens instead of vial - I like the idea of having the insulin split up in case I drop the vial. Pharmacist asked if I maybe wanted cartridges instead of the pens, but I'm not sure what the difference would be. Is there a preference? I will still be using needles to draw out the insulin so which is better? (P.S. I'm in Canada)

Thoughts?

Wondering if @Wendy&Neko and/or @Marje and Gracie have any input?

Thanks!

Hi there is a member selling the lantus pens in the supply closet for 30.00 plus shipping, let me know if you want her name

 

[Wendy&Neko]

@Diane Tyler's Mom Judy, as do I, lives in Canada.$30 per pen is way more than it costs us OTC at the pharmacy.

 

[Judy and Freckles]

Hi there is a member selling the lantus pens in the supply closet for 30.00 plus shipping, let me know if you want her name

Thanks for thinking of us Diane, but it's easy to get the supplies here.

 

[Judy and Freckles]

@Diane Tyler's Mom Judy, as do I, lives in Canada.$30 per pen is way more than it costs us OTC at the pharmacy.

Thanks Wendy,

I'm wondering if I should hold off getting more Lantus and talk to vet about switching to Levemir? Looks like we are increase the dose again tonight to 7u.