Going off insulin?

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K's Mom

Member Since 2015
My 11 y/o cat was diagnosed last July. Switched to Friskies canned pate food from dry and he gets Lantus 1 unit twice a day. His fructosamine level in Oct was 271 and 231 (140-450 normal). I very much want to try him without insulin--any success stories out there? Did you do it cold turkey? Or? My vet seems a little reluctant--think it reflects her lack of experience with diabetic cats, but I'm at the end of a $200 vial of Lantus and think it's worth a try--???
 
Welcome!

Unfortunately, frustosamine tests cannot give accurate enough data to base dosing decisions on--they give an average of blood glucose levels over a several week period, and do not tell you how the insulin is actually working in your cat.

Normally, we say a cat is in remission when he can maintain a daily blood glucose level in a normal range (50-120 on a human glucometer) for a period of two weeks. Often, cats do best when they are weaned of the insulin with gradual dose reductions--when Bandit went into remission, he went from 1 unit, down to .75u, to .5u, to .25u, to .1u over a period of many weeks.

Are you testing your cat's blood glucose levels at home? If so, this would be the best way to know if your cat still needs insulin and how it is working to lower his blood glucose levels. If not, there are some wonderful resources here that can teach you how. It's something that seems scary to some people at first, but even fractious cats will accept it after a little while if you use lots of treats. :) If your vet isn't very experienced with feline diabetes, she may not know that the current treatment recommendations advocate home testing over office curves and fructosamine tests. It's the only way to accurately know how your cat is doing. Hometesting will tell you if your cat still needs insulin, or if the dose should be raised or lowered. If you have any difficulties, or need any advice on how to hometest, there's a whole forum full of people here who can help you out. :)

I would strongly recommend not to remove the insulin before you know how the dose is working for your cat. Suddenly removing insulin from a cat who needs it can cause a deadly complication of diabetes called diabetic ketoacidosis (DKA).
 
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Also, if you do need to continue insulin with him, many people here order their insulin from Canada because it's far less expensive than in the US. Bandit recently had to go back on Lantus after 5 years of remission and I just about peed my pants when I found out how much a vial of Lantus costs now ($277 where I live, and $456 for a box of pens!). I would get a script from your vet for the Lantus Solostar Pens. You get 5, 3ml pens so they will last you a year or more, and you draw from them just like you can a vial. I ordered from Mark's Marine Pharmacy. Shipping is $25.
 
Also, if you do need to continue insulin with him, many people here order their insulin from Canada because it's far less expensive than in the US. Bandit recently had to go back on Lantus after 5 years of remission and I just about peed my pants when I found out how much a vial of Lantus costs now ($277 where I live, and $456 for a box of pens!). I would get a script from your vet for the Lantus Solostar Pens. You get 5, 3ml pens so they will last you a year or more, and you draw from them just like you can a vial. I ordered from Mark's Marine Pharmacy. Shipping is $25.
Thank you for the helpful info! My vet has said she relies more on the fructosamine test because it reflects more of an average over time, rather than curves which are very stress-affected. I do not test at home. Frankly, after giving him shots twice a day, I do not want to be sticking him anymore. He seemed to get sick practically overnight (BS 465)and then responded practically overnight as well, once I got him on the canned food that is--my biggest battle by far. His glucose level at the vet last week was 92, 5 hrs post insulin. He is healthy on exam and all other labs and tests are normal--beautiful healthy coat, normal activity and appetite, peeing normal amounts again, and his "cat-i- tude" is definitely back! Can you give me an idea of how much the pens cost?
 
Just went to Mark's website and found the current Lantus price there.
$ 99.99 for 1000 units as 10 mL vial; cost per unit = $0.099
$144.99 for 1500 units as 5 pack pens; cost per unit = $0.097
 
See Chloe's moms post 'HELP!!! Time is running out cat - has DKA! 'for an example of what can happen when you withdraw insulin when the cat still needs it. I'm not sure why you'd be considering it at all when the vet said no and you have no evidence that it would be a good thing to do. The vet is right that vet curves reflect stress, but tests taken at home generally do not. Home testing is the only way you're really going to know whether he could take a reduction (unless you find out the horrible way when kitty goes hypo) reductions with lantus are based on the nadir and even if he is getting low enough we definitely wouldn't recommend dropping from 1 unit to none. Not home testing would freak me out completely, when introduced properly cats aren't generally bothered about tests. They have very few nerve endings in the edges of their ears (where we usually test) so it doesn't really hurt and since they get a treat after most cats end up being very keen to have their tests. It's really the only way to keep them safe.
 
To clarify, my vet has not said no to DC'ing insulin--in fact she thinks he might be a prime candidate to do so! She just has not done it before (except for two cats whose diabetes was steroid-induced) and is being cautious about how to proceed, and I get that. But, he made practically an overnight turn-around and I truly think he might be in remission or converted back to normal. One of the reasons I think this is because I was in the hospital several months ago and for about 10 days my husband was giving K his insulin. He apparently got confused (my husband, not the cat!) and thought the 1st black line on the syringe was 1 unit, not the 0 point. So for 10 days K got NO insulin! He did not miss a beat--no I do not test his BS, but as an RN I can recognize many other symptoms--peeing too much, excessive drinking, activity level, appetite, etc etc and he showed no adverse signs (ALL of which he showed to a very marked degree right before diagnosis). In addition his curve and fructosamine readings were "as those of a non diabetic cat" two weeks after cold turkey no insulin. I have read in a number of situations where just switching from the "killer" dry food to canned (I use pate not the gravied/sauce varieties) can reverse the diabetes. Why more vets don't know how bad the dry food is for cats especially is beyond me! Just wondered if anyone had, or knew of any success stories of cats converting back to normal?
 
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