Hello! New diagnosis and expensive vet quotes!

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Bohdi

Bohdi

Member Since 2021
Good evening! Today our family found out that our off-the-street rescue has diabetes. We love him so very much so we were horrified to learn that our vet recommended "expensive, life-long treatment or euthanasia". My husband is currently on unemployment and I am undergoing chemotherapy and on disability. We are incredibly tight in cash and the prices the vet is quoting scared us! Almost 1000$ for a urinalysis, insulin set up, specialized food, CBC, and fructosamine. If it wasn't for this forum we would have given up in defeat!
We are determined to help our baby and have committed to purchasing insulin, syringes and low carb food (we got a box of Shiba as our grocery was slim pickings). My mother has offered us her diabetes test supplies as she is in remission and we are ready to fight for our little guy!

I just have a few questions:
Why is the vet charging us for a urinalysis straight from the bladder? Half of our huge bill is that and the food/syringes.
Can we just start giving him the insulin rather than wait for another vet appointment? They recommended monthly visits at almost 400$/mo (not including insulin costs). Could I reasonably test and adjust dosage from home or are the in office visits at the beginning essential?

Thank you all in advance for your support and advice! If it weren't for this forum we would be having an incredibly grim weekend.

Bohdi's results:
RDW: 30.8%
GLU: 578
CA: 11.7
TP: 9.6
GLOB: 5.6
ALT: 250

Everything else was in normal range
CHOL: 243
 
Bohdi said:
Can we just start giving him the insulin rather than wait for another vet appointment? They recommended monthly visits at almost 400$/mo (not including insulin costs). Could I reasonably test and adjust dosage from home or are the in office visits at the beginning essential?
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Once I got my script for Lantus (and got it filled at a Canadian pharmacy where it's 1/3 to 1/2 the price), I never took my China back to the vet for her diabetes. I home tested using the Relion Prime meter from WalMart ($9) and strips ($17.88/100). A box of lancets is from about $2-$12 depending on brand. Most of us freehand the lancet so don't buy a lancet device unless you really want one.

Depending on the type of insulin you're using, you may be able to get 100, U100 insulin syringes for $12.58 at WalMart (and they have half unit marks which is important for the smaller doses we use on our cats) The Relion 3/10ml, 30 or 31 gauge insulin syringes for U100 insulin all have the half unit marks.

If the insulin you end up using is a U40 insulin, you can get U40 insulin syringes with half unit marks HERE

If there are no ketones present, you can start with just doing the diet change (Fancy Feast Classics, Friskies pates, 9-Lives ground, Sheba are all low carb...you do NOT need "prescription" food) and learn to home test. By testing at home, you'll get more accurate results than when your cat is stressed out at the vet (which can raise the blood glucose up to 200 points)

Bohdi said:
Why is the vet charging us for a urinalysis straight from the bladder? Half of our huge bill is that and the food/syringes.
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Do they think there's a urinary tract infection? That's the only reason for needing a sterile urine sample to do a culture and sensitivity.

If you're low income, you can also contact DCIN (Diabetic Cats In Need). We're a charity that helps low income caregivers with the costs involved with treatment of their sugarcats instead of having to euthanize or surrender to a shelter due to finances. If you have Facebook, you can message DCIN. If you don't have Facebook, you can go to our website.

You can do this for a lot less than your vet is saying. I'm on SSI and was still able to care for my China for over 5 1/2 years by feeding Fancy Feast Classics or Friskies pates, buying Lantus from Canada and syringes/lancets/testing supplies from WalMart.
 
Bohdi said:
...our vet recommended "expensive, life-long treatment or euthanasia". ....
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Wow! What a pessimistic outlook! Our experience has been just the opposite. Of course, every cat is different, but my Lola was on insulin for only 5 weeks before going into remission. And I wonder whether she would have needed insulin at all if I had started with the diet change to low carb food first?

You've 1) committed to helping your cat, 2) started the transition to low carb food, 3) committed to testing him at home to keep him safe, 4) sourced the testing supplies, and 5) found the Forum. That's just so, so excellent! You're already well on your way on the diabetes journey.

However, if you're in the US you'll still need a vet because the insulin (and likely the syringes, depending on where you live) will require a prescription. Not all vets are willing to provide prescriptions so you can source those two necessities more cheaply elsewhere, so you may be stuck with your current vet (but I know I'd be shopping around for a new vet if mine had suggested euthanasia at the time of diagnosis). Some vets are also completely opposed to home testing ("it's not necessary," "your cat will hate you"). It would really be helpful if you had a vet who was more of a partner and advocate in the process.

Many months ago, while Lola was still on insulin, I ran the cost numbers and detailed them in a (very) (long-winded) post here. Here's the executive summary:

"So if I buy my bare necessity supplies (insulin & syringes) from the vet it costs $1.63 per day to treat Lola's diabetes, and it would cost $0.93 per day if I bought supplies online."​

Did your vet happen to mention what kind of insulin? I ask because it seems many of the "old school" vets are only familiar with Vetsulin/Caninsulin. As the name suggests, that insulin was developed for dogs - which metabolize insulin quite differently from cats. There are much better insulins available for cats, like ProZinc and Lantus. (AAHA Guidelines)

Finally, the $400/mo vet visits? They won't be necessary because you'll already have all that information and you'll have the dosing guidelines here. In fact, your data will be better that any obtained by the vet because it will not be influenced by vet stress. (Lola, during her first (and only) in-clinic curve read so high that their testing equipment couldn't measure it (!!) -- and she was off insulin completely only weeks later.)

Thank you for looking beyond your vet's gloomy assessments. My first diabetic was a street stray and he was the cats of all cats as far as I'm concerned. That was 20 years ago, and I didn't do any home testing then, but he went on to live another 10 years on insulin before passing away at age ~18. Feline diabetes is NOT a death sentence.

Enid
 
The information above is completely on target. The vet is likely proposing you bring your cat in for monthly curves. This involves a day at the vet's office where they are likely charging you for testing every 2 hours along with boarding. It's completely unnecessary if you are home testing. In addition, most cats experience "vet stress" when at the vet's office and their numbers are higher than what you would find at home. As a result, the vet suggests doses that are too large.

Getting blood work can be helpful to rule out an infection. Any infection or inflammation can cause elevated glucose levels. It's helpful to rule that out.

I haven't a clue why the vet is suggesting a cystocentesis (sterile urine draw) unless, like Chris said, there is a chance your kitty has a UTI. You can test for ketones at home. (You get urine ketone strips -- Ketostix -- at any pharmacy.) You just have to stalk you cat to the litter box. If you are going to have labs done, they can test for blood ketones (or they could have offered to do that test in the office since it requires a meter that's very similar to how your test for blood glucose).

Lantus and Prozinc are among the more expensive insulin. As Chris mentioned, many people here purchase Lantus from Mark's Marine Pharmacy in Canada. A box of 5 Lantus pens runs about $500 here. It's about 1/3 of the price from Marks. Depending on how much insulin your cat will need, one pen can last roughly 3 months.

If you've not done so already, you'll want to switch your cat to a low carbohydrate, canned food diet. You do NOT need to use a prescription, diabetes diet. In fact, if the vet tries to sell you the prescription brand, especially if it's dry food, it's far too high in carbs to be given to a diabetic. (It's like a human eating cookies!) Many people here use Fancy Feast or Friskies which both have low carb options and are economical. This is a list of foods along with information on their carb amounts. You want to stick with foods that are under 10% carb.

Bottom line -- you do not need food, a pet-specific meter (the strips cost a fortune), or syringes from your vet. Some vets sell Prozinc or Vetsulin. If the vet is trying to sell you any other insulin, you can't get it at a human pharmacy. Novolin/Humulin N is among the less expensive of the insulins available. It is not the best for cats but it's feasible.
 
Semglee insulin is a generic Glargine (Lantus) insulin that was only approved by the FDA last June. It costs less than real Lantus from Canada.
https://www.goodrx.com/semglee
I do all my BG tests and curves at home with a human meter and the change the dose myself. You can post the results of BG tests of your cat in this forum and wee can help you determine if dose can be changed.

The blood test results you post are not that bad.The out of spec values could be due to the uncontrolled diabetes. For example the high TP (total protein) is very likely due to dehydration caused by high urination caused by the diabetes.
 
Life-long treatment or euthanasia, your vet has a way with words, all negative. The following is not medical advice.
To be truthful both our sugar cats were low maintenance and neither one ran off to the basement at shot time. Their "life long treatment" involved 20 minutes both in the morning and at night. Some people take longer than that picking out the shoes they'll wear that day. I know it seems like a tragedy now, it did for us for 24 hours, then we did what we had to do and diabetes had nothing to do with either cat's demise.
You don't need to buy insulin, syringes or your meter from an "approved source". This is generally a scam perpetuated by vets who are either anal or greedy. In time this will become an inconvenience and not a liver transplant.
If you're as lucky as we were with our first cat we laid out a beach towel on the kitchen table, I gave the table a thump and Nigel would jump up. He knew it would hurt but he trusted us. Our second cat was a nervous wreck so I laid out everything in front of him, cleared the other cats from the room and we were done in minutes.
You can stop crying now and know you're in the right place. We've all been there but now you're among friends including Bohdi.
 
Thank you all so much for the amazing advice! I was really hoping to go to Walmart and grab a vial of insulin while we were shopping today but if I need a prescription for the insulin then I will certainly go back to my vet with many questions and much scrutiny!! It was actually his statement about expensive treatment or euthanasia that really upset me! Our baby is only 3 and he came to OUR doorstep for protection. I would never consider putting him down for something that was so treatable!
 
As with many things in life, there is the high cost version and the more realistic cost version. Vets (or most MDs for that matter) are often clueless about the costs or how to manage treatment more modestly. Just one example is what you feed your cat. The vets will often recommend a "prescription" diabetes diet. For the cost of the Rx food, you could be feeding your cat a human grade cat food that is of far better quality and lower in carbohydrates that the food the vet wants to sell you. Many people here give their cat Fancy Feast or Friskies which is better quality than many of the Rx foods and far less expensive. (And there's nothing that is "prescription" in the prescription food.)

Euthanizing a 3yo cat for a treatable condition is sad. You may want to ask your vet how many diabetic cats he's treated.
 
Bohdi said:
Thank you all so much for the amazing advice! I was really hoping to go to Walmart and grab a vial of insulin while we were shopping today but if I need a prescription for the insulin then I will certainly go back to my vet with many questions and much scrutiny!! It was actually his statement about expensive treatment or euthanasia that really upset me! Our baby is only 3 and he came to OUR doorstep for protection. I would never consider putting him down for something that was so treatable!
Click to expand...

Since you're already transitioning him to a low carb diet you are already helping Bohdi tremendously. Since his BG (blood glucose) readings are likely dropping as a result of the diet change, so may his need for insulin. Therefore it would be best that you wait until he is fully transitioned to the low carb diet before starting the insulin (so you don't accidentally overdose him). (A transition to low carb diet by a cat already on insulin can and should certainly be done, but it has to be done slowly and carefully, with lots of testing.) You can use this time to procure the insulin. (FYI, I've read that it is possible to buy certain kinds of insulin from Walmart without a prescription, but that they are NOT recommended for cats because they are harsh, fast-acting, and have a short duration. Personally, I'd hold out for a better insulin even if it takes longer to get it.)

Now you need to get your spreadsheet set up: 1) so you can document his readings and see for yourself how his numbers are improving on the low carb diet, and 2) because no one here can give you dosing advice without seeing the data on which to base an analysis.

All the spreadsheet setup instructions can be found here:
Spreadsheets, Tech Support & Testing Area

Please also set up your "signature." That provides everyone with pertinent information at a glance. You set it up in your Profile.
Editing your Signature, Profile, and Preferences

Have you been able to get your first reading yet? This Index "sticky" links to some valuable shortcuts, including home-testing tips.

It's certainly a fair a amount of work initially as you get set up and learn the ropes, but it does get easier.

Enid
 
Once I started testing my cat at home she didn't go back to the vet for a year. Skip the perscription food. Most people are feeding fancy feast classic or Friskies pate foods.

So glad you found us!!!!
 
Bohdi said:
Thank you all so much for the amazing advice! I was really hoping to go to Walmart and grab a vial of insulin while we were shopping today but if I need a prescription for the insulin then I will certainly go back to my vet with many questions and much scrutiny!! It was actually his statement about expensive treatment or euthanasia that really upset me! Our baby is only 3 and he came to OUR doorstep for protection. I would never consider putting him down for something that was so treatable!
Click to expand...
It's very treatable and they can live long healthy lives with it. Don't get the cheap insulin from Walmart (Novolin). Instead get a perscription for ProZinc or lantus. Lantus is expensive at the vet but some have lucked out getting it cheap at a pharmacy with a perscription card like GoodRx. Many hear but it from Marks Marine pharmacy in Canada (they ship to the US). ProZinc is affordable ($104) through chewy.com. Vials last about 5-6 months of kept in the refrigerator.
 
Semglee is a generic glargine (Lantus) insulin that was approved by the FDA last June. With GoodRx oine can get five, 300 ml pens for about $170.
JanetNJ said:
Lantus is expensive at the vet but some have lucked out getting it cheap at a pharmacy with a perscription card like GoodRx.
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For Lantus, the GoodRx coupon has restriction include:

This discount has some eligibility requirements. Please review below.
Learn more


I agree to the following statements:

  • I am not filling a prescription for a pet
 
The vet has recommended Vetsulin and I want to request the Lantus prescription from him. What's the best way to go about that?

We got some good testing in today he's hovering at the low 300s we started the spreadsheet and I'll be get my signature up and going once I'm in front of a computer again!
 
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