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SonnyB

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Hello. I'm Terri, and my sweet Sonny was just diagnosed today. He will spend tomorrow at our vet's to try to get regulated and come home in the afternoon. May need to go back on Saturday though. His reading today was 559. Yeah, I typed that right. He was diagnosed 6 weeks ago with mild hyperthyroid which is now controlled.

Diabetes is a new one for us. We have 2 angel cats who we battled hyperthyroid with, and 2 angels who left us from CRF and old age. Our babies usually live until at least 17. I'm not certain exactly how old Sonny is...he was my mom's cat, and mom passed over 6 years ago...I know she had him at least 8 years, but it may have been as many as 12 or 14. We rescued him from a bad situation with my former stepdad 4 years ago and he's so wonderful. If we'd only known, we'd have brought him home with us immediately after she died.

He's a good boy. Was very good during his blood draw. The vet is giong to start him on humulin in the morning.
 
Hello,
I am new this week as well. This place is amazing. I wish I had found it years ago. So much support and information.
If you have not learned to hometest yet I suggest starting, it will help you to stay on top of the numbers. I prefer the Alpha Trak. It is expensive but its most convenient for us because our vets use it too.
Also I learned the hard way that the prescription diets are not the highest protein/lowest carb diets available.
I wish you both the best :)
 
Hi. And thanks. Our vet is not a fan of any of the prescription diets. He called this evening with the bloodwork, and I drop him off first thing in the am. He said not to change his diet, for now. Sonny likes his crunchies, so I imagine we'll need to start limiting the dry, but maybe offer additional wet. We have 3 cats who we feed together, and they get 2 cans (small, usually pouches or Meow Mix or Fancy Feast) a day. We'll probably increase that.

Thanks again.
 
Hello and welcome both of you to the best place to be for your FD friend.

I would love to share with you just a little bit of what I have learned. My cat, Baxter was DX in Nov. He is on ProZinc so I can't give you info on the insulin you are going to use. Please visit the Humulin board. There will be user there that can give advice.

Ok a few important things...

Diet-Diet is plays a very important role in FD. A diet that consist of low carb/high protein is important. Canned food is low carb. Dry food is high carb. If you are currently feeding dry food I would switch to canned food that has less then 10 carbs. Here is a list of canned food to help http://binkyspage.tripod.com/CanFoodNew.html
The sooner you get him off of dry food the quicker you will see lower BG #s. Some see a 100 bg drop. It can also increase your chances for remission.

Home testing-Home testing is very important as well. It will help you know where are cats BG is & how much insulin to adminster. It can also, help with prevention in hypogluciama or during a hypo situtation. It is hard for a cat to get regulated at a vets office because it's hard to get accurate BG #s do to the stress it puts on a cat. Stress drives BG #s up. You are better of saving your money & doing your own BG curve & calling the vet with results. I am not sure how the vet will regulate your cat in one afternoon. Some cats never get regulated.
I would ask your vet if he supports you home testing. If he doesn't or gives a you answer similar to...you don't need to home test. Please consider finding a new vet. Home testing is so important. You don't need a expensive meter. Many on the board use the Relion from Walmart. The test strips are less expensive & require a very small amount of blood for the reading. You will go through a lot of test strips especially in the beginning.

Everything seems very overwhelming right now. I know it seems like so much stuff to learn. So many do's & don'ts. Everything will be okay. Everyone is here to help each other. All you have to do is ask question.

One more thing when you get a chance please read this www.catinfo.org. It helped me so much when I was new.

Jenn & Baxter
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Thanks for the information. We free-feed dry and give wet food twice a day. Right now, our vet doesn't want to change anything because then he'd be adjusting to insulin and food changes. He doesn't expect to get him fully regulated in one day - he said he may spend several days (but come home at night, most likely, because we live right across the street and would certainly call him if something happened like he appeared to be going hypo) and, he told us that while some cats do fine on humulin, some don't. The crisis right now is getting him out of the 550 range, and he said that they need to give the insulin, see how he responds, and then experiment to find an appropriate dose. He'll probably be back there tomorrow for a few hours, then next week. Our vet is typically very pro-doing things at home, provided the owners are able. For example, with our CRF boys, we did sub-Q's at home because I have no problem doing it, don't get squeamish, etc...but he has patients who come in every day or so to get them done in office. He said he doesn't care, as long as the pet gets what they need, so I'm sure he'll support home testing. My husband has borderline diabetes, so we'll probably just use his meter. He's not on insulin, so that will be new.

Hoping the humulin works because our vet told us that right now the only supplier of the beef insulin he knows of is a compounding pharmacy in Texas, and it costs 4X what the humulin is supposed to. He told us we can get the humulin at Walmart for $25 without a prescription. It surprised me that you don't need a prescription!
 
Good morning and welcome!

Grayson initially tested at 451. At Kim's (from this board) suggestion, rather than jump into the insulin, we took about 1.5 weeks and I did the food change to Fancy Feast Classics... and started testing. You'll read here that food can make as much as 100 point change. Mine was even more: initially 360, 381...then 277 - BEFORE starting insulin!!! Grayson would find crumbs around the free-feeding plates of his siblings and sneak them... and his numbers climbed. It was amazing how much impact the kibble had on him!

You'll find wisdom here... if you can do the food change first, it will probably be easier, but if you start with the insuilin, be sure to take the advise of folks here on how to transition him. Good luck and keep us posted on his progress!

Lu-Ann
 
Great news your vet is very pro about doing things at home.

If I could go back & change one thing after Baxter being DX it would be to change his diet 1st for 1 week then start insulin. When using insulin you want to give at true numbers, not inflated do to eating or food.
When changing to canned found you are going to need to transition & adjust insulin. It seems to be easier to change food then adjust insulin after food change. BG #s might not change much if you still feed high carb food.

I would really change diet first to see how much his #s drop. I am not a vet though.

Also, make sure you get a price on how much it's going to cost for him to stay at the vet to get regulated. WARNING.....it could be sticker shock. You can try to regulate at home with your own meter. You would get more realistic numbers.

Keep us updated.
Jenn & Baxter
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Hi Terri,

I would just like to speak about insulin choices for cats. Humulin N (the type of Humulin I assume your vet will use) and PZI (the compounded insulin he mentioned) are not the only choices of insulin for cats. Please see the AAHA guidelines for diabetic cat and dog care. You may want to share it with your vet. Lantus has a much better remission rate. There is also ProZinc, which many vets now use, also a beef type insulin.

http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

Cost of insulin is a factor of course, but if there's a possibility of a more expensive insulin helping Sonny to remission, it is worth the extra cost. Of course remission is not guaranteed with any insulin, but Lantus offers the best chance for newly diagnosed cats in our experience. There is a particular protocol we can help you with, it is found here:

http://www.tillydiabetes.net/en_6_protocol2.htm
 
one thing for sure.... you are going to waste alot of money having your cat at the vet to be 'regulated' as it's not going to happen there, and especially on any Humulin insulin. nope.
The stress on the cat by being at the vet will skew the numbers, so they are basically useless.
One of my cats is always higher BG at the vet, and the other one is lower. Weird, but that's how they are. Once we are home, they return to their true 'home sweet home' BG numbers.

if you had not started on any insulin, it would be the perfect time to make the food switch to ALL wet low carb food..... several cats are DIET CONTROLLED and after the food change, they don't need any insulin!

not sure where you are, but there are lists of good foods that are low carb you can try.

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

I also feed my cats all dry food before their diagnosis. I didn't know how bad it was either.
I have one diabetic cat who can't eat even a few pieces of dry food or her BG soars very high.
Lots of people feed fancy feast or friskies wet pate flavors, no gravy ones or grilled ones as they are much higher carb.

Home testing is simple and it's the best way to know how your cat is doing, even if on no insulin.
Testing on cat’s ear
... and it's way cheaper and easier on your cat than being stuck at a strange vet office.

I much prefer Levemir, but Lantus is good as well. They are very good long lasting insulins.
Another insulin that is almost as long lasting is PZI from the vet, but I have no experience with this type as I prefer to get my insulin and supplies from the pharmacy, whereas PZI and syringes are usually obtained from the vet.... if their office is closed and you run out of something.... oh oh. That's why I prefer the stuff I can get from any pharmacy.

Once you are home testing, you will see quickly that the humulin insulin is not lasting anywhere near the 12hrs, and you will see lots of ups and downs in the BG numbers which is pretty harsh on the cat's body and system. Your vet may say that humulin and PZI are the only choices but not true.... they are the only choices of insulins that you can get from the vet, but the human insulins Lantus and Levemir are better I think and will get you a healthier cat, and maybe even off insulin altogether which will not happen with humulin.
 
Welcome Terri!

Unfortunately, your cat is not going to get regulated at the vet. Just like human diabetics, it takes time, monitoring, and dose adjustments in order to regulate a cat, and this can only be done at home. Cat's blood sugar rises at the vet's office and makes vet testing unreliable. More often than not, a cat will come home from the vet overdosed, and once their blood sugar lowers they are at risk for hypoglycemia. When dealing with insulin, you should ALWAYS err on the side of a too high number vs. a too low number. High numbers may seem scary, but they can be dealt with patiently, over time. They aren't going to kill your cat tomorrow. However, a too low number can kill in a second. This is very important to remember.

As others have mentioned, While Humulin N is good insulin for people and dogs, it is not a good insulin for cats. It is very harsh and has a short duration of action. Cats' metabolisms are twice as fast as dogs and humans, so the insulin is only working to lower blood glucose for about 4-6 hours for each shot. Long acting insulins like Lantus and Levemir last a full 12 hrs in a cat, which means with two shots a day, the insulin is always working to lower blood glucose. Lantus and Levemir are human insulin analogs that you can get at any local pharmacy--you just need a prescription from your vet.

However, the worse thing about Humulin N is that most cats will have steep drops into hypoglycemia. Because they reach a too-low number, their livers dump glucose into their bloodstream as a survival mechanism to counteract the low number and their blood glucose shoots up very high. This happens over and over until the cat either experiences a severe hypoglycemic incident, or deteriorates further from the constant high numbers.

Here's a link to the current AAHA guidelines: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. If you look at page 4, you'll see that the current recommended treatment are the insulins Lantus (glargine) or PZI. Levemir works the same way as Lantus, so that is ok to use as well. The current treatment guidelines also recommend home monitoring--not testing at the vet's office. You'll also see that the diet change is recommended before starting insulin--some lucky cats do not need insulin at all once switched to a low carb canned diet.

Lantus (or Levemir) have an 84% remission rate for newly diagnosed cats in conjunction with the correct diet (low carb canned food) and regulation via home testing. Your chances of remission on Humulin-N are little to none. In fact, what we usually see with Humulin-N is the cat's condition worsening. So even though the "L" insulins are pricier initially, they pay off big time. And you will save a lot of money home testing (there is no need to bring your cat to the vet at all for testing if you're monitoring at home). There is a window with the 84% remission rate--the longer you wait to start the right treatment, the smaller that window gets.

I've attached an article from a veterinary journal that discusses treatment with Lantus and the remission rates I mentioned. I strongly urge you to print out that article and the AAHA guidelines and bring them to your vet, if you like him and think he is receptive to new information. If he's not, you may need to find a new vet. I've found that most vets are open to learning new things as long as you bring them the studies--Vets are general practitioners and must deal with many animals and many diseases, so they can't always stay current with every disease for every animal.
 

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Thank you for the comments. I have to admit, I am a little disappointed at the immediate response that out vet is going to gouge us for keeping him there. He's doing what he has to in order to monitor a cat whose level is deadly at the moment. Assuming he gets it down enough to come home, which he believes he should be able to, we will pick him up when they close. We might need to drop him off again in the morning, but yes, the plan is to change his diet and monitor at home - just not when he's up near 600, and not the first time in his life when he receives a drug that could elicit a poor reaction.

At the moment, we are not in a position to do anything besides humulin. When our tax refund comes, hopefully in a week or so, we may be able to try Lantus or something else. He said in his experience, the humulin will typically work to get them out of critical levels, but may not work for real regulation in about 50% of his patients. Hopefully Sonny will be in the 50% it will work for. If not, once he is stabilized, yes...we will try to find a way to pay for the more expensive insulin. Not an easy task when you've been out of work for over 5 years.

I do appreciate the input, but not all vets are out to get you. Ours has stayed after-hours so my husband could be with us when we had to say goodbye to our almost 19-year-old, has offered to come in on his day off when our late CRF cat was doing poorly, and when we had two critical cats (who wound up passing 10 days apart) handed over his cell number and told us to call anytime. Our previous vet was a gouger, so I get that...but not all of them are.
 
I'm sure their intentions are good. But his levels could be significantly elevated because of the stress, and they're probably feeding him some kind of high carb Hills food that will keep him up there. With what you are going to pay at the vet, you could have spent it on the expensive Lantus, glucometer, ketostix, and everything you would need to care for him at home. And that way, he would have been off to a proper start. My vet office charges $20 for a single BG sample - 3 of those and I can get a meter, 50 strips, and some lancets. He might be there for a while... Insulin doesn't just work instantly. Cats don't just get regulated overnight. Scooter has been on Lantus for over a month and he still is often over the renal threshold and at risk for DKA. And their numbers can bounce all over the place when they start getting it. Especially with unsuitable insulins like Humulin N. Back then, there were no other choices - but now there are quite a few.

I don't know personally how switching insulins go, but I would assume that switching from N to glargine could see his BG levels elevated again for a brief period of time because of the way Lantus works. The sooner you can start it, the better. There is financial support available out there, too. Me and my SO are low income as well. Scooter is a DCIN sponsored cat and they cover his Lantus prescription, testing strips, and lancets. The only thing I pay for is the syringes. It is a huge weight off my shoulders and I wouldn't be able to do this without them.
 
Hi,
Just wanted to share my initial experience as a newbie. My 17 year old was diagnosed in late November. Her initial reading at the vet was over 500. After first switching her to canned only food for 4 days, her first reading before starting insulin was in the mid 300's, so I think it's true that vet readings can be higher because of stress. She's not a picky eater, so the food part wasn't hard. I started her on 2U of Lantus twice a day per the vets advice, but that turned out to be too high. The nice thing about Lantus was that even though I was overdosing her for a couple of weeks, she never went hypo (thank goodness). Before I found this site, I was only testing her once a day, every other day. It took me about a month to find the right dose for her, but now she's been well regulated for over a month. I only have one other cat in the house, a 10 month old picky eater, so the food has been relatively easy. I just picked up 3 or 4 cans on different food on Binky's list for trial an error to find something both cats would eat to make it more convenient for me. We've settled on 4 or 5 flavors they like. I haven't tested nearly as much as a lot of people do, but after having a consistent feeding/dosing schedule, things seem to be pretty smooth. It was totally nerve-racking for the first couple of weeks, and I'm sure the bigger your family is the harder, but it's definitely doable. It takes time to achieve regulation, but I think consitency is key. Best of luck to you.
 
Is your cat in diabetic ketoacidosis? If he's not, then 587 is by no means a deadly number. If there are no ketones present, then the situation is not life threatening by any means. You have plenty of time, as long as you are testing for ketones at home, to enact a diet change. Ketoacidosis is a different story, and requires hospitalization.

It's much easier to enact the diet change (as recommended in the AAHA guidelines) before you try to regulate the cat. Think of it in human terms--would a doctor tell a type 2 diabetic to continue eating McDonald's food every meal and try and counteract the high numbers caused by the food with a higher dose of insulin? Or would he send him home with a new diet, have him monitor to see how much his blood sugar drops from the diet change, and then start insulin therapy?

I am not trying to bash your vet--I'm sure he believes he is doing the best thing for your cat and is not trying to simply get money out of you. He just seems outdated in his treatment plan--and unfortunately it's a plan that's been proven not to work well. This is very, very common--we see new people here every day in the same situation. You simply aren't going to get a cat regulated on N at the vet's office for the reasons explained earlier. We don't want you to leave your vet if he's a great vet--we simply want to educate you both so you can start the right treatment immediately. As I mentioned earlier (and is shown by the article I attached to my previous post), the odds of remission are incredibly high if it's started right away.

PLEASE examine the documents I provided for you, and bring them to your vet. He sounds like a good vet who just needs to be updated. These are articles from peer-reviewed scholarly journals, not random stuff from the internet. You can also educate yourself so you feel confident discussing treatment with him--the wikipedia page on feline diabetes is a good place to start: http://en.wikipedia.org/wiki/Feline_diabetes#Treatment

As Ry mentioned, there are places you can go for assistance to get you on the right treatment path: http://fdmb-cin.blogspot.com/p/education.html. My cat is currently in remission (my vet started us on Lantus, canned food, and had us home testing from the start), but I am currently helping a friend out whose vet had her cat on the same treatment plan--Humulin N, no home monitoring, and prescription dry food. 6 months later she got a hold of me for advice because her cat was doing so much worse-the poor thing was literally on death's door and had neuropathy so bad he couldn't walk. The vet had him on 6 units of Humulin N, and he was in a state of constant rebound. I convinced her to start testing at home (she picked up a meter from Walmart), switched to Lantus, and got rid of all the dry food. This was in November. Her cat is improving leaps and bounds every day--he may not ever reach remission because the correct treatment was started so late, but he can walk again, and he's active and healthy, and she is incredibly grateful that he is still alive.
 
In reference to my early comment....by no means was I insinuating that your vet was going to gouge you. Sorry you misunderstood my reply. Simply what I was trying to say is that all the blood work test done at the vet adds up. Many newbies are unaware of all the cost & fees invovled. Therefor are shocked when they pick up their cat & there bill is $300 & charged $20 for a BG test that could be done at home.

You are correct not all vets are out to get their clients. My vet is great! I have is cell phone number with the invitation to call any time. He calls to follow up on Baxter. He has stayed late for me to talk about Baxters health. He also gives me a discount on ALL work done (I am blessed that money is not a real issue for me). Here is the kicker...all the services he does aren't free. He is a vet..NOT a feline specialist in feline diabetes.

Everyone on the FDMD speaks from hands on experience & many hours individual research. We are all here for one reason....to help our own sugar cats or to help someone else's sugar cat. We have been brought to this extremely special place because ALL of our cats are diabetic or diet controlled diabetic. There are vets who visit the board. There happens to be one extremely special vet here....Dr. Lisa Pierson. She has wrote books, & has her own website. I really hope you will take some time & visit her site. It has very knowledgable information. It will help you understand FD a little more & understand where some of our replies come from if they aren't from our own experience. www.catinfo.org.

Also, please visit this thread it is EXTREMLY important. Print it out & keep it in a safe place. It takes only one shot of to much insulin to kill your furry best friend no matter the BG #. Once the insulin is in there is NO getting it out.
viewtopic.php?f=28&t=15887
http://felinediabetes.com/start-low-go-slow.htm

I wish you the best of luck. Please keep us updated.
Jenn & Baxter
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Hi and welcome to the board.

I have to agree with others. Simply put, regulation of feline diabetes takes weeks, sometimes months, to achieve. It cannot be done in a day, especially in a day at the vet's. Those very high readings the vet is seeing could well be affected by stress. In many, probably the majority of cats, stress raises BG levels. The vet's office is a stressful place even for the most laid-back cat. Therefore, the numbers the vet is getting are very likely inflated by stress. BG curves do NOT need to be done at the vet's. My cat has never had one done there since he was diagnosed in November, and his numbers are getting better every week.

The danger of this is very serious. It's likely that the cat will get a higher dose of insulin at the vet than will be necessary at home. And while it's true that a very high BG is very damaging over time, especially if the cat is prone to ketones, hypoglycemia is immediately life-threatening.

Definitely talk to your vet about the type of insulin. Many vets won't even prescribe Humulin anymore as it is no longer recommended for cats. It can be useful in a hospital situation, but is not considered appropriate for long-term regulation. AS has been said, there is a protocol for Lantus that has proven to have an exceptional remission rate if it is started right away.

Home testing of BG is critical. Nobody would even think of giving insulin to a human without blood testing often, so giving it to a cat without doing the same is a very dangerous notion. In cats, hypo symptoms may not show until the level is critically low. Most of us use human meters (you want to avoid Freestyle meters as they are notorious for reading way low at higher BG levels and the ones with "true" in the name. Many of use the Relion Micro or Confirm from Walmart, as the test strips are relatively inexpensive. You do NOT need an expensive veterinary meter! Most of us don't use them. You CAN use one, but you will need to be aware that dangerous hypo numbers will be different (80 vs. 50 on a human meter)

Finally, diet. While your vet is partially correct in that rx foods are unecessary and that a diet change WILL change the insulin requirements, he is wrong not to suggest an immediate diet change to low carb, wet food. Some cats cen become diet-controlled simply by switching food; my own cat's BG levels dropped by over 100 from the food change alone. That means he needs less insulin to achieve regulation and has less chance of having a hypo episode from too much insulin. Here's a link that explains diet: http://catinfo.org/?link=felinediabetes You can print it out and give it to your vet. It includes a link to a chart that shows the carb content of many commercial wet foods, and tips on transitioning dry addicts to wet. The info on the can is NOT accurate for figuring 5 of calories from carbs. Perhaps you can start a low-carb wet diet at the same time you change to a better insulin, starting with a lower dose.

It's not necessarily that your vet is trying to gouge you, but they may well not be up-to-date with current protocols for diabetes in cats. your vet's methods are outdated. Vets don't get a lot of training on diabetes in vet school, and what they learned years ago has been replaced by methods that have been proven more effective and safer.
 
I just want to chime in and say that my cat was diagnosed in mid-Dec. and he's still not regulated. My vet is a great guy, but he recommended we start with Humulin N at 2.5 units 2 times per day and to not change his diet (same as yours did). This was a disaster!!! Finally, after changing his diet, changing insulin, and learning to home test I am closing in on the right dose to regulate my kitty. It's been hard and overwhelming, but I can't tell you how much of a relief it is to have learned all the wonderful things people on this board have helped me to learn. I feel so much more in control of my kitties health and of my pocket book! Vet curves are expensive and not very helpful with a stressed out kitty. And hypoglycemia is a real danger!

My kitty is doing okay after three hypoglycemia events and now drastic reductions in his insulin. I am now microdosing 0.25 units of Lantus insulin (ten times less insulin than my vet prescibed). I believe my kitty would have died if I had done what my vet told me to do. I really wish I had found this board the first day of diagnosis instead of five weeks in. I would have done a lot differently and I things would have been a lot smoother I believe.

Good luck! And welcome. I hope you learn as much as I have.
Heidi
 
Hi & Welcome!

When Racci was first diagnosed, she had a vet that I liked very much and was very nice also but he readily admitted that he hadn't had many feline diabetics. He kept Racci for a few hours one day to run tests and then had me bring her back another day to do the same. He started her on PZI, which is a good insulin but not for Racci & at a low dose, 1U. Racci was about 17 lbs at the time and a dry food junkie who thought wet food was nauseating. My other cat, the healthy one, loved wet food, naturally. Needless to say it did next to nothing for her, but we were moving and he was willing to learn with me. I found this site, convinced him I needed to home test, taught him how it was done, and he agreed. We raised the dose, she did a little better. Than I moved.

Luckily, I found a cat specialist vet here. She raised her dose a few times, when I just couldn't get her switched over to wet food. Racci would starve for days rather than eat it. The vet said to try the Purina DM and see if she liked it. She loved it. I tried switching her to a better quality, no luck. Finally the vet said to leave her alone for a while and lets just change her to Lantus because its safer and better and raise her to where she has to be with the dry food. We did and Racci finally became regulated!!!!! This is just in the past few months after all this time that she has gotten to the point where I felt safe saying that.

I started switching her to wet food and this time she would eat it! She immediately dropped her blood glucose and I started lowering her dose. She is on a lower dose now, she was getting 4.5u-5u and now she's getting 3u-4u but usually 3.5. That's a tremendous drop! She's a big cat, almost 20 lbs and that makes a difference too. Right now she's sick with an infection so her bg is all messed up again but the vet told me not to worry and to feed her whatever she will eat for now and get her back on track when she's feeling better but not to increase her insulin. She likes to do a fructosamin, urine & exam every 6 months, but other than that, I take care of Racci's doses, etc unless I have a question for her at this point.

I guess what I'm trying to say is, the Lantus in my estimation is the best insulin that I have experience with and I would ask for that, but the switch should be easy for you on the food since your kitty already is eating wet food and likes it and if it's done afterwards, it's just going to be a little longer before kitty's numbers go down and not such a big deal. We all have to do what we feel is best. Just stay on the site and keep reading the material and educate yourself. Ask questions so you learn. Home testing at least 3x a day, before the am shot, at the nadir (lowest point of the day usually +6), and before the night shot, and educating yourself are the most important things you can do to help him. What's his name btw? How big is he?

Melanie & Racci
 
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