How do I know which insulin is best for my cat?

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Judy and Pinkie

Judy and Pinkie

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I have a newly diagnosed rescue cat and am learning so much from this board. We are using Vetsulin with success, and my vet is aware of the problems, but apparently she feels that the batch she gave me was safe and it has been effective: glucose went down from 321 to 118 in 6 days with grain free food. I am now aware of the fact that I should just be checking Janet's chart for carbs below 10 % which make my life a lot less stressful. But I'm reading about the other types of insulin that are preferable to Vetsulin. Can someone tell me how do you choose the right one, and then where can I order it? Do I need a Rx? I work with a holisitic vet and she prescribed some pancreatic supplements, but they make Pinkie ill and she gags them up. We are using much lower doses now, and she is gaining weight and her coat is much improved. Any suggestions or information is greatly appreciated. Judy and Pinkie in WY confused_cat
 
Hi Judy. I am going to copy this thread to your own thread on the main health board. I hope it will be helpful for you to hear answers from all different insulin users.

A question for you. Are you hometesting? is that where the blood glucose you gave were from?
I ask because one isolated number over a group of days does not really fill out the whole picture. Please have a good read through of this user guide to vetulin...viewtopic.php?f=19&t=302

As to safe and not safe batches. I would encourage you to really think about a switch. Levemir and lantus have shown to be a gentle, longer lasting insulin.
Currently though, the values you have shared are not that high and therefore, if not doing so already, hometesting will allow you to see what is happening. Changing diet to a lower carb one, can dramatically reduce insulin needs, so the dose you started with, may well be too much now.

Hang in there, I will post this on health for you and leave this post here as well.
Kimmee
 
I highly recommend the L insulins - lantus or levimer.

They are available from any human pharmacy with a prescription. Here is a link to the forum so you can read about the insulins.

viewforum.php?f=9

I would suggest getting them in pens as they are smaller and will last longer than purchasing a vial. While the upfront cost may seem more, the overall cost will be less as the unopened pens will last until the expiration date and once opened, you could get several months out of one pen.

You will also need U100 syringes (recommend with 1/2 unit markings) and in many states need a script from the vet. Do not get the needles that come with the pens as they don't work well for cats and micro dosing.

And of course, if you aren't already, I highly suggest you home test.
 
If not hometesting , that would be my suggestion as a next step. You should be home testing before you change the diet to lower carb because, as Kimmee said, the insulin can drop dramatically. For Beau it was from 2.5u to 1u by the time I got rid of all the high carb food.

I too would recommend levemir or lantus over vetsulin. From the vetsulin warning I am unclear if it is a batch to batch or vial to vial inconsistency and I would just not want to take any chances with my cat. I switched Beau from vetsulin to levemir and can highly recommend it.
 
Hillary & Maui said:
I would suggest getting them in pens as they are smaller and will last longer than purchasing a vial. While the upfront cost may seem more, the overall cost will be less as the unopened pens will last until the expiration date and once opened, you could get several months out of one pen.
Click to expand...
Can you expand on the issue of cost. I just called some drugstores and found the best price on Lantus in the vial to be $103 and the solostar pen (5 3ml pens) to be $215. You pay 1.5 times the amount when buying the pen but pay twice the price.

Is the savings a result of the Lantus insulin going bad before it's all used when in the vial? I asked one drugstore the expiration date for their insulin. He checked a vial and it had an expiration date of 11/2011 (today is 05/13/10).

Which brings up a point about expiration dates. Is the insulin losing effectiveness the closer it gets to expiration? Or is the expiration date so conservative that it will be fully potent at the expiration date?

It appears that the only way to order the pens is in a package of five, 3ml pens.
 
johnny, yes, the insulin starts losing it's efficacy once opened.

so the 2011 expiration date goes out the window once you start using the vial. sooooooooo, let's say you get a vial with an expiration date of january 2011 and you get 5 pens with the same expiration date.

you start using the vial today, may 14th, 2010. about july or so there is a very good chance that the insulin stops working because it starts decaying basically, or losing it's efficacy. so now you go and spend another $103 to get another vial. repeat that about october and then again maybe the end of december or beginning of january.....all depending on how you handle the vial. roughly what 7-8 months and you're out $309

with the pens, based on my experience, i'm getting roughly 2 months out of each pen and i'm using it down to the last drop with it still working as effectively as it did when i first opened the pen. sooooooooooooo, i'll get roughly 10 months out of my pens before i have to worry about spending another $200 for pens.

make sense?
 
Ok it makes sense that anything, once opened, begins a decay process. I just surprised that it can be so quick. You're saying at 2 months the insulin has significantly decayed and loses effectiveness. As I re-read your post, the 2 months seems to be a them.

Then you've got the comment "all depending on how you handle the vial." Well, I know that I would remove the vial from the top shelf of the frig, withdraw the insulin, and immediately put the vial back into the frig. I would not agitate the insulin since it doesn't need it. Anything else I should do when handling the vial?

I read elsewhere on the forum that I should not be pulling to much insulin and than pushing the excess back into the vial because the syringes have a coating of something on the inside of their body that would contaminate the insulin. Is this really true. I would have thought the entire syringe was clean and sterile.
 
understand my comments pertain to lantus only, wanted to make sure that's clear since we're on the vetsulin forum :)

yes, technically, and when doled out to humans, they even tell people to toss it after 28 days buttttttttttt, based on experience here, people get anywhere from a month to as much as severals months out of it before it goes weak. i'm only on my second pen now and can say that we were getting numbers waaaaaay low at the very end of the first pen so clearly it didn't lose it's strength and we got almost exactly 2 months out of it.

but keep in mind, you can tell when it goes weak if you are hometesting

as far as handling it, you got it.....no shaking, no extreme heat or cold, no dropping it, etc.....

and as far as pushing excess back into the vial, lantus just seems to be a pretty fragile insulin when it comes to all this stuff. i did it with pzi vet and never had a problem but i've been watching and reading the lantus board for a couple years now i think and it seems a bit more persnickety than the other insulins about how it's handled and stuff :)
 
On the cost issue, all of the above plus the occasional dropped or broken or accidentally spoiled vial quickly makes the smaller vials a better deal for cats.

On the "which insulin is better?" question, people and vets will argue endlessly about what 'better' is, but once you're testing your cat's blood sugar at home a couple times a day, and doing occasional 'curves' on the weekend, you will absolutely know what you want.

What you want is an insulin that keeps your cat's blood sugar safely low (between, say, 80 and 180) all day long, from shot to shot. This will not be true at first, and likely never true with Vetsulin since it has such a huge effect in the first 4-5 hours, and very little after that. But don't take my word for it. Every cat is different, and your cat might be getting exactly what she needs.

Check the blood sugar, make a chart of it, and ask again in a week or two. And you will KNOW.
 
I need to get something straight in my head about figuring out what the starting dose of Tahoe will be on the Lantus. Currently she gets 8.8 units of u40 vetsulin 2xdaily. Since Lantus is a U100 insulin it is 2.5 times as concentrated. Does that mean I would give her 8.8/2.5 units of insulin which works out to 3.5 units per dose?

I realize this is just a starting dose and that with Lantus she may need less, she may need more, but it's a starting dose.
 
to be honest, you'd be better off asking that question in the lantus insulin support group since they know lantus there in out up down and backwards :)

i do just have to say though that wow! is that a hefty dose of vetsulin or what. :)
 
Technically, no -- the 'units' should have the same amount of insulin in them, since a unit measures insulin content, not volume of liquid. You would use 8.8 units of the more concentrated liquid, which should be a smaller shot but will still look like 8.8 units on the proper syringe.

Now practically speaking, the likelihood that you'll need that much Lantus every day is pretty low. If you're not hometesting yet, the likelihood that you needed that much Vetsulin was pretty low too. You really can't tell.

In your position I'd start hometesting (frequently) and do a few curves with the Vetsulin, especially checking frequently during the first 5 hours, on my current dose. Then ask the Lantus people how to begin dosing Lantus.
 
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