I feel like Growling at the vet!!!

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Barbara and tuffy said:
States that require script for syringes are: AL, DE, CT, Fl (Broward Co only), IL, ME, MA, NH, NJ, NY, PA, RI.
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PA law on syringes changed in late 2009. Syringes can now be purchased without a prescription in PA:
http://www.pacode.com/secure/data/049/c ... 27.18.html
(s) Sales of hypodermic needles and syringes shall be made by a pharmacist or under the direct, immediate and personal supervision of a pharmacist in accordance with the following:

(1) Hypodermic needles and syringes may be sold without a prescription.

(2) Hypodermic needles and syringes shall be kept in the prescription area of the pharmacy, as defined in § 27.1 (relating to definitions), and be accessible only by pharmacists and pharmacy personnel authorized to be in the prescription area of the pharmacy while the pharmacy is open.
 
Hi again,
You don't need a prescription to buy syringes from Hocks. I order all of mine from Hocks (I live in NY State). If you can get your vet (or any vet) to write a prescription for Lantus, you can send it to CanadaDrugsOnline and it will be much, much cheaper than in the US. I buy the Lantus cartridges (they come in a box of 5). They are less wasteful than the vial because you don't have to throw so much of the unused insulin away after the 28 or so days. CanadaDrugsOnline price for the 5-pack is around $120. This is a good 5 months worth of insulin (more, if you keep it in the fridge and are careful not to shake it). Check out this link: http://www.canadadrugsonline.com/DrugMoreInfo5636.aspx
Your order arrives in about 10 days and is well wrapped and kept cool in an insulated mailer with cold pack.

Keep up the good work. Don't worry if Pumpkin Pie's numbers are not optimal now. Lantus takes a while to settle in. It is best to start with a low dose and work up by small increments, than to start too high and run the risk of the cat being so overdosed that he has to "spill" the excess insulin into his urine and bloodstream. (This happened to me with Stu, who was started at 7 units bid. If I hadn't found this board, he would likely not have survived. In the end, it was not diabetes, but other conditions that took him from us.)

Ella & Rusty
 
DCIN is sending Joy and Pumpkin a Contour meter and strips, lancets, and syringes.

Joy, a 10ml vial of Lantus contains 1,000 units. If the insulin remains effective, your vial should be good for 500 shots at 2U/shot. That is 250 days shooting twice/day. Usually vets write insulin scripts with at least one refill. Do you not have a refill?

I haven't read this thread closely, but has anyone suggested and are you considering backing the dose down to 1U BID, to keep Pumpkin safe until you get your meter?
 
Venita, it seems as if Joy's vet dispensed the Lantus herself and did not give Joy a prescription (that's how I interpret it, in any event). I'm sending you a PM. It's great that DCIN will get those supplies to Joy.

Ella

p.s. speaking of "joy", Rusty is a joy!
 
Sorry to hear about you problems w/ the vet . You are not the first and unfortunately probably not the last either. Think about what was said about the amount of money you will save home testing w/ a human meter. It will pay for a lot of 15 mile taxi trips!

Definitely look into Hocks, they have really great prices and fast delivery. Check out the Infinity meter that they sell, I've been using the Maxima AST meter (same company but it is being replaced w/ the Infinity) these strips are the least expensive around. You can also get the half unit syringes, lancets etc. If you are being charged for "medical waste disposal" it's probably for the syringes. You can get a needle clipper that makes the syringes safe to throw in the trash.

Since you already go to Walmart for the insulin their Relion meter is very popular too. They have several styles, get the one that uses the least amount of blood.
 
What a blessing!! Thank You DCIN!!! Actually Pumpkin was given a scipt for the insulin with no refills on it.The script was for 3Units twice a day.Which I did from Tuesday night to Saturday. Then I lowered it to 2 units twice a day. He seems ok Sunday but Monday he was in bed nearly all day :( and he started drinking a little more from the bowl only one exta trip. Last night and this Morning (Tue) he was acting like a starving cat. Which I guess is good, So I'm not sure if two is ok or him. I'll wait anothor 24 hours. I am keeping the lantus in the refrig,the exp.date is 12-2011 on the bottle but I've been reading that if its kept cold. The vial reads Lantus Vial 100u/ml QTY 10 no refills Dr.must authorize.So if I'm understanding correctly this bottle will Not run out by 12-31??? It such a small vial.
 
Get a human monitor, and the test strips to go with them, and start hometesting yourself. YOU WILL see a nice difference of #'s compared to what the vet reads. Your cat gets stressed out in the vehicle, and at the vet's office. The smells, noises, etc., all stress him out. I know. I've been there. Every time we took Blackie to the vet, her #'s were very high. We brought her back home, and they relaxed a bit.

Just give the vet YOUR #'s, or print out the spreadsheet and show the vet your cat's #'s.

Btw... I've never signed anything, and you shouldn't have to, either.
 
Another thing nice about the Relion... I've been able to find a couple walmart stores that sell a 20 pack of strips for $9. Which, if you've got a week where money is tight and you just need a few to tide you over until you get your check, would be easier than having to buy a 50 pack.

I can't believe how unreasonable your vet is being. My vet was very insistent on the AT as well, and I ultimately caved, but I know they would never have gone to the extremes your vet did. Although, I also live in a major metro area with lots of other options close by.
 
If you've a library you can get to easily, you might check for books on assertive skills, negotiation, and diplomacy. These may give you some ideas on how to handle the vet if you continue to go there. No, you shouldn't need to do this, but the vet isn't likely to change, so maybe changing the approach to the vet will help. Maybe not. You won't know until you experiment with the ideas. You'll want to practice techniques in a non-important arena before doing them with the vet.

Specific books I can recommend:

"Tongue Fu" by Sam Horn - she has a wonderful sense of humor and believes that having a 3 or more different tactics you might use gives you choices and flexibility.

"The Gentle Art of Verbal Self Defense" by Suzette Haden Elgin - including how not to get sucked into an argument you can't win.
Ex "If you really cared about your cat, you'd bring him in for the curve" implies you do not care about your cat.
A response might be along the lines of "Its interesting how some vets believe that being unable to afford a procedure means a person doesn't care about the animal." Note how it is in the 3rd person neutral, not talking specifically about the vet, you, nor your cat.

"When I Say 'No', I Feel Guilty" by Manuel Smith - this classic uses direct assertive skills and may be more confrontive than the previous two mentioned.
Broken Record - you repeat the basic content to every statement from the vet.
ex "I understand you want me to bring the cat for a curve and I am not able to afford that at this time.
and repeat variations of that same content over and over and over .....
 
Thank You BJM great tips. I'll see how things go with the vet re. postponing the curve til 1-6-2011. If I understand correctly lantus is only good for 28 days so I'll need to get another script by by then and I'll have some # from pumpkin being at home.
 
Joy.T said:
Hi Barbara and Tuffy, Thanks for your reply. I can't wait to see for myself what pumpkin BG will be when I test him here at home. I plan to start the spreadsheet on Saturday. He does hang out in his bed a lot today so I'm not sure what's up. His eating is normal and so is his urinating. I just worried because this Vet was so demanding and HMM.... what the right word..... well it was you do as I say ONLY like its the vets way or else. So I just have to see what will happen at the end of the month when Pumpkin needs more insulin.
Click to expand...

If Pumpkin is in bed as you say or hiding, or behaving in any funny way like that, it could be a sign of Hypo.
As others have suggested it would be much much safer to please only give Pumpkin no more than 1 unit of insulin per shot - until you know what the real BG reading is.

Please stop shooting 2 units? Change to 1 at the next shot?
 
I was going to try 1 unit tonight and see. I'm not sure it might be hypo because pumpkin usally is a napper. We have some freezing rain one day then snow the next. So he may just be having a lazy day. Usally he is lounging at the sliding glass doors or his bed which is near the heat. That why I think yesterday he was in his bed. Shoot all he needed was the remote for the tv and a cup of hot cocco. HAHA. He is funny when he gets in his bed he even pulls the blanket half way up around himself. When he leaves and comes back and if the blanket isn't at the bottom of his bed He will meow til I come and pull it to the bottom.He jumps in gets comfy and then comes the front paw to grab his blanket. Sometimes I wonder if he thinks he's a human with fur HA
 
Joy.T said:
Thank You BJM great tips. I'll see how things go with the vet re. postponing the curve til 1-6-2011. If I understand correctly lantus is only good for 28 days so I'll need to get another script by by then and I'll have some # from pumpkin being at home.
Click to expand...

I am using a Lantus vial right now. My last vial lasted us 3 months before I saw Oscar's numbers going slightly wonky. It definitely lasts more than 28 days though! The manufacturer says 28 days because that is how long they paid to have it tested on humans. They cannot legally claim a longer effectiveness unless they pay for the study to prove it. All comes down to $$ and not necessarily the facts.

Here are some links to studies that advocate the use of testing with human meters for you in case you want to print them out for your vet to read.

Page 4 begins talk about hometesting. Page 5 mentions how stress can alter numbers taken at the vet and hometesting is more ideal. DOES NOT specifically say the AT has to be used.
http://www.aahanet.org/PublicDocuments/ ... elines.pdf

Here is a FDMB thread that includes abstracts on veterinary journal articles that mention the use of homemonitoring and human meters
viewtopic.php?f=28&t=2509
 
I love the advice on being assertive. I find vets extremely intimidating. Its like they can sense it in me and I give them power. I will check into these books. I do know that I will not accept a vet that treats me this way though and I won't be giving his current vet another shot.

I think your vial will last a lot longer also. 2 units is just two itty bitty lines on the needle. 1 Unit is safest until you start testing. You can always increase after. Lantus needs stability though so keep it at 1.0.
 
Thank You DCIN. I've Been re-read the stickys notes and watching the video about testing the on the ear. I really have to say he is doing better. His coat has improved 90% he doesn't drink that much from his water bowl,and he isn't attacking his food plate!!.I know the #'s will be interesting to see.I will be setting up his spread sheet also.
 
Joy...just wanted to welcome you and Punkin to LL and wish you great luck with your vet. It's a crime what she is doing but I think many of the folks here have given you the tools to assist you. Hopefully she will listen. There's great info here and AMAZING support!!!
 
I live in New Jersey and buy my syringes from Amazon.com with no RX. Box of 100 Monojects with 1/2 " markings for less than 14.00. The short needles are less than 16.00 for 100 Monojects. There are plenty of ways to save mney and get supplies without leaving your house once you find a different vet and take your kitty for an initial appointment. This vet has to have some racket going on. The nerve to "make" you spend all of that money and tell you that you have to sign something or treatment might be withheld. I'd find a new vet and then contact the veterinary board about this one. Something is really wrong here. IMO
 
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