When you know what insulin Bruno is going to be on, please let us know. At that point, you'll also want to check out the stickies for your insulin in the appropriate Insulin Support Group. To do that, in the lower right corner of the screen is a 'Jump To' box (ProZinc is part of the PZI forum and NPH is part of the Vetsulin/Caninsulin/Humulin N forum).
Also, please be careful with dosing. One of common mistakes we see from vets is treat diabetic cats as if they were small dogs; in reality, dogs and cats process insulin very differently. This can result in three types of errors:
1. Error: Dosing based on weight. If this occurs, your vet will tell you to give more than 1 unit at a time. In general, cats should be started at no more than one unit at a time. (The only exception to this might be Bruno had ketones or diabetic ketoacidosis (DKA).)
2. Error: Raising the dose too quickly. Cats need time to 'settle in' to their dose, usually 5-7 days. Unless Bruno has or develops ketones, please do not be tempted to increase the dose too quickly.
3. Error: Dosing once a day. Many dogs can get along fine with insulin shots just once a day, but cats have very fast metabolisms and almost always require twice-a-day dosing.
(And, yeah, I and everyone else here on the boards know *exactly* how hard it's going to be for you to trust a bunch of random internet strangers on this sort of thing instead of your vet that you've known and trusted for years ... )
In general, cats also tend to do better on the longer-lasting insulins -- Lantus, Levemir, and ProZinc/PZI. Each one has it's plusses and minusses, which you read about in the stickies in the various Insulin Support Group forums. If your vet prescribed any of these, they're definitely worth trying.
If your vet prescribed Vetsulin or Caninsulin, please ask him/her to reconsider their choice of insulin. Vetsulin / Caninsulin is the subject of an FDA warning and is no longer being made. For those reasons, it's not a good choice as a starting insulin for a newly diagnosed cat.
If your vet prescribed Humulin N / NPH, those are often harsher insulins than many of us would prefer, but there are some cats that do tremendously well on them. They're also generally less expensive than the long-lasting insulins and may be worth trying.
If your vet has prescribed Lantus or Levemir, and doesn't hand you an open vial that you've already paid for: think about asking for a script for Lantus or Levemir in pens or cartridges. Depending on their treatment, insulins can have a limited shelf life. While the pens/cartridges are a higher initial investment, they're often more economical in the long run. This is particularly true if Bruno goes into remission (where his diabetes is controlled solely through diet and he no longer needs insulin shots). The pens/cartridges are sold in 5-packs of:
- Lantus 3ml SoloStar Pen
- Lantus 3ml Cartridge Refill for the OptiClick Pen
- Levemir 3ml FlexPen
Additionally, some pharmacies *may* sell pens/cartridges individually, but you should call around to see whether any in your area actually do.
Also, shop around for pricing; costs can vary dramatically. Remember to call any warehouse clubs in your area as well (Sam's, BJs, CostCo, etc); in the US, warehouse club pharmacies are legally required to fill prescriptions from members of the general public, even if they aren't club members, and they'll often have good prices.
If your state / locality requires a prescription for needles, ask your vet to write you a prescription for U-100 insulin syringes; you'll be most interested in 0.3cc syringes; that will give you the most accuracy in drawing up your doses. Many folks like the 31 gauge syringes, because those are the thinnest syringes on the market; some folks whose cats have thick skin prefer the 29 gauge.
You'll be interested in the U-100 syringes, even if your vet prescribed one of the U-40 insulins (Vetsulin / Caninsulin, ProZinc, some versions of PZI). That's because, if you use a U-100 syringe to administer a U-40 insulin, you can do very accurate micro-dosing, even to a fifth of a unit. (If you're given a U-40 insulin and want to use U-100 syringes, please come back and ask about the conversion chart.)
One more thing to cover: ask your vet whether Bruno has tested positive for ketones. Ketones are not-common but still possible side effect in any person or animal with unregulated / under-regulated diabetes. Small amounts of ketones may be treatable at home; large amounts of ketones may require hospitalisation in a 24-hour care facility. If you test for ketones at home, you can catch them early and hopefully avoid the expensive hospitalisation.
To test for ketones at home, pick up some ketostix from the diabetes section of your local pharmacy. (I've always found them in the aisle, though some folks report their pharmacist keep them behind the counter.) You test for ketones by sticking the the stick in fresh urine. If the stick changes color, ketones are present.
And that's about it from me for now. I know it's a lot of stuff to absorb; the good news is that, while the initial learning curve is pretty steep and will seem overwhelming, it's also comparatively short. And we'll be here to answer any questions you may have, and to help you help Bruno.
-- Jean and her Gwyn
![JJ & Gwyn [GA]](/FDMB/data/avatars/m/0/167.jpg?1419296044){kind=avatar}
