Insulin comparison

[CraignShadow]

My 10 yr old best friend was diagnosed with FD about a month ago. I bought a Lantus 100 u vial for $250 and am now discovering that at the current rate of usage, I will need about $1250-$1500 a year for her insulin ! I asked my veterinarian about other insulin, some of which were on her webshop, only to find out she has no experience with any of them except Lantus. I know many friends here are given different types of insulin and I would like an overall opinion of which are the best, not only for value, but more important, for effectiveness. Please, any feedback would be greatly appreciated :smile:. Thanks in advance!

 

[dirtybirdsoaps]

Thats a tough one to say really because every cat is different and reacts differently.

I had Hidey on Prozinc, and with strict diet change (5% or less carbs for food) and having his teeth cleaned and a few extractions he went into remission within a month and a half BUT once again every cat is different and you have to also think about genes, weight, diet, general health, and how early diabetes was caught.

The Prozinc cost me about $85 for a vial, and was told it would last 3-4 months (dosage was supposed to be 2 units twice a day)

 

[Lisa and Witn (GA)]

Ask your vet for the prescription for the pens instead of vial. There is also a discount available on the Lantus website for the pens.

Even though they have an expiration date of 28 days, that is for humans and not cats. I am not sure what dose you are using, but most cats only need 1-2 units twice a day. You can use a vial or the pens until the insulin becomes ineffective. This is determined through hometesting.

The issue with the vials is that they contain more insulin than a pen and it will become ineffective long before you can use all of it. So you will end up throwing most of the vial away. With the pens, you receive 5 pens in a package and the total package has the same amount of insulin as a vial. However, since they are packaged in smaller containers, you should be able to use almost every drop of insulin in each pen. Most people are able to have enough insulin to last 8 months or more. When Witn was on insulin, one package of pens would give me enough insulin to last over 9 - 10 months.

 

[Elizabeth and Bertie]

Hello, and welcome to FDMB!

We have a saying here that "The best insulin is the one that works best for your cat." Unfortunately though, it's not possible to predict which one that will be...

The longer-lasting insulins, Prozinc/PZI, Lantus and Levemir are preferred here over the shorter-acting insulins (Vetsulin/Caninsulin etc) because they tend to have a gentler action and also last longer in the cat's system.

Lantus and Levemir are 'depot' insulins. Some of the insulin is stored in the body and released over time. Folks here find that these insulins work best if the dosage remains constant for a time and the shots are given (as close as possible to) 12 hours apart.
There are quite a lot of people here with cats on Lantus.
Prozinc/PZI insulins are slightly more flexible both with dose change and the timing of the shots. They can be used in two ways, either as a fixed dose or with sliding scale dosage (where the dosage changes according to the blood glucose level immediately prior to the insulin shot.)

Often, folks stick with the insulin that they start out with. But some folks will try a switch to another insulin after a while to see if they can get better results.

Most of us here test our cats' blood glucose at home ('hometest') using ordinary glucose meters made for humans. Hometesting is the most useful tool for determining how effective an insulin is in controlling a cat's blood glucose levels.
Hometesting probably sounds a bit scary at first, but it's really not hard to learn. Like anything new though it will probably take a few goes to get the hang of things.
Hometesting basically involves pricking the outer edge of one of your cat's ears (this won't hurt the kitty) to get a blood droplet; transferring that blood droplet onto a test strip in a glucose meter; waiting for the meter to count down and give a result; and rewarding said kitty with a treat or a cuddle.

Diet also plays a major part in diabetes management.
May we ask what you're feeding your kitty at the moment?

And would you like to tell us your kitty's name?

Eliz

 

[CraignShadow]

I Thank you for the reply. I have 2 cats that adopted me. Shadow is my 10 yr old w/FD, Callie is about 2-2 1/2 yrs old and in perfect health :smile: . Until the diagnosis, they were both eating dry meow mix and I was splitting a can of fancy feast between them at about 3-4 times every 2 wks. Now I have Shadow on the fancy feast classics plus a little wellness grain free dry food and give Callie the same dry with some fancy feast daily. Callie still prefers dry so I will slowly change her to wet food only, but Shadow likes wet food just fine so it was no trouble changing her diet.
Am I missing something here about the dosages? Some people are stating that a single vial of 100 U will last them over 6 Mo. :? ? Then my math must be goofed up because for Shadow she gets 1 1/2 u 2/day so by my math your at little over a month for a vial ( 3 U/day X 30 days = 90 U) or do they sell larger vials? I use the BD insulin needles with the 1/2 graduations to gauge the dose.
I also have a HUGE problem trying to get a sample. Shadow (and Callie) are strays bordering on feral (Callie is actually a TNR that I befriended once she was released into my old neighborhood). They do not respond well being handled and they are completely fearful of other people. So trying to hold Shadow while rubbing her ears for bloodflow starts to become a wrestling match, and the moment the lancet touches her ear, it's on! I have tried unsuccessfully for 3 weeks now to get even one sample with no luck. She is now starting to keep her distance from me because of the trauma I have given her :sad: . Home testing seems to be out of the question and I cannot afford to take her in to the vet every couple of days for a test. I am really at a loss on what to do about it. She now starts to back away when I give her the shot and she never did that before.

 

[Larry and Kitties]

Each vial contains 1000 units. Assuming 5 vials per year that is 5000 units. Divide by 365X2 that equals 6.8 units twice a day. That is a high dose especially for starting.

My 10 yr old best friend was diagnosed with FD about a month ago. I bought a Lantus 100 u vial for $250 and am now discovering that at the current rate of usage, I will need about $1250-$1500 a year for her insulin ! I asked my veterinarian about other insulin, some of which were on her webshop, only to find out she has no experience with any of them except Lantus. I know many friends here are given different types of insulin and I would like an overall opinion of which are the best, not only for value, but more important, for effectiveness. Please, any feedback would be greatly appreciated :smile:. Thanks in advance!

 

[CraignShadow]

Each vial contains 1000 units. Assuming 5 vials per year that is 5000 units. Divide by 365X2 that equals 6.8 units twice a day. That is a high dose especially for starting.

So are you telling me that 1 U human = 10 U feline? The vial and box both state it is a 100 U vial. Was I jobbed by the pharmacy? Should I have received a 1000 U vial for the price I paid?

 

[Larry and Kitties]

The U100 is the strength, it means there are 100 units per ml. Each vial contains 10 ml (1000 units)

For info, some insulin for animals like ProZinc is U40 (40 units per ml)

Each vial contains 1000 units. Assuming 5 vials per year that is 5000 units. Divide by 365X2 that equals 6.8 units twice a day. That is a high dose especially for starting.

So are you telling me that 1 U human = 10 U feline? The vial and box both state it is a 100 U vial. Was I jobbed by the pharmacy? Should I have received a 1000 U vial for the price I paid?

 

[Anitafrnhamer]

Most use ear sticks but you can also use the pawpad (the large one in the center of the foot not the ones on the toes) as an alternative. This way you can wrap your cat up in a towel like a burrito and it takes the urge to resist out of them. Just use an oatmeal or rice filled baby sock slightly heated in the microwave for about 30 seconds to warm the foot and help make the blood flow.

Hope this helps.

Anita and Squeaker

 

[Barb & Mr. Frog]

Maybe you should start over, and go more slowly, first just get her used to you touching the ear, give (low carb) treats, when she's warmed up to that, start bringing the lancet near but not poking yet, give treats when she lets you, etc. Your tone of voice makes a big difference too, if I get frustrated and let Frog know it, he's ready to skedaddle (bolt). He's been doing this (testing) for well over a year now, and I still have to be very careful not to let him see my frustration if he shakes his head or something.

 

[CraignShadow]

Thanks again for all the help and info. I will try to use them in the next few days.

 

[Elizabeth and Bertie]

Maybe you should start over, and go more slowly, first just get her used to you touching the ear, give (low carb) treats, when she's warmed up to that, start bringing the lancet near but not poking yet, give treats when she lets you, etc. Your tone of voice makes a big difference too, if I get frustrated and let Frog know it, he's ready to skedaddle (bolt).

I agree with Barb; take it a little more slowly. And remember to breathe....

I thought my cat would be impossible to test (he was 7kg of pure attitude at diagnosis). If he didn't want to do something then we didn't do it. So I did as Barb has suggested above, getting him used to have his ears touched, rewarding with a treat, etc, etc....
And when I test him I crumble treats for him to keep him still and then do the test while he's munching on those (there is no way he can be held). Very soon he actually came to enjoy the process because of the treats he received! (And as I write this he's clawing at my leg to get me to test him!!! (Ouch!))

Re the lancets; are you trying to do this freehand or are you using the lancing device? Whichever you're trying it may well be worth your trying the other way. I find the lancing device way easier as it's so quick and I don't have a steady enough hand to prick the ear freehand.

You will get the hang of this. Just take your own time. And be patient with yourself.

Eliz

 

[Tisha's_Person]

I was very frustrated with testing at first too. I wouldn't say that I'm a pro yet, but it has gotten easier. Using suggestions from a couple of people, we picked the same location to test every time. Our cat is not allowed on the kitchen counters, so we test her there. She knows it is the only time she is on the counter. I get everything ready first, so that I have my warmed sock with rice and catnip (20 seconds in the microwave), lancing device, meter, cotton balls and neosporin all close at hand before I get the cat so I can grab everything with one hand. We make her lay down first, which helps quite a bit. I have one of my kids or my husband stand in front of her and rub her chin to distract her. I stand behind her, use a sock filled with rice and catnip to warm her ear, then poke her with the lancing device that came with the meter. Once I get the reading, I put on pressure with a cotton ball while the meter is reading, then swipe on some quick neosporin before I let her go. That's about as long as I can keep her confined. Then I give her a low carb treat.

The first day we did a curve, she hissed and scratched at me. She has gotten to the point now where she purrs when we start the process. She still squirms a little bit, but she doesn't really fight me. (If I don't have help, she slowly moves her way to the other side of the counter in an army crawl so she can jump off.) But she knows the process and she knows that when I put the pressure on her ear, she is almost done. As soon as we let her go now, she comes right back to the edge of the counter for her treats. If you establish a routine and reward after testing, it will get better. Just give it some time.

 

[CraignShadow]

Again thanks for all the great comments from everyone. Could you direct me to the page that has the low carb treats in a list? I still have some whiskas temptations from before the diagnosis. It claims to be just 2 calories per treat, but are they really fine for her? Which others are good to give?

 

[Elizabeth and Bertie]

Could you direct me to the page that has the low carb treats in a list?

Here ya go, Craig:
viewtopic.php?f=14&t=9172

Pure meat and fish treats are good; ie, freeze dried meat treats, bonito flakes, or little cubes of cooked chicken etc. (One cat here loves fresh shrimp!)
And some folks give teensy cheese cubes, or a little plain unsweetened yogurt.

I still have some whiskas temptations from before the diagnosis. It claims to be just 2 calories per treat, but are they really fine for her?

They are higher carb. But if Shadow is currently getting these as treats then you may wish to continue with that until you're comfortable with hometesting her. The same goes for any dry food that she's currently getting. That's because removing the higher carb foods may lower Shadow's blood glucose, and for the moment it would be safest for her if the status quo remains. Once you're OK with hometesting it becomes safer to remove the higher carb foods as you'll be able to monitor any effect on her blood glucose.

Eliz

 

[CraignShadow]

Hello again after a long 'distraction' I can ask a couple of other questions. After observing Shadow these few months after being diagnosed. Well lets put the basics up here first. She is 10+yrs old, about 11lbs, was diagnosed in mid August, placed on Lantus at 1U 2/day, being fed Fancy Feast classics 2/day at dosing plus some Blue Buff dry for grazing in between. She has not lost any noticeable weight since being diagnosed, but was still drinking and peeing (though again not as much as before) higher than 'normal' so after about a month to see if the diet change would be the difference but no real change, I increased her dosage to 1 1/2 2/day. this change happened about a month ago and there is no change overall to her condition one way or the other.
I have become concerned that she may have the beginnings of neuropathy as she slips while walking on the hardwood floor and steps. We just moved into a house with hardwoods for the first time in her little life, and I'm unsure if her slips are because of her unfamiliarity with hardwoods or because of early neuropathy. She walks on the balls of her feet just fine, but seems to be more sensitive when I pet her haunches, especially a few hours after dosing. She slides and slips mainly when she turns, and that happens maybe once out of ten times she turns. She slips going up the stairs at about 1 in 20-25 times. I know the percentages are small, but not having seen her do that before at other homes where there were tile floors in the kitchen and bathrooms concerns me. She also has a slight limp in her hind quarters that I did not notice until after she began her treatments so I don't truly know if it's an existing condition, the beginnings of neuropathy, or she hurt it trying to get away from me when I tried to draw blood from her ear for a BG. Because of that possibility and the lack of response from the last increase, I increased her dosage to 2U 2/day this week. Am I being a cat hypochondriac? Am I finding things that aren't there? Or should I be concerned and look to get some of the B12 that has been discussed on other posts?

P.S. I have all but given up on getting BG from shadow. She has not taken to any of the tips given here and it started to become troublesome giving her the medicine during that time. I was not stressed at all when I start to try, but she is really stubborn(gets it from her human friend) and skittish when she feels uncomfortable and I want to be able to give her the dosage trouble free at least.

Thanks for any insight you can help me with!

 

[BJM]

Blue Buffalo isn't low carb. Young Again 0 Carb is 5% calories from carbohydrates as we calculate it. Epigen 90 may be another option.

See my signature link Secondary Monitoring Tools for other assessments you can make to evaluate your cat. In particular, please pick up some KetoDiaStix for urine testing of ketones and glucose. Ketones form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis, a potentially fatal complication of diabetes (watch for lack of food intake and infection, combined with glucose spilling in the urine). Glucose in the urine means the renal threshold has been exceeded and the blood glucose was too high since the previous void.

Also start monitoring the amounts of water and food being consumed, the urine volume, and the feces as described. These are indirect indicators of diabetic control.

And maybe a gradual, positive reinforcement program will eventually enable to blood test your cat.
Start by picking your testing spot, take the cat there, massage the head and ears, give a low carb treat, and release. Do this for a week.

 

[Melanie and Smokey]

Can you get her tested at the vet at least once a week or every other week around her nadir (6hrs from shot time)? Though not as good as home testing at least it would might you an idea of her progress with the insulin even if vet numbers are stress affected, it would be better than no numbers at all. I have two little cats from a hoarder situation, and though I've never failed to get a cat to like test time and they now love being petted, I doubt I'd ever be able to test them on a regular basis if at all so I can understand what you are going through. Some cats come from backgrounds that just make being held onto unacceptable to them and it makes testing very hard. I find vet fear is sometimes useful with these kinds of cats because they freeze up there and you can get done what you need done. Try using the urine stix for testing at home that BJM mentioned to see if that gives you a way of monitoring, though it won't be as "real time" as blood glucose checks.

I would recommend getting rid of the Blue Buffalo dry food. Not only is it too high in carbs for a diabetic cat, a very respected vet friend of mine is strongly encouraging all cat owners to not feed any BB dry to their cats due to vets seeing a very high instance of crystals showing up in cats being fed Blue Buffalo dry food.

B12 won't hurt her if you get it to try. it can be very helpful in senior kitties.