June 7th, newbie - stressed

[Acadaca]

Hi. My cat FCC (7 year old male, indoor cat) was just diagnosed with diabetes (pending a further test for confirmation). I have been reading as much as I can and am feeling a little overwhelmed. I will probably overshare as a result. I am sorry. The problem is compounded by the fact that our vet only lets one of person per animal in at a time right now because of covid so my partner and I can't get information together. We are supposed to go learn how to give injections, but I am not confident that either of us will understand well enough to pass it on. The onus ends up falling on him because I am not so good one on one in these situations. It's tough because he's my cat.

I'm in Vancouver, Canada and living on a very fixed income. I am worried about a billion things including cost, but since there is no alternative I am going to try and figure this out bit by bit. It's already cost 500 dollars for one visit and the tests plus an additional 65$ test that they are running to confirm diagnosis. They mentioned needing an overnight stay in a couple weeks to make sure everything was going appropriately (though I read on this site that that isn't always necessary). I don't want to pay any more than I need to, but I also don't want to sacrifice care. I also want to do everything in my power to stay away from a position where I can't afford to do everything that is best for him.

I have all the thoughts of never being able to go away for the weekend again because of an insulin/feeding schedule to never being able to go away again because I won't be able to afford it.

I also have another cat (f, 16) who is on the slender side. Normally we give them wet food in the morning and then before bed, but let them free graze the rest of the day. I don't know how to make it so she can still graze and have regular food while making sure his diet changes and is more regimented. I don't think she can afford to lose any weight.

FCC is otherwise healthy and happy. He eats well and purrs constantly. I just noticed he was drinking and peeing a lot and there were a couple of behavioural quirks that I wanted to look into (he never throws up even when he occasionally tries to cough up a hairball and has just eaten grass). Apparently the other issues are allergies or not a big deal. When I originally made the appointment he was also meowing a lot and seemed a bit restless, but because of the wait to get into the vet that behaviour passed.

I guess I was just hoping for any tips or tricks of the trade and hopefully some budgeting suggestions. I realize most of this board is probably American, but it never hurts to ask.

I am really anxious about this and one of my support systems asked earlier if I could handle it (probably not the exact words) and that's made it even tougher because obviously I am not going to try and rehome my very loveable, handsome, and tied for favourite cat. I can't even comprehend poking him with a needle. It will hurt my soul.

I know there are people out here dealing with this stuff everyday and I thought that perhaps the best thing for me to do would be to reach out to a community that understood and knows a lot more than I do.

 

[Bandit's Mom]

Hello and welcome!

While a good many of our members are from the US, we have quite a few from Canada as well - including one of our Moderators.

Do you have any initial lab work done for FCC that you can share for us to look at? If they are yet to be done, could you please ask the vet to check for ketones?

What diet is FCC on? A diabetic cat needs to eat a low carb diet (food with less than 10% from carbs). If you aren't feeding a low carb diet and FCC doesn't have ketones, you could first try switching him to a low carb diet and see if his diabetes can controlled by just a diet change. If that works, he won't need insulin.

Diabetes can be very overwhelming at the beginning and we have all been there at some point. You are not alone on this journey. We are here to help you.

 

[FarmKitty]

Hi. My cat FCC (7 year old male, indoor cat) was just diagnosed with diabetes (pending a further test for confirmation). I have been reading as much as I can and am feeling a little overwhelmed.

Welcome to the forum Just wondering, is the further test a fructosamine test? It will give a broad idea of what your cat's blood glucose levels are like for the last few weeks. I'm guessing you already have had a lab test done for them to diagnosis him with diabetes, and the symptoms of drinking and peeing a lot are both symptoms of an unregulated diabetic cat. If you are planning on testing your cat's blood glucose levels at home, then you can skip the fructosamine test and save some money! That is what I did. But if you are already going through with it then no harm done.

I will probably overshare as a result. I am sorry. The problem is compounded by the fact that our vet only lets one of person per animal in at a time right now because of covid so my partner and I can't get information together. We are supposed to go learn how to give injections, but I am not confident that either of us will understand well enough to pass it on.

Yeah this is a big struggle during covid... It is nice that they will let one of you in though (some places they let nobody in). What will probably happen is that they will give you an syringe filled with saline and will show you how to pull up the skin and inject. Then let you have a few tries. I think you can also try it on your own with an orange... but maybe I am misremembering . There are lots of videos online as well.

Another idea I have had (but haven't done yet) is putting my phone on speakerphone when going into the vet and having my partner listen on the other end. Currently, I will come out of the vet's office and try to relay all the knowledge but there is too much stuff to remember!

We are supposed to go learn how to give injections, but I am not confident that either of us will understand well enough to pass it on. The onus ends up falling on him because I am not so good one on one in these situations. It's tough because he's my cat.

Let your partner give the injections and you can focus on getting the supplies and learning all the info for now. That is what I did. For the first month, my partner was mainly giving the insulin shots and doing the blood sugar tests. I would watch him and slowly got the courage to do it. Now it is like nothing at all. Honestly, I never thought in a billion years that I could be poking something with a needle . If you have a support system, then use it!

I'm in Vancouver, Canada and living on a very fixed income. I am worried about a billion things including cost, but since there is no alternative I am going to try and figure this out bit by bit. It's already cost 500 dollars for one visit and the tests plus an additional 65$ test that they are running to confirm diagnosis. They mentioned needing an overnight stay in a couple weeks to make sure everything was going appropriately (though I read on this site that that isn't always necessary). I don't want to pay any more than I need to, but I also don't want to sacrifice care. I also want to do everything in my power to stay away from a position where I can't afford to do everything that is best for him.

Here is the most inexpensive setup ($0.40/strip) for you, and it will all ship right to your door in Vancouver

• $7.98 CAD for 100 28G lancets

• $39.99 CAD for Bravo glucometer and lancing device and 100 test strips

Shipping is around $13 CAD and I have found it is extremely fast (usually a day or two). I am very happy with this site!

So you can basically get the glucometer, 100x test strips, 100x lancets, and a lancing device for just $60.97+tax CAD It will get to you fast and no stress of researching

Some optional things you can order are:

• $39.99 for 100 Bravo Test Strips (this is just the test strips)
• $7.99 for 50 Ketone urine strips (you can find them in other brands for cheaper on amazon

There are some other supplies that you will want to gather for testing:
Here are some things that you will want to look into for testing Miles' BG:

• Hot rice bag (put rice in a small clean sock and tie it off. Thinner socks are better b/c you want the knot to be small and not burn in the microwave)
• Vaseline to help the blood bead up (optional, I don't use this)
  
• Headlamp (this was extremely useful for me because I don't have very good natural light in my place)
• Low-carb treats for after testing, such as freeze-dried chicken treats
• Container to put everything in

The container has also made a huge difference later on. I would shake the container with the lancets and I guess she has associated that noise with a treat now. All I need to do is pick up the container and she will wake up out of a deep sleep and come running for a test .



I also live in BC. I did a breakdown of cost in my response on this post. Per month, the rough breakdown is:
$109 for test supplies
$24 for food +
$23 for ProZinc insulin +
$18 for syringes +
= $174 CAD/month

You can buy syringes and test supplies in bulk to get free shipping, but that will come later on when you get more familiar with the process and pick out an insulin!

By far my biggest cost was getting a dental done. My Dixie was long overdue for a dental and had almost all her teeth extracted. This cost almost $2500, but was the biggest thing that brought down her blood sugar levels. Luckily, she will never need a dental again . The second biggest cost for me is now food because she has kidney disease, so I need to get more particular about buying the right food for her. If your cat's kidneys are good, then there are far cheaper options!

You will probably want to have more vet visits. When a cat has diabetes, it hurts their organs and basically makes bad stuff pop up. Ideally, try to jump on the process of regulating FCC's diabetes as quickly as possible. Then, keep up regular vet visits (every 4-6 months maybe... depending on how bad things are) so that you can catch the bad stuff sooner.

I have all the thoughts of never being able to go away for the weekend again because of an insulin/feeding schedule to never being able to go away again because I won't be able to afford it.

Take a deep breath! You will figure this all out in time. I haven't gone away for the weekend yet but the general day-to-day insulin/feeding schedule is very minor. At breakfast/dinner I clean out the automatic feeder, refill the bowls with food, do a blood sugar test, give insulin and done! Takes maybe 15 mins. There are other options such as the FreeStyle Libre metre which attaches to your cat and will automatically get blood sugar tests if you need a cat sitter. Also, situation depending, you can skip insulin shots if you need to, but to do all this stuff you will need to gather some blood sugar data!

I also have another cat (f, 16) who is on the slender side. Normally we give them wet food in the morning and then before bed, but let them free graze the rest of the day. I don't know how to make it so she can still graze and have regular food while making sure his diet changes and is more regimented. I don't think she can afford to lose any weight.

The important thing for FCC will be:

1. Making sure he is hungry at insulin shot time (breakfast and dinner)
2. Removing food from him 2 hrs before insulin shot time (this will prevent the food from raising his blood sugar and affecting your decision in how much insulin to give him)
3. Making sure he can't access any high-carb food

Personally, I use an automatic feeder that gives my single cat 4 meals a day and will remove all food 2 hrs before insulin shot time. Perhaps you can just leave out the wet food for both of the cats? This will take some thinking!

FCC is otherwise healthy and happy. He eats well and purrs constantly. I just noticed he was drinking and peeing a lot and there were a couple of behavioural quirks that I wanted to look into (he never throws up even when he occasionally tries to cough up a hairball and has just eaten grass). Apparently the other issues are allergies or not a big deal. When I originally made the appointment he was also meowing a lot and seemed a bit restless, but because of the wait to get into the vet that behaviour passed.

When I got Dixie (a year ago), she would lay down at the water bowl and drink for like 10 minutes straight... then go to the litter box and pee huge lakes! Definitely diabetic symptoms. These symptoms, along with her lethargy and dandruff have completely subsided after I got her diabetes regulated with insulin! Another sign of diabetes is crazy hunger... you might notice him not being as eager to eat all the time when he gets regulated .

I am really anxious about this and one of my support systems asked earlier if I could handle it (probably not the exact words) and that's made it even tougher because obviously I am not going to try and rehome my very loveable, handsome, and tied for favourite cat. I can't even comprehend poking him with a needle. It will hurt my soul.

The needle is super thin! With Dixie, I give her the needle when she is eating and she literally doesn't even stop eating to notice it. Testing their blood sugar levels also does not hurt them (sometimes Dixie sleeps through it). I will be honest, the absolute hardest part is the beginning where you need to establish routines with them. If FCC is a frisky cat who doesn't like to be touched, then you will have a more difficult time. Even if he is a chill cat, you will still want to focus on establishing routines as much as possible! For example, if you give him a blood sugar test, then shake something to get his attention, do the test in the same location of the house, and then reward him with a low-carb treat (even if the test was unsuccessful). This will make a huge difference!

I don't have advice if you are scared of needles, but I am a bit scared poking Dixie's ears with a lancet in my hand. So I just use the lancing device (one comes free with the Bravo Meter I linked) and I don't need to handle the lancet needle at all . You can try both ways to see which one you are more comfortable with.

I know there are people out here dealing with this stuff everyday and I thought that perhaps the best thing for me to do would be to reach out to a community that understood and knows a lot more than I do.

You have found the right place! I'm sure your vet will be very happy that you are being so proactive in FCC's treatment.

Here is my summary of things that you can start working on right now

1. Order the glucometer, glucometer test strips, lancets, and some Ketone test strips that I linked above. This will arrive very quickly if you are in Vancouver. It should only be around $70 and will get you started ASAP! I use all these materials myself.
2. Start establishing your test routine with FCC. Pick a place in the house (I use a cardboard scratcher Dixie lays on), and bring him there, rub the tip of his ears for 1 min, and pretend to poke him. Then give him a low-carb treat. Do this as many times a day as you can!
3. Look into low-carb wet food options. In my response here I link to a couple low-carb Friskies foods that you can start off with. They are very inexpensive, and you can always change to a different food later if you want to do more research. But in my opinion, just get something to start out with because the whole food research thing can be a time sink which you probably don't need right now!
4. Get some low-carb treats. I use PureSnacks Freeze Dried Chicken Dog treats. These are low carb (pure chicken) and are great for after tests. They also have a lot of other different flavours. Try to reserve a special treat just for blood glucose test time!

Once your glucometer arrives, you can begin the process of getting some blood sugar tests. This will reveal if he needs insulin or not!

Please don't feel afraid to ask anymore questions... we are all over-sharers here

 

[Peggy & Clawdius]

Hi, I too am a newbie. I am in Alberta. My 11 year old siamese was just diagnosed a couple of weeks ago. I have had to take in so much new info that I truly thought at one point that my head was going to explode! Add to that the fact that I am needle phobic and now have to give my fur baby 2 shots a day and you can understand how overwhelming it got. However, it isn't nearly as scary or as hard as I thought it would be. My cat actually comes to me after he eats to get his needle (and his big cuddle after) and the needle and dosage are both so tiny that he doesn't mind it at all. I got my insulin pens and needle tips from Walmart and my vet said they are cheaper than they can get them themselves. It makes me chuckle because the vet sent the prescription in under my cat's name and that's how I have to ask for it. His name is Clawdius Hopper. He has extra toes on all his feet and that name sounded a little classier than plain old Clodhopper. If you have a free/give away facebook page for your area you can ask for supplies and can often get a glucometer, lancets, test strips etc. from someone that doesn't need them anymore. As a caregiver for my dad and my late mum I know that when a loved one passes away people can be very generous about giving away unneeded equipment to someone who will put it to good use. There are lots of videos on youtube and diabetic pet sites that show very clearly how to give the shots, it really is easy if you stay calm so your fur baby does too. Take a breath, cuddle your baby and start on this new adventure knowing that there are lots of people here to help.

 

[FarmKitty]

I have a picture tutorial in my response #43 here (sorry not sure how to link directly to my response, but you can see the response # in the bottom right of each response), just so that you can get an idea of what the blood sugar testing procedure is like with the lancing device. When you first start out, it can take like 15 mins to do this (and lots of crying on my part ) but now I can do it in 30 seconds with my eyes closed .

One of our members has uploaded a video that shows how to test without the lancing device. She uses an AlphaTrak pet glucometer (as opposed to the Bravo human glucometer that I linked for you). The AlphaTrak is a LOT more expensive ($2 per strip!). You might think, well it is specifically designed for pets therefore I should definitely pick that one! But actually, our forum is more focused on using the human glucometers because their cost is so low! So all the dosing protocols you see here will be referencing the human glucometer values. Just thought I would mention that because that was also I concern I had when I started! But I am glad I went straight for the human meter (and ignored my vet's advice about the AlphaTrak one, which wasn't even available for purchase in Canada last year...)

Here is a video of how to give the insulin injection.

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

Almost everyone who finds us feels completely overwhelmed by having their cat diagnosed along with the amount of information you have to absorb. As @PeggySue noted, it becomes routine after a relatively short time. We all do continue learning! I've been here a long time and I'm still learning.

I would echo the idea of calling your partner and putting the call on speaker so you can both listen and ask questions. It's the best accommodation most people can do given the restrictions imposed by Covid.

There is a wealth of information on out Health Links page. There is a page on home testing, financial help, information about feline diabetes, and much, much more. (I know -- more information to absorb!!)

Almost all of our members are apprehensive about both home testing and giving their cat an injection. Some vets will even tell you that you will ruin your relationship with your cat. That was not my experience. (Read "Gabby's Legacy" in my signature -- see my post - #7 in the thread.) It's also not been my observation and I've been a member here for over 12 years. The "trick" is to give your cat a treat every time you test. You associate a treat with poking your cat's ear. They catch on quickly -- and the edges of a cat's ear do not have very many pain receptors. As for the shots, I gave Gabby her shot while she was eating. She barely noticed. (This may not be feasible unless your vet prescribes Lantus. The other insulins require that your feed your cat and wait a bit before injecting but the treat method will still work.)

It is fine to allow your cat to graze. As long as the available food is low in carbohydrates -- which is fine for your non diabetic cat, as well -- having food available is what most people here do.

We will want to know which insulin you are/will be using. Lantus (glargine) and Prozinc are the two insulins that are recommended for treating feline diabetes. This is a link that will help us to help you.

I'm also tagging @Wendy&Neko who is on the west coast of Canada.

 

[Acadaca]

You guys are lifesavers. Thank you so much. The first thing I did when I woke up was cry and then I read the forum and took a bunch of notes and felt more in control of the situation.

I will do all the diet changes today and worry about the details surrounding this at a later date. That is very good information and an extremely useful tip. Thank you. He is definitely not on low carb stuff right now.

I will also ask my partner to request copies of all the lab work and ask about ketones. So far the information has been supplied to him over the phone. I do know that the vet's first intended line of attack was insulin because he mentioned a prescription. It is really good that we can now inquire if there is a reason he doesn't think it's appropriate to start with a diet change. As soon as we get the copies (which I assume they have to provide us with if we ask I will upload them).

I was reading stuff on the internet yesterday and there was so much information and I was just so overwhelmed that I wasn't sure what I was taking in. Clearly I have found the most amazing place and resource to help me out. You have no idea how much I appreciate everyone who took the time to respond (and all the people who put work into this board).

I think I feel better armed with some information I understand and a bit of a plan in terms of questions and suggestions. We did try the speakerphone approach, but I was only able to catch about half the information.

 

[Sienne and Gabby (GA)]

This is the best place you never wanted to be! (And we've all been in your shoes.)

 

[Bandit's Mom]

I will do all the diet changes today

This is not an exhaustive list but you should be able to find some low carb food here.
https://catinfo.org/chart/index.php

The above list does not have Tiki Cat but you can find that here:
https://www.felinediabetes.com/FDMB...-luau-aloha-friends-and-velvet-mousse.248242/

All of the above are wet food. If FCC is a kibble addict, you can first change to a low carb dry food before attempting a transition to wet food. The low carb options in dry food are Young Again, Dr. Elsey's Cleanprotein and Wysong Epigen 90.

 

[Wendy&Neko]

Waving at you from across the water in North Vancouver.

I do know that the vet's first intended line of attack was insulin because he mentioned a prescription.

If your vet is thinking Lantus, a prescription is totally unnecessary in B.C. You just walk up to the pharmacy and ask for Lantus - the cartridge 5 pack. Tell them it's for your cat. First time I got it was at Save On Foods (not the cheapest place it turns out), but the pharmacist was very helpful and knowledgeable - she has many diabetic kitty clients. I shopped around and found the Safeway pharmacy was actually the cheapest for both insulin and syringes. Superstore was also pretty good pricing as is Costco. You want the BD Ultrafine II (purple and yellow box) syringes.

Ketones test sticks (Ketostix) are available at most people pharmacies too, I got mine at Save On.

Home testing will save you a ton of money. No overnight or during the day stays needed for a curve, just do it yourself and report the numbers to your vet. Most people end up coming here for advice on dosing instead of talking to the vet about it. There are other options to the Bravo meter, basically you want one that takes the smallest blood drop. My London Drugs pharmacist was also very helpful with me spending time on that. Told you I shopped around. And they threw in a meter for free when I bought test strips. The Freestyle at the time had the smallest blood drop. Cost of test strips is important, you will go through those the most. The Bravo is amongst the cheapest for test strips. You can also find deals on eBay for test strips. Back in the day, you could cross the border, which is what I did for test strips, or had it shipped to a post box just across the border. Maybe later this year?

As for holidays and weekends away, it will be doable. My current pet sitter does insulin shots and you can often find a vet tech or assistant at the clinic who is willing to help for a fee. Autofeeders are also a great help on the feeding side of things. I got my Petsafe 5 at Petsmart on sale.

 

[Diane Tyler's Mom GA]

I would go with Lantus since you won't need a script. I think you will be very happy using Lantus

 

[FarmKitty]

I will do all the diet changes today and worry about the details surrounding this at a later date. That is very good information and an extremely useful tip. Thank you. He is definitely not on low carb stuff right now.

Excellent! Changing from high carb food to low carb can and will significantly drop FCC's blood sugar values. I think it is great that you are doing this before starting insulin. Otherwise, it can be unnecessarily tricky in managing a changing insulin dose and food all at the same time!

 

[Acadaca]

I took away his dry food and he is looking at me with pitiful, but handsome blue eyes. I was going to get a bag of low carb dry food for today too, but couldn't find any. He's pretty easy going so we'll just see what happens. I know I need to figure out a feeding schedule and portion control, but I thought getting all of our feet wet immediately was the best approach. I did get some of the freeze dried treats that were mentioned in this thread and am relieved that he likes them.

I am waiting for the vet to call tomorrow because all of the results weren't in and he wants to go over everything at once. The last test they tacked on was a fructosamine test so I was reassured that it was what FarmKitty mentioned. I still am not sure what kind of insulin he is planning on prescribing.

I am really hoping the vet is supportive of the diet change and that it will be safe to see what effect it has on him, but I won't know anything until tomorrow. I have also requested FCC's records and am hoping they will either email them to me or I can walk and pick them up tomorrow as well.

I will certainly take advantage of all the knowledge and support on here as soon as I have more information to share.

Thank you all again! This information is making it easier to wait for the call because I feel that I am at least being somewhat proactive. You've all helped me take a deep breath.

 

[Bandit's Mom]

I am really hoping the vet is supportive of the diet change and that it will be safe to see what effect it has on him, but I won't know anything until tomorrow

A lot of vets suggest prescription food which is high carb, expensive and not even great quality considering the price. A lot of cats hate the food as well. I hope your vet is one of the sensible ones who sees the sense in the diet change. It's the same thing as with human diabetics - if you have diabetes, you stop eating sugar and other high carb food like bread and rice and potatoes. Feeding high carb and then giving insulin is counterintuitive, but that's what a lot of vets do!

I am waiting for the vet to call tomorrow because all of the results weren't in and he wants to go over everything at once.

Do check with him about ketones. If FCC has ketones, you would need to start the insulin right away. If no ketones, you can try the diet change first and start the insulin only if the diet change does not regulate his BG.

If he does need insulin, a cat-friendly insulin like Lantus or Prozinc would be better than Vetsulin, Caninsulin or Novolin which some vets like to prescribe but are better suited to dogs.


Good luck with the vet tomorrow!

 

[FarmKitty]

I took away his dry food and he is looking at me with pitiful, but handsome blue eyes. I was going to get a bag of low carb dry food for today too, but couldn't find any. He's pretty easy going so we'll just see what happens. I know I need to figure out a feeding schedule and portion control, but I thought getting all of our feet wet immediately was the best approach. I did get some of the freeze dried treats that were mentioned in this thread and am relieved that he likes them.

There aren't any dry foods that are low enough carb. You will need a low-carb (<10%) wet canned food. The cheapest I have found are the following which can be ordered at Walmart.

• Friskies Pate Chicken Dinner
• Friskies Pate Turkey and Giblets Dinner

You can also look at the Cat Food Database to find other suitable foods.

I am really hoping the vet is supportive of the diet change and that it will be safe to see what effect it has on him, but I won't know anything until tomorrow. I have also requested FCC's records and am hoping they will either email them to me or I can walk and pick them up tomorrow as well.

So... just want to warn you that the vet will probably be pushing some sort of 'prescription' food (potentially wet or dry), and also the AlphaTrak pet glucometer. Both of these things are very expensive, and we can point you to better and more cost-effective alternatives. When Dixie was diagnosed, I had only had her for a few days so I was very swayed by everything the vet was saying and I bought their prescription dry and wet Purina DM prescription cat food... boy do I regret that! It was expensive and the dry was too high in carbs (13%) so I ended up throwing it away. I also ordered the AlphaTrak meter from the U.S. (only option at the time), but thankfully the order was cancelled for some reason so I didn't end up having to pay for it!

I recommend that you listen to what your vet says about the food and glucometer, and then say thank you, I'd like to do some at home research first, I'll contact you later about it. Then just leave it at that. It might be a bit hard to do this if they try to sell you it while you are learning to give the insulin shot (emotions will be high!). Otherwise, you will end up like a lot of new members here with 100$ invested in some fancy food and another 100$ in an AlphaTrak meter. Instead, go your own way and pick up some of those Friskies cans I linked (or another <10% carb food from the Cat Food Database) and work from there. You don't need to run every food change by your vet. This can sound a bit weird at first, but think about how you handled FCC before his diabetes diagnoses. You would probably change his food without running it by the vet each time, so it isn't that big of a deal!

Vets will really vary in how they go through with feline diabetes. You will read a lot of cases on these forums where vets are adamant that daily testing is unreasonable. Unless you have some amazingly understanding vet, you will sort of just have to go off on your own. That is what I did, and when I came back to both my previous and current vet, they were extremely impressed with how I have managed Dixie's diabetes. They are amazed at her results each time I come in, and I have it all thanks to this forum!

I agree with Bandit's Mom that you should ask about the Ketones.

We Canadians have to pay a lot more for all the diabetic tools, like the test strips and lancets (I get so jealous when I read the prices the Americans pay on this forum!), but we luck out when it comes to insulin. In Vancouver, you can walk into any pharmacy and buy Lantus insulin without a prescription. You will just say it is for your cat at they will probably open up a file for FCC. This article is from 2013, but it shows a comparison of Lantus prices from around Vancouver. If you get the pack of 5 pen-vials, then that is the most cost effective because you can open up a fresh one every few months to always have fresh insulin. If you go with ProZinc, then it only comes in one large vial and you will need to get it from your vet.

 

[Bandit's Mom]

There aren't any dry foods that are low enough carb

While wet food is much better than dry food, there are low carb options in dry food - Young Again (<1% carbs), Dr. Elsey's Cleanprotein (chicken flavour is < 5% carbs) and Wysong Epigen 90 (around 5% carbs). They are expensive but of better quality that other dry food (including prescription food).

https://jlcm-enterprises.myshopify....products/young-again-zero-mature-dry-cat-food
https://www.petsmart.ca/cat/food-an...rain-free-adult-cat-food---chicken-57972.html

 

[FarmKitty]

@Bandit's Mom Thank you! I had no idea those options were available. I'll keep that in mind for next time.

 

[Wendy&Neko]

Dry food in general, even if low carb, is not a good solution for any cat. For more, take a look at the website by Dr. Lisa Pierson, a vet nutritionist. She's the one who developed the cat food database referenced above. She also has a document with Tips on Transitioning to Wet.

 

[Acadaca]

Hi. So I spoke with the vet this morning and asked for a copy of the records, but he hasn't emailed them yet. I have decided that FCC can adjust to a wet food diet without getting low carb dry food right now since he does eat it and seems to like it, but still stands at his kibble bowl (which I put some extra wet food in).

Thank goodness for all the information here because the vet not only insisted that I needed a prescription for Lantus, but also tried to send me to a specific pharmacy that's not even particularly close. He did say that I could do the testing at home and not have to subject FCC to boarding at the vet for the day or night and getting checked there every hour, but only after I asked. I am sure they will try and sell me everything when my partner brings FCC in for an information session? I guess he has some information on diabetes for us and suggestions for his diet and also wants to give him his first insulin shot and let my partner practice.

I asked about whether or not we could just try a low carb diet and he said no, his levels were too high and the diet needed to be in conjunction with the insulin. I hope he sends the records today so I can upload them, but I did ask about ketones and he said they were not present. He gave me two numbers, but it was hard to understand over the phone. He said one of the sugar levels was at 27.2 (when the normal range is 4.9) and that the fructose levels were 610 (he said they should be between 191-349).

Since I had some questions and insisted on getting my own supplies I am hoping he will take my participation seriously. I know he has FCC's best interested at heart, but the insulin thing has me a little wary. Also I am not sure why when I asked about a low carb diet he didn't tell me to start right away, but rather wait for my appointment. I guess to sell me food. He said to book asap as soon as I've gathered the supplies.

 

[Acadaca]

Here are his test results. I think. The drag and drop confused me a little.

Thank you!

 

[Wendy&Neko]

It does sound like the vet is planning on book an appointment to show you how to give insulin. In times of COVID, that's a good thing. Some members have been sent on their way to learn via Youtube without getting a demo. (you could also browse Youtube). As far as the blood work goes, the glucose is high, the chart shows normal of 4.0 to 9.7. Don't worry, we've seen worse starting numbers for a newly diagnosed diabetic. The Fructosamine also shows high, it's like an average of the last couple weeks, so it rules out vet stress as an indicator of glucose being high. Looks like he does need insulin after all.

One thing about this board, it is hosted in the US, so by convention, we use the American way of talking about blood sugar - they haven't quite made the switch to metric which the rest of the world uses. To convert from mmol/L to mg/dL (US), just multiply by 18. Most of us end up using a spreadsheet to track our cat's sugars, and we have a version that does the version automatically for you. If you look at Neko's SS, you'll see two tabs, one for World numbers and one for US.

As for food, keep him on the low carb wet food if he's eat it. No need to delay starting it. When your partner goes in, the phrase "thanks, I'll consider it" or "I have to talk to my partner about it", if they start talking about "prescription" food, which isn't really prescription food but well marketed food. Many cats get tired of it anyway and it costs too much.

More on the blood work, it's not unusual to see some numbers out of range at the beginning. Newly diagnosed diabetics tend to be dehydrated and not getting the proper nutrients into their system, which insulin helps them do. Once he's in better blood sugar range with insulin, the out of range entries should get better.

 

[Sienne and Gabby (GA)]

The lab results confirm a diagnosis of diabetes. The glucose of 27.2 mmol/L translates to 489 in US measurement (mg/dL). The fructosamine is an average of blood glucose over 2 - 3 weeks and is also reflecting a diagnosis of diabetes. Most of the other higher numbers are likely blips and will be in normal range the next time or may be reflective of FCC being a bit dehydrated. (And I just saw that Wendy posted as I'm writing. At least we're consistent!)

If your partner is going to be at the vet visit, I would recommend that you talk ahead of time and deal with the vet the way you would deal with a teenager. "I need to discuss this with your mom/dad before I give you a decision." That way, you buy yourselves some time, can do your research and reading, ask us, etc. and not feel boxed into a corner where you have to commit to buying a Mercedes when a Kia will do just fine. Unfortunately, most doctors -- vets and MDs alike -- often have no concept of what drugs or paraphernalia cost.

As for learning to give an injection and test, it's not that hard to learn. I actually did learn by watching YouTube videos. I speak fluent medicalese. I had a veterinary resident and a vet treating my cat. They both assumed I was an MD. I was so rattled given how sick Gabby was (she'd spent 3 days at the kitty ICU) that it didn't even occur to me that I didn't know how to give an injection. They never even mentioned home testing. I hadn't yet stumbled into FDMB so I learned on my own.

 

[FarmKitty]

Hi. So I spoke with the vet this morning and asked for a copy of the records, but he hasn't emailed them yet. I have decided that FCC can adjust to a wet food diet without getting low carb dry food right now since he does eat it and seems to like it, but still stands at his kibble bowl (which I put some extra wet food in).

Excellent! Wet food will be much better and will keep FCC better hydrated.

Thank goodness for all the information here because the vet not only insisted that I needed a prescription for Lantus, but also tried to send me to a specific pharmacy that's not even particularly close. He did say that I could do the testing at home and not have to subject FCC to boarding at the vet for the day or night and getting checked there every hour, but only after I asked. I am sure they will try and sell me everything when my partner brings FCC in for an information session? I guess he has some information on diabetes for us and suggestions for his diet and also wants to give him his first insulin shot and let my partner practice.

Very strange info he has about the Lantus! I went out and tried to buy it at a small local pharmacy and they were also surprised that it didn't need a prescription. I then went to Shopper's Drug Mart and they set me up very easily. If you pick one of the human insulins (e.g. Lantus), then I recommend going to a bigger pharmacy since they will be less expensive and will sell more so you are less likely to end up with insulin expiring soon. It sucks, but it seems like a lot of vets just aren't as up to date on feline diabetes. It is hard to blame them because I know that it is a very difficult job and a lot of continuing education is required. After he shows you how to give the insulin shot, you likely won't need anymore support from the vet regarding the diabetes. You can learn about it on your own and then use the vet for checkups and lab tests. My vets have actually never gave me any dosing advice other than the starting dose of 1 unit! Everything else I got from this forum.

I asked about whether or not we could just try a low carb diet and he said no, his levels were too high and the diet needed to be in conjunction with the insulin. I hope he sends the records today so I can upload them, but I did ask about ketones and he said they were not present. He gave me two numbers, but it was hard to understand over the phone. He said one of the sugar levels was at 27.2 (when the normal range is 4.9) and that the fructose levels were 610 (he said they should be between 191-349).

His levels are pretty high so you will definitely want a low carb diet combined with insulin. Looks like the blood glucose was 27.2 mmol/L, and there was a lot of glucose in his pee (I think my vet said 3+ or 4+ is the max reading!). My Dixie started off with 22.6 mmol/L, and 3+ in her pee as well, but it all came down with insulin, low-carb food, and care I even tracked the glucose in her pee since the ketone test strips I bought came with a glucose test... my 2020 spreadsheet has some of those values. It was very encouraging to see the glucose in her pee slowly come down to 0

Since I had some questions and insisted on getting my own supplies I am hoping he will take my participation seriously. I know he has FCC's best interested at heart, but the insulin thing has me a little wary. Also I am not sure why when I asked about a low carb diet he didn't tell me to start right away, but rather wait for my appointment. I guess to sell me food. He said to book asap as soon as I've gathered the supplies.

My advice is to not try to get too much validation from your vet about things such as testing or feeding specific foods. With my first vet, I was very excited to show them all the progress I had made after the first couple of months, and they just kinda shrugged and said that it looked like I knew what I was doing and that was it. You likely won't find that your vet will be enthusiastic about any food that they don't sell in store. I mean, they are busy! The probably have the food reps come in and tell them all about the food and show them the studies and then that is just what they recommend. There is no way that they can keep up with all the different food choices there are!

 

[Bandit's Mom]

The other thing to watch out for is the dose he starts FCC on for Lantus. Some vets start kitties out on doses that are too high. With a food change in the mix, the starting dose is even more important.

 

[Acadaca]

Thank you again for all the helpful information and insight. I am glad that they sent a copy of the test so that I could see how clearly out of whack his numbers are. I have gotten my hands on a glucometer and some strips from a local buy nothing group (thank you for that suggestion as well) and will go sort out insulin and other supplies tomorrow now that I've cleared up with him that I don't want a prescription filled at a random pharmacy not of my choosing.. I was thinking about the dose and am not sure how he is intending on figuring it out. Since he wants to walk my partner through the first dose he clearly has something set in his files. I am also not sure how amenable he will be when we show up with insulin and needles that did not follow his prescription. I am hoping that FCC's numbers will be a little better after the diet switch. Is there something I should or can do to work that out?

The information about the spreadsheet is greatly appreciated. How often do you guys end up testing sugar levels? I assume I will have to do it a lot more frequently in the beginning. I'm sorry if these questions have answers in the articles on this site. I have been reading them, but am going a little cross eyed with all the information coming at me. Currently I am focusing on how much wet food he should be getting and how on earth to make sure my other cat gets her fair share.

I feel like this is a really stupid question, but just to check - those of you who use automatic timed feeders are doing so with dry food?

FCC needs all the help I can give him clearly. Looking all those out of the park numbers broke my heart. He's such a trooper given the amount of purring and general contentment he spreads everywhere. Even though my other cat (Typewriter, it feels weird leaving her unnamed) picks on him all the time.

I see how it makes sense not to lean on the vet for too much validation. I don't even know how it will work when it comes to checkups. How often do your kitties go in? Do you get vet tests when they do? Our vet bill ended up being just under 550$ for tests and the checkup (as well as ear cleaning and hazardous waste disposal fees!) and that's an unfathomable amount to have to do continually. I owe a great deal of thanks to all the budgeting people have shared with me because it gives me a much better idea of what to expect for monthly at home costs and to figure out how to accommodate those, but I am hoping the vet bills stay trim barring any complications.

 

[Wendy&Neko]

those of you who use automatic timed feeders are doing so with dry food?

No, you can put wet food in there. If kitty is a grazer, you don't need an automatic feeder, but I had a hoover and I needed to spread feedings out so she'd have some food at the time of her cycle when her numbers were lower.

To start, we suggest testing minimally just before each shot, to make sure the number is high enough to give insulin. If you can, somewhere in the middle between the shots is also useful, as the low numbers or nadirs occur then. We determine how to change the dose based on how low the dose takes the cat. When the low points are in the cycle also depend on the cat. We have a saying here, ECID or each cat is different. Typically the low point is midway or 6 hours after the shot, but can range a few hours on either side of that. And you are right, a little more testing at the beginning to see how your cat responds on Lantus is a good idea.

We have a couple of different Lantus dosing methods here - people pick one which suits their life style. One picks the starting dose based on weight, (for a typical cat would be around 1.0 units), the other method would have you start at 0.5 units if feeding all low carb wet or raw.

 

[Bandit's Mom]

We have a couple of different Lantus dosing methods here - people pick one which suits their life style. One picks the starting dose based on weight, (for a typical cat would be around 1.0 units), the other method would have you start at 0.5 units if feeding all low carb wet or raw.

I'm sure you've already seen this, but in case you haven't I'm linking the sticky with the two dosing protocols mentioned by Wendy:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

In a nutshell:

1. SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You get pre-shot tests every day and do a weekly curve with SLGS.
2. TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50. The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

 

[FarmKitty]

The information about the spreadsheet is greatly appreciated. How often do you guys end up testing sugar levels? I assume I will have to do it a lot more frequently in the beginning. I'm sorry if these questions have answers in the articles on this site. I have been reading them, but am going a little cross eyed with all the information coming at me. Currently I am focusing on how much wet food he should be getting and how on earth to make sure my other cat gets her fair share.

Don't worry about getting it all in the beginning. Just keep researching the info as you need it. First, you will probably be researching info about getting the blood sugar levels and how to track them in a spreadsheet. Since FCC's sugar is high, it gives you a bit of a buffer to learn all this stuff! When his blood sugar levels start coming down, then you will get to enjoy the journey of learning how do deal with dosing insulin But you can just take it one step at a time!

I feel like this is a really stupid question, but just to check - those of you who use automatic timed feeders are doing so with dry food?

I use a 5-meal pet feeder with wet food. This one is the most popular here. If you look up the automatic timed feeders online then there are a lot of ones that dispense only dry food, so I could see how you would be confused! I like my pet feeder because it keeps the wet food fresh since it covers the meals up, and also it ensures that some uneaten food will be available if I want to go to sleep and am concerned that Dixie's blood sugar levels will drop low throughout the night. They definitely aren't necessary though. There are various types of automatic feeders. There is one that can detect which cat is at the food bowl, so it can prevent unauthorized cats from eating

FCC needs all the help I can give him clearly. Looking all those out of the park numbers broke my heart. He's such a trooper given the amount of purring and general contentment he spreads everywhere. Even though my other cat (Typewriter, it feels weird leaving her unnamed) picks on him all the time.

I felt the same way when Dixie was diagnosed... but lots of her values improved after she got regulated. Diabetes really takes a toll on the system! It is great that he isn't showing symptoms.

I see how it makes sense not to lean on the vet for too much validation. I don't even know how it will work when it comes to checkups. How often do your kitties go in? Do you get vet tests when they do? Our vet bill ended up being just under 550$ for tests and the checkup (as well as ear cleaning and hazardous waste disposal fees!) and that's an unfathomable amount to have to do continually. I owe a great deal of thanks to all the budgeting people have shared with me because it gives me a much better idea of what to expect for monthly at home costs and to figure out how to accommodate those, but I am hoping the vet bills stay trim barring any complications.

The longer diabetes goes untreated, the more damage it can do to the body. It is better to catch these things early, and cats are pros at masking signs of illness, so you will want to take your cat to the vet for blood tests more often in the beginning. For healthy senior cats (10+) they recommend every 6 months, and Dixie is 14 years old, so I took her in for a vet checkup after 6 months and discovered that she had hyperthyroidism. I am really glad that I took her in to catch that!

I think it will depend on how FCC's blood sugar values go. If they are tough to bring down, then you may want to make another vet checkup in <6 months. If he is starting to show symptoms, then you will need an earlier appointment... it is just really hard to predict!

Now that Dixie has a whole host of issues (kidneys, thyroid, liver), I have taken her to have 4 blood tests this year already... yikes! To save money, my vet helps me pick the blood tests that are the most cost effective. There is a blood test set that is a bit less thorough, but is less money. It still covers all the important parts. If you let your vet know that you are working on a budget, then they may have ways to make it work.

I also save money by getting the blood/urine tests done with the vet tech, but don't schedule a full vet checkup appointment. This saves me $100 each time. I've got an incredible vet who actually calls me up after each test and answers all my questions about the results, but I can't imagine that is very common! If I do schedule a full checkup with the vet, then I make an effort to come prepared with questions so that I can get my $$'s worth.

Another option is to just shop around for different vets. For your next checkup, just read some reviews and go to a new vet. They may be less expensive and a lot more agreeable with how you are managing FCC's diabetes! I am very glad I switched

 

[Acadaca]

Thanks again. First, I want to apologize to anyone who provided me with an answer to a question that I later asked when the answer was already there. I swear I am reading (and re-reading) these posts. I was still getting so caught up in panic mode that I was asking everything that was coming into my head. I think I've calmed down a little now because you've all helped me feel less overwhelmed and I also realize that this is such a wonderful community that will offer help and support. It does make all the difference. I am off to buy the insulin and book my appointment which I hope will be soon. Even though I'm not making progress with FCC other than his food change (he now lies on top of where I used to keep his dry food several times a day and stares me down hopefully.)

I am going to listen to everything the vet says and then use that in conjunction with the information on here and come up with a real plan. Though the vet may really surprise me and have suggestions that don't require me to spend more money than I need to and aren't "prescription" based. I really hope he helps me work out how much food I should be feeding FCC, but I don't know for sure. I continue to try and figure out if both the cats are getting enough to eat. Unfortunately Typewriter is very much a grazer and I am worried he will eat all her food and leave her hungry. She's such a dainty old cat.

I've started a book to write all the information and suggestions in and I think it will help these things sink in a little more. It is so nice to feel more in control now and I think that will help the situation. I realize it is very much once step at a time for the next while and then maybe the bigger picture will come into focus. I am also writing out questions that I would like my partner to ask so we make sure we get the information we think we need from him.

 

[Acadaca]

Hi again. Sorry for more questions. I am sure the answers are on here, but I've been reading a lot of the links and I can't seem to find what I need. I have read through this thread multiple times so I'm really hoping I'm not missing something.

When I went to the pharmacist and I don't think he's had any experiences with cats and because I never got the prescription from the vet I didn't have any guidance on his plans. Hopefully tomorrow when my partner goes in the evening to meet with lab technician they will help some clarity.

The biggest issue of confusion for me is the needle size. They didn't have the brand suggested above so I ended up getting NoviFine Plus 32G 4 mm. Are these appropriate?

The other question is if the dose the vet technician administers is the dose we should stay on no matter what? For the first little bit. I am still reading about the two methods and trying to decide what to do. I am leaning towards the TR, but I'm scared to do all those tests. I also need to calculate how long our strips would last with this method. It's been an expensive week and we haven't even bought all the new food we'll need yet. Luckily the cans we have are the Friskies pate.

The good news (I think) is that it's only been a couple days since we started feeding him wet food only and switching out his treats for freeze dried chicken bites and he is already acting a bit different. Maybe I'm projecting. He's peeing a little less as well.

I haven't filled out my signature information yet because it's still baby steps at the moment.

Thank you!

 

[Wendy&Neko]

If the NoviFine Plus 32G 4 mm are the pen needles, take them back, that's not what you want. You want syringes, U-100 3/10cc syringes with half unit markings. BD Ultrafine II are in almost all pharmacies here. It's a while box with purple and yellow markings on it.

The other question is if the dose the vet technician administers is the dose we should stay on no matter what?

No, definitely not. First of all, I would listen to the vet over the technician. Second, we've seen some vets start with too high a dose. Find out what dose they want you to start with and post here. We don't want you to be one of those people who end up with an overdosed cat right away.

Peeing less is good! The change in diet is helping.

 

[Acadaca]

If the NoviFine Plus 32G 4 mm are the pen needles, take them back, that's not what you want. You want syringes, U-100 3/10cc syringes with half unit markings. BD Ultrafine II are in almost all pharmacies here. It's a while box with purple and yellow markings on it.

The pharmacist said we needed to get the insulin in the disposable pens and that these were the compatible types? He was very insistent when I told him I just wanted the cartridges. Did I mess up already? He strongly suggested that I must have misunderstood. The needles were behind the counter so I couldn't see them at all.


No, definitely not. First of all, I would listen to the vet over the technician. Second, we've seen some vets start with too high a dose. Find out what dose they want you to start with and post here. We don't want you to be one of those people who end up with an overdosed cat right away.

Peeing less is good! The change in diet is helping.

That's what I thought. I was just worried that once the first dose went in he would have to stay on it for a bit. Unfortunately they wouldn't book us an appointment with the vet, only the technician. I suspect they are super busy and just fit us in wherever and however. The vet had told us he had gathered some information for us, but I assumed we would be seeing him again.

The pharmacist said we needed to get the insulin in the disposable pens and that these were the compatible types? He was very insistent when I told him I just wanted the cartridges. Did I mess up already? He strongly suggested that I must have misunderstood. The needles were behind the counter so I couldn't see them at all.

 

[Wendy&Neko]

You can get Lantus insulin in vials, or 5 packs of pens or cartridges. Cartridges are like pen refills. Pens just have so much more waste which you don't need, so I went for the cartridges. And they are cheaper. This was actually first advised to me by my pharmacist who had lots of kitty clients. NovoFine pen needles are for Norvo Nordisk insulins, of which Lantus is NOT. Take them back to the pharmacy. This post has a picture of a Lantus cartridge, a little over half way down:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

It's fine for the technician to show you how to give the insulin, but the actual dose should be by the vet.

 

[Acadaca]

I cannot believe how patient you are walking me through this (repeatedly). Thank you. I think I will get the syringes from a different pharmacy today and return the others tomorrow. I'm the worst at confrontation so after saying "no that's not what I want" once it's very easy for me to assume I'm wrong and not be able to question again. My notebook is starting to have multiple pages of notes from this site and the various links so I will get the hang of this at some point. Once he gets his initial injection at the vet's office do I mention it in this post or should I move over to the Lantus message board?

I will pass on your patience and help somewhere in life when I have the opportunity.

 

[Wendy&Neko]

You can keep posting on this forum if you want. We like people to have their signature and spreadsheet set up before hopping over to the Lantus forum. It's a little busier there so we assume some basics. This forum here helps you get started and get going with testing.

 

[FarmKitty]

Here is the Lantus that you can get at any pharmacy. It is Lantus in the cartridges. It comes with a pack of 5. You can see one of the cartridges to the right there. I take a syringe and poke it into the purple part and draw up insulin like that.

They also sell it in bigger bottles for a bit cheaper. I prefer the cartridges though because the insulin will go bad before you can use it all up anyways (since it is meant for humans who use much higher doses than we use on cats).

Don't ask your pharmacist about any pet insulin stuff, since they won't have any training it it and will want to do due diligence, so they may then just ask you to get info from your vet. If you just go in and have the pic I showed you, then they will know exactly what you need.

Once you have the insulin, you can get the syringes. I have bought all mine online during the pandemic, and recently bought these CarePoint VET U-100 syringes. The site gives free shipping if you order over $75, so I bought 4 packs for a total of $91.06 CAD. Not sure if you can find better than $21.68/100 syringes in stores since I haven't looked yet though... but just thought I would recommend this as an alternative if you don't want to look in the stores! With 2 doses a day, this will last you 6.5 months!

Unfortunately they wouldn't book us an appointment with the vet, only the technician. I suspect they are super busy and just fit us in wherever and however. The vet had told us he had gathered some information for us, but I assumed we would be seeing him again.

Yeah the vet tech is the one who will show you how to do the injection. The 'info' I got from the vet was just a pamphlet (that actually linked here ), and some outdated info such as I can only feed 2 times a day, and dry food is necessary for teeth health (both untrue)... oh and that I needed their "prescription" foods... There really aren't any secrets to diabetes that they can give you. It is all about controlling the blood sugar levels and the main way to do that is with insulin and maintaining health with low-carb wet food, regular checkups, dentals, exercise, etc. Just don't go in expecting to get some amazing advice or validation from your vet (that is what I did... disappointing!! hahah).

 

[Acadaca]

Thank you. I think I am going to go for the TR method although it seems very intimidating. I don't know if he has a chance of remission since his starting levels are so high, but this may be his best chance.

Would anyone recommend against this given that I'm still feeling fairly confused and somewhat overwhelmed?

I am home most of the time at the moment so I have the opportunity to be present. Hopefully my partner can do most of the insulin shots and help me with all the monitoring in the beginning.

When it comes down to it, FCC is what matters so I am just going to have to get over all the trepidation that I am sure everyone else feels. I used to make my partner dose out the wet food because I don't eat meat and that part grosses me out, but I've started to feed him little bits throughout the day since the dry food has been completely removed. My cat is the one who is going to have to do all the hard work of getting better.

 

[Acadaca]

Here is the Lantus that you can get at any pharmacy. It is Lantus in the cartridges. It comes with a pack of 5. You can see one of the cartridges to the right there. I take a syringe and poke it into the purple part and draw up insulin like that.
View attachment 61222
They also sell it in bigger bottles for a bit cheaper. I prefer the cartridges though because the insulin will go bad before you can use it all up anyways (since it is meant for humans who use much higher doses than we use on cats).

Don't ask your pharmacist about any pet insulin stuff, since they won't have any training it it and will want to do due diligence, so they may then just ask you to get info from your vet. If you just go in and have the pic I showed you, then they will know exactly what you need.

Once you have the insulin, you can get the syringes. I have bought all mine online during the pandemic, and recently bought these CarePoint VET U-100 syringes. The site gives free shipping if you order over $75, so I bought 4 packs for a total of $91.06 CAD. Not sure if you can find better than $21.68/100 syringes in stores since I haven't looked yet though... but just thought I would recommend this as an alternative if you don't want to look in the stores! With 2 doses a day, this will last you 6.5 months!


Yeah the vet tech is the one who will show you how to do the injection. The 'info' I got from the vet was just a pamphlet (that actually linked here ), and some outdated info such as I can only feed 2 times a day, and dry food is necessary for teeth health (both untrue)... oh and that I needed their "prescription" foods... There really aren't any secrets to diabetes that they can give you. It is all about controlling the blood sugar levels and the main way to do that is with insulin and maintaining health with low-carb wet food, regular checkups, dentals, exercise, etc. Just don't go in expecting to get some amazing advice or validation from your vet (that is what I did... disappointing!! hahah).

Thank you. Those needles are much cheaper than the ones I just bought. I needed to make sure I had something to bring to the vet tomorrow. All of the links for online ordering will be super helpful after this. I was gifted an Accu-chek Aviva Nano along with a couple boxes of strips so that helps a lot with the initial costs. I will likely switch to the Bravo mentioned above once the strips run out as long as I can find a home for the original glucometer.

 

[FarmKitty]

Also you don't need the vet to give the actual first dose of insulin. If anything, that would be annoying since it is supposed to be given 12 hrs apart, and you would probably be at the vet during business hours... Usually with the vet tech you will just inject something else for practicing with, and they will say "oh start him on xyz dose and then come back for a glucose curve" or whatever (which you won't need to pay for cause you can test at home )

Would anyone recommend against this given that I'm still feeling fairly confused and somewhat overwhelmed?

I started with a different insulin (ProZinc), and the advice was to start with SLGS for a month to get the hang of things. Not sure if you have gotten any blood sugar tests in yet, but that can be a very tricky process to get the hang of at first and it may be hard to get as many tests in as you'd like. Once you have more experience and data, you will feel comfortable moving up to TR.

I used to make my partner dose out the wet food because I don't eat meat and that part grosses me out, but I've started to feed him little bits throughout the day since the dry food has been completely removed. My cat is the one who is going to have to do all the hard work of getting better.

That's great that you are getting more comfortable with that! FCC will need extra care, but it is sooo worth it and very rewarding!

I will likely switch to the Bravo mentioned above once the strips run out as long as I can find a home for the original glucometer.

Also, it is nice to have a backup glucometer just in case. Not sure how many strips you have for the Accu-Chek, but if you have a sealed bottle then you could keep it around for times when you want to verify the Bravo meter results. Sometimes I was getting really low or really high Bravo meter results, and I wanted to make sure the glucometer or strips wasn't faulty. I had a couple other glucometers on hand which were super useful so that I could verify the readings!

I'm the worst at confrontation so after saying "no that's not what I want" once it's very easy for me to assume I'm wrong and not be able to question again.

I get you! In this case, I like to have written down exactly what I need on paper. You can just hand it to them. For some reason, things written out are taken more seriously?

 

[Wendy&Neko]

I started TR right away, no problem doing that if you want with Lantus, as long as you are feeding all low carb wet food or raw. It's a faster method to get him into a dose that will get him better blood sugar numbers.

Take a look at eBay for test strips for the Accu-check. You can get some good prices there. Even if you do switch to the Bravo, keep your old meter around as a backup for which you can get test strips quickly and locally. We always recommend a back up meter. I could tell funny stories I've seen here of cat tails flicking the meter into water, microwaving the meter instead of the rice sock in the wee hours.

 

[Peggy & Clawdius]

I wouldn't worry about just seeing the vet tech if things are going well. I saw my vet for the first visit when all the blood work was done and Clawdius was diagnosed. She took a lot of time to explain things to me and answer any questions. She put him on a dose of 1 unit twice a day and we will revisit it after the glucose curve is done. After that first visit it has been the vet tech Jocie I have dealt with. She has a sugarbaby of her own and has been extremely helpful with all this. She is very knowledgeable. She will show the vet the glucose curve when I email it to her, let me know if there are to be changes in dosage and whether I need to come and see the vet, and pass on any questions I have. That saves me not only having to make the time for a vet visit but the cost as well. I was not charged for either visit when I went to learn how to do the insulin shots and how to do the glucose curve. Jocie is always available by email.

 

[Peggy & Clawdius]

You can get Lantus insulin in vials, or 5 packs of pens or cartridges. Cartridges are like pen refills. Pens just have so much more waste which you don't need, so I went for the cartridges. And they are cheaper. This was actually first advised to me by my pharmacist who had lots of kitty clients. NovoFine pen needles are for Norvo Nordisk insulins, of which Lantus is NOT. Take them back to the pharmacy. This post has a picture of a Lantus cartridge, a little over half way down:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

It's fine for the technician to show you how to give the insulin, but the actual dose should be by the vet.

What is the difference between the pens and the cartridges? Are the cartridges refills for the pens? I like the pens because I am needle phobic and the pens look less like needles but cheaper would be good.

 

[Bandit's Mom]

What is the difference between the pens and the cartridges? Are the cartridges refills for the pens? I like the pens because I am needle phobic and the pens look less like needles but cheaper would be good.

Yes. Cartridges are refills for pens and are usually cheaper than buying the pen. @FarmKitty will be able to help with the actual prices.
Here we use syringes to draw the insulin from pens/cartridges and inject into our kitties. The disadvantage of using pens is that you can only dose in whole units and we increase and decrease the dose in multiples of 0.25U. The syringes with half unit markings help with that.

Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

 

[FarmKitty]

I wouldn't worry about just seeing the vet tech if things are going well. I saw my vet for the first visit when all the blood work was done and Clawdius was diagnosed. She took a lot of time to explain things to me and answer any questions. She put him on a dose of 1 unit twice a day and we will revisit it after the glucose curve is done. After that first visit it has been the vet tech Jocie I have dealt with. She has a sugarbaby of her own and has been extremely helpful with all this. She is very knowledgeable. She will show the vet the glucose curve when I email it to her, let me know if there are to be changes in dosage and whether I need to come and see the vet, and pass on any questions I have. That saves me not only having to make the time for a vet visit but the cost as well. I was not charged for either visit when I went to learn how to do the insulin shots and how to do the glucose curve. Jocie is always available by email.

Sounds like you have a very caring vet tech! They make all the difference.

What is the difference between the pens and the cartridges? Are the cartridges refills for the pens? I like the pens because I am needle phobic and the pens look less like needles but cheaper would be good.

Gonna try to figure out the prices cause I am curious (just for fun )

Here are prices from DiabetesExpress (might find them cheaper in person, but these are a bit cheaper than what I paid at Shoppers):

• Lantus 10 mL vial is $72 CAD
• Lantus 5 x 3 mL cartridges are $113 CAD

Since Lantus is a 100 U/mL insulin, it has 100 units in a mL:

• Lantus 10 mL vial has 10 mL * 100 units = 1000 units
• Lantus 5 x 3 mL cartridges are 5 * 3 mL * 100 units = 1500 units

If we just go cost per unit, then we get:

• Lantus 10 mL vial is $72 / 1000 units = $0.072 / unit
• Lantus 5 x 3 mL cartridges are $113 / 1500 units = $0.075 / unit

So, by unit, how much more do the cartridges cost?

• Cost of 1500 units in vials = ($0.072 / unit) * 1500 units = $108
• Cost of 1500 units in cartridges = $113

So the cartridges cost $113 - $108 = $5 more than than the vials. Now, let's consider how it is actually used. Suppose your cat is on 1 unit twice a day, and that you draw up 1.5 units to get rid of air bubbles. So you use up 3 units a day:

• Lantus 10 mL vial is 1000 / 3 units = 333 days = 10.9 months
• Lantus single cartridge is 300 / 3 units = 100 days = 3.2 months per cartridge. You get 5 cartridges, so that is 16.4 months total.

This will obviously vary depending on the cat. If your cat is at 5 units then you might use 11 units a day, so 1000/11 = 90 days = 3 months on the vial which is pretty good. I used 1 unit since that is often the recommended starting dose (and I am biased cause that is where Dixie was at for a long time )

So why pay $5 more to buy the cartridges instead? Well the insulin will lose its efficiency as it gets older. With the cartridges, you can open a fresh one every 3.2 months and get full use of all the insulin. With the vial, you will be
using the same insulin for 10.9 months and that is pushing it... I used up almost every drop of my ProZinc vial (~ 9 months) and was seeing rising BG values. I was reading here that some people notice changes after 1 month of the same insulin bottle. I think it will just depend on your cat and the insulin storage conditions. So if you want to change out the insulin more often then the cartridges are worth it!

On the other hand, the 10 mL vial is only $72... so if you want to give Lantus a try for a few months and then might switch to a different insulin, then the vial is less money up front. Although, I have read on the forum that some nice pharmacists will sell single cartridges which would be even better to try it out.

This is all assuming that the cartridges are kept in the fridge to prolong their use. @PeggySue, if you are using the pens then I am guessing you are storing them outside of the fridge? I have read some info online about how storing the pens inside the fridge will cause dosing inconsistencies since the pen mechanism's temperature will be changing (I can find sources if you want them). Insulin will degrade quicker if it isn't kept in the fridge, so this would be the more expensive option. There is also the disadvantage that the pens can't give smaller dose increments like 0.25 units. I believe the pen mechanism itself also adds to the cost. But if it works for you, then keep at it! We gotta do what we gotta do .

 

[Acadaca]

I haven't figured out if I can quote more than one person so I'm just going to reply to everything. Or try.

When I bought the insulin the pharmacist told me there was no difference in pricing between the pens and the vials. I didn't realize until the pens were even a thing until told me they were what I needed. We phoned the vet this morning and they said we needed a pen for our demonstration. It's frustrating that no one is acknowledging that I just want to use the cartridges and syringes. I just assumed you can't return insulin so I figure we're stuck with the disposable pens until the insulin runs out. I did buy the syringes mentioned in this post, but I don't know if they're compatible with how they want to show us. The confusion over the prescription might have been that they want us to get a single pen and that is only available by prescription? Regardless I don't like how they insisted we would have to go to one particular pharmacy. I really wish the vet would make himself available to answer our questions, but I am hopeful that the vet technician will be able to answer some of them. I think it's complicated for them because they're busy and they have to deal with all the Covid protocols. My partner will ask if the vet will be available for any email. It would have been nice to have a meeting with him after the bloodwork came in, but we just received a phone call with the results. I am not trying to bash the vet! I just feel like I wasn't really given any help and everything I know I have learned from here.

I am hoping they show us without the actual insulin as mentioned above because they appointment is just before six and that will be an early wake up for me 12 hours later.

Writing things down to show the pharmacist is a very good idea.

This forum has been a lifesaver, but it's a lot to take in (this whole experience is) and I can't even imagine what it would feel like if it weren't for this board.

I totally see the usefulness of having two glucometers around because I am absolutely the kind of person who would accidentally put it in the microwave.

Also, I like all the number crunching! It's pretty useful.

 

[Acadaca]

I think we probably are going to have to do the SLGS method, at least for the first bit because after one and a half days of attempts we still haven't been able to test his blood levels. I'm not giving up, I just don't see us being able to successfully do it four times starting tomorrow.

 

[FarmKitty]

I haven't figured out if I can quote more than one person so I'm just going to reply to everything. Or try.

Click on the text box where you want to insert the quote. Then go up to the person's message, highlight the part you want to quote, and a 'Reply' button will pop up near the quote. If you click that, it will insert it into your message box! Sometimes takes a few tries.

We phoned the vet this morning and they said we needed a pen for our demonstration.

Yeah I am really not sure what they are talking about... maybe they exclusively use the pens for some reason? Maybe just bring in your syringes (make sure they are the correct 100 U/mL ones, otherwise they will be very concerned about you potentially not using the correct syringes with the correct insulin which would be very bad!).

I really wish the vet would make himself available to answer our questions, but I am hopeful that the vet technician will be able to answer some of them.

What questions do you have? Even if a vet tech might know the answer to your question, they will usually need to defer to the vet anyways because the tech isn't allowed to give out information that they aren't trained and licensed in (could end up vet badly for the vet clinic!)

just feel like I wasn't really given any help and everything I know I have learned from here.

I am sorry things are going this way, but it is pretty common.

I think we probably are going to have to do the SLGS method, at least for the first bit because after one and a half days of attempts we still haven't been able to test his blood levels. I'm not giving up, I just don't see us being able to successfully do it four times starting tomorrow.

Getting the blood samples in the beginning is definitely the hardest part. The ears take a while to 'learn to bleed'. When I started out, it would take several pokes to get any blood out at all. Now, I get almost too much blood each time . It will get easier. You just gotta persevere for this first month to get over the hump.

Some questions for you:

1. What are exact names of the supplies that you have (insulin, syringes, glucometer, lancets)? I want to make sure your syringes are compatible with your insulin.
   
2. Did you get a lancing device when you got the supplies? It isn't necessary and a lot of people do without, but I personally use one and like it.
3. What are your questions you have planned to ask the vet tech? Maybe we can help you gather info about them and figure out which ones would be more appropriate for the vet vs. the tech.

 

[Acadaca]

Click on the text box where you want to insert the quote. Then go up to the person's message, highlight the part you want to quote, and a 'Reply' button will pop up near the quote. If you click that, it will insert it into your message box! Sometimes takes a few tries.

Just checking.

I've kind of lost track of my questions. I have a notebook for FCC, but I also seem to have paper strewn about with scribbles everywhere. I keep thinking I have a handle on things and then it just ends up not being the case.

Here are the exact supplies I've ended up with:

5 Lantus solostar 100 units 3ml disposable pens (maybe where things started to go wrong)

I have 100 BD insulin syringes ultra-fine (they said they've changed their packaging so there is not ultra fine II). For u-100 6mm 3/10ml 15/64" x 31g

A handful of BD sterile needles .25 mm x 8mm 5/16" x 31g

The vet gave us the latter and I presume I need to get more for this batch of insulin?

An Accu-chek Aviva Nano glucometer (with lancing pen) and a handful of lancets (I can't find any information on them, the plastic is white.

I have drawn blood succesfullyish once. When I put the strip to the ear I got an error message for low battery. Which is kind of funny in the grand scheme of things. I didn't see any mention of a low battery sign until then. Tomorrow I will go get the necessary batteries, but I don't have any numbers yet.

The vet has told us to start him on 2 units twice a day (I don't know if that is the correct term). The technician told us we would be able to email the vet. I am very thankful for this.

My partner just told them we had the testing equipment at home and they asked whether it was cat specific and he just said yes so there wouldn't be a sales pitch.

They told us to look into a particular brand of food (he cannot currently remember the name, but we are expecting an email), but was not "prescribed" anything. I asked that he mention that we had already switched him to a low carb wet food exclusive diet (plus freeze dried treats) and they said it wouldn't factor into dosing and they we needed to pay attention to the kcal count when it came to Friskies. I have not looked this up yet, but also am not too worried because of all the information I have read on here.

They did not tell us how many calories to feed FCC, but he weighs 7.3 kg (down from 7.4 last week) and his ideal weight is 6 kg. I might email that question to the vet.

They did not specify when we should come back since my partner told them we wanted to do FCC's curve at home.

His name is Field Commander Cohen, but I thought it was better to abbreviate it. I don't want anyone to think I just yell initials at the cat.

 

[Peggy & Clawdius]

This is all assuming that the cartridges are kept in the fridge to prolong their use. @PeggySue, if you are using the pens then I am guessing you are storing them outside of the fridge? I have read some info online about how storing the pens inside the fridge will cause dosing inconsistencies since the pen mechanism's temperature will be changing (I can find sources if you want them). Insulin will degrade quicker if it isn't kept in the fridge, so this would be the more expensive option. There is also the disadvantage that the pens can't give smaller dose increments like 0.25 units. I believe the pen mechanism itself also adds to the cost. But if it works for you, then keep at it! We gotta do what we gotta do .[/QUOTE]

The pharmacist told me to keep the pens in the fridge but not in the door because with the opening and closing all the time the temperature would not stay constant. I am hoping that Clawdie's dose stays in whole units because I do really like the pen. I am also very lucky because my brother works at Walmart. They get 10% off anything they buy and can use that discount for close family. As well, since covid the walmart here has been giving their staff a 20% off day about once a month or so. I got all the supplies I needed then so it was a significant savings.

 

[Peggy & Clawdius]

5 Lantus solostar 100 units 3ml disposable pens (maybe where things started to go wrong)

This is what I use and I love them. I don't have to worry about anything but screwing on a new needle tip each time. In all the craziness of beginning this I misunderstood the directions and didn't realize that the pen resets to 0 after each dose so I was dialing it up to add one more unit each time I gave him a shot. I was up to 8 units before I realized what I was doing wrong and then of course I panicked! I stayed awake all night pretty much staring at Clawdius and every time he lay down I had to poke him because I was sure that he was dying and I had killed him. I hadn't found this site yet and had no idea what to do. It was a bad night to say the least. If the vet insists again that you HAVE to use a certain pharmacy or feed a certain food I would just smile and agree and then do what you want. I love my clinic but they are telling me that Friskies pates are adequate but not a good food and I am sensing a sales pitch coming. So I smile, nod, then go buy my Friskies.