Just Diagnosed

Hi everyone! I'm new here so I apologize for any mistakes.

Well, I got the call yesterday that my boy has diabetes. We weren't entirely sure so I waited to get the confirmation today and now we're certain. It started when I noticed that he was drinking a lot of water. It was unusual for him to drink the bowl down to the last drop. He also started to feel a little bonier, despite his weight staying the same. His last check-up was last year in March (with a different vet) and his lab results were perfect, so this is very sudden. This new vet didn't want to give me too much hope and told me that remission is very rare. Despite that, I'm still hoping for remission in our future.

Mus is going to be taking Novolin now every 12 hours after meals. He was also prescribed Royal Canin Glycobalance food dry and wet. I've already bought the foods, but I read that cats shouldn't be eating dry food at all if possible.

Any guidance regarding diet and remission goals would be greatly appreciated.

 

Correct, dry food is not recommended. However, there are a few commercial dry foods that are OK if a cat will not eat canned, Those are Dr Elsey's Clean Protein tdy, Epigen 90 by Wysong and Young Again Zero. Prescription foods are not recommended since they are unnecessary. For canned many of us feed the Fancy Feast Classic pates since they are low carb. Or Friskies pates. Novolin N insulin is not really suitable for cats, it only lass 8-10 hours. Better is the pet-only ProZinc or human glargine (Lantus is one brand name). You can get the generic glargine using a GoodRx coupon. Make sure you select grneric in ther pulldown menu and select carton since you want the pens (which you use with a syringe) since a 3ml pen can generally be used up before it goes bad compared to not doing that with a 10ml vial.

Most of us test our cats BG before each shot and periodically between shots using a human meter since a human meter is adequate compared to the cost of using a pet meter like an AlphaTrak meter. Most trend to use a Walmart Relion brand which the current one being their Premier line. Strips are only $9 for 50. NG is recored in a spreadsheet
HOW TO CREATE A SPREADSHEET
HOW TO USE THE SPREADSHEET

 

Hi and welcome.
I agree with Larry. Novolin Is not a suitable insulin for cats at all. It is a harsh short acting insulin that hits hard and fast. You will need to make sure you are feeding your cat an hour before the insulin dose to make sure he has enough food aboard to manage the insulin.
Also please give him snacks during all the cycles as well. Only feeding before the dose is old thinking. A snack is a couple of teaspoons of food. I would give at least 2 snacks each cycle..
I would go back to the vet and ask to be changed to either Lantus or Prozinc which are what is recommended for cats. You will have a much better chance at remission with one of those insulins. If he won’t change the insulin, I would seriously think about finding another vet who will.
What dose has the vet prescribed?
A word of warning…do not change over to a low carb diet unless you are hometesting. First please blood glucose can drop up to 100 points with the change over.
Bron

 

I'll be sure to ask my vet about the insulin when they're available, I believe they're closed for the weekend. All I have at the moment is the Novolin until I can request another brand. It's 3U twice a day. Do I really need to wait an hour after feeding? I was told to give it to him immediately after a meal. Are the insulin you've recommended okay to use with the syringes I've already purchased? I did ask her about possibly using Fancy Feast, but she insisted that it needed to be a 'higher-quality brand' like Royal Canin or Hill's MD.

I also asked if I should test his levels myself and if using a human glucose meter was alright (my late grandmother may have left one). She said I don't need to test as none of her patients do but I can and it can only be a cat/dog glucose meter.

What treats should I give him? I think I just have some dental treats and some of the Temptations ones.

 

Your vet may not be as current on feline diabetes, which is common if they don’t see a lot of diabetic cats. The reason why we recommend you wait an hour after feeding is because this type of harsh insulin hits very fast and can bring your cat’s bg down quickly. If there’s no food onboard, he could go too low and into a hypo. You should by all means home test to make sure he’s at a safe dose, which by the way 3U is really not. It’s a very high dose to start your cat on. We recommend starting at 1/2 or 1 unit at the most. The Royal Canin is not high quality it’s only high priced. Vets buy into their marketing and branding and start recommending as if it’s going to work miracles when in fact, it’s quite the opposite. It’s high carb and that’s like feeding a human diabetic fast food daily. If you’re hoping for remission, you really need to a) get him on a better safer gentler longer lasting insulin like prozync or Lantus so he’s covered a full 24 hours and b) feed him only low carb food, which is 10% or less carbs. Anything over that is high carb. But it’s very important not to switch him to low carb foods until you start home testing because that alone can bring his bg down quite a lot and on such a high 3 units starting dose, it could be dangerous. A lot of cats we see here go into remission simply by being put on a low carb diet so that’s why it’s really important to home test because if he drops to a normal range, 80-120, and you’re giving him 3 units of insulin, it can take him into a hypo.

Lastly, we hear that a vet said you can only use a pet meter here all the time, honestly I feel like at least once a day. Guess what? Before pet meters were invented, which is not that long ago, vets used human meters too. The majority of us here do. I did. I used Walmart’s ReliOn which had the least expensive test strips, which is really the big cost, and I never had an issue. It’s $17.99 for a 100 versus $1 per each pet meter test strip, so $100 for $100.

for treats, most of us use freeze dried ones which are low carbs. The 2 brands is always had at hand were PureBites and Vital Essentials. I also do baby food sometimes and some folks do regular chicken or turkey as well. Tuna is also okay

 

PLEASE DONT GIVE 3 UNITS OF NOVOLIN TO YOUR CAT TO START OFF WITH.
I WOULD ONLY GIVE I UNIT at the most. 3 units is dangerous, especially if you are not testing the blood glucose.
I can’t stress this enough?
Is it Novolin N you are using?

Yes, absolutely. Your vet is wrong. Novolin hits hard and fast and if there is no food aboard to work with the insulin, the blood sugar will plummet and you could have a hypo on your hands
Please read these links about Novolin
INTRODUCTION TO CANINSULIN AND NOVOLIN…please note this talks about two different insulins…Caninsulin and Novolin N
BEGINNINGS GUIDE TO NOVOLIN

You need to tell me the syringes you have bought so I can tell you is they are suitable please.

It is not necessary to use the expensive prescription foods from the vet. They get their nutritional education from the big food companies and they peddle their own food. And most of them are high carb and u suitable for diabetic cats
A low carb food is what you need. Look for foods 10% or less carbs.
But please do not change over to a low carb food until you are hometesting the blood glucose levels as you will risk the BGs dropping too low as a change over to a low carb diet can drop the BGs up to 100 points.

I’m sorry but your vet is wrong. The only way you will be able to keep your kitty safe is to be hometestomg and I think it is great that you want to do it. Thee are many vets out there that are not up to date with feline diabetes and they feel threatened if the caregiver does home testing. Vets who are very up to date with feline diabetes welcome caregivers who hometest as they know it helps so much in keeping the cat safe and being able to see how well or not well the dose of insulin is working.
A head in the sand approach is not good practice any more. By the time a cat is showing signs of a hypo, they are dangerously low and at great risk of a seizure.
And a human glucose meter is perfectly OK to use. That is what most of us use here and what all vets used until the last meter came into being not that long ago. And our dosing methods are based on the human meter. It is perfectly safe to use.

[QUOTE="Cat Mom97, post: 3034905, member: 37341"]What treats should I give him? I think I just have some dental treats and some of the Temptations ones.[/QUOTE]
Until you get some suitable one, they are ok but they are high carb.
More suitable treats are the freeze dried foods you can buy now or some chicken breast cooked and cut up into small bits and frozen and taken out as needed.

Please keep asking questions, I am very concerned your vet does not know much about feline diabetes.
Bron

 

I am very inexperienced in all of this and I've honestly felt very overwhelmed. I gave him some of the new wet Royal Canin food mixed with his usual dry food. After he finished I gave him his dose and I was told previously to observe him for an hour after giving it to him, so that's what I'm doing currently. I've been crying all of yesterday and today because I'm so scared to do anything that might hurt him, but I don't want to go overboard with what I read on the internet nor am I too happy with the vet (she said that remission was rare and she did not want to give me false hope).

It's the u-100 syringes. And yes, I believe the package reads "Novolin N".

 

Yes they are the correct syringes. Can you tell me are they the 3/10 ml syringes or the larger ones?

what dose of insulin did you give him?

It is overwhelming in the beginning and most of us do cry…so don’t feel you are doing anything different!
there is a lot to learn in the beginning but you have come to the best possible place.
I know it is hard to believe an internet site over a vet but I can promise you we do know what we are talking about. We are all cat owners who have had diabetic cats and we have looked after them 24/7 for years and know all the ups and downs and pitfalls that can happen.
We frequently get caregivers here who have been given bad advice or the wrong insulin by the vet. Most vets do not see that many diabetic cats and they tend to treat them like a diabetic dog which is not the way it works.
I can only tell you what we know and you will have to make your own judgment as so who you want to listen to.
The main thing you have to do is keep your boy safe and to do that you need a suitable insulin and a way of knowing that the blood glucose is not dropping too low. And the way to do that is hometesting.
Keep asking lots of questions.

 

They are 3/10mL. I gave him 3U as the vet had recommended. However, I'm thinking of not giving him another dose and just waiting until I can seek a second opinion (on both diet and insulin) as soon as I possibly can. Do you think this is okay?

 

I think another opinion and trying to get the insulin swapped to either Lantus or Prozinc is an excellent idea. I like Lantus bette myself. And you will use the same syringes you have if you get Lantus. If you get Prozinc, you need different syringes.
I don’t think it is a good idea to just stop the insulin as the are risks associated with that if you do that.
I would reduce the dose to 0.5 or 1 unit twice a day until you see another vet and swap insulin, and I would go out and buy a human meter such as the ReliOn premier meter from Walmart which is $9 and 100 test strips which are $17.88.
You will also need a box of 100 lancets size 26 or 28 to prick the ear with and some cotton Rounds to hold behind the ear
Tell the new vet you are going to be testing the blood glucose with a human meter. Don’t let him dissuade you. I don’t think I gave you the food chart to look up suitable low carb foods
FOOD CHART
Also make sure you have a hypo kit set up asap in case it is needed…..this is very important.
You will find the hypo kit and the spreadsheet and the signature in the link
HELP US HELP YOU
If you find it too overwhelming we can get someone to help you get those things set up

 

What if they need to conduct more tests and can't get an accurate lab from the use of the insulin?

 

What do you mean.?
Have a look at some of the spreadsheets of other people. You will find them underneath the posts in their signature. …thank you for setting your signature up!
You will see that the blood glucose numbers changes all the time, depending on the time of the day and when the shots were given. The only test they need to look at when thinking about the insulin is what the blood glucose is and they can see that when you have your spreadsheet set up.
You don’t need to have a fructosamine test done except at diagnosis.
After that if you are home testing, that is much more accurate than a fructosamine test, which is just an average of the last 3 weeks BG numbers. It doesn’t tell you if they have been high or low or in the middle. The spreadsheet will give you a detailed view of what has been happening all day every day.
We can help you with dosing, if that is what you are concerned about, but you will need to be home testing and feeding a low carb diet as a we need data to help you.

I can assure you that we do not go overboard with the care we recommend and we get many kitties into remission with our dosing methods. I am not saying we can get your kitty into remission, but what I can say is that you will have a much much better chance of that happening if you are feeding a low carb wet diet and are hometesting and following one of our proven dosing methods.

 

I'm a bit worried about this as I don't know if I can afford these. I've just checked the prices online.

 

Are you talking about the prices of the Lantus and prozinc?
There are cheaper generic brands of Lantus and it can also be bought cheaply from Canada and posted.
I’ll tag @Diane Tyler's Mom as she lives in the US and has information about that.

 

Heremis GoodRX coupon for generic Lantus which is just glargine. Make sure you select the generic and carton to get pens. The price for the generic is about 1/3 of real Lantus. The price depends upon the pharmacy too.

 

Welcome to FDMB.

As much as I hate to say it, being overwhelmed at first is a part of this process. We've had vets, vet techs, and medical professionals of all sorts who have been members of this board and everyone is initially overwhelmed. You clearly care a great deal about your kitty -- enough that you did your research and found us -- so of course this hits like a ton of bricks! This is a very supportive community and we're here to help. This is the best place you never wanted to be.

In reading your initial post, my first thought was that of course your vet's impression is that remission only rarely occurs. The vet is giving you less than wonderful information! When my cat was first diagnosed and hospitalized at an emergency vet clinic, she was prescribed Novolin. When I was back to see my regular vet who was feline specialist, she immediately changed the insulin. Her comment was, "Novolin is a great insulin for dogs. It's lousy for cats." That was in 2009. Since then, the American Animal Hospital Assn has published guidelines for the treatment of diabetes. Since 2018, they no longer recommend Novolin. The insulins they recommend are Lantus (or now, one of the generics/biosimilars) or Prozinc. I've linked their guidelines if you want to read through or share with your vet.

I agree with Bron. Starting a dose of 3.0u is a huge dose. It's also worrisome that your vet recommended such a large dose and discouraged you from home testing. We're huge proponents of home testing as it gives you control over what's happening with your cat and keeps your cat safe. It's even more concerning that between a whopping dose of insulin and no encouragement to home test, it sounds like your vet is unavailable on weekends. That leaves you in a position of having to spend a lot of dollars if you need to go to an emergency vet if your cat's numbers drop very low. You do NOT need your vet's permission to home test. We have tons of information on home testing.

We all realize that we're asking you to take a leap of faith and trust what could easily be a group of crazy cat people on the internet. This board had been here for over 25 years. We have been tracking some of the cats that have gone into remission. On the Lantus forum alone, we have over 500 cats that have gone into remission since 2008. No doubt we've missed some but this is an impressive track record. That list doesn't include cats that are well regulated -- it's only the cats that no longer need insulin. The research on the use of Lantus in newly diagnosed cats supports what we've seen and is not in line with what your vet told you. In fact, both the AAHA and the research on Lantus supports home testing and a low carbohydrate diet and that remission is possible.

The food your vet recommended, despite telling you it's a "high quality" food is not. Prescription diabetic food has no ingredients that are meant to treat diabetes. (In fact, the pet manufacturers lost a class action suit for erroneously calling their food "prescription.") As an example, these are the first several ingredients in the Royal Canin dry food: Chicken by-product meal, barley, wheat gluten, corn gluten meal, soy protein isolate, tapioca, powdered cellulose, chicken fat, natural flavors, dried chicory root, fish oil". Barley is high in carbs. Powdered cellulose is another name for sawdust. There are a great deal of fillers included and chicken by-products are not muscle meat. The dry Glycobalance is over 30% carbohydrate. A low carb cat food is less than 10% carb. The Glycobalance canned food is low in carbs (around 4.5%) but the ingredients are questionable (Water Sufficient For Processing, Chicken Liver, Chicken, Pork Liver, Pork By-Products, Chicken By-Products, Powdered Cellulose, Pork Plasma, Gelatin, Modified Corn Starch, Wheat Flour). If you want to learn more about feline nutrition, this is a link to a wonderful website authored by a vet.

I would not suggest getting rid of the dry food unless you lower the insulin dose. I don't mean to scare you but there is a very good chance that the only thing that is preventing a hypoglycemic episode is that you are feeding your cat a high carb food.

We are truly here to help. Please let us know if you have questions.

 

Thank you very much. I know I just won't have any peace of mind until I can get things sorted out for him.

Right now I'm looking at a list of AAHA-accredited vets to see where I should go. It's very difficult to find a feline specialist here and the one I called (it's the only cats-only clinic I could find) told me over the phone that they prescribe Novolin N and have cats in remission. Other places say that they can't tell me what insulin to give my cat until they see him in person and would probably want to conduct their own tests. Seeing the $100+price tag on these other insulins is also a bit intimidating as I don't make much and Mus doesn't have pet insurance. Does anyone know how good Vetsulin is? (Unfortunately it wouldn't use the same syringes, as I am seeing).

Yes, my relative also scratched their head at the 3U twice a day. In a phone call, the vet said that I could feel free to test at home (only because I brought it up myself), but that none of her current patients do and I shouldn't feel the need to. She also told me that she's never had a patient in remission, which is probably partly why she didn't want to give me much hope.

When I brought up a low-carb diet she said that I could do that if I wanted, but didn't mention anything about changing the dosage of insulin, just told to keep an eye on him and give him honey if I see him having a hypoglycemic episode (a concern that I brought up) before taking him to an emergency clinic. She also insisted that Hill's MD or Royal Canin Glycobalance was the right way to go. It is so expensive and I'm starting to trust vets a little less. I don't know where to go. Is Banfield Pet Hospital a good place to take him?

 

The prescription food IS expensive and you're truly not getting your money's worth. My guess is that the majority of members here feed their cats Fancy Feast or Friskies pate-style foods. You can buy a human grade food for the same as you're spending for the prescription stuff. Frankly, there's a money back guarantee on the prescription food. You could bring it back to where you purchased it from and tell them your cat won't eat it!

Novolin is one of the least expensive insulins around. As others have noted, it's not ideal given how fast a cat's metabolism is. It is our of your cat's system well before the next shot is due. Thus, it causes wide swings in blood glucose levels. A longer acting, gentler insulin is preferred (i.e., glargine or Prozinc). Vetsulin has the same problems as Novolin. I'm guessing that your vet sees more dogs than cats. (The name of Vetsulin outside of the US is Caninsulin -- it was developed for canines.) Cats can go into remission with either Novolin or Caninsulin. Those insulins just don't have the track record that glargine or Prozinc have and it's less wear and tear on you. Both Novolin and glargine use the same size syringes (U100); Prozinc and Vetsulin use the same syringes (U40).

Vets get very little education about diet and nutrition when in training. The majority of what they learn is from the sales reps from the pet food companies who visit their office and sell them the prescription food. In a sense, they've been indoctrinated in what the companies tell them. Unless they have gone out of their way to do more reading or take continuing education classes on diabetes or nutrition, they don't learn anything other than what they've been told by the pet food companies. It would like being told by the Keebler elves which of their cookies to feed your diabetic child. I'd suggest asking your vet what the percent of carbs is in the dry Glycobalance and see what she says. I'm guessing she doesn't have a clue.

None of your vet's patients home test because she doesn't bring the subject up. Most of us are used to taking what doctors tell us at face value unless we do our own research and frankly, none of us know what we don't know. If your vet started telling the caregivers she works with that it would be in their cat's best interest to test, they might do so. The other factor is that you get charged for having the vet do a curve in the office. If you're home testing, there's no need to bring your cat to the vet's office to get them to do a day's worth of testing (and it's not cheap). The vet loses money if you home test.

If you indicate what city you're in, we may have members who can recommend a vet.

 

I live in the Miami area and would be really grateful for any information anyone has on where I can take him.

I would love to give him the gentler insulins, but I'm also very worried about being able to afford it on a long-term basis.

 

I am a bit new as well, but I do want to offer this up for consideration..... the Insulin you use will last a long time (others can help guide you with that), say the bottle is 100 ml. A tiny little cat (or even a real chubby one) only needs a tiny little dose, compared to 150+ lb hooman.
We all have budgets, and I feel that the best budget is where you can save on test strips, and some of the less expensive nice healthy foods.

 

Do you know how long people normally make it last? To be fair, I still need to meet with another vet to discuss and I'm looking into other employment and/or a side gig to help me with the costs. Thank you for your response! I'm wishing you and your fur baby a smooth journey.

 

I cannot say with certainty, I'm sure someone else will be more definitive, and it may depend on the type you get. (I get the Lantus) But when you get it, you keep it refridgerated, and handle it very gently as you draw from it (i treat my bottle like nitroglycerine,,,hahahaa) , always watch for any floaties or cloudiness that may occur, as this can affect it, protect from freezing (frozen is done for). Never squirt excess you draw into the syringe back into the vial or pen,,,, shoot it in the air like in the movies... I think there is a STICKY POST that expalins all this better , I will find it and post it here for you. Manufacturer says 28 days after opening, but insulin has proven to be much more stable than once thought, and many have found it can be used for 6 months or more, or up to it's expiry date.
Either way, my bottle of insulin was bought Nov 1 of last year,,,, and its still over 1/2 full.. i recon I will get 6 months out of it,,, this will obviously adjust a bit, depending on your dosage needs. Hope this helps.

 

I should know better than to offer to post it to you, I am bad at computers,,,lol,,,
But the longer way to get there and find it...back out of this and go back to main health forum,,,,, scroll down to insulin support groups and you will see Lantus/biosimilars forum, click this and you will see the 3rd STICKY posted is Insulin Drawing/ Handling/ fine dosing. Read that one

 

Sorry, to add to what I said above..... take gentle care of your insulin and it will last a good while.

 

Lantus? 6 months is how long you can store it in the fridge generally. Just follow a couple precautions to ensure it lasts the full 6 months.

1.) Never reuse needles; this renders the contents of the vial non sterile, and could contaminate it.

2.) Avoid re-injecting excess insulin into the vial. This can cause latex to get into the vial and cause problems with long term stability.

3.) Keep the bottle sitting up, in the fridge, in it's little cardboard package/box.

 

Gabby was prescribed Lantus/glargine. She was never on a large dose of insulin. With a few exceptions due to a pharmacy tech mishandling the insulin, a single pen (I did not use a vial) would last roughly 3 months. The pens typically come 5 in a box. You can also get vials but I preferred the pens since if you drop and break the vial, you're in trouble. If something happens to a pen, you have a back up.

I would suggest your start a new thread in order to ask about a vet. State something like, "Looking for a vet in Miami, FL area" and include some relevant info in the text. You just want to let people know you've gotten less than stellar advice from your vet and you'd like to find a vet who is knowledgeable about feline diabetes.

@chuckstables - there is not latex in the syringes. There's a lubricant. There are other reasons to not re-use needles as the metal begins to become ragged and giving a shot will hurt. Not everyone uses a vial. Most insulin now is available in pen form and do not need to be stored in an upright position. The dispensing mechanism is different than a vial.

 

Thank you, I'll create a new thread for that!

If a single pen lasts roughly 3 months, wouldn't the other 4 pens go bad around that same time? Or are they okay as long as they're not in use? Sorry if I'm not understanding.
I thought some people made Lantus last almost 6 months. Is that the vial kind?

 

What Sienne is saying is that there is enough insulin in each pen to typically last for ~ 3months worth of injections. ( and pens typically come in a 5 pack). Unopened are good until expiry date. (15 months supply)
It also comes in a single glass vial, which lasts 6 months or even more, depending on dose.

 

So if I were to buy the pens, they could last me for a year or so? The unused ones won’t go bad past expiry and have an adverse effect?

 

Yes they would be bad IF they are past their expiry date. Do not used expired insulin, it likely has very reduced effectiveness, as well as other possible problems.
When you purchase just check the exipry date (it does have a long shelf life). As an example my vial bottle of Lantus expires in August 2024.

 

Wow, thanks I’ll keep that in mind!

 

You can have the vet write the script for generic lantus ,many members use it
Here is some info
Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

@Cat Mom97