Make the switch to???

[JanetNJ]

Ok so for the past week or so I have been tracking CC's numbers (yeah, finally figured out how to do the ss!), and I have yet to see her out of the 300's. I just don't think the Vetsulin is working for her, plus from what I read it's so short acting that it's not a great choice. I do like it's price, but that's about it.

SO armed with that info we are planning on talking to the vet about switching to a longer acting gentler insulin. I know Lantus is the first choice of many of you. Now my problem is that when school starts and we are all back at work, we won't be around to check her levels mid day, which from what I understand is very important when using Lantus. That's just not going to be possible other than on the weekend.

Do you guys think given our coming work schedule that ProZinc would be a better choice as it's more dependent on preshot levels, but is longer lasting than the Vetsulin? (Correct me if I'm wrong with any of this info... this is a whole new world for me).

Thanks for your patience with this newbie.

Janet

 

[Tuxedo Mom]

Ok so for the past week or so I have been tracking CC's numbers (yeah, finally figured out how to do the ss!), and I have yet to see her out of the 300's. I just don't think the Vetsulin is working for her, plus from what I read it's so short acting that it's not a great choice. I do like it's price, but that's about it.

SO armed with that info we are planning on talking to the vet about switching to a longer acting gentler insulin. I know Lantus is the first choice of many of you. Now my problem is that when school starts and we are all back at work, we won't be around to check her levels mid day, which from what I understand is very important when using Lantus. That's just not going to be possible other than on the weekend.

Do you guys think given our coming work schedule that ProZinc would be a better choice as it's more dependent on preshot levels, but is longer lasting than the Vetsulin? (Correct me if I'm wrong with any of this info... this is a whole new world for me).

Thanks for your patience with this newbie.

Janet

A couple of things I like to consider when insulin (any type) does not seem to be working.

Is the insulin good..has it been stored properly and still within a good "use by" time period once open.

With Vetsulin the insulin needs to be gently rolled before shooting. Is this being done?

Are you confident that you are getting the shot in properly...is your shooting technique good?

Vetsulin usually will have an onset (start of action) around +2 after shot and a nadir (lowest glucose reading) around +4 or +5 after shot. If possible could you get a couple of test around +2 and +4 hours after shooting to see if there is any major movement.

There is always the chance that Vetsulin is not working well for CC and you may want to change to a longer acting insulin like Prozin, Lantus or Levemir.

 

[JanetNJ]

The insulin is about 6 weeks old so yes it's ready to be replaced, but it has never seemed to be very effective. We do roll it each time. We are pretty sure we are shooting it correctly... No wet fur afterwards.

 

[Tuxedo Mom]

The insulin is about 6 weeks old so yes it's ready to be replaced, but it has never seemed to be very effective. We do roll it each time. We are pretty sure we are shooting it correctly... No wet fur afterwards.

If all the basic are ruled out then there are 2 possibilities. CC may need a higher dose OR CC may not be responding well to this type of insulin. You could have a talk with the vet and see what their opinion is.

 

[JanetNJ]

If all the basic are ruled out then there are 2 possibilities. CC may need a higher dose OR CC may not be responding well to this type of insulin. You could have a talk with the vet and see what their opinion is.

I just did a +2 and there was no change from the preshot

 

[Tuxedo Mom]

I just did a +2 and there was no change from the preshot

That is unusual with Vetsulin. The "normal" is that Vetsulin starts working at +2 or just earlier and peaks at +4, then slowly wears off usually after 8-10 hours depending on the kitty. If this is the regular pattern then perhaps a change to a longer acting insulin like Prozinc, Lantus or Levemir might be a better match. Lantus and Levemir are expensive in the US but can be ordered from Mark's Marine Pharmacy in Canada at a greatly reduced price. Many of the US members on this forum order from there. You would need a prescription from your vet. The vet can fax the prescription to Mark's or you can e-mail a copy to them:

https://rxcanada4less.com/

 

[jayla-n-Drevon]

I have used vetsulin and Dre was so miserable-he dropped but he was so sad-
pro zinc--he was happy but it did not last long for him-
I wish we had started with lantus.... it is a learning curve and Dre holds a large depot-but others do not---the more data the better and previous data from another insulin is not going to be very helpful although it may be a little bit of a guide-
good luck with your decision

 

[JanetNJ]

I have used vetsulin and Dre was so miserable-he dropped but he was so sad-
pro zinc--he was happy but it did not last long for him-
I wish we had started with lantus.... it is a learning curve and Dre holds a large depot-but others do not---the more data the better and previous data from another insulin is not going to be very helpful although it may be a little bit of a guide-
good luck with your decision

Ty. With lantus is pretty important to get those mid cycle numbers though, yes? That could be a problem when the summer is over and we are all working full time.

 

[jayla-n-Drevon]

Ty. With lantus is pretty important to get those mid cycle numbers though, yes? That could be a problem when the summer is over and we are all working full time.

Yes most cats have nadir at mid cycle--Dre is a early nadir at 4 hours (unless he isn't )
We base our dosing on the lowest number of the cycle for a increase or reduction so when you know the nadir you can be more aggressive and allow the pancreas more healing time.

 

[Tuxedo Mom]

Ty. With lantus is pretty important to get those mid cycle numbers though, yes? That could be a problem when the summer is over and we are all working full time.

Lantus typically will have a nadir around +4-+6. If you start CC on Lantus over the summer you will get a feel for how he reacts to it. You can always use an automatic feeder for when you are at work to feed at time when he may be going lower.

 

[BJM]

Have you read our Caninsulin/Vetsulin Guide?
One thing it suggests is feeding about 30 minutes before you give the insulin, to allow the food to start getting into the bloodstream and match the insulin.

Also, if you test around +9 to +11, you can document when the Caninsulin/Vetsulin is wearing off so your vet will be willing to use a different insulin.

 

[Chris & China (GA)]

We have had lots of people use Lantus and do the Tight Regulation Protocol while they worked full time jobs!!

Lots of great ideas in this "Is Tight Regulation Possible with a full time job? Yes!" sticky

 

[Alexi]

Sometimes with vetsulin you see a food spike at 2 hours, can you do a curve as I don't think we have enough numbers to know whether or not it is working for your kitty and this will help to identify how many hours after the shot the low point is and what her lowest number is during the cycle. You are looking for blue numbers at the lowest point to start with, she may just need a dose increase but without those numbers it is impossible to tell.

 

[JanetNJ]

That is unusual with Vetsulin. The "normal" is that Vetsulin starts working at +2 or just earlier and peaks at +4, then slowly wears off usually after 8-10 hours depending on the kitty. If this is the regular pattern then perhaps a change to a longer acting insulin like Prozinc, Lantus or Levemir might be a better match. Lantus and Levemir are expensive in the US but can be ordered from Mark's Marine Pharmacy in Canada at a greatly reduced price. Many of the US members on this forum order from there. You would need a prescription from your vet. The vet can fax the prescription to Mark's or you can e-mail a copy to them:

https://rxcanada4less.com/

I am curious why you choose levemir over the very popular lantus?

 

[JanetNJ]

Lantus typically will have a nadir around +4-+6. If you start CC on Lantus over the summer you will get a feel for how he reacts to it. You can always use an automatic feeder for when you are at work to feed at time when he may be going lower.

The problem with the automatic feeder idea is that we have 6 other cats so we couldn't be sure who was eating unless she was confined to a room.

 

[Tuxedo Mom]

I am curious why you choose levemir over the very popular lantus?

My first diabetic kitty Tuxie is a high dose kitty, because of other health issues. He was on Lantus originally, but seemed to flinch every time he got his shot. Lantus is at a different PH level than Levemir and tends to have less "sting" to it. At lower doses it doesn't make much difference but at higher doses some kitties feel the sting more. Tuxie was one of those. When his sister was diagnosed I was already using Levemir so I started her on the same insulin. Levemir and Lantus are both good long lasting insulins. Levemir tends to have a later nadir than Lantus. With my two usually the nadir is around +7-+9 hours after the shot. Some people on Levemir have found that their nadir time is even later...closer to the next shot time, which may work better for some people depending on their schedules. They are both good but some kitties will do better on one than the other. Just like people, there is not just one good insulin that works for all.

The problem with the automatic feeder idea is that we have 6 other cats so we couldn't be sure who was eating unless she was confined to a room.

That makes it more difficult to have food during the day when you are away. Confining CC to one room while you are away might cause more stress than it is worth. Are you feeding strictly wet low carb food or are you also using some dry food?

 

[JanetNJ]

My first diabetic kitty Tuxie is a high dose kitty, because of other health issues. He was on Lantus originally, but seemed to flinch every time he got his shot. Lantus is at a different PH level than Levemir and tends to have less "sting" to it. At lower doses it doesn't make much difference but at higher doses some kitties feel the sting more. Tuxie was one of those. When his sister was diagnosed I was already using Levemir so I started her on the same insulin. Levemir and Lantus are both good long lasting insulins. Levemir tends to have a later nadir than Lantus. With my two usually the nadir is around +7-+9 hours after the shot. Some people on Levemir have found that their nadir time is even later...closer to the next shot time, which may work better for some people depending on their schedules. They are both good but some kitties will do better on one than the other. Just like people, there is not just one good insulin that works for all.




That makes it more difficult to have food during the day when you are away. Confining CC to one room while you are away might cause more stress than it is worth. Are you feeding strictly wet low carb food or are you also using some dry food?

She has MOSTLY all wet d/m and FF. We put a handful of the dry dm out but she only picks on it occasionally.

 

[Tuxedo Mom]

She has MOSTLY all wet d/m and FF. We put a handful of the dry dm out but she only picks on it occasionally.

The dry DM is a higher carb food...around 30% if I recall correctly....which may be off since my coffee is still kicking in Unfortunately there are very few dry foods that are lower in carbs and the few that are out there have to be ordered on line and are very expensive.

The one thing with switching to Lantus or even Levemir is that they are gentler than Vetsulin...they do not hit as hard as Vestulin usually does. Prozinc is also a gentler insulin and is more of an "in and out" type. You might have a little more flexibility with Prozinc as far as the times you shoot. Lantus and Levemir have a "depot" of insulin that builds up giving a bit of a "spare tank" of insulin and these ones work best when shot at a 12 hour period between shots. Prozinc is a "time release" insulin that is basically gone from the system between shots. As long as the glucose levels are not still dropping Prozinc can be shot a bit earlier or later if your schedule is more erratic. Also as you get to know how your kitty responds to it, Prozinc can be given on a sliding scale, with different doses at shot time. This could work to your advantage as well as you are not able to monitor when you are at work.

Here is some information on Prozinc:
http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

Here is some information on Lantus and Levemir:

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

If you feel that Vetsulin is not a good match for CC the best thing you can do is to do more reading on the different types of insulins, discuss it with your vet and decide what fits best for both CC and yourself.

 

[JanetNJ]

The dry DM is a higher carb food...around 30% if I recall correctly....which may be off since my coffee is still kicking in Unfortunately there are very few dry foods that are lower in carbs and the few that are out there have to be ordered on line and are very expensive.

The one thing with switching to Lantus or even Levemir is that they are gentler than Vetsulin...they do not hit as hard as Vestulin usually does. Prozinc is also a gentler insulin and is more of an "in and out" type. You might have a little more flexibility with Prozinc as far as the times you shoot. Lantus and Levemir have a "depot" of insulin that builds up giving a bit of a "spare tank" of insulin and these ones work best when shot at a 12 hour period between shots. Prozinc is a "time release" insulin that is basically gone from the system between shots. As long as the glucose levels are not still dropping Prozinc can be shot a bit earlier or later if your schedule is more erratic. Also as you get to know how your kitty responds to it, Prozinc can be given on a sliding scale, with different doses at shot time. This could work to your advantage as well as you are not able to monitor when you are at work.

Here is some information on Prozinc:
http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

Here is some information on Lantus and Levemir:

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

If you feel that Vetsulin is not a good match for CC the best thing you can do is to do more reading on the different types of insulins, discuss it with your vet and decide what fits best for both CC and yourself.

Thank you. I have a feeling diabetes is not my vets area of expertise, so I'm really going to have to read and be CC'S advocate. I'm going to the beach today but I'll get in touch with her later and see what she had to say. At the moment ear leaning toward ProZinc for its flexibility.

 

[Tuxedo Mom]

Thank you. I have a feeling diabetes is not my vets area of expertise, so I'm really going to have to read and be CC'S advocate. I'm going to the beach today but I'll get in touch with her later and see what she had to say. At the moment ear leaning toward ProZinc for its flexibility.

Many vets are not well versed on FD. As with our own doctors, they know a little bit about a lot of areas, but not necessarily a lot about just one area. Since my first kitty was diagnosed I have made it a point to learn as much as possible about FD in order to become a "para-professional" on the subject. I know virtually nothing about kidney disease in a kitty, but I know a lot about FD. Being self-informed is in my opinion the best thing you can do for your kitty.

Enjoy your day at the beach!!

 

[JanetNJ]

Many vets are not well versed on FD. As with our own doctors, they know a little bit about a lot of areas, but not necessarily a lot about just one area. Since my first kitty was diagnosed I have made it a point to learn as much as possible about FD in order to become a "para-professional" on the subject. I know virtually nothing about kidney disease in a kitty, but I know a lot about FD. Being self-informed is in my opinion the best thing you can do for your kitty.

Enjoy your day at the beach!!

My oldest cat, Zim, who is 16 has stage 1-2 kidney failure. He's doing pretty well atm so CC has been my focus. That reminds me though that it's time for his subq fluids. He gets them just once a week so far.

 

[Tuxedo Mom]

My oldest cat, Zim, who is 16 has stage 1-2 kidney failure. He's doing pretty well atm so CC has been my focus. That reminds me though that it's time for his subq fluids. He gets them just once a week so far.

Sorry to hear that you have two kitties with problems. Glad that Zim is doing well and hopefully you will be able to get CC into a good range soon too.

 

[JanetNJ]

Sorry to hear that you have two kitties with problems. Glad that Zim is doing well and hopefully you will be able to get CC into a good range soon too.

It's been an expensive year for vets this year. We took in two kittens born to a stray in our garage... One of which was gravely ill with eye infections and pneumonia at just 7 weeks old. (We didn't think she was going to make it but she's a fighter.) then we of course got those two kittens spayed. Then Zim with his kidney issues started peeing blood so lots of tests, medications, and an ultrasound later it cost a fortune... He had a deep kidney infection that was not detected with blood and urine tests that he needed strong antibiotics for. And now diabetes in cc. It's been rough. I have spent more time at the vet in the past year than the past 5 years put together.

 

[Tuxedo Mom]

It's been an expensive year for vets this year. We took in two kittens born to a stray in our garage... One of which was gravely ill with eye infections and pneumonia at just 7 weeks old. (We didn't think she was going to make it but she's a fighter.) then we of course got those two kittens spayed. Then Zim with his kidney issues started peeing blood so lots of tests, medications, and an ultrasound later it cost a fortune... He had a deep kidney infection that was not detected with blood and urine tests that he needed strong antibiotics for. And now diabetes in cc. It's been rough. I have spent more time at the vet in the past year than the past 5 years put together.

You have certainly had a rough go of it this year. Bless you for taking in the 2 kittens and giving them a chance at life.

Poor Zim and all the complications. I understand the financial strains with sick kitties. My first diabetic had SO many tests done that I kept pushing for, until it was finally determined that he is borderline/early Cushing's (which I had suggested to my vet), which explained his poor response to insulin and other symptoms that the vet couldn't figure out. The extra blood tests, clinic test and ultrasounds have about drained me. Then just over a year later his litter sister was also diagnosed with FD. I caught it early since I was testing her every month or so after her brother was diagnosed. No real reason for either kitty to have ended up diabetic either...home-made food the last almost 10 years, the first one NEVER ate any dry (wasn't interested), the second one was off dry for 10 years, not overweight, never any health issues for over 14 years..etc. People I know have said I am crazy to have spent the money I have so far and continue to with the diabetic supplies, but there are my "babies" and I will do the best I can for them both.