Monitors, Syringes and Insulin Dose

[Cherryl & Mouzer]

I am speaking on several things, so I did not make any post in any particular current threads, so forgive me if I should not be starting a new thread.

I have been looking at monitors and I do not like the reviews I am seeing. Relion did not have good reviews. People who did test five and more times in a row, said they never got a same reading and something about the differences between the numbers were too large for their liking. I havent bought a monitor yet, because I want to find one with good review. I have a headache from searching.

Also, the syringes my vet had me get are Insulin Syringe U100 0.3cc 29g x 1/2inch 100ct with sharps And my vet started kitty on .02ml and Friday was a week. He has raised the dose to .03ml.

We did a reading, to start, which was 463. A week later, on .02ml Lantus, doing the low time of day reading, his reading was 371. In a week, we do another reading, to get the high time of day reading, and the vet is hoping for 250 at least at that point. And the glucose curve is to follow.

I have been told - first off, to use Relion for a monitor, by a diabetic group admin on facebook, which I am not buying unless I have no other choice and because I do not like the reviews. And I am not being ugly but I dont care what anyone tells me, if the reviews stink, I aint up for buying it.

Secondly told is, the dose should be raised in half increments. Isnt .02ml to .03ml a whole increment? And if so, how do I argue with the vet over this hahaha And what syringes would give half dose marks? If it is that .02ml to .03ml is not half?

And if I do need to disagree with the vet on the raise in dose, do I just give half increment raise in dose, when the vet tells me to go up? And tell the vet to show me on the syringe with half markings, where to take it to for a half up?

 

[Djamila]

Hi Cherryl and welcome!

I'm not quite sure how to respond to your questions just yet. Here is my confusion: insulin is usually dosed using units, not mL. However, if you're using a U100 insulin such as Lantus, then I think I can understand the numbers you mentioned. I just want to make certain that you are talking about Lantus, and not one of our other insulins. Is that correct? Are you using Lantus? Once that is cleared up, we can give better advice about dosing as well as how to discuss this with your vet.

As for the meter, no one will force you to get any specific meter. Many around here prefer the ReliOn because it's cheap and convenient as most people have a WalMart near them, or can order online. One thing to know while you're doing your research though is that all meters have a 20% allowed variance. That means that if the meter gives you a reading of 300, the "real" number could be anywhere from 240 to 360. If you don't know about this allowed variance and just did a bunch of tests, then I imagine that the results would be a bit disturbing. We have found around here that one meter is pretty much as good as the next, once you know that they all have that variance, so when you make a decision I would encourage you to consider what you can afford (we recommend testing several times/day and the test strips can get expensive on some of the meters), and what you can purchase quickly when you discover that you're running out of strips. One final consideration is the size of the blood sample needed to get an accurate reading - the smaller the better as it makes it easier for your cat.

Speaking of your cat, what is her/his name?

 

[Noah & me (GA)]

Hi Cheryl, are you in Canada or another metric country? But if you were your meter would not go higher than 35. For my first 4 years no one told me what a unit was. It was "The line on the syringe" so when I didn't like the elephant syringes the vet gave me I got my own and did the conversion myself and used ml. We can discuss that later, I'm sleepy. This forum is devoted to just one thing, very unlike Facebook. Over a thousand members, approaching 2 million messages. Noah is our second diabetic cat and I wish for his brother Nigel's sake I had found this place years ago. The meter thing is your choice but most people here love the Relion. I don't use it but my opinion, and "Well known member" over my head mean nothing. I will be switching soon. The numbers you get will NEVER EVER be the same. That 20% variance is allowed by Federal law. No wonder they're free in Canada. You're not being ugly. I love my vet but they didn't get me set up very well years ago. And I think I recall saying these words "I don't care what anyone tells me, if the reviews stink, I aint up for buying it". You're allowed to disagree with your vet but make absolutely/triple check/check again sure before you change a dose. There will be more people here tomorrow.

 

[Cherryl & Mouzer]

Djamila - Yes, I am talking about Lantus - This is what was ordered - Lantus Solostar Insulin Pen 100u/m 1 x 3m
And I had my vet say it to me very clearly hahaha Because someone else did not understand the ml and I wasnt sure if it was 2ml or .2ml, so I asked my vet to clarify and he said, it is neither 2ml or .2ml - it is point 02 ml - .02ml and now it is .03ml.

I would like to have a meter, just so I can know what is up with my cat. I did see that those strips for the Relion monitor are $17.88 for a box of 100. With the .02ml dose of Lantus, along with every three month checkups with the vet and that is to keep an eye on other body organs, because of what all can take place, and to go along with syringes and food, it is going to cost an average of $235 a month.

I did just remember, I told my vet I am going to be ordering through Canada. I had found the site before getting my first Lantus solostar pen but I was in a hurry to get kitty on the insulin, so I let my vet put in for it, for this first time. I do not even know how to know when I should place an order for more. With ordering the Lantus pen from Canada, it will be $45 cheaper and I can apply that to buying the strips.

If I can find a cheaper place to get the syringes, that will even help more. I paid $35 for a box of 100, for the first purchase, because, again, I was in a rush to get kitty on the insulin and I had little knowledge about where to buy and how fast I could get them. I did like the fact they sent a bin with the syringes, for disposal.

I heard my vet tell the tech that he just needed to get a very tiny bit of blood. And someone told me, if I use a meter at home, I would need to take a reading before each shot of the day. Not that I know what to do about any reading but ok

I am not sure I understood the reviews, as in the lingo and what they were talking about, because I am new to this diabetes. I think the bad reviews were saying the readings were off by 10 and they were not liking that. I do not know what 10 they mean or anything. I just figured they all know what they are talking about and I know nothing, so if they said that was bad, I took it for granted, that must be bad.

Does Relion only require a small amount of blood? Or is it the strips to make that decision? But do Relion strips require a small amount of blood, if that is the decider?

Kitty also has neropathy, so I am hoping we can get him walking normal again.
I am giving him a fourth of a dropper, twice a day, of this, to help with neuropathy:
MAX ABSORPTION, Vitamin B12 Sublingual Liquid Drops, 3000mcg Methylcobalamin Per Serving, 60 Servings, Non-GMO, Vegan Friendly

I will attach photo of kitty and select the thumbnail view.
And kitty's name is Mouzer




Edit to add: To the other response.
Noah or Me hahaha - I am in the USA. I would not change dose without talking to my vet. I dont know what I am doing, I am not stupid enough to kill my cat with idiocy I am reluctant to do anything outside of my vet, at this time. The syringes my vet chose are very small with very tiny, ever so easily to bend, needles. I have to be very careful. I already dropped a brand new one on the ceramic tile and the needle bent, so I had to toss it in the disposable bin they provide with the order of the syringes.

I think my vet has done an excellent job in getting me set up. He let me know that the solostar pen will run out in about 70 days, when on the .02ml dose. We have gone to .03ml now, so not sure when it will run out. The pharmacy tried to tell me I have to throw the pen away at 28 days, which I had already read that is only due to patent and the insulin is good for three months, and my vet said the same thing as I read. He also chose very nice syringes, I think, being as the needle is so tiny, thin, easily bent but better like that to have to stick my kitty with.

Only thing is, my vet is doing ml doses, and if people here do not know what that is, how can they help me do anything, if anything should change? Just for that fact alone, I will be clarifying everything through my vet. I dont need two different lingos going on. I need to know exactly where on that syringe to put the dose for my kitty.

And when I say, "I don't care what anyone tells me, if the reviews stink, I aint up for buying it", I mean what I say - I am that type of person. I say what I mean, I mean what I say, at all times, and I am not easily persuaded to change. That is a very well known trait of mine and I am often not liked for it, but I 'always' do not care whether people like me for who I am or not. I am not in this world to be liked. But I did also say, if I have no other option, then I will buy the Relion. And if you have a suggestion on a meter, I would like to hear it, so I can check it out, for pricing and for reviews hahaha

 

[Noah & me (GA)]

This is what was ordered - Lantus Solostar Insulin Pen 100u/m 1 x 3m / it is point 02 ml - .02ml and now it is .03ml.

>I would like to have a meter, just so I can know what is up with my cat.
>With ordering the Lantus pen from Canada,
>If I can find a cheaper place to get the syringes, that will even help more.
>And someone told me, if I use a meter at home, I would need to take a reading before each shot of the day. Not that I know what to do about any reading but ok
>Kitty also has neropathy, so I am hoping we can get him walking normal again. I am giving him a fourth of a dropper, twice a day, of this, to help with neuropathy:
MAX ABSORPTION, Vitamin B12 Sublingual Liquid Drops, 3000mcg Methylcobalamin Per Serving, 60 Servings
>kitty's name is Mouzer
>Noah or Me hahaha - I am in the USA. I would not change dose without talking to my vet. I dont know what I am doing, I am not stupid enough to kill my cat with idiocy. I am reluctant to do anything outside of my vet, at this time. The syringes my vet chose are very small with very tiny, ever so easily to bend, needles. I have to be very careful. I already dropped a brand new one on the ceramic tile and the needle bent, so I had to toss it in the disposable bin they provide with the order of the syringes.
>He also chose very nice syringes, I think, being as the needle is so tiny, thin, easily bent but better like that to have to stick my kitty with.
>Only thing is, my vet is doing ml doses, and if people here do not know what that is, how can they help me do anything,
>I dont need two different lingos going on. I need to know exactly where on that syringe to put the dose for my kitty.
>I say what I mean, I mean what I say, at all times, and I am not easily persuaded to change. I 'always' do not care whether people like me for who I am or not.

Hi Cheryl, hi Mouzer. Let's start again. Every time I don't know something I just ask, there's no such thing as a stupid question here. And I do not like "Not knowing" because I'm OCD. I thought an insulin pen already has a tip or needle on it. Our first diabetic cat had these pens so I don't get why you need syringes. I use U100 syringes and they are not marked in units, they're marked in ml. So you are correct, how can you measure units when the syringe is marked in another language? In a U100 syringe 1 unit=2.5 lines on the barrel of the syringe. We all say "units" because that's the international standard. So if I post a question at 3AM and someone from Spain or Australia answers me they know what I mean. The money part is never easy. Lots of people here order from Canada because it's cheaper. I love Noah and you love Mouzer but that doesn't mean we can't save money. You will need to take a reading with a meter at home. Years ago my wife and I stared at all this stuff we bought home and had no clue what we were doing. Don't sell yourself short saying "Not that I know what to do about any reading but ok". Pretty soon you'll be doing it in the dark. Changing the dose is something we talk about between ourselves but I cannot talk to you about. This is why. I got a little flustered a few months ago and typed the decimal point in the wrong place. I could have killed someone's cat because some guy on the internet said "Do this". Cheryl, I never said or implied you were stupid but more than once I have been stupid, even extra stupid. The lingo can be annoying. A drooler is a dog? I thought LOL meant Lots of love. All you have to do is ask.
No one is here to be liked or disliked. I post cutesy photos in Off Topic that some people find funny and I'm sure some people just want me to shut up for 5 seconds.
The point is we've all been thrown into a war zone with some kind of first aid kit we've never seen before. This is the best place on Earth to get help understanding what is in that kit and how to use it.

 

[Jill & Alex (GA)]

Hello and welcome to the group Cherryl and Mouzer!

Just to help avoid confusion...

• Each Lantus SoloStar pen contains 3m/L of insulin (300 units)

• For dosing purposes, insulin is typically referred to in units

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus or Levemir from vials, cartridges, and pens. BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings. Needle gauge and length is your preference Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest & usually the most comfortable for cats)
  • Full and half-unit syringe scales:

Notice, these U-100 syringes are measured in units. Would it be possible for you to post a picture of the package of syringes you're using?

I have been told - first off, to use Relion for a monitor, by a diabetic group admin on facebook, which I am not buying unless I have no other choice and because I do not like the reviews. And I am not being ugly but I dont care what anyone tells me, if the reviews stink, I aint up for buying it.

Interesting. Have you seen the US & Canadian Blood Glucose Meter Ratings from Consumer Reports (2016)? I just checked the other day. It doesn't look like Consumer Reports has done/released new ratings for 2017 yet, but the 2016 ratings may be of some help.

Secondly told is, the dose should be raised in half increments. Isnt .02ml to .03ml a whole increment?

*Usually*, Lantus doses are increased in increments of 0.25 unit (for cats).

With the .02ml dose of Lantus, along with every three month checkups with the vet and that is to keep an eye on other body organs, because of what all can take place, and to go along with syringes and food, it is going to cost an average of $235 a month.

Yike$! That's a lot! If you're interested, I'm sure there are plenty of members who would be willing to share their cost-cutting measures including doing our own blood glucose curves at home as well as buying diabetic friendly foods and supplies that won't break the bank.

Kitty also has neropathy, so I am hoping we can get him walking normal again.

I am giving him a fourth of a dropper, twice a day, of this, to help with neuropathy:
MAX ABSORPTION, Vitamin B12 Sublingual Liquid Drops, 3000mcg Methylcobalamin Per Serving, 60 Servings, Non-GMO, Vegan Friendly

You might want to ask your vet about the ingredients: Purified water, Organic Grape Alcohol, Natural Flavor Blend (Cherry type), and Stevia. See what he thinks about the grape alcohol and the cherry flavor blend. Oftentimes "flavors" are sweetened to make them more palatable. Zobaline is the methylcobalamin many of our members give their kitties for neuropathy.

The pharmacy tried to tell me I have to throw the pen away at 28 days, which I had already read that is only due to patent and the insulin is good for three months, and my vet said the same thing as I read.

When handled properly, many of us have been able to use the Lantus pens to the last drop! If you haven't already, you might want to review the Lantus & Levemir - Syringe & Insulin Info: Handling, Drawing, & Fine Doses sticky posted in the Lantus & Levemir Insulin Support Group. Since Lantus is so darn expensive, we've compiled some good information which will help you get the most out of each pen.

Hope this helps a little...
and have a good day!

 

[Djamila]

Cherryl-

First of all, Mouzer is gorgeous! And second, yes to everything that Jill said. She explained all of that much better than I would have, so I won't try to add anything to her great responses!

As soon as you decide on a meter, we can help you learn how to do the tests and understand the numbers you get.

Here is the link to the Lantus forum: http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

You can post there and they can help you figure out the dosing. We do recommend very small changes in dose at a time because you'll be able to monitor at home and adjust when it's needed instead of waiting for the vet to test and decide. It's a lot to learn at first, but there are very knowledgeable and wise people over there who can guide you along the way while you're learning. Vets are great - I love my vet - but the people here deal with feline diabetes all day (and night!) long, so the amount of knowledge here exceeds any vet I've ever met. And that includes my vet who is great at this! They just don't have the time to study it as carefully as folks here have since vets deal with such an array of health issues. Definitely listen to your vet, of course, I'm just saying that you can trust people here.

$235/month is a lot! We can definitely help you find some ways to save money! You can get syringes for about a third of the price you mentioned, most of us feed Fancy Feast Classic (pate style), or Friskies pate (even cheaper), and the tests strips can just vary depending on which one you decide to get. The insulin is the most expensive part, but as know, Canada is a great source of Lantus at a much lower price so that at least helps somewhat.

As far as blood sample size, the Relion Confirm and Relion Micro are the two that most people use here. They both take a pretty small blood sample (0.3). The Relion Prime needs a bigger sample (0.5). The meter I use takes a 0.5 sample too, but we make it work. I'll probably switch to something smaller though when this one has outlived its useful life.

I think that's probably about the end of my ability to be useful since I use a different insulin than you do. I know the folks over in the Lantus forum will take good care of you!

 

[Cherryl & Mouzer]

I am going to respond to everybody, in between my last post and this one and I am getting a headache in my attempt but I will push on hahaha

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Noah & Me - This insulin pen's needles have to be purchased separately and to cost as much as the syringes. The dosing on the pen is very large increments, to be used for humans, so the syringe is to draw out the right amount for Mouzer, a kitty of course. So, I dont know of any other pen. This is the first one I have ever had in my hands to see.


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Jill & Alex - My vet speaks ml. It looks to me as if you are calling ml as units. And I am using the one you have pictured on the right, with full ml dose - what you seem to be calling full unit dose. Insulin Syringe U100 0.3cc 29g x 1/2inch 100ct with sharps.

I dont want a thinner needle. This one bends too easy already. It is 29 and pretty darn thin to me. I have had to trash two, unused syringes already now, due to the needle being so easily bent. This needle is not hurting Mouzer at all. He doesnt even feel what I am doing.

I will look at Consumer Reports for the US meters and see what they have.

My vet raised Mouzer from .02ml to .03ml and I am not qualified to understand disagreeing with him, at this point. My vet is not some newbie, yuppy scum, trying to pay off his college debt, been there, done that and will never step foot in such a vet's office again. My vet is a 40 year vet and has been our family vet since I was a teenager and he was trained by our first family vet, that we had for all of my childhood, who has now passed away.

I do trust my vet on his dosing. I will ask him about the increments of raising the dose, to see what he has to say to explain going from .02ml to .03ml. As is, I dont even understand the 0.25 increment, being as my cat is being given .02ml to .03ml - which in other words could come out as 0.02 and 0.03 - there is no 0.25 in there that I would understand.

The insulin and syringes will cost $75 a month and that is with my dividing the price over a 70 day period, as my vet said, on a .02ml dose, I should run out in about 70 days - however he is now on .03ml dose, so I am taking it that the pen will now run out sooner and so, this affects the cost, meaning higher cost. That cost, plus his food, $120 a month. Mouzer will also have to have blood work done, every three months, approx. $115, so approx. $38 a month for blood work - which is $233 a month - not to include anything for neuropathy or strips for a meter. I will be ordering insulin from Canada, on the next order, which will cost $45 cheaper than the pen I just bought. I am feeding Mouzer fancy feast and sheba chicken pate. He eats six cans a day and the recommended amount for his weight of eleven pounds, approx $120 a month. I dont know of any cheaper food.

As is for now, I want my vet to do this first works for the glucose curve. I need him to know what is going on and tell me what dose to give to Mouzer. Once we get Mouzer's BG under control, then my vet and I both feel more comfortable about letting me go with this and to see him every three months for bloodwork, to keep and eye on body organs.

I ordered the B-12 I bought, based on what I saw someone saying they gave to their cat. I was trying to avoid pills, so I got the liquid. I will get the Zobaline and I found this on Amazon and will order it. I hate that it is not an Amazon Prime deal though. I would like it to get here quickly. But I will wait.
https://www.amazon.com/ZobalineTM-Diabetic-Cats-60-tabs/dp/B008G3LI2M/ref=sr_1_1?ie=UTF8&qid=1495404713&sr=8-1&keywords=zobaline for cats

I am confused what you are saying. I am using the Lantus pen and drawing the insulin out with a syringe. I dont see why I wont be able to use every last drop. I havent used my first pen up yet lolol let me get there to find out how that goes


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Djamila - Thank you on Mouzer but of course, I didnt create him hahaha But he has a brother like him and did have two other brothers like him but they disappeared. I did get Mouzer and one brother neutered and I hated that the one disappeared and am in hopes someone gave him a good home. The other brother, I never could trap and he disappeared but my guess on him is he got hit by a car. Long story on how I came upon these cats. Mouzer has been kept inside since 2011. He is seven years old now.

I guess I will move to the Lantus board haahhaaha

The one who told me to use Relion, told me to use the Relion Prime - and now I see it takes more blood, so I dont know what Relion to get, if I get Relion haha

I am feeding Mouzer Fancy Feast and Sheba chicken pate. He eats six cans per day, and that is even the recommended amount for his weight. The cost is $120 each month. I am not fond of Friskes and have other cats who have to eat the FF and Sheba, so even more convenient that I buy it. The other cost put into the $235 is for insulin, syringes and every three month bloodwork to keep an eye on his body organs. That cost does not include anything for neuropathy or strips needed for meters.


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OK - I think I covered everything
I think

 

[Noah & me (GA)]

Cherryl, sorry I mangled your name. Happens to me all the time. The 29 gauge should not normally bend so easily but no cat is normal. Could depend on previous scar tissue or where you're injecting. With Noah I get him on his laying on his side, talk to him and pull his tail (this relaxes him) and inject in his right rear shoulder, above his knee and below his spine (obviously) and I also tent the skin. That's when you gently pinch a bit of skin and then I just slide in there at a shallow angle. It takes practice. I'll show you how to "tag" some one. Type @, leave one space, then one at a time type the characters of the name. As you type a tiny screen will drop down showing members with matching names. With each letter you type that list gets shorter. @Noah & me When you hit Post Reply that person will get an alert called a tag and whatever other page they're on they'll know you wanted their attention. The @Noah & me won't show up in blue until you hit Post Reply. It's just the way the software works here. Did what I said about giving dosing advice make sense? Our vet's Dad was a vet so we also have complete faith, it's a nice feeling. I use an Aviva Accuchek and the amount of blood needed wouldn't cover the head of a pin. Only a member in Australia and I use that meter but it's consistent and has great memory functions. Unlike other meters it cannot make compensations between humans, cats and dogs.

 

[Jill & Alex (GA)]

The dosing on the pen is very large increments, to be used for humans, so the syringe is to draw out the right amount for Mouzer, a kitty of course.

Actually, the Lantus SoloStar pen dispenses insulin in whole units. However, most of our members do not use the pen needles because as has been mentioned, we generally make dose adjustments in increments of 0.25 unit.

My vet speaks ml. It looks to me as if you are calling ml as units. And I am using the one you have pictured on the right, with full ml dose - what you seem to be calling full unit dose. Insulin Syringe U100 0.3cc 29g x 1/2inch 100ct with sharps.

Yes, if you are using a syringe with markings the same as in the picture on the right, each of those lines after the zero line marks a whole unit. It's too hard to try to measure quarter units with syringes marked with whole units. It's much easier to eyeball quarter units when you're using syringes marked like the picture on the left. That's why we suggest using U-100 3/10cc syringes with half unit markings for dosing Lantus (picture on the left).

I'm curious and trying to understand how you're dosing...
When you measure Mouzer's current dose of what you're calling .03ml Lantus in the syringe with the same markings as shown on the right in the picture, do you draw the dose to a line? Which line? The top line is the "0" line, the next 1 unit, the next 2 units, the next 3 units, and so on.

The insulin and syringes will cost $75 a month and that is with my dividing the price over a 70 day period, as my vet said, on a .02ml dose, I should run out in about 70 days - however he is now on .03ml dose, so I am taking it that the pen will now run out sooner and so, this affects the cost, meaning higher cost. That cost, plus his food, $120 a month. Mouzer will also have to have blood work done, every three months, approx. $115, so approx. $38 a month for blood work - which is $233 a month - not to include anything for neuropathy or strips for a meter. I will be ordering insulin from Canada, on the next order, which will cost $45 cheaper than the pen I just bought. I am feeding Mouzer fancy feast and sheba chicken pate. He eats six cans a day and the recommended amount for his weight of eleven pounds, approx $120 a month. I dont know of any cheaper food.

WalMart has the correct syringes for around $13 for a box of 100. As you already know, in the future you can buy Lantus from Canada at a considerable savings. I have to be honest... unless Mouzer has other concurrent health issues, doing blood work every three months is extremely excessive. Also, glucose curves done at the vet's office are usually a waste of time and money because of vet stress and kitty not eating as they would at home when they're at the vet's office. Kitty's true BG numbers usually run lower at home.

I am confused what you are saying. I am using the Lantus pen and drawing the insulin out with a syringe. I dont see why I wont be able to use every last drop. I havent used my first pen up yet lolol let me get there to find out how that goes

When insulin is handled properly, you should be able to use a pen to the last drop! I embedded the link to the Syringe & Insulin Info: Handling, Drawing, & Fine Doses for your review to show you how you'll be able to use every drop in a pen. We know from experience too many vets and their staff offer their clients the same instructions they've been handing out for years... handling instructions for the "older" insulins versus handling instructions for the "newer" insulins used with cats such as Lantus and Levemir.

Let us know how/if we can help...

 

[Cherryl & Mouzer]

@Noah & me - The needles are not bending due to sticking kitty hahaha They bend due to dropping them onto my stinking ceramic tile that is in this house

I only understand the dosing I am doing for now. I dont understand enough to change from what my vet is teaching me, so I will not be changing syringes, amount of dose or anything, until I feel I understand and am comfortable with doing so.

I dont think I am understanding what you are saying about your monitor and I would say what I dont understand but I understand not one word, just about hahaha And probably because I have never had one. I am a hands on person. I dont learn very well by reading. That is why I am needing my vet, all the way, for now, until I do feel I understand.

I tried the @ thing and your name came up - I hope it worked



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@Jill & Alex (GA) - With giving dose - I pull back a little, stick it in the pen, pull back to 5 or so, then push in as - on 5 mark - count down - line below 5 is .04ml - line below .04ml is .03ml

And the pen is an obviously huge difference in amount, if I did the same thing, so I will trust my vet on this one. And besides, I would have to buy needles for the pen, so may as well buy the syringes with needles - not a big price change on that.

I saw Walmart's syringes online and I plan to order those next time of purchase.

I am going to allow my vet to monitor this until he is comfortable enough to tell me we can go longer than three months and until I am comfortable with feeling like I know what I am doing. I am not jumping up and doing my own thing, when I do not feel comfortable.

And I did go to the link to see about getting every drop. I am doing nothing any different from what is shown. It is the way my vet taught me to do it, so I should have no issues in getting every drop.

My vet tries his best to help me keep cost down, as much as he can. He knows my financial circumstances with caring for 53 animals, as he has had to treat many of them and some are ongoing treatment.

It cost up to $2000 a month to care for these animals. I run fundraisers and have gotten some taken care of, through fundraisers, but sadly, people are not so very helpful in sharing fundraisers. It is not their problem. Apathetic.

Out of $8550.07, spent so far for 2017, on animal expenses, I have received $2370.00 in donations, and mostly due to the fact that people will not share the fundraisers. So, this is my burden to bear alone, for the most. I am 30k in debt, over animal care, and counting, since I began having aging animals, needing the vet, and that was 2014.

 

[Jill & Alex (GA)]

Hi Cherryl! Something not all vets are aware of because it's different than other insulins used to treat feline diabetes... Lantus dosing is based on nadirs with only some consideration given to preshot numbers. Lantus is a depot insulin. The effects are cumulative, meaning one dose builds upon the next. It usually takes a good 5 or 6 cycles to see how low the dose takes kitty... sometimes more.

@Jill & Alex (GA) - With giving dose - I pull back a little, stick it in the pen, pull back to 5 or so, then push in as - on 5 mark - count down - line below 5 is .04ml - line below .04ml is .03ml

Thank you for the explanation. When using syringes with pens, you don't want to shoot any air into the pen nor do you want to push any insulin back into the pen. There's a good video on drawing Lantus into syringes in that Syringe & Insulin Info: Handling, Drawing, & Fine Doses sticky I linked earlier.

Given your reply, what you're calling .03 ml Lantus drawn into a U100 0.3cc 29g x 1/2inch syringe is typically called 3.0 units or 3.0 international units. I've been concerned that was the case... hence all my questions. I know you trust your vet, but that's a mighty high dose for a newly diagnosed kitty. I'm concerned for Mouzer's safety. Let me explain why.

For example only, if you were to follow the Tight Regulation Protocol we use on the FDMB... a method which is very aggressive and averages about five BG tests a day... Mouzer's Lantus starting dose based on weight would be 1.25 units (0.25u x 5kg = 1.25u), given every 12 hours. Our less aggressive method called the "Start Low, Go Slow (SLGS) method would have Mouzer starting out with either 0.5 unit or 1.0 unit depending on if there was any dry food in Mouzer's diet. You started with administering 2.0u twice a day and are now up to 3.0u BID.

Here's the thing with insulin... too much insulin can result in high numbers just as not enough insulin will result in high numbers. The high numbers you've seen... the reason for the dose increase to 3u twice a day could be from a starting dose which was set too high to begin with. Or they could be a reaction from Mouzer dropping too fast or too low without you knowing.

So what can happen from here? If the Lantus starting dose was set too high, BG numbers will do one of two things: either numbers will stay high and flat OR kitty's numbers can take a nose dive when you least expect it... resulting in hypoglycemia or create another bounce into high numbers.

What is bouncing? From "The Basics: New to the Group? Start here!" sticky:

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Since initially it takes around 6 cycles for a bounce into high numbers to clear kitty's system, test taken during that time will most likely yield high numbers. If one increases the dose based on those high numbers, kitty will become over dose in no time!

I'm glad you'll be testing Mouzer's blood glucose at home. It'll help you catch any lows that could put Mouzer in danger. I don't know if anyone has given you this information, but if not here you go:

SYMPTOMS OF & HOW TO TREAT HYPOGLYCEMIA - what to do if your kitty experiences a hypoglycemic event
Jojo's HYPO TOOLBOX - what to have on hand in case of an emergency


If you have any questions, please ask. We'll do our best to get you the answers.

 

[Noah & me (GA)]

Hey Cherryl, you did the tag exactly right. You are so much like me, reading means nothing. Someone has to show me and then I have to hold it and do it myself. I am OCD and borderline ADD. Money and animals is never easy, a lot of guilt, frustration and sometimes it feels like no one cares. Meters have a memory so instead of writing everything down I can press a button and see what Noah's reading was everyday and at what time for the last year. I write it down in a little book anyways to make myself feel better. The meter I use makes me feel better because it doesn't need a big sample. I cringe if I see a lot of blood. You see "Moderator" under Jill & Alex? They have been here since 2009, they don't get paid for this, all they want to do is help.

 

[Cherryl & Mouzer]

@Jill & Alex (GA) - Mouzer was 463 to start. He was on .02ml for one week. His low for the day read 371. He will be on .03ml for a week and is scheduled to get a high time of day reading at that time. Mouzer is acting normal so far. Eating normal. Drinking normal. Peeing normal. No lethargic behavior. No sleepy or wobbly or dizzy behavior. He went from 463 to 371 in one week on .02ml. The vet hopes to see him at 250 after the week of .03ml and at his high time of day for a reading.

I dont know how to just up and change the dose my vet has him being given and what to tell the vet as to why I am going against what he is doing, when what he is doing so far, seems to be ok. Mouzer is not acting like we are messing him up. I am not a vet. And I am not changing syringes when I just paid $39 bucks for 100 of the darn things. And I am not changing syringes unless I feel I understand enough to be playin around with this. I am here to see what there is but I am not jumping up and changing anything. I dont know enough to do that.

I am not even checking Mouzer's reading right now. I do not have a meter. I am not sure what meter to even get. Dont know what to do with one if I had one. And dont even know how to take the blood from Mouzer to do whatever I am supposed to do with it. And for me to even buy a meter and strips and whatever the heck I am supposed to use to take blood out of him, will all be a debt charge and skipping house payment, like everything else has been for him, to get this started this month.

My vet told me to get some Karo Syrup to keep on hand and I still need to get to the grocery store to buy the Karo Syrup. I dont have any because I have never had a reason to. And I have this Friday's vet appt to pay for and the glucose curve will be the next thing to pay for -- all for May. It is between charging what I can and I will be skipping yet another house payment for June first, so paying more late fees, because of all of this.

 

[Noah & me (GA)]

I just looked at the file. An alarm watch? What is "storage for insulin supplies", a little box? Someone's charging too much. Cherryl, I know the pharmacist will show you how to use the meter. You can practice on yourself just like a human diabetic. Start a new thread in Feline Health and just ask what meter do you recommend, why do you like it, where can I buy one. There's lots of stuff on YouTube about everything as well. You will not want the meter I use, trust me. I need to go to bed.

 

[Jill & Alex (GA)]

He went from 463 to 371 in one week on .02ml.

That was simply a single reading... a snapshot in time. Click on the link to Alex's spreadsheet in my signature. If you look at any one number it's only indicative of that particular time on that particular day. It may be the low for the day OR it might not be. If one happens to pick a number from the day kitty is bouncing, the number will naturally be high, but it won't tell you how low that dose is capable of dropping kitty's blood glucose. Make sense?

Mouzer is acting normal so far. Eating normal. Drinking normal. Peeing normal. No lethargic behavior. No sleepy or wobbly or dizzy behavior.

Awesome! These are all very good signs.

And I am not changing syringes when I just paid $39 bucks for 100 of the darn things. And I am not changing syringes unless I feel I understand enough to be playin around with this. I am here to see what there is but I am not jumping up and changing anything. I dont know enough to do that.

No one has asked you to change syringes. It would be nice to have U-100 syringes with half unit markings, but truth be told, many of our members in Europe have trouble finding syringes with half unit markings so they make do. For the time being, you can, too.

I am not even checking Mouzer's reading right now. I do not have a meter. I am not sure what meter to even get. Dont know what to do with one if I had one. And dont even know how to take the blood from Mouzer to do whatever I am supposed to do with it.

We can help you with that. Here's some online help:

• Hometesting Links and Tips ------> there are videos included in that link

• US & Canadian Blood Glucose Meter Ratings from Consumer Reports (2016)

Getting a meter and learning to hometest as soon as you can is important given Mouzer's current dose. I am concerned about his dose. Most diabetic kitties never even reach a 3 unit dose. Call me a worry-wart.

My vet told me to get some Karo Syrup to keep on hand and I still need to get to the grocery store to buy the Karo Syrup. I dont have any because I have never had a reason to.

Any syrup/simple sugars will do. Maple syrup, honey, agave, karo, small tubes of frosting, sugar water, vanilla ice cream, etc.

And I have this Friday's vet appt to pay for and the glucose curve will be the next thing to pay for -- all for May. It is between charging what I can and I will be skipping yet another house payment for June first, so paying more late fees, because of all of this.

I'm sorry. When it rains, it pours. I get it. When Alex was diagnosed my DH was forced into retirement and had a nervous breakdown because of it... not to mention the unexpected deaths of two close family members. A whole lot of upset, no income and a ton of unexpected bills! I remember it like it was yesterday. All any of us can do is the best we can.

I also looked at the file you attached to your post. I feel badly because there's much on that list that isn't necessary. I wish we could have met before you purchased half of this.

You see "Moderator" under Jill & Alex? They have been here since 2009, they don't get paid for this, all they want to do is help.

Ha! Actually, I've been here since 2006, but you're right. None of us get paid for this. We're all volunteers.

When we switched to this software it gave existing members who began to post here the starting date of 2009. It also started the post count over for individual members as well as the forum and board totals. Our first message board was formed in 1996. We have many more members, threads, and posts than what's reflected in the current totals.

 

[Cherryl & Mouzer]

@Jill & Alex (GA) - @Noah & me

The Blood Sugar Gold, from my list, was purchased because I was not going to treat Mouzer's diabetes, with insulin, because I cannot afford to do it. I took him to the vet, found out he has diabetes, told the vet I was just going to take him home and when I felt it was time, I would have him put to sleep.


A couple of days later, I couldnt stand watching Mouzer struggle to walk to the litter pan, struggle to get into the litter pan, struggle to dig his spot in the litter pan, struggle to turn around to use the spot and fall flat on his face, so I notified the vet and told him I will try to do this and hope for donations,

of which, all the people who wanted Mouzer treated, have now disappeared, since I told them I was going to do it, so now all of the money is coming from running a few cards back to the max and to skip my house payment,

of which I skipped in April, due to veterinarian care for three other kitties, and had to pay a payment and a half with late fee in May and now cant pay the other payment and a half with late fee, so will be paying for several more months, with late fees, to try to catch it up.

And there are 50 cats - the way it has gone, since 2014, I will have yet another cat or two or three, going to the vet, before I can catch up my house payments. I am going to lose my darn house if this keeps up. I cannot go homeless because of animals and that is where this is all going.



I might change syringes but not until I use these 100 syringes I have already purchased. And I dont know that my vet plans to keep Mouer at .03ml. He is doing the low time of day reading, the high time of day reading and then to do the glucose curve, to decide on a dose to end with. If he does want to go up any higher, I am not sure how to tell him, I do not want to do that. All I know to do is just not do that and from there, I dont know what dose to choose for Mouzer because I am not a vet and have no idea, so Mouzer's life will hang in the balance, with my not knowing anything.

I will get a meter, when I figure out what to get. I need strips to go with the meter and I think I want to get the lancets, because Mouzer is not going to let me just take his blood out of his arm, like the vet does. It takes the vet and vet tech to hold Mouzer's arm to do that. If I end up with Relion, of which I read somewhere not to use Relion Prime, which Diabetic Cat Help forum uses hahaha And I laugh because you see how people differ and so, ya dont know who to listen to ---

Relion approx $10, strips approx $18, lancets approx $4 - and I guess I need the lancing device approx $6 -- So, approx $40 to start - And I dont know how often I would have to buy the strips or lancets. If testing twice a day, well that really sux hahaha



And I wont do well to have to read a whole lot of charts and whatever you call those things - spreadsheets or whatever lol - and to read a whole lot of information. It will take me a very long time to learn that way. I do best when someone is with me and shows me - displays it to me in action - and then lets me try - like my vet did, when he was teaching me how to pull insulin and give the shot. He probably wont mind teaching me how to use the meter, so I will ask him to show me on his but I dont know if meters are different in how to use them, so if they are, then I need to wait until I can get my own and let him show me on mine.



As for an alarm watch - If I dont have an alarm to tell me when it is time to give shots, the shots wont be given on time. I take care of 53 animals, 50 cats and three dogs. It takes nine to eleven hours, seven days a week, no day off, no vacation and none since 2004, to take care of these animals. They are aging and coming into those years that things come up and they need the vet. Many are on special foods, special supplements and medications. Mouzer is one more added to the burden I already carry and I need that alarm watch for these insulin shots or he wont be getting them when he is supposed to get them.

Supply storage - Actually was a case to hold the pen and syringes and another case for all of the extra stuff - and I do intend to use all of the extra stuff - And I bought some smaller bottles to pour some karo syrup in to keep with the supplies - and that because I have so many supplements and medications going on with cats, I need to remember what belongs to who and keep it all separated from each cat's supplies but together with what cat's supplies.

I bought the B-12, which is the one with the grape and alcohol and whatever, so I am not using it and that is now trashed money and Zobaline is its replacement. The other stuff, cat urinary tract support and blood sugar gold, I am using because I am using it - because I want to use it - because I believe them to be good things.

So, there is not half of the stuff on that list that would have been prevented from purchase. Only the B-12 would have not been purchased and Zobaline would have been purchased in its place.

As for a pharmacist showing me anything, I dont go to a pharmacist. My vet will have to show me.

And LOL Aint anybody taking my blood, not even me. There will be no practicing on me hahaha

 

[Jill & Alex (GA)]

Hi Cherryl! I was hoping you'd post today. How are things going with the shots? Is Mouzer giving you trouble or cooperating?

Since our kitties are more than just glucose numbers, we like to hear about how everything else is going with them. We call it the 5 Ps: peeing, pooping, preening, playing, and purring. If all is well in those departments, things must be going pretty well with the cat.

Have a nice evening!

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

Mouzer is doing good so far. I dont know what to do, though. You have me scared. Last night, I gave him on the halfway mark between where, what I know to read .02 and .03 -- I went down half. Then this mornin, I did a little further, closer to the .02. And then tonight, I did .02 -- And I hope I am not messing anything up for my vet to read it on Friday if I keep it at the .02 ---- And I dont know what to do if my vet disagrees with you.

I have a kitty that went for Radioactive Iodine Treatment on Tuesday, due to hyperthyroidism. He is my personal kitty. He is 14 years old and I have had him since he was a year old. We have never been apart, since I got him, not even for one day. I need to get in the bed. I have to get up way early in the mornin to make sure I get animals taken care of and have time for a shower and get dressed and I got to give Mouzer his shot at 7am. I have to leave the house at 7:45am, to pick up FatBoy at 9am. This moves all of my animal work to 3am!! Gonna get my FatBoy in the mornin!!!!! Good Night!!

The photo upload with the ginger and white kitty is my FatBoy

The photo upload of the tabby is my Tommy Cat - He has Feline Stomatitis and has been very expensive, since 2014.

Mouzer is a sweetheart but figured I would show ya two more sweethearts

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

Right now, I thave a feeling that my vet is going to whisk away all that you have said. I could be wrong and he might see something in it he should be doing differently, but my past experiences are, if I found it on the internet, it is excused away as a big joke, because you can find anything said on the internet.

So, with that in mind, I do not know what to do. I dont know where to start in dosing and how to know what to do at all with knowing how to know what dose, when to lower or raise it, how to do glucose curves, etc... And for me to read how to do this from some chart, is going to be very hard for me and I will not feel comfortable and secure in what I do. I cannot stress how hard it is for me to learn that way. It is a disability and I cannot help that.

Also, who is going to write the prescription for me to get insulin? If I dont have my vet? I dont know that my vet is going to be up for my doing my own thing, as he just writes out prescriptions for me to do what I want to do. I dont even know that he is allowed to do that.



Edit to add: I am finding information, leading back to this forum, as I search google for answers - do not ask me why, but I cant find it when I type the same questions into the forum search.



Edit to add: OK - from a google search, I am reading in this forum about meters and lancets - and I see someone saying that the Canadian pharmacy for Lantus may not ship if the weather is too cold or too hot. I live in Florida. The weather is going to be very hot and has already been very hot, so I guess I might not can even use the Canadian pharmacy.

And I did not know I would have to take a picture of it with a phone. I dont have phones that do that - or put it this way - my tracfone appears to take a shot of something but I do not know how to send it anywhere. I dont even know how to take a shot of anything with the phone. I dont use the phone unless I break down on the road and all I know how to do is to call out and answer it if it rings. And I do not have fax machine.

You just need a prescription from your vet that you can fax or take a picture of on your phone. You want the box of 5 pens which will last you a long time. Marks may not ship if the weather is too cold or too hot. Best ask. http://www.felinediabetes.com/FDMB/threads/newbie-pondering-meters.172078/

Also, I see people talking about buying the box of five lantus. I read, in my google search, and my vet has said the same thing, Lantus will be good for about three months, so to buy the set of five, three or four will be thrown in the trash.
And if I have to buy Lantus at the price for this first pen, I am not going to buy any set of five, to get one or two - it cost way more to do that.



Edit to add: I just found this in that thread, so I am going to do this shopping list hahahaha But I still do not know how to dose kitty, And I just learned in that thread, not to feed him before the test. Protocol is test/feed/shoot .... I asked my vet if I should not feed Mouzer, before arriving for test, he said it didnt matter.

Here is the shopping list and someone commented to add something to that list:
Relion confirm monitor
ReliOn Confirm test strips
ReliOn lancets, 26 gauge (I thought a finer gauge would be less painful..getting nervous)
Neosporin with pain relief.

Additional Comment: Get some cotton cosmetic rounds too. Perfect for putting behind the ear when you poke and for pinching the ear afterwards.

I do see stuff mentioned in that thread about using spreadsheets. I dont use them. Dont know how to use them. Dont even know how to make one. I can do the old school, keep a book with handwritten whatevers. I guess that is just as good. I aint up into the modern world anyhow - you should be able to tell this by the fact that I do not use a cell phone like the rest of the world lives on one



Edit to add: Well - Doing my meter ordering and they do not have relion 28g lancets. They have 30g lancets. So, I ordered everything but the lancets are 30g. Arrives by Saturday.
Can lancets be used more than once?



I am going to need help with dosing. I think I saw the link, either you gave it to me and it is in my bookmarks, or I saw it in that thread - to get help with dosing, so maybe somebody can help -- but I dont know if the vet will still write the script for insulin or not. I guess? Like, is a person allowed to make up their own dosing?

 

[Jill & Alex (GA)]

Cherryl, I'm posting in bold type and have changed the font to Tahoma and the size to 4 in hopes that it'll be easier to read. If you continue to have problems, please let me know. We can try typing in capital letters or making the font even larger. Breaking type into smaller paragraphs may also help. We'll do what we can to make this easier for you.

Mouzer is doing good so far. I dont know what to do, though. You have me scared. Last night, I gave him on the halfway mark between where, what I know to read .02 and .03 -- I went down half. Then this mornin, I did a little further, closer to the .02. And then tonight, I did .02 -- And I hope I am not messing anything up for my vet to read it on Friday if I keep it at the .02 ---- And I dont know what to do if my vet disagrees with you.

Since you do not have a meter yet, the best advice I can give you is to make sure food is available to Mouzer. Many cats will self feed if they feel their numbers dropping. I'm happy to hear Mouzer is doing well.

Your vet may very well disagree with the dosing methods used on this forum. If I were in your shoes and until I could start monitoring Mouzer at home, I would simply tell my vet I'd like to go slower with insulin.

Fat Boy and Tommy Cat are such handsome kitties! Hope all is well with Fat Boy. I bet you're glad to have him home!

I do best when someone is with me and shows me - displays it to me in action - and then lets me try - like my vet did, when he was teaching me how to pull insulin and give the shot.

If you're willing to post your city and state, perhaps we can find a member nearby who would be willing to help one-on-one.

I have time now to look at Consumer Reports but I am still searching for a link to their site for meters. I am not able to read the pdf file. My glasses are a total blur, when trying to look at computer screens, so I am not able to use them to read this pdf file and the words are too tiny for me to read without my glasses.

Blood glucose meters: If you're willing to trust the conclusions I've drawn after looking at the chart myself, the Walmart's ReliOn Micro and Target's Up & Up blood glucose meters are the most economical with decent accuracy. Most here choose the ReliOn meter simple because of availability. Walmart's in the USA seem to be in most towns and many are open 24/7 which makes it easy to pickup test strips. The strips are what ends up costing a lot. ReliOn strips cost less than most.

Also, who is going to write the prescription for me to get insulin? If I dont have my vet? I dont know that my vet is going to be up for my doing my own thing, as he just writes out prescriptions for me to do what I want to do. I dont even know that he is allowed to do that. I mean, that would be like me walking in to a doctor and saying, hey man, write me a script for Xanax and I will tell ya how I am doin by monitoring myself - And that would not happen. I dont know any doctor who would do that, without fear of losing his license.

I understand. You definitely do not want to alienate your vet. Ideally, you'll want to maintain a mutually respectful relationship. Like I mentioned earlier, just let him know you want to go a little slower for now.

Edit to add: I am not finding anything in the forum that would tell me how much the dose for Mouzer should be or how to know. Unless it is that I just am not seeing it. I see talk about too much, too little - but nothing to tell me what to do with where to go with this, from where I am at, with the vet having him at .03ml and I have gone back down to .02ml on my own.

Here's the info for a starting dose when following the "Start Low, Go Slow" approach, one of the methods used on the FDMB:

Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet

• 0.5u BID if kitty has been switched to a wet/canned low carb diet

• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

• Generally, shots are to be given 12 hours apart.

I have no earthly idea what I am doing about how much to dose. I am going to kill my cat because I have allowed being disrupted in what the vet is doing and I have allowed someone to cause me fear. Now I dont feel comfortable about this at all whatsoever. So, what now? I cant treat the cat, when I have no idea what I am doing and my vet is said to be doing it wrong. So, Mouzer just gets nothing or killed by me or killed by my vet.

Take a deep breath. Don't let fear paralyze you. Mouzer is counting on you.

I am truly sorry if my concerns about giving a 3 unit dose to a newly diagnosed cat have caused your fear. There's only one way to know if the dose is too high and that's to test Mouzer's blood glucose at home... which is why you've been encouraged to get a blood glucose meter as soon as you possibly can. I understand it's not possible to do so at the moment. In the meantime, leaving food out for him to self feed is the next best to monitoring.

If you're not comfortable with my suggestions or anyone else's for that matter... do what you feel is best for Mouzer. Let us know if there's anything we can do to help.


I have to get back to work, but will check back as soon as there's a break in my schedule.

 

[Noah & me (GA)]

Hi Cherryl. Don't worry about bold type. If you can't read what you're typing then type your post in bold and then un-bold it before you Post Reply.
Here comes my 500 word reply to the almost everything else. I read Consumer Reports too but sometimes you can over do it looking for a perfect meter. There's no such thing! I threw my first meter away, I have another free meter that I don't use because it is so small it squirts out of my hands, I think I'm the only one here who uses an Aviva Accuchek. I got that meter because Consumer Reports said it only needed a tiny bit of blood. I used to test our first kitty Nigel by the sliding glass door because there was a lot of light and he always laid there watching the birds. Our first meter was a Bayer and needed a lot of blood and a lot of times I would have to poke Nigel twice because the meter said "ERROR", not enough blood. One day I looked at the wall by that window and there were little blood drops everywhere where Nigel shook his head after I tested him. That's when I threw my first meter away. It's easy to say "Test your cat" but no one says "Poke a hole in your cat's ear, it's going to hurt". That is what we're doing and a good meter means that hole doesn't have to be so big and you only have to do it once.
I know it's hard to trust someone on the internet but it's not a dating site, a whole bunch of us need new glasses and the only thing we argue about is who is older and found a new wrinkle today. And my car is way crappier than yours, with a lot of rust and it smells bad too.
Only your vet should write a prescription for little Mouzer.
When you get a meter you can test yourself just like millions of people do every day. You'll get a way better idea of how far to poke the lancet, how much blood you need, does the meter have to be on for 5 seconds before it's ready, does the meter turn itself off after 60 seconds.
Your vet will tell you how much to dose Mouzer. He's going to start you off small and then see how that's working. We want to help you but we are not there with you so we can't say what his dose is should be.
No Cherryl, you're not going to kill Mouzer because you love him and that's kind of why you're here. We all started somewhere. Even after all these years I still have to tell Noah "I'm sorry" every time I test him. But I do have to test him because he's a diabetic cat. It's laundry day, have to go.

 

[Jill & Alex (GA)]

Cherryl, I've made the type larger, changed the font and size in the entire thread.
Hope it helps! If not, let me know. We'll get something figured out.

 

[Chris & China (GA)]

I see someone saying that the Canadian pharmacy for Lantus may not ship if the weather is too cold or too hot.

Yes, they will ship!! They prefer to ship when it's cooler, but when I first found Marks Marine Pharmacy, it was late June in Missouri (so over 90 degrees every day) and there were two holidays (4th of July and Canada Day) that slowed my shipment down even more. I was still able to use all 5 pens and the insulin was fine. All the information is in the "Insulin from Canadian Pharmacies" thread

Lantus will be good for about three months, so to buy the set of five, three or four will be thrown in the trash.
And if I have to buy Lantus at the price for this first pen, I am not going to buy any set of five, to get one or two - it cost way more to do that.

Actually, with the pens, they are good until the expiration date on the box...usually at least 2 years away, so you won't be throwing away any insulin!! The good thing about the pens is that until you "open" them, they will be good until the expiration date....Once "opened", since they only hold 300 units, most cats will be able to use every drop before it looses efficacy (Lantus isn't as fragile as once believed....we can usually get 4-6 months before it starts to "poop out"....sometimes even longer!)

They will also sell you just 1 pen if that's all you want, but it's more expensive to buy it that way. (but still cheaper than the US)

Another nice thing about using Marks....Once they have a script on file, you'll never need to get another one. Unlike the US where you have to get a new script at least once a year, I've gotten multiple refills without having to submit a new script.

 

[Cherryl & Mouzer]

OH MY!! I kept editing to try to cut down on so much for you to read but I just scrolled up and I see you have answers and I dont know if you were answering all along and I was stuck on edit uuummm heehee

I havent read everything yet but I am going to. I have been sitting here for quite a long time now, between editing to talk to you, reading as I found stuff in the forum and I found all that with google first - I couldnt get this information with forum search - once I realized, as I asked google and it was this forum I was able to find the answers - I just searched google and then for the answer from this forum hahaha

I have to go get animals taken care of but I will be able to sit back down a little later on today. I found time now, because I had the animals cared for way early this morning, due to picking up my FatBoy --- and I only had a couple of hours work with animals when I got back - So, I found time to sit here and do this meter thing. It did all cost $77 LOLOL But ok --- I am thinking it will be cheaper, once I get set up.

I dont have time to read to see what you say about vet and writing script and my doing my own thing with you guys and not doing what the vet says but I will see if you had help to say on that -- oh and dosing - I am worried about dosing - obviously, being as I am scared to give Mouzer the .03 -- And I am still confused but I think .03 means 3 units in your way of talking but correct me if I got that much wrong.

LOL I freaked out when I arrived and everything was bold ahahaahahaa I was like, OMG What have I done
I thought maybe I hit a button that messed up the whole thread and you were going to be really angry

OK I will be back later. I want to sit and take my time with this because I need slow and time - at least until maybe I understand things and that way I wont get all flustered and say stuff that --- probably to you appears I am angry but I am not angry - I am very scared, confused, dont know enough and I get flustered about it. Please forgive me, I maybe should have explained that before, just in case I sound mean or angry.

OK I will return.

 

[Nan & Amber (GA)]

Hello and welcome, Cherryl! Mouzer and your other kitties are gorgeous!

You've already gotten lots of great advice in this thread, so I'm just saying hi and answering a couple of specific questions here. Keep asking!

You just need a prescription from your vet that you can fax or take a picture of on your phone. You want the box of 5 pens which will last you a long time. Marks may not ship if the weather is too cold or too hot. Best ask. http://www.felinediabetes.com/FDMB/threads/newbie-pondering-meters.172078/

Also, I see people talking about buying the box of five lantus. I read, in my google search, and my vet has said the same thing, Lantus will be good for about three months, so to buy the set of five, three or four will be thrown in the trash.
And if I have to buy Lantus at the price for this first pen, I am not going to buy any set of five, to get one or two - it cost way more to do that.

I'm sure you can send an Rx to Mark's by regular mail-- it'll take longer, but if you already have some insulin, that will be OK. I haven't dealt with them, but everything I've heard says that they have excellent customer service and will be willing to work with you. If you get in touch with them, they'll also let you know whether shipping to Florida is feasible this time of year, and how it will be done.

If you keep your pens refrigerated, they can last much longer than the "official" time-- the company only tested it up to a month, so they do not claim any longer effectiveness, but we have found (over and over) that properly-cared-for pens can last until the expiration date.

You do see on the internet some human diabetics reporting that their opened pens lose effectiveness after a month, but keep in mind, they tend to be using the pens under non-ideal circumstances (carrying them around with them at room temperature, for example). Around here, with typical usage for feline diabetes, we see opened pens lasting up to six months!

[edit: OK, Chris beat me to posting and basically said everything I just said!]

And I just learned in that thread, not to feed him before the test. Protocol is test/feed/shoot .... I asked my vet if I should not feed Mouzer, before arriving for test, he said it didnt matter.

For his purposes, that makes sense-- he was trying to get a representative snapshot of Mouzer's blood glucose, so he wanted things to be as "normal" as possible.

If you are testing regularly at home, and testing before a shot, though, it's best to make sure that the number you get isn't food-influenced. You are making sure that the number is high enough to shoot, food can make blood glucose temporarily higher so you'd get a misleading picture.

Edit to add: Well - Doing my meter ordering and they do not have relion 28g lancets. They have 30g lancets. So, I ordered everything but the lancets are 30g. Arrives by Saturday.
Can lancets be used more than once?

It's really best not to-- they get dull (more painful), and there's a risk of infection if you re-use them. The 30g are thin and it may be hard to get blood at first (though they will be great to have them later, after the ears "learn" to bleed). If you can get to a human pharmacy (or Walmart/Target) before you start testing, they should have 26 or 28g lancets (often marked for "alternate sites"). They're pretty interchangeable, so it doesn't matter much what brand you get for these unless you decide to use the little device that comes with the meter (most people find it easier to just "freehand" the pokes).

Again, welcome! And keep asking questions! There's an awful lot to learn in the beginning, but you are on the right track!

 

[Cherryl & Mouzer]

@Noah & me - I did not see replies. I already made the order - that is what I was doing, at the time I made the post. Walmart did not have the 28g for the relion, so I have to use the 30g that I ordered. I did not know if I had to use relion or not, so that is what I bought. I see other 28g lancets on the Walmart site but again, I did not know if I could use anything other than relion lancets. So, I am stuck with what I have paid for, at this time.


@Jill & Alex (GA) --
I actually have just lost my vet. This is a long story.

Some time in last year, my vet was not in. Tommy needed a shot for his stomatitis. I had to see another vet in the office. She spoke as if to jump on me because this shot can cause diabetes and I need all teeth extracted. Of which I had told my vet this from the beginning and he highly disagrees about extracting all teeth, saying it will not help. I do not have the money to extract all teeth and have not been able to raise the money. My vet insists this shot is the way to go. I have been doing what he says. This woman vet disagrees and told me she spoke on the phone with my vet and he agrees with her ......... and if he agrees with her then why has he had me do what he has had me do?? See, he cant let them know he does not agree with them.

And then when I did get to see my own vet again on next visit for Tommy, he verbally disagrees with that other vet, when talking to me. But he wont disagree with them -- with them --- so he makes me look bad - like I am the one doing the wrong thing and not doing it because my own vet has me doing what is being done. So, my vet told me I cant be disagreeing with them like this - the owner will eventually tell me to find another vet.


-----------------------------


Around August of last year, my vet was not in and I took one of my kitties and saw another vet, from the office. He was not able to eat and acted as if pain in the mouth. This vet barely opened his mouth, looked up at me and said, he has several badly decaying teeth that need to be pulled. So, I made the appt. My vet was in on the surgery day. I went to pick up my cat and asked my vet, so how many decaying teeth did Sunny have (Sunny is kitty's name). My vet looked surprised in the face and said, he didnt have any decaying teeth, in fact, he has very good teeth. I cleaned them and removed some very hard tartar. This total cost, with blood work before being ale to put him under, xrays, teeth cleaning, was approx. $500. I had raised the money through a fundraiser.

I reported back to the people and they were not happy. Why? Because it was as if this was all done under false pretenses. There were no decaying teeth but the money was raised with need to have decaying teeth extracted and kitty an older kitty and dangers of what infection was doing to his kidneys.

So, there was a little fuss about this over the phone, between me and one of the girls at the desk. And as the owner of the place sent message with me - I did send a message and it was a reply --- they spoke as if Dr. Marks was saying what was done needed to be done ........ And I could see my vet was actually covering his surprised look on his face when I asked about the decaying teeth -- of course he is not going to go against the office.

And when it was just me and my vet talking, he spoke of how jumping up and pulling teeth is not the cure.... He spoke in a manner that let me know he didnt agree with the other vet ...... but of course, he is not going to let his boss know this. And again, he told me I cant be disagreeing with them or the owner will have me find another vet.

And ok so, let us say kitty needed teeth cleaning - that is not what I had kitty there for. I had him there because of pain and he could not eat and I needed that tended to. I did not need money to be wasted on teeth cleaning. My vet told me it is good to get their teeth cleaned --- ok yeah --- but that is not what I was there for at that time. It was raised money, to get the kitty able to eat. I do not appreciate being told badly decaying teeth and the people who paid for it are not trusting where I take the kitties, because of this being done - said - and all that took place.


-----------------------------


Anyhow, so now - last week - I needed separate invoices for FatBoy and Mouzer. I had a remaining balance on FatBoy for some blood work they had to send out and I was to pay for it. They printed out the sheet with FatBoy's cost on Mouzer's invoice and a separate one for FatBoy but I needed one for Mouzer - for just Mouzer. I was keeping my voice down because there were other people in the waiting area. They insisted they could not provide one for me, the way I needed it. I told them I know they can because Lana - another girl - has done it and knows how. They insisted they could not. I said, I need it done that way.

Ok - just my insisting what I need, has been turned into - that a scene was made and there was no scene. I was talking low, because I did not want everybody in the waiting room to hear the conversation but I was insisting what I need and it would appear this office is not going to allow people to disagree with them ................... I have been informed I need a new vet --- which actually, with what they did with Tommy Cat and the Sunny Cat ordeal and here it sounds like my vet is doing a wrong dose on Mouzer - ok yeah - maybe it is time to change and find another vet. This office is not going to want to allow me to let them know when what they have done is not a right thing, from one kitty and stomatitis to a kitty supposedly to have decaying teeth pulled and there were none to be pulled --------- to now Mouzer and his dosing..........


-----------------------------

And with all of this said, maybe you can understand why I have been afraid to even have to mention to my vet that we need to be doing something else for dosing Mouzer's diabetes .......... I am not to disagree with that office or they will have me find another vet ........ OK it is now done - I have to find another vet and I need another office to deal with anyhow.

-----------------------------


Mouzer will not have his appointment tomorrow. I do not know what to do about this. He is newly getting in with this diabetes and you see what is going on with that and the dose, so I dont know what I should be doing at this time. I do have another vet in mind to try but I dont know that they can get all records for Mouzer in time for a visit tomorrow - It is too late to call now to find out if Mouzer can even be seen by this other vet tomorrow. And there is a chance they are filled up for tomorrow. Monday is a holiday, so no vet will be open.

I also have to get things in with a new vet for Tommy Cat's stomatitis and for FatBoy's radioactive iodine treatment follow ups. So I will at least get in touch with the new vet by Tuesday and get him to send for all records on the many kitties that have records and the other vet's office.


-----------------------------


For now............. Start low ------------ I am not sure if I should be dropping way down on the syringe or going down little by little. And I only have this syringe with the markings from that photo you displayed on the right.........

Mouzer has had .03ml from Friday up until the night before last - then was between .03ml and .02ml for one shot, then a little closer to .02ml from .03ml for the next shot, then .02ml this morning and I have 7pm coming tonight........

So, if you were me ........ what dose would you give at this point? Meter wont arrive til Saturday and I dont know how to use it yet and testing on me is questionable but I will try ... I cant even watch them take blood from a cat ..........
But for now, there is no acting vet .. I have the insulin and you know what I have. I have the syringes and you know what I have. Mouzer has been on the food needed for him for about three weeks - canned.

For now, to hold me over until I can get to another vet for Mouzer --- can you help me know what to do?
Should I continue .02ml at least? Until I get to another vet? Or should I drop it and if so to what?
I cant leave food out for Mouzer. He is not the only kitty here and if it is canned food, the others will eat it and wont any be left.
Again, the monitor wont be here until Saturday and I am hoping I can figure out how to use it.
I cannot afford any emergency room visits and I do not even live very close to an emergency place for animals - but mostly, there is no money for emergency, if I did.


I dont know what BID means -
And being as I dont have a monitor, I dont know if I should drop to that 0.5 number -
which I dont have a 0.5 mark - or I dont think I do. It is --- from the 5 - a mark down is 4, down is 3, down is 2 down is 1

I am still reading your replies from above but I thought I better get this message out here so you can know that right now, I have no acting vet to help me.

 

[Jill & Alex (GA)]

Oh boy, what a mess with that vet! As much of a pain as it to find a new vet, it sounds like it's probably a good idea.

So, if you were me ........ what dose would you give at this point?

Questions:

• Has anyone mentioned Mouzer having ketones or a diagnosis of diabetic ketoacidosis -aka- DKA?

• You mentioned you can't leave canned food out because the other cats would eat it. Is there any dry food left out for grazing during the day? If so, does Mouzer have access to the food?

If...

• there's been no mention of ketones or DKA

• and you can leave some dry food down for grazing

until you can start getting some blood glucose tests done after your kit arrives I would drop the dose to 1 unit given twice a day (every 12 hours).

That's what I would do if I were in your position. At least Mouzer would get some insulin and it's better to be safe than sorry! Once you start testing his blood we can help you adjust the dose accordingly.

How does that sound?

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

OK - I was reading where you sent me to read on start slow and saw this...

• In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  
  And I have no idea what that means --- and I see now in your post you say something about ketones and DKA -- nothing has been said to me about that and yes there is always dry food out for the kitties and Mouzer has free range if he wants it. He hasnt touched it since he has been getting special canned food haha But I guess, if he needed it, he would know to eat it? It is a mix of regular dry with a grain free dry, half and half. Should I just put out the grain free dry in whichever room Mouzer decides he wants to be in? He alternates rooms - at his own decision and I allow it.
  
  I am hoping I do find a vet that I trust. I have felt odd about my vet since the Tommy stomatitis and disagreement thing with that other vet and my vet acted as if he agreed with her when he absolutely did not agree with her. But he is the only vet I know and trust. I have been to a couple of other vets in our area and I dont trust them. I have two vets that I am willing to give a try.
  
  OH And so to go to 1u - means - there is that very first bottom mark on the syringe and then it goes up 1 -- is that the 1u mark? And so by going low, then that means Mouzer's sugar could go up but if I stayed high, it could go down? So safer that it goes up than down?

 

[Cherryl & Mouzer]

And once you tell me for sure that mark is the 1u mark --- I should start this now, with the 7pm shot - it is nearing 6:30pm now???

 

[Jill & Alex (GA)]

And once you tell me for sure that mark is the 1u mark --- I should start with the 7pm shot - it is nearing 6:30pm now

The whole unit scale for the syringes you have is on the RIGHT.
The top line is the zero line.
The next line down is the 1 unit line.

I'll answer your other questions soon, but wanted to get this posted so you can stay on time with his shot.

 

[Noah & me (GA)]

Sorry, time to delete a post. @Jill & Alex (GA)
Cherryl, I haven't had time to go through all your posts. You mention frequent headaches. My wife and I get migraines. They are not "migraine headaches", they're migraines! A headache is a boo-boo, a migraine can make you hunch over a toilet. Some doctors still think these are not real, "Here's an Advil". That might be something to get checked out.
Earlier I took so long typing a post that by the time I posted Jill's post had popped up first so they went in the wrong order.
This is what a reused syringe looks like, same with lancets. Mouzer says "That hurts". But he also says "I love you Momma".
In Windows 7 if it's too small to read press Ctrl and the + sign. That should make the message bigger. Ctrl and the - sign will make it smaller again. This is the biggest picture I can find. Looks like a rusty old nail doesn't it?

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

Thank you! And I will do the 1u at 7pm and until I can get that meter and I am guessing it wont be too hard to learn how to read the meter or use it. I do not understand numbers I see posted to do with meter -- I think it is meter readings they are showing.
I understand that Mouzer was 463 and a week later 371 ...
So I will probably have meter questions later.

These are the numbers I dont understand..... And I am sorry to be such a pain :/

• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unitimmediately
• 
  

 

[Cherryl & Mouzer]

@Noah & me

Ok I do reuse syringes but only two or three times and I do watch to make sure they are pointed and I also can tell by how they go in to the kitty's skin, if they should no longer be used.

But I am not sure how the lancets work - so I will look at them --- I do use my glasses with all of this on the syringes, because I cant see the marks without them hahaha So, I also observe needles with glasses on.

My glasses issue is for some reason, they dont read good on a computer. I read better without them, when on the computer, but still things are a little blurry and I have to concentrate real hard - that is what gives me headaches - that and strain on the eyes. My eyes stay very red, when I do a lot of computer reading.

The headaches are curable by my tylenol - they are not migraines - they are just the strain on the eyes on the computer reading.

I have windows 8.1 on this laptop but I see the magnifier thing in the google area up there somewhere and will try to use that.

 

[Jill & Alex (GA)]

Cherryl, I have to make dinner now, but I will be back to answer your questions after dinner and kitchen duty... unless someone else beats me to it. I don't think there's any urgency at the moment, but I promise I won't leave them unanswered tonight.

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

If you say 1u for dosing, starting with this 7pm dose, I am ok and I feel fine. Dont rush dinner.
I feel a little nervous about a new vet because I have Tommy and his stomatitis and that is why I have hung onto this vet. He has been treating Tommy since 2014 and I am not sure what other vets will do for stomatitis. I dont want them messing up my Tommy Cat. He is going to eventually have to be put to sleep because the shots will stop working for him---- and the shots will eventually cause diabetes too. But I am keeping him with me for as long as I can. It is going to kill me when I have to say goodbye. I am not going to do well with that at all. I get very sick at the very thought, like even now, just saying it, has me sick.

I will come back in a while and see what you have to say. I do have a few things to do and I have to get Mouzer his shot soon too.

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

My husband just brought something to my attention. I had sent my vet all that you had said, info on Lantus and how it works and how it is to be done ... etc.... I asked him to please read and see if there is anything he is not knowing about the dosing for Mouzer and I let him know it is being said the 0.3 and 0.2 dose is too high, especially for new kitty being started on it...

I got a call this morning, from the vet's office, to confirm Mouzer's appt. But I got a call much later today, informing me I need a new vet and my vet had just spoke with them about the invoice ordeal from last Friday - which the only ordeal was that I needed something they would not provide and I knew they could provide it and I insisted I needed it - and I did not raise my voice - I was trying to be low and quiet because I did not want the waiting room to hear.

So, my husband is thinking that my vet did not appreciate my sending him a bunch of info that he probably does not know about Lantus and he decided, if I am going to disagree with him, I need a new vet... He has stated, several times, I cannot be disagreeing with them or I will need a new vet.

OK No need to go on about this but I thought I would mention this to you. I think your information may have intimidated my vet, to be honest. I know he has quickly whisked away any information I have found to do with whatever is being treated, when it disagrees with what he is doing --- he has done this with several kitties. And the information I have found, has been from reliable sources, on the order of this message board. I havent jumped on any craziness.

 

[Nan & Amber (GA)]

@Jill & Alex (GA)

Thank you! And I will do the 1u at 7pm and until I can get that meter and I am guessing it wont be too hard to learn how to read the meter or use it. I do not understand numbers I see posted to do with meter -- I think it is meter readings they are showing.
I understand that Mouzer was 463 and a week later 371 ...
So I will probably have meter questions later.

The meter readings Mouzer got at the vet (463 and 371) are in mg/dL units. Since you're in the US, those are the same units that your meter, when you get it, will read.

So, what does this mean? Well, non-diabetic cats generally read between 50-120 mg/dL. Diabetic cats can hit much higher numbers-- 500's and 600's in extreme cases. Mouzer's readings at the vet definitely indicate diabetes, and that he is pretty far from being regulated.

@Jill & Alex (GA)

These are the numbers I dont understand..... And I am sorry to be such a pain :/

• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unitimmediately

In the "Start Low, Go Slow" instructions above, we're trying to set consistent rules for holding and changing doses. The two goals are: get kitty well-regulated (below 200 most of the time), and keep kitty safe from hypoglycemia. The "reduction point" of 90 mg/dL is conservative-- it's still within normal range of 50-120, nevertheless, whenever we see a blood glucose number that low we're going to reduce at the next insulin dose (and later doses) , just to make sure that we are leaving a big enough safety buffer.

 

[Cherryl & Mouzer]

@Nan & Amber -- I just realized it was not Jill & Alex talking hahaha Sorry about that.
A new person talking heehee Thank you for responding

@Jill & Alex (GA) - @Noah & me

Oh Wow! Check this out
I kept raising that magnifying number up top in google browser, until I could see without so much strain. I am at 150% and that isnt too bad. I might go up a little more but this aint bad. Than you Noah
And Chris? That is your name?
Jill & Alex - You dont have to fix your font for me. I can use this magnifying thing.



@Jill & Alex (GA)
Thank you for explaining the meter readings. So, far from being regulated? Mouzer is that bad off?
Does this mean it is going to be a long time to get him regulated? The vet was hoping for a 250 tomorrow - was that rushing for a lower reading?

And once I get the meter - Am I understanding we can do a glucose curve?

The vet's office said they have all records ready. I dont know if I have to pick them up myself or if they can be sent to a new vet ---- or is it I should make it a point to pick them up myself? I am not sure I want to go back in there - I am trying to be nice to them but if they say something stupid, like if I talk to my vet, he is going to say - I told you, you cant be disagreeing or they will have you see a new vet - that is going to anger me ----- I should be able to speak up, if I feel they are not doing something correctly. hhmmm The more I think on this, I think my husband is correct. It has been a week and nobody has told me to get a new vet -
I send a bunch of information on Lantus - and now I need a new vet and it is my vet who brought this up to the owner.

 

[Chris & China (GA)]

Hi again Cheryl!!

Sounds like you have a vet like so many others of us have had!...Basically, totally useless!! My first vet told me that "insulin is a hassle and just feed her this dry W/D and maybe she'll live another 4 months" ...didn't take me long to find another vet!! China just passed 4 years since diagnosis and we're on year #5!!

I was lucky though. I found this message board very early and had read a lot of the information here and it all just made sense to me (with what I already knew about human diabetes) Once I got a vet to give me a script for Lantus, that's the last time China has been to a vet for her diabetes. She see's another vet for things like dentals and checkups, but she's never once had a curve run or anything else having to do with diabetes from a vet. I trusted the people here 100% with guiding me and teaching me what I needed to learn. It's not easy! Diabetes is a difficult disease, but who better to teach you than people who have been doing it every day for years!! The sad truth is that most vets might see a handful of diabetic cats in their lifetime....they see a lot more diabetic dogs, so they just don't keep up to date on the latest treatments.

We can help you learn what you need to learn, but it does mean trusting a bunch of crazy internet cat ladies with your dear sweet Mouzer. I know that's a giant leap of faith, but I assure you that nobody here ever wants to be responsible for hurting another person's cat, so our first rule is always safety.

Once you have your meter, you can test as often as you want to!! We recommend always testing before shooting (to make sure they're high enough to give insulin at all) and if at all possible, at least once somewhere mid-cycle during the day (like 4-7 hours after the shot) and at least a "before bed" test at night. Most cats go lower at night, so it's important to get that "before bed" test to make sure he'll be OK overnight

If you can get at least those 4 tests in per day, that's enough! Of course if you can get more tests, that's even better but not everyone can stay home all day to poke their cat! If you can't, then at least once a week, you'll want to do a full curve. That's testing every 2 hours for 12 hours or every 3 hours for 18 hours.

The vets office can fax records to another vet, or you can walk in and tell them you want copies for your own files. You paid for them....they are YOURS

 

[Cherryl & Mouzer]

@Chris & China

LOL Did I some how tag you? Or you just came in? I am just curious, because of asking Jill & Alex, if her name is Chris - If it called you

But ok wait a minute --- I cant afford to test four times a day. That is a lot. I am going to try the two times a day. I hope that is ok. And so, for a curve, I am going to use up these lancets and strips like crazy???? Oh man ----- So, these $37 test strips and then the lancets - are going to cost twice the money - uummm near $80 or more, every 50 days???
I cant do that - with buying syringes and Lantus too --- I am getting sick now. I dont know what to do. I am wondering if I should just put Mouzer to sleep and I hate to do that because he is fine, except for this diabetes, and it is going to hurt me very badly, to have to put a kitty to sleep due to lack of money. But this is all climbing in cost and I cant do this kind of cost.

I am home all of the time, except for veterinarian visits, going to the grocery store, which is just under two miles up the road and going to church, which my husband then drives. I am on disability, so as a norm, I am home. I try not to have to go anywhere. I dont shop in stores, except the grocery store. The driving makes me sick and also going to stores makes me sick but I can handle the grocery store. I know where everything is and it isnt that far to drive. I live in the country, so other places are farther and I just dont go, unless my husband can be home to take me --- but he works and hours get wacky on him, so I dont count on that --- I shop the internet for everything, except the grocery store.

I wish I would have put in my first order of Lantus to the Canadian site, so they would have it on file and I wouldnt need a new script. I just wasnt sure about using them. Now, another place has the script and it cost more for the Lantus. I have to get a new vet, so I can get a new script, and I need to do that soon, so I dont run out. I dont even know how long ahead of time I should order more Lantus, if to get it from Canada, so I dont run out. I also have a kitty that will need the vet, so he can eat. He has feline stomatitis - and will need a vet by June 5 - and another kitty will need some follow up work done for the radioactive iodine treatment vet, by June 20. I hate having to learn a new vet. I dont trust them to begin with and I am going to be so leery of them. I dont have many choices near me, either.

 

[Chris & China (GA)]

Cherryl....sending you a Private message....Look in your "Inbox"

Let's try to get you hooked up with DCIN

 

[Cherryl & Mouzer]

@Jill & Alex (GA)

Before I forget to ask --- And I hope you see this in between other conversations --
I am still reading http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
I have read it several times but I did explain how I have to read over and over to understand and still I dont understand all of this - I hope that is normal that I dont understand yet.

But it is said in this sticky --- Or from what I am understanding it saying ---
I would keep a record of the readings and give them to the vet, so he can do dose, and he will start low and go high .......... But that isnt what happened. The vet started at 2u and a week later, with a 371 reading, went to 3u ....... So, I am not going to be able to trust a vet with this.
Does that mean, I go to a vet, with Mouzer, because I want my script, and figure the dose out for myself - which actually, you did say, once I get a script into the Canadian site, I wont need the vet for it ........
But ok does that mean I dont have to use a vet for dosing? Because well, if they dont know how to do it, why do I need them?

Oh yes - Wont I need bloodwork done to keep a check on his kidneys, liver and whatever organs, due to the insulin?

I am not having good luck. The vet I 'had' hahahaha I am already gettin comfy with saying 'had' --
He disagreed with all information I found on Feline Stomatitis - and he even disagreed with the known experts ---- And then he starts Mouzer off with this dosing on Lantus ----
I do not trust veterinarians any more!

 

[Cherryl & Mouzer]

Cherryl....sending you a Private message....Look in your "Inbox"

Let's try to get you hooked up with DCIN

@Chris & China -- DCIN will not help me. I am not low income. I am low-end, middle income, caring for 53 animals - and they have me in a woeful debt - that is why I cannot afford to take on more expense and I need to keep it down as much as I can. Places that help with finances, do not go by where the money is going --- They see income - that is it. I do not fall into their low income criteria. I have tried to get help, over the years, and this is always the case. Not poor enough to get help, not rich enough to pay the full way, but have to pay the full way or do without.

 

[Nan & Amber (GA)]

So, these $37 test strips and then the lancets - are going to cost twice the money - uummm near $80 or more, every 50 days???

Wait, where are you getting the lancets and what are they costing you? Lancets are relatively cheap-- even at CVS (which isn't the cheapest by any means) they are selling a box of 100 for $4.55. If you do 4 pokes a day, that's almost a month's worth.

 

[Chris & China (GA)]

Well once you have Mouzer's ears bleeding well for you, you can switch to the Relion Prime.....the strips are only $17.99 for 100

We usually suggest at least starting with the Confirm because it takes a tinier sample size and with a new cat, it's easier to get a good reading with a tiny sample, but once the ears "learn to bleed", you could save on strips by switching to the Prime meter

You can get syringes from WalMart (but you'll have to actually go there) for $12.58 for 100

Lancets are cheap....You can get a box of 100 28 gauge lancets from ADW for less than $2 (plus shipping)....they also have some good deals on syringes

All these have half unit markings and are the correct syringes for U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
BD Ultra-Fine

 

[Cherryl & Mouzer]

I am reading back up the thread -- I keep reading and re-reading --

And I see I thought Jill & Alex were talking when Nan & Amber and Chris & China have been talking, so forgive me for not realizing it was new people talking

I am figuring it all out now - Nan & Amber spoke of sending mail to Canada to take long - I now dont even have a script to mail hahaha And I dont know when I should be mailing anything because I dont know how long it takes to get there and will I have the Lantus here in time before I run out. I wonder if I can reorder from where the vet has the script at now and I will just have to pay the higher price until I can get a script to Canada. I have a digital camera but it doesnt always show up clear to read stuff but if I can get a clear photo - would they accept an email of that?

And Chris & China mentioned I think how long the pens really last, so I will buy the box of five, if I can ever figure how to get a scrip to Canada --- once I even get a new script

 

[Jill & Alex (GA)]

Let me try to answer your questions...

I dont know what BID means -

BID or bid is a medical abbreviation for twice a day / twice daily / 2 times daily.

OK - I was reading where you sent me to read on start slow and saw this...

• 
  
  
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
    
    And I have no idea what that means --- and I see now in your post you say something about ketones and DKA -- nothing has been said to me about that

I'm happy to learn he hasn't been throwing ketones in his urine and was never diagnosed with diabetic ketoacidosis. Ideally, if lowering the dose substantially, urine should be checked for ketones with ketostix. They can be purchased at most pharmacies and places like Target and Walmart. However, since finances are an issue you *could* hold off on these for now as long as Mouzer is eating well and his behavior is normal. If anyone disagrees, please speak up. It's the best I can think of given the circumstances.

If his appetite becomes "off" and/or he's not feeling well, you'll want to get some ketostix to check for ketones as soon as possible. If this happens, let us know immediately. Checking for ketones involves dipping the strip in a little bit of Mouzer's urine. Some people stick the strip in the stream of urine as kitty is peeing. I used a long-handled soup ladle to collect urine for testing with Alex.

... yes there is always dry food out for the kitties and Mouzer has free range if he wants it. He hasnt touched it since he has been getting special canned food haha But I guess, if he needed it, he would know to eat it? It is a mix of regular dry with a grain free dry, half and half. Should I just put out the grain free dry in whichever room Mouzer decides he wants to be in? He alternates rooms - at his own decision and I allow it.

Most kitties will seek out food when their blood glucose numbers are dropping. For now, I would continue with the half and half dry food mixture until you're able to test him. Depending on his numbers that advice is subject to change at a later date.

And I will do the 1u at 7pm and until I can get that meter and I am guessing it wont be too hard to learn how to read the meter or use it. I do not understand numbers I see posted to do with meter -- I think it is meter readings they are showing.
I understand that Mouzer was 463 and a week later 371 ...
So I will probably have meter questions later.

Deal. Let's worry about meter numbers after you have a meter.

These are the numbers I dont understand..... And I am sorry to be such a pain :/

• 
  
  
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately

• 
  

You're not a pain. You're trying to understand and learn. I understand. There's quite a learning curve attached to treating feline diabetes.

Numbers will make more sense after you have a meter and are testing Mouzer's blood glucose. When following SLGS (Start Low, Go Slow) you would know to reduce the dose by a quarter unit if his numbers drop below 90 mg/dL.

Lantus dosing is based on how low the dose takes kitty (nadir) with only some consideration given to preshot numbers. Therefore, a drop below 90 means a reduction because we don't want to continue giving the same dose that drops him so low (below 90). Make sense?

Ok I do reuse syringes but only two or three times and I do watch to make sure they are pointed and I also can tell by how they go in to the kitty's skin, if they should no longer be used.

Tomorrow I'll look to see if I have any syringes and lancets that I can send you. I know some people re-use syringes, but it can't be comfortable for kitty AND there's a bigger to consider. Re-inserting a syringe into the pen can cause the insulin to become contaminated. Using a new syringe for each shot is a whole lot cheaper than replacing insulin if the pen has becomes contaminated.

I feel a little nervous about a new vet because I have Tommy and his stomatitis and that is why I have hung onto this vet. He has been treating Tommy since 2014 and I am not sure what other vets will do for stomatitis. I dont want them messing up my Tommy Cat. He is going to eventually have to be put to sleep because the shots will stop working for him---- and the shots will eventually cause diabetes too. But I am keeping him with me for as long as I can. It is going to kill me when I have to say goodbye. I am not going to do well with that at all. I get very sick at the very thought, like even now, just saying it, has me sick.

About Tommy Cat...
This probably isn't what you want to hear, but very often it's in the cat's best interest to remove all it's teeth when kitty has a bad case of stomatitis.

OK No need to go on about this but I thought I would mention this to you. I think your information may have intimidated my vet, to be honest. I know he has quickly whisked away any information I have found to do with whatever is being treated, when it disagrees with what he is doing --- he has done this with several kitties. And the information I have found, has been from reliable sources, on the order of this message board. I havent jumped on any craziness.

Oh boy! I'm sorry. I know it's easy for me to say, but it sure sounds like you might have needed a new vet anyway.

Thank you for explaining the meter readings. So, far from being regulated? Mouzer is that bad off?
Does this mean it is going to be a long time to get him regulated? The vet was hoping for a 250 tomorrow - was that rushing for a lower reading?

And once I get the meter - Am I understanding we can do a glucose curve?

There's no telling how long it'll take to get Mouzer regulated. Some cats are easier than others. Time will tell.


I see Chris and Nan have posted since I started typing. They've given you some awesome information!

I think I've answered most of the questions, but bear with me. Despite taking two classes, I never learned how to type. It takes me forever to get a message posted because at best I'm using two or three fingers at a time! You may be asking more questions before I'm done typing the last response.



Edited to add: And then my Internet connection went out!!! Geesh!

 

[Cherryl & Mouzer]

I bought everything at Walmart and I am not going to buy a new meter. I wanted to buy the meter I needed, the first time.


I need U-100 3/10cc syringes with half unit markings
And there are plenty of syringes sold on the Walmart website, shipped to home. I just am not sure how to find these exact syringes. I search Walmart site with that string and I get a whole bunch of syringes but none appear to be like that string up there.

And I cant stress enough -
If it has to be purchased by my going to the store myself - It is not happening

This is what I am using and I dont see it on Walmart - Insulin Syringe U100 0.3cc 29g x 1/2inch 100ct with sharps. I dont know if I can change to the others, with the place I got these, or if they even have the others.
Which there was actually a big hassle in getting the darn syringes. My vet kept saying they will come with my insulin order. I kept calling the place where the order was put in - they said I had to order syringes - my vet kept saying the syringes will come from the pharmacy side --- the place said no they wont --- I mean two days of many calls, between calling the place to get them and calling the vet and trying to get everybody to get it together that I had to place the darn order myself, they were not going to just put them in with the darn insulin! LOL That was a headache!


I dont find this on Walmart unless dont understand them -
U-100 3/10cc syringes with half unit markings

OK Enough of searching pages of syringes -


On the site you gave, the sure comfort and carepoint appear to be the cheapest. That with the lancets are $6.95 shipping. So, that would make the syringes cost $19 and lancets together $21. I will not be ordering until I do use what I have and have coming. I would prefer to order from Walmart, if the syringes could be found there - because free shipping would make it even cheaper. But this is ok.

 

[Cherryl & Mouzer]

BID or bid is a medical abbreviation for twice a day / twice daily / 2 times daily.

LOL That makes no sense at all! That is funny! BID
I was thinking of some words that started with a B then an I and then a D
Like Blood Identification even

Ok - holding off on the ketostix - unless I should get some to have on hand, being as I have to order them and there would be wait time for them to arrive. And ok good luck to me on gathering pee from Mouzer *oh brother*

And OK - half and half mix dry for now to keep out

On the quarter reducing thing - with the syringes I have now, I dont know how to do that. But I guess you can tell me how? Until I use these up and get the other syringes?

Makes since - no go below 90 and I will need to be babysat for a bit, to know if I am to give a shot or skip a shot or whatever.

This is not good - new syringe each time. Vet said reuse them - Vet is stupid again? And so this doubles my cost or more for syringes :/ So, the $19 with shippping included, is now $40


I know Tommy Cat's teeth should all be extracted but it is $2000 and up - and I dont have it and I havent been able to get people to donate for this. They seem to think it is not necessary, no matter how much I explain that it is necessary. And Tommy Cat is now ten years or older and I am worried about his being put under long enough to do this. The vet said, time is of essence, he cannot stay under long. But I dont have the money anyhow.


I have felt I needed a new vet, ever since the ordeal took place over Tommy Cat. I just do not have a great selection here in my local area and I have been fearful to change. But I am now forced to - so I can hope that God sees something better for us.


As for typing. I took three years in high school LOL And I am good at it, however, I OCD over perfection - commas drive me insane - typos - etc... So, I cant say I am any faster than a one or two finger pecker ---
I call my husband a two finger pecker lolol He dont get on the computer any more but when he used to, I would watch him with those two fingers and he was pretty good with it --- better than I could do at two finger pecking

And I have a router issue - for whatever reason. It isnt my cable modem. I have checked it out and it is my router and I have to go unplug and re-start it. I had a brand new router when this started happening. I bought a more expensive router, based on a list of what are the best, which the first new one and the one previous, being same brands, are on the list of good routers, but I still bought the more expensive, in case it was the brand ---

So, my wireless could go down at any time and I have to come back --- in case I disappear in a conversation, thought to mention. Oh too, if I disappear or appear to disappear, it could even be that I am reading a comment and searching links put in or something like that

And - I need to learn this for Mouzer, in case internet did go down, so I am not here freaking out, not able to get to the board.

Mouzer seems ok now. He got the 1u at 7pm. I do check on him from time to time to make sure he is acting ok. I feel sick about trying a new vet more with Tommy Cat than with Mouzer - being as I do have this board for Mouzer but Tommy Cat is a different situation.

I will shut up now. I do keep coming back to this thread and reading and re-reading and referring back and to the links ... so I have not ignored anybody or anything said... It is just taking me time to learn and it is a lot to remember, so I cant remember and have to come back to read.

Thank you all for your time and help