Mr. Kink's first vet visit - not happy with the vet AT ALL.

[Caitlin & Mr. Kink]

[My intro post is here]

Ugh. I am so frustrated right now. :evil:

Took Mr. Kink in for his initial visit + a glucose curve (I know, I know...the vet convinced me)

I spoke with this vet yesterday on the phone. Granted, she sounded a little hassled by my questions but I gave her the benefit of the doubt since a) she's probably really busy and b) she probably doesn't get as many "informed" diabetic cat owners with lots of opinions.

I asked her about home testing, and she said that they've tested a bunch of meters, and the only one that matches up with their "machine" is the AccuCheck - I said, cool, whatever, I'll buy it, just so our numbers match up. I asked if she supported home testing...she said that it's a "liability" for them if they don't test them themselves because they won't want to change doses based on my home test numbers. I offered up that I would bring him in for an initial glucose curve with them, and then continue to home test from there, and she said "That could work. And then you could just bring him in every 2-3 months" - here's where I started thinking we would get along.

Cut to the vet today. I took him in at 8am, brought his food, asked if they could give him all four cans while he's there every 2-3 hours, just because that's what I've been doing (they only gave him 2 cans the whole day - 1/2 can every 2-3 hours...what part of PLEASE FEED HIM did they not understand?), I forwarded them his bloodwork and chart from the previous vet via email while I was standing in front of the receptionist, and we left him.

We went back at 5 to get him and for a consult with the vet. She talkedsofastandbarelyletmespeak. I could tell she was already on the defense. She said she wants to put him on 1u 2x day. I'm fine with that. Then she said he would need to come back in two weeks, and that there was no need to home test him and literally fled from the room to tend to another patient. I barely got in my concerns about him possibly having hyperthyroidism based on his bloodwork - which she said she hadn't seen, oh and the email is password protected and too hard to get into, and she would call me tomorrow.

ARRRRGGGHHH. :-x

So then the vet tech came in, and gave us Lantus (which the vet tech tried to tell me was ONLY for felines, so I'd ONLY be able to get it there...). I pretty much strong-armed her into bringing in their meter they use to test so I could compare it to my Relion that I had brought with me. She literally brings out an AccuCheck and I was like is she serious right now? Why would they not be all about home testing if I can use the SAME ONE THEY USE AT MY OWN HOME? Oh right, because then they don't make $100 off of me every time I come back to do a glucose curve.

So, I'm frustrated. I want to take him to another vet, because I realize I should be doing this with some professional help, I just want to be supported by my vet and not ignored/brushed off/argued with. Needless to say, we will be having a conversation tomorrow when/if she does call about his hyperthyroidism. But after we talk, I don't think I'll want to take him back to her. I might not be nice, and then I don't want him in her hands.

(BTW, I know my post probably sounds like I went in guns blazing, but I promise I was super nice, smiling, and just asking lots of questions!)

Back to the vet drawing board...and giving my first insulin shot tonight in an hour and half! nailbite_smile

 

[Vicky & Gandalf (GA) & Murrlin]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Hi Caitlin,
Your experience is unfortunately something we hear all too often, especially about how home-testing isn't necessary. If they were a human doctor, would they say that same thing to a parent whose child was diabetic? Maybe that makes us sound like crazy cat-ladies and men around here, but to us NOT home-testing is being an irresponsible diabetic cat owner. You don't have to do it every hour, just at least before every shot and once in the middle of the cycle whenever you can. And you can do curves once a week, rather than waiting 2 weeks like the vet wants you to do.

I don't know how home-testing is a liability for them. What they aren't telling you is that you don't need them to prescribe a certain dose, you just need them to prescribe the insulin. And the tech telling you that you can only get Lantus from them puts my radar up that they are in this for the money rather than the best interest of you and your pet.

We have members here who are more knowledgeable about how Lantus works than most vets and I say that with confidence. You don't need a vet's approval to home-test and the Reli-on meter you have is fine, many people here use it and it got excellent ratings from Consumer Reports. The important thing with testing a cat's BG is that you use the same meter all the time, patterns are going to emerge even if the BGs are off 20 pts or so. Most meters are fairly accurate at low values, high ones maybe not so much, but a 450 is not much different from a 400, both are way high.

You can set up a spreadsheet and report the BGs on it for other members to see, instructions are here: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 You can go to the Lantus Tight Regulation Insulin Support Group and report in to there daily. They can help you manage Mr Kink's diabetes. Most of us do the sugar dance with the help of people here rather than vets anyway. We still need vets for many diagnostic tests and knowledge about other diseases, but testing BGs at the vet's is a waste of your money.

I'm sorry you had such an aggravating day. What a good job waiting to blow off your steam till you could get on the board!! I hope you feel better now.

 

[jt and trouble (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Guns blazing??? Ha stick to em Caitlin you're right.
jeanne

 

[Julia & Bandit (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

If you really want to drill home your point about home testing, give the vet this article:



The Accu-chek is a very good meter (it's the one I use), but if you don't get the strips online it's very expensive. Your Relion is fine, however, and there is no need for your meter to match the vet's. The vet should be using your data only, and not charging you for useless office tests. What is important is that the same meter is used for all testing, because comparing numbers from two different meters will drive you batty. You need to have a meter where the strips are inexpensive enough to allow you to test as frequently as needed (3-4 times a day, and a curve once a week).

You should definitely find a vet who you are comfortable with and who is open to having a dialog and working with you, even if they don't get everything right at first (because it is incredibly rare that a vet gets every aspect of treatment right). What is important is that you feel you can speak to them freely, they are comfortable with letting you have a part in controlling the dose, and they are accepting of information you bring them.

Print and give the vet the article I attached, and the Lantus dosing protocol: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. See what her response is--if she is positive and agrees to help you with the treatment plan YOU chose, then she might be worth sticking with. If she still gives you resistance, find a vet who will read the information and work with you on this the way YOU want to do it. It's your cat, so you always have the final say. Honestly, vets never get dosing advice right with Lantus anyway, so you'd be better off getting advice here as you learn the protocol and how to make adjustments on your own (just like human diabetics do). But it would be very nice to be able to use a good vet as a sounding board, and to help guide you through this information, even if it's new to both of you.

 

[Venita]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

When Maxwell was DX in 2005, we went to a nearby, fancy-smancy, high-priced vet. It took only two FD visits that vet to realize that I wouldn't be able to work with her. She started Max on a compounded PZI, and I came to FDMB. I seemed to quickly know more about diabetes than the vet did.

When I next felt the need for a partnership with a vet for the diabetes, I called my nearby ER vet hospital and asked what vet seemed to refer the most diabetic cats to them. I then took Max to that referring vet. What a breath of fresh air it was talking with him. I felt like I was talking to a peer. And he seemed to feel the same.

And I am still with that clinic all these years later, with all my cats. And we seldom talk about diabetes. The vet there trusts me when it comes to diabetes.

 

[Hillary & Maui (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Oh, I got the same "liability" nonsense from my now former vet! She actually forbade me from home testing and then relinquished by saying I could only home test if I purchased the alpha trak meter from them!

So, yeah, we understand your frustration. The only good thing is, you are learning what you need to do and have this board as a support system. No, it's not a substitute for a good vet, however, let's see if we can find you one.

I do know a member who is in Nashville and may be able to provide vet suggestions, let me get her to see your post.

 

[Caitlin & Mr. Kink]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

I do know a member who is in Nashville and may be able to provide vet suggestions, let me get her to see your post.

That would be amazing! Thank you so much!

BTW, I took a look at your SS, and Mr. Kink has been getting about the same numbers as Maui did in the beginning (I stupidly deleted them last night, and wish I hadn't, just because I wanted to start fresh with his "on the juice" numbers.) - just wanted to know if you adopted the "tight regulation" Lantus protocal - still wrapping my head around it.

 

[Carl & Polly & Bob (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Caitlin,
I have to say that was an awesome narrative of the typical "frustrating vet visit". I LOL'd at a couple points. :lol:

she said that it's a "liability" for them if they don't test them themselves because they won't want to change doses based on my home test numbers.

I guess the "I want to home test so I won't need dosing advice from you" point went flying right over their heads, huh?

I wonder if vets feel any "liability" about sending most people home with high-carb "prescription" foods because they are the "best thing for a diabetic cat"? (don't know if your vet did that, but most seem to). It's hilarious that she pulled out the same meter she insists you buy if you want to do-it-yourself. ohmygod_smile And then says they can't trust the numbers you get at home to base dosing adjustments on!

which she said she hadn't seen, oh and the email is password protected and too hard to get into

Not sure I'd go with a vet who can't figure out how to sign into an email account... pc_work

Carl

 

[Caitlin & Mr. Kink]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Well at least someone could LOL about the whole thing, Carl! ;-)

They did have the low carb food suggestion down, though. They kept trying to offer me to buy DM, but I know it's more expensive than my FF, so I passed and they didn't push. She had so many vet techs running around the place, it was like a zoo.

I got a message from a vet tech today letting me know that she was finally able to take a look at his bloodwork and that he doesn't have hyperthyroidism, so PHEW. But I didn't get to speak with her. Grrr. So I guess I'll have to call her at some point this week and try to pin her down on her initial statements and about using the same meter as they do...etc. If she gives me any grief, I think I'll just pass on her and try to find someone else.

Not sure I'd go with a vet who can't figure out how to sign into an email account...

Yeah, she seemed to think that it was somehow "cute"...she was all "It's like Fort Knox in here!" - I think I was supposed to laugh, but I just blinked at her. :roll:

 

[Hillary & Maui (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

May I suggest that you get a copy of his medical records, especially this recent blood test. Because, I'm curious to see if they really did all the necessary tests to determine hyperT or not.

There are two tests, one that is part of standard bloodwork testing called T4 test and one that is not part of the standard testing called Free T4 test. Both of these tests need to be done in order to accurately determine hyperT.

And I'm curious if they did both or just one. And besides, now that you may change vets, it's easier if you have your cat's medical records.

The other thing I neglected to mention, when my former vet forbade me to home test and when I told her that I was bringing Maui home that first day and not leaving her at the vet's office for a week to do a curve and get regulated. The vet said to me - if you do this, then I will not treat your cat, I will not be held liable and sued by you if something goes wrong.

Really???? you won't be held liable if I take care of my cat.....

Answering your question, yes I followed the tight protocol method with a little flexibility built in.

1) Maui is a grazer and I had to teach her to eat canned food. Once she got the hang of it and I gave her, her meals, I also left wet food out 24/7 so she could always have access. The protocol talks about removing food 2 hours before shot/test time. I never did.

2) I also took some leeway in shooting times, I tried to stick to the 12/12 schedule, however, I sometimes shot up to 30 minutes early or late, depending. I know they want you to stick as close to 12/12 as possible.

As you can see, Maui wasn't on insulin long and it was a huge relief that she went into remission so quickly.

But the vet really did scare me, when I thought I would be all alone with this and no professional support. This board was great and helped tremendously, but it's so important to have a professional vet to go to when needed.

So, since things weren't working out at the former vet, I looked up all the vets in my area and started calling and asking questions. I found one that would support home testing, shooting on a 12/12 schedule. I never could find one that would not recommend prescription food, though, so I decided 2 out of 3 not bad and just ignore all talk of food. Whenever any of my cats have to stay at the vet's, I bring their food with instructions on feeding and that they are only allowed to eat what I brought for them (unless of course, someone has a yummy ham or turkey sandwich and want to share!).

 

[squeem3]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

So then the vet tech came in, and gave us Lantus (which the vet tech tried to tell me was ONLY for felines, so I'd ONLY be able to get it there...)

Lantus is FDA approved for Human use only: LANTUS is a long- acting human insulin analog indicated to improve glycemic control in adults and children with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. http://products.sanofi.us/lantus/lantus.html You can buy it at any Human pharmacy with a prescription. Cats use the insulin "off label". Where did the vet tech get the idea that Lantus was only for cat use? I hope you corrected her so she doesn't continue to misinform other clients.

If the vet tries to sell you Lantus in a container other than the original 10 ml bottle or 3 ml SoloStar pen, don't buy it! Lantus is sterile inside the original container. Removing the insulin and repackaging it into another container can introduce contaminates which may lessen the effectiveness of the insulin or even harm your cat. Even if the vet insists that it is sterile and precautions were taken and blah blah blah, don't take the chance.

It won't hurt to get a second opinion, or even a new vet. Here are questions to ask: http://gorbzilla.com/decisions_decisions.htm Be sure to get all copies of your cat's records for the new vet to look at.

 

[Caitlin & Mr. Kink]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

May I suggest that you get a copy of his medical records, especially this recent blood test. Because, I'm curious to see if they really did all the necessary tests to determine hyperT or not.

There are two tests, one that is part of standard bloodwork testing called T4 test and one that is not part of the standard testing called Free T4 test. Both of these tests need to be done in order to accurately determine hyperT.

Yep - I've got it in my signature. It was done at another vet, so I made sure to get it from them to take to the new vet. Looks like the Free T4 was NOT done, because from what I can tell, the blood test results are suggesting it. The only reason I brought it up is because he got a 3.3 on a scale of .8 - 4.0, which I thought should raise some flags. She's starting to sound more and more incompetent by the minute.

So, since things weren't working out at the former vet, I looked up all the vets in my area and started calling and asking questions. I found one that would support home testing, shooting on a 12/12 schedule.

I think that's going to be my next step.

As for grazing, I really can't do that with Mr. Kink - a) he gobbles, always has, and always will. And b) we have Angel, his BFF, and she nibbles and gets finicky and walks away, and he's an opportunist. So he really has to be on a meal feeding schedule. I bought a couple of automatic feeders to try and make life easier. Do you think that will affect his regulation? I've been wanting to delve more into the "tight regulation protocol" but I did see the part about "grazing" and I know that's not an option for us.

Cats use the insulin "off label".

I'm a little confused by this, but I'm a total newbie to the diabetic kitty world, so forgive me. I'm not sure how to even tell what she gave me. I'll attached a photo of what we bought - $35 for the amount they gave us, and it LOOKS to me like it's been repackaged. Doesn't say anything on the bottle at all.

 

[Caitlin & Mr. Kink]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

OH OH OH. You guys will just LOVE this (note my sarcasm...)

Forgot to tell you about how the vet informed us that she has never seen a cat get hypoglycemic on Lantus. She says she had a diabetic cat herself, who was supposed to get 4u in the morning, and her son accidentally gave him an additional 4u because he thought she hadn't, and she freaked out and brought him into the office to keep an eye on him and he was just fiiiine. Pretty sure that hypoglycemic episodes can and do happen, and if *I* were a vet, I'd want to warn people about them and prepare them for the possibility rather than tell them there's nothing to worry about...right!?

 

[squeem3]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Cats use the insulin "off label".

I'm a little confused by this, but I'm a total newbie to the diabetic kitty world, so forgive me. I'm not sure how to even tell what she gave me. I'll attached a photo of what we bought - $35 for the amount they gave us, and it LOOKS to me like it's been repackaged. Doesn't say anything on the bottle at all.

"Off label" means using a prescription for purposes other than what it was intended for. None of the FDA approved Human insulins (and many other Human medicines) are approved for use in animals. Many Human medicines work well in pets so it has to be used "off label". The manufacturer of the medicine cannot be held liable for "off label" use of their product.

Your vet definitely repackaged the insulin. I don't even see "Lantus" printed anywhere on the green bottle label, unless it's off to the side and not viewable from the picture. What she gave you could be saline for all you know. Insist in the vet writing you a prescription for Lantus so you can buy it from the Human pharmacy. It will cost more (usually $110 for the 10 ml bottle, $250 for the SoloStar pens but there are five pens in the box which is at least a 5 month supply) but you know you will be getting the correct insulin in the original container and it has not been tampered with. If the vet balks, run and find a new vet.

There are pictures here of what the Lantus containers look like: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=71152#p772838

OH OH OH. You guys will just LOVE this (note my sarcasm...)

Forgot to tell you about how the vet informed us that she has never seen a cat get hypoglycemic on Lantus.

A diabetic cat can hypo regardless of the insulin used. There are cats here who have hypoed on Lantus, Levemir, and the other insulins. My diabetic cat has hypoed several times on Lantus on his usual dose for some reason or another.

Symptoms can be very subtle or it may be serious like seizures. Here is the hypo reference sheet: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122 Here is what to keep on hand to use to treat a hypo at home: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354

Does your vet feed dry food to her diabetic cat? Dry food keeps blood glucose levels so high that an accidental double dose of insulin might not result in a huge drop in bg levels. Plus, taking the cat to the office to be monitored all day makes a cat so stressed out that bgs stay really high as well.

 

[Hillary & Maui (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

I don't know what you paid for that insulin, but I would certainly return it and demand a refund. And yes, get a scrip for lantus. The least expensive place I found it is Costco pharmacy (if you are a costco member it's even cheaper), if you aren't a Costco member, it is still priced better than most chain pharmacies.

The other problem with how they repackaged the insulin, is you have no idea what the expiration date is on the original insulin. You have no idea how they have handled the insulin, they could have dropped it several times by accident.

Oh was it cold when they gave it to you? If not, then it means they don't keep it in the fridge, which also affects the longevity of the insulin.

Like squeem said, get a scrip for the pens and not vial. And get a scrip for insulin needles - U100, 30 or 31 gauge, short needle with half unit markings.

The half unit markings are important as many of us microdose and the only way to do it correctly is if it's marked with half unit markings. For inexpensive syringes - Walmart is pretty cheap - about $13/100 syringes.

Personally, I like the short needles better, but you can ask the pharmacist to show you the difference between short and regular and then decide. What's important is the 1/2 unit markings and the gauge 30 or 31 is best for the needles.

The higher the gauge number, the thinner/smaller the needle.

Without the Free T4 test, you really don't know if you need to be concerned about hyperT. The T4 test alone doesn't give you enough information.

UGH -- yes it's time for a new vet. I'm still waiting to hear from Kathy & Kitty, she's in Nashville. I'm going to send another pm today.

 

[MommaOfMuse]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

You have already gotten good advice from everyone but I will address the ability to go hypo on Lantus...Oh Yes!!! It can happen, while it might have all the outward signs of hypo i.e. the walking drunk, etc they most certainly can go too low on Lantus, not only as Musette done it on both Lantus and Levemir (caught it with the meter, rather than visual clues) I have personally sat up and walked others through hypos on this very board.

I would so be vet shopping at this point! I wouldn't trust this woman to take care of a pet rock at this point.

Unfortunately what you are going through is very common of story on here, but with every one of these stories that I read the more thankful I am for my vet...It took me going through all 3 of the clinics in my little one horse town to find them, so I know the good ones are out there, but my first vet reminds me very much of this one. He didn't even want to test my first diabetic to see if she was diabetic because she was 17 years old...as a consequence by the time I found my vet now and got her started on treatment it was too late for her the organ damage was already done and I lost her the first of June almost 2 years ago...but the upside is that I have a wonderful new vet that works with me as a partner, and has even learned a few things about Feline Diabetes from me, and I now have 3 wonderful new sugarcats in the family that are doing fabulous thanks to the wonderful folks here.

Mel, Maxwell, Musette, Autumn & The Fur Gang

 

[Julia & Bandit (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Arrghhh! If your vet is repackaging insulin with god knows what expiration date, it's likely that her cat didn't hypo on that dose of insulin because the insulin wasn't working. You can do that to Lantus and expect it to work!

The other thing that could have happened was that since her cat was on a really high dose of insulin (4u!), that he had already rebounded by the time she tested him. When cats drop really low, their livers release glucose into their bloodstream as a survival mechanism. That is why it's very important to test daily, and get mid-cycle checks. If you're not doing this, a cat being chronically overdosed will appear to have very high blood sugar. Until one day when the cat's body can longer keep compensating, and you have a severe hypoglycemic incident. Cats can go on for MONTHS on high doses like this and not appear to be hypo, but still have constant hypoglycemic episodes. Which is why home testing is so important!!!

Return that insulin, get your money back, and ask for a script for the Lantus for the pharmacy. The pens are more economical, so I would ask for a script for those.

 

[Caitlin & Mr. Kink]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

GAH. She's starting to become one of my least favorite people EVER.

What's the difference between pens & syringes? Do you use them together? I bought a giant box of syringes yesterday - should I return them? Thank you, Julia!

 

[Hillary & Maui (GA)]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Nope, you are fine.

The difference is pens and vials. Which is the type of container that holds the insulin. The vial is similar in size to what the vet gave you. The pen is much smaller and holds less insulin.

The reason we recommend getting pens instead of one vial, is that for cats the dosing amount is so small that you will never get through an entire vial of insulin before it goes bad and therefore, you will have wasted/spent money for something that you can't maximize the use.

With the pens, you get 5 in a box and as long as the pen remains unopened, stored in fridge it should be viable until the expiration date. Which is why you want to ask the pharmacist for a box with the longest expiration date they have.

And if one pen goes bad before it's used up, your waste is much less than with the vial.

Now for humans they sell syringes that go with the pens. We do not recommend that you get those, instead treat the pen just as you would the vial and use the syringes you bought for that purpose.

Make sense?

HEre is a link to what the pen looks like with the cap on. : http://www.lantus.com/solostar-insulin- ... n-pen.aspx and a coupon on this page for $25 off. Not bad.

Actually, this website has some good information regarding lantus. Remember though, it's directed to humans, not cats. So certain things won't apply.

 

[Kathy and Kitty]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Hi, Caitlin,

I'm also in your area. Just sent you a DM. I'll be happy to share what I've learned during Kitty's sugar dance. We had a rough time finding a vet, too, but after 15 months on insulin, Kitty has been in remission for 2 full years!

As I said in my DM, you are in the right place now. Kitty is in remission because of this wonderful website.

:mrgreen:

Kathy

 

[MommaOfMuse]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

You can hang onto those syringes because you will be using those to draw the insulin out of the pens...The pens are designed for humans so they only work in full unit increases and decreases...cats usually need something inbetween full units and you never want to raise or lower by full units so we still use the syringes to draw the insulin. There is a little rubber stopped kind of thing in the pens where the pen needle will normally attach if it was for a human's use, just stick the needle of the syringe in that like you would a vial and draw up your dose.

Since this vet doesn't seem to know the difference between a pet rock and a turtle...lets go over some of the basics...your syringes are the ones with the ORANGE caps right? Not the RED ones...just checking since the orange ones are for U100 insulin which Lantus is, the red caps are for U40 insulin like PZI/Prozinc

Also hopefully you have either read here or she actually got something right, but you don't want to inject either insulin or air back into the vial or pen, and you don't roll or shake Lantus. You want to store it in the fridge to make it last longer but it isn't the end of the world if you forget and leave it on the counter (been there, done that ).

Mel, Maxwell, Musette, Autumn & The Fur Gang

 

[squeem3]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

What's the difference between pens & syringes? Do you use them together?

You use insulin syringes with the SoloStar pen, not the pen needles like a Human diabetic would. With insulin syringes, you can measure half and quarter unit does. The SoloStar pen only doses in whole units which is fine for a Human diabeic but not so much for cats.

I bought a giant box of syringes yesterday - should I return them?

Did you buy those from the vet or from the Human pharmacy? If you bought them from the Human pharmacy, then you can keep them :smile: Human pharmacies only sell U100 insulin and insulin syringes. Do you have the 3/10 cc (30 unit) ones? Do they have half unit markings or not? Half unit markings just makes it easier to measure half and quarter units. You can use whole unit insulin syringes for now and just buy the half unit marked ones when you need more.

Two other syringe sizes are 1/2 cc (50 unit) and 1 cc (100 unit). The 1/2 cc can be used but they are not ideal because it's hard to measure half units. 1 cc is not ideal at all because the markings on most brands are for every 2 units. There are some 1 cc insulin syringes that do have markings for every unit but the markings are really close together and it may be too confusing to figure out how to measure correctly.

If the vet gave you insulin syringes, check the box before you use them. Make sure that it says U100 or For U100 insulin and that the syringes themselves have U100 printed on them. If they say U40, then immediately return the box to the vet. You cannot use U40 insulin syringes for U100 insulin such as Lantus. U40 and U100 are two different insulin strenghts and using the wrong insulin syringe will result in the incorrect amount of insulin the cat will get.

 

[Caitlin & Mr. Kink]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Can I first just say how much I heart you guys? :YMHUG:

Moving on...

Insulin bottle - nope, nothing on the other side other than dosing instructions. Give 1 unit every 12 hours. And some random numbers, but no "Lantus" printed anywhere. I don't remember it being cold when she gave it to me, but it's cold now. LE SIGH. I'll be getting some new insulin VERY soon. I only paid $35 for that amount, so it wasn't a total wash.

Syringes - got 'em from the human pharmacy. 100 count box of U-100 .3 mL - 31 gauge - 5/16" needle for $14.99, I think it was. So at least there's THAT! :roll:

Pens - GOT IT. Thanks so much for the thorough explanations!! Totally, totally got it. And I'm actually a Costco member...so YAY for saving some dough! Since I just wasted ~$200 at her stupid office. :-Q

Also hopefully you have either read here or she actually got something right, but you don't want to inject either insulin or air back into the vial or pen, and you don't roll or shake Lantus

They didn't tell me to roll or shake it. And the vet tech did show me how to not get any air in the syringe when extracting the insulin, but DANGIT, they did not say anything about shooting air in the vial, which I'll bet I've done once or twice now. Oh well. I'm getting new insulin soon.

I hope you corrected her so she doesn't continue to misinform other clients.

I didn't - because I wasn't sure. BUT, I googled it on my iPhone in the car and was like...UM, IT'S IS FOR HUMANS. IDIOTS. And just ranted at my sister about it. I think it may have just been the vet tech. She was really nervous and mumbling and scratching her neck raw, and tried to tell me SHE wouldn't hometest and use those numbers to determine dosing because...well, she just wouldn't. SO, I'm just shaking my head at that one.

As for the vet's cat - no clue about diet. She had the vet tech tell me to put Kink on a low carb diet, which I already had, so I'm assuming she had hers on one, too? I don't know. I would hope so!

Kathy & Kitty! I just saw your PM! About to respond to you! Yay Tennessee!

 

[jkbank]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Also hopefully you have either read here or she actually got something right, but you don't want to inject either insulin or air back into the vial or pen, and you don't roll or shake Lantus.

UGH - my original vet, when Gem was Dx'd the first time last year, specifically said roll it in your palms of few times to "take the chill out"!! I don't shake it, and don't roll vigorously but still!!! Why is there so much misinformation amongst these vets?! I know they have a lot to learn about a lot of stuff, and a lot of animals but grrr, it's frustrating!

 

[Venita]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

Also hopefully you have either read here or she actually got something right, but you don't want to inject ... air back into the vial

They did not say anything about shooting air in the vial.

I have to disagree with Mel on this minor point. One has to inject air into a vial if you want to draw the insulin out. The vials are sealed and unless you introduce an amount of air equal to the insulin you will be drawing, the negative pressure builds to the point that you are unable to draw anything.

 

[squeem3]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

I have to disagree with Mel on this minor point. One has to inject air into a vial if you want to draw the insulin out. The vials are sealed and unless you introduce an amount of air equal to the insulin you will be drawing, the negative pressure builds to the point that you are unable to draw anything.

I have never injected air into the Lantus 10 ml bottle and never had a problem getting insulin out. I made sure that the plunger was at zero, stuck the insulin syringe needle in, slowly pulled back the plunger to draw up a little more insulin than I needed (takes a second or two for the insulin to flow into the syringe), removed the insulin syringe from the rubber stopper, hold insulin syringe with needle pointing up, tap syringe to float bubbles towards the needle, then slowly push plunger in to the push out the air bubbles and extra insulin.

 

[BJM]

Re: Mr. Kink's first vet visit - not happy with the vet AT A

There's probably enough 'give' in the rubber stopper that it slowly equalizes pressure through where you've poked even if you don't put air in it yourself.

The pens have a little clicker on the end which lets you "pump" up the pressure (it actually will move the slider down towards the tip), so that getting it out with the syringe works more smoothly.