So sorry to hear you're having such troubles. Here's a few tips that have worked for Ebony and me:
My dad (who is also on Lantus) told me that the shot really stings when it's cold (straight from the fridge), so I draw the dose and let the syringe warm up, at least to room temp if not my hand temp, before I shoot. You don't want to wait a long time between drawing up the insulin and shooting, as the syringe has a lubricant that can mix with the Lantus and weaken it, but a few minutes in my hand or under the lamp to warm it a bit doesn't seem to hurt. Also, don't shake the Lantus, and don't leave the vial out after drawing up the syringe. The pharmacist gave me a sample of BD u100 6mm 31g syringes, and Ebony seems to prefer them over the previous 29g 12mm syringes. He's still not thrilled with the shots, but loving on him and warming up his back helps it not sting as much. Our vet, and all the info I've seen online, says to avoid the scruff of the neck and to vary the shooting spots on either side of his spine (not directly on the spine) from shoulder blades to hips. Also, make sure not to get it in his muscles. They say insulin going into the scruff or muscle is nowhere near as effective as going just under the skin (hence the shorter needles, for me). After rubbing on Ebony's back in the general area where I'm planning to shoot, I lift up the skin & fur to make sure I don't hit muscle. The 6mm needle doesn't go through the 2 layers of skin like the 12mm needle sometimes did, so it's easier for me to get his full dose in him. The only problem with these needles is they don't come in 1/2 unit markings, yet, so you might look for the dosing by micrometer sticky. As long as the Lantus is kept in the fridge, it can last around 3-6 months (per the AAHA website and all of this forum), so if you can vary the shooting site so he tolerates it better, the cost should even out a bit. Also, BD has a current rebate going for a box (100) of the 6mm syringes, so that could help you with the cost of the first box (
http://www.bd.com/en-us/offerings/capabilities/diabetes-care/pen-needles, then click on the rebate offer on the right).
As for testing, we had issues with that in the beginning, too. I was even wrapping him up in a towel to make a kitty burrito for a while. But we found that the whole process is a whole lot easier on both of us if I spend 5-10 minutes (or more) loving on him and getting his motor running while I warm up his ear. I have a spot on my computer desk with "his" blanket folded up (so he doesn't slip), under the desk lamp (which helps warm him), with all my supplies in a basket nearby. This gets him high enough that I can easily do the test, and I have everything nearby. We've only been dealing with this for 3 months, and Ebony comes up to me when he hears me sit down or close the vial with his test strips and asks to come up to his spot for loving. We spend time snuggling, and he now lets me know when he's ready to "get on with it" and get his ear tested by changing from curled up position to sphinx position. I no longer have to hold him in place (unless someone is moving around in the kitchen). He likes to know what I'm doing, so I let him sniff each step. He has a preference for me testing on his left ear, so even though he's got a bruise there, that's where we test. The spot on my desk has become his snuggly spot, and if I'm sitting at my computer, he'll often come to me and want up for snuggles and loves, even though twice a day his ear gets "stabbed" (sometimes multiple times) when he's up there.
For the food, I definitely agree with the others about getting Nemo off the dry as it's much higher carb than your vet thinks. My vet insists on WET (canned) Purina DM (never dry), and since I can afford it right now, I'm humoring her. But PLENTY of others are using non-prescription, low carb wet food and doing just fine. When Ebony was first diagnosed, I found this forum and Dr. Lisa Pierson's nutritional guide for canned cat food, and promptly switched Ebony to Friskies Pate (I bought the 48 pack from Costco). I'm on my 2nd vet as the 1st one wouldn't listen to me at all (he preferred talking to my husband who doesn't deal with all this stuff but was there to get his own questions answered). The 2nd vet changed us from Vetsulin (which was quitting early) to Lantus (which is definitely acting longer), but insists on the expensive Purina (1.25 cans 2x/day). Like I said, I'm humoring her, since I can afford it right now. But the nutritional values are about the same as the Friskies we were using (she had to show me the nutritional guide for the Purina DM before I would even consider it). Ebony isn't terribly picky (thank God), so he eats it, but he refuses to eat the quantity the vet wants (he's underweight) at the schedule the vet wants. So, I offer it to him several times over several hours. The big thing is not to feed in the 2 hours prior to a test so the test isn't skewed by a food spike.
The higher water content in wet food should help keep Nemo from having urinary tract problems. You can also mix in extra water, if needed. Ebony prefers when I add extra water to his wet food. If Nemo hasn't been actually diagnosed with urinary tract problems, I wouldn't worry about it. If he has, Dr. Lisa has info on that and all kinds of topics on her website, too:
http://catinfo.org. It's worth browsing around if you haven't been there, yet.
Numbers in the 200's are something I'd celebrate. My vet has a goal of Ebony staying under 300, right now. I'd be real hesitant about increasing the dose, especially if your vet wants a full unit increase (most recommendations are 1/4 to 1/2 unit increases). But others on this forum are much better at dosing questions. I've only been dealing with diabetes for 3 months, and Ebony is still unregulated. Sounds like you're doing a lot of research, which is great. Take a deep breath, make sure you're taking care of yourself, and spend lots of time loving on Nemo. I've gotten closer to Ebony through all of this. It takes time to learn what will work best for you and your cat, but you can do it.
