Erica & Carter
Member Since 2016
Ah you're a life saver, I went to that page but obviously missed that other tab.
Yeah I'd like to know too. I assumed Dry Matter applied to the dry formulas so I have a lot of learning to do haha!
New - At-Home Blood Glucose Questions!
- Thread starter Erica & Carter
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Ah you're a life saver, I went to that page but obviously missed that other tab.
Yeah I'd like to know too. I assumed Dry Matter applied to the dry formulas so I have a lot of learning to do haha!
Chris & China (GA)
Member Since 2013
Looks like the 6.27% is the important one, so since it's below 10%, it should be OK
From the Food chart on Dr. Lisa's website
2) Carbohydrates: This is an important area of consideration – especially for diabetic patients. Unfortunately, this macronutrient is not actually measured in a lab. Instead, it is calculated by subtraction. In other words, we add up the moisture + protein + fat + fber + ash and subtract that value from 100% leaving us with the carbohydrate fraction. However, any error in those Big Five values will result in an error (usually an overage) in the carbohydrate value. Stated another way: The carb values noted below are probably higher than they actually are. Even a value of 10% carbs could actually be closer to 0% carbs. Therefore, stick with the directive to stay below 10% carbohydrates but do NOT get caught up in whether a diet says 10%...or 5%....or 0%. Take it one step further and read the label. For example, if you do not see any grains, peas, potatoes, “starch,” or vegetables on the label, even if it is listed as 10% carbs, chances are that it is much lower.
From the Food chart on Dr. Lisa's website
2) Carbohydrates: This is an important area of consideration – especially for diabetic patients. Unfortunately, this macronutrient is not actually measured in a lab. Instead, it is calculated by subtraction. In other words, we add up the moisture + protein + fat + fber + ash and subtract that value from 100% leaving us with the carbohydrate fraction. However, any error in those Big Five values will result in an error (usually an overage) in the carbohydrate value. Stated another way: The carb values noted below are probably higher than they actually are. Even a value of 10% carbs could actually be closer to 0% carbs. Therefore, stick with the directive to stay below 10% carbohydrates but do NOT get caught up in whether a diet says 10%...or 5%....or 0%. Take it one step further and read the label. For example, if you do not see any grains, peas, potatoes, “starch,” or vegetables on the label, even if it is listed as 10% carbs, chances are that it is much lower.
Julia & Bandit (GA)
Member Since 2009
Just a quick note... If you're changing the diet please make sure you're testing and lowering the dose as needed! Eliminating the dry food can cause big drops in BG, and he's on a pretty hefty dose of Vetsulin. The same dose of insulin can cause a dangerous hypoglycemic incident once the dry is removed.
Erica & Carter
Member Since 2016
Great. Thank you!
Erica & Carter
Member Since 2016
Yes absolutely! I am only just trying him on a 1/2 3oz can(s) to see how he likes it but I am still feeding him the dry as of right now until we find the wet food he likes the most hopefully by the end of the week.
Should I test a lot (more than 3x a day) at this point since I still have the dry in his diet?
I am suppose to call my vet with a fasted BG on Friday morning so I didn't know if I should wait, tell her about the diet change, get the okay from her regarding the insulin dose?
Chris & China (GA)
Member Since 2013
There's no such thing as too much data when it comes to insulin and our sugarcats. We always test before shooting, and then if at all possible during the AM cycle get at least one test between +5 and +7 and then on the PM cycle get at least a "before bed" test (since most cats go lower at night)
It's really important that you start keeping track of his numbers on our spreadsheet (Instructions on getting the FDMB spreadsheet) It's a very important tool here and we'll want to see how he's been doing before giving much in the way of dose advice in the future.
As for your vet, I'd REALLY try to get a better insulin like Lantus, Levemir or ProZinc for Carter. A good insulin can make the world of difference in his chances of possible remission or regulation
Erica & Carter
Member Since 2016
Can you explain to me the +5 + 7 etc? I have looked over the spreadsheet but I haven't been able to create one yet because I've been swamped with school finals, immigration forms, and I share my laptop with my spouse who has been applying for jobs. I'm off tomorrow though so I will have time to create it.
So essentially I should be testing around 3 times a day unless he really starts to fluculate?
I also need to go to Wal-Mart this weekend and look at the Relion meter.
I would like to get him on Lantus but I'm not sure how to bring that up or request that, especially if she wants to stay on Vetsulin for a few more weeks? Like how do I suggest what I want without sounding like I'm telling her how to do her job?
Chris & China (GA)
Member Since 2013
We use the "+" system here because we're from all over the world....it just refers to how many hours since the last shot...so +5 is 5 hours after the shot, +7 is 7 hours after the shot....all the way up to +11 and then it starts over
If you can get 4 tests a day, it's even better...we do the PS (Pre-shot) tests just to make sure they're high enough to give insulin at all.....the mid-cycle tests tell us more about how low they're going which is the most important part of the sugardance
I had to find a new vet to get Lantus, but what I'd suggest if you like your vet otherwise is to tell her the truth...that you've been researching feline diabetes and found that Lantus is one of the best insulins for cats and would she be willing to let you use it instead? There's a published protocol on using Lantus you might want to send her in advance of your visit for her to look at too. The link to the protocol most of us use in in this sticky from the Lantus Forum
If you can get 4 tests a day, it's even better...we do the PS (Pre-shot) tests just to make sure they're high enough to give insulin at all.....the mid-cycle tests tell us more about how low they're going which is the most important part of the sugardance
I had to find a new vet to get Lantus, but what I'd suggest if you like your vet otherwise is to tell her the truth...that you've been researching feline diabetes and found that Lantus is one of the best insulins for cats and would she be willing to let you use it instead? There's a published protocol on using Lantus you might want to send her in advance of your visit for her to look at too. The link to the protocol most of us use in in this sticky from the Lantus Forum
Erica & Carter
Member Since 2016
Gotcha.
Was your veternarian just not comfortable with that insulin? Or was is more of a money-making thing?
I do like my vet otherwise, everyone knows us up there, our dog boards there whenever we go out of town, they are pretty familiar with our all of our 4 pets. I'm from Canada but I live in the US with a Green Card so this was my first veterinarian in the US. It is a small town, a lot of the alternative veternarians around here are... questionable. Not personable. "Country" if you will.
I'm wondering if when I speak to her on Friday and let her know about his numbers I can casually bring up Lantus as an alternative. I'm just curious as to why Vetsulin would be the first insulin she would put him on if not many cats can successfully use that insulin but she did mention something about Vetsulin being one of her favourite insulins...
Was your veternarian just not comfortable with that insulin? Or was is more of a money-making thing?
I do like my vet otherwise, everyone knows us up there, our dog boards there whenever we go out of town, they are pretty familiar with our all of our 4 pets. I'm from Canada but I live in the US with a Green Card so this was my first veterinarian in the US. It is a small town, a lot of the alternative veternarians around here are... questionable. Not personable. "Country" if you will.
I'm wondering if when I speak to her on Friday and let her know about his numbers I can casually bring up Lantus as an alternative. I'm just curious as to why Vetsulin would be the first insulin she would put him on if not many cats can successfully use that insulin but she did mention something about Vetsulin being one of her favourite insulins...
Chris & China (GA)
Member Since 2013
My original vet said "insulin is a hassle and if we can keep her in the 300's she should live a few more months".....I never did like him much, but that was the last straw. I was "lucky" that I had a night to research before making any decisions, and almost every Google search I did landed me here, so I spent a lot of time reading and knew how I wanted to treat her....and giving up wasn't even close to what I had in mind!!!
So I spent the next week or so calling around to find a vet that was willing to give me a script for Lantus and we're still here almost 3 years later and China's doing GREAT. We don't even see a vet for her diabetes.....I listen to the people here who have years of real life experience when it comes to making dose changes. When I do have to take her for a dental or when she had an URI last fall, I just tell them she's on x.x units of lantus and her blood glucose numbers run from 50-120 most of the time and that's pretty much the end of that conversation. When they DO feel like they need to say something (last time it was that she should be eating the D/M food), I just smile, nod, say "I'll consider that" and leave to come home and continue what's been working so well for us all this time.
If you live close to Canada, you could just hop across the border and buy Lantus from any human pharmacy...it's OTC in Canada!
Chris & China (GA)
Member Since 2013
Mostly we hear that because they see a lot of diabetic dogs...and Vetsulin IS good for dogs....just not for cats. But a lot of vets treat their cat patients like small dogs instead of learning more about a cat's metabolism and how longer acting, gentler insulins are better choices
Erica & Carter
Member Since 2016
Did finding another vet mean brining the cat in to have more bloodwork etc done or could they just faxed your files over to the new clinic?
That's awful, I can't imagine a vet treating diabetes like a death sentence.
Ah I wish I lived close to Canada haha unfortunately I live in Alabama. But I am immigrating my spouse back to Canada within the next year.
Chris & China (GA)
Member Since 2013
I just picked my original bloodwork up from vet #1....YOU pay for them, they are yours, not the vets. To prevent a big confrontation, I just told them I wanted copies to keep in a folder at home
Then I hit the phone book and started calling around. I'd ask them to have the vet call me back because I wanted to discuss how they treat their diabetic cats (these calls usually happen after office hours). Ask things like "what kind of food do you recommend?, is there a particular insulin you like to start with? Are you willing to try a different insulin? How have your previous patients done? Have you ever had one go into remission?"....questions like that can give you a good idea if another vet will be a "good fit" for you and Carter
And if they're "too busy" to call you back, that's important information too....cross them off and move on to the next one!
Erica & Carter
Member Since 2016
Yeah I'm not exactly good at confrontation. Hopefully she says switching won't be an issue... I'd like to stay in their good graces because they are all super sweet and friendly, my dog boards their often and they have an excellent boarding faciliity and an off-leash dog park which is unheard of anywhere else in this small town. I also want to use them as a veterinary reference for when we move in regards to renting a place etc to show we provide all the necessary and annual care for our animals.
I mean I could always stay with them but get another veterinarian to give me a script for Lantus and then order online? I had no idea Lantus was OTC in Canada.
Julia & Bandit (GA)
Member Since 2009
Here's a link to the AAHA guidlines that you can print and bring to your vet:https://www.aaha.org/professional/resources/diabetes_management.aspx. Point out to your vet where it says (under insulin therapy in the cat) "The insulin preparations with the appropriate duration of action in most diabetic cats are glargine (U-100) [Lantus] or the veterinary-approved human protamine zinc insulin" and "This panel does not recommend the veterinary-approved porcine zinc (lente) insulin suspension [Vetsulin] as the initial treatment for the cat, because its duration of action is short and control of clinical signs is poor." When I get back to my computer, I also have another, more recent article you can print that goes into more detail about dosing and remission rates that I'll post here for you. Most of the time, the wrong treatment gets recommended not because the vet is bad--they just don't know the correct treatment guidelines for cats and need the right information. If your vet still insists on a different treatment path after reading the articles, then it's time to find a new vet.
Even vets that get some things right can be off about other things. When Bandit was diagnosed back in 2009, all of these guidelines were still very new, but his vet was very forceful told me I had to home test (and that human meters were fine), handed me a list of low carb, commercial canned foods in different price ranges, and gave me a script for Lantus. All good things, except her dosing recommendations were WAY off because she had two diabetic dogs, and adjusted Bandit's dose like a dog, in whole unit raises and only having me shoot once a day. I found this site and read the current research and dosing protocols, and when I confronted her with the correct published dosing protocol, she insisted that her protocol was better because she had great success with it in all her dogs. *facepalm* Because she wouldn't work with me, I switched to a vet that knew much less than her about the correct treatment, but was willing to read and follow the material I brought her, and we had a great relationship for many years until I had to switch vets again last year when Bandit started having health issues her practice didn't have the ability to diagnose (immune-mediated myelofibrosis, unrelated to his diabetes), and he now has to see an internal medicine specialist at Cornell. Fortunately, Bandit's new vet is very knowledgeable about feline diabetes and advocates the exact same treatment we do here, so no arguments were needed with him! However, I still bring my younger cat to the other vet--we established a very good relationship over the years and we always have a good rapport, even if we disagree on something.
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Erica & Carter
Member Since 2016
Well, luckily I spoke with her today and she has no problem if I wanted to switch to Lantus. She mentioned ProZinc(?) is also good but didn't know enough about Levamir.
She said the reason she starts out with Vetsulin is because of the price affordability. She said she had another cat the didn't adjust to Vetsulin as well either and the owners just today decided to try Lantus. This is a small Alabama town where most people don't give a crap about their animals so she probably lives in that mindset that anyone with a diabetic cat, who lives here, is probably poor and wanting the cheapest method available. I'm not rich but price isn't an issue, especially if I can buy it from Canada for 1/3 of the price..
I told her I was going to look around at prices and get back to her regarding the script.
Julia & Bandit (GA)
Member Since 2009
I see Chris already gave you the links to Mark's Marine for the Lantus, which is great! If you get a 5 pack of pens it is around $170, but they will last you a year or more (working out to be around $14 a month, which is actually cheaper than Vetsulin, I believe). And when you consider that Lantus is very effective in cats and Vetsulin not so much, Lantus is by far the better bargain. I really hope the price for Lantus comes down in the US next year when their patent expires. It was only (and I can't believe I'm saying only, it seemed so expensive to me at the time!) $110 for a vial and $233 for a pack of pens in the US in 2009.
Chris & China (GA)
Member Since 2013
Well hopefully if your vet is willing to work with you on using Marks, they'll start recommending it for their other patients as well!
I know my vet was amazed at how much cheaper it was! Around here, a 5 pack of pens is over $500....compared to $149.99 plus $25 shipping from Marks is the difference between China being on Lantus and being on nothing...and you can see how great she's doing!
Erica & Carter
Member Since 2016
Oh wow! Yeah the Vetsulin was $50 for a 10ml bottle.
How do they last that long? What's the expiry usually range around?
Erica & Carter
Member Since 2016
I don't see why she wouldn't be. I had mentioned wanting to purchase Vetsulon (previously) online and she had no issues with providing or faxing a script to an online company.
Chris & China (GA)
Member Since 2013
The pens last until the expiration date on the box...usually at least 2 years away. You just keep them in the refrigerator, take one out long enough to draw the dose into the syringe and put it back
Chris & China (GA)
Member Since 2013
Just so you're ready....you pull the cap off the pen and inside there's a rubber stopper just like a vial. You just insert a regular insulin syringe and pull out the correct dose. You do NOT use the special needles that humans use with the pens.
Erica & Carter
Member Since 2016
Awesome, I was wondering how the pens worked!
That's great how the expiration date. I wonder why it different so much between a vile of Lantus and the Lantus pens?
Julia & Bandit (GA)
Member Since 2009
If handled properly, a pen can last 3-6 months once opened (unopened they last about 2 years). I've never gotten more than 3 months of life from a pen but others here have, and even at 2-3 months per pen that's still 12-15 months of insulin.
Once your Lantus arrives, check out the stickies in the Lantus forum for proper handling! The two big things to extend the life is to keep it refrigerated, and don't shoot insulin back into the pen when drawing the dose (you take more insulin than needed into the syringe and shoot the excess into the sink). The lubricant from the syringes makes it go bad faster if it gets into the vial/pen.
Chris & China (GA)
Member Since 2013
The price or the amount of time it lasts?
Erica & Carter
Member Since 2016
I guess both haha!
Chris & China (GA)
Member Since 2013
Well a vial around here is a little over $300 and holds 1000 units....5 pens is a total of 1500 units for about $500 so they're comparable
The reason the vials aren't recommended for most cats is because most cats need less than 2 units of insulin twice a day, so a vial would have to last at least 250 days for you to use 1000 units.....but even if it's taken perfect care of, the insulin is going to poop out at 4-6 months, so you end up throwing half of it away
Each pen holds 300 units and the entire 5 pack is good usually for at least 2 years....they're used like "mini-vials" that last longer because of the way they're packaged and handled
The vials are fine IF you have a cat on high doses, but generally, you end up throwing too much of them away
The reason the vials aren't recommended for most cats is because most cats need less than 2 units of insulin twice a day, so a vial would have to last at least 250 days for you to use 1000 units.....but even if it's taken perfect care of, the insulin is going to poop out at 4-6 months, so you end up throwing half of it away
Each pen holds 300 units and the entire 5 pack is good usually for at least 2 years....they're used like "mini-vials" that last longer because of the way they're packaged and handled
The vials are fine IF you have a cat on high doses, but generally, you end up throwing too much of them away
Chris & China (GA)
Member Since 2013
Just a note for tomorrow....this thread is getting really long, so best to start a new one tomorrow so you don't get "lost in the shuffle"
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