New here intro, frustrated & confused :(

[RRoss]

Hi there! I'm Renee with Binxy. Newly diagnosed 12 days ago. Huge rollercoaster since. I'm in tears ready to give up & other family members frustrated & upset trying to home test. (See end comment). Vet put him Lantus 1.) SO EXPENSIVE had a one time discount for $30 not sure what to do when we need a refill. 2.) Vet put him on Freestyle Libre & again $30 one time coupon and it has only lasted 9-10 days. I had purchased Relion Premier Blu a couple of days & vet said it gives incorrect numbers and compared to AlphaTrak in their office. I told him I realized the numbers would be a bit different after reading sooo many posts here & he shrugged it off & wanted me to get AlphaTrak- I divided my Relion number by .65 & it came out to what he got on AlphaTrak so I think I'm OK using Relion Premier? 3.) Binxys BG ALL over the place 3a.) I have switched his food from the dry & wet Royal Canin Urinary which the vet said would be fine & after reading Dr. (Lisa?)list I am now giving Purina Pro Diabetes, Weruva, Tiki Cat & others with proper nutritional balance. 3b.) Lowered dose from 2 to 1 unit per vets advice & I just lowered to .75 today without vet advice hoping I can actually give him 2x per day doses without wild swings in numbers. 4.) Finally the BIGGEST stressor is now trying to home test. I've read everything I can, watched videos, researched. Need a Lancing device recommendation please?? Don't like to freehand it. CANT SEE where to inject because so much black & long ear hair. Can I test the hairless middle of his ear using one of the suction lancing devices? Need alternatives please Relion lancing device with clear plastic cap & lancets don't even poke above plastic piece?? Would really like a one step, gentle & firm device without poking all over the place. Please help us? Anyone use Genteel Lancing device & can I use in middle hairless part of ear?

 

[Jenny&Tux]

I’m new here as well, so I don’t have much advice to offer, other than to say I know how you feel!

My Tux was diagnosed end of February (‘23), and he’s just now finishing his first full week of insulin. If you can find generic Lantus (glargine), or something similar, it’s much cheaper. I almost had a heart attack in Costco when I picked up Tux’s Rx - it was over $300! They found glargine and it was less than half the price.

There’s so much information, and it gets overwhelming very fast! I’ve received so much help and useful information here - I hope you can as well.

From what I’ve read and experienced so far, their BG will be all over the place as you figure everything out.

If anything, just take it slow. Have faith that you will figure it out step by step. I still get frustrated and confused, especially since everything I’ve read is different than what Tux’s original vet has told me. We found a second opinion and switched vets.

When I read that people free-hand with lances, I was like nooooo way am I doing that. I tried and failed over and over with the lancing device - I couldn’t get it lined up with the edge of his ear. Tux is also black, so hard to see. Get a head lamp! Life saver. I do it free-hand now, and I’m comfortable enough to get some blood and a reading in a few minutes. He’s not thrilled about it, but we make it work with high-value treats.

I guess I don’t have many answers, just support. I’m pretty sure a lot of us feel the same way when this all starts. Am I doing it right?? Am I feeding right? Can I afford this?? Am I crazy for trying? What if I give him too much? These numbers don’t make sense! So much information!

Take it slow, read and re-read information, take notes and make a notebook if it helps to write stuff down, and if you have the time, go through and read other’s posts. I’ve picked up a lot of tidbits of information that way.

Good luck, and welcome!

 

[Bron and Sheba (GA)]

HI Renee and Binxy and welcome to the forum. It is stressful in the beginning but from what I can see you are doing a great job getting sorted out...lucky Binxy!
You are very well organised! signature and spreadsheet up and running...thank you so much. it helps us a lot in helping you!

Vet put him Lantus 1.) SO EXPENSIVE had a one time discount for $30 not sure what to do when we need a refill.

As Jenny mentioned you can get cheaper lantus. Ill tag @Diane Tyler's Mom as she has good information about that and can advise you. Lantus is a great insulin for cats so stay with that one.

Vet put him on Freestyle Libre & again $30 one time coupon and it has only lasted 9-10 days. I had purchased Relion Premier Blu a couple of days & vet said it gives incorrect numbers and compared to AlphaTrak in their office. I told him I realized the numbers would be a bit different after reading sooo many posts here & he shrugged it off & wanted me to get AlphaTrak- I divided my Relion number by .65 & it came out to what he got on AlphaTrak so I think I'm OK using Relion Premier?

The freestyle libre is a human meter and the vet put that on but says the ReliOn meter (human) is incorrect.....how does that work? He can't have it both ways.
The alphatrak reads a bit higher than the human meter but the human meter is far cheaper to run and is totally reliable...most of us use it here. You can't divide the numbers and get a reliable answer as there has been no comparison been made that is official. Just accept that they are different. The closer they get to normal range, the closer the BGs are. The higher they get, the bigger the difference. So if you had a BG of say 80 on the human meter, the alphatrak may be around 95 for example but if you had a BG of 420 on the human meter, the alphatrak meter would be higher and may be 500 or more.

3.) Binxys BG ALL over the place

This is normal in newly diagnosed cats as they get used to the insulin which is a hormone, not a medication such as an antibiotic.

3a.) I have switched his food from the dry & wet Royal Canin Urinary which the vet said would be fine & after reading Dr. (Lisa?)list I am now giving Purina Pro Diabetes, Weruva, Tiki Cat & others with proper nutritional balance.

Have you seen this FOOD CHART by Dr Lisa Pierson? look for foosa that have carbs 10% or under. Most of us feed around 4 to 7% carbs.
Also make sure you have a hypo kit set up with higher carb foods and some honey or karo.

) Lowered dose from 2 to 1 unit per vets advice & I just lowered to .75 today without vet advice hoping I can actually give him 2x per day doses without wild swings in numbers.

Have a look at our 2 dosing methods for lantus. Start Low Go Slow and Tight Regulation.
With SLGS you hold the dose for 7 days unless you drop under 90 in which case you reduce the dose by 0.25 Units.
TR you reduce the dose at 50 and hold the dose for at least 3 days unless you drop under 50 in which case you reduce the dose by 0.25U. TR requires at least 4 BG tests a day.
I suggest printing off the two dosing methods and reading them closely to get more information about them and then choosing one. If you are not sure, ask us.
Always test before every dose to make sure it is safe to give the dose. If the BG is not high enough, stall, don't feed and test again in 20 minutes and post and ask for help. You will need to change the subject like to alert us. Say something like...preshot xxx stalling, please help.
Also try and get a test in somewhere between +4 and +7 to see where the nadir or lowest point is as Lantus dosing is based on the nadir not the preshot BG.
I can see earlier on where Binky dropped under 50 and you did not reduce the dose.
Another thing to look for is if the +2 or +3 after the preshot dose has been given is lower than the preshot BG, that is an indicator that the cycle is an active one and the BGs could keep dropping, so always test again. An example of that is the PM cycle on 3/2/23

Finally the BIGGEST stressor is now trying to home test. I've read everything I can, watched videos, researched. Need a Lancing device recommendation please?? Don't like to freehand it. CANT SEE where to inject because so much black & long ear hair. Can I test the hairless middle of his ear using one of the suction lancing devices? Need alternatives please Relion lancing device with clear plastic cap & lancets don't even poke above plastic piece?? Would really like a one step, gentle & firm device without poking all over the place. Please help us? Anyone use Genteel Lancing device & can I use in middle hairless part of ear?

You need to test close to the edge of the ear. There is a diagram in this link to show you where.
HOME TESTING HINTS AND LINKS has lots of links and pictures to help you.
It takes a few days or a week or two for you both to settle to the new routine especially BG testing. Expect to fail....we all did!
But you will get there...I promise. I am going to tag @Melinda and Kitkat who was in exactly the same position as you and she is now an expert vampire!
With long black hair try putting a bit of vaseline on to the ear first and the blood should bead up for you.
What size lancets are you using? you need size 26 or 28 to start with.
There are usually 5 different depths on the device...have you adjusted those?
Don't give up...I know it is really hard and stressful for you at the moment but this will pass and it will soon be routine.
Bron

 

[Diane Tyler's Mom GA]

As Jenny mentioned you can get cheaper lantus. Ill tag @Diane Tyler's Mom as she has good information about that and can advise you. Lantus is a great insulin for cats so stay with that one.

lantus is an excellent insulin, but expensive in the US that's why most members get the generic glargine
Here is some info
Check this out
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
One pen would last me about 3 -4 months . we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

We don't use the pen because you can only adjust the dose by full units, we adjust the dose by 0.25 units at a time. Are the U-100 syringes you already have do they have half unit markings


Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!

 

[Larry and Kitties]

Check this out
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1

Note that when using GoodRx you have manually select via pull down menus "glargine insulin (generic)" since the default is real Lantus. You also have to "carton" since the default is vial.

 

[Jenny&Tux]

lantus is an excellent insulin, but expensive in the US that's why most members get the generic glargine
Here is some info
Check this out
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
One pen would last me about 3 -4 months . we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus

What is the shelf life of a pen? The pharmacist at Costco told me up to 6 months unopened for the vile - or is that just manufacturer suggestion?

Also, does the GoodRx coupon have to be used with a human Rx? If I had my vet call in the glargine Rx to a Rite Aid, I should be able to use it? Maybe Costco is different, but they couldn’t use a GoodRx I did have for a pet Rx. I have a Rite Aid right by my house and that coupon is so much cheaper than what I paid at Costco for a vile.

 

[Melinda and Kitkat]

Finally the BIGGEST stressor is now trying to home test. I've read everything I can, watched videos, researched. Need a Lancing device recommendation please?? Don't like to freehand it. CANT SEE where to inject because so much black & long ear hair. Can I test the hairless middle of his ear using one of the suction lancing devices? Need alternatives please Relion lancing device with clear plastic cap & lancets don't even poke above plastic piece?? Would really like a one step, gentle & firm device without poking all over the place. Please help us? Anyone use Genteel Lancing device & can I use in middle hairless part of ear?

Hi Renee and Binxy, we all can have troubles with home testing when we first start out, so you are not alone that it can bring you to tears. I will point out a few things, some may be obvious (just want to give you good information)
The relion lancing device is popular here, but do check the gauge of the lancets, the higher the number the thinner the lancet, and more difficult it can be to get a sizable drop of blood for your meter, 31 should work just fine once Binxy's ear learns to bleed, but starting out 26 or 28 gauge may be more successful.
Ensure the lancet is properly clicked into place in the device, and that the cap is clicked into place.
Test the device on yourself, and another brave family member, you should feel the tiny prick, and may have to give a tiny squeeze to draw a drop. I have read that most cat ears will require the highest settings (between 4 and 5) to get a good drop. Keep in mind the setting of the device is not truly equivalent to a much higher degree of pain. The device needs to go through the cutaneous layer and into the capillary bed area, and for cats this tends to be on the higher scale. Check your setting, and try kitty on highest (don't be afraid). Remember these devices are designed for babies, 90 year old humans, and 40 year old thick skinned tradesmen, the settings are there to accomodate all.
The Relion brand is compatable with a few other brands of lancets if you need to hunt down a thicker gauge (listed on packaging).
You mentioned it tough to see where to poke. This is true. Just keep in mind You are aiming for the sweet spot in the diagram linked. It is the least painless area for kitties. thats what to shoot for,, You want to avoid the marginal vein, and you know it when you hit it. But don't worry if you do, you will not damage his ear by hitting it occasionally, we all do. Some people with black haired kitties will do the poke on the front (face side) rather than the backside of the ear.
Ensure you have something behind kitties ear when you poke, your finger with a cottonball or a makeup cotton pad, so you can apply firm gentle pressure on the ear with the device as you click it. Always hold the device perfectly vertical (@90 degrees) to the ear.
I always warm up my hands under hot water so that my fingers (as well as his ears) are toasty warm to help with blood flow.
Using treats as a reward for tests will go a long way with Binxy's cooperation. I set out the device, the tester and the bag of treats and plunk them down right under his nose so he can sniff. An immediate treat after every test (successful or not) will develop his trust.

Anyone use Genteel Lancing device & can I use in middle hairless part of ear?

I was not familiar with the Genteel device, or other vacuum style lancing devices but I did google and watch a few videos...... my first instinct is that unless you have the most Zen kitty in the world that will allow you to do the 10 second hold to create the vacuum (without squirming), and then sit still as you apply the glucose meter on the drop( without a head flick), it might be near impossible to get it to work. It also appears costly.

 

[Larry and Kitties]

Also, does the GoodRx coupon have to be used with a human Rx?

Depends on the med you are trying to purchase. The GoodRx coupon for real Lantus says it can't be used for a pet. There is no such restriction for the generic glargine. However, some pharmacies may have their own policy but I have not found one yet.

What is the shelf life of a pen? The pharmacist at Costco told me up to 6 months unopened for the vile

For an unopened/not yet used, the pen/vial is good until the expiration date printed on the label. For an in-use pen/vil the manufacture says good for 28 days or so. However, that is if unrefrigerated. The manufacturer says nothing about if refrigerated. I have used open Lantus for over a year with no problems. I have also used pens past the expiration date printed on the pen with no problem.

 

[Diane Tyler's Mom GA]

What is the shelf life of a pen? The pharmacist at Costco told me up to 6 months unopened for the vile - or is that just manufacturer suggestion?

It could last up to 6 months depending on how many units you give your kitty
Some pharmacists will tell you 28 days but that is for human use because they use it more often ,as long as you put the pens in the fridge middle shelf they will be good until the expiration date on them. You are better off getting the pack of 5 pens .
Not a vial

 

[Carole & Indigo]

Welcome Renee!
Take a deep breath, the first couple of weeks are the hardest but it gets easier. I started off with a regular Lancet and did pretty well but when my husband started testing I bought the Genteel because I thought it would be easier for him, keeping in mind that Indi was already accustomed to testing and very patient with us. You do have to hold it on the ear for 5-10 seconds after the poke for the suction to do it's thing. It is good but also pricey and not totally necessary, testing will get easier as you go as the ears "learn" to bleed for you

 

[Bron and Sheba (GA)]

How are things going with Binxy, Renee?
We are concerned we have not heard back from you.