New member 11/8 and I am tired

I am so great at following what my vet office says and yet, nada. No improvement and half of those people don't know what they're doing. My little Kitty has been hard at work trying to get rid of her Libre cgm (recommended by someone who does) so I resolved to get a glucose testing kit. We've had a diagnosis for a month ish

In the middle of the night Kitty had what I'm pretty sure is a hypo seizure briefly but I gave her some honey, treats she never gets to eat anymore cause they're trash and fav wet food.

I am mad at myself for not already having a glucometer which seems daunting to use -- because the more I exist in the Internet, the more of a ridiculous idea it is to be to just blindly give insulin (I have vetsulin) off of a couple of pricks at the vet here and there over the course of weeks

 

@Kitty committee
Welcome sorry your kitty had a hypo ,
Are you waiting 30 minutes after your kitty eats then give Vetsulin
You also need to withhold feeding anything 2 hours before you test first thing in the morning which is called the AMPS ( AM Pre Shot) because you don't want the BG to be influenced by food and to be sure that number is safe to give insulin
You couldn't have found a better group to join, you're right most vets don't know much about feline diabetes, the experienced members here know more than most vets do.
If it wasn't for me taking the advice I was given here I know Tyler wouldn't be in remission since 1-24-21
Vetsulin is not a great insulin for cats. It is a dog insulin and dogs have a slower metabolism than cats.

You would be much better to think about swapping to lantus (Glargine) or prozinc, which are both recommended for cats by the American Animal Association. These two insulins are slower acting, longer lasting and more gentle than Vetsulin and you will get better results with them.
is a link to the guidelines published by the American Animal Hospital Associationfor diabetes treatment. I'd encourage you to print out the information and bring it along. If your vet gives you a hard time about Lantus, you can hand him the copy of the guidelines. They were first published in 2018 and have been consistently updated.

 

Here is the link so you can set up your signature and spreadsheet
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
You can just tap in your name up top ,then tap in signature and add all the information below
The signature is at the end of everyone's post in gray ,information about our cats

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Also almost all of us use human meters that's what our numbers are based on

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers



You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it


If you need help setting it up just ask ,we have a wonderful member who will be happy to set it up for you

 

You will need U-100 syringes with half unit markings for Lantus
I can suggest some just ask me
Lantus is expensive in the US so members use the generic version
Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon. Most members use the generic because Lantus is to expensive.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that they match your prescription pull down menu says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot
Let us know if the vet writes the script for you because you will need U-100 syringes with half unit markings , I can tell you which ones you can use
We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units ,we adjust the doses by 0.25 units


Also
The 5 pens will last about a year, 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.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens. GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822


You can read all about Lantus here, all the yellow stickys
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars 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.
• 
  
• I would suggest the sure comfort or the UltiCare Vet RX or if you have a Walmart by you
• You can get the syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
  This is what the packaging looks like: either box is fine
  They won't say it half unit on the box but the are . open then and look before you leave the store, can't be ordered on line , need to go into the store
  :
  
  
  
  
  
  
  
  Or ADW diabetes call them and tell them what you want and they will contact your vet to fax over a script , ask your vet for refills so give your vet a heads up, either one of these are fine
  https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct
  
  https://www.adwdiabetes.com/product/5739/ulticare-u100-vet-rx-half-unit-syringes-31g-3-10cc-60ct
  
  Here is a coupon if you get them from ADW diabetes
  
  10% off your next order!

You can also get the U-100 syringes with half unit markings at Amazon with out a script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

 

I suggest you set up your hypo kit in case you need to bring your cats BG up
For your Hypo kit
Med and High Carb food and some honey/karo
If you can get these where you live


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

 

Can you get those readings that your vet did so you can enter them on your spreadsheet when you set one up
Most of us use the Relion human meter from Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar



Just keep asking any questions you have

 

Tagging Suzanne for you who is familiar with Vetsulin
@Suzanne & Darcy

Suzanne as you can see I gave her some information

 

Thanks! A lot of this info I already lurked through, that's how I knew what to do when my cat had an attack. <3

I do live in the US! I would like help with the spreadsheet, even though I don't have anything to put it in yet. I have those old numbers from the vet basically.

I have a backup script for Lantis, I just need one of the silly vets in my practice to okay it before I switch I think, they're hard to reach on the phone, work in different places in different days, which annoys me.

I got a Contour Next Gen at CVS today at least for now cause that's all they had. My cat is hiding under the bed so I didn't get to try it anyway! It hurts me quite a bit too try on myself, is it really true that cats don't really feel it?

 

A cat's ear is not as sensitive as a human fingertip.

Giving a low carb treat after each test or attempt will help.

Tagging @Bandit's Mom for help with the spreadsheet.

We have all been where you are. So glad you were proactive with Kitty's care. This is the best place you never thought you would be. Welcome. Waving from Canada.

 

I ended up at urgent care after another mysterious hypo episode this afternoon and they are recommending dropping the dose by half a unit but to give vetsulin a chance of 30 days since that's what was started on and it may take time to take proper effect.

6 o clock is not typically supposed to be her low point according to the trends I saw in the the old cgm before it expired. So this is mysterious to me and the urgent care vet.

 

So sorry this happened again, poor baby. How many units is your kitty on now ?
It would be helpful if you can start testing Kitty that's her name correct?
so you can see when she's dropping too low and intervene with food right away to avoid another hypo.
As soon as Bhooma @Bandit's Mom sees this tag and sets up the spreadsheet for you , you can enter BG numbers you have that the vet did and what you have when you can get some tests in. Just write them down for now so you have them so you can enter them as soon as Bhooma contacts you to set up the SS

Just remember we don't go by times , because we are all in different time zones
If you do get a test in let's say first thing in the morning (AMPS) at 8 AM ,then you test again at 10:00AM you will say @+2 ( 2 hours after giving the insulin)

The meter you got is fine , I don't know how much you are paying for the tests strips for that meter , but if you want to save money most of us use the Relion Premier Classic from Walmart, you can either go to the store and pick it up and the rest strips or order online

Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

@Kitty committee

 

@Suzanne & Darcy
Hi Suzanne can you take a look at posts #1, 8, and 10
Thanks Suzanne

 

What were Kitty's numbers this afternoon?

And a word of warning: some cats can be a bit more insulin sensitive after an active hypo.

 

Home testing is the best way to keep them safe. Testing them at home is less stress and less expensive than taking them to the vet for a curve. You also get more accurate results when you test at home. It does not hurt them and it is just a matter of establishing a routine. With time and practice it becomes just one more thing they get used to – like insulin shots.

I can help set up your spreadsheet. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

My first try was unsuccessful, I didn't get enough blood but I gave a treat anyway and will try again later.

 

Are you using 26 or 28 gauge lancets? Can you add the meter you ate using to your signature also, that's what the members here will look at first
Just click on your name above ,tap in signature and add it , tap save.
Good luck with the testing. A favor can you hit the word like after someone replies back to you, just so we know you saw it
@Kitty committee

 

28, that's what my CVS had. I did it once! My cat growled so I might not be hitting the right spot but she's hiding her ears

 

28 should be good ,take another look at post # 6 again it might help
Kitty is adorable

 

Easier said than done but I'm still super nervous, which doesn't help. She's not still like the tutorial kitties

 

I know try putting her in the same spot all the time and pet her and play with her ears even if you're not testing
Sooner or later she will associate getting a treat before and after you test her.
Sounds silly but some members sing a song
I always put Tyler on the couch with his head facing the arm of the couch and I'm sitting right beside him.
You will get it sooner or later don't get discouraged

 

Hi I see you got a test in @+8 on 11-9 during the day cycle , good job how did it go did she move around a lot?
Can you fill in how many units you gave ,it's not filled in on your spreadsheet.
Can you get the past readings from the vet that were done in the past and enter them too
@Kitty committee

 

Oh, yes, learning curve with the spreadsheet!
She moves her ears away from me but doesn't run away completely (I have an enticing treat in front of her).

I will get the old readings from my old vet soon. I'm a little afraid to leave her alone after those two hypo episodes in a row. I have a bunch of data from my Freestyle Libre cgm from a week ago, is that useful for something?

 

@Kitty committee
Morning, yes the readings from the Libre would be very help, just fill those numbers on your spreadsheet with the dose you gave

I know you are still new at testing kitty but you really need to get a test in at AMPS and PMPS to be sure the number is safe to shoot, then get some tests in after that to see how the insulin is working and to see how low kitty's BG is dropping

Any BG under 90 needs to be decreased by 0.25 units
I see on 11-8 kitty dropped to 30 that warranted a decrease , did you continue testing her again after that to see if her BG was coming up with feeding her high carb food,
I see before you started testing kitty was on 2 units , so when you got that 30 you should have given 1.75 units for the next dose.
I see you gave 1.25 units on 11-9 but you didn't get a test in first AMPS.
Then on 11-9 during the night cycle there was no PMPS test and you gave 1.25 units again but no testing after that.
On 11-10 no AMPS test and gave 1.5 units , don't know why you increased the dose,then at night there is nothing filled in
I'm not a Vetsulin user , and I'm not sure what dose you need to be giving now
I can tag a few members for you
But you need to be testing kitty at AMPS and PMPS and after that
I see she had 2 hypo events already as you said in your posts

Here you can read about Vetsulin
https://felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

@Suzanne & Darcy
@JanetNJ

 

Sorry, dealing with a few crises at a time and I was unable to try again to glucose test until today but I did have a libre cgm on her which a vet recommended.

1. at the time of 30 and day after - I wasn't able to test successfully. I was afraid to give her any dose after each of the two close calls, the 1.5 is what the vet told me to continue doing for a week. I dealt with 2 vets already and both said they wouldn't have started me on vetsulin but since that's what I have, I must continue trying it and give it a month to see how it goes and not switch.
2. I got a libre installed the day after so I have some readings to input from that. They said it takes about 3 days to stabilize on a new dose

So far, the 2.5 dose I received from my initial vet was too big because the libre readings bounced between 500 and 50, so they decreased it to 2 after a week, my cat had two hypo events on it, so they decreased it to 1.5.

The issue I see is that it still bounces a lot? Every day it still goes up to 450/500 at the peak and drops 300 points to be 100-150 at the lowest (the lowest-lowest is at night)

To me that still seems wildly unregulated? But the bigger dose that was prescribed gave my cat hypo so that doesn't seem like it would be right either.

 

So the readings from the libre were from 11-10 to 11-17 correct, I see you put that in the remarks section. Does Kitty still have the Libre on?
I'll try tagging a few other members but they aren't Vetsulin users , only @Suzanne & Darcy is familiar with Vetsulin, but I see she hasn't been on for awhile

Hi ladies do you think you can take a look at @Kitty committee
Intro thread, and some of her replies , I really don't know what to tell her , Suzanne must be busy at the moment. Kitty already had to hypos already, she has some info in the remarks section on her SS
Thank you

@Elizabeth and Bertie
@Wendy&Neko
@Sienne and Gabby (GA)
@Bron and Sheba (GA)

 

For now! I think it's going to come unglued soon but I have a script for one more.
I am low key mad that that vet won't approve switch to different meds and are like: give it more time to work, even if they know it's not the best.

I did get a real meter glucose reading this morning and it matched the libre at the time so I am pleased about that.

 

I just want to be sure Kitty was diagnosed 9/23 is that when you started Vetsulin?
Hopefully one of the other members I tagged will have some advice
Can you do me a favor so members are aware that Kitty has a Libre on, can you also add that to your signature also and your spreadsheet , just put a /after the contour Next and add Libre

 

Oops, I will fix it. Going back through my calendar should be 10/4 when I got the insulin, 2 days after diagnosis. That first vial was expired which I didn't catch when the tech gave it to me and my cat was on it for 2-3 weeks

 

Can you please fix the DX date on your spreadsheet also
@Kitty committee

 

Can I ask you your name, just wondering what lc wet food are you feeding Kitty
@Kitty committee

 

It's Anna. Hiii. I have a hard time with the food, my cat is a picky eater. I used to supplement with dry food but I phased it out when she got the diagnosis.

It's mostly Nulo freestyle chicken and a couple of other flavors. She does kind of like the Science Hill Glucosupport wet food but it upsets her stomach when she has too much so I'm not a fan (and I read here that it's not the best anyway so I won't force it). I have some Veruwa but only likes specific flavors. I've used Soulistic, which some flavors are better than others carb-wise I believe from my terrible math. I have some salmon and chicken fillets from different brands for snacks, and Orijen freeze dried chicken. Got PureBites a couple of times. I have to rotate, otherwise she gets bored and doesn't want to eat the same thing every day and that won't work.

My local pet shop has brands from some of the good food master lists but not necessarily the same foods so I do my best to do math on the spot to pick something that looks healthyish, knowing that the numbers on the can aren't the most accurate. The venn diagram of the optimal food, what I can find locally, and what my cat will eat is pretty small.

 

Hi Anna
Have you tried any of these flavors
Weruva Pates
They are low carb and low phosphorus which is good for kitties who have CKD
You can probably pick up some of these in Pet smart ,or Petco so you can try them out to see if your kitty likes them

BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 133%

BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5.20%
Phosphorus 134%

BFF play chicken cherish
Protein 31%
Carbs 4.90%
Phosphorus 132%

BFF chicken & turkey tiptoe
Protein 31%
Carbs 5.10%
Phosphorus 133%

BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5.20%
Phosphorus 152%

BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 152%

BFF play chicken & duck destiny
Protein 32%
Carbs 5.10%
Phosphorus 163%

BFF play chicken & beef best buds
Protein 33%
Carbs 5.30%
Phosphorus 175%

Don't know if your kitty likes pate but here is the list of the BFF line.
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Also

https://www.amazon.com/Weruva-Focus...cphy=9003521&hvtargid=pla-1796056536677&psc=1

I know you can buy single cans of the BFF I listed at Petco, Petsmart to see which ones your kitty likes , the Focused one not to sure




With weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.


You can even check out the soulistic pates
https://www.soulisticpet.com/pate
When you click on one of the flavors then click on
COMPLETE NUTRITIONAL INFORMATION (link to page)
and look at the same two places like on the weruva site


Here is also the food list that list the carbs


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

 

Anna -

I'm going to make an assumption that you're in the US since you're referring to Vetsulin (vs Caninsulin which is what it's called outside of the US). If your vet is giving you a hard time about switching insulin, please print this article out and give him a copy. The article is the guidelines for treating diabetes that was published by the American Animal Hospital Association. If the vet says he doesn't want to change Kitty's insulin, I'd ask why he's not following the recommendations of one of his recognized professional organizations. And then I'd find a new vet since those guidelines came out in 2018. He's not staying current and/or he's treating your cat like a small dog. Your vet may be great for treating other problems but it seems like he's not up to speed with treating feline diabetes.

The numbers you're seeing aren't bad. They are just big drops from your pre-shot to the lowest point in the cycle (i.e., the nadir). However, what you are also seeing is the problem with Vetsulin -- it doesn't provide enough duration to last the 12-hours that a longer acting insulin will provide and the longer duration is needed due to a cat's fast metabolism.