NEW MEMBER: Kitty diagnosed with diabetes and feeling very overwhelmed

[Jessica E]

My older male cat (M, 11 years old) was diagnosed with diabetes this week and while I thought diabetes was as simple as just an insulin shot a day, I am finding myself increasingly stressed and overwhelmed with the research on it.

We basically have two options: the insulin shots or the Bexacat pills which are fairly new. The pills excited me at first, as M hates taking medication and always has - even putting flea and tick medication on his back when he was younger was a huge challenge, as he'd buck around and literally launch himself into the air. It took two of us to do flea and tick medicine! Doing more research on the pills, I've seen a glimmer of hope in the ease of it. But I'm also concerned with some of the side effects, DKA being the main one, but also it's a new drug and we don't know the long term effects of it yet. I've also seen a lot of information about testing glucose, testing ketones daily, testing blood ketones (?) and it sounds like so much.

With the insulin shots, you know more of what you're getting as that is the primary medication for diabetes, but again, giving him the shots is giving me wild anxiety, not to mention the fact that we do travel a lot (and when I mean a lot, I mean a lot. 3-5 international trips a year, and 3 domestic out of state, not including any weekend trips) and finding someone to give him the shots while watching him will be challenging - and what if he won't let them? If he's too nervous for that close contact with a stranger, how will he get his meds? How fast will it negatively effect him if he doesn't get it? What if he's finnicky with his food and doesn't eat, how can I give him his medication if he doesn't eat? I feel even more pressure because we are leaving in just under a month for an international trip and I feel like I've got to get started on this quickly so I can make it easier to have him watched next month and watch for symptoms or side effects... or else just having to cancel, which I would rather not do.

Let's not even begin on the financial costs of all of this.

I'm just overwhelmed with all of the information and I still need to talk to my vet about what they recommend, but if anyone could inform me that it just gets easier as you start the process, that would be immensely helpful. Unless it doesn't and then, well... oh well. Or if you've used Bexacat, how is that going for you? If you're using insulin for a stubborn cat, how did you get them used to it?

Signed,
An Overwhelmed Cat Mommy

 

[Diane Tyler's Mom GA]

@Jessica E
You might want to put in front of Kitty diagnosed
NEW MEMBER
To do that tap on the word Thread Tools to the right then tap on Edit Title and type that in front then tap save

 

[squeem3]

Two reads to calm your anxiety and worries:

https://felinediabetes.com/newdiag.htm
https://www.felinediabetes.com/dear-mom.htm

A diabetic cat doesn't mean you have to go broke. The main ongoing costs are insulin (or whatever you decide to treat your cat with), insulin syringes (not applicable with pills), blood glucose meter test strips and lancets (daily testing is important just as it is for Human diabetics), and food. Few, if any, people take their cats to the vet weekly or monthly for blood glucose checks or anything diabetic related.

If you are in the US and have a FSA or HSA account, you can use those funds to purchase the Human insulin and diabetic supplies. Check your plan for specifics. FSA and HSA cannot be used for pet insulin / medicines or pet insulin syringes or pet test strips. If you're not in the US but have something similar to FSA or HSA, check the plan for what Human diabetic supplies qualify.

Food - you don't need expensive (and useless) prescription food. There's nothing in prescription food that helps diabetic cats. The ingredients are no better or different than what any cheap commercial brand of food contains. It's ok to disagree with the vet about food and not buy the prescription stuff. Low carb canned food is what most people feed. Brands such as Fancy Feast Classic pate and Friskies are just fine and what many people can afford and easily find in stores. There are many other brands. See this chart: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf Any brand that has under 10% carbs is good for diabetic cats. Do keep some higher cab foods (over 20%) on hand to use in case of hypoglycemia.

Testing supplies - a lot of people use an inexpensive meter such as Relion because the test strips don't cost very much. You can do your own blood glucose at home instead of paying the vet $$$ to do it and get inaccurate results. Cats are super stressed at the vet's office and that means elevated blood glucose levels.

A few members use the Libre meter which attaches directly to the cat's shaved skin and readings are sent to your cell phone via an app thing. One drawback is that the meter has to be replaced about every 2 weeks or if it falls off or malfunctions. The vet can replace the meter ($$) or you can learn how to replace it yourself.

Insulin doesn't have to cost a lot. If the vet prescribes Lantus, a great insulin to use for cats, there is a way to get the box of pens for $35. The box of five pens will last you at least 5 months if not close to a year depending on your cat's dose. The only pet insulin that works well for cats is ProZinc. I'm not sure how the cost of Bexacat compares to insulin.

For trips / vacations, a lot of people have a trusted pet sitter to take over the daily routine. The vet techs are your vet's office may do pet sitting on the side for extra money. You can ask. Some people have a relative or friend or neighbor who are willing to do injections and test and all that. Boarding the cat is another option if expensive. Some vets do medical boarding.

Very few members use Bexacat. I found some threads on it:

https://felinediabetes.com/FDMB/threads/new-treatments-for-feline-diabetes.284789/
https://felinediabetes.com/FDMB/threads/elanco-announces-fda-approval-of-bexacat.271670/
https://felinediabetes.com/FDMB/threads/any-experience-with-bexacat.285374/
https://felinediabetes.com/FDMB/threads/newly-diagnosed-cat-rx-bexacat-anyone-using-this.278050/
https://felinediabetes.com/FDMB/threads/tips-for-giving-bexacat.287658/

 

[Diane Tyler's Mom GA]

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 capillaries 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 any brand
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

Try putting a thin layer of Vaseline on the ear so the blood will bead up


Here is a video one of our members made, just ignore when she has to code it, that's because she is using a pet meter ,with a human meter like the Relion no coding is needed
VIDEO: How to test your cat's blood sugar

If you decide to go with Lantus Insulin


Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line

This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.

 

[Diane Tyler's Mom GA]

Try to start rubbing M's ears so he gets used to it .
Give him a low carb treat after you start rubbing his ears so he associates getting a treat after that
When you try to test him bring him to the same spot all the time give him a treat and try testing him then give him a treat. Even if you fail still give him the treat.

Here is some information on freeze dried treats
Click on this link and look at post #6. Numbers are to the right
You can get any freeze dried treats ,information is there
https://www.felinediabetes.com/FDMB/threads/brand-new-many-questions-3.255627/#post-2878703

Freeze dried treats that only contain one ingredient (the meat or fish) is zero carb and fine to feed to a diabetes

You can definitely get 5 pens of Lantus or the generic Glargine

You can Check
CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens either Lantus or the generic Glargine , plenty of members use the generic
Just call around and see who has the cheapest price , it's really not that expensive
With the pens just keep them in the fridge middle shelf , they all have the expiration date on them .

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

If you use the Good Rx
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


GoodRx coupon.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menu says generic glargine 1 carton of 5 3ml pens.


Also
A membersaid she followed this prescription info exactly and it worked perfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.

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

 

[squeem3]

Giving insulin shots does make a lot of people squeamish. The shots don't hurt the cat at all Ask the vet to show you how to correctly measure insulin with the proper syringes (U40 insulin with U40 syringes OR U100 insulin with U100 syringes). Then ask the vet to show you how to inject into a cat (best to use sterile saline on your cat for a practice run).

Diane posted info about U100 syringes above. If your vet prescribes ProZinc which is a U40 insulin, you will actually need U40 syringes. While you *can* use U100 syringes with ProZinc, there is a conversion you must do and that's probably too much for you to handle right now. So use U40 syringes with U40 insulin until you are less overwhelmed.

Oh, you can buy insulin syringes (both U100 and U40) online. Amazon doesn't require a prescription. Some other web sites may ask for the vet's phone number or a faxed prescription. I think Chewy will ask for a phone number so they can confirm with your vet. I buy my cat's syringes online from a Human diabetic supply site with no prescription but others have reported needing to provide a vet's phone number when purchasing from the same site. It seems to depend on what your state law is, assuming you are in the US.

Testing ketones is ideal. It doesn't need to be done daily unless your cat has had DKA or is prone to ketones or has some other issue that may result in ketones. The presence of ketones is concerning and can lead to diabetic ketoacidosis which requires immediate veterinary treatment. Info: https://felinediabetes.com/ketones.htm You can test either the urine or the blood for ketones. A fresh urine sample is needed. If you stick a test strip under the cat and let fresh pee soak the strip, great. If not, there are ways to collect fresh urine. Blood ketone testing requires a blood glucose meter that also tests for ketones. I think these meters and their test strips are pricey.

 

[Diane Tyler's Mom GA]

Using syringes with a pen, cartridge, or vial:

• 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.
• Syringes come in 5/64 inch (6mm), ½ inch (8mm) or 5/16 inch (12.7mm) needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
• Full and half-unit syringe scales:

Or form Amazon without a vets script for U-100 syringes for Lantus
half unit markings without a vets script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

 

[Diane Tyler's Mom GA]

 

[Diane Tyler's Mom GA]

Diane posted info about U100 syringes above. If your vet prescribes ProZinc which is a U40 insulin, you will actually need U40 syringes

Here are those syringes for Prozinc, but I prefer Lantus myself

1. Amazon has the U-40 syringes with the half unit markings
   UltiCare VetRx U-40 Pet Insulin Syringes, Comfortable and Accurate Dosing of Insulin for Pets, Compatible with Any U-40 Strength Insulin, Size: 3/10cc, 29G x ½’’, with Half Unit Markings, 100 ct Box
   Amazon'sChoice
2. Picture below

1. 
   Here is the link
   https://a.co/d/hEhbvSZ
   1. 

 

[Diane Tyler's Mom GA]

Keep us updated and let us know what you decide

 

[Bron and Sheba (GA)]

H and welcome to the forum.
Personally I am not a fan of the new oral medications for feline diabetes.while thee have been a few successes, there have also been some bad outcomes.
As far as travel goes, you need to find a reliable person who can take over when you are away. It may be a friend or you may have to pay someone. Get your kitty used to them before your first trip if possible.
Looking after a diabetic cat is very doable. Travelling needs organisation.
Getting the food, testing and routine sorted early helps a lot.

 

[AutumnMom]

Boy, do I understand about feeling overwhelmed! Autumn was diagnosed a little over a week ago and I felt totally lost! A couple of lessons learned:

1. There's a lot of good information on this site and lots of helpful people. If you decide to go with Bexacat, there's a subgroup of FDMB on Facebook specifically for users of Bexacat/Senvelgo. I chose to go with Senvelgo for Autumn, and have gotten a lot of great information from that group. I swear I freaked out at everything the first three days! Being able to ask advice, or just vent, helped at lot!
2. Ask questions! My practice has three vets - the one who called me with Autumn's diagnosis gave me several pieces of inaccurate information, and didn't explain anything! Fortunately, there is another vet at the practice who has had training on Senvelgo and has a diabetic cat herself. I sent her a list of questions and we had a great talk at Autumn's second checkup. I also read the clinical trial for Senvelgo, which was pretty technical but answered more questions than the information in the medication's box.
3. Bexacat/Senvelgo do have a risk of DKA, particularly in the first two weeks of treatment. There's also some risk for hypoglycemia, particularly if your cat is not eating. Your vet check ketones before starting the medication and then will be monitoring at 3, 7, and 14 days. If ketones are above normal, your cat will need to go on insulin. There's good information on continuing home monitoring on the Facebook Bexacat/Senvelgo group.

As for getting easier, Autumn has been on Senvelgo for a little over a week. She is a very skittish cat, so I just didn't think she'd do well with shots or the ear sticks for daily glucose monitoring. Her blood glucose was 500 when we did her first ketone test before starting the meds. By day 3, her glucose was back within normal ranges and her ketones have been in the normal range. The first week of giving meds was a real challenge! While she still doesn't like it, she's getting used to it. So am I....

 

[Bron and Sheba (GA)]

Please keep us updated on her progress. As this is a new medication for feline diabetes, we like to hear as many stories as possible.