New member lila and steven

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Lilitiger2

Member Since 2023
Hi! Newbie here this go round.

Steven is a 15ish yo tabby, 11 ish lbs, love of my life. He has GI lymphoma, IBD, renal issues and now...diabetes. BG at last check was 300, fructosimine was 329. In may, had BG of 374, higher fructosimine but, after an awful week on lantus (completely tanked, totally lethargic, anorexic, etc) went into remission. Yay.

But, now his BG is up again and I can't begin to describe how much I hate this. Really really do not want to do this but am just afraid of DKA. Dusting off that damn alphatrak so can get bg Readings. Sigh . I'm an anxious girl and find all the insulin stuff very stressful.

Just did dose #1 (for this round) he's a grazer, has NEVER eaten regular meals, so timing is hard. Doing it after his biggest feed in the early am.

he is on 2.5 mg pred, for the cancer
Mirtazapine(transderm) for appetite
Cerenia for nausea, was giving him injections at home but am trying transderm, PRN
Buprenex injections PRN for pain (transmucosal just knocks him out waaaaay too much so I give subq
Daily subq fluids
And now, 1/2 U insulin (MAJOR drama finding syringes that notate 1/2 units)

So, grateful there is a community of support for this. He loves lying in the sun, sleeping on my chest... travels with me everywhere.
 
Welcome Lila and Steven do you live in the US?
,I can tag a few experienced members for you
Meantime can you do your signature and our spreadsheet so members can help you

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.
The blue link will also explain how to set up our spreadsheet, if you need help setting it up just ask, I can tag a member for you to set it up

If you need help setting up the SS just ask we have a member that would be happy to do it for you

If you are still going to use Lantus or the generic which is much cheaper
You can use any of the U-100 syringes with the half unit markings
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 ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
  • Full and half-unit syringe scales:
49823063143_3437e9e997_o.jpg
.
A lot of members like the Sure Comfort or the Ulti Care ones

Lantus its expensive in the US.
When you need to get it again
Most members get the generic 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 the Match your prescription pull down menue 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

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
U -100 syringes with the half unit markings
I can suggest a few if you would like


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
 
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Alpha Trak 2 just wanted to let you know
that the AT2 is being discontinued and AT2 test strips will no longer be available for sale as of September this year. There will be an AT3,but why bother, it takes completely different test strips and I heard some members are having trouble with it
If you can find the Alpha Trak 2 test strips at all, they have gone up in price

Most of us use human meter ,since that's what our numbers are based on, plus the strips are so much more affordable

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
 
Thank you! Thank you!! Yes, am in US! Wyoming (boonies and then some) I have an AT3 and so far....no problems. Hoping it stays that way!

Yes, I picked up lantus from Walmart w syringes that would not work, then got ANOTHER script at local pharm but their didn't work either, so, vet (36 mi away) had some with 1/2 unit hash marks (ultimed) so got a few last night. Very glad with the syringes I was given I didn't go, "oh, 5, that must be new and mean .5!!!!!;!!! Actually called pharmacist to make sure!!) :)

Gave lantus 2.5 hours ago and he is just completely down for the count (he did this last time and we were at the vets every day for 6 days until they decided to stop, his numbers 140 - 170) Am going to check BG around noon, 6 hours post injection .
 
Lilitiger2 said:
Hi! Newbie here this go round.

Steven is a 15ish yo tabby, 11 ish lbs, love of my life. He has GI lymphoma, IBD, renal issues and now...diabetes. BG at last check was 300, fructosimine was 329. In may, had BG of 374, higher fructosimine but, after an awful week on lantus (completely tanked, totally lethargic, anorexic, etc) went into remission. Yay.

But, now his BG is up again and I can't begin to describe how much I hate this. Really really do not want to do this but am just afraid of DKA. Dusting off that damn alphatrak so can get bg Readings. Sigh . I'm an anxious girl and find all the insulin stuff very stressful.

Just did dose #1 (for this round) he's a grazer, has NEVER eaten regular meals, so timing is hard. Doing it after his biggest feed in the early am.

he is on 2.5 mg pred, for the cancer
Mirtazapine(transderm) for appetite
Cerenia for nausea, was giving him injections at home but am trying transderm, PRN
Buprenex injections PRN for pain (transmucosal just knocks him out waaaaay too much so I give subq
Daily subq fluids
And now, 1/2 U insulin (MAJOR drama finding syringes that notate 1/2 units)

So, grateful there is a community of support for this. He loves lying in the sun, sleeping on my chest... travels with me everywhere.
Click to expand...
@Wendy&Neko about the GI lymphoma
@Sienne and Gabby (GA)
@Suzanne & Darcy
@tiffmaxee
Thanks ladies
 
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Lilitiger2 said:
Thank you! Thank you!! Yes, am in US! Wyoming (boonies and then some) I have an AT3 and so far....no problems. Hoping it stays that way!

Yes, I picked up lantus from Walmart w syringes that would not work, then got ANOTHER script at local pharm but their didn't work either, so, vet (36 mi away) had some with 1/2 unit hash marks (ultimed) so got a few last night. Very glad with the syringes I was given I didn't go, "oh, 5, that must be new and mean .5!!!!!;!!! Actually called pharmacist to make sure!!) :)

Gave lantus 2.5 hours ago and he is just completely down for the count (he did this last time and we were at the vets every day for 6 days until they decided to stop, his numbers 140 - 170) Am going to check BG around noon, 6 hours post injection .
Click to expand...
What are you feeding Steven? Low carb wet, any kibble or both?, can you add it to your signature and the date you started lantus
What was his BG when you tested him this morning? How low did it go?
Are you feeding him small snacks during each cycle?
We don't use times because we all live in different time zones so 6 hours after insulin would be +6 and so on
Do you want help setting up the spreadsheet?
Do you have a hypo kit set up
@Lilitiger2

Can you add to your signature any of these things you left out
  • 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.

Please add this to your signature
He has GI lymphoma, IBD, renal issues

You might want to read all the yellow stickys about Lantus , especially the 2 dosing methods
See which one suits you, if you are feeding any dry food you will have to follow the SLGS method
 
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Welcome to FDMB.

Great start with getting. your signature set up. Please set up a spreadsheet as well. I'm linking one of our members who's great with spreadsheets in case you need or want a hand. @Bandit's Mom

As far as syringes, ADW is a great online resource for diabetes supplies. The stock most of the syringes that Diane noted above.

The downside with the AT3 is cost. You're paying $1.00 per strip. The cost per strip for a Relion meter is $0.17. The minimum number of tests per day is 4 -- a test before you give insulin to ensure it's safe to give insulin and a test somewhere around mid-cycle. Many of us test a lot more. You're paying $4/day with an AT meter and well under $1.00 with a human meter.

It's fine if your cat is a grazer. With Lantus, the insulin doesn't typically kick in (i.e., onset) until 2 hours after a shot. You just want to pick up any food 2 hours prior to shot time. You don't want your pre-shot insulin test to be influenced by food.

FWIW, everyone finds the managing their cat's diabetes stressful at first. You wouldn't have found us if you weren't devoted to your kitty! I have spent my career working at medical centers and still found managing my cat's FD stressful. I can say with certainty though, it gets easier. You are realistic in being afraid of DKA. My cat was a survivor. The best way to keep your cat safe is home testing Steven's blood glucose and testing for ketones. You can pick up Ketostix at any pharmacy. As long as he's not showing anything above trace levels, he's fine.

It's likely that the pred (and I hope it's prednisolone not prednisone) is what caused Steven to fall out of remission. Given the IBD, you may want to consider a raw diet. This is a great website for information on both a raw diet and IBD.

Please let us know how we can help. The members here are very generous with their time and knowledge so please, don't hesitate to ask questions.
 
Hi and again, thank you! Will try to get all that added to sig. It did tell me at 6 lines it was too long so shortened but will add what I can.

Yep, dry food. Yes, I've read Dr Pierson many times but this cat, for 15 yrs, will NOT eat wet. Just won't eat. Tried EVERYTHING but he is committed so gets a mix of Purina DM and hydrolyzed protein (HP) kibble. He is on mirtazapine to stimulate appetite.

I did not test pre injection as vet told me GIVE IT regardless (if he eats 50% of food during the night) but I will tomorrow if I can. We are 2 days late in starting bc vet ,(specialist) is 6 hours a way and couldn't get home in time.

And yes, prednisolone, for his cancer bc I didn't go the chemo route ( he already had appetite issues)
 
But I am confused about food and lantus... I was told to give it while he was eating ( which I can't do anyway) but to be sure he had eaten a bunch. But what you say makes sense...thank you!
 
It’s easier to give the shot while they’re eating because they’re distracted but you don’t have to. Lantus is a great insulin for cats because it’s gentle and long lasting. It takes about 2 hours to start working so you can test, feed and shoot. In that order so you know he’s eaten and it’s okay to give insulin. You always want to pre test to make sure the bg is high enough and it’s safe to give the dose you’re giving. It would be good for you to read all the yellow sticky notes in the Lantus forum so you can learn about the insulin and the dosing methods we use here. The more you know, the better equipes you are for dealing with his diabetes.

if you want to get the Lantus 1/2 unit syringes at Walmart, which I’ve always done, this it the ones you need. In CA you don’t need a prescription for them but I do have to buy it at a store as they won’t ship it.
 

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Thank you! Vet confirmed, I guess, with multiple BG tests for a week or so, then Ive done irregular tests since.bhes been wnl until he had to go 2 days w no subq. Got dehydrated, I dunno but that seems to be the guess? Or just...all the other factors.

I do have test strips for urine. Yes to glucose, no ketones, but I think vet said trace.
 
If there were trace levels of ketones, getting insulin into your cat is important. However, giving a shot if your cat's blood glucose (BG) is 300 is very different than giving a shot if your cat's BG is 30. The only way you will know if it's safe to give an injection is if you test before you shoot. So, apologies to your vet but please, test your cat before you give insulin. Just like being attentive to the presence of ketones is crucial because DKA can be life threatening, cats can die from a symptomatic hypoglycemic episode. To the best of my knowledge, it hasn't happened here but it can happen.
 
Lilitiger2 said:
And yes, prednisolone, for his cancer bc I didn't go the chemo route ( he already had appetite issues)
Click to expand...
On my third cat with GI lymphoma, and went with chlorambucil (chemo) for all three. Neko was also diabetic, CKD and heart disease. She could not take prednisolone due to her heart condition, so she took budesonide instead. It did not impact her blood sugar and doesn't for most though it does for a few cats. You might want to talk to your vet about that option. We've seen some cats here go off of insulin with the switch from pred to budesonide. It's a steroid too, but acts locally in the bowels.

Neko had multiple reasons to have lousy appetite. You aren't giving the right drugs for nausea. You want to be giving ondansetron, it's the best drug for that. Cerenia is great for vomiting and helps a bit with nausea, but ondansetron is hands down a better tool. If you go on the most modern chemo protocol, which is a dose every two weeks, you might get a few days of iffy appetite, and then it gets better. My current lymphoma kitty is also an IBD kitty, is currently in remission and off of chemo. She got diagnosed over 5 years ago. For her IBD, I do try to give raw, though she needs a lot of variety, so it doesn't always work and gets canned. Have you tried giving freeze dried raw, or air dried like Ziwipeak? They have novel proteins and are low carb, and have crunch.
 
Thank you so much. I will definitely ask vet about ondansatron. A previous kitty of mine who died from his large cell (,I think what it was, very aggressive even w chemo) GI lymphoma, got that in an oral cocktail. Cerenia (injected) has been a miracle drug for us (found out yesterday transderm is worthless, for him. Back to injecting..insert very sad face)

Went to ER last with him. At +14 (checked bc he looked bad, he'd been 299 at +6) he was 421. Had vet recheck about an hour later and he was 347. He'd had approximately 50mls of subq during the afternoon and, given the worry of plural effusion, I didn't want to give more. But this vet felt it was ok, so, another 60 (doses 8 hours apart) and he perked up considerably

This am (amps) he was also 347 (had just finished eating) so got his shot.

Your kitties are so lucky to have such an attentive and competent parent!!! I thought really hard about the chlorambucil, spoke at length w his oncologist. I may have made the wrong choice, dunno, but at the time he was stable(ish), was eating (which is always a miracle) and I decided not to mess w something that worked. Reading over our (extensive) medical hx last night w this vet, I saw that I did pull him off pred (in preparation for the chlorambucil, so I must have agreed at that point) but then he did poorly enough they put him back on and he improved (and ate) so I kept w that protocol. He has an upcoming ultrasound and echo so I'll ask again then.

Back in the spring of 2022 when he was first dx'd w the lymphoma, the hydrolyzed protein diet was recommended bc he would not eat. That was the one thing he WOULD eat (and seems to agree w him gastrointestinally). He likes the DM so I mix it, but I'm aware it's not ideal.

I am going to ask about probiotics, altho part of me hates to mess w a stable thing. But I've read they can be very helpful.

Thank you again!!!!
 
Bobo is one of those cats that became diabetic after taking budesonide. I did an online deep dive and found some research showing that in a cat who already has a pre-existing kidney or liver condition, budesonide is more likely to not stay at the GI tract only and spread to the entire body. If she’s already diabetic, it shouldn’t be an issue. It might raise her bg it may not
 
Yes, Steven became diabetic on pred. Is spreading to the entire body good or bad? Very interested in others experience with this and thank you!
 
When you said "GI lymphoma" I was presuming small cell lymphoma, which is a pretty common disease in kitties, and a slow moving disease. Hence the mild chemo chlorambucil vs what is needed for large cell. Chlorambucil is given in addition to prednisolone (or budesonide if diabetic or heart condition), at least until SCL remission is solid, when it can be tapered off. Unless of course it's also needed for IBD.

Have you tried giving Cerenia in pills? If you put it in a gel cap, they don't notice the bitterness. A size 3 or 4 gel cap, depending on the dose of Cerenia. I was curious to hear about your experience with transdermal. My vet has given me transdermal maropitant (generic version) to use, and it does seem to help with vomiting. Though I rely primarily on ondansetron for nausea.

Ale & Bobo & Minnie (GA) said:
some research showing that in a cat who already has a pre-existing kidney or liver condition, budesonide is more likely to not stay at the GI tract only and spread to the entire body.
Click to expand...
Neko had CKD (stage 3-4) at the time she started budesonide, and it seemed to stay in her GI track and did not impact her numbers. Maybe ECID?
 
You are exactly right. Steven has small cell, my other kitty had large cell. His oncologist had suggested pulling pred for two weeks ( no taper) then starting the other drug. I got her to agree to at least a taper of the pred but as I'm remembering, he really tanked. I do t recall the option of pred AND chlorambucil, I would have probably gone for that (maybe).

I have tried the pills. I think ( only an opinion, no actual data) that his GI issues may get interfere w sbsorbing the cerenia, so it ve tried other routes. So far, injections are the best. Just tried the transderm cerenia yesterday and I don't THINK it did much. The injections seem to sting so I usually do with the subq. Hate to go back to that but, he's like a new cat with them!!!
 
Wendy&Neko said:
When you said "GI lymphoma" I was presuming small cell lymphoma, which is a pretty common disease in kitties, and a slow moving disease. Hence the mild chemo chlorambucil vs what is needed for large cell. Chlorambucil is given in addition to prednisolone (or budesonide if diabetic or heart condition), at least until SCL remission is solid, when it can be tapered off. Unless of course it's also needed for IBD.

Have you tried giving Cerenia in pills? If you put it in a gel cap, they don't notice the bitterness. A size 3 or 4 gel cap, depending on the dose of Cerenia. I was curious to hear about your experience with transdermal. My vet has given me transdermal maropitant (generic version) to use, and it does seem to help with vomiting. Though I rely primarily on ondansetron for nausea.


Neko had CKD (stage 3-4) at the time she started budesonide, and it seemed to stay in her GI track and did not impact her numbers. Maybe ECID?
Click to expand...
Absolutely ECID, but once I read that I knew that’s what happened with Bobo
 
Hi! Is somebody helping you set up a spreadsheet? I too have experience with both an IBD cat and an IBD that morphed into small cell lymphoma and chlorambucil and prenisolone used together. The chlorambucil/prednisolone was like a miracle for my cat. I also cannot more highly recommend Visbiome Vet probiotic for IBD cats and cats with any GI issues (and really all cats because it supports the immune system.)
 
Hi and no, don't have a spreadsheet yet but am noting everything down. About to do a +12 read (although not terribly confident). Will be chatting with oncologist about the two meds asap and THANK YOU!!!!
 
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