? New Member need advice on insulin

[Tinah0505]

The vet just called me and confirmed my cat Bear has diabetes. Bear has a lot of trouble walking which i now realize is plantigrade stance related to diabetes. The vet told me to go to Walmart and get some Novolin and that i do not need a prescription. Immediately I joined support groups and started reading up on Diabetes. Is the vet correct - I should just go to Wal-Mart? I read somehwere in here that Novolin is not good for cats. I"m not sure what to do.

Also, i was told to give 1 unit twice per day. I'm not sure how I am going to do this since i work all day and the cat is at my moms. I go over there after work to feed dinner. Please any advice is appreciated.

 

[Lisa and Witn (GA)]

Novolin is not a good insulin for cats. Lantus, Semglee and Basaglar are all insulin glargine insulins that work well in cats. You will need a prescription and I recommend ask for the prescription for pens instead of a vial.

You will also need syringes. Ask the pharmacy for U100 Syringes 31 ga 3/10 ml 30 units ½ unit. Make sure they are 30 unit syringes. Cats get smaller doses than people and you will need this size to accurately give the right dose.

It sounds like your vet does not have experience treating feline diabetes. We can help you learn how to properly care for a diabetic cat. One thing we encourage is home testing. This means testing your cats glucose levels before every shot to make sure it is safe to give the dose. Walmart's Relion brand glucose meters are good and also inexpensive to use. I suggest you also get a meter and test strips.

Did your vet talk to you about diet? A low carb canned or raw food diet will help lower glucose levels. Pate flavors are lower in carbs than anything with gravy. Many of us feed Friskies and Fancy Feast pate flavors. Almost all dry foods are high in carbs. This will keep the glucose levels high. If your cat is a dry food additive can help you change his diet.

 

[Diane Tyler's Mom GA]

Welcome to the best group you could ever find
A favor please take down the 911 it's meant for emergency's , you can replace it with a ?
To remove it look to the right and you will see the word Thread Tools tap on that then tap on Edit Title remove the 911 and put a ?

Hi this info I saw in your information
Bear was diagnosed with diabetes on 5/11/2023 - 11 years, 8 months male - feeding raw food. He has experience neuropathy in his hind legs and has severe difficulty walking

What we need you to do is put as much info you can for now here
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.


Lisa is absolutely correct Novolin is not a good insulin for cats at all
Bear needs to be tested before you give any insulin to be sure the BG number is safe enough to give it.
If you can go over to your moms house before work and test Bear and give him his insulin that's the only thing I can think of and then after work go and test again
Insulin has to be given every 12 hours. Maybe you can teach your mom how to test and give insulin and also you need to get a few tests in during each 12 hour cycle to see how the insulin is working for Bear and how low he's dropping, you don't want him to have a hypo incident.
We can help you with this and explain things about how to home test

You might want to read about Novolin N
https://felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/

 

[Diane Tyler's Mom GA]

If you do switch to Lantus
Lantus is expensive in the US so many members use the generic
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 6 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. You would need U-100 syringes half unit markings



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

Walmart also has the U-100 syrines with half unit markings,you need to go into the store to get them. We use the syringes so we can adjust the dose by 0.25 units at a time
Don't know if you have a vial or the pens that can only be adjusted by full units
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
:

 

[Diane Tyler's Mom GA]

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
You can order them on line also
Our numbers are based on human meters
When you do start testing
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

 

[Diane Tyler's Mom GA]

Bear has a lot of trouble walking which i now realize is plantigrade stance related to diabetes. T

For the neuropathy
You can order this Methyl B-12 . I have used it for years and a lot of other members use this Methyl B-12 , just open up the capsule mix it in with the wet food add some water, it's tasteless.

The Zobaline is too expensive

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
14.49 for 100 capsules
Give one a day



Once you get Bears BG under control this will help with it also.
Tyler had diabetic neuropathy and it took about 1-2 months and he was back to jumping, running etc.
I did see an improvement every 2 weeks
You can start it now if you want to

 

[Tinah0505]

For the neuropathy
You can order this Methyl B-12 . I have used it for years and a lot of other members use this Methyl B-12 , just open up the capsule mix it in with the wet food add some water, it's tasteless.

The Zobaline is too expensive

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
14.49 for 100 capsules
Give one a day



Once you get Bears BG under control this will help with it also.
Tyler had diabetic neuropathy and it took about 1-2 months and he was back to jumping, running etc.
I did see an improvement every 2 weeks
You can start it now if you want to

Thank you for the information and advice. I was in such a panic yesterday with the diagnosis. I actually ordered the Zobaline from amazon after reading about it on this page. I will use that first and next time try the Methyl B-12.

 

[Tinah0505]

Novolin is not a good insulin for cats. Lantus, Semglee and Basaglar are all insulin glargine insulins that work well in cats. You will need a prescription and I recommend ask for the prescription for pens instead of a vial.

You will also need syringes. Ask the pharmacy for U100 Syringes 31 ga 3/10 ml 30 units ½ unit. Make sure they are 30 unit syringes. Cats get smaller doses than people and you will need this size to accurately give the right dose.

It sounds like your vet does not have experience treating feline diabetes. We can help you learn how to properly care for a diabetic cat. One thing we encourage is home testing. This means testing your cats glucose levels before every shot to make sure it is safe to give the dose. Walmart's Relion brand glucose meters are good and also inexpensive to use. I suggest you also get a meter and test strips.

Did your vet talk to you about diet? A low carb canned or raw food diet will help lower glucose levels. Pate flavors are lower in carbs than anything with gravy. Many of us feed Friskies and Fancy Feast pate flavors. Almost all dry foods are high in carbs. This will keep the glucose levels high. If your cat is a dry food additive can help you change his diet.

I actually called the vet and asked for a RX for Lantus after reading about insulin yesterday for cats. After work i went to Walmart and purchased the medication. He is prescribed 2 units twice a day. I gave it to him at 7 pm last night and then again at 7 am this morning.

Bear is already fed a raw diet. I started him on it in November when I took him and his siblings under my care. Fortunately he loves it and had no problem transitioning off of dry food.

I am going to spend today learning about in home testing and order the supplies. Thank you for the recommendations.

 

[Lisa and Witn (GA)]

Two units is a high starting dose. Most cats start at 1/2 to 1 unit. I recommend starting at 1/2 unit until you start testing and know what his glucose levels are. Also did the vet determine he was diabetic through a fructosomine test or just a single glucose reading? If it is a glucose reading that is not the proper way to diagnose diabetes. A fructosomine test is a average glucose similar to A1C test for humans. A glucose test only shows what the level is at the time the test is taken. There are many things that can affect that reading including vet stress. Since he is already on a raw diet and your vets original treatment plan, make me question the diagnosis.

If you haven't already read this, please read the sticky on treating hypoglycemia. This can happen when glucose levels drop too low. I recommend that have corn syrup on hand. Hopefully you will never need it, but you don't want to be without it if you do https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

[Tinah0505]

If you do switch to Lantus
Lantus is expensive in the US so many members use the generic
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 6 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. You would need U-100 syringes half unit markings



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

Walmart also has the U-100 syrines with half unit markings,you need to go into the store to get them. We use the syringes so we can adjust the dose by 0.25 units at a time
Don't know if you have a vial or the pens that can only be adjusted by full units
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
:

Thank you so much for the information! This is super helpful. I was able to get the vet to prescribe me Lantus but it turned into a big ordeal. They vet didn't just send me a prescription. They told me their email and fax machine was down and to just have the pharmacy call them. As you can imagine, Walmart Pharmacy wasn't very accommodating. I stood there on the phone with the vets office having a 3 way conversation with the pharmacist. Ultimately the vet called Walmart directly and gave the prescription over the phone. Initially Walmart told me they did not have a generic and that it was $350 dollars. I did sign up for the Lantus coupon and was aware that the RX had to be written a certain way. It was all getting to be too much chaotic because i was in a hurry to get the medicine, drive home and administer by 7 pm. At that point, I was willing to pay the $350. When I was checking out at the Pharmacy, he said they did have a generic and it was only $118. I was happy to hear that! It is vial and not a pen. I also purchased the ReliOn (blue) box as pictured in your post.

Next time around, I'll have more time to do everything the right way.

 

[Tinah0505]

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
You can order them on line also
Our numbers are based on human meters
When you do start testing
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

Thank you so much for the detailed post including links! I was copy and pasting information yesterday. I wanted to go back today to find information on the meter. You have saved me so much time putting it right here with clear instructions on how to test. Thank you!!!

 

[Tinah0505]

Welcome to the best group you could ever find
A favor please take down the 911 it's meant for emergency's , you can replace it with a ?
To remove it look to the right and you will see the word Thread Tools tap on that then tap on Edit Title remove the 911 and put a ?

Hi this info I saw in your information
Bear was diagnosed with diabetes on 5/11/2023 - 11 years, 8 months male - feeding raw food. He has experience neuropathy in his hind legs and has severe difficulty walking

What we need you to do is put as much info you can for now here
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.


Lisa is absolutely correct Novolin is not a good insulin for cats at all
Bear needs to be tested before you give any insulin to be sure the BG number is safe enough to give it.
If you can go over to your moms house before work and test Bear and give him his insulin that's the only thing I can think of and then after work go and test again
Insulin has to be given every 12 hours. Maybe you can teach your mom how to test and give insulin and also you need to get a few tests in during each 12 hour cycle to see how the insulin is working for Bear and how low he's dropping, you don't want him to have a hypo incident.
We can help you with this and explain things about how to home test

You might want to read about Novolin N
https://felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/

So sorry for the 911. I was in a panic! I knew I had to get the insulin after work and administer by 7 pm. I did end up calling the vet and asking to prescribe Lantus after reading up on the Novolin. The vet never mentioned at home testing and doesn't even want to see Bear again for another month or two. I thought they brought you in a week later once you start insulin? I am going to order the at home testing supplies today and read up on it.

I started Bear on the Lantus last night (2 units). I went over again this morning at gave it to him at 7 am. It looks like i'll be going over every morning before work after i walk my dogs. This is all so very overwhelming. I was already stretched thin and running myself ragged. I'm prayign that i can keep up with this. To make matters worse, i'm recovering from back surgery that was exactly two weeks ago. My evenings are crazy. Home from work, walk my dogs, feed them dinner, run to my moms to feed the cats and hangout for a little while, back home to walk my dogs. Most nights i don't have time to eat dinner myself. Please tell me that there is a chance of Bear not needing insulin forever? When will i know he doesn't need it? The vet never even told me his #'s. I called yesterday about the RX and asked his BG # and was told 306. That doesn't sound liek it's off the charts. Maybe it's because of his raw diet? However the walking issue is really heartbreaking. I am praying that we can help with that.

I will read up on the "helping us to help you" link today and do what is needed. Thank you very much for all of the information!

 

[Tinah0505]

Two units is a high starting dose. Most cats start at 1/2 to 1 unit. I recommend starting at 1/2 unit until you start testing and know what his glucose levels are. Also did the vet determine he was diabetic through a fructosomine test or just a single glucose reading? If it is a glucose reading that is not the proper way to diagnose diabetes. A fructosomine test is a average glucose similar to A1C test for humans. A glucose test only shows what the level is at the time the test is taken. There are many things that can affect that reading including vet stress. Since he is already on a raw diet and your vets original treatment plan, make me question the diagnosis.

If you haven't already read this, please read the sticky on treating hypoglycemia. This can happen when glucose levels drop too low. I recommend that have corn syrup on hand. Hopefully you will never need it, but you don't want to be without it if you do https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

I am not sure how he determined it. He took a blood test and then made us come back two days later to get urine to confirm the diagnosis. Now i'm nervous that I'm giving too much. Thank you for the link. I'm going to read now. The problem is that i do not live with Bear. He resides at my moms house because i'm in an apartment with two dogs. I go over there every day (now two times a day to administer insulin). She is only a few blocks away and fortunately she is retired and home all day. I will tell her to keep a close eye and have the corn syrup ready just in case in happens while i'm at work.

 

[Lisa and Witn (GA)]

As you probably have figured it out, this is the best place to get the info for caring for your cat. This board has been a life saver for many cats. Everyone here has had a least one diabetic cat and many of adopted other diabetic cats later. We are here to help you.

 

[Lisa and Witn (GA)]

I am not sure how he determined it. He took a blood test and then made us come back two days later to get urine to confirm the diagnosis. Now i'm nervous that I'm giving too much. Thank you for the link. I'm going to read now. The problem is that i do not live with Bear. He resides at my moms house because i'm in an apartment with two dogs. I go over there every day (now two times a day to administer insulin). She is only a few blocks away and fortunately she is retired and home all day. I will tell her to keep a close eye and have the corn syrup ready just in case in happens while i'm at work.

Can you get a copy of the tests and results? We can help you determine which test was used.

 

[Diane Tyler's Mom GA]

Please tell me that there is a chance of Bear not needing insulin forever? When will i know he doesn't need it?

I'm sorry that you have so much on your plate. I'm sorry to tell you but the only way you would know if Bear will not need anymore insulin is to teach your mom how to test him throughout each 12 hour cycle to see how the lantus is working , how low he's dropping . If you only test him once in the AM and once in the PM you will never know if an increase or decrease is needed.
Did you get the meter yet?
When you do get it you need to tell your mom not to feed Bear 2 hours before you test him. You don't want his BG number to be food influenced.
Plus you need to see that his BG number is safe enough to give him insulin.
With new members we usually advise don't give it if his number is under 200.
If it is we suggest to stall, don't feed and test again in 20 minutes to see if it comes up on his own. That's where your mom would come in because I know you need to get to work.
Even if your mom can get one test in @+6 ( 6 hours after the shot) that's usually the lowest point during the cycle.
She would need to do this at night also
There would be no way that we could tell how the insulin is working by only testing once in the AM and once in the PM .
So your shooting times are 7 AM and 7 PM from what you said.
So maybe you can teach your mom how to test Bear, the more tests the better if she can do it. I'm going to tag Bhooma @Bandit's Mom to message you to set up your signature and spreadsheet because you have so much going on
@Bandit's Mom

 

[Diane Tyler's Mom GA]

I know you are feeding Bear raw but you should have a few of these cans in case you have to bring his BG up to safe numbers
Such as

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
And some honey in the house

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-
11% -15 is medium carbs.

16- 24 is high carb.

 

[Noah & me (GA)]

since i work all day and the cat is at my moms

Sorry but this isn't going to work in the long term. What's keeping you from having the cat at your place? Have you got a meter, lancing tools etc?
Before you answer that know that people don't come here to get snickered at or shamed and no question is too stupid. As someone else already pointed out we all started somewhere and 99% of the people here have no scientific training. We figured this out by ourselves and as a group over 30+ years and that's despite what poorly trained vets tell us. It's mostly not their fault, so few cats are diabetic it's not taught well at veterinary colleges.
If you can bring him home you'll have a much better understanding of his cycles and get a routine established. There's a lot to take in so just take it one day at a time and prioritize. More than anything remember that cats do not die from diabetes, it will eventually just become an inconvenience.
It would help if your user profile had some more basic info. The cats name, age, preexisting medical conditions. Your location (without giving away too much) and any constraints regarding time and money.
Trust me, this really is the best place you can be right now.