New Member

[Marje and Gracie]

Summer

You’ve been doing great testing last night and today. Thank you so much. You can see that Susie dropped an enormous amount in one hour last night. Any drop in excess of 50 mg/dL in an hour is a steep dive and that’s why you are seeing the BGs you are today. You can now see what we suspect has been happening....she’s dropping quickly at night which sets off a hard bounce the next day.

I use Whole Life freeze dried treats. My cats also did not like Pure Bites.

 

[Summer and Susie (GA)]

Thank you.

If you have any chance to look around this site, you’ll see that we do not support the existence of Somogyi in cats. One of our most experienced member and a moderator, Sienne, has access to a university medical library and is in the medical field herself. She has done extensive research on this subject. Roomp and Rand have also dismissed the existence of Somogyi in cats. In actuality, it hasn’t actually been proven to occur in humans but the difference between Somogyi, in its theory, and bouncing is that Somogyi results from a chronic overdose.

Hi, thanks for the clarification. I appreciate the distinction you noted in the use of "if" and completely agree with you. As for the question about correlation between lows and highs I would point out that the word I used was "unproven" not "unknown". I chose that word very deliberately because I'm personally not convinced, and some literature supports my skepticism. Correlation and causation are tricky. Somogyi is still referred to in some literature as a theory. I'm not definitively saying it's not real, I'm just saying that in my cat it is not proven.

With all due respect and many apologies, I'm not ready to repost my SS here yet. My partner has asked me not to do so, which is reasonable, given Sergei's current situation. Numbers lead to advice and advice makes it very easy to second guess my vets instructions and to get off plan. Eventually I may be happy to do so again.

Scott, I have to agree with you on the advice. I appreciate the advice I am receiving on this site and it is sometimes contradictory to what my vet says so I am torn between the two. I am learning to present the advice I get on this site to my vet and we talk about it. I do think the information I receive here is probably better than my "very busy" vets but it is hard to go against his medical advice.

 

[Summer and Susie (GA)]

Summer

You’ve been doing great testing last night and today. Thank you so much. You can see that Susie dropped an enormous amount in one hour last night. Any drop in excess of 50 mg/dL in an hour is a steep dive and that’s why you are seeing the BGs you are today. You can now see what we suspect has been happening....she’s dropping quickly at night which sets off a hard bounce the next day.

I use Whole Life freeze dried treats. My cats also did not like Pure Bites.

When I saw her numbers dropping last night it concerned me. That is why I did the 9:00 pm test. I could not go to sleep until I saw the number was starting to come up. Thanks for the tip about the treats. I will order her some Whole Life.

 

[Marje and Gracie]

When I saw her numbers dropping last night it concerned me. That is why I did the 9:00 pm test. I could not go to sleep until I saw the number was starting to come up. Thanks for the tip about the treats. I will order her some Whole Life.

I order from chewy.com. They are quick, have great customer service, and you can get a smaller size to start to be sure she likes them. They also have flavors other than chicken.

 

[Summer and Susie (GA)]

I order from chewy.com. They are quick, have great customer service, and you can get a smaller size to start to be sure she likes them. They also have flavors other than chicken.

Thanks! I get almost all my pet supplies (dogs, cat, bird) from Chewy. I honestly don't know how they get my orders to me so quickly. I think they are in Florida so that would help. Thanks, Marje. More questions: Do you have any cats now? Where did you get all your diabetes expertise? Are you a vet? I hope you have a cat or two now. I could tell that losing Gracie was very painful. I, too, have lost many beloved cats and dogs during my lifetime. I went through the kidney disease nightmare with a beloved cat two years ago. There isn't much you can do when you discover it late and that is why I always do a senior panel blood test at least once a year. I only had my Simon for two weeks after his diagnosis. I will say one thing, though. The kidney disease was "cut and dried". There were only a few things I could do to help - until the end. The diabetes, although not the "death sentence" with the kidney disease, is so, so much more complicated. One of these days I pray I will understand how all this works.

 

[Summer and Susie (GA)]

I order from chewy.com. They are quick, have great customer service, and you can get a smaller size to start to be sure she likes them. They also have flavors other than chicken.

Marje, not happy with the +10. 5 test before dinner tonight. It was 398. I tried to hold out longer but Susie needed to be fed, again, and she is not used to this long delay in the afternoon. I do not want to cause more stress for her because I do know stress affects the numbers. Please tell me how to order Lantus from Canada? I just don't think the Vetsulin is lasting for the 11 to 12 hours that she needs. My vet is onboard with changing from Vetsulin to Lantus but tells me the Lantus is very expensive. I need advice and I need to know how to transition from Vetsulin to Lantus. Thanks.

 

[Marje and Gracie]

Thanks! I get almost all my pet supplies (dogs, cat, bird) from Chewy. I honestly don't know how they get my orders to me so quickly. I think they are in Florida so that would help. Thanks, Marje. More questions: Do you have any cats now? Where did you get all your diabetes expertise? Are you a vet? I hope you have a cat or two now. I could tell that losing Gracie was very painful. I, too, have lost many beloved cats and dogs during my lifetime. I went through the kidney disease nightmare with a beloved cat two years ago. There isn't much you can do when you discover it late and that is why I always do a senior panel blood test at least once a year. I only had my Simon for two weeks after his diagnosis. I will say one thing, though. The kidney disease was "cut and dried". There were only a few things I could do to help - until the end. The diabetes, although not the "death sentence" with the kidney disease, is so, so much more complicated. One of these days I pray I will understand how all this works.

You’re welcome. Chewy is great!

I have two cats now: 10 yr old Tobey who we got as a baby right before Gracie was dx with FD and who was very, very close to her and 4 yr old Livia who we got nine months after Gracie crossed because Tobey was so very sad. I’ve had cats nonstop for 59 years. I’m not a vet but I do have an MS in wildlife biology and have taught classes such as anatomy & physiology at the university level. But....I learned every single thing I know about FD from the wonderful people here. My main mentor, Jill, who was one of the first to use Lantus and the TR protocol with her kitty, Alex, and who was a long-time moderator here, suddenly passed away Sept 28, 2019. It was devastating for us all here on the board, especially those of us who had known and worked with her for many, many years. There were a couple other extremely wise people/moderators here then, as well. Sienne, another current mod, taught me a lot and she along with the third moderator, Wendy, and I have a close relationship. We share a lot of knowledge as we each find it.

I am very, very sorry about your Simon. You are smart to do the senior panels. Even with Liv, I do a senior panel twice a year and most certainly have done it with Tobey (and Gracie) for many years. I also weigh my cats every two weeks. Unlike a lot of kitties here, Gracie was not showing clinical signs of FD but a day or so before I took her in so she was dx really fast. Yes, I agree, FD is certainly more complicated. There are some great resources for CKD and my last CKD kitty was extremely stable over four years in stage 3 when he passed from lymphoma. He was not our only CKD kitty but only one actually passed from it and he actually had genetic polycystic kidney disease (PKD) which, clinically presents as CKD, but is much, much worse. It is almost I,possible to keep a PKD cat stable once they are showing clinical signs and lab values increase. They go downhill very fast.

@Sergei Thanks for the RVC video. I just got a chance to watch it and it’s quite interesting that, this forum, as far back as I know which even precedes me joining, we’ve stressed knowing the “5Ps” of one’s diabetic kitty: peeing, pooping, purring, preening, playing. When we first came on, in fact, everyone in the Lantus group would discuss their kitty’s 5Ps as we have long recognized those clinical signs are as important as the BG. While they don’t include weight loss, that became part of the discussion for each cat if it was losing weight.

 

[Marje and Gracie]

Marje, not happy with the +10. 5 test before dinner tonight. It was 398. I tried to hold out longer but Susie needed to be fed, again, and she is not used to this long delay in the afternoon. I do not want to cause more stress for her because I do know stress affects the numbers. Please tell me how to order Lantus from Canada? I just don't think the Vetsulin is lasting for the 11 to 12 hours that she needs. My vet is onboard with changing from Vetsulin to Lantus but tells me the Lantus is very expensive. I need advice and I need to know how to transition from Vetsulin to Lantus. Thanks.

First, check the Supply Closet on this forum. Sometimes there are Lantus pens there for sale or to give away. If there are none, here is a post regarding the purchase of insulin from Canada. You will also need to buy U100, 0.3cc syringes (most of us use 31g), with 1/2 unit markings. I wish I could recommend a specific one for you but I used Terumos and they no longer make them but you can use the search box to search “syringes” on the Lantus/Levemir ISG and you’ll get a lot of posts that recommend different ones. You cannot use the U40 syringes you are currently using. American Diabetes Wholesale (online) is where I always bought my syringes and even though they no longer carry them, they have others. I know Walmart sells ReliOn syringes of the correct specification but I, personally, didn’t like them; however, many people use them and like them. That’s what Jill always used.

Insofar as how to transition from one to the other, once you get the Lantus and set a date to start, then we will look at her SS and make the dose suggestion to you. I suggest starting on an a.m. cycle so you can test. We determine how the current dose is working on Vetsulin and then use that to suggest a Lantus dose. As an example, if a cat has been on, say, 2u of Vetsulin and seen nothing but the 300s and the caregiver had been testing enough for us to know the BG isn’t going lower than that, we’d start the cat on 2.5u Lantus. Conversely, if the cat on Vetsulin has been seeing a lot of blue nadirs, we’d start the Lantus dose at either the same dose or beck it down 0.25u depending on how low in the 100s the cat was getting. But we don’t decide until the day or so before you want to switch.

 

[Diane Tyler's Mom GA]

https://rxcanada4less.com Marks Marine pharmacy

Here is the link for Canada with the pens we use them like a vial because with the pens you can only increase or decrease by whole units, so you would just take your syringe and stick it in the little grey rubber stopper and just draw the insulin from that







Lantus Solostar Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


Like I said you are better off buying the 5 pack of pens
They will last you way over a year depending on how many units you give
After your vet writes the first script you won't ever need another script.
Call them and will tell you what to do
They are very nice people

Oh when you buy the pens they will have an expiration date on them
Most likely 2022 or 2023 by now.
Put them in the frig , a middle shelf
As long as you don't puncture them they will be good until the expiration date
So you are actually saving a ton of money


We also use syringes with half unit markings.
We increase or decrease by 0.25 units at a time.
It makes it easier using the half unit syringessyringes
For Lantus you will be using U-100 syringes
Have your vet write the script for the 5 pack of pens

 

[Summer and Susie (GA)]

https://rxcanada4less.com Marks Marine pharmacy

Here is the link for Canada with the pens we use them like a vial because with the pens you can only increase or decrease by whole units, so you would just take your syringe and stick it in the little grey rubber stopper and just draw the insulin from that







Lantus Solostar Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


Like I said you are better off buying the 5 pack of pens
They will last you way over a year depending on how many units you give
After your vet writes the first script you won't ever need another script.
Call them and will tell you what to do
They are very nice people

Oh when you buy the pens they will have an expiration date on them
Most likely 2022 or 2023 by now.
Put them in the frig , a middle shelf
As long as you don't puncture them they will be good until the expiration date
So you are actually saving a ton of money

First, check the Supply Closet on this forum. Sometimes there are Lantus pens there for sale or to give away. If there are none, here is a post regarding the purchase of insulin from Canada. You will also need to buy U100, 0.3cc syringes (most of us use 31g), with 1/2 unit markings. I wish I could recommend a specific one for you but I used Terumos and they no longer make them but you can use the search box to search “syringes” on the Lantus/Levemir ISG and you’ll get a lot of posts that recommend different ones. You cannot use the U40 syringes you are currently using. American Diabetes Wholesale (online) is where I always bought my syringes and even though they no longer carry them, they have others. I know Walmart sells ReliOn syringes of the correct specification but I, personally, didn’t like them; however, many people use them and like them. That’s what Jill always used.

Insofar as how to transition from one to the other, once you get the Lantus and set a date to start, then we will look at her SS and make the dose suggestion to you. I suggest starting on an a.m. cycle so you can test. We determine how the current dose is working on Vetsulin and then use that to suggest a Lantus dose. As an example, if a cat has been on, say, 2u of Vetsulin and seen nothing but the 300s and the caregiver had been testing enough for us to know the BG isn’t going lower than that, we’d start the cat on 2.5u Lantus. Conversely, if the cat on Vetsulin has been seeing a lot of blue nadirs, we’d start the Lantus dose at either the same dose or beck it down 0.25u depending on how low in the 100s the cat was getting. But we don’t decide until the day or so before you want to switch.

I will check all this out tomorrow morning. Right now I AM IN SHOCK! She just had a 521 glucose score one hour after her nighttime shot. I am so stressed about her health and everything else going on in this country. I will look at this tomorrow. Thank you.


We also use syringes with half unit markings.
We increase or decrease by 0.25 units at a time.
It makes it easier using the half unit syringessyringes
For Lantus you will be using U-100 syringes
Have your vet write the script for the 5 pack of pens

 

[Diane Tyler's Mom GA]

https://www.adwdiabetes.com/product...100-vet-rx-half-unit-syringes-31g-3-10cc-60ct

These are from ADW Diabetes to use with Lantus if you switch

You can also post and ask what other members use

 

[Diane Tyler's Mom GA]

https://www.adwdiabetes.com/product/16367/carepoint-vet-u-100-pet-syringe-31g-half-unit

Another brand from ADW Diabetes , they ship pretty fast

I posted promo codes below

 

[Diane Tyler's Mom GA]

Management Affordable.

ADW Diabetes Storewide Promotions
ADW5OFF

Take an additional $5.00 off all orders of $50.00 or more!

DIA10

10% off your next order!

 

[Summer and Susie (GA)]

https://rxcanada4less.com Marks Marine pharmacy

Here is the link for Canada with the pens we use them like a vial because with the pens you can only increase or decrease by whole units, so you would just take your syringe and stick it in the little grey rubber stopper and just draw the insulin from that







Lantus Solostar Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


Like I said you are better off buying the 5 pack of pens
They will last you way over a year depending on how many units you give
After your vet writes the first script you won't ever need another script.
Call them and will tell you what to do
They are very nice people

Oh when you buy the pens they will have an expiration date on them
Most likely 2022 or 2023 by now.
Put them in the frig , a middle shelf
As long as you don't puncture them they will be good until the expiration date
So you are actually saving a ton of money
Okay, I will look at all this tomorrow. My cat is getting worse and worse with the diabetes. She scored a 521 tonight after her dinnertime meal and shot. I am feeling hopeless. Maybe I need to take her back to the vet for further blood test. This just does not seen right and I am already overwhelmed with everything going on in the county right now.

We also use syringes with half unit markings.
We increase or decrease by 0.25 units at a time.
It makes it easier using the half unit syringessyringes
For Lantus you will be using U-100 syringes
Have your vet write the script for the 5 pack of pens

 

[Summer and Susie (GA)]

Management Affordable.

ADW Diabetes Storewide Promotions
ADW5OFF

Take an additional $5.00 off all orders of $50.00 or more!

DIA10

10% off your next order!

Thank you, Diane. Right now I am overwhelmed with a score of 521 tonight. I have never gotten into the 500's and rarely the 400's. I don't know how to handle all of this. What am I doing wrong with Susie?

 

[Diane Tyler's Mom GA]

@Summer and Susie
Hi Summer , I'm sorry but I it's been ages since I used Vetsulin
Can you try tagging members that have helped you in the past .
and ask them

 

[Marje and Gracie]

Thank you, Diane. Right now I am overwhelmed with a score of 521 tonight. I have never gotten into the 500's and rarely the 400's. I don't know how to handle all of this. What am I doing wrong with Susie?

You are seeing bouncing plus lack of duration. It also looks like +1 might have some food spike in it. You are starting to see her onset looks to be +2.

I wouldn’t make the assumption you are doing anything wrong. IMHO, Susie was probably getting into some of these higher numbers but because you weren’t testing, you didn’t know. I think she’s been diving and bouncing back up for a bit.

Just as an example, here is a kitty following TR on Lantus. Look where he started (look at his 2020 SS), then he got regulated, then tightly regulated, and he just now started an OTJ (off-the-juice) trial. Susie’s SS looks much better than his did at the same length of time being FD.

One last thing: thanks for changing the PMPS to show you are shooting early. Because shots are supposed to be 12 hours apart, if you are not giving her a.m. shot at the same time as the p.m., then it’s not at +12. If you are shooting the PMPS at 4:45, for example, and the AMPS at 6:15, then the AMPS is not at +12 but at +13.25 (12 + 1-1/4 hours after PMPS). Could you please make those adjustments on her SS to show AMPS is not at +12? Again, what you are doing with this is not something we suggest here.

I would suggest you feed Susie a little bit around +5 and then give her a few freeze dried treats at +9 to hold her over. They are very LC if you just get the meat and won’t affect her BG. Then you can be sure you are shooting at +12 each cycle. Where there’s a will...there’s a way. Cats adjust.

 

[Sergei]

Thank you.

If you have any chance to look around this site, you’ll see that we do not support the existence of Somogyi in cats. One of our most experienced members and a moderator, Sienne, has access to a university medical library and is in the medical field herself. She has done extensive research on this subject. Roomp and Rand have also dismissed the existence of Somogyi in cats. It hasn’t actually been proven to occur in humans but the difference between Somogyi, in its theory, and bouncing is that Somogyi results from a chronic overdose.

Hi Marje, The suggested operation behind the "bounce" sounds a whole lot like the suggested operation behind Symogi. That's why I connected the two in my interpretation. But never mind, it's not really the concept of "bounce" that concerns me but rather the certainty with which it is often asserted on this board. It's a convenient explanation for the higher numbers that follow lows, but is it necessarily always the correct correlation? Does "bouncing" have a scientific name? To tell someone their cat is "bouncing" involves a level of certainty that not even my specialist could give me about inconsistencies in my cat's glucose levels. Instead, the problem of inconsistency was presented to us very speculatively: "duration of insulin action might be at fault as well as this variability." To be told then here on this board that a cat is definitively bouncing seems not to be introducing adequate uncertainty into the discussion. It also might influence me to believe that I can probably correct the problem through different management or push me toward a preferred insulin and protocol. I've noticed an interactive approach on the board that moves the owner ever closer to tight regulation on glargine insulin. First up is the message that if you are on anything other than glargine your cat is at risk of x, y and z and will probably not achieve remission. That is followed by the urgency to immediately increase our testing and then increase from there. So I think it is an underlying strategy (fine to have a strategy but I think the site should be a little more open and direct about it). I have no problem with tight regulation, home testing, or glargine insulin. Each are tools with upsides and downsides. In my opinion, they are too often presented here as ideal tools to treating feline diabetes, and the only ones that will achieve the oversold probability of remission—something some reputable researchers question.

But more concerning to me is that explanations like "bouncing" and dosing advice are sometimes forcefully and incautiously given and not always based on anything more solid than some combination of speculation, hope, personal experience, a lay interpretation of literature, and perhaps a pinch of orthodoxy. This is how confidence in the protocol is sold: "I know what to do!" No physical examination of the cat is ever involved and the "experts" here often rely on biased or incomplete health histories of the cat. When one is in a confused situation with a newly diagnosed cat and everything feels urgent, it's very easy to offer advice as an act of kindness and to accept advice as an act of desperation. And in the end, should someone on the board happens to tell me to do something that accidentally harms my cat, that person never has to answer to anyone. Those are my concerns about "bounce."

 

[Summer and Susie (GA)]

You are seeing bouncing plus lack of duration. It also looks like +1 might have some food spike in it. You are starting to see her onset looks to be +2.

I wouldn’t make the assumption you are doing anything wrong. IMHO, Susie was probably getting into some of these higher numbers but because you weren’t testing, you didn’t know. I think she’s been diving and bouncing back up for a bit.

Just as an example, here is a kitty following TR on Lantus. Look where he started (look at his 2020 SS), then he got regulated, then tightly regulated, and he just now started an OTJ (off-the-juice) trial. Susie’s SS looks much better than his did at the same length of time being FD.

One last thing: thanks for changing the PMPS to show you are shooting early. Because shots are supposed to be 12 hours apart, if you are not giving her a.m. shot at the same time as the p.m., then it’s not at +12. If you are shooting the PMPS at 4:45, for example, and the AMPS at 6:15, then the AMPS is not at +12 but at +13.25 (12 + 1-1/4 hours after PMPS). Could you please make those adjustments on her SS to show AMPS is not at +12? Again, what you are doing with this is not something we suggest here.

I would suggest you feed Susie a little bit around +5 and then give her a few freeze dried treats at +9 to hold her over. They are very LC if you just get the meat and won’t affect her BG. Then you can be sure you are shooting at +12 each cycle. Where there’s a will...there’s a way. Cats adjust.

Gideon Blue's Spreadsheet certainly did improve in the later part of the year. What did this owner do to get the diabetes in control? Was it just the length of time he was being treated? I did see adjustments in the insulin dosage. Do you think I need to adjust Susie's insulin to 1.5 units. I will try your plan of feeding her a little around +5 and then giving a few treats at +9. Anything I can do to get her to hold out the 12 hours I will but I don't like the feeling that I am depriving her of food when I can tell she is very hungry. I will be looking at the Lantus but want to use up the Vetsulin first. My vet is hesitant to switch me to a human meter. He likes that the AT is designed for dogs and cats. Did I mention that I have purchased a scale and when I receive it I can track her weight. A couple of other questions. I am worried about infection in the ear tips from all the poking. Should I be using neosporin on her ears instead of the vaseline?
Also, I still don't have an explanation for the "Dosing Method (SLGS or TR)"? I don't know what this is and what Susie is on?

 

[Summer and Susie (GA)]

Diane, I appreciate the coupons and contact info. I would prefer to use a vial and not the pen. I am used to vials now and used them when my husband had diabetes. Is there a problem with that. I don't know if my current syringes would be appropriate but could check with my vet or the pharmacy. I'm holding off on order the Lantus - for now. I spent a lot on the Vetsulin and would like to use that up first.

 

[Summer and Susie (GA)]

https://www.adwdiabetes.com/product/16367/carepoint-vet-u-100-pet-syringe-31g-half-unit

Another brand from ADW Diabetes , they ship pretty fast

I posted promo codes below

I assume these are for Lantus vials? Thanks, Diane. The syringes I can afford. Everything else is expensive. Never mind, I got my answer from your other post. Thanks.

 

[Summer and Susie (GA)]

https://rxcanada4less.com Marks Marine pharmacy

Here is the link for Canada with the pens we use them like a vial because with the pens you can only increase or decrease by whole units, so you would just take your syringe and stick it in the little grey rubber stopper and just draw the insulin from that







Lantus Solostar Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


Like I said you are better off buying the 5 pack of pens
They will last you way over a year depending on how many units you give
After your vet writes the first script you won't ever need another script.
Call them and will tell you what to do
They are very nice people

Oh when you buy the pens they will have an expiration date on them
Most likely 2022 or 2023 by now.
Put them in the frig , a middle shelf
As long as you don't puncture them they will be good until the expiration date
So you are actually saving a ton of money


We also use syringes with half unit markings.
We increase or decrease by 0.25 units at a time.
It makes it easier using the half unit syringessyringes
For Lantus you will be using U-100 syringes
Have your vet write the script for the 5 pack of pens

It has been a really long time since I have used a pen. I think I would be more comfortable with the vial with the half unit markings. Thank you for all this information.

 

[Summer and Susie (GA)]

First, check the Supply Closet on this forum. Sometimes there are Lantus pens there for sale or to give away. If there are none, here is a post regarding the purchase of insulin from Canada. You will also need to buy U100, 0.3cc syringes (most of us use 31g), with 1/2 unit markings. I wish I could recommend a specific one for you but I used Terumos and they no longer make them but you can use the search box to search “syringes” on the Lantus/Levemir ISG and you’ll get a lot of posts that recommend different ones. You cannot use the U40 syringes you are currently using. American Diabetes Wholesale (online) is where I always bought my syringes and even though they no longer carry them, they have others. I know Walmart sells ReliOn syringes of the correct specification but I, personally, didn’t like them; however, many people use them and like them. That’s what Jill always used.

Insofar as how to transition from one to the other, once you get the Lantus and set a date to start, then we will look at her SS and make the dose suggestion to you. I suggest starting on an a.m. cycle so you can test. We determine how the current dose is working on Vetsulin and then use that to suggest a Lantus dose. As an example, if a cat has been on, say, 2u of Vetsulin and seen nothing but the 300s and the caregiver had been testing enough for us to know the BG isn’t going lower than that, we’d start the cat on 2.5u Lantus. Conversely, if the cat on Vetsulin has been seeing a lot of blue nadirs, we’d start the Lantus dose at either the same dose or beck it down 0.25u depending on how low in the 100s the cat was getting. But we don’t decide until the day or so before you want to switch.

Thanks. I have been wanting this information for when I do switch to the Lantus vials and new syringes.

 

[Summer and Susie (GA)]

You’re welcome. Chewy is great!

I have two cats now: 10 yr old Tobey who we got as a baby right before Gracie was dx with FD and who was very, very close to her and 4 yr old Livia who we got nine months after Gracie crossed because Tobey was so very sad. I’ve had cats nonstop for 59 years. I’m not a vet but I do have an MS in wildlife biology and have taught classes such as anatomy & physiology at the university level. But....I learned every single thing I know about FD from the wonderful people here. My main mentor, Jill, who was one of the first to use Lantus and the TR protocol with her kitty, Alex, and who was a long-time moderator here, suddenly passed away Sept 28, 2019. It was devastating for us all here on the board, especially those of us who had known and worked with her for many, many years. There were a couple other extremely wise people/moderators here then, as well. Sienne, another current mod, taught me a lot and she along with the third moderator, Wendy, and I have a close relationship. We share a lot of knowledge as we each find it.

I am very, very sorry about your Simon. You are smart to do the senior panels. Even with Liv, I do a senior panel twice a year and most certainly have done it with Tobey (and Gracie) for many years. I also weigh my cats every two weeks. Unlike a lot of kitties here, Gracie was not showing clinical signs of FD but a day or so before I took her in so she was dx really fast. Yes, I agree, FD is certainly more complicated. There are some great resources for CKD and my last CKD kitty was extremely stable over four years in stage 3 when he passed from lymphoma. He was not our only CKD kitty but only one actually passed from it and he actually had genetic polycystic kidney disease (PKD) which, clinically presents as CKD, but is much, much worse. It is almost I,possible to keep a PKD cat stable once they are showing clinical signs and lab values increase. They go downhill very fast.

@Sergei Thanks for the RVC video. I just got a chance to watch it and it’s quite interesting that, this forum, as far back as I know which even precedes me joining, we’ve stressed knowing the “5Ps” of one’s diabetic kitty: peeing, pooping, purring, preening, playing. When we first came on, in fact, everyone in the Lantus group would discuss their kitty’s 5Ps as we have long recognized those clinical signs are as important as the BG. While they don’t include weight loss, that became part of the discussion for each cat if it was losing weight.

By the way, I'm impressed with your background! Love the MS in Wildlife Biology.
Amazing that you CKD kitty was stable for over four years in stage 3. Simon was diagnosed in stage 4 and, like he said, he went downhill very quickly. The subcu fluids seemed to make him feel better everytime but he just stopped eating and I was trying for feed him through a syringe but it was obvious that he needed to go. My vet told me I should get Susie down to 10 lbs. That was shocking to me. Last she was weighed she was 14.6. Don't cats lose weight on diabetes? So here I am trying to get her weight down, normally, but I won't know if the weight loss is from diabetes complications. Another confusing factor.

 

[Summer and Susie (GA)]

Hi Summer, I’m glad that you got some value from the video. I shared it because, as you said, not everyone has access to a specialist, and I am happy to share what I can of that experience with others so that they can maybe consider clinical approaches to the disease. I thought the video might be a helpful complement to other information you’ve received, especially after I read that your vet kept telling you to test less. My vet said the same thing to me! The video, in my opinion, contains a clue about what’s going on there. I think a lot of vets are trained to listen for certain details from their patients like, “my cat is asking me for water from the faucet ten times a day” or “I just hauled a huge bag full of litter clumps from the box; this is not right” or “my cat has lost 1 kilo this month and he eats like a horse but acts like he’s starving.” If instead they hear “my cat’s blood glucose level was 350 at +4, something must be wrong!” they may not be hearing what we really mean to say, which is, “My cat is ill, and I am worried about it.” That’s precisely what happened between me and my vet. I kept sending her glucose readings that were high and she kept saying test less. I thought she would intuit from the BG numbers that Sergei was not feeling well. She didn’t. And he kept getting sicker. Perhaps the RVC score was developed to help clients learn how to get their vets to hear them: talk about thirst and urine quantity and attitude.

You asked what insulin we are using. We started with Caninsulin (Vetsulin). They started Serg at a dose of 2.5U, which turned out to be the max he could safely take. Our lowest test came back around 60 (3.3), so we knew Caninsulin could get him down to greens. And it even seemed to have good duration. Our first curve was surprisingly lovely. He went to 108 (6) at +7. The problem was that for whatever reason, shortly thereafter the insulin just stopped having good effect and symptoms came back. We speculated about failures within the VetPen itself, failure of the particular vials of insulin, failures of administration. Everything got looked at. Specialist just noted variability and duration as possible problems. He switched us to ProZinc and said if that is not optimal then we can go to Lantus. As for our meter, we use Contour. We are in Europe, so the brands may be different than where you are. Our vet uses FreeStyle Lite and as I mentioned, there is some divergence between the two meters. Above 180 the divergence is pretty significant. Alphatrack 2 is supposed to be the meter calibrated for cats, right? To me that seems like a pretty reasonable benefit. I’ve heard the strips are more expensive, but I would be glad sometimes not to worry about how far off I am from cat calibration. You’ll get a lot of advice from people here. And they genuinely mean well. But it can be overwhelming to feel like everything you are doing is wrong. I’ve had to let that go a bit and just give myself space to do things my own way.

For the record, I’m not opposed to letting others see my data, so if you want to have a look, I’d be glad to make it available to you. My partner has asked me not to post it here publicly and since I don’t really accept dosing advice from anyone other than my vet, its value here is pretty limited. I keep my discussions here to things like helpful extra tools, moral support, and cat snack chat. It can feel like a lonely, overwhelming disease sometimes. It’s good to find a place where others understand what you are going through.

I think you are the first person on this site to not admonish Vetsulin. I sometimes also worry about the duration of the strength and when I get really high numbers at +1 it doesn't make sense. Thanks for offering to show me Sergei's data but I think right now I am overwhelmed with everyone's data. You can tell me if you know of any good cat treats. I know you are not in the US but I would still be interested. My cat didn't like PureBites and I just ordered from Whole Life (freeze dried). What do you buy or do you make your own? Thanks, again, for your support!

 

[Marje and Gracie]

The suggested operation behind the "bounce" sounds a whole lot like the suggested operation behind Symogi.

Sounds like it but if you read my statement in a post above, Somogyi, in theory, is caused by chronic overdose. Bouncing also known as rebound is typically caused by dropping into lower numbers than the liver is accustomed or steep dives. Unfortunately, many sources that discuss Somogyi use the term “hyperglycemic rebound” but it is not the same, in concept, as the rebound we see here which is not caused by a chronic overdose.

it's not really the concept of "bounce" that concerns me but rather the certainty with which it is often asserted on this board

You are correct here but if you look at my post 147 above, you’ll see I mention lack of duration. In fact, I’m one of two currently on this board who can spot lack of duration and if you were to search “lack of duration” and my user ID in the LBL forum, you would find I’ve mentioned it many times. Sadly, members see numbers go up, they automatically assume it’s a bounce. The two of us who understand lack of duration and what it looks like can’t be everywhere to discount that. We try to stress that it’s important that members understand their cats onset, nadir, and duration. Most do not....a handful will try but most focus on nadir which is only a small part of the picture. It also takes time and studying hundreds of SSs to be able to identify loss of duration and most members dealing with diabetic cats don’t have the time to do that.

We do encourage the use of Lantus or Levemir here primarily because of their longer duration which benefits the health of the cat. They also have a higher rate of remission. They are also less harsh insulins with less of a chance of symptomatic hypoglycemia. That does not mean it can’t happen; it can and it does although if members follow our methods of regulation here and test, it is very less often to occur and thankfully, there have only been a few losses of cats due to hypoglycemia using the L insulins on this board and only one that I can think of who was a member here for a long time and got complacent. The others were new members who found us when their cat had suffered the symptoms or were already in the hospital or had passed. Tight regulation is the primary method that we support for use of the L insulins. That’s our choice on this board. There are other boards that use different methods and even sliding scale dosing of the L insulins. We use what we feel is the safest and best backed in published research. SLGS is the original method of regulation used here, until the L insulins and TR came along. Members not using the L insulins or PZ (which members can use modified dosing similar to TR) use SLGS.

I wonder if you’ve ever taken the time to read through the massive amounts of material on this board, much backed up by scientific research and referenced where we can. Is some anecdotal...certainly but we have had a lot of really smart people contribute to these documents including vets like Dr. Lisa, vet techs with solid backgrounds, other healthcare professionals with access to medical publications, and others who have taken the time to do the research through the literature. Check out our Health Forum and FAQs. Our information also comes from a relationship we share with the German diabetic cat forum which was the first to use TR as developed by Kirsten Roomp. You should google her CV. I am still in touch with her.

We do not proclaim to be vets here and it’s written on many, many stickys that we are not. I don’t spend much time on Main Health or the other ISGs than LBL but it’s frequent that members will post their vet’s exam info or their labs. We do ask how the cat is doing clinically and you can search a phrase like “ because our cats are not just their BGs” or “numbers”. Is it perfect here? No, but what site is? We strive for safety first. Our members are trying to do their best and give support. Our rate of remission in LBL cats is quite high and we do it safely. The bottom line is any member can choose which of the diabetic boards they want to post on and any member can choose to not be here. Our forum has been in existence the longest and we often get many members from other boards and FB. We’ve saved many, many diabetic kitties lives, including my Gracie, that would have likely otherwise been lost to hypoglycemia based on their vet’s advice. So you decide which is more problematic.

I’m happy to discuss with you further but you should start your own thread so we don’t hijack this one about Susie. Thanks very much.

 

[Marje and Gracie]

Gideon Blue's Spreadsheet certainly did improve in the later part of the year. What did this owner do to get the diabetes in control? Was it just the length of time he was being treated? I did see adjustments in the insulin dosage. Do you think I need to adjust Susie's insulin to 1.5 units. I will try your plan of feeding her a little around +5 and then giving a few treats at +9. Anything I can do to get her to hold out the 12 hours I will but I don't like the feeling that I am depriving her of food when I can tell she is very hungry. I will be looking at the Lantus but want to use up the Vetsulin first. My vet is hesitant to switch me to a human meter. He likes that the AT is designed for dogs and cats. Did I mention that I have purchased a scale and when I receive it I can track her weight. A couple of other questions. I am worried about infection in the ear tips from all the poking. Should I be using neosporin on her ears instead of the vaseline?
Also, I still don't have an explanation for the "Dosing Method (SLGS or TR)"? I don't know what this is and what Susie is on?

She followed tight regulation. She listened to those helping here. My intent on showing his SS to you was not so you would grab onto the thought that Susie needs more insulin. It was so you could see how much worse his BG looked than Susie’s and how improvement can be attained.

I do not think you should raise Susie’s dose at this time. She hasn’t been on this dose a week yet and we still aren’t certain we’ve caught the lows but it has been helpful to see the curve and the additional BGs.

Perhaps you are not feeding Susie enough calories? Did you read what I wrote about that above? It might be that you need to try the method I suggested and give her more calories overall if she is losing weight. I’m glad you purchased a scale so you can see what her needs are. My little one, Livia, gets fed two ounces of homemade, balanced raw a day with a few Whole Life treats. She seems hungry sometimes but her weight is very stable. She is a small cat and I do not want her to be overweight and at risk for diabetes. I discussed it with my vet and she said, “Her weight is perfect and stable. I’m hungry all the time, too, but if I ate all the time, I’d be as big as a house”. Liv is really at the very perfect weight for her size and I know I’m giving her enough calories as her weight does not go up or down. Cats are smart and, as long as you know she is getting enough calories, you will have to be the strong one to make sure she stays at the perfect weight.

Almost every vet wants the clients to use the AT. Is he willing to pay the extra cost for your strips? Maybe he needs to expand his knowledge by learning about the use of human meters in pets. My vet was willing to do so and I was never, ever pressured to use the AT even though I have one. Susie is your cat. Dealing with FD can be expensive especially if the kitty doesn’t go into remission fairly quickly.

I never used Vaseline; I always used neosporin with pain relief ointment, not cream, or a similar product that Wendy sent me from Canada.

 

[Marje and Gracie]

By the way, I'm impressed with your background! Love the MS in Wildlife Biology.
Amazing that you CKD kitty was stable for over four years in stage 3. Simon was diagnosed in stage 4 and, like he said, he went downhill very quickly. The subcu fluids seemed to make him feel better everytime but he just stopped eating and I was trying for feed him through a syringe but it was obvious that he needed to go. My vet told me I should get Susie down to 10 lbs. That was shocking to me. Last she was weighed she was 14.6. Don't cats lose weight on diabetes? So here I am trying to get her weight down, normally, but I won't know if the weight loss is from diabetes complications. Another confusing factor.

Not all diabetic cats lose weight. Gracie didn’t. If you follow the method of weighing, feeding for a week, adjusting food, you’ll slowly get to her ideal weight but don’t rush the food decrease. It has to be slow. Dr. Lisa is a member here and helps many members with nutrition. Dr. Lisa has valuable weight loss information here on her website. She also has great food charts you can find there as well.

I will make one other point about Vetsulin. I belong to several other FD boards (I do not post on them) just to stay aware of what is going on with different approaches, etc. As far as I can find, this is the only FD board that still supports the use of Vetsulin and by support I mean, offers an ISG where members using it can post for help. Having said that, it simply is not the best insulin for cats. Have some cats going into remission on it....yes. But, IMHO, it’s analogous to the choice between using one of those old time computers with the huge backs that jutted out and a new, flat screen fast desktop. Both work but one is much better in terms of efficiency. Still...it’s your choice.

BTW, if you are going to switch to Lantus, I’d strongly urge you to pop over to that ISG on this board and start by reading how to handle it because it isn’t the same as Vetsulin. There is no rolling or mixing required and it really shouldn’t be rolled. It would also be a good idea to start reading the stickys there a bit at a time while you wait to switch. Once you start using Lantus, we will ask that you post there instead of here on Main Health because there are more members there to help you with that insulin. That frees up the people here, like Mogs, who are excellent at helping new members.

 

[Tiffany Smith]

My 8 year, 8 month old kitty, Susie, has just been diagnosed with diabetes. I don't have a problem with the insulin injections but she doesn't like her current prescription diet (expensive). My Vet wants her on a prescription diet but if she isn't going to eat it I am not going to give her the shots. She was given the Hills W/D (wet) and I have also ordered the Hills W/D dry which I have not received. I also ordered the wet Purina DM and wet Royal Canine Glycobalance. If she won't eat these foods I am going to be devastated. I have read, in other sites, that the prescription diets are not necessary and that the Fancy Feast Classic are a good alterative. She like Fancy Feast and has been eating it for years. What do I do if my Vet will not allow it?

Welcome, I am relatively new here too but let me tell you something, you will be absolutely amazed at what you will learn here in the short amount of time. My Nala had BG readings of the 300's and higher when my vet diagnosed her. She prescribed her the dry prescription Diet and 2 units twice a day on insulin. Checkup and new glucose curve later her readings were in the 400's! It was the dry food, too many carbs. She means well, but ultimately our vets don't have all the time it takes to educate us on this and are really just doing their best to regulate our kitty, which is a lot of trial and error which I learned can wreak havoc on kitty. With the help of this wonderful group I began self testing at home, switched Nala to strictly canned (she prefers the Fancy Feast Classic Pate and the Beyond Grain Free pate). We implemented the start low go slow method on insulin dosage, and Nala now surfs the mid to high 90s to mid to high 100's on just .75u currently twice a day. Our goal is remission. My vet wasn't exactly skeptical or against me as when I first told her I was going away from her treatment plan, just if I could keep up with it. When it was time to update her on Nala, I sent her an email with the open link to Nalas spreadsheet so she can see all her numbers, dosages, and the notes I take on her any time she wants to check in on her. She is very happy with what she sees and says we are def headed in the right direction. I hope your vet is not the type to not "allow" something, but ultimately these are just like our children and we have to do what is best for them as we are the ones who are emotionally, physically, and financially involved in their care. Basically, they can't "not allow" you to do something. It is ultimately your choice hun. And I think, no I know, you will find so much help here. These people are patient, and kind.. in the beginning I had SO MANY questions, and yes I repeated a lot of them just for the sake of making sure I understood the answer, had a few panic attacks along the way that they assured me was not something to worry over and helped me feel better. You will be ok, this group has your back!

 

[Elizabeth and Bertie]

A test at PM+2 typically gives you an idea of how far and fast the drop is going thus far

I agree with this. I've found a +2 test useful with all the insulins I've used (and Caninsulin/Vetsulin was the first insulin I ever used). But I've actually found it particularly helpful with Caninsulin/Vetsulin precisely because it can often give a good indication of the blood glucose trajectory, and this is so important with an insulin that can drop the blood glucose fast and have a short cycle. Many others have also found the +2 test helpful with Caninsulin/Vetsulin. If the blood glucose is dropping fast at that point then you know you need to test again a bit later to monitor the situation, and you have the chance to intervene with food to try to slow down that drop in blood glucose.

Caninsulin/Vetsulin can have a very early onset though in some kitties, maybe even starting to work well within 45 mins of being injected. And if a cat's data shows that they have early onset, and are inclined to drop quickly, then testing at +1 or +1.5 may give useful information earlier on. (It is worth doing some tests in the first couple of hours of a few cycles just to try to determine when the blood glucose 'typically' starts to drop.)

Eliz

 

[Critter Mom]

But more concerning to me is that explanations like "bouncing" and dosing advice are sometimes forcefully and incautiously given

We ask people to record BG readings in shareable spreadsheets precisely so that any dosing suggestions made are based on an individual cat's actual data. Experienced members will not make specific dosing suggestions without it. In the absence of adequate data, all that experienced members replying can do is give very 'broad brush' speculation on what might be happening based on the characteristic mode of action of the insulin being used, treatment methods that have been developed over years (and in the case of TR based on published, peer-reviewed scientific studies), and general response patterns they have observed in the data of hundreds (in some case thousands) of cats whose caregivers have sought help here over the many years that FDMB has been active.

First up is the message that if you are on anything other than glargine your cat is at risk of x, y and z and will probably not achieve remission.

Scientific research into feline diabetes has shown that remission rates in cats treated with longer-acting insulins (glargine, detemir, Prozinc) are higher than in cats treated with shorter-acting insulins. While remission is possible in cats treated with the likes of Caninsulin/Vetsulin or NPH - and we have had cats here who fall into this category - statistically it is less likely.

That is followed by the urgency to immediately increase our testing

When members seek help here those replying to their posts endeavour to give honest and helpful advice regarding home testing (as well as all manner of other aspects of managing a cat with diabetes). If we think that additional testing could be beneficial to a cat then we will suggest certain testing strategies. Initially the strategy will be based on the characteristics of the insulin in use (that's all anyone - veterinary professional or lay person - has to go on at first). As more data for a particular cat becomes available and its specific pattern of response to its insulin can be better understood then more tailored suggestions about testing are possible. For example, many cats on Lantus might typically reach nadir some time between +4 and +6 hours after dose administration so that's likely a good time to check how low the dose might be taking the cat (provided one's schedule permits). However, another Lantus kitty might be one that metabolises their insulin faster than is typical and thus hit nadir earlier in a cycle. Therefore testing at, say, +3 might be more likely to catch the lowest BG level for that cat. Another thing that influences testing suggestions is the caregiver's particular circumstances and we try to help members to optimise their testing to fit in with their schedules and other commitments (e.g. work, family, etc.). The more information members replying to posts have available about a particular cat and a particular caregiver's situation, the better suggestions they can make but ultimately the caregiver holds the syringe and chooses how they manage their cat (which insulin to use, what to feed, when to feed, whether or not to test, etc.).

I have no problem with tight regulation, home testing, or glargine insulin. Each are tools with upsides and downsides. In my opinion, they are too often presented here as ideal tools to treating feline diabetes, and the only ones that will achieve the oversold probability of remission—something some reputable researchers question.

According to the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats:

In cats, diabetic remission is a reasonable goal [...] Predictors of diabetic remission in cats include achieving excellent glycemic control within 6 mo of diagnosis, using intensive home monitoring, discontinuation of insulin-antagonizing medications, and use of insulin glargine(Lantus) or detemir (Levemir) along with a low-carbohydrate diet.​

Mogs
.

 

[Summer and Susie (GA)]

She followed tight regulation. She listened to those helping here. My intent on showing his SS to you was not so you would grab onto the thought that Susie needs more insulin. It was so you could see how much worse his BG looked than Susie’s and how improvement can be attained.

I do not think you should raise Susie’s dose at this time. She hasn’t been on this dose a week yet and we still aren’t certain we’ve caught the loss but it has been helpful to see the curve and the additional BGs.

Perhaps you are not feeding Susie enough calories? Did you read what I wrote about that above? It might be that you need to try the method I suggested and give her more calories overall if she is losing weight. I’m glad you purchased a scale so you can see what her needs are. My little one, Livia, gets fed two ounces of homemade, balanced raw a day with a few Whole Life treats. She seems hungry sometimes but her weight is very stable. She is a small cat and I do not want her to be overweight and at risk for diabetes. I discussed it with my vet and she said, “Her weight is perfect and stable. I’m hungry all the time, too, but if I ate all the time, I’d be as big as a house”. Liv is really at the very perfect weight for her size and I know I’m giving her enough calories as her weight does not go up or down. Cats are smart and, as long as you know she is getting enough calories, you will have to be the strong one to make sure she stays at the perfect weight.

Almost every vet wants the clients to use the AT. Is he willing to pay the extra cost for your strips? Maybe he needs to expand his knowledge by learning about the use of human meters in pets. My vet was willing to do so and I was never, ever pressured to use the AT even though I have one. Susie is your cat. Dealing with FD can be expensive especially if the kitty doesn’t go into remission fairly quickly.

I never used Vaseline; I always used neosporin with pain relief ointment, not cream, or a similar product that Wendy sent me from Canada.

I agree about the high cost of the AT strips as I just reordered. It appears that Lantus is quite a bit more expensive than the Vetsulin, though. I did give Susie about 1.5 oz of FF at +5.5. I like to lie down between 10:00 and noon so I will probably be closer to feeding her, mid day, around 11:30. Susie is a pretty big cat and has always had a strong appetite - even before the FD. I'll switch from the vaseline to the neosporin ointment. So I guess from something else I read that Susie's dosing method is SLGS and not TR? I still don't understand this but maybe you have already explained it somewhere.

 

[Summer and Susie (GA)]

Welcome, I am relatively new here too but let me tell you something, you will be absolutely amazed at what you will learn here in the short amount of time. My Nala had BG readings of the 300's and higher when my vet diagnosed her. She prescribed her the dry prescription Diet and 2 units twice a day on insulin. Checkup and new glucose curve later her readings were in the 400's! It was the dry food, too many carbs. She means well, but ultimately our vets don't have all the time it takes to educate us on this and are really just doing their best to regulate our kitty, which is a lot of trial and error which I learned can wreak havoc on kitty. With the help of this wonderful group I began self testing at home, switched Nala to strictly canned (she prefers the Fancy Feast Classic Pate and the Beyond Grain Free pate). We implemented the start low go slow method on insulin dosage, and Nala now surfs the mid to high 90s to mid to high 100's on just .75u currently twice a day. Our goal is remission. My vet wasn't exactly skeptical or against me as when I first told her I was going away from her treatment plan, just if I could keep up with it. When it was time to update her on Nala, I sent her an email with the open link to Nalas spreadsheet so she can see all her numbers, dosages, and the notes I take on her any time she wants to check in on her. She is very happy with what she sees and says we are def headed in the right direction. I hope your vet is not the type to not "allow" something, but ultimately these are just like our children and we have to do what is best for them as we are the ones who are emotionally, physically, and financially involved in their care. Basically, they can't "not allow" you to do something. It is ultimately your choice hun. And I think, no I know, you will find so much help here. These people are patient, and kind.. in the beginning I had SO MANY questions, and yes I repeated a lot of them just for the sake of making sure I understood the answer, had a few panic attacks along the way that they assured me was not something to worry over and helped me feel better. You will be ok, this group has your back!

Thanks, Tiffany. I agree that our vet's probably do not always know best. I was speaking to mine a couple of days ago. I mentioned that it was hard to hold off feeding for 12 hours. He said maybe she should go back on a low carb dry food. I said "no". I never want her on dry food again. He also recommended the Hill's W/D, wet and dray, which even the wet food is too high in carbs. He never says he won't allow something. He listens to me and works with me. He is willing to go along with anything I suggest. He just sometimes does not give good advice. I am feeding the Fancy Feast Classic which she really likes. I also have sent the link to my vet that shows the "real time" spreadsheet. I doubt he has time to look at it much. I am very happy with all the support I am getting on this site. I am still in the dark about a lot of things but they are becoming clearer. I really, really struggled with learning to test. It broke my heart to poke my cat's ears until they bled. Everyone on this site said I would become more and more comfortable and they were right! Thanks for welcoming me, Tiffany. Sounds like your kitty is doing very well. What insulin are you using and how long have you been treating your kitty?

 

[Elizabeth and Bertie]

@Sergei, as Mogs says above, "Scientific research into feline diabetes has shown that remission rates in cats treated with longer-acting insulins (glargine, detemir, Prozinc) are higher than in cats treated with shorter-acting insulins. While remission is possible in cats treated with the likes of Caninsulin/Vetsulin or NPH - and we have had cats here who fall into this category - statistically it is less likely."

I've certainly seen quite a few cats go into remission on Vetsulin/Caninsulin in the 14 years that I've been on the forum. I worked with a lot of Caninsulin/Vetsulin kitties at one time, and so because of this was much more aware of the number of remissions. But those cats that have gone into remission are usually those that only need a short time on insulin and maybe a change of diet in order to go into remission. If a cat doesn't do well on Caninsulin/Vetsulin fairly early on then it can be well worth switching to another insulin.
Statistically it absolutely is the case that better glycemic control is more likely to be achieved with longer lasting insulins, such as Prozinc, Lantus, and Levemir.
Incidentally, in the largest ever remission trial (by the RVC) it was found that Prozinc and Lantus produce similar remission rates. (It was long thought that Lantus produced the best remission rates, but this was disproved by a researcher who actually won an award for disproving it...)

 

[Tiffany Smith]

Thanks, Tiffany. I agree that our vet's probably do not always know best. I was speaking to mine a couple of days ago. I mentioned that it was hard to hold off feeding for 12 hours. He said maybe she should go back on a low carb dry food. I said "no". I never want her on dry food again. He also recommended the Hill's W/D, wet and dray, which even the wet food is too high in carbs. He never says he won't allow something. He listens to me and works with me. He is willing to go along with anything I suggest. He just sometimes does not give good advice. I am feeding the Fancy Feast Classic which she really likes. I also have sent the link to my vet that shows the "real time" spreadsheet. I doubt he has time to look at it much. I am very happy with all the support I am getting on this site. I am still in the dark about a lot of things but they are becoming clearer. I really, really struggled with learning to test. It broke my heart to poke my cat's ears until they bled. Everyone on this site said I would become more and more comfortable and they were right! Thanks for welcoming me, Tiffany. Sounds like your kitty is doing very well. What insulin are you using and how long have you been treating your kitty?

My vet has her on ProZinc 40 and we've been on insulin since 11/30 of last year, so not quite 2 months yet. The ear poking got me at first too, but it does get easier. I think its harder on us than it is them bc Nala has never acted as if she minded it, it was always me..lol

 

[Marje and Gracie]

Susie...could you please start a new thread in the morning; this one is getting too long. Please paste this link in your first post in the new thread (it’s the link to this one for easy reference): https://www.felinediabetes.com/FDMB/threads/new-member.240295/page-2#post-2718550

Thank you!

 

[Summer and Susie (GA)]

My vet has her on ProZinc 40 and we've been on insulin since 11/30 of last year, so not quite 2 months yet. The ear poking got me at first too, but it does get easier. I think its harder on us than it is them bc Nala has never acted as if she minded it, it was always me..lol

You are fortunate if your kitty doesn't mind the ear pokes. Mine tolerates it best when she is not feeling too well. When she is hungry it is a real challenge. I appreciate the info. I'm just weighing my next move with possible switching from the
Vetsulin to something else.

Susie...could you please start a new thread in the morning; this one is getting too long. Please paste this link in your first post in the new thread (it’s the link to this one for easy reference): https://www.felinediabetes.com/FDMB/threads/new-member.240295/page-2#post-2718550

Thank you!

Susie...could you please start a new thread in the morning; this one is getting too long. Please paste this link in your first post in the new thread (it’s the link to this one for easy reference): https://www.felinediabetes.com/FDMB/threads/new-member.240295/page-2#post-2718550

Thank you!

I'm sorry but I don't know how to start a new thread. When I click on your link it takes me to post #178

 

[Marje and Gracie]

I'm sorry but I don't know how to start a new thread.

It’s exactly like you started this thread. Just go back to the Main Health forum where this thread is and click on “Post New Thread” and then fill in the subject line and start posting.

Please include this link at the beginning if your new text: https://www.felinediabetes.com/FDMB/threads/new-member.240295/

Once you are able to do that, I will put your new thread link in this one so those helping will know where to find you. Thanks very much.

 

[Marje and Gracie]

New thread for Susie