New to the board and questions

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Jeanne & Buddy

Jeanne & Buddy

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Hi everyone,

I’m new to the board. I just wanted to say this website has been a great help to us over the past year. : )

Our cat Buddy (11 years old) was diagnosed with diabetes early last year. He’s currently on 2 units of insulin (Vetsulin) twice a day. We feed him non-gluten Fancy Feast wet food in the morning and in the evening.

We just switched vets to an all-cat clinic in town since we were having problems with our old vet. Our new vet is encouraging home testing, especially since Buddy has been having some issues lately. He seemed to be fine for several months, but then started having some problems. Some days he’ll be fine, other days he’ll either be very lethargic or, at the other extreme, very hyper and always begging for food. Lately, he's had a major issue with using the litter box 5-6 times a day (or more) to poop. It's not diarrhea, but it's still a major nuisance and he never had this issue before.

I just started home testing a few days ago. It can be a challenge to get blood at times, but Buddy is pretty cooperative and I am starting to get the hang of it. We use a Walmart Relion Ultima since the test trips are cheaper (and we're very tight on cash at the moment).

I have a few questions regarding Vetsulin. I didn't know until recently that there was an FDA-issued recall. Does this affect all bottles or just specific ones? Had we known about this, we wouldn't have bought any from our old vet last month. We had no idea there was a recall issued and our vet never even told us (which is one of the reasons we switched vets). We're afraid this may be causing some of Buddy's problems. We really want to get a refund, since we barely used any of the new bottle. Has anyone had any success with getting a refund (from their vet or directly through the company)?

Also, what insulin do any of you recommend we switch to? I hear Lantus is very good, but it seems very expensive and we're very tight on cash. I believe our new vet suggested PZI.

We are going to do a BG curve on Buddy in the next few days and give our findings to our vet. I feel bad about pricking his ear all day long. : ( Does anybody have any advice on making it easier on Buddy?

I managed to do a couple tests today on him. His BG was 246 at 1:00 this afternoon (he gets 2 units of insulin in the morning at 6:00 and again at night at 6:00). Then he was acting odd (drinking a lot of water and begging for food constantly) around 10:00 this evening. Did another test and his BG was 57, which is not what I expected at all due to his symptoms. Something seems a little off, but I suppose I will need to do a full curve to be sure.

I appreciate any advice or help you can give us. This is all very frustrating, but we're trying our best to pull through. Thank you. : )
 
Hi Jeanne, I'm glad to see you are home testing now. I think you'll find that Buddy has been swinging too low and the symptoms are those of hypo, though not a full blown one yet. When you notice a change in his behavior get a test right then, it will help you see how things are working.

The recall is on particular lots of Vetsulin, not all of it, but Lantus is a far better insulin. If you buy a package of cartridges or pens the cost, over time, is significantly less than buying a vial and the cartridges will last you six months or longer. Visit the Lantus group and read the stickies posted there to learn more bout this insulin.

You don't need to wait to do a curve, and you do need more information. Keep it in the form of a spread sheet so it will be accessible to others here and so your vet will have all the information in a graphic form.

I also suggest you print out Melissa's periodic post on hypos and tape it to your refrigerator door. Buddy's swings are of concern and it's best to have the information right there when you need it.
 
Hi, Jeanne. From the very few BG tests you have it seems like he is dropping very fast in the first few hours and then shooting back up fast. That is called rebound and it can cause BG tests to look like the cat isn't getting enough insulin (high numbers) and the dose gets raised making it worse. How did you arrive at the 2u dose? 2u of vetsulin is a lot of insulin. Most cats that were on it were on 1u bid, or less. Before I was testing, Beau was up to 7u of vetsulin (!!!!) from being tested at the vet once a week. His basic dose ended up being .8u after I switched him to wet food.

I think the most important tests right now might be +1, +2 and +3 (that 1 hour after shot, 2 hours after...). We don't use actual times since everyone is all over the world/time zones. So the morning test and shot is amPS (PS = preshot) and then the test after have the + numbers until the next shot (pmPS). Using that method of reporting numbers will help us understand what is happening.

When you test do you use something to warm his ear, to dilate the vein? What kind of lancet are you using? I have found only one that works well: BD Ultra Fine II. All others cause me to have to jab hard several times rather than a quick, single poke. I use the lancet freehand because I feel I have much more control over it and can aim more precisely. Plus, the click of the device startles some cats. After you get the strip loaded and it's counting down, wrap a piece of facial tissue or cotton over the ear edge and apply gentle pressure for about 10 seconds. That will stop the bleeding and prevent bruising. Do you know to aim between the vein and the ear edge? That way you get the proper capillary blood and don't "hit a geyser" that bleeds a lot.

The first week or so of testing is harder, but then it seems like the ear "learns" to bleed and things go more smoothly.

Lantus is a good insulin, as is levemir. Levemir may end up costing less because the pen cartridges last until they are gone. I just used up a cart that I started last June and used on two cats, but they were/are both OTJ (off the juice) for all but about 3 months each during that time. I bought the package of five cartridges and ended up selling 3 of them to other members here because I would not have been able to use them by the expiration date. So you may find a member here willing to sell one cartridge to get you started - of either levemir or lantus. I don't know anything about the new ProZinc insulin, but if it works like the old PZI, it is a better insulin than vetsulin and probably a bit more flexible than levemir or lantus.
 
I would definitely print up the notices that Larry provided in the post above and take them to your old vet. I would be firm in asking for your money back. They should not have been supplying Vetsulin after November 2nd, 2009.

Threaten to report them if they don't refund your money. Then be done with them.
 
Thank you everyone for the suggestions and advice. I will definitely be contacting my old vet on Monday and requesting a refund. I will print out those notices and show them. I'm just flabbergasted that they were never aware of this and continued to supply it. If I can't get a refund from them, I will contact the company that supplies it and see what they say. I really would like that $75 back to put toward some new insulin.

Buddy was originally on 3 units of Vetsulin for almost a year. Then he started experiencing a few hypo episodes (where he would start staggering and walking into walls). At that point, we took him to our old vet and she told us to reduce it to 1 unit. Then he started having issues again with drinking a lot of water and his BG levels were on the rise again. So, she told us to bring it back up to 2 units and that's where we're at currently.

Lantus seems like a good choice if we can afford it. Does anyone have any exact prices? Do you buy online or through a store pharmacy?

I will do a curve on Buddy on Monday and post my numbers here, as well as give them to my vet. I am warming up the ear with my fingers for about a minute before testing him. I use Relion Ultra-Thin (30 gauge) lancets freehand. The pen seems to scare him and I find it easier to just do it freehand. I do prick him right between the vein and the edge of the ear (I've watched several videos on YouTube and I've seen several pictures of where to prick him on this site), but sometimes it seems like I barely get any blood and then I'll have to toss the strip out and start over. Sometimes the needle will go all the way through his ear, but I'll still hardly get any blood. I hate pricking him over and over again just to get enough...

Thank you again for your help and support. I know Buddy really appreciates it. : )
 
You need to shop around for the Lantus. Price varies. Some people buy it from Canada but now that still required a prescription. Although a 10 ml vial is cheaper, the best buy is the five pack of 3 ml cartridges. This is because the 10 ml vial is very very likely to go bad before even half is gone. The end of the cartridge has a rubber plug just like a vial. You can also buy the five pack of 3 ml disposable pens but they cast more than the cartridges. The end of disposable pen has a rubber plug like a vial.
 
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