Newly diagnosed in BC Canada

[Erin and Sugar]

My cat Sugar (yes that’s her real name ) is about 9 (rescue at around 3 years old so not 100%) and diagnosed with diabetes last week. We have a follow up “diabetic consult” with a vet tech tomorrow and I’m not sure what to expect. Is she going to teach me about home glucose testing and insulin shots? I want to keep long term cost to a minimum so I was thinking of getting a human glucose meter so the test strips will be cheaper- is that right? Should I buy one and bring it to the appointment? I have already switched her from kibble to Fancy Feast pate and Tikicat, but only the last couple days. I am afraid of getting talked into buying pet-specific supplies and prescription food. I also have questions about the insulin and the delivery systems… do I get that stuff from the vet? Does everyone use pen-style delivery? I’m in the BC interior in Canada, not sure how different things are here from the US. I also have a 3 year old boy Flash, I should switch him to the same diet right?

Extremely overwhelmed, just want the best for my girl.
Can’t figure out how to add a picture of her
Erin

 

[Bron and Sheba (GA)]

Hi Erin and welcome to toy and Sugar to the forum. Sugar is a beautiful girl.
I’ll tag @Wendy&Neko as she lives in Canada and she can give you some tips about food and a good human glucose meter from Canada.
It is very normal to feel overwhelmed at the moment. Everyone arrives here feeling overwhelmed. But the good news you will soon feel much more relaxed about it all. It’s a big learning curve at the beginning and then it all becomes routine.

We have a follow up “diabetic consult” with a vet tech tomorrow and I’m not sure what to expect. Is she going to teach me about home glucose testing and insulin shots? I want to keep long term cost to a minimum so I was thinking of getting a human glucose meter so the test strips will be cheaper- is that right? Should I buy one and bring it to the appointment?

I would think the vet tech will show you how to give the insulin. Hopefully they have prescribed Lantus which is a great insulin for cats.
She may or may not suggest hometesting. Don’t be surprised if she says it is not necessary. Many vets don’t think it it’s important, but we see every day who important hometesting is. Don’t be talked into getting a pet meter. A human meter is just as good. It’s accurate and our dosing methods are based on the human meters. Just say you have bought a human meter and if she pressures you just say…I’ll think about it. And then keep using the human meter. Until fairly recently all vets used human meters on cats. You may not have time to buy a human mater before the appointment as I can’t help you with which one…but Wendy can tell you. I think from memory the Bravo is used in Canada.

have already switched her from kibble to Fancy Feast pate and Tikicat, but only the last couple days. I am afraid of getting talked into buying pet-specific supplies and prescription food

Well done switching to low carb food! There is nothing special about prescription food so don’t let them talk you into it. They will try I am sure. Just say you are going to try low carb foods you have already bought. And if pressed just say you will think about it. But remember you are Sugars advocate and you are paying the vet for information and you don’t have to act on their information. It’s your choice. Sugar is your cat.

also have questions about the insulin and the delivery systems… do I get that stuff from the vet? Does everyone use pen-style delivery?

If they prescribe Lantus ….and I hope they do…it can be bought in cartridges which can be used in pens. But you don’t want to be using a pen as they can only go up and down in 1 unit increments and we recommend going up and down in 1/4 unit increments. So the insulin syringes you need are :
U100, 3/10, 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit markings. the vet may want to sell you some syringes, but if they are not the ones I have written above, say you have already ordered some and they have arrived. I think you would get the syringes from a pharmacy but Wendy will tell you.
If they order another insulin, the syringe will probably be different so check with us first.

also have a 3 year old boy Flash, I should switch him to the same diet right?

Yes I would change him over to the same diet. I feed my cats who are not diabetic a low carb food.

Can’t figure out how to add a picture of her

To add any photos or documents to the page you copy and paste them.. I see you have got the avatar up

 

[Bron and Sheba (GA)]

@Karolina KJ & Nestle is also from Canada.
And @Jodey&Eddie&Blue
And @Sara-Jane

 

[JL and Chip]

@Christie & Maverick is also from Canada.

Like Bron said, Lantus (generic name glargine) is a great insulin. I believe in some areas of Canada it can be purchased at pharmacies over the counter without a prescription. It’s a human insulin, so most vets don’t carry it. Also agreeing that you don’t need the pen needles that are used with the insulin cartridges (some pharmacists try to convince you that you need them—you don’t).

If you’re changing to low-carb canned food, it’s definitely worth getting a blood glucose meter and start testing asap, even maybe before you start insulin. A change to low carb food can have a significant impact on lowering BG.

 

[Sienne and Gabby (GA)]

Here's hoping that the vet recommends either Lantus (glargine) or Prozinc. These are both insulins that are recommended by the American Animal Hospital Assn for the treatment of feline diabetes. If the vet recommend Caninsulin, it's a problem. It's no longer recommended although it was the insulin of choice in several places outside of the US. It is an insulin that was formulated for the treatment of diabetic dogs. It is harsh and does not have the duration necessary for a cat's fast metabolism. Push for either Lantus or Prozinc. Prozinc would need to be purchased through a vet or an online resource since it's a pet specific insulin.

We have resources to help you learn how to home test. Let us know if you need them.

As for "prescription" food, there's a very easy response to being told it's what you need for your diabetic cat. The pet food manufacturers lost a class action suit a few years ago for making claims that their food was "prescription." The reason they lost the suit was that there was nothing medically necessary in the food that would warrant a prescription. In fact, the dry "diabetic" food is very high in carbohydrates which would certainly not make it appropriate for a diabetic cat. Several of the canned prescription foods are also not low in carbs. If the vet tech gives you a hard time, ask her to look at the ingredients. Cats are obligate carnivores. If there is any plant matter in the food, a cat can't digest it. Most of the time, the veterinary professionals don't have a clue as to what the amount of carbs are in the food they are recommending. And yes, it will make your life appreciably easier if both of your cats are eating the same food. A low carb diet is appropriate for your non-diabetic cat.

FWIW, I don't think there's a single member here who hasn't been overwhelmed by finding out their cat is diabetic. Even members who are diabetic themselves are overwhelmed! In the beginning, there's a lot to learn. I promise -- it all becomes routine. This is a great community of people who are not only devoted to their cats but will become devoted to your cat. The members are generous with their time and knowledge. Please let us know how we can help.

 

[Wendy&Neko]

Hello from the Wet Coast of BC - or at least wet today. It's great that you are asking questions before going into the vet office. That way you can be well prepared for whatever discussion you might have.

Lantus can be purchased from any pharmacy without a prescription. Cheapest to buy is a 5 pack of cartridges, not the pens. Alternative generics like Basaglar might be offered, that's OK to, as long as it's a glargine generic. Any pharmacy will also have the syringes you'll need, which are the BD Ultrafine II, purple and yellow box. They are U-100 syringes with half unit markings. I found Safeway pharmacy the cheapest place to buy insulin supplies, surprisingly enough. Costco or Canadian Superstore also good prices. London Drugs sometimes has good sales.

If your vet want to go the Prozinc route, that'll mean going to the vet to buy insulin and syringes, and thus more expensive.

As far as human BG meter - the Freestyle Lite needs the smallest blood drop, so a good choice. Plus London Drugs often has the test strips on sale or a buy 100 strips get a free meter deal. You vet tech should be able to show you how to do a BG test as well as how to give insulin with a syringe. The pet meters are a fairly recent thing. Back when I started, my vet used a human meter and we used to swap ideas on where to get the cheapest test strips. Tell the vet/vet tech you are cost sensitive if they want to sell you the AT and just say you can't afford it. We've used human meters for years here.

I'd been going to my vet for years before Neko's diagnosis. I told her I was going to be feeding a good quality low carb wet food. Of my choice. End of conversation. Again, cost sensitivity can also be used as an argument. The quality of the so called "prescription" foods is also not great, the ingredients are poor.

 

[Erin and Sugar]

Thank you everyone for your advice so far. I will have some more questions after our appointment, I am going to suggest we wait for her to transition to the low carb food this week and get a glucose meter before we start the insulin. If I get overwhelmed at the appointment I will write everything down and bring it home to think about it

 

[Wendy&Neko]

I used use the phone to record conversations with the vet, after asking them if I could record. Less stress about writing everything down.

Can you tell us what number her blood sugar tested at when she was diagnosed? Was a urinalysis done too? Any chance it showed ketones? If yes, you shouldn't delay in starting insulin. You can get ketone test strips (Ketostix) at any pharmacy as humans use them too. Tips to catch and test a urine sample

 

[Christie & Maverick]

Hi Erin and welcome Waving from Calgary!

A couple of other things to note in addition to the great help you’ve already received. I was wondering how your vet diagnosed Sugar as diabetic? Did Sugar have symptoms like drinking a lot of water, peeing a lot which brought you to the vet? As Wendy mentioned, did the vet run some blood work and urinalysis? And as well did they run a fructosamine test to diagnose?

I’m glad JL mentioned the switch to low carb wet food that can with some kitties have a marked impact on blood sugar, especially if switched from high carb dry food. The good news is insulin syringes like the BD brand mentioned above are over the counter at all pharmacies as are BG test meters. I tried a few meters but settled on the Freestyle Lite since it only requires a small blood drop. You can also get the lancets from the pharmacy. You’re lucky you are in BC, I’ve continued over the years to require a prescription from my vet in order to get both Lantus which we started with and now Levemir, since insulin is categorized as requiring scripts in the standards for pharmacy practice in Alberta (use of drugs and medications for humans in animals are considered extra label drug use so use in animals in Alberta anyway, insulin requires a prescription from the vet).

As for food, it sounds like you’ve got fancy feast and Tiki on the menu, and there are others on this list; many of the foods available in the US are also available here in Canada: Food chart

I’d also suggest you pick up some medium (around 10-15%) and high carb (above 15%) canned food depending on how carb sensitive the cat is, and some cotton balls or those make up rounds, which help to place behind the ear during and hold on the ear after the BG ear tests.

 

[Tosca]

Hello, I am also in Canada, in Quebec. I order online my meter, test strips and lancets, on Diabet express.
https://diabetesexpress.ca/
I use the Bravo meter, with the least expensive test strips. The only condition is to always get these strips online, as they don't carry this at the pharmacy. On Diabet Express sometimes they have free meters as long you pay for the strips.
I was very overwhelmed at the beginning, but I get used with time.

 

[Finnegan]

Hi from Manitoba Erin and Sugar!
My Finn was diagnosed 2 years ago last week. We had our ups and downs, especially that first year, but he is doing fine (touch wood).
I got a human BG meter and strips (Freestyle Lite) from the local pharmacy and they were cheap and work fine. We use Lantus pens, which I also get from the local pharmacy (vet calls in the prerscription), and those also work excellently. I have arthritis and so needles would have been a problem - but the pens are easy to use. Here mine cost $112. but that's for 5 pens and each pen (for me) lasts almost a month. The food is more expensive. The vet has me using Purina DM for dry food but he mostly eats wet - mostly Fancy Feast and Friskies. Both pate and both the lowest in carbs. We also use Werutha but he doesn't like that as much and it is very expensive, here anyway. Refer to the food chart on this site. It will help enormously.
He has never minded the daily shots (he gets 4 units twice a day) - perhaps because I always give him his Fancy Feast right afterward. Pricking his ear for blood was and remains a completely different issue but I managed and, thankfully, we now don't have to do it all that frequently.
Just something no one told me and which likely contributed to his unstable reading those first few months - keep the pens in the refrigerator prior to use, but once you start a pen it must be kept at room temperature! Apparently having it in the fridge and bringing it out can cause condensation and that can lead to erratic dosages. Once at room temp, the insulin will begin to degrade, but will last "almost a month" so my pharmacist tells me. This means discarding some (the amount left over will depend on how much Sugar gets daily) but it is unavoidable.
Anyway, I hope this helps. It gets easier, trust me. I wouldn't have believed that when in the first throes of our treatment, but it is true.

 

[Wendy&Neko]

keep the pens in the refrigerator prior to use, but once you start a pen it must be kept at room temperature!

Not true if you are using syringes. Most of us use syringes for many reasons. Check out this Sticky Note in the Lantus forum:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

The reasons for using syringes described in that note are:

• When dosing cats, there can be more negatives to using pen needles with an insulin pen than positives:
  • Inability to administer doses in increments of 0.25 - 0.50 units with pens.
  • Forgetting to "prime" the pen prior to each use will result in a smaller dose than intended. Priming the pen involves wasting 2 units of insulin for every shot.
  • One must keep the pen needle in for 5 - 10 seconds after the shot or you'll run the risk of not administering a full dose (can be tough with some cats).
  • Manufacturers do not recommend refrigerating an in-use pen. Therefore, shelf life may be shortened to 28 days (Lantus & Basaglar & Semglee) and 42 days (Levemir).
  • Some FDMB members have reported shots administered from insulin pens are more uncomfortable than from a syringe (?)

I have used the pen refiills, called cartridges, until the last drop, or up to 90 days. Those using the pen mechanism cannot refrigerate the in use pen as described above.

 

[Finnegan]

Sorry. Was just trying to relate my experience.
As for pens versus needles - I live alone and have severely arthritic hands, so the pens really are my only option. Others likely have easier and better experiences with other things.
I do prime prior to injection. The inevitable wastage is unimportant to me as there is always plenty left after the 28 days anyway, and I always switch to a new pen at that time. Again though, others might have different experiences, especially if giving higher doses.
Mostly, Erin, you should listen to the others on this site. They have more experience than do I, and experience with things I do not have and cannot access.
You'll be ok, and so will Sugar. Just remember to breathe from time to time.