Newly Diagnosed.. need advice on insulin

[Ivyandmacki]

Hi everyone, my name is Ivy and my kitty’s name is Macki.
Short intro: he is 11y/o, 12.3lbs, indoor/outdoor, medium haired, healthy all his life until the past month I noticed increased thirst and urination. Took him to the vet and did bloodwork. His glucose was 474 and got dx with diabetes. All other labs normal.

The vet called me and told me these results and offered 3 options: insulin, senvelgo, or “letting him go” if I can’t afford either option. This hurt when she said this. Then I found this lovely website and have been doing lots of research but of course am still overwhelmed. I’m a full time student and not working right now, so I definitely am trying to figure out what is the best financially friendly option, as “letting him go” is NOT an option!

His diet has consisted of purina senior dry food, and fancy feast cans with gravy - he loves these but I just learned these are so high in carbs. I am going to slowly cut out the dry food and also switching to the fancy feast pate like everyone suggests. Also boiling chicken to feed him too. I ordered an alphatrak and it’s coming in the mail today.

My main question - I have to call my vet today and tell her my decision. I will be choosing insulin (I saw too many scary things about senvelgo) and I also saw there is a goodrx coupon for Lantus that is $35/vial. I wanted to request this for Macki as i can afford this one, BUT how do vets/you guys know which insulin the cat should start on? Short acting/long acting? What determines this? Is it okay to start on long acting Lantus? Help! I’ll take any info I can. Just wants what’s best for him without getting scammed by my vet.

Additional question: how long until his thirst / urination is under control once we do start insulin?

-Ivy

 

[squeem3]

Welcome! Responses may be slow since US members have the Thanksgiving holiday.

Yes, definitely switch the diet now before your cat goes on insulin. And learn how to do test your cat's blood glucose levels. I suggest that before you get the prescription for insulin, do a curve on your cat once he's on 100% low cab canned food to see if the diet change improved blood glucose numbers. Normal is roughly 60 to 150 mg/dl. If the curve shows numbers over 200, start the insulin.

There isn't really a way to determine which insulin to use. The two good insulin to use are Lantus and ProZinc, both are long acting in cats. Which one to start is mostly preference. Some people have switched from Lantus to ProZinc or vice versa if after a few months there isn't much improvement with numbers despite dose increases. Lantus is fine to start with and the $35 coupon will get you the box of pens which will last you at least a year if not longer. One pen is good to the last drop and that may take a few months to use up depending on dose.

You don't need the AlphaTrack. The test strips are expensive and aren't sold in stores. A Human blood glucose meter works well and test strips can be cheap depending on brand. You can go to any pharmacy and get more test strips if you forget to place an online order or are running through strips like water because your cat is in hypo. Pet meters are no more accurate than Human meters and they tend to read lower than a Human meter.

The excessive peeing and urination will go away eventually. Time line varies since every cat is different

 

[CORKY]

Welcome to FDMB
Ivy and Macki, boy oh boy, for starters, you may need a new vet, A vet that is schooled on Feline Diabetes knows not to tell a Mommie to put her down, not even for financial reasons, there are many options, like Financial assistance for cats in needs, like DCIN , here is a link to Financial assistance: Financial Help Links , and Squeem3 has giving a lot of valuable information about home testing first before going with insulin, also if you could get Macki to become an indoor cat only, it will be much easier controlling her food intake, so a diabetic cat need to have a diet of wet can food or raw between 0-10% carbs, both of the foods you are feeding are very high in carbs the FF gravy alone is 15% carbs the Purina the same if not more, most members here feed Fancy Feast pates between 0-10% most feed up to 5%, so I'm sending you a link for Drs food list, the third column will have the % of carbs , and a food calculator, when calculating the carbs, you will use the Dry Matter Carbs, this is what to look for, it will be a start to lower Macki's BG, you can get at Walmart the ReliOn Premier human monitor and strips, most of the members use it, the monitor is $19.99, the strips are $9.00 for 50 and $17.88 for 100, always good to have extra strips handy especially at the beginning. on line these supplies are cheaper. Don't worry we will be here for you to help you on your journey, and if Macki was to need insulin, we can assist you with dosing, many members including myself do, Macki is healthy with no other illnesses, so it will be like a walk in the park, less Vet visits sometimes none, this does not means you do not need a vet from time to time if needed, but we can help you regulate Macki's. glucose numbers, and dosing needs., please continue to post any other concerns you may have, on our main menu there are many sticky notes with a lot of valuable information
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
Cat Food Nutrition Calculator | Elizabeth C Scheyder

 

[Diane Tyler's Mom GA]

@Ivyandmacki
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capillaries it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets any brand
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up

Here is a video a member made testing her kitty, she's using the Alpha Track which has to be coded , a human meter doesn't

VIDEO: How to test your cat's blood sugar


Normal blood glucose numbers for a cat are between 50 and 120 on a human meter.

Squeem is right , you don't need the Alpha Track. The price of the test strips will kill you

If you want to safe money most of us use a human meter
Most of us use the Relion Premier Classic from Walmart
Relion Premier Classic Meter at Walmart for 9 dollars
ReliOn Premier Classic Blood Glucose Monitoring System HSA/FSA Eligible - Walmart.com

The tests strips are 17.88 for 100
ReliOn Premier Blood Glucose Test Strips, 100 Count HSA/FSA Eligible - Walmart.com
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart on line.

 

[Diane Tyler's Mom GA]

IF YOUR VET DOES PRESCRIBE LANTUS
Which I hope the vet does

You can definitely get 5 pens of Lantus or the generic Glargine

You can Check
CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens either Lantus or the generic Glargine , plenty of members use the generic
Just call around and see who has the cheapest price , it's really not that expensive
With the pens just keep them in the fridge middle shelf , they all have the expiration date on them .

Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus

If you use the Good Rx
GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822


GoodRx coupon.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menu says generic glargine 1 carton of 5 3ml pens.


Also
A membersaid she followed this prescription info exactly and it worked perfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.

Found this also posted by another member
finally got the pharmacy to honor the 5 pens for $35 coupon. I had my vet write the prescription as 8 to 25 units twice a day and that seemed to do the trick.

If you go with Lantus or the generic you will need these syringes


You can get them from Amazon without a vets script for U-100 syringes for Lantus
half unit markings without a vets script
Amazon.com: UltiCare VetRx U-100 Pet Insulin Syringes, Comfortable & Accurate Dosing of Insulin for Pets, Compatible w/Any U-100 Strength Insulin, Size: 3/10cc, 31G x 5/16’’, w/Half Unit Markings, 60 ct Box : Health & Household


If you tap on this link you get also get the Relion syringes
Also
See this post about the Relion Syringes also. You might need a vets script for these. You can't buy them on line you have to go into the store
New. Need help with insulin does


Here's a pic,

• Full and half-unit syringe scales:

You can read all the yellow stickys about Lantus here
Lantus / Levemir / Biosimilars

 

[squeem3]

The GoodRX coupon seems to be a one time use at a pharmacy. When you need a refill and have a new printed coupon, you an try the pharmacy again but if they won't honor it, go to a different pharmacy chain (not a different location for the same chain). It's something to do with the BIN number printed on the coupon. It seems to be one number that gets printed on the coupons and can only be used one time per customer. See Info - Sourcing Insulin More Economically

 

[Ivyandmacki]

Thank you everybody for your replies and such valuable information!!!! The links and videos were extremely helpful, I feel 1000x more confident about the whole situation and ready to take on this journey with Macki!

I will definitely switch to the ReliOn meter. Although, my alphatrak did come in the mail and I used it about 1.5 hr after he ate, his BG was 350. He used to pee 4x a night and now down to 2x, so far have only adjusted the diet. He seems less thirsty too. I’m telling myself this is progress

He does like to eat small meals throughout the day so I’m trying to figure out when to test his BG levels. I find it’s easier to freehand the lancet vs using the device. And I will also be making a rice sock to warm up his little ear. I didn’t get enough blood this morning for a reading so I’ll try again in a few hours. It’s all about Trial and error right?!

 

[Diane Tyler's Mom GA]

@Ivyandmacki
Hi Ivy when you start the insulin you can fill out your signature, it's information we need for Mack. It's at the end of everyone's posts

You might want to fill out your signature
Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information. It's at the end of everyone's post in gray letters

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Bexacat or Senvelgo (if applicable) and dates
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


Here is the link on how to create your spreadsheet. It will also explain how to use it, it's pretty easy. We use it to track our cats BG numbers . If you have trouble setting it up just ask ,we have a wonderful member who will be happy to set it up for you. Take a look at anyone's Spreadsheet to see what it looks like .
Just keep asking questions.
Once you start the insulin you don't want to feed anything 2 hours before testing Mack in the AM and the PM because you don't want the number to be influenced by food.
You can then continue to feed him small snacks throughout each cycle. A snack is usually about a tablespoon of low carb wet food.


spreadsheet is here https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

I see you said Mack is a indoor/outdoor cat
If possible I would try to keep him inside as much as you can do you can check his BG

 

[Diane Tyler's Mom GA]

When using the lantus pens

we use the syringes with the half unit markings because we adjust the doses by 0.25 units at a time

You definitely want to keep the insulin in the fridge middle shelf


Just take the cap off the pen or cartridge and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there

 

[Diane Tyler's Mom GA]

For your hypo kit in case Mack drops too low
Just wanted you to know on Dr Pierson's food chart

the Fancy Feast Gravy Lovers Beef Feast In Roasted Beef Flavor Gravy (which. Dr Pierson’s list says is 20%
Comes back with 14%

These are correct for med carbs
Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs



Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

You can even look at the Friskies for high carbs and med carbs.. They are less expensive than the FF Gravy Lovers and the cans are bigger
So buy a few cans of each. Good idea to mark the cans with how many carbs on it.


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

 

[CORKY]

Thank you everybody for your replies and such valuable information!!!! The links and videos were extremely helpful, I feel 1000x more confident about the whole situation and ready to take on this journey with Macki!

I will definitely switch to the ReliOn meter. Although, my alphatrak did come in the mail and I used it about 1.5 hr after he ate, his BG was 350. He used to pee 4x a night and now down to 2x, so far have only adjusted the diet. He seems less thirsty too. I’m telling myself this is progress

He does like to eat small meals throughout the day so I’m trying to figure out when to test his BG levels. I find it’s easier to freehand the lancet vs using the device. And I will also be making a rice sock to warm up his little ear. I didn’t get enough blood this morning for a reading so I’ll try again in a few hours. It’s all about Trial and error right?!

That's right, as you know the Alpha track strips are very expensive, especially when you are learning how to test, the
ReliOn strips are less than a penny's worth, I am glad you are beginning to be more comfortable and that Macki is showing improvement, the diet is so important, I'm glad you can see the difference; I am an obsessive tester, I test every two hours, though I am trying to test less now. but at least 3 tests during the day, the AMPS/PMPS and if you can 2 more in the evening after PMPS, as the days go by the capillaries will swell more and more blood comes out you can also gently squeeze a bit more blood if need to. You and Macki are doing a great job!

 

[Ivyandmacki]

Yes I went and bought ff pate and he LOVES them! I add some water and he enjoys it. I also got the friskies to try but have not gotten to it yet.

I made the rice sock and it was incredibly helpful with the blood flow. Just checked his sugar and it was 261! He had the pate about 3 hours ago.

 

[CORKY]

I think you are going to make good use to this cat carb calculator, look at the label, find the nutrient %s , insert them in the cells of the calculator, we are looking for the Dry Matter Carbs. also, a Drs food list the third column contains the carbs of each food, stay away from Gravies they are high in carbs, this is the breakdown :
low carbs 0-10%----------this is where we want to be
Medium carbs 11-15%
High carbs 16-24
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
Cat Food Nutrition Calculator | Elizabeth C Scheyder
PS: you are doing Great!

 

[Ivyandmacki]

Hi everyone, me again…. Here with an update.
With the holidays, there’s been delayed communication with the vet so I haven’t gotten the Lantus insulin yet. I should pick it up tomorrow from the pharmacy.
Macki’s officially on an all low carb diet - FF pate, boiled chicken, occasional tuna, and freeze dry chicken treats for after BGL checks. As for macki’s BGL’s, I’ve been checking twice a day and the number have been declining!! He usually is in the upper 250’s, sometimes 300’s, but tonight he reached a new reading - 182!!!! (AlphaTrak)

Here is my issue: The vet ordered 2.5units of Lantus BID…. After reading through this forum, I would rather do the “start low go slow” method with .25u instead. She also wrote that she wanted to do a curve after 2 weeks of insulin, and then to send her the results. She stated IT WILL COST $110 FOR HER TO INTERPRET THE RESULTS (!?) and determine if the dose (2.5units) needs to be changed. My question is: Does your vet make you pay this much for eval of glucose curve numbers?!?
I have yet to respond to this email because I’m honestly upset. She also mentioned that she “strongly discourages dose changes without veterinary consult.”
Thoughts?

 

[CORKY]

So far so good, GREAT! On your part. You do not need the vet for a curve, you can do this at home yourself and no stress Mack, which will result in higher BG numbers, A curve is simply testing every two hour do a cycle, 12 hours, save your money and both your stress, I will tag a couple of members as well to help you with dosing, 2.5 units to start seems a lot, but the members using Lantus and assist with dosing know best, and you do not need to explain to your vet the why of your decision to curve at home, she knows is not necessary, but unfortunately, the $$ speaks faster, before common sence to a vet sometimes, thanks for letting us know, Macki has no other issues you can get her regulated right here, without stressing each other out
@Diane Tyler's Mom GA
@Sienne and Gabby (GA)
@Wendy&Neko

 

[Ivyandmacki]

So far so good, GREAT! On your part. You do not need the vet for a curve, you can do this at home yourself and no stress Mack, which will result in higher BG numbers, A curve is simply testing every two hour do a cycle, 12 hours, save your money and both your stress, I will tag a couple of members as well to help you with dosing, 2.5 units to start seems a lot, but the members using Lantus and assist with dosing know best, and you do not need to explain to your vet the why of your decision to curve at home, she knows is not necessary, but unfortunately, the $$ speaks faster, before common sence to a vet sometimes, thanks for letting us know, Macki has no other issues you can get her regulated right here, without stressing each other out
@Diane Tyler's Mom GA
@Sienne and Gabby (GA)
@Wendy&Neko

Thank you so much for the response! unfortunately the $110 IS to be tested at home, she wants me to pay her to interpret my at home results…. :’(

 

[Diane Tyler's Mom GA]

Hi everyone, me again…. Here with an update.
With the holidays, there’s been delayed communication with the vet so I haven’t gotten the Lantus insulin yet. I should pick it up tomorrow from the pharmacy.
Macki’s officially on an all low carb diet - FF pate, boiled chicken, occasional tuna, and freeze dry chicken treats for after BGL checks. As for macki’s BGL’s, I’ve been checking twice a day and the number have been declining!! He usually is in the upper 250’s, sometimes 300’s, but tonight he reached a new reading - 182!!!! (AlphaTrak)

Here is my issue: The vet ordered 2.5units of Lantus BID…. After reading through this forum, I would rather do the “start low go slow” method with .25u instead. She also wrote that she wanted to do a curve after 2 weeks of insulin, and then to send her the results. She stated IT WILL COST $110 FOR HER TO INTERPRET THE RESULTS (!?) and determine if the dose (2.5units) needs to be changed. My question is: Does your vet make you pay this much for eval of glucose curve numbers?!?
I have yet to respond to this email because I’m honestly upset. She also mentioned that she “strongly discourages dose changes without veterinary consult.”
Thoughts?

@squeem3
@tiffmaxee
@Sienne and Gabby (GA)
@Wendy&Neko

Hi Ladies here is Ivy's Introduction Post so you don't have to look for it.
Doesn't 2.5 units to start with too high?

Ivyandmacki​

Member Since 2025​

• Friday at 7:52 AM

Hi everyone, my name is Ivy and my kitty’s name is Macki.
Short intro: he is 11y/o, 12.3lbs, indoor/outdoor, medium haired, healthy all his life until the past month I noticed increased thirst and urination. Took him to the vet and did bloodwork. His glucose was 474 and got dx with diabetes. All other labs normal.

The vet called me and told me these results and offered 3 options: insulin, senvelgo, or “letting him go” if I can’t afford either option. This hurt when she said this. Then I found this lovely website and have been doing lots of research but of course am still overwhelmed. I’m a full time student and not working right now, so I definitely am trying to figure out what is the best financially friendly option, as “letting him go” is NOT an option!

His diet has consisted of purina senior dry food, and fancy feast cans with gravy - he loves these but I just learned these are so high in carbs. I am going to slowly cut out the dry food and also switching to the fancy feast pate like everyone suggests. Also boiling chicken to feed him too. I ordered an alphatrak and it’s coming in the mail today.

My main question - I have to call my vet today and tell her my decision. I will be choosing insulin (I saw too many scary things about senvelgo) and I also saw there is a goodrx coupon for Lantus that is $35/vial. I wanted to request this for Macki as i can afford this one, BUT how do vets/you guys know which insulin the cat should start on? Short acting/long acting? What determines this? Is it okay to start on long acting Lantus? Help! I’ll take any info I can. Just wants what’s best for him without getting scammed by my vet.

Additional question: how long until his thirst / urination is under control once we do start insulin?

-Ivy

 

[Diane Tyler's Mom GA]

I will definitely switch to the ReliOn meter. Although, my alphatrak did come in the mail and I used it about 1.5 hr after he ate, his BG was 350. He used to pee 4x a night and now down to 2x, so far have only adjusted the diet. He seems less thirsty too. I’m telling myself this is progress

@Ivyandmacki
Hi Ivy Maria and I have tagged a few experienced members for you about the dose to start with.

I assume you will be using the Alpha Trak then when the strips run out you will be using the Relion?
Our numbers are based on human meters anyway.
If you are going to follow SLGS like you said please add it to your signature, just tap on your name up top then tap on signature and add it ,then tap save.
When you do start Lantus you can add that to your signature then.
We need you to set up our spreadsheet so you can enter the numbers you have already.I gave you the link for it . If you need help just ask and I can tag one of our members to set it up for you.
If you are going to use the Alpha Trak first that's fine, but when you switch to the Relion the last two color codes for the spreadsheet will need to be changed to reflect a human meter. You can just tag me and I'll tag Bhooma to change it for you
I see you said you are testing Mack twice a day. I know you are a full time student but you at least need to test him again during the day cycle and the night cycle
The more tests you can do the better.
That it just crazy your vet is going to charge you $110 dollars to go over the curve. Like Maria said you can do the curve and ask our experienced members here to look at it. Adjusting the dose by just looking at the curve is not really the correct way to increase or decrease the dose.
Doing tests every day and night is the correct way because you want to see how low the dose is taking Mack.

 

[tiffmaxee]

Welcome. You wint want to you the AT meter as the test strips are really expensive. Do you live near a Walmart? Many use their Relion as the test strips are much more affordable.

Since you have switched to low carb wet food and will follow SLGS 2.5 units is way too high a starting dose. Start with .5. Even if using the more aggressive TR method you would start at 1.0. The food change will make a huge difference.

The only curve my cat ever had was after his first shot at the vet. Home testing is so much less expensive and you get more realistic results because the vet office stress is eliminated. My very docile cat we learned had cage fever that first curve day and the vet who took over fur my vet when he had to leave early temporarily labeled him aggressive!

Keep posting daily if possible when you start insulin and ask all the questions you have. Someone will be happy to help. That’s an advantage as people here are from all time zones and around the world.