Newly diagnosed - need help with buying Lantus

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sugarsuzie

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Hello to everyone! Humans and their cat(2)_steam

I am Diane and my cat Suzie, age about 8, was diagnosed a month ago. She was obsessed with her water bowl (she hung her head over it) and peed huge pee balls, so I knew something was wrong. Her insulin levels were up to 400 when I brought her in but now she is regulated at about 120. I am using Lantus 100units/ml and syringe needles. She doesn't mind the needles at all!! We settle down and I put Suzie in my lap, stroke her neck and give her the needle. I am also feeding her Purina DM. Her vet bills this year will probably reach around $1500. If anyone knows a cheaper place to buy the Lantus please let me know!! My CVS pharmacy is charging $128 for the vial and $35 for the needles and I can't afford to go on like this! :sad:

Hugs to all the sugar kitties and their owners.
 
You do not need a prescription food. A low-carb canned food is fine. You can buy generic syringes for about $15 a box or order them from Hock's (see advertisement at upper left). The $128 is about the ing rate for a 10 ml vial of Lantus. You can purchase the disposable SoloStar pen in a pack of five 3 ml vials. Per ml it is more expensive but almost all caretakers will never use a 10 ml vial before it goes bad. Some caretakers. Some caretakers order it from Canada. See the topic in the Supply Closet forum for ordering from Canada.
 
If you can afford it, I recommend getting your vet to write the prescription for the Lantus Solostart pens. The initial cost is about 1 1/2 to twice the cost of one vial, but you get 5 pens. The problem with the vials is that you will not use all of it before it becomes ineffective, even though you can use it for several weeks beyond the 28 day expiration. With the pens, you get 5 of them and you will be able to use almost every drop. So in reality, for less than twice the cost of a vial, you will get almost a year's worth of insulin.

Another option is to ask your vet to prescribe BCP PZI instead of Lantus. You vet can even order your first vial for free from their website. http://www.bcpvetpharm.com/products_bovine.htm

$35 is high for the syringes. Buy the generic brand syringes. I use Walmart's Relion brand syringes and they cost about $13 for a box of 100.

You also do not need to feed her prescription food. Almost all of us feed our cats regular cat food such as Fancy Feast or Friskies canned food.

Another suggestion is to also learn to hometest. By testing before every shot, you will know 1) if it is safe to give the insulin, 2) if you need to adjust the dose and 3) eliminate the unnecessary trips to the vet just for testing.

I use Lantus and my overall costs a month average around $40 a month including the cost of insulin.
 
Hi Diane!

I had financial problems when starting Bandit out on Lantus, and here's what I did to help with the costs. After my first vial of lantus, I switched to the pens (there are five 3ml pens in one box). They are a little more expensive initially (because you're getting 15 ml instead of 10 ml) But they are FAR more economical in the long run. That vial of lantus will go bad after a month or so and most of it will go to waste. Because there's only 3ml in each pen, you can get through almost a an entire one before it goes bad. 5 pens lasted me about 6 months, and I believe I paid $230 for them. That's about $40 a month as opposed to $130 a month.

There's a coupon now for the pens, too: http://www.lantus.com/solostar-insulin- ... oupon.aspx

You just need to ask your vet for a script for the solostar pens instead of the vials.

You just put your syringe in the top like you would a vial. No need to buy the needles that go with it, you're going to use your regular syringe to dose and shoot, not the pen.

One last thing you can do...call or visit a few different pharmacies and ask what they sell a package of pens for without insurance. Some pharmacies will be a bit cheaper than others. I think Walmart ended up being the cheapest for me, about $20 cheaper than CVS.

Hope this helps. Good luck!
 
If you have a hospital(s) nearby, please call their Outpatient Pharmacy & ask them if they will sell a single pen (most will because they use them in higher volume) then you can buy 1 pen at a time (with tax between $45 - $50) or a lot of people order from 77 Canadian Pharmacy & get their order quickly, it cost $15.00 for the shipping, but their price is about $100 less than United States price. If all else fails, I have an extra pen I will sell you for $20.00 (If I could afford to donate I would)

Good Luck.
 
Frugal Feline Diabetes Tips http://binkyspage.tripod.com/frugal.html

sugarsuzie said:
. I am using Lantus 100units/ml and syringe needles. She doesn't mind the needles at all!! We settle down and I put Suzie in my lap, stroke her neck and give her the needle.
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Lantus is a good insulin to use :thumbup Great that your cat doesn't mind the injections :smile: Make sure to give a healthy low carb treat afterwards so she continues to be a good girl for her shots :smile:

sugarsuzie said:
I am also feeding her Purina DM.
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Good news: you don't need to feed the DM at all. It's nothing but a bunch if poor quality ingredients at a very expensive price.

Many commercial brands of canned foods are better for your cat and much less expensive. Fancy Feast, Friskies, Wellness, Merrick, Nature's Variety are just a few. Use the canned food charts: http://binkyspage.tripod.com/canfood.html Look at the column for carbs and choose foods that have a number 10 or less. These are "low carb". Here's a list of gluten-free low carb Fancy Feast http://felinediabetes.com/glutenfree.htm

BUT..... Don't change the diet just yet. Doing so can cause a big drop in blood glucose numbers, epescially going from dry food to canned food. How much Lantus is you cat getting? Are you testing your cat's blood glucose levels at home? If not, you should do it so you know how the insulin is working. Learn how to test blood glucose levels and then slowly change the diet. You don't need any fancy equipment. A basic Human blood glucose meter and the necessary supplies are all you need and can be bought at any Human pharmacy.


sugarsuzie said:
Her vet bills this year will probably reach around $1500. If anyone knows a cheaper place to buy the Lantus please let me know!! My CVS pharmacy is charging $128 for the vial and $35 for the needles and I can't afford to go on like this!
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It's not worth buying the 10 ml bottle. It tends to "poop out" after a month or so and you throw away a barely used bottle. Buy the pack of Lantus SoloStar or OptiClick pen cartridges instead. The box contains five 3ml pens or cartridges and the entire box is at least a 5 month supply.

You don't need pen needles to use with the SoloStar or an insulin pen to use with the OptiClick cartridges. Humans do but for cats you just stick the insulin syringe needle right into the rubber stopper at the end, just like you would with the 10 ml bottle. Here are pictures:

How%20to%20use%20an%20%20insulin%20pen%20for%20cats.jpg


OptiClik.jpg


What brand of insulin syringes are you buying? The BD UltraFine ones are expensive but there are many lesser expensive brands you can buy. Wal Mart's Relion brand of insulin syringes is good and not expensive. If you live in the US, you can buy insulin syringes online without a prescription. Hocks.com and AmericanDiabetesWholesale.com are two places. Look for U100 3/10cc with half unit markings. Gauge and length is your preferenec. The half unit markings makes it really easy to measure half and even quarter unit doses. Here's an old thread with members' preferred brands of half unit marked insulin syringes: http://www.felinediabetes.com/phorum5/read.php?8,1959122,1959486 I've used the Monoject ones and they cost about $13 for a box of 100.

EDIT:

Some people here buy Lantus from online Canadian pharmacies for much less than what a US pharmacy charges. That might be something you can look into. GlobalDrugsDirect.com is one place. I think you just fax over a prescription.

There are also free prescription drug cards you can use at any US Human pharmacy: http://www.felinediabetes.com/phorum5/read.php?8,1946184,1946184 You might only save a couple dollars but anything helps :smile:
 
Thank you so much everyone for all your helpful information!

I never expected such an outpouring of support. And that diagram of the pen is just wonderful....thank you for taking the time to post it.

Great idea about the generic needles. I am now using the BD ultra fine needles 31G 8mm from CVS. Is the generic brand just as good?

So I should just ask for a low-carb food when I buy?

I wonder why the vet didn't suggest the pens to start out? I wouldn't have bought the vial if this was an option.

I'm trying to get a picture of my Suzie in the avatar box, but I can't figure it out!
 
Regarding using generic insulin syringes, some caretakers say that with some generic brands it is harder to prevent/get out air bubbles.
 
Thanks again everyone!

Next week I am going to get a prescription for the SoloStar pens. How long do they last, about 5-6 months? That seems very economical. If 5 pens cost about $160, then that's only about $32 per month. This makes me so happy. I can treat my baby well and not break the budget. Do the same rules apply to the pens - in other words they should only be used for about 1 month (but I'm assuming most of the liquid will be used and not go to waste)?

I am waiting for my first home test kit to arrive. I am a little nervous about home testing. Right now, I'm just giving Suzie her shots twice a day, 12 hours apart and not testing her - just taking her in to the vet about 2x a month for a test. Her level was 120 last time, down from 400 or so when she was first diagnosed!!

Also, how does an indoor cat lose weight?? :-D My Suzie is about 17 pounds and it's nearly impossible for her to lose weight. confused_cat She doesn't even eat 8 oz of food a day and still gains. She lost a bit before she was diagnosed, got a bit thinner, but she's put it all back on. Any advice would be appreciated. She's always been a big-boned kitty!!

Diane & Suzie
 
Was her blood glucose level 120 at the vet? How long after insulin was this number? I am sounding concerned because cats are usually higher at the vet than at home, as they are usually stressed at the vet and stress raises the levels.

120 6 hours after the insulin, at home, would be a good number. 120 at shot time would be too low to give insulin. 120 at the vet could be much lower at home.

Sure will be glad when you are testing and can get some numbers at home. The insulin seems to be working well. What dose are you giving?
 
sugarsuzie said:
Great idea about the generic needles. I am now using the BD ultra fine needles 31G 8mm from CVS. Is the generic brand just as good?
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Just as good :smile: People do have their prefrences of generic inexpensive insulin syringes. Some like GNP brand, ohers like Relion, etc.

sugarsuzie said:
So I should just ask for a low-carb food when I buy?
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Pet food are not labeled as low carb and asking a store employee won't help. You'll need to use Binky's caned food charts. Take the charts to the store with you so you can be sure to get only the low carb foods.

sugarsuzie said:
I wonder why the vet didn't suggest the pens to start out? I wouldn't have bought the vial if this was an option.
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Lots of vets are unaware of the SoloStar and OptiClick options. They only know about the 10 ml bottle. Sometimes you need to educate your vet a little to get what you want.


sugarsuzie said:
Next week I am going to get a prescription for the SoloStar pens. How long do they last, about 5-6 months? That seems very economical. If 5 pens cost about $160, then that's only about $32 per month. This makes me so happy.
Do the same rules apply to the pens - in other words they should only be used for about 1 month (but I'm assuming most of the liquid will be used and not go to waste)?
Click to expand...


Each individual pen or cartridge lasts at least a month. Some people can get up to 2 months from a pen or cartridge. You usually know when it's time to toss the pen or cartridge and start a new one when your cat's blood glucose levels start to creep upwards and you know that nothing has changed recently (stress, infections, etc). You most likely won't ever use up the entire 3 ml of Lantus within a month or two unless your cat requires large amounts of insulin because of acromegaly or other health condition.


sugarsuzie said:
Also, how does an indoor cat lose weight?? :-D My Suzie is about 17 pounds and it's nearly impossible for her to lose weight. confused_cat She doesn't even eat 8 oz of food a day and still gains. She lost a bit before she was diagnosed, got a bit thinner, but she's put it all back on. Any advice would be appreciated. She's always been a big-boned kitty!!
Click to expand...

There are weight loss tips here http://catinfo.org/?link=felineobesity You can start by makign sure yoru cat gets plenty of excercise. Just a few minutes a day can help a lot.
 
The 120 level was at the vet 6 hours after her morning injection. She's a calm cat and doesn't get too stressed at the vets.
Her dosage is 3 units of Lantus 2x a day.
 
Thanks for all the helpful answers! Right now I am using the 10ml vial of Lantus and the date it was filled was 2/19/11.
I guess this means that it's going to become useless soon and that I should toss it? How can you really tell when it's time to toss it? I am saying this from the point of view of someone who hasn't started home-testing yet, so I can't tell the insulin's effectiveness by how her levels are. So I am wondering if it's just guesswork on the date.
I have heard from some that it's life span is one month and from others that it can go two months. I am waiting for next week to get a prescription from my vet to start the pens.


Each individual pen or cartridge lasts at least a month. Some people can get up to 2 months from a pen or cartridge. You usually know when it's time to toss the pen or cartridge and start a new one when your cat's blood glucose levels start to creep upwards and you know that nothing has changed recently (stress, infections, etc). You most likely won't ever use up the entire 3 ml of Lantus within a month or two unless your cat requires large amounts of insulin because of acromegaly or other health condition.
 
Hi Suzie and welcome to FDMB.

Just as an FYI, the Opticlick cartridges are no longer available. They were discontinued several months ago. The only way to get a box of Solostar pens at a cost under roughly $200 is to order through a Canadian pharmacy. Definitely call around to pharmacies (e.g., CVS, Sam's Club, Walmart, Costco) and price shop. Also, the outpatient arm of a hospital pharmacy may sell a single pen. It's not so much because of the volume they order but because they have to break the boxes apart to send pens to hospital floors for medicating diabetic patients. Not all hospital pharmacies do this so again, it's a matter of calling around.

I'd really like to echo Sue's concern about home testing. Is there a Walmart nearby? The Relion meters, strips, lancets, and syringes (you want U100 syringes that are marked in half unit increments) are inexpensive. If your cat was at 120 at mid-cycle in the vet's office, he may be lower at home. The dose you are giving is a good size dose of Lantus. Could you describe how you worked up to that dose?

Since you are using Lantus, you may want to read up on the information that's provided in the Lantus forum.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.
 
sugarsuzie said:
Thanks for all the helpful answers! Right now I am using the 10ml vial of Lantus and the date it was filled was 2/19/11.
I guess this means that it's going to become useless soon and that I should toss it? How can you really tell when it's time to toss it? I am saying this from the point of view of someone who hasn't started home-testing yet, so I can't tell the insulin's effectiveness by how her levels are.
Click to expand...


There is no way to tell from the 10 ml bottle if it has lost effectiveness. Sometimes you can see white specks floating around in the insulin. Othertimes the insulin is still crystal clear whenit poops out. That's one reason why hometesting is so important :smile: If bgs start creeping up and the insulin is a month old, you need to use new insulin. Your bottle is probably still good but do look into buying the SoloStar pens soon.
 
http://hocks.com/hocks-healthcare/hocks ... 40030.html

I really like these syringes from Hocks. They cost $17.49 per 100

To get free shipping, the order total needs to be over $79.

So.... I buy several months supply at one time --

2 boxes $35
2 boxes Lancets $3.00 (1.49 per 100 for Invacare 30g)
4 <50ct> test strips for Maxima / Infinity meter $16.50 each $66

total = $104 - lasts 100 days with two syringes and two tests per day. (more than 3 months)

We sometimes buy extra lancets and strips because we do additional testing for curves, etc.
 
For the Lantus pens, if you have a Costco nearby, they will often sell pens one at a time as well. Doesn't save you money, but does allow you to not have to pay $200+ up front. Also, if you have AAA, I understand that it provides a small discount as well.

Good luck!
 
Hello again everyone!

Yes, I assumed that you really couldn't tell if the Lantus vial has become ineffective just by looking at it. It's still clear and cloudless so I will use it until I can get the pens.

Thank you, yes, I do have AAA and it does provide a small discount but I don't think I can use it for Canadian pharmacies.

I am going to either order the syringes from Walmart or from Hocks as you all have suggested.

I was just on the Lantus website and I wanted to ask a question - the SOLOSTAR pen says it's for once daily 24-hour lasting use. Does that mean if your kitty is getting Lantus 2x a day you continue to do that or do you switch to once a day every 24-hours?

Hope everyone is enjoying their weekend.
 
sugarsuzie said:
I was just on the Lantus website and I wanted to ask a question - the SOLOSTAR pen says it's for once daily 24-hour lasting use. Does that mean if your kitty is getting Lantus 2x a day you continue to do that or do you switch to once a day every 24-hours?
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Keep in mind that Lantus is only approved for Human use. The Lantus web site is all info for Human use.

Cats metabolize insulin twice as fast as Humans. You need to give a cat insulin injections twice a day, roughly 12 hours apart.
 
Another tip on syringes (I too use Lantus) is that (my) Target switched to a brand called Soft Comfort that cost $14/100. With Target being a chain, there is a good chance they all switch(?) They used to have the BD for $35 and I got them for about $28 with an RXAccess card. Since I have no insurance I use it for a little break on all my prescriptions - and it covers cats! :-D My Lantus is $103 (with the card - here's a link http://www.togetherrxaccess.com/) There are several of those discount prescription card offers, but this one is legit and I have used it for several years - and it covers cats! :-D

So there are 2 possible cost savings tips.

Now I may get yelled at for this, but I use the vial and I keep it well past the 30 day cut off. I home test so I monitor closely and I have kept it up to 4 months - that's about $25/month. I keep it in the fridge, test regularly. Right now her BG is up but it has nothing to do with the Lantus, in fact she got a new vial 2 weeks ago, but that's for another thread.

Hope the tips help - good luck with your kitty!

B&K&L

ps - having no health insurance I call all over to find the cheapest scripts and I find CVS to be one of the more expensive and Target the cheapest (and sometimes Canadadrugs.com - they are great folks and offer free shipping on orders more than $99) - I takes 6 daily and some others as needed so it can mean a lot of $avings for me!
 
I only want to add one thing, when purchasing syringes make sure you get the ones with half unit markings. I bought the Relion ones at walmart and they weren't marked very clearly and did not have half unit markings. I will just use them when I get an even dose or donate them but you can't usually return supplies so make sure you get the right ones out of the gate, less stress! Good luck!
 
Steph and Java said:
I only want to add one thing, when purchasing syringes make sure you get the ones with half unit markings. I bought the Relion ones at walmart and they weren't marked very clearly and did not have half unit markings. I will just use them when I get an even dose or donate them but you can't usually return supplies so make sure you get the right ones out of the gate, less stress! Good luck!
Click to expand...

Walmart does have the Relion ones with the half unit markings...your vet should be able to indicate that in the prescription. I always checked the box before I left the store to make sure they gave me the right ones.
 
Loving all the information you are all sharing with me! Thank you to everyone!

Can someone link me to the list of discount drug cards, please? I had a look at it, thought that I bookmarked it, but I guess that I didn't.
 
Now I may get yelled at for this, but I use the vial and I keep it well past the 30 day cut off. I home test so I monitor closely and I have kept it up to 4 months - that's about $25/month. I keep it in the fridge, test regularly. Right now her BG is up but it has nothing to do with the Lantus, in fact she got a new vial 2 weeks ago, but that's for another thread.
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I, too, use the vials. Of course I was given lots of them. I checked the other day when I opened it (Dec. 3, 2010 and it supposedly expires 1/31/11) and it still has potency as witness Zena's 43 the other morning. I talked to a friend and she is using a vial also that expires 1/31/11 and she says it is working for her too. So don't be afraid, should someone on our message board have a vial to give away or you get a coupon for a discount on a vial, to use it. Someone in the Supply Closet got them off Craigslist for $14 a vial and was selling them. Might check over there to see if they are still available.
 
I'm confused about keeping Lantus in the refrigerator. The pharmacist and vet told me not to keep it in the fridge once it's been used.
I also read that injecting a cat with cold Lantus is painful.
Can someone clarify this? Thanks!!
 
Keep in the fridge. Otherwise it will not last much longer than 30 days. Unless your cat is on a high dose, the syringe will warm the small amount of insulin that is injected. If you want you can roll the filled syringe in your hands to warm it up. If you use a pen, the instruction say to not refrigerate a opened pen. This is to prevent leakage out of the pen and drawing air into the pen. Air in the pen can result in inaccurate dosing using the pen's dosing mechanism. Since we just draw the Lantus out of he pen with a syringe air is not a concern.
 
sugarsuzie said:
Can someone link me to the list of discount drug cards, please? I had a look at it, thought that I bookmarked it, but I guess that I didn't.
Click to expand...

http://www.felinediabetes.com/phorum5/read.php?8,1946184,1946184

Dale said:
I checked the other day when I opened it (Dec. 3, 2010 and it supposedly expires 1/31/11)
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The date printed on the label and box (10 ml bottle, pen, or cartridge) is for the unopened unused Lantus. Once you pierece the rubber stopper with an insulin syringe needle, the insulin is only good for about a month. Some people have gotten 2 months use or more out of a 10 ml bottle.
 
argh. don't roll lantus (rolling or shaking it could damage it--it's ready to go, as is). if you need to warm it in the pen just hold it between your fingers to warm it a little. most cats use such small doses that they don't need the lantus prewarmed, tho.

keeping it refrigerated can extend the life of the lantus. the instrux about not refrigerating are because of the extreme temperature differences when a person uses lantus and carries it around during the day. (in a hot car, in the fridge, etc.) it's a different story for cats.
 
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