Newly diagnosed, Vet recommendations in Toronto (west end)

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lynngaut

Member
Hello,

My cat Fluffy was just diagnosed this past Saturday, pending the results of the fructosamine test, which became available today and confirmed the diagnosis. The vet's BG test read 32.8mmol/L. Since Saturday, someone close to me suggested I read this forum and has provided lots of support and advice. So, with the help of that person and the resources on this board, my husband and I have cut out all of Fluffy's dry food and treats, switched his wet food to Wellness Chicken - he gets a 5.5oz can divided over 2 meals, spaced 12 hours apart, and I've been giving him the occasional freeze-dried chicken breast,shrimp or chicken liver treat. I've also been home testing him with a glucometer. His readings yesterday were 18.4mmol/L 3.5h after his last meal and 19.8mmol/L 12 hours after his last meal. Today his reading was 17.0 measured 8 hours after his last meal. I say after his last meal, but he's really a grazer, not a gobbler, so he'll eat about half the amount I put down and then come back to his bowl off and on until it's all gone. We also have 3 other cats fyi who are not diabetic but are following the same diet because everyone eats out of everyone else's bowls.

After reading lots of the excellent resources on this board, including the start low and go slow advice, the Roomp and Rand study and the AAHA Diabetes Management Guidelines for Dogs and CAts document, and based on our schedules (we work pretty long hours but will make every effort to do the q 12 hour dosing/feeding schedule), it seems like Lantus would be the way to go treatment-wise.

I've had 2 telephone conversations with the vet since Saturday. On Monday, when the vet suggested I bring Fluffy in on Wednesday (tomorrow) to be started on insulin, I asked which insulin he'd be starting him on and he said Canninsulin. I asked if Lantus was something he would consider and he said that Canninsulin is the product he uses. Today when I asked about Lantus again, he said I could bring it in if I could find it (we live in Toronto) and he would administer it but he's never used it before. Then he asked me if it was available here in Canada. So of course, I said yes, and that I would bring in the vial for him to administer during Fluffy's inpatient day. He also asked me to bring in some syringes to use along with the Lantus.

Since the vet has no prior experience with Lantus - and didn't even know it was available in Canada, I'm worried he won't know what the initial starting dose should be and won't know how to titrate the dose based on dosing guidelines and Fluffy's BG levels. I've already given the vet our home readings, so he knows that Fluffy's clinic BG level was much higher than his home readings have been, and I plan to stay home with Fluffy for his first at-home insulin day so that I can monitor his BG levels and behaviour for any signs of a hypo. I'll also always test BG levels pre-shot and try to do an additional third test during the day on the rest of the days that I have to work and can't be at home.

I'm wondering if I've made the right decision to let the vet administer the Lantus or if I should just let him use what he knows and administer the Canninsulin. If Fluffy does end up on Lantus, what sort of schedule should I be keeping shot vs food wise, if I usually feed at 7am and 7pm? On his first day home, how often should I test BG levels? I've seen some discrepant information about how often I should do this on the first day. Is there anything else I should be doing? I'm trying not to panic and this board has been a lifesaver!

Thanks so much for reading this and for any suggestions you might have!

Lynn
 
Re: New here - newly diagnosed, lots of questions

Welcome Lynn! You've already done a lot of research and have good instincts. That you are already testing at home is fabulous.

Yes, Lantus is a much better insulin than Canninsulin. But I can understand your hesitancy with the vet. He doesn't seem to know much about it. You're in luck! We have a Lantus forum with protocols on how much to dose,when to dose - everything you need to know. Here's the page: it's the starred topics on top.
[url=http://www.felinediabetes.com/FDMB/viewforum.php?f=9]viewforum.php?f=9[/url]

Although some vets want to have the cat for the first day of insulin, it's not necessarily. As you know, the numbers at the vet are likely to be higher than at home so they aren't good numbers to base doses on. Would your vet let you come in for the first shot, then take him home and do the testing? Send the vet your numbers and keep him in the loop?
 
Re: New here - newly diagnosed, lots of questions

lynngaut said:
Hello,

My cat Fluffy was just diagnosed this past Saturday, pending the results of the fructosamine test, which became available today and confirmed the diagnosis. The vet's BG test read 32.8mmol/L. Since Saturday, someone close to me suggested I read this forum and has provided lots of support and advice. So, with the help of that person and the resources on this board, my husband and I have cut out all of Fluffy's dry food and treats, switched his wet food to Wellness Chicken - he gets a 5.5oz can divided over 2 meals, spaced 12 hours apart, and I've been giving him the occasional freeze-dried chicken breast,shrimp or chicken liver treat. I've also been home testing him with a glucometer. His readings yesterday were 18.4mmol/L 3.5h after his last meal and 19.8mmol/L 12 hours after his last meal. Today his reading was 17.0 measured 8 hours after his last meal. I say after his last meal, but he's really a grazer, not a gobbler, so he'll eat about half the amount I put down and then come back to his bowl off and on until it's all gone. We also have 3 other cats fyi who are not diabetic but are following the same diet because everyone eats out of everyone else's bowls.

After reading lots of the excellent resources on this board, including the start low and go slow advice, the Roomp and Rand study and the AAHA Diabetes Management Guidelines for Dogs and CAts document, and based on our schedules (we work pretty long hours but will make every effort to do the q 12 hour dosing/feeding schedule), it seems like Lantus would be the way to go treatment-wise.

I've had 2 telephone conversations with the vet since Saturday. On Monday, when the vet suggested I bring Fluffy in on Wednesday (tomorrow) to be started on insulin, I asked which insulin he'd be starting him on and he said Canninsulin. I asked if Lantus was something he would consider and he said that Canninsulin is the product he uses. Today when I asked about Lantus again, he said I could bring it in if I could find it (we live in Toronto) and he would administer it but he's never used it before. Then he asked me if it was available here in Canada. So of course, I said yes, and that I would bring in the vial for him to administer during Fluffy's inpatient day. He also asked me to bring in some syringes to use along with the Lantus.

Since the vet has no prior experience with Lantus - and didn't even know it was available in Canada, I'm worried he won't know what the initial starting dose should be and won't know how to titrate the dose based on dosing guidelines and Fluffy's BG levels. I've already given the vet our home readings, so he knows that Fluffy's clinic BG level was much higher than his home readings have been, and I plan to stay home with Fluffy for his first at-home insulin day so that I can monitor his BG levels and behaviour for any signs of a hypo. I'll also always test BG levels pre-shot and try to do an additional third test during the day on the rest of the days that I have to work and can't be at home.

I'm wondering if I've made the right decision to let the vet administer the Lantus or if I should just let him use what he knows and administer the Canninsulin. If Fluffy does end up on Lantus, what sort of schedule should I be keeping shot vs food wise, if I usually feed at 7am and 7pm? On his first day home, how often should I test BG levels? I've seen some discrepant information about how often I should do this on the first day. Is there anything else I should be doing? I'm trying not to panic and this board has been a lifesaver!

Thanks so much for reading this and for any suggestions you might have!

Lynn

Hi Lynn,
Welcome to the site and don't worry about your vet not knowing about Lantus... it doesn't matter because being in Canada, you can just go to Shopper's DrugMart and ask the pharmacist for a pack or 5 cartridges of Lantus.
Be sure to get their Optimum Card because the points will add up.... every 3 months or so, I would be able to get my insulin pack free, just by using the points I had amassed on all my purchases there.

Lantus and Levemir are human insulins, so your vet may not know about it.

Here's where I give a plug for an awesome vet in Toronto. Dr. Jon Mittelman at Kingston Road Animal Hospital. It's an emergency vet hospital, are open 24/7, and have Xray and ultrasound, etc equipment on site, plus have a big pharmacy for meds onsite. He and Dr. Samson are amazing and if I had remained in Toronto, they would still be my vets. They DO know about Lantus and recommend all their clients use it... they know that Caninsulin is lousy.

If you want to know about other vets in the Toronto and surrounding area, just change your Subject of your first post in this thread to ask the others.... there are a handful of members here who are in Toronto, Mississauga and other near areas.
 
Re: New here - newly diagnosed, lots of questions

Sue and Oliver (GA) said:
Welcome Lynn! You've already done a lot of research and have good instincts. That you are already testing at home is fabulous.

Yes, Lantus is a much better insulin than Canninsulin. But I can understand your hesitancy with the vet. He doesn't seem to know much about it. You're in luck! We have a Lantus forum with protocols on how much to dose,when to dose - everything you need to know. Here's the page: it's the starred topics on top.
viewforum.php?f=9

Although some vets want to have the cat for the first day of insulin, it's not necessarily. As you know, the numbers at the vet are likely to be higher than at home so they aren't good numbers to base doses on. Would your vet let you come in for the first shot, then take him home and do the testing? Send the vet your numbers and keep him in the loop?

Thanks for the link to the lantus forum. As for letting me come in for the first shot - I'll have to ask him tomorrow when I see him. I'll need lessons in SC injecting anyway so this might be a good time to do that.
 
Re: New here - newly diagnosed, lots of questions

Gayle Shadoe & Oliver said:
lynngaut said:
Hello,

My cat Fluffy was just diagnosed this past Saturday, pending the results of the fructosamine test, which became available today and confirmed the diagnosis. The vet's BG test read 32.8mmol/L. Since Saturday, someone close to me suggested I read this forum and has provided lots of support and advice. So, with the help of that person and the resources on this board, my husband and I have cut out all of Fluffy's dry food and treats, switched his wet food to Wellness Chicken - he gets a 5.5oz can divided over 2 meals, spaced 12 hours apart, and I've been giving him the occasional freeze-dried chicken breast,shrimp or chicken liver treat. I've also been home testing him with a glucometer. His readings yesterday were 18.4mmol/L 3.5h after his last meal and 19.8mmol/L 12 hours after his last meal. Today his reading was 17.0 measured 8 hours after his last meal. I say after his last meal, but he's really a grazer, not a gobbler, so he'll eat about half the amount I put down and then come back to his bowl off and on until it's all gone. We also have 3 other cats fyi who are not diabetic but are following the same diet because everyone eats out of everyone else's bowls.

After reading lots of the excellent resources on this board, including the start low and go slow advice, the Roomp and Rand study and the AAHA Diabetes Management Guidelines for Dogs and CAts document, and based on our schedules (we work pretty long hours but will make every effort to do the q 12 hour dosing/feeding schedule), it seems like Lantus would be the way to go treatment-wise.

I've had 2 telephone conversations with the vet since Saturday. On Monday, when the vet suggested I bring Fluffy in on Wednesday (tomorrow) to be started on insulin, I asked which insulin he'd be starting him on and he said Canninsulin. I asked if Lantus was something he would consider and he said that Canninsulin is the product he uses. Today when I asked about Lantus again, he said I could bring it in if I could find it (we live in Toronto) and he would administer it but he's never used it before. Then he asked me if it was available here in Canada. So of course, I said yes, and that I would bring in the vial for him to administer during Fluffy's inpatient day. He also asked me to bring in some syringes to use along with the Lantus.

Since the vet has no prior experience with Lantus - and didn't even know it was available in Canada, I'm worried he won't know what the initial starting dose should be and won't know how to titrate the dose based on dosing guidelines and Fluffy's BG levels. I've already given the vet our home readings, so he knows that Fluffy's clinic BG level was much higher than his home readings have been, and I plan to stay home with Fluffy for his first at-home insulin day so that I can monitor his BG levels and behaviour for any signs of a hypo. I'll also always test BG levels pre-shot and try to do an additional third test during the day on the rest of the days that I have to work and can't be at home.

I'm wondering if I've made the right decision to let the vet administer the Lantus or if I should just let him use what he knows and administer the Canninsulin. If Fluffy does end up on Lantus, what sort of schedule should I be keeping shot vs food wise, if I usually feed at 7am and 7pm? On his first day home, how often should I test BG levels? I've seen some discrepant information about how often I should do this on the first day. Is there anything else I should be doing? I'm trying not to panic and this board has been a lifesaver!

Thanks so much for reading this and for any suggestions you might have!

Lynn

Hi Lynn,
Welcome to the site and don't worry about your vet not knowing about Lantus... it doesn't matter because being in Canada, you can just go to Shopper's DrugMart and ask the pharmacist for a pack or 5 cartridges of Lantus.
Be sure to get their Optimum Card because the points will add up.... every 3 months or so, I would be able to get my insulin pack free, just by using the points I had amassed on all my purchases there.

Lantus and Levemir are human insulins, so your vet may not know about it.

Here's where I give a plug for an awesome vet in Toronto. Dr. Jon Mittelman at Kingston Road Animal Hospital. It's an emergency vet hospital, are open 24/7, and have Xray and ultrasound, etc equipment on site, plus have a big pharmacy for meds onsite. He and Dr. Samson are amazing and if I had remained in Toronto, they would still be my vets. They DO know about Lantus and recommend all their clients use it... they know that Caninsulin is lousy.

If you want to know about other vets in the Toronto and surrounding area, just change your Subject of your first post in this thread to ask the others.... there are a handful of members here who are in Toronto, Mississauga and other near areas.

Oh my gosh, I forgot to use my optimum card when I bought the Lantus! Thanks for the reminder for next time!
Thanks also for the vet recommendation. Unfortunately I live in the west end of the city, close-ish to the Mississauga border, so Kingston Rd would be a bit far but it's good to know of another emerg place other than the Mississauga and Avenue Rd. emerg hospitals.
 
Re: New here - newly diagnosed, lots of questions

I got almost all of my supplies at Shoppers; syringes, pepcid, test strips, insulin, and I waited till there were the $10 cards or else the 20x points specials.... then I stocked up.

If you are interested in vet referrals, just post Mississauga in your subject line as there are several members who live on that side of town and can let you know about their own vet experiences.
 
Re: New here - newly diagnosed, lots of questions

Your vet may be familiar with it if you asked him about "glargine". Lantus is a brand name, I think.

Carl
 
Re: New here - newly diagnosed, lots of questions

Carl & Bob in SC said:
Your vet may be familiar with it if you asked him about "glargine". Lantus is a brand name, I think.

Carl

Thanks, Carl. Sorry, I should have put this info in my original post - he does know that Lantus is glargine. It came up in both of our conversations.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

hi Lynn,

definitely add Mississauga to your title line - there are a few members from that area in this board!
I am on the west end too, but closer to south Etobicoke and the lake.
In my neighbourhood, I use Long Branch Animal Clinic, and the vet there Dr W, is great!
Mimico's Marina clinic - not that good.
I don't know any in Mississauga, but like Gayle mentioned, there are members in that area!

Be sure to read up on Lantus in the Lantus forum, print out as much as you can, all the info here is great!
Good luck to u!
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Ronnie & Luna said:
hi Lynn,

definitely add Mississauga to your title line - there are a few members from that area in this board!
I am on the west end too, but closer to south Etobicoke and the lake.
In my neighbourhood, I use Long Branch Animal Clinic, and the vet there Dr W, is great!
Mimico's Marina clinic - not that good.
I don't know any in Mississauga, but like Gayle mentioned, there are members in that area!

Be sure to read up on Lantus in the Lantus forum, print out as much as you can, all the info here is great!
Good luck to u!

I'm actually just a little north of that neighbourhood and Long Branch animal clinic is not too far away so I may check them out. Thank you for the recommendation!
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

lynngaut said:
Today when I asked about Lantus again, he said I could bring it in if I could find it (we live in Toronto) and he would administer it but he's never used it before. Then he asked me if it was available here in Canada. So of course, I said yes, and that I would bring in the vial for him to administer during Fluffy's inpatient day. He also asked me to bring in some syringes to use along with the Lantus.
Lynn

Did you purchase the U100 syringes to use with the Lantus? I am glad that the vet asked you to bring these in, as Caninsulin is given with a different kind of syringe. How long will Fluffy be at the vet? The insulin should only be given once every 12 hours, and a usual starting dose is 1 unit. (Just checking, as you mentioned that the vet asked for syringes - plural). Fluffy's numbers will likely be higher at the vet than at home, as you know. In addition, Lantus needs some time to build up in the body, so the effects of the first dose will not be fully apparent on the first day.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Hi again,

Ditto on the previous post above me - about the syringes and injections every 12 hours.
Double check which kind of syringes ok?
As an example we use BD brand, short, 3/10 cc's in 1/2 unit markings - easier to measure smaller doses.

Lantus does need a bit of patience for a dose to settle, so keep in mind it wont happen on the first day.
A collection of data (hometesting) will give u a good and better idea of how the Insulin is working thru each cycle.
If your vet insists on a curve in the clinic - u may want to make sure they dont feed dry food, as that can help maintain numbers on the higher range - I see you have transitioned your kitties so that is a great step!

I also wanted to mention - if u haven't purchased the lantus yet, shoppers drug mart for sure sells it, 5 pack of 3ml vials is about $120. I buy my insulin at Costco, lantus 5/pack is $95.
And u dont need a membership at Costco pharmacy, as well as u dont need a prescription to buy insulin at all here.
At least in Ontario.


Ok thats it for now, let's hope it goes well with the vets!
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Linda and Bear Man said:
lynngaut said:
Today when I asked about Lantus again, he said I could bring it in if I could find it (we live in Toronto) and he would administer it but he's never used it before. Then he asked me if it was available here in Canada. So of course, I said yes, and that I would bring in the vial for him to administer during Fluffy's inpatient day. He also asked me to bring in some syringes to use along with the Lantus.
Lynn

Did you purchase the U100 syringes to use with the Lantus? I am glad that the vet asked you to bring these in, as Caninsulin is given with a different kind of syringe. How long will Fluffy be at the vet? The insulin should only be given once every 12 hours, and a usual starting dose is 1 unit. (Just checking, as you mentioned that the vet asked for syringes - plural). Fluffy's numbers will likely be higher at the vet than at home, as you know. In addition, Lantus needs some time to build up in the body, so the effects of the first dose will not be fully apparent on the first day.
Ronnie & Luna said:
Did you purchase the U100 syringes to use with the Lantus? I am glad that the vet asked you to bring these in, as Caninsulin is given with a different kind of syringe. How long will Fluffy be at the vet? The insulin should only be given once every 12 hours, and a usual starting dose is 1 unit. (Just checking, as you mentioned that the vet asked for syringes - plural). Fluffy's numbers will likely be higher at the vet than at home, as you know. In addition, Lantus needs some time to build up in the body, so the effects of the first dose will not be fully apparent on the first day.

Hi,
Yes, I did get the U100 syringes. Fluffy will be there tonight until 7. The vet called me a little while ago to strongly recommend the use of caninsulin. His concern is the long acting nature of glargine and that I will inadvertently overdose Fluffy on his second dose. He said he consulted with a colleague who also suggests caninsulin. He also said he'd ask his caninsulin rep if glargine is better than caninsulin (which seems like a ridiculous question to me. Of course she's going to say caninsulin is better than glargine. She's the sales rep!!). I think I need a new vet. I'm going back tonight to pick Fluffy up but also to plead my case that I will always test before giving a shot and I will adjust based on BG readings, the dosing protocol and the recommendations and support on this board. I'm also going to bring the curve information for both insulins and try to explain to him why I favour one over the other. Even though I plan to switch vets, I don't want the next person who is caring for a diabetic cat to have to deal with some of his unwillingness to learn.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Ronnie & Luna said:
Hi again,

Ditto on the previous post above me - about the syringes and injections every 12 hours.
Double check which kind of syringes ok?
As an example we use BD brand, short, 3/10 cc's in 1/2 unit markings - easier to measure smaller doses.

Lantus does need a bit of patience for a dose to settle, so keep in mind it wont happen on the first day.
A collection of data (hometesting) will give u a good and better idea of how the Insulin is working thru each cycle.
If your vet insists on a curve in the clinic - u may want to make sure they dont feed dry food, as that can help maintain numbers on the higher range - I see you have transitioned your kitties so that is a great step!

I also wanted to mention - if u haven't purchased the lantus yet, shoppers drug mart for sure sells it, 5 pack of 3ml vials is about $120. I buy my insulin at Costco, lantus 5/pack is $95.
And u dont need a membership at Costco pharmacy, as well as u dont need a prescription to buy insulin at all here.
At least in Ontario.


Ok thats it for now, let's hope it goes well with the vets!

Hi, yes, those are the exact syringes I bought. I plan on doing the curve myself. Fluffy's reading was so much higher in the clinic than the readings at home so a curve at the clinic seems like unreliable information.
Thanks for the cost info! I asked the vet if he wanted me to get the cartridges or a vial and he asked me to get the vial so that's what I bought but I will get the cartridges on my next purchase.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

my first vet first put my Annie on Caninsulin, and it was a horrible horrible insulin. It's meant more for dogs. I switched vets to the one someone suggested to you, Dr Mitleman at the Kingston Rd Animal Hospital, and he switched Annie to Lantus instantly and he refuses to use Caninsulin on cats. If you start low on doses of Lantus, and as long as you are home testing, the chances of overdosing your cat on it are very very slim. This board is a GREAT guide.

Please find a new vet, and please don't put your Fluffy on Caninsulin...
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Fluffy's mom, I feel for u!
We to started on caninsulin back in 2009, I knew nothing of it, went along with the vet at the time for 2 months - my cat Luna was up and down, miserable, lethargic, and just not himself :(

We had switched to lantus after wasting 2 months on caninsulin and withing a few weeks, the changes were awesome!
Like a lot of us from Canada and a few from Europe, we have been thru bad times on caninsulin, I wish the vets who are behind on the times would come forward into 2012 and have an open mind to human insulins that have been proven to do well on our kitties.
Caninsulin is just harsh, and it just depresses me thinking about it...I think u already have a pretty good idea thou
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Hi,
Yes, I did get the U100 syringes. Fluffy will be there tonight until 7. The vet called me a little while ago to strongly recommend the use of caninsulin. His concern is the long acting nature of glargine and that I will inadvertently overdose Fluffy on his second dose. He said he consulted with a colleague who also suggests caninsulin. He also said he'd ask his caninsulin rep if glargine is better than caninsulin (which seems like a ridiculous question to me. Of course she's going to say caninsulin is better than glargine. She's the sales rep!!). I think I need a new vet. I'm going back tonight to pick Fluffy up but also to plead my case that I will always test before giving a shot and I will adjust based on BG readings, the dosing protocol and the recommendations and support on this board. I'm also going to bring the curve information for both insulins and try to explain to him why I favour one over the other. Even though I plan to switch vets, I don't want the next person who is caring for a diabetic cat to have to deal with some of his unwillingness to learn.

Caninsulin may be just fine for dogs, but it's pure garbage for cats. When you home test, you can prove to the vet that there is NO WAY that Caninsulin lasts anywhere near 12hrs. If it lasts 8 hours, that's pushing it.

The vet I mentioned, they have 3 offices I believe and I was told that none of their vets would even consider Caninsulin for cats. Ever.

Sadly, there are people in UK who are stuck with having to use Caninsulin and even with giving shots TID every 8 hours, it's still horrible.

If you vet is stubborn, there is not much you can do to change the vet's attitude, but you can post a review of this vet and the office online to warn others.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Hi hi!

I see that you're a fellow GTA-er! Kit and I would like to welcome you to FDMB!! This is such a wonderful place with such great people, it's just amazing! Kit and I started this journey on the Christmas long weekend, and with the help of the people here, he was OTJ by the end of March. So exciting!

Ronnie asked me to chime in about vets in the area....we live in Mississauga and brought Kit for the first time to Burnhamthorpe Animal Hospital to see Dr. K.A.. She was wonderful! Got all our tests in the first time, she didn't gouge us for anything (esp since it was our first time there) - just bloodwork. She was nice enough to call us the next day with the results and we came in to learn about insulin, etc. She informed us about home testing and said that the choice is ours, she would support our decision, she didn't push Rx food, advocated for strictly wet food and when I emailed her this link and Binky's charts she was more than happy. Although I don't know much more about the place, because we haven't been back since - my conversations with them have been wonderful, very supportive, and always quick to get back to me.

I wish you guys all the best and remember to keep asking questions!! You and Fluffy will become a great team as you begin this dance together :)
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Well, I just picked Fluffy up from the vet's office. He told me he wouldn't administer the lantus that he asked me to buy because it wasn't FDA approved and he didn't want to get in trouble. I tried citing the literature demonstrating the efficacy of lantus over caninsulin but it didn't seem to matter. At one point he said "I don't have a pig degree, you know". So, I left with Fluffy without any caninsulin and I need to find another vet tomorrow.
I'm going to try some of the places already suggested above. Thanks, everyone for your support and kind words. Fluffy is resting comfortably in one of his favourite places by the front door and seems happy to be home.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

lynngaut said:
Well, I just picked Fluffy up from the vet's office. He told me he wouldn't administer the lantus that he asked me to buy because it wasn't FDA approved and he didn't want to get in trouble.


Lantus is FDA approved..... for Humans. Cats use Lantus, and many other Human medicines and drugs, "off label". The manufacturer of Lantus, Sanofi, only makes Human medicnes/drugs so they can only get the FDA's approval for the use of the medicines/drugs in Humans.

Have you shown the vet the Rand study? http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf There are other published veterinary studies on usign Lantus for cats.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

squeem3 said:
lynngaut said:
Well, I just picked Fluffy up from the vet's office. He told me he wouldn't administer the lantus that he asked me to buy because it wasn't FDA approved and he didn't want to get in trouble.


Lantus is FDA approved..... for Humans. Cats use Lantus, and many other Human medicines and drugs, "off label". The manufacturer of Lantus, Sanofi, only makes Human medicnes/drugs so they can only get the FDA's approval for the use of the medicines/drugs in Humans.

Have you shown the vet the Rand study? http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf There are other published veterinary studies on usign Lantus for cats.

Yes, I did bring up the off-label use of some drugs for neuropathic pain, to which he did admit to using gabapentin for neuropathic pain, even though that's off-label for that drug. I did also show him the Rand study - left it for him this morning. He handed it back to me this evening.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

What does that mean the vet handed the Rand study back? Not impressed? What did the vet say about it?

Make a list of questions important to you and start interviewing vets.
Be sure to get copies of all the test results and blood work done at your current vet as it will be important history to give to your new vet.
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

oh geez Lynn, I'm sorry about that vet.
Reminds me of the vet we had while on Caninsulin, one of the last things he said to me was "you don't have my blessing if you use canned cat food"
seriously, it is probably for the best that you move on.

What I did when I met Dr W, is I paid for a consultation, just her and I, and I explained the previous vet's issues with canned food and his general attitude that it's his way or the highway.
Dr W was very understanding, accepting in my choices of what I had learned, and like I mentioned, she was very happy to work with me and to be our regular vet should I need her for anything. If you go with her, be sure to give her my name and Luna's like I mentioned in my pm to u, maybe you will get a discount!

I am really sorry about what you went thru, as Gayle mentioned, do try to get your kitty's records asap, copies usually, they may charge you a fee, it's a given most times, I gladly paid my fee to pull Luna's records just to get away from that vet!

It will be ok, you will make a good choice with the recommendations you received.
The board is pretty much here 24/7, always someone to help out!
(((hugs to u and Fluffy!)))
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

You need a new vet... badly. Please run, don't walk, from that vet. Bad vets will feel threatened by people bringing in new information for them. You need a vet that is willing to work with you. This is your cat. Not theirs. The treatment protocol is YOUR decision. And please, make the right decision... do not let this oldschool vet convince you to put your cat on an insulin that is a decade old, ineffective, and often dangerous treatment. Your cat will be the one to suffer while the vet laughs and pulls in big $$$ because you are buying the insulin through them, the syringes through them, paying to use their fancy schmancy AlphaTrak meter and charging you massive fees to keep your cat all day to get "regulated" (which is an absolute waste of money), etc.

You have the Lantus and your syringes. Buy a meter, strips, lancets, etc. and start treatment yourself. Don't let any vet tell you their way is the only way. Because, even though years ago Caninsulin, Vetsulin, Humulin N, etc. may have been the recommended insulins for cats, times have changed. And so have treatment protocols. Cats have a faster metabolism than dogs and humans. About twice as fast. So the 24 hr human insulins ie. Lantus and Levemir last approximately 12-14 hrs in a cat. Caninsulin/Vetsulin and Humulin N last about 6-8 hrs in cats, at the most. And they cause steep, harsh drops. By the 3 or 4 hour mark your cat is on the rise again and those numbers bouncing all over the place are NOT going to make it easy to get your cat regulated and remission is a faint hope. There is a window on remission. The faster you start insulin, the better chance you have of remission. The more time you waste messing around with an insulin that very likely isn't going to work, the less chance you have at remission.

Here is a typical curve of a cat on Caninsulin (aka. Vetsulin, discontinued). The cat is given Vetsulin at 8am, BG is 450. By 12PM (+4) the cat is at its nadir (lowest point), BG is about 130. That is a big drop in 4 hrs. And by 4PM (+8), the cat's BG back at about 400. See how a harsh, short curve like that would make regulation difficult?

Vetsulinactivitycat-us.png


You are lucky because you are Canadian. Folks in the USA actually have to get their vet to write them a prescription for the insulin they want - imagine how difficult THAT is. You will probably want to do what I did, which was use your vet for a diagnosis only. And when they say you need to feed Hills MD, you need to buy the AlphaTrak, and you need to use Caninsulin, you say no thanks, I'll do it my way and you will either support me or I will fire you and find another vet. And that's how you have to do it. You will need a vet for things like bloodwork, routine checkups, dental work, emergencies, etc. but diabetes is a home monitored disease and FDMB will help you every step of the way. :YMHUG:
 
Re: Newly diagnosed, Vet recommendations in Toronto (west en

Thanks, Ry & Scooter and Ronnie & Luna for the advice. I am absolutely taking your suggestion of going to see Dr. W. and will let you know how it turns out.
 
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