Newly Dignosed: No money for hospitalization

Status
Not open for further replies.
B

bandb100

New Member
Hi!

My 17 year old cat, Teaspoon, just got diagnosed. The vet said it would be around $1000 for hospitalization to stabilize. There's no way to swing that. I would love to start doing something today. I live in a major city but my vet closes in 3 hours for the weekend.

Am I on the right track if I:

1) Get grain free wet food under 10 carbs (Teaspoon has been eating innova senior - 32% carb, ugh!)

2) Grab a glucometer and lancets. Test at the ear and document reads by date and hour.

3) Grab insulin and syringes at a major chain. Here's where I get lost: What insulin can I get without a prescription? Should I go through my vet or can I just go over the counter?

4) Start with a conservative dose twelve hours apart. Continue to test blood levels. Be ready to respond to hypoglycemia.

I will keep reading here, but I need to get the insulin now if I hope to jump on this tonight. Any advice on brands. I live in California.

Thanks!
 
You seem to have the right idea about almost all of this! There is no need for hospitalization. BUT you do need a RX for the insulin if you are in the US. So start with the diet change and testing over the weekend, and ask your vet for a prescription for Lantus pens as soon as you can.
 
Thanks Debby!

I will do loads of reading tonight to make sure I'm doing this properly. I am so thankful for this forum! I just called my vet in hopes of getting that prescription. Bracing myself for an inevitable lecture as well. The information in all these pages helps immensely in making a case that I am capable of this.

Warmly,
Bridget
 
Did your vet mention ketones at all? That's a pretty hefty price tag and it makes me wonder if there are additional problems that we're not aware of. Do you have an estimate from the vet? What do they plan to do in those few days?

If your cat is in ketoacidosis, 24 hour hospitalization is a must.
 
She left a message while I was at work and I haven't been able to get a call back yet. I have emailed her as well. I was wondering the same thing. She was very detailed in the message. Teaspoon's glucose was at 433 (yikes) but she did not say anything about ketones. She said in the message that the hospitalization would be to stabilize his level and it would cost around $1000. Then she said it would be another $900 over the next 6 months to continue monitoring and treating.

That's when I found you all.
 
Be prepared for a fight from your vet. My former vet was very insistent that I had to leave Maui with them to get "regulated" as well. I learned very quickly that it doesn't happen that way, and unless there are other problems (such as DKA) there is no reason why I can't do everything from home.

When I explained this to my former vet, she refused to treat Maui or write the prescription for insulin needles and insulin. So, start looking for a new vet in your area as you may need to find a new one who is open to home testing and home treatment.

Remember:

- you don't need prescription foods
- get a meter (Walmart Relion) is good and inexpensive, if you want name brand Bayer Contour is great - both are easy to use and only requires small amount of blood
- when you get insulin - keep it in fridge
- do not roll or shake it
- Start low and go slow - start with a low dose - 1 unit or less and slowly adjust the dose in 1/2 increments or less depending on what several days of tests tell you

- get U100 syringes with 1/2 unit increments (helps for the microdosing) Walmart sells it cheaply about $13 for box of 100
- Costco is typically cheapest for insulin (if you are a Costco member - can save even more $)

- food options - stay under 10% carbs, even between 1-4 carbs is best, typically any pate style will work - for example Fancy Feast classics are good for this

also get a few cans of high carb (for example FF gravy lovers) is a good one and keep it separate from the every day food (only use this if you have a potential hypo situation.

And we're here to help you anyway we can.
 
hey there fellow californian :-) whereabouts are you? i'm in southern california myself. still at work for the day but if you're close and i can help with anything, just yell. i'll check back as i can the rest of the day
 
Hi and welcome!

I just wanted to add don't stress too much about not being able to get the insulin over the weekend. As long as ketones are not an issue (go get some strips to test for them) it will be good to start with the diet change first. Changing the food to low carb can really drop their BGs by itself. When Orange was diagnosed he was also eating high carb dry food only. He was started off at 1 unit of Lantus and didn't really want to eat the wet food. It took a few weeks to change him over to wet, but one day he decided it was ok and just started gobbling it down. During that time the vet wanted to up his dose to 2 units, people here told me not to change insulin while I was changing his food, and guess what? He needed less insulin after the food change, not more!

I think a few days of testing with the new diet before starting insulin will give you a good starting point - cats can usually handle high numbers short term ok. Just look out for those ketones.
 
Such thanks for all the advice. The vet called and she was great. Very supportive and some good cautionary advice. She did advise that I use Hill's DM- said it was a more consistently low carb option that over the counter. The vet is open tomorrow so I'm going to go in to get the insulin (glargine) and I already got the other equipment at the store. Hopefully, I can source insulin cheaper next round?

Teaspoon does have ketones (1+). The vet also said I need to know that it's unusual for Teaspoon to get this at 17 and there may be an underlying disease. He's always been a fit cat- and is still really active. Poor mouse he caught yesterday can testify to that. I'm hoping this works and that it is diabetes causing everything. Can't afford a the tests to rule out cancer- but definitely couldn't afford to treat cancer- so lots of finger crossing that this is the path to regulation and a bit more time with my wonderful cat.
 
bandb100 said:
Such thanks for all the advice. The vet called and she was great. Very supportive and some good cautionary advice. She did advise that I use Hill's DM- said it was a more consistently low carb option that over the counter. The vet is open tomorrow so I'm going to go in to get the insulin (glargine) and I already got the other equipment at the store. Hopefully, I can source insulin cheaper next round?

Teaspoon does have ketones (1+). The vet also said I need to know that it's unusual for Teaspoon to get this at 17 and there may be an underlying disease. He's always been a fit cat- and is still really active. Poor mouse he caught yesterday can testify to that. I'm hoping this works and that it is diabetes causing everything. Can't afford a the tests to rule out cancer- but definitely couldn't afford to treat cancer- so lots of finger crossing that this is the path to regulation and a bit more time with my wonderful cat.
Click to expand...

That DM food has poor ingredients; there's nothing good about it, so just go with Fancy Feast pates or even Friskies pates. Take a look at these ingredient in DM... do you see good solid food ingredients in the first 2 of the list? I don't.
Ingredients
Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, guar gum, potassium chloride, carrageenan, salt, Vitamin E supplement, calcium phosphate, taurine, thiamine mononitrate, zinc sulfate, ferrous sulfate, niacin, calcium pantothenate, copper sulfate, Vitamin A supplement, manganese sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide.

Why is it unusual for a 17 yr old cat to get ketones? The recipe for ketones is not enough insulin + not enough food + infection. I would wonder why the vet wants to test for cancers; you already had a regular blood panel done. What about testing urine for infection? I can't see a jump to suspecting a cancer just from a positive ketone result?
Be sure to test urine any chance you get at home with KETOSTIX to keep a close watch on the ketones.

Why not get the prescription for Lantus from the vet and shop around for the cheapest prices? I am sure the vet is tacking on an amount so you could likely get it much cheaper at a pharmacy or Costco or some other place, other than from the vet.

If bloodwork and urinalysis were already done, get copies from the vet so that you can see the results for yourself.... I keep a binder for each of my cats with all paperwork from the vet office. Look over the numbers and ask your vet about any of the other values that are out of range.
 
If you read many of the discussions, you'll find that a lot of vets recommend the DM. Most of the people here do NOT use DM and apparently a lot of cats don't like the taste. There are plenty of good low carb cheaper options available. A lot of people here feed their cats Fancy Feast Classic varieties.
Janet and Binky's page http://binkyspage.tripod.com/CanFoodNew.html has a list of common cat foods and their carb %.
 
I'd echo Gayle's question "Why is it unusual for a 17 yr old cat to get ketones?"

Ketones and diabetes sort of go together.... here's some basic info about ketones, what they are, and how they come about in a diabetic cat:
http://www.felinediabetes.com/hodgkinsarticle3.htm
Post by Elizabeth Hodgkins DVM on a public message board, October 2000.
It is helpful to understand the whys and whens of ketones (or ketone bodies as they are sometimes called) in order to understand the answer to this (these) questions. In the animals with which we are most familiar (including people and cats), the brain's preferred fuel source is glucose. Skeletal muscle and other tissues are pretty happy using fat (triglycerides) for energy, but the brain is characteristically picky about this (and it's generally wise to give the brain what it wants!). One of insulin's chief jobs is to make sure that circulating glucose gets into the brain on demand; insulin is the molecule that "drives" glucose across the cell membrane.
When insulin is in short supply or absent, the body (and the brain) perceive that there is a shortage of glucose (even if there really isn't, as when the animal is hyperglycemic), and the brain's second and final fuel source begins to be produced, ketones. Ketones are produced by the liver from the oxidation of the body's fat stores. In conditions of true starvation (when body fat is legitimately broken down for necessary calories), or perceived starvation (hyperglycemic, uncontrolled diabetes), the liver believes it needs to produce ketones from body fat for the brain. This is the reason you see ketones in the urine of unregulated feline diabetics. You see ketosis in humans on some of the more strict high protein, low carb diets, because there is little dietary carbo to supply glucose from the g.i. tract, and the human body is not as efficient at gluconeogenesis (liver production of glucose from protein) as the cat (we have discussed this very major difference between cats and most other mammals on the board in the past). Because gluconeogenesis in people cannot keep up with the brain's needs under these circumstances, the liver makes up the shortfall with ketone body production. Except in extreme prolonged ketosis, this is not harmful to the normal human. After all, it is a normal survival mechanism. Naturally, it is not good to have severe metabolic acidosis (ketones cause the body to become relatively acid) for too prolonged a period (many weeks) because it can deplete body stores of buffers (mineral, generally). In starvation, however, it certainly beats the alternative (rapid brain death).
This brings us to the question of whether a low carb, high protein diet is bad for a diabetic cat, and does it cause ketosis? If you've been following this discussion so far, you are probably ready to guess that no, such diets do not cause ketosis in cats, diabetic or normal. In diabetic cats on high carbo diets (especially dry, extruded commercial cat foods where the dietary glucose is rapidly absorbed into the bloodstream from the gastrointestinal tract), the cat's brain nonetheless perceives "starvation" and ketones from the liver catabolism of fat begin circulating (and spilling into the urine, right along with the excess dietary glucose). This chronic circulating glucose has a suppressive effect on the cat's pancreas (mechanism unknown at this point), not to mention all of the other undesirable effects of chronic, poorly regulated diabetes. Most, if not all, commercial preparations of exogenous insulin work poorly in the cat (I don't have to tell all of you that!), so the hyperglycemia is essentially constant in most diabetic cats on high carbo diets.
When the cat eats a low carbo, high protein diet, however, little preformed glucose enters the blood stream. The liver produces what glucose the brain needs in a much more moderate, "time-released" fashion through gluconeogenic transformation of dietary protein, the pancreas-suppressive effects of hyperglycemia is significantly lessened (and in many cats, endogenous production of insulin resumes) and the body of the cat perceives a much more normal process of glucose production and uptake that satisfies the brain's needs.
We have not seen ketosis in cats on low carbo, high protein diets. This is the normal diet of the cat and its metabolic machinery is especially adapted to such a diet as the normal order of things, in times of feast as well as famine.
Click to expand...

http://www.sugarpet.net/glossary.html
Ketones:
Ketones are a by-product of fat metabolism. Without insulin, the body burns muscle and tissue in an effort to feed itself. A by-product of burning fat and muscle are ketones (or ketone bodies). The body can cope with a certain amount of ketones, which are flushed out of the body by the kidneys. But left unchecked, ketones build up over time, overwhelming the kidney’s ability to get rid of them. Ketones that build up in the body for a long time lead to serious illness and coma. Large amounts are toxic to brain function
Click to expand...
http://www.cat-world.com.au/feline-diabetes
Diabetes has many effects on the cat's body.
Because the glucose is unable to enter the cells, the body is starved of energy & the cat begins to lose weight, despite having a healthy appetite. If the diabetes goes untreated the body will begin to break down the body's own fat & protein to use as energy, leading to weight loss. Ketones in the urine & blood are a by-product of the body's digestion of it's own tissues to produce energy. The presence of ketones in blood or urine are a sign the disease has progressed. Ketoacidosis is a serious complication & requires immediate veterinary attention.
Click to expand...

And ketoacidosis:
http://www.fabcats.org/owners/diabetes/info.html
Ketoacidosis
Ketoacidosis is an uncommon complication of poorly controlled diabetes. It can be rapidly fatal if not treated so requires immediate action where suspected. The clinical signs most frequently seen with ketoacidosis are:

• Loss of appetite
• Lethargy/weakness
• Vomiting/diarrhoea
• Dehydration/collapse

The breath may have a fruity odour (pear drops). Owners of diabetic cats should be provided with urine glucose and ketone sticks by their veterinary surgeon to allow periodic monitoring of the urine. This should be done as part of the normal routine (once or twice a week initially) or if there is any suspicion of ketoacidosis, for example if any of the above clinical signs are seen in a previously well diabetic cat. Ketoacidosis can also be confirmed by demonstrating the presence of ketones in the saliva, tears or blood using reagent strips.

If a positive ketone result is seen, immediate veterinary advice should be sought. This rule applies even if the cat seems quite well in itself. Ketotic cats require immediate intensive treatment with insulin given intravenously or intramuscularly for a rapid effect to regain control of the diabetes. In addition to this other treatments including intravenous fluid therapy, antibiotics and bicarbonate may be required. Treatment for ketoacidosis usually requires hospitalisation.
Click to expand...

Carl
 
fwiw, i actually read it as the vet thought it unusual for the cat to get diabetes at 17. maybe bandb can clarify when they post next?

and another fwiw, i haven't found glargine (aka: lantus) to be cheap anywhere here in cali :-) but there are ways to make it more economical, i.e. have the vet write the prescription for a pack of solostar pens, rather than 1 vial. the initial outlay is a bit more but the pens last alot longer and you don't waste as much of the insulin. i get pretty much a year out of one 5 pack of the solostar pens, per cat (i have a foster kitty diabetic too now so i'm treating two. will have to see how long the insulin lasts for us now)

oh, and there was a $25 coupon posted in the Supply Closet here on the board. would have to take a look to see if it's still there.
 
Please be cautious about the vet selling you the Lantus (glargine). Especially if they re-package the insulin. Recently there was someone else on this board who's vet did just that - they sold her insulin and put it in an unmarked vial. No dates, no nothing on the bottle.

Lantus is a HUMAN insulin and therefore easily available at all human pharmacies. There is honestly no need to purchase this from the vet. Especially if you are looking to save money.

Just ask the vet to write a prescription for the lantus in pen form - it will be more economical for you over time and a prescription for U100 insulin syringes with 1/2 unit markings.

Then call your local pharmacies and price it out. I do believe that Costco sells it the cheapest. The pharmacy may also be willing to sell you one pen at a time (and that will save you some money too).
 
One thing you can do is check Craigslist - sometimes people sell unused Lantus - make sure its not expired and its unopened. The drawback is that you don't know how it was stored or treated. I've thought about doing this but just can't bring myself to do it. Another thing would be to get a written prescription from your vet and use a canadian pharmacy to get it mail order. Jan
 
Status
Not open for further replies.
Back
Top