Pumbaa will be going on insulin - Lantus.

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Pumbaa

Pumbaa

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If I get everything together, I might be able to give Pumbaa his first dose tomorrow morning.

For an underweight 8 lb. cat, around the 277 to 325 BG range, who has been on a low-carb diet for 7 days now, would it be prudent to start him at .5 units BID instead of 1 unit BID?

First I have to say that I love my vet. She was pleased that I've been doing the home BG and urine testing, was thankful that I called the numbers in so that she could look at them before her taking the time to call me back, she had no problem that I preferred the Lantus over the Prozinc that they carry, and is all for not having Pumbaa come in for regular visits considering how agitated he becomes.

Yikes, those insulin prices are high. But, per someone's suggestion, I looked on Craig's list and someone local was changed from Lantus to something else, and she is willing to sell 3 of her Lantus Solostar pens, which expire 4/12, 5/12 and 7/12. Since we're already halfway through 4/12, I don't want that one, and still need to verify that these have been stored correctly, but it's going to save me a lot of money, initially, if this works out, and will buy me some time to research ordering from Canada.

I've started my spreadsheet (instructions for this are here), I've re-read the "Start Low Go Slow" documentation, as well as the posts about how to inject and what to watch for/do in case of hypoglycemia.

Now if I can only get that little wiggle-butt Pumbaa to cooperate and let me draw his blood before he gets his morning food...

I can not begin to say how helpful people on these boards or, or describe my delight at the wealth of information available. A week ago, I was a basket case! But the best advice ever, which I see frequently, is "take a deep breath!" I'd love to see a smilie for that one! *LOL*
 
I don't know if this helps, but my cat sounds very similar to yours--similar BG ranges and similar weight--and I've had her on 1 unit of Lantus BID and it's been fine. She's gone as low as 108 but never lower. Yet, anyway!!
 
Thank you, Grapey. Is your cat also on a low-carb diet?

Your cat looks sweet. Pumbaa always looks evil in his photos! *LOL*
 
Looks like Pumbaa and Shiro are going to be Lantus buddies!! I'll be tracking your progress with interest. Unlike Pumbaa, Shiro is an OVERWEIGHT 13lbs -er who's been on a low carb diet for 7 days and I was also told to start him at 1unit twice a day. I'm glad you got one of the good vets! Mine has been a nightmare and as soon as my boy is regulated i'm switching to another. How much does the Lantus cost in your area? One vial costs $120 here in SoCal but one PEN runs $47 and a pack of 5 pens costs $230. We're gonna go for the one pen for now. I'll have to ask my vet how she wants me to handle feeding and whatnot - but I'm not sure I feel comfortable altering him from 1 uni to .5. Unless I see hypo numbers that is.
 
Yes, Lily's on low-carb wet. Mainly Purina DM (but I'm going to be trying other things from the Janet and Binky list).

She is a very sweet kitty. She's not a brat like our other two pets :)
 
Avalon: Sorry to hear that your vet is a nightmare. :( Maybe someone here would have a good vet in your area to recommend?

Here's a deal...I'll ship you Pumbaa until he gets regulated so then he and Shiro can really be Lantus buddies. Hahahahahaha!!!

We can share progress. Interesting, because I want Pumbaa to gain some weight, so have been trying to feed him all the hi-protein low-carb food he wants. He was a little pudge before the diabetes hit him, so I'll have to watch that he doesn't gain too much weight. (Not really a fat cat, just not as sleek and slim as he was when he was a more active juvenile delinquent.)

Best price on Lantus here was at Costco, 10 ml vial = $124.31. Pack of five - 3 ml pens $227.08. I didn't find any store that would sell one pen here, so you are fortunate, and will throw away less. But, I did check Craig's list and hopefully I can purchase one pen with an expiration date of 7/12...even on one unit BID, that should last 150 days. Oh crap, I forgot about the "throw away after 28 days once opened", but I did read just today (I should have bookmarked this) that if you don't contaminate the insulin, you don't have to toss it after 28 days. I think that's where the huge cost is...cat owners who don't need much having to throw this expensive drug away!

My vet was totally against Pumbaa grazing, as he does now, and I've read grazing is okay on the Lantus. Thankfully, I work at home and can watch him and his numbers. I'd be more concerned by him not eating enough at one meal, and going hypoglycemic, than eating small meals frequently over the course of the day.

I have learned SOOOOOOOO much!
 
Grapey: Look for Innova EVO turkey and chicken. It comes in large cans and says right on the can "Less than 7% carbs."
 
You can honestly start at either .5u or 1u whichever you are more comfortable with. Just remember that Lantus takes about 3-5 days for the shed to build up, so you won't see much action before that. That is why we hold a dose with Lantus for 3-5 days or longer until we run a curve to see if the dose needs to go up or down. It is also based off the nadir or lowest point in the cycle rather than on the preshot numbers.

Mel, Maxwell, Musette and the Fur Gang
 
Cared for well, you can use the full pen contents beyond the 28 days.

Refrigerate, but NOT on the door. You want to minimize disturbing the insulin, other that withdrawing it.

Never return any insulin back into the vial; it has been contaminated by the lubricant in the syringe.

Do not pre-fill syringes; fill when you are going to shoot.

If your tests suggest the insulin is becoming less effective near the end of the pen, you can a) start a new pen or b) slightly increase or 'fatten' doses to adjust for the decrease in potency. If you do option b, when you do change to a new pen, compensate back by slightly dropping the dose for the higher potency in the new pen. It helps to make notes on your spreadsheet AND somewhere on the vial so you don't forget you did this!
 
MofM: I love, love, love Max's spreadsheet! He's doing so well!!!!!

And thank you for the tips!
 
BJM: How long past the 28 days if cared for correctly, do you know?

Do you store the pen/vial upside down so you don't have to turn it over/disturb it when filling the syringe?
 
Most users get months out of a pen before it goes bad/loses it effectiveness. Lantus insulin is a solution. Thee is nothing to mix so it does not matter the position when you store it or draw insulin out of the pen. You do not inject air into the pen.

Pumbaa said:
BJM: How long past the 28 days if cared for correctly, do you know?

Do you store the pen/vial upside down so you don't have to turn it over/disturb it when filling the syringe?
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Thank you, Larry. That is great news about months out of a pen before it loses its effectiveness! I interpreted "minimize disturbing the insulin" as treating it like it was a vial of liquid nitroglycerin. :) Then again, humans are carrying it around in their handbags nowadays, aren't they?

Now, if I can just find a source that will sell it one pen at a time...
 
Pumbaa said:
Thank you, Larry. That is great news about months out of a pen before it loses its effectiveness! I interpreted "minimize disturbing the insulin" as treating it like it was a vial of liquid nitroglycerin. :) Then again, humans are carrying it around in their handbags nowadays, aren't they?
Click to expand...

Its not even chilled when they carry it around! Not quite nitro, but you want to optimize its use. Putting it on the fridge door shakes it every time you open the fridge and may accelerate the rate of deterioration.

Pumbaa said:
Now, if I can just find a source that will sell it one pen at a time...
Click to expand...

Try a hospital, or someone on Craigslist who needs to split their costs to afford it.
 
I will be calling hospital pharmacies this morning. I had found someone on Craig's list who was selling unused Lantus Solostar pens, but she and I haven't been able to connect.
 
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