Returning Member with questions

Hello,

I am back because a little more than a year after losing Mopem, his brother (non-blood) Jack was diagnosed. I have been trying to do what I did with Mopem (who was actually in remission) but Jack being a different boy, it doesn't seem to be working. So, I have returned to the place that helped me get Mopem off the insulin for advice. I have reached out to my vet clinic, but they are extremely short staffed, and turn around time is longer and longer. Not to mention, I do feel the folks here are slightly more informed at times.
If anyone has any advice on the following questions, Jack and I would sincerely appreciate it!

1. Shouldn't Jack's numbers be lower, based on the amt of insulin he is getting (3.5units 2x daily)? (hopefully spreadsheet appears correctly in sig line)
2. Will switching to Lantus be of any help? Do Lantus and ProZinc work differently?
3. Lantus is over $300 a bottle at Walmart, so this would be a HUGE budget issue. If this insulin would work for him, does anyone know where I could get it cheaper?
4. IF switching to Lantus, what is the recommended dose to start at?
5. Jack refuses to eat any type of wet food, so this is a problem for his numbers. How bad would it be if he ate human tuna and human chicken in a can? Too much salt and mercury?? He won't eat plain boiled chicken or chopped meat. He hates human food, freak that he is. He is currently eating the lowest carb/kcal dry food available- A 50/50 mix of Young Again pure protein and Dr Elsey's clean protein. Young Again is lower than Dr Elsey's but more than 50% mix gives him diarrhea. Any suggestions?
6. At what point/how do we test/determine if he is insulin resistant or has another condition that may be affecting his BG?

Thanks again for any help you folks can offer!!

 

Try "generic" glargine. Next would be Semglee glargine. GoodRx list tose two options in addition to real Lantus
https://www.goodrx.com/semglee?dosa...ulin glargine&quantity=1&sort_type=popularity
Note that some place have a restriction that say it is not for pets. That page also give link for non-restricted price which is lower than real Lantus.

 

I use Semglee for Charlie and I like it. I previously used Lantus with my other diabetic cats. According to your spreadsheet it looks like you are using both Vetsulin and ProZinc. Is that correct? If so why are you using both?

 

Thank you!

 

We started with Vetsulin because that is all the vet clinic had in stock. I ordered the ProZinc because my previous cat Mopem went into remission on it, but Jack wasn't responding, so I tried to go back to vetsulin for a bit to see if that would actually work better, but it didnt. So now we are only on ProZinc, which is also, not working so well. Thanks for the advice on Semglee

 

Don’t forget to get some tests in during the PM cycle as well. It is just as important and some cats drop lower at night.
Are you testing for ketones with Ketostix?

 

I have been unable to test him for ketones. He is completely uncooperative. He lives with multiple cats, so to get a sample I have to lock him in a bedroom or bathroom with a box. He howls, scratches, and even peed on the carpet in the bedroom as opposed to in the box. He is not cooperative. The day I left him at the vet in Jan they were able to get a sample and it was negative but I haven't been able to test since. I know I need to test BG in the PM, my new work schedule makes life very difficult, but I do plan on trying as soon as I can-hopefully tomorrow. I freaked when Mopem was diagnosed, but eventually got a handle on things. He had the best temperament and my work life was very different- I was working from home. When Jack was diagnosed I was much calmer, but between his attitude and my own complicated work life, this is proving to be a nightmare. Thanks for your input, we appreciate it.

 

There is a blood ketone meter that works like a blood glucose meter that makes testing for ketones much easier if you have an uncooperative cat. I hope things get easier for you. It’s tough sometimes.

 

OH WOW...really?? I have never heard of that type of meter. THANK YOU for that info! That is a ray of hope!

 

Abbott Freestyle Optium Neo blood and ketone meter and there is the Nova Plus Max and the Precision Xtra blood and ketone meters.

 

This is the one we bought.

https://www.amazon.com/gp/product/B01G5OE0QY/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1


Ketone test strips are stupid expensive ($20 for 10 strips) but to me, the cost was well worth it to keep tabs on Hen's ketone levels

you can use the same blood droplet as a BG test as long as it's not a super-tiny droplet. If too small, the BG test strip will suck up all the blood leaving none for the ketone strip.

 

Thank you again!! How often do you test for ketones? Every day? A few times a week? Jack's numbers are always high....

 

THANK YOU for the link and the advice! How often do you test for ketones? Every day? A few times a week? Jack's numbers are always high....

 

kinda depends on the kitty's situation, any history of DKA, etc. We were doing once a day when Hendrick was in the higher numbers and his DKA was just a few weeks in his past, as he could go from trace amounts to a warning-sign amount in just 24-48 hours.

These days, we test maybe once every few weeks because he is further from his DKA and BG numbers are much lower but I've read even cats with lower BG numbers can have ketones so we still spot check.

 

Thank you for sharing that. I ordered the Nova Plus Max from Amazon, should be here by Friday. Will try to test every day til numbers are lower. Still no word from vet...sigh...still high numbers...another sigh...

 

happy to help!

Looking at Jack's SS -- is there any way you can get more test data during the PM cycle (after PMPS). I am wondering if those recent reds are bounces from going lower at night than you realize.

Also, I see you've bounced between Vetsulin and ProZinc -- have you considered Lantus or a biosimilar?

 

Are you able to get any BG tests in during the PM cycle? Even a before bed test is very helpful.
The pm cycle is just as important as the am cycle and a lot of cats drop lower at night.
It does look like you need to increase the dose however we need to see what is happening in the pm cycle first to make sure Jack in not dropping low overnight..

 

My work schedule is a beast, so getting numbers at night is rough. I'm going to try tonight. I am considering switching to Lantus or Semglee...still waiting to hear back from vet clinic on a script for both, needles, and transition dose. My concern with the Lantus is the price. I guess Lantus or Semglee may work for him even though the ProZinc doesn't seem to be? Any suggestion on what a starting dose for Lantus or Semglee would be?

 

My work schedule is a beast, so getting numbers at night is rough. I'm going to try tonight.

 

Semglee is cheaper than Lantus. It can also he bought in Canada for a much cheaper price.
https://felinediabetes.com/FDMB/threads/buying-insulin-from-canada.
Will need different syringes for Lantus or Semglee and it works differently in that it is a depot insulin. DEPOT INSULIN
If you do swap over we can help you with the dose. We usually suggest a slightly lower dose than what you are giving now.

 

Thank you for these links. I will read through and hopefully hear from vet about scripts by end of weekend. Ketone meter should be here by next Tues. Will work on pm numbers tonight and hopefully the weekend. Thanks for all your help!

 

It has taken a while to get back here, between my health, crazy stuff (like a totally broken septic system) at my house and my work schedule. Got the ketone meter, trying to use sparingly due to cost of strips, but seeing 0.3 to 0.8. Started to panic at 0.7 so went to vet and had fluids yesterday, came home with set-up for at home sub q's, which need to happen again today after my morning meetings. Also switching to Semglee, have scripts but still shopping pharmacies in the area...most are claiming they need to order it. Hoping to switch by this weekend.

Two questions:
1. At what ketone level do I panic? We ran to vet at 0.7/0.8, but were only able to get a tech appt for fluids. No chance to speak with the vet. Is there anything else I can do?
2. Vet is suggesting starting Semglee at 1u. Considering he is now up to 4.75u of ProZinc am I to expect super high numbers and lots of ketones in the beginning? Has anyone who switched started at a higher dose?

Thanks in advance!