Shunned by my vet!!!

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Bucasmom

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Hi guys,
so I'm really upset right now because I just got off the phone with my vet. I did a BG curve for Buca today and the numbers started high at 588, dipped to 379-405 between 2-4 hours after his morning insulin (4u caninsulin), and then started to climb to 509 and that's where I ended the curve (vet said to stop after insulin has peaked if I get two consecutively climbing numbers and I got three).

So I called them up and shared the results, and said to her "I would like to try lantus" she said ok and that she would call the pharmacy and get them to get it for me. Then she got cold, and was very short with me on the phone. I feel like I insulted her or something. When I asked her about the syringes for the lantus and if she had any she scoffed at me and said "Um no, it's a human insulin so you have to get those from the pharmacy" like excuse me sorry I didn't really know...

I asked her about dosing and that I wanted to go back down to a low dose of 1u or something and asked what she thought of that, and asked her if I tried it and did another BG curve if she would like me to share that with her and she goes "that's fine and if you want to see another vet I can refer you". I just felt like as soon as I told her I wanted off the Caninsulin, she abandoned me and doesn't even want to deal with me anymore. I live in a small town and they are the only vet for three hours! We left the conversation at her saying she would order up the lantus for me at the pharmacy, and me saying I would call them later to pick it up... I have no idea if the pharmacy has syringes, I have no idea what dose to administer and I feel like she doesn't even want to help me anymore! Like WTH?

I said that i didn't want to see another vet (not sure who she would refer me to!) and asked again if I could keep her in the loop and she said "Fine". That's it. When I got off the phone with her she didn't even say goodbye she just hung up... I've just had a very stressful day of home testing for the first time and my cat hated it. It was such a struggle but we did it, and now I just feel so alone in this and that I have no professional support whatsoever!

Any suggestions because I am just so overwhelmed and disappointed right now. Thanks for listening to my rant.
 
I'm sorry that your vet seemed to shun you. Maybe she was having a bad day.

In the beginning my vet did not know about other insulins, we were using Humulin and then switched to PZI Idexx, a now discontinued insulin. From this board I learned about another PZI that was better for kitties so I asked my vet if we could switch. She did not want to, she knew nothing about that insulin but said she would research it. She did research and still didn't like it, but I had some information on that and Lantus printed out for her and I gave it to her anyway and pushed for the BCP PZI.

It's been a few years and I have since switched to other types of insulin, but during this time my vet who didn't know about home testing and didn't want to prescribe anything that she didn't give to me herself, including syringes, sharps containers, insulin and food, she's changed since then.

She now prescribes Lantus and even sends people information on how to buy from Canada, information that she asked me for because she knows that's how I buy my kitties their insulin.

Maybe if you give your vet some time, she will be able to learn a little from you.

But in the mean time, it is overwhelming when you first start out so try to take a deep breath and know that you are already doing so well and Buca is benefiting so much from what you've learned. Buca is a very lucky kitty and in no time you are going to be an old pro at this.
 
Ruby started out on PZI and it wasn't working so we switched to Lantus. For some reason I was terrified about the switch and they all held my hand and walked me thru it.

I'm lucky that my vet realized quickly that Ru was much better off being tested at home than me bringing her into the office. She stresses so much when she's in the car!
 
You are very lucky to be in Canada.... you don't need the vet to get Lantus, so that shows you how much your current 'vet' knows.

Go to the pharmacy, Shoppers Drug Mart or some other, and get a 5 pack of Lantus from them.
Pick up your U100 box of syringes and you are good to go.

As for getting a ref for another vet, from a crappy vet, I'd say thanks but no thanks.

You can get all the help you need on the Lantus forum, and no rx is needed for your insulin supplies because you are in Canada.
We are lucky in Canada!
 
So sorry that happened to you! We just went to a vet for the first time and she was very cold with us, too. Just defensiveness. I think they resent us for wanting to be informed and proactive - they just feel threatened. It's a natural response, but I would want to help people to be empowered, not make them feel more scared and alone.

tuckers mom said:
She now prescribes Lantus and even sends people information on how to buy from Canada, information that she asked me for because she knows that's how I buy my kitties their insulin.
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Tucker's Mom - could you PM me with info on how to buy from Canada if I'm in the US? Is that doable? More expensive? Thanks for any info! My vet sold me repackaged Lantus the other day, so I'm on the hunt for other options.
 
Caitlin & Mr. Kink said:
Tucker's Mom - could you PM me with info on how to buy from Canada if I'm in the US? Is that doable? More expensive? Thanks for any info! My vet sold me repackaged Lantus the other day, so I'm on the hunt for other options.
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I can PM you, but it's easy enough to share it with everyone. I think there are probably links in the "Supply Closet" here on FDMB also. I buy Lantus from here: http://www.canadadrugcenter.com/

Delivered to my door in CT cost was $109. I faxed a copy of my license and the script to them with the understanding that I would mail hard copies to them but they do process the shipment before receiving the hardcopies so I didn't have to wait too long.

If the Lantus you bought was opened, used and then repackaged or opened and put in a different vial it won't stay stable very long. DCIN did have a couple of pens that are close to expiring that we needed to find a home for, I think Venita was only asking the person to pay shipping. The post is here: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=71112

I also see there's a link there on buying from Canada so I'll post that here for you also: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=11530
 
My vet sold me repackaged Lantus the other day, so I'm on the hunt for other options.
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Wha?? Vet's can't legally sell Lantus can they. It's a human insulin only used off label for pets.

Sorry your vet acted poorly, hopefully she will find this to be a learning experience and come around to learn about Lantus. Do keep in mind that you are going out and finding out about stuff on your own and then going back to her and expecting her to treat with it. If she doesn't know anything about Lantus, she shouldn't be giving you dosing advice and referring you to a vet that knows something rather than treating blindly would be better than a lot of people's vets who just wing it and almost kill people's cats because they don't know what they are doing.
 
It sounds like the consensus may be that your vet isn't overly familiar with Lantus. Caninsulin is popular in Canada so it's likely that's what she's comfortable with.

This is a veterinary journal article that includes the dosing protocol that we use on the Lantus Tight Regulation board. You could ask your vet what she thinks of the article as a round about way of getting her information.


You do need U100 syringes with Lantus. It is also very helpful if you can get syringes that are in half unit increments. Lantus dose changes are generally make in 0.25u amounts so it's easier to dose with the half unit syringes.

I wouldn't worry about the vet. Bad day, bad mood, whatever. She'll have to get over it. Abandoning a patient is poor practice and in the day of the internet, giving a vet a bad review can have a BIG effect on business.
 

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Sienne and Gabby said:
It sounds like the consensus may be that your vet isn't overly familiar with Lantus. Caninsulin is popular in Canada so it's likely that's what she's comfortable with.

This is a veterinary journal article that includes the dosing protocol that we use on the Lantus Tight Regulation board. You could ask your vet what she thinks of the article as a round about way of getting her information.


You do need U100 syringes with Lantus. It is also very helpful if you can get syringes that are in half unit increments. Lantus dose changes are generally make in 0.25u amounts so it's easier to dose with the half unit syringes.

I wouldn't worry about the vet. Bad day, bad mood, whatever. She'll have to get over it. Abandoning a patient is poor practice and in the day of the internet, giving a vet a bad review can have a BIG effect on business.
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Thanks for the article! Something I need clarification on... The article states the following:

"The mean maximum dose per injection during the
stabilisation period for cats which eventually became
non-insulin dependent was 2.6 IU bid (range ¼
1.0e9.0 IU). The mean maximum dose/kg of ideal
weight per injection was 0.43 IU/kg bid (range ¼
0.20e0.90 IU/kg)."

So is IU the same as U as in 1u bid of insulin or what is the conversion there? I'm going to wean him completely off dry food this weekend and start with the Lantus 1u on Monday since I'm off all day and can monitor him and see how he does.
 
tuckers mom said:
Delivered to my door in CT cost was $109. I faxed a copy of my license and the script to them with the understanding that I would mail hard copies to them but they do process the shipment before receiving the hardcopies so I didn't have to wait too long.
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So you definitely still need a script. SIGH. That's my problem - I gotta find a vet who will write me a script instead of giving me repackaged insulin. :-x Thanks for the info, though!

tuckers mom said:
DCIN did have a couple of pens that are close to expiring that we needed to find a home for, I think Venita was only asking the person to pay shipping.
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I saw that in Lantus Land last night, and I already emailed Venita about it! Would love to take one off DCIN's hands so I can use it in the meantime while I search for a new vet. Fingers crossed I can get it from her!
 
I have used Lantus for years. My suggestion is that you start over at 1 unit twice a day. I am not sure what your current does is, but Lantus acts differently than Caninsulin. Lantus is a longer acting insulin. The majority of cats usually only need between 1/2 to 2 units twice a day.

You can get the syringes at any pharmacy. You want 100 unit, .3 ml or cc (30 units), 30 or 31 gauge syringes, preferably with 1/2 unit markings. When you start Lantus, stay on your starting dose for at least one week before making any changes. It takes that long for the body to adjust to each dose change. Then if you need to increase, only increase by 1/2 units.
 
I saw that in Lantus Land last night, and I already emailed Venita about it! Would love to take one off DCIN's hands so I can use it in the meantime while I search for a new vet. Fingers crossed I can get it from her!
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I think DCIN requires a current script before they will dispense insulin too.

When I asked her about the syringes for the lantus and if she had any she scoffed at me and said "Um no, it's a human insulin so you have to get those from the pharmacy" like excuse me sorry I didn't really know...
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Any pharmacy that sells insulin will also sell syringes. Most will only have the 1U markings so you may need to get those online. I order the Monoject with 1/2 unit markings from American Diabetes Wholesale through the Shop button on this site. Its a good price, gives the site a little commission, and they get to me really quickly (usually 2-4 days).
 
Lisa and Witn (GA) said:
I have used Lantus for years. My suggestion is that you start over at 1 unit twice a day. I am not sure what your current does is, but Lantus acts differently than Caninsulin. Lantus is a longer acting insulin. The majority of cats usually only need between 1/2 to 2 units twice a day.

You can get the syringes at any pharmacy. You want 100 unit, .3 ml or cc (30 units), 30 or 31 gauge syringes, preferably with 1/2 unit markings. When you start Lantus, stay on your starting dose for at least one week before making any changes. It takes that long for the body to adjust to each dose change. Then if you need to increase, only increase by 1/2 units.
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Thanks! I called the pharmacy yesterday and got a 5 pack of lantus and those exact syringes :-D

I'm going to pick them up today and start tomorrow or Monday while I am still home for the long weekend
 
I also updated Buca's SS with the numbers I got yesterday. The caninsulin wasnt doing much, and clearly was out of his system in 4 hours after his morning shot.
 
If you can, its probably best to start as soon as possible, so you can be around to monitor him for as long as possible. The recommendation is at least 3 days.
 
Bucasmom said:
Thanks! I called the pharmacy yesterday and got a 5 pack of lantus and those exact syringes :-D
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Make sure you check the box of insulin syringes before you pay to be sure that you have the correct ones. Some people here on FDMB haev said that they were given the wrong insulin syringes and didn't realize it until they got home. Sometimes a pharmacist will give you 1/2 cc insulin syringes or insulin syringes with 1/2 inch needles and insist that is what you really meant to buy. Others will say that half unit marked insulin syringes do not exist at all.
 
squeem3 said:
Bucasmom said:
Thanks! I called the pharmacy yesterday and got a 5 pack of lantus and those exact syringes :-D
Click to expand...

Make sure you check the box of insulin syringes before you pay to be sure that you have the correct ones. Some people here on FDMB haev said that they were given the wrong insulin syringes and didn't realize it until they got home. Sometimes a pharmacist will give you 1/2 cc insulin syringes or insulin syringes with 1/2 inch needles and insist that is what you really meant to buy. Others will say that half unit marked insulin syringes do not exist at all.
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I'm actually really impressed with my drugstore! lol They got me exactly what I asked for :smile: These syringes are sooo teensy! I'm hoping that Buca won't even feel it... and hoping it doesn't make it tougher to get through his skin... I'm actually really excited about the Lantus! I checked Buca's BG before I gave him the 4u caninsulin and he was 31.9 (574 to you guys).... Ridiculous. That kind of yo-yo-ing can't be good on his system!
 
arozeboom said:
The needles I used were super thin (maybe 29 or 30 gage). Ruby rarely felt them going in.
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Buca flinches and tries to back up when we use the u40 syringes with the caninsulin. I think these will be much easier on him. I think they are 30g
 
When I tried ProZinc with Spitzer, I noticed the U-40 syringes were basiclly harpoons.

It is possible to do a math conversion to use U-100 syringes with a U-40 insulin ... but now that you're starting Lantus, no need!

(basically, you multiply the U-100 syringe marking by 0.4 to get the dose, so a U-100 mark of 1 unit, is actually only 0.4 units of a U-40 insulin)
 
I noticed a huge difference just by switching from the 1/2 inch u-100 syringes to the 5/16 inch ones--I can't imagine how big those U-40 ones must be in comparison! I think you'll definitely see less of a reaction from him. I always gave Bandit his shot while he was eating, and once we went down to the 5/16" I don't think he ever once even noticed he was getting a shot.
 
The shorter needles were also way better for us. Ru's kind of chunky, so she doesn't have a whole lot of loose skin to tent. With the longer needles, it wasn't unheard of for me to go all the way thru the tent and into my hand.
 
arozeboom said:
The shorter needles were also way better for us. Ru's kind of chunky, so she doesn't have a whole lot of loose skin to tent. With the longer needles, it wasn't unheard of for me to go all the way thru the tent and into my hand.
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Oh my that's not good! Well we haven't done THAT yet but we have gone through and through and ended up shooting most of the shot out the other side :? It sucks because you can't give another shot because you don't know how much actually went into him....

I'm so glad to hear that it might be easier on him now... although, as soon as I tent he knows. Some people talked in another thread about tenting other places to administer the shot... is there a difference in absorbtion rate when you do it somewhere else? Or can you do it anywhere you can tent as long as you arent getting any blood vessels?
 
Ru is seriously motivated by food, but I can't touch her while she's eating from her bowl.

I would sit on the floor with my legs stretched out in front of me. I would put her between them laying down, with her head near my feet and give her a freeze dried fish treat while rubbing the spot I was going to shoot into. She was usually still pretty occupied with the treat when I would give the shot and I made sure she got another one when we were done. I gave her fish for shots (she loves loves looooooooves the fish) and chicken for testing.
 
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