Starting Lantus tomorrow & crying today

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Jenner & Felix

Jenner & Felix

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Deep breath, I know. You all have been wonderful on the few posts I've made recently.

We've been trying to diet control Felix's BG's, but his shedding is much worse today, almost kemo-esque, and he's been at 195 most of the day. Our vet wants to start him tomorrow on 1 unit Lantus 2xday and monitor for the week. (will need later input on cheaper options for Lantus-ouch...)

I asked about starting at 1/2 unit, but she wanted to start at 1. Does that sound about right for his numbers? (mid-180's last three days until today- will also need to learn to print-out the spreadsheet)

She also sent us home with 5/16" needles...should these be easy to use? Ear pricking with lancets (30 gauge) have become easier since we started home-testing Sunday.

Our consult starts tomorrow. I asked that the tech give the first shot-to ensure he gets it-but now I'm second-guessing....thoughts from the pros?

We're also testing our Walgreens True Result against their Alph Trak. She hasn't said it directly, but I think she would prefer I buy the Alpha Trak. (which I don't plan to do).

Incase I forget, I just wanted to tell everyone that I appreciate the strength of character I read in the threads. FDMB is helping me through FD 101 and helping me to not receive a flunking grade.

Felix's gone-crazy mom,
Jenner
 
Jenner & Felix said:
Deep breath, I know. You all have been wonderful on the few posts I've made recently.

Please don't cry. I know its stressful but looking back, diabetes is such a treatable disease! ANd Squeak will be celebrating 8 years off of insulin in a few weeks...
We've been trying to diet control Felix's BG's, but his shedding is much worse today, almost kemo-esque, and he's been at 195 most of the day. Our vet wants to start him tomorrow on 1 unit Lantus 2xday and monitor for the week. (will need later input on cheaper options for Lantus-ouch...)

You need the cartridges for the lantus...solo star I believe but others can confirm.
I asked about starting at 1/2 unit, but she wanted to start at 1. Does that sound about right for his numbers? (mid-180's last three days until today- will also need to learn to print-out the spreadsheet)

Considering those are pretty low, I'd be going with 0.5 units
She also sent us home with 5/16" needles...should these be easy to use? Ear pricking with lancets (30 gauge) have become easier since we started home-testing Sunday.

Our consult starts tomorrow. I asked that the tech give the first shot-to ensure he gets it-but now I'm second-guessing....thoughts from the pros?

No, you give it :)

We're also testing our Walgreens True Result against their Alph Trak. She hasn't said it directly, but I think she would prefer I buy the Alpha Trak. (which I don't plan to do).

Skip the alpha track, but I'm not certain how good the true result is, others can comment. Tell her that other vets use human glucometers and if human glucometers are good enough for humans then they are good enough for your pet too :)

Incase I forget, I just wanted to tell everyone that I appreciate the strength of character I read in the threads. FDMB is helping me through FD 101 and helping me to not receive a flunking grade.

Felix's gone-crazy mom,
Jenner
Click to expand...
 
If Felix's blood sugar is in the 180's-190's from DIET ALONE ---- 1u is probably too much to start with.

We generally recommend not injecting when the blood sugar is below 200 until you get a good idea of how your kitty is going to react to the insulin.

Do you have syringes with half-unit markings? These are available but not all pharmacies may stock them.

I order my supplies from Hocks (use link above for FDMB to receive a donation) and like these syringes:
http://hocks.com/hocks-healthcare/hocks ... 53121.html
30gauge, 5/16" needle, 3/10cc with half unit markings (Monoject brand)

to get free shipping, I also buy my test strips and lancets from Hocks.

Many people here get their supplies at Walmart.

My cat Tiggy is on Levemir, and he gets 0.5u BID and sometimes less -- to stay well regulated.

Re: Walgreen's True Result meter -- it has a reputation HERE for being kind of fussy - lots of errors (= wasted test strips = $$)

Many use Walmart's Relion meter, which received a terrific rating in Consumer's Reports last year.

Since I order from Hocks, I discovered and like the Maxima AST and Maxima Infinity meters (AST is now being phased out / replaced by Infinity)
 
Thanks Jen. You're post helps :>)

I didn't get any cartridges with our Lantus..just the juice & syringes (?) and I agree...I should give the shot tomorrow-I'm just terrified (I've always hated needles) that I'll do it wrong and hurt Felix. Or won't be able to do it by myself.
 
Hubby and I were needle-phobic and were very surprised to find out how easy it is to give insulin, because it is done subcutaneous. You grab a piece of scruff, poke the needle, push the plunger and you are done. Takes seconds. Once you get that down, you can vary the injection site a bit.

Honestly, I was terrified too but it is SOOOO easy.
 
You are doing a wonderful job for Felix, Jenner. Just think about how much you have learned in the past few days. And you are already hometesting! That takes some people days to get the hang of.

I agree that they are pretty low numbers to start insulin with. How long has your lo carb trial been? Our concern is that you will be immediately thrown into the numbers game with numbers already under 200. Usually new diabetics can start with one unit and skate for a few days until they get used to the routine. With those numbers, you will need to be very careful with doses and be home testing often.

I would get the U100 needles so you can do minute doses. And I think I would be more cautious than others and consider starting at .25 units. You can always add insulin over the next few weeks, but a tiny dose will give you some breathing room as he adjusts to insulin.

I haven't heard great things about the Walgreens meter. I would take it back and get the ReliOn or one of the name brand meters and plan to get my strips on ebay. ($$$)
 
The needles are for u-100 Insulin 3/10cc for 30 u; 5/16", 31 gauge Sure Comforts-available from our Shopko pharmacy. They don't look to have 1/2 markings-only 1 u.

I've been reading how you all use the 200 rule and talked with the vet about what happens if I get a reading at home, after tomorrow's initial dose, of say 190 again tomorrow night. She said to give him the 1u regardless. She still wants me to test amps /pmps, but give the shot regardless. Is is harmful starting at 1 instead of 1/2 ? She wants us to do this routine for one week, close monitoring, then do a home curver every 4 hours to see how he is.

Our low-carb is two-weeks today. I just can't get Felix to "eat" the wet M/D. He was raised on kibble, and eats kibble fine- but suffers from belly-licking/hot spots probably related to grain. I've been experimenting, using the canned food list, with Friskies as alt. to wet M/D-but he pushes that around more than he intakes. Dilemma! Its like he just can't figure out how to eat the stuff!!

Our vet won't be in tomorrow-just the tech taking us through the procedure. There will be a vet on call-who isn't familiar with Felix's BG history. Do we try to change from 1 u to 1/2 u?
 
Jenner,

I know it is hard to get advice that conflicts with your vet, but I would err on the side of caution. You can always increase the dose over time if it turns out to be too little. Once the insulin gets into the cat, you can't get it out and you can be dealing with a hypo. You could just say "I'm terrified and I want to start very low and go slow. I want to give .25 or .5 (whatever you decide). " It's your cat; they can't treat it without your permission.

I do think the advice to just give one unit under 200 is dangerous. Your vet has no idea how your cat will react. I would test preshot am and pm and then decide what is safe to give. Just a blanket dose makes no sense to me. And given the fact that Felix is not eating well yet, I again would be cautious.

Here is some info on where to shoot: How to give a shot There seems to be on going discussion here about the best place to shoot. We shot in the scruff of the neck and it worked fine. In the beginning, I would go with whatever is easier for you. (Once you leave the vet office, you can shoot wherever you want....)

You might try feeding him in your hand or on your finger for awhile. (I know, it sounds ridiculous but sometimes it helps them get started.)

The bottom line is that Felix is your cat and you want him safe. The vet and vet tech are being paid by you; you get to decide his treatment.
 
Ok Sue, Thank you for the reality check and the chuckle. I do tend to be a follower sometimes...and not always a follower of my own gut. I just envision me walking in tomorrow, telling the vet I'd like to start lower, and having her tell me she has to follow dr.'s orders-who won't be there, by the way.

Your're right, though. Felix is our cat. He deserves to be safe. So off I go for his pm BG. :>)
 
Hi Jenner,
I would agree with the others..you can always raise the dose right? but if it's too much insulin, well, that would not be fun. I was surprised my vet suggested starting tom on 3.5 units 2 times a day. I started at 1 unit and within days I had to go to .75 units.
I never intended to listen to her advice but just nodded my head to get the insulin. BUTTTTTT I have been on this board for 4 years and was just switching insulins so I knew a thing or two.
 
Hi again - I'm a fellow Michigander, but a troll -- my sister has lived in Marquette for many years though.

Lori means she had to go down to 0.75u -- not 75 units.

I have treated 3 diabetic cats (2 adopted here) since 2006. I inject where the skin is loose behind the front legs on the kitty's side.

The key is the skin being loose enough to get a gap under so the needle does not hit the muscle.

Since the needle is 5/16" long, if you can lift the skin up more than that - you make sure that you won't poke in an ouchy way. Most cats hardly notice the tiny needle piercing the skin.

Since you may not have a lot of options in the U.P. stores (we go Shopko, eh?) definitely check out the HOCKS link. They ship out of Indiana, and I generally receive my orders in 2 to 4 days. Add a day or two for U.P.

Edited to add: Felix may not need insulin for very long since he is already under 200.

How are Felix's teeth? Sometimes bad teeth can cause temporary diabetes
 
Jenner & Felix said:
p.s. injections are going in the belly, not the scruff of fur like I thought.
Click to expand...

I shoot into the side (behind the ribs and in front of the meat of the back leg) or the belly with a short needle. I shoot straight in at a 90 degree angle. It's all fat there, nothing like bone, blood vessels, or nerves to worry about hitting. I don't pinch up the skin; my cat's skin does not pull away from his body. It's easy as pie. I never get a fur shot.
 
Phoebe's question concerning Felix's teeth is a good one!

I'm not familiar with M/D, but if it's something you have to buy at the vet, or prescription, you can probably experiment with Wellness, Friskies, or Fancy Feast, I hope you can find something he enjoys.

I give my cat his shots while he's eating, he's very agreeable at that time.

I think it sounds like you're doing great for a beginner. Oh, another good thing about the Relion meters from Walmart is that it can be easier to pick up strips if you need them in a hurry.

Lantus comes in a couple different sizes - if you got the vial, that is probably the most expensive to use in the long run, that's why many of us use Solostar pens, or cartridges. They cost a little more up front, but you get 50% more (5-3 ml. pens/cartridges, as opposed to 1-10 ml. vial) and there's less of a chance of waste if your insulin starts to lose its potency. If your cat ends up not needing insulin you can always keep the unused pens/cartridges around a while, or possibly find someone else in the area that would buy them from you. Something to think about if you need to buy more. : )
 
Jenner & Felix said:
Thanks Jen. You're post helps :>)

I didn't get any cartridges with our Lantus..just the juice & syringes (?) and I agree...I should give the shot tomorrow-I'm just terrified (I've always hated needles) that I'll do it wrong and hurt Felix. Or won't be able to do it by myself.
Click to expand...


Lantus is available in a 10ml vial (1000 units). But it 'goes bad' quickly after opening (2 months ?) so
you end up throwing out a whole lot and getting a new vial. $$$$$$

Lantus is also available as cartridges/pens. It comes 5 3ml cartridges at a time (that's 1500 units), though
some larger pharmacies may be able to sell you only one cartridge. You open one 3ml cartridge at
a time, and many here use it to the last drop. No waste. So wayyyyy cheaper in the long run.

You still use insulin syringes with the cartridges. Just remove the pen cap and stick the needle into the
little rubber thingy.

I hope your vet is NOT selling you Lantus that she/he has repackaged at the vet office. This is a no-no for
Lantus. You should have got either the 10ml vial, or one of the 3ml cartridges, in the ORIGINAL manufacturers
packaging.
 
Jenner & Felix said:
The needles are for u-100 Insulin 3/10cc for 30 u; 5/16", 31 gauge Sure Comforts-available from our Shopko pharmacy. They don't look to have 1/2 markings-only 1 u.
Click to expand...

Here's a picture of half unit markings and whole unit markings:

resource.aspx


You can use the whole unit marked insulin syringes. You'll just have to eyeball where the half unit is. If you want, go buy a box of half unit marked insulin syringes. Many store pharmacies require a prescription. Or you can buy online from Hocks.com with no prescription, if you live in the US.
 
Hi Jenner and Felix. Just wanted to chime in as a newbie going through a lot of the same things you are. My Java has only been on insulin for a week so I feel your pain. Just know that every day gets better, you get better at the pokes. I got a lot of great advice here, one thing is when you do the BG be organized. I tried to do BG then go get food and insulin ready and by then Java was PO'd and hid under bed. Now I have it all ready, locked and loaded and once we do the BG, I plop down his food and Voila! He starts chowing down and I sneak in with the shot(which is really easy compared to the BG). I also feed wet and have been for a while but someone here recommended I add water. WOW, they lap it up, consistency of applesauce. Maybe that would help felix? Anyway good luck and remember if the tech doesn't get you the answers you want or need tell them to check with someone else. I sent her back three times to talk to the vet. Be aggressive, this is your baby! You will be great!
 
Just an FYI - that expensive m/d food that the vets hock isn't the best diet for a diabetic kitty. Diabetic cats should be fed food that is 10% or less carbs, and both the dry and wet m/d food is around 14-16% carbs. If your cat absolutely refuses to eat any kind of wet food the m/d kibble would be your best bet (since most dry foods are 30-50% carbs), but I would highly recommend trying some other wet foods like Fancy Feast (any of the "CLASSIC" varieties) or Wellness (my kitty won't eat Wellness, little snob). My cat was insulin dependent for 5-1/2 years, we recently switched him to a strick low-carb all-wet diet and he's been off insulin for over a week now and has maintained nice low numbers.

A little trick I learned recently to get a cat to eat wet food is to sprinkle a little flaked tuna on top. I got a jar of 100% dried flaked tuna at Petco for about $5, it's paper thin and breaks up if you rub it between your fingers. It smells VERY fishy and my cat goes crazy for it. If he's being picky I just sprinkle a tiny bit on top and press it into his food a little so he'll have to eat the food to get the delicious tuna. :)

You can also try mixing in a little tuna, chicken or turkey into the wet food to make it tastier.

I've been using the Relion meter from Walmart and love it. And it's really cheap ($9 for the meter, $20 for 50 strips).

Another thing you may want to look into is getting some Ketostix or Dia-Ketostix to test his urine for glucose and keytones (this will tell you if his numbers are too high and heading into dangerous waters).

And don't worry about the shots! I was terrified at first too but my cat never even noticed when he got a shot. Remember to stay calm, if you're stressed your cat will sense it and get stressed too.

You're doing everything right - home testing, reaching out for advice/support, being proactive. Good luck tomorrow!
 
I'm very new to this as well, and I think the advice that the people have given you here is fantastic, I don't think I could add anything more to what they have said beyond encouragement. I can say after 10 days into the routine, I feel that things feel easier.

This is one thing that I found helpful that a friend pointed me towards (he is in med school and has type 1, so he's been doing this for himself for a while)- there is no federal law concerning syringes, so it varies state by state and sometimes within states. This is one of the more comprehensive lists concerning syringes (the info for insulin is for older insulin): http://www.isletsofhope.com/diabetes/st ... -laws.html

So it looks like Mich. does not require an Rx for syringes. I was able to find some inexpensive ones at Walgreens and CVS in a pinch in Chicago. Walgreens was able to open a box of 100 and sell me a packages of 10 while I was waiting for a mail order
 
You are doing great! I am needlephobic and couldn't believe I would be able to give shots. But giving the shots was MUCH easier than the blood testing. If you can do that, you will find the injections a snap. I don't think the cats even feel it. Goodluck!
 
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