Starting Over - The Cost of Diabetes

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I posted a topic earlier today but after talking with some folks realize I didn't tell the full story which could affect the advice given so here I go again :-)

Sara's History (my cat)
-Almost 17 years old female Calico with 6 toes on each foot
-Raised on dry food. Purina cat chow for 15 years and then switched to Hills Prescription WD a year ago due to constipation issues.
-Cracked her left canine tooth 6 years ago and didn't get enough nutrition resulting in fatty liver disease. Fully recovered.
-Has been having issues with constipation and hard stool for the last year and lactulose has been the only thing that helps. Removed her from this immediately when diagnosed with diabetes as it is pure sugar.
-Took her in for annual shots on 9/3/2010 and they discovered a loose right canine that appeared infected. Suggested I wait to pull it until after the move to Las Vegas.
-Moved her from Florida to Las Vegas using a pet transport company on 9/23/2010. They made it as relaxing as they could but she was really stressed out when I arrived 2 days later (my parents watched her until I arrived)
-I took her to the vet in Las Vegas on 10/11/2010 to have the tooth pulled and they discovered several other teeth that needed pulling (I swear I was on top of her dental checkups). They did the pre blood workup and her glucose was 423. They said it could possibly be the pain of the tooth, stress of the move, etc so sent her home with antibiotics and pain meds and told me to bring her back in about 1 week. She was doing really well the first 4 days and eating more and drinking less and urinating less so I thought maybe it was the stress. Then the second half of the week she stopped eating as much and then her eyes became even more cloudy (she has cataracts) and got really squinty and small.
- I took her back to the vet on 10/20/2010 and they did an in house glucose test that came back at 299 and a Fructosomine test which came back on 10/21/2010 as being 500 and was diagnosed officially as being diabetic.
- I took her to the vet on 10/21 in the afternoon and they tested her urine for ketones and there were none. They also told me she had anterior uveitus which is inflammation of the eyes caused by the diabetes and that even though steroids aren't good for diabetes they felt it had to be treated so they gave her a shot of Metacam for the inflammation and sent me home with the following and told me to bring her back in a week:
1 10ml bottle of Prozinc Insulin with instructions for 2 units in the am and 2 units 12 hours later
100 40unit syringes
1 bottle of Dexamethasone with instructions to put 2 drops in her eyes in the am and 2 drops 12 hours later
1 bottle of Tobramycin with instructions to put 2 drops in her eyes in the am and 2 drops 12 hours later

The members here have been wonderful and have given me great advice on how to control costs and it appears the $450 I estimated is way off. I would ideally like to keep it all to $150 a month but if it isn't doable I will pay what is needed to bring her back to health. Here is my plan and I would love any additional advice you can give:

- I am pulling up all of the dry food and only feeding 2 cans of fancy feast per cat (I have 3 which is where the cost comes in but the can says 4 cans should be given which I now see if overfeeding) 2x a day with 1oz of raw food when I can find it.
- I will do a curve reading every few days starting on Sunday (I will be gone most of the day Saturday) and will test AMPS and PMPS starting today (with PMPS)
- I will adjust the insulin down to 1 unit if the AMPS and PMPS are too low (I did test her 6 hours after her shot today and she was 227 but she had eaten a little bit of dry diabetic formula food about an hour before). Otherwise I will keep with the 2 units 2x a day until something changes where I adjust.
- I will buy a hypo kit this afternoon
- I seem to have enough syringes for the next month and a half but then I will look for places that sell the Prozinc and syringes instead of going to my vet for those.
- I am not struggling too bad financially so thank you for those who offered but I will let you send your kits and supplies to someone who may be in more financial need.

I am not sure whether I should continue to eye drops as they do have steroids in them but I am scared what will happen when I stop them. I also feel like I am being cruel giving her all this stuff and doing shots, etc but if it is what gets her better then I will.

Thanks for everything - Jennifer
 
sounds good to me :-)

just want to address a couple things.

first, the hypo kit. it's not necessarily something you go out and buy in and of itself, but moreso supplies you assemble and keep handy. jojo, a very well known and respected vet tech in these parts, put this together that you can use as a reference as to what you should have on hand
viewtopic.php?f=14&t=2354

second, the steroid use. other health issues will and do arise in our kitties' lives and the best advice i can give in regards to that is they have to be treated and diabetes is easily worked around it. so, if she needs the drops to keep her eyes healthy, then she needs the drops and the insulin dose can be adjusted accordingly if the steroids effect her glucose levels. each kitty is different and in some, steroids don't effect them too much. for instance, a few years ago my Mousie got a horrible ear infection and had to have ear drops that contained steroids. her glucose levels weren't effected at all by it. so you never know. :-) the glucose meter and the data you gather with it will help you with that.
 
Eye and ear drops are more localized steroid applications, with a limited absorbtion into the body.

If she had to have injections or pills of steroid, you'd likely see much more of an effect.

As you read up on nutrition - ex http://catinfo.org - you'll find that there are some foods and supplements which help with inflammation, too.
 
You do not have to use/buy U-40 syringes. When using a U-40 insulin, majority of us buy and use the U-100 syringe, 3/10cc and use the conversion chart shown here in the link http://felinediabetes.com/insulin-conversions.htm We also buy the syringes that have 1/2 unit markings on them so we can dose in smaller amounts if needed. I get mine at Walmart.......Reli-On Insulin syringe, 3/10cc, U-100, with a 1/2" needle. Some like and use the shorts, 5/16" needle.
 
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