Update on Gorda - with spreadsheet!

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pistachioboy

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First of all, a link to Gorda's spreadsheet:
https://spreadsheets.google.com/pub?hl= ... utput=html

Thanks for hooking me up with that! It's incredibly helpful, plus I was starting to get buried with all of my paper data-recording.

BUT - it may be a little confusing. I've gotten pretty confident with my readings and my dosage, and have tried to keep her pretty tightly regulated, which means that sometimes I've done three shots a day. So the data may not look right in places.

All in all, I'm very encouraged with her progress. She's back to her old self, begging for food and snuggling up with me at night. The first time I was genuinely annoyed by her I realized that things must be back to normal. :-)

But with the return of her appetite has come some pretty funky readings, and I've gradually lost my faith in Humulin-N. The problem is not the nadir - it seems to come in anywhere from 5-7 hours, which is great. But the speed with which her numbers have climbed after the nadir has been disconcerting to say the least. There have been days where I could have reasonably given her four shots of insulin, and she would have been fine. Waking up this morning with an AMPS of 502, despite a shot at 11:30PM last night was probably the last straw. I'm definitely switching insulins in the next few days.

Unfortunately, my vet only carries Humulin-N and PZI, which, from what I understand, is another short-acting insulin. There's another vet in the area that carries Lantus, but they're being bastards inasmuch as they want me to come in for a $50 "consultation" (I'm pretty well past that point...), and won't take a written prescription from the other vet. They claim it's against the law - which is, of course, bullsh*t. Sorry for the language, but I get pretty frustrated when people are trying to take advantage of my love for my kitty-cat to make a few extra bucks.

Anyways, I've got no specific questions this time, but feedback is definitely appreciated! Thanks again everyone.

-Steve
 
Hi Steve

I'm in a rush so apologies for brevity

1. I'd hate to be on a rollercoaster like the one Gorda is on. I hate tight regulation using something like N. I am glad you realize that the huge changes in bgs aren't good for her
2. I think dosing more than twice a day shouldn't be needed and there are much better insulins
3. PZI is not a short acting insulin.
4. any new vet is going to charge you a few to go over your cat's history, etc. before prescribing insulin
5. every jurisdiction has different rules around prescriptions so the other vet may or may not be telling the truth. I don't believe that vets actually carry lantus, you may want to call a pharmacy nearby and see if they have it and whether a prescription is required

Jen
 
Hi Steve,

Jen has given you some great information. Like she said PZI is a long acting insulin. If your vet goes to BCP PZI's website, they can order the first vial free of charge for you to try. There is a link to the order form at the bottom of the page http://www.bcpvetpharm.com/products_bovine.htm. If it works well, BCP can ship future orders directly to you.

Lantus is a human insulin. Your vet should be able to write a prescription for it and you take it to a pharmacy. If the vet does prescribe it, ask for the prescription to be written for the Solostar pens instead of a vial. With a vial, you will end up throwing a lot of it away because it will become ineffective long before you finish the vial. With the pens, you will be able to use almost every drop. You get 5 pens per prescription and that is enough insulin to last almost a year. Also there is a $25 coupon in the Supply Closet for your first prescription.
 
Thanks for the info on PZI! I guess I didn't read enough...

She's already down to 50 at +3 - I wish I could adjust her dose without her dropping so god-awful quickly. No signs of hypoglycemia, but I just gave her some Karo syrup. Once she's stabilized I'm going to my vet to get some PZI insulin.

And count my voice as another strong vote against Humulin-N. Why is it the most common prescription for cats? It's sad.
 
Humulin N isn't necessarily the most common.

When I started here in 2002, the insulins available were humulin N, L and U as well as a few types of PZI and vetsulin/caninsulin. L and U were phased out, despite the fact that many cat owners loved them, especially the U. We've since seen IDEXX PZI phased out as well, and the invention of lantus/glargine and levemir/determir.

Some vets have kept up with advances in diabetic treatment, others haven't. When L and U were discontinued, some vets reverted to N or vetsulin/caninsulin without considering PZI. These vets stick with what they know vs trying something new and better.

There are quite a few studies now about how lantus works great for cats, and there is lots of anecdotal evidence about PZI and levemir as well. There is no reason or excuse to be prescribing Humulin N (in my not so humble opinion).

Jen
 
I think you will be much happier with PZI. In most cats, it does not have the early nadir; it usually has a nice shallow curve and lasts 9-12 hours in most cats. Here is some info on how it works: viewtopic.php?f=24&t=32799 and here is our support group forum: viewforum.php?f=24 You might read through some of the threads and see how people are doing with it.
 
Lantus and Levemir are human insulins and you do not need to buy them from a vet.

Go to your original vet and ask for a prescription to take to a human pharmacy (or fax to order from Canada)

If you are close to Canada or some FDMB member that has extra insulin --- you can get it without a prescription -- then show your vet your records and say "Voila!"

If your vet will write a prescription - ask for the 5-pack of 3ml cartridges "for use with pen", though most of us use regular syringes instead of the pen part.

Lantus has more documented studies, but Levemir is very good and less fragile -- which means it lasts longer before it "poops" out.

Personally, I've been using Levemir for my diabetic kitties for 2 years and love it. it acts a lot like Lantus, but no sting (Lantus is acidic, Lev is not).
 
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