Vet appointment and questions?

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Erika&Harrycat

Erika&Harrycat

Member Since 2015
Hello all!
Went to a new vet today since Harry was diagnosed a little over a week ago. The last vet prescribed him Novolin. I found out how crappy it was first hand so I did tests and decided to get him on a better long lasting insulin. Also, the last vet told me not to change his all dry diet, which was Meow Mix! So I completely ignored her and gradually changed him to wet food. He's on fancy Feast classic. I have also been giving his insulin 3 times a day since the Novalin only works for 8hrs. And every 12 hours is not doing it for him. Ok so now that you know some of the back story I went to this new vet. This is how it went.
The new vet agreed that Nova is crap insulin and changed to Glargine. Which is Lantus right?! Yay!!! BUT! It's like $200 a bottle and she said it only lasts 3 months. (Found out it's more like $260 in my areas pharmacy) she didn't even mention the pens. What's the difference?
She said I can call around to other pharmacies and get a better price. Any suggestions for cheaper choices?
Next, she wants Harry on a diabetic only diet. Royal canine something or other and the flavor is gravy. Seriously? Lol I told her that he was on Fancy Feast and its under %4 carbs and she said that him eating FF everyday is like me eating mcdonalds every day. The cans are also expensive. For 24 cans it's $36. And the have to order it for me.
I told her about home testing. She didn't like that I was using a human meter. Suggested Alphatrak- "numbers are off, not reliable" also wants to do curves in office. That's $123 a day. And she suggest every two weeks to start at first. I asked about doing the curve at home and she said only if I have a Alpha meter.
So, I didn't make the appointment for the curve. I didn't order the fancy diabetic food she pushed.
The only thing that is good is the lantus. But the price tag not so much. She wants him on 1 unit to start out with. He was on 2.5 every 8hours with food. Haven't had a chance to test today but I want to start Harry on Lantus tomorrow. Is 1 unit a good start?
HELP!!! Should I find another vet?
Thanks!
Erika
 
The price of Lantus is what's driven a lot of us to buy from Canada...There's a great pharmacy a lot of us are using called Marks Marine (details are in the last post in the "Insulin from Canadian Pharmacies" post)

You're better off buying the 5 pack of Lantus Solostar pens than the vials since the vials contain 1000 units and although they can last up to 6 months if taken care of, you're still not going to use it all up and will end up throwing a bunch away.

The pens are 300 units each (so a box of 5 is 1500 units) but they'll last until the expiration date on the box..usually 2 years away

Good for you on holding your ground on the food and meter issues! A lot of us don't even talk to our vets much about the diabetes anymore...we get our dose advice from the people here that have been doing this dance for a long time.

How much does Harry weigh? And is that weight a good weight for him or is he underweight/overweight?
 
Oh yeah...One more thing...if you buy the pens, don't buy the special needles that come with them. You just use a regular insulin syringe (3/10mL, 30 or 31 gauge, 8mm length) and pull the cap off the pen....there's a little rubber stopper just like on a vial

You'll need syringes with half unit markings too since we do dose adjustments in .25 unit increments
 
Thanks Chris! Cindy just linked me up to your post about the pens. I'll have to look into it for sure. How long have you been ordering from them?
Harry weighs 12.25. I'm not sure what his ideal weight is. When he was first weighed at the vet he was 11.2 and the vet said he was "a little over weight".
 
I've been ordering from them for over a year and I talk to Jordan (the pharmacy manager) regularly...I got my first 5 pack in July of last year and my 2nd 5 pack in April this year ....Marks really is great...their customer service has been awesome!!

Well, if at 11.2 he was "a little overweight", let's just start a 11lbs as his "ideal" weight, so the formula would be [weight in kgs x .25] which would be 1.25...but we usually start a little lower than that, so 1U sounds like a good dose

Another thing you're going to have to decide is whether you want to use the Tight Regulation Protocol (this gives the best chance at remission and is what most people here use) or the Start Low, Go Slow protocol

The TR protocol has more frequent dose changes to respond to how they're doing and doesn't take reductions in dose until they drop below 50 on a human meter.

SLGS holds the same dose for a week, then a curve is done (every 2 hours for 12 hours or every 3 hours for 18 hours) and dose adjustments are based on those results, and reductions are taken if they drop below 90 on a human meter
 
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OK great! Glad to hear! About how long is shipping? I want to start it right away but don't know if I should bite the bullet and get some now and then order later.
Thanks for the help with the weight. That will be very helpful!
I think I'm more comfortable with the SLGS method. It's seems to be more "forgiving"? Lol
 
Takes about 5-7 days from when they get the script...and they'll give you a tracking number so you can watch it go through the postal system.

When you start on the Lantus, make sure you make it really clear on your spreadsheet that you've changed insulin too (as well as changing your signature line)

A lot of us will block out an entire line with another color to differentiate between different insulins to make sure it's very easy to notice.

As for "more forgiving", I don't know....I actually think TR is better because it lets us respond to bad numbers sooner instead of waiting a whole week worrying about the damage they could be doing

Leaving a cat on a dose that's not getting them where we want them can cause glucose toxicity to set in ...and then you just have to keep going higher and higher to reach that "breakthrough" dose that starts to really work for them

No matter what, we'll support whatever you decide...and just because you start on one protocol doesn't mean you can't change to the other later!
 
You're so kind!! I read all the stickys in the LL forum. Maybe I need to go over that protocol again. Lol
My vet only prescribed me for a month and it's just for the vial. She never mentioned the pens to me so I wonder if she supports them. I really didn't like her. Might switch to a different doc in that office.
 
Yep, if you didn't like her, definitely switch. After all, YOU are paying the bill.

Have to share a funny with you about the vets not being familiar with the pens. My vet and I don't see eye-to-eye on diabetic treatment so we agreed that I handle the diabetes, he handles all other medical stuff. He writes my prescriptions for insulin as needed by what I tell him. After I finished one of the pens a year go, I took it into their office for the vet tech to see it. I still see it on different desks when I go in - the last time the head vet finally brought it into the exam room and asked how I used it. She never noticed the little rubber seal where we use the syringe to draw from.
 
If you think she's open to learning anything, point that vet to Cat Info.

As far as glucometers go, all the guidelines here are written using human glucometer reference numbers and they have worked pretty well for that. The Walmart ReliOn Confirm or Confirm Micro, and the Target Up and Up, are pretty inexpensive and take small blood drops.

While you work on home testing, you might want to use some Secondary Monitoring Tools, listed on my Notes to Share link in my signature. Water drunk/thirst, and urine output characteristics should change significantly as you start getting good control.

If you don't want to go with Lantus, you might investigate ProZinc and BCP PZI.
 
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