vial versus pen

[sandra+kiwi]

Dear fellow cat with diabetes lovers,
I am new to this board and have been reading a lot here. However, at the moment I am looking for info on how to use the 3ml cartridges. I am sure it is somewhere explained but I can't find it. My cat was diagnosed in febr and is still not regulated. He also had pancreatitis which was only discovered in june. I had to hospitalize him four time since febr! His insuline from febr to june went up to 7 units lantus twice/day. In june they discovered the pancreatitis, they gave him antibiotics and then he had two months of being regulated well. Then in august he had a hypoglycemia after which the vet put him again on one unit. Since I call her every week to tell her that he still pees, drinks and eats too much, the kito strips always show high sugar (the daily bg numbers aren't bad), she has been highering with half a unit every two weeks. At the moment we are at 3 units and he is still eating huge amounts of purina dm (today he ate almost 4 cans!). I am extremely worried and don't know what to do. Sofar I used the lantus for three months each time (vet said it was ok). As far as i can see there are three options, either his pancreatitis has come back, we haven't reached the right dose yet, or the lantus isn't potent anymore. I am reading different things on how long the lantus lasts. I read a lot on how it only is good for sure for 28 days. Since the lantus is so expensive and I have to find out it it is the impotent lantus that keeps him unregulated, I need to figure out a cheaper way of getting the lantus. I read just this evening about the cartridges but have trouble imagining how it works. Please help!
a almost desperate owner of a great cat (kiwi) with diabetes.
sandra

 

[Deb and Pippin]

The pens are much more cost efficient and simple to use. I would think your vial is probably past its lifespan by now if you have been using it that long.
The pen is simple, remove cap, insert insulin needle into the rubber end and draw up your dose. This is what it looks like.

 

[Sienne and Gabby (GA)]

Welcome Sandra.

I tend to agree with Deb. Your insulin may be old. Do you see "floaties" in the cartridge?

The manufacturer states that Lantus is only good for 28 days once opened. Many people here get longer than 28 days use -- three months may be pushing the envelope, though. Lantus can be purchased on-line through Canadian sources. The price is much less than in the U.S. (if that's where you're located). The pens/cartridges tend to be more economical than the vials. Because most of us tend to discard some of the insulin in a 3ml pen/cartridge, you are losing less to waste in a box of five, 3ml pens/cartridges than you would in an 10 ml vial.

I would also consider whether Purina D.M is the best choice. It's 7% carb, which isn't bad, but the quality of the food is really poor. You might want to take a look at Janet & Binky's food charts. We encourage feeding a low carb, canned diet of less than 10% carb. There is a wide range of food that is in the 5% carb range and costs much less than DM and is of far better quality.

I'd also suggest that you take a look at the information in the sticky notes at the top of the Board -- specifically the note on the Tight Regulation Protocol This is the information on the dosing protocol that we use. Doses are increased in the amount of 0.25u. By increasing in small amounts, it's very unlikely that the optimal dose is misses. If you've been increasing in larger amounts, that may also be contributing to Kiwi's higher numbers.

Are you home testing? If not, this will also give you considerable control over what is going on with your cat's BG levels.

 

[sandra+kiwi]

thank you very much, the pictures are very helpful. I got another vial today because I wanted to get new insuline fast, but next month I am going to try the cartridges, it gives me also more time to become familiar with them. I have so many questions. My vet highers the units with half a unit whenever I call to let her know that my cat shows clinical signs of de-regulation. One question I have is this: how long should it take before we decide that we need to higher the dose? A week? A few days? Also, why is highering by half a unit cause his glucose levels to be higher? What is the mechanism of it? But anyway, I feel that we are going too slow. I do test my cat's glucose level at home on a daily basis, but my vet still wants to do the fructosamine tests anyway, which are very expensive. She doesn't really like highering the dose without a fructusamine test. She does it anyway because she can't do a test like that every week. We highered the last dose on sept 29 (to three units). However, at the moment Kiwi is still eating, drinking and urination too much and I am very worried. She told me Kiwi has to stay on the higher dose for two weeks and then she wants to do another fructosamine. But if my cat is obviously not regulated then it doesnt make sense to wait. He obviously needs more insuline. I am also worried about the pancreatitis coming back and that preventing the insuline from being taken up in his body again. Is there a way to exclude the pancreatitis diagnosis without expensive pictures? (it was diagnosed by a $400 scan the first time, I can't afford those). Also. going so slow highering the dose might actually be very bad for his pancreas, since he spends too much time basically not being regulated. Thanks for the food advice. It would actually be a relief to find food that is cheaper yet better. Finances is another huge worry. I might have to get a second job waitressing or something like that in order to afford the care for kiwi.

 

[Sienne and Gabby (GA)]

If you are home testing and getting more than 2 tests per day and especially if you are doing curves at least once a week, IMHO a fructosamine test is a waste of money. Once my vet saw how I test, the topic of fructosamine tests never came up again. All a fructosamine test tells you is the average BG level over a 2 - 3week period. However, if you are only testing intermittently, you may need to get a fructosamine level.

Please read the dosing protocol sticky note. There is no way to knowledgeably answer your questions about when to raise doses without a spreadsheet.

 

[mybuddybinks]

no advice here, but just wanted to say welcome, and you've got some great guidance here on the forum! these folks know their stuff...they have helped us immeasurably.

celi & binks