We're new here - Snowman & Nicole - DX 4/3/23

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GreySnowman

GreySnowman

Member Since 2023
Hi everyone -

I really appreciate this amazing resource and hope I can pay it forward soon.

I have two cats - Grey and Snow - and Snow was just diagnosed with diabetes. I have had them since they were 5 weeks old and they are now 5 years old. No other medical issues. I took Snow to the vet on 6/24/23 for a hot spot on her inner leg for which she was given a steroid shot and an antibiotic shot. She has had this same regimen 2 times prior, each about 6 months between appointments. I am horrified the steroid may have caused this but am not dwelling on that yet...

Thankfully, I have a litter robot that weighs my cats. I immediately noticed Snow was losing .1 to .2 lbs/day along with peeing everywhere, mostly at night. My vet finally relented and did blood and urine testing on 7/1/23 and called me with Snow's results on 7/3/23. I took Snow in that same day for a mini BG curve and when I picked her up that evening, was told she should have 2U of Vetsulin 12 hours apart and no more free feeding.

To ensure the steroid was out of her system, she did a BG curve on 7/5/23 as well. When I picked her up, my vet threw some numbers at me which I now recognize were BG levels throughout the day. I will call for the numbers now, but recall an early one around 130 and around 4:00 p.m. they tested a few times because one was around 450. We have an appointment for another BG curve in 2 weeks but I am hoping to find a new vet before then. Any suggestions around Irvine, CA? :)

I am convinced after reading this all night and today that we need a new vet but I also have considerable work to do (and am happy to do it)! However, I'm a tad overwhelmed. I just ordered the ReliOn glucose meter and strips that another FD member linked in a different post and lancets (I was overwhelmed just deciding on a meter). I will pick them up from Walmart in about an hour. I have a few questions:

- How do I go about getting a different insulin other than Vetsulin? Does this have to come through the vet?

- Should I do Snow's first BG test this evening? I have been doing feedings around 8am and 8pm.

I've read a ton of materials here but still feel so unequipped to do the testing. Would it be ok to just get numbers for the first day and then formulate a plan to adjust things? We'll def be changing up the food and I'd like to feed them more than 2x/day but figure I should get the testing down first.

Jumping ahead, for a night feeding while I sleep, any tips on ensuring Grey doesn't eat all of Snow's food? He's 14 lbs and much more pushy than my Snowman.

I hope this makes sense and I appreciate you all so much!!
 
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Hi and welcome!

I’m glad you found us and are looking to switch insulin. Vetsulin or caninsulin is not the best insulin for cats. With Vetsulin, though you need to make sure you feed at least 30 minutes before the shot since it hits fast and hard. You don’t necessarily need a different vet if your vet is okay with the switch and giving you a prescription for either Lantus or prozinc. But if he/she won’t, then you’ll need to see another vet.

You want to make sure you withhold food for at least 2 hours before the preshot tests. You want to test, feed, wait 30 minutes then give the insulin shot. If you’re feeding around 8, you can test just right before that. Ideally you want to test before each shot so you know it’s safe to shoot. Starting on 2 units is a lot so it’s important to test him to make sure he’s safe and especially if you’re going to transition to low carb food. What are you feeding him now? Smaller meals throughout the day are easier on their pancreas and also help avoid big sugar spikes. Most of us feed the largest meals around shot times and 2-3 snacks or smaller meals in between.

testing is the best way to keep Snow safe. Trust me, I didn’t think I could do it either and though I’ll just do the curves at the vet and let them deal with it, but once I started I realized it was actually not that bad. Start practicing touching and massaging his ears now. We have ton of testing tips to make it easier for both of you!

With a diabetic cat you need
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
A word of warning though…don’t change the food you are feeding at the moment over to the low carb food until you are testing the blood glucose because a change over can drop the BGs by up to 100 points and we don’t want you to have a hypo on your hands.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more!
 
Thank you Ale (& Bobo & Minnie)!

She (I know I call her Snowman so it's confusing lol) was eating Royal Canin adult instinctive wet and dry food but I have been doing mostly wet food and a small scoop of the dry since diagnosis. She eats very little (like 1.5oz. MAX each time w feeding 2x/day). In terms of switching up her food, I understand I'll need to be wary of hypoglycemia and have testing under control first. I also want to have my emergency hypo box kit together! Since she's extremely picky, I figure we'll just go down the list of recommended 4-7% carb wet foods until we find one she likes.

I printed the two posted sheets and created my spreadsheet. I thought I added it and the other pertinent details to my signature but it doesn't seem to be showing up so I'll tinker with that now.

I think I am going to struggle with interpreting test results but I suppose I should get started and comfortable with the testing and take it from there/have a re-read of the resources here when I am at that point to get into dosing methods and optimizing Snowman.
 
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hi there @GreySnowman and welcome to the club. As usual, Ale is one of the first to respond to a new thread and gave solid advice. I would second the recommendation against Vetsulin -- I'm a big fan of Lantus or glargine they did wonders for my boy. I'm not one of our resident expert FD gurus, just a guy who was thankful to find this site about 1.5 years ago when my boy Hendrick was diagnosed. The people here saved me, and saved him -- he is now a diet-controlled diabetic feline in diabetic remission!!

Don't worry too much about interpreting test results the gurus here can help with that part, it's something they are very very good at after having seen data from hundreds, if not thousands, of diabetic cats over the years.

I have to say, your intro is very impressive and you seem like you've really hit the ground running with this! It is rare for a first post to sound so informed and on the ball. Did you know, over 75% of felines diagnosed with diabetes are euthanized. Most people don't, or can't, put in the time and effort to try to regulate the diabetes or make an attempt at diabetic remission. Which is so sad. But not you! You're one of the good ones. Welcome!
 
Kyle is so right and I agree, great job on getting all the basics set up and ready to go!

I didn’t know what I was doing either but the pros here will help you and guide you. That’s why it’s so important to test and have your spreadsheet updated so they can review and interpret those mind boggling numbers for ya :bighug:

I’m not sure if the royal canin wet is low carb but I know the dry isn’t. If you can transition him off the dry, that would be best. If not, some cats just don’t like wet food, the 2 low carb dry options are Dr. Elseys and Young Again Zero Carb. FOOD CHART have a look on this chart and choose foods that are under 10%. You will also need some higher carb foods for that hypo box.

When you start testing, make sure to warm up the ear first. It makes all the difference in getting a decent size droplet. I use a sock I filled with rice and I nuke it for 20-30 secs. You also want to aim for the sweet spot
upload_2023-7-6_17-26-35.jpeg


This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!

PS - You may want to share the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats with your vet. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes. This may get him/her to give you a prescription for Lantus or prozinc
 

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Hi and welcome to the forum
I would go back to 1 unit twice a day. 2 units is too much to start with.
The normal starting dose of vetsulin is 1 unit if you are feeding a higher carb /dry food diet Or 0.5 unit are feeding a low carb wet diet.
I would also give some snacks during the cycles as Ale suggested. Don’t wait until you were testing to do this.
Do you have a hypo kit set up. You will find the information in the link Help Us Help You that Ale gave you.
Well done getting the spreadsheet and signature set up. We appreciate it.
Keep asking lots of questions.
Bron
 
Thank you all so much. Each time I read a new message @Hendrick Cuddleclaw @Ale & Bobo & Minnie (GA) @Bron and Sheba (GA) it makes me tear up due to your kindness.

I will be attempting our first blood glucose test this afternoon. Rice sock is ready! Afterward I will only do 1u vetsulin for Snow tonight--still waiting on my vet to respond regarding prescribing a different insulin. Once I have a new prescription, do I send it in to Chewy? I am anticipating having to call all of my local pharmacies as well to see if anyone has it in stock so that I can pick it up.

I believe I understand how to input the values into the BG spreadsheet. I have the guide bookmarked, but if I have issues I may ask some questions.

I have a lot of questions below - I'm sorry!

I may be getting ahead of myself but am a little confused about the difference between the Tight Regulation Protocol and the modified Prozinc method? I assume the latter is only applicable if my vet prescribes us Prozinc?
The method used, e.g., Start Low Go Slow is dictated by the insulin type? Also, what is a "reduction point"?

In terms of food, I have a list of all the wet foods from the FOOD CHART that are less than 7 carbs (and not pate, as my cats seem disinterested in this texture). Heading out now to pick up as many as I can find + remaining hypo box supplies. Questions:
- Has anyone experimented and found a strategy that worked for most efficiently determining what your cat will eat?
- If Snow ends up preferring a low carb food that's higher in fat than protein, is this bad? I'm hoping a high protein, super low carb one will win out but she's SO PICKY.
- If you feed your cat(s) 2 big meals and a few smaller snacks, do you feed the same wet food all day but in varying amounts or do you mix it up? I will grab a bag of the low-carb dry food as well but am hoping we don't need to use it.

Thank you thank you! I hope you all are having an amazing day.
 
Let me answer what I can since I’m not a prozinc user. For Lantus, you want to shop around because it can be quite expensive. I ordered mine from Canada because it was so much cheaper but I hear some folks get a good deal at Costco’s pharmacy and there are online coupons you can use too like goldrx. I believe @Diane Tyler's Mom has a ton of info about online coupons.

with Lantus, if you're not feeding dry food you can choose either SLGS or TR. if you’re feeding dry, your only option is SLGS.

I was feeding Minnie and Bobo his FF spread out within 2 hours from shot time. So same food but smaller portions. Then I do actual treats as snacks 2-3 more times in between. You can do either. It’s really up to what works best for you and your cat and what he ends up liking to eat. Unfortunately, it is trial and error. When Bobo was diagnosed I literally bought every brand the pet store had and tried them all until I realized nothing worked other than FF for him.
 
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We tried to take Snow’s pre-meal blood glucose and it was a total fail and I feel horrible. My boyfriend was here helping which I can’t count on every time so I’m at a loss.

Warmed her ear up w warm rice in a sock. I applied vaseline to help the blood bead. Maybe that was a mistake? We couldn’t get enough blood across 3 separate tests (Er4 on the ReliOn Premier). I feel horrible and didn’t want to put her through anymore. I’m also nervous bc it looked like the blood was pooling inside her ear from our efforts. (I uploaded it to imgur: https://imgur.com/a/S0qwhd5).


She’s not happy and now is supposed to be having dinner but won’t eat any of the food options I put out (which are normally fine) or her favorite treats. I’m not sure what to do. I was planning to give her 1u vetsulin but don’t think I should on an empty stomach. Any ideas? :(
 
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I'm sorry no-one got back to you.
How did it all go.?
Honestly, the first few days, please expect to fail. I did, miserably!
It will take a few days or a week for you all to get used to the new routine.
It is just fantastic you are willing to try.
Try humming as you test next time. That often helps relax you and the cat.
I looked at the photo. That little bruise will disappear in a few days. When you have got the blood, just hold a piece of cotton wool over the spot foe a minute and that will help stop any bruising.
Are you warming the ear? Try milking the ear towards the top to encourage blood.
If you hold a torch behind the ear you will see a vein running right around the ear. You need to aim between the vein and the edge of the ear.
Make sure you give Snow a treat every time you try, even when you fail. And give your self a treat too.
I can promise you will "get it" soon. I don't know how many times I have had this conversation with new members, but if I had a dollar for every time, I would be rich! And they all say the same thing ..they were sure they would not be able to do it. But they all did! And the cats were fine too!!
It is fine to use vaseline.
With Vetsulin, I would not give the dose until she has eaten something. Then you wait 30 minutes before giving the dose.

Have a look at Lyle testing his kitty. He could not do it in the beginning and he ended up getting his kitty into remission.
 
GreySnowman said:
Also, what is a "reduction point"?
Click to expand...

You'll see posts where people state "congrats, kitty earned a reduction!" This is when an insulin dose is reduced based on the cat's numbers. This site is very numbers driven which I love. Lots of analytics. The different dosing methods have reduction points baked in, so depending on what method you use if Snow's numbers went below a certain threshold, the dosing method would dictate that you reduce the dose by .25u.

GreySnowman said:
In terms of food, I have a list of all the wet foods from the FOOD CHART that are less than 7 carbs (and not pate, as my cats seem disinterested in this texture). Heading out now to pick up as many as I can find + remaining hypo box supplies. Questions:
- Has anyone experimented and found a strategy that worked for most efficiently determining what your cat will eat?
- If Snow ends up preferring a low carb food that's higher in fat than protein, is this bad? I'm hoping a high protein, super low carb one will win out but she's SO PICKY.
- If you feed your cat(s) 2 big meals and a few smaller snacks, do you feed the same wet food all day but in varying amounts or do you mix it up? I will grab a bag of the low-carb dry food as well but am hoping we don't need to use it.
Click to expand...

We just tried lots of different foods. No real strategy lol

Many of the low-carb options on the food charts are higher in fat than protein

Yes we mix it up. They get a variety of foods, usually breakfast is different than snacks and dinner is homemade raw food.
 
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Let me offer a bit of course correction. I've been here for a long time and have a bit more knowledge of history.

Start Low Go Slow (SLGS) is a dosing method that was developed here. While it doesn't have formal research to support its use, it has a lot of good experience behind it. The method is applicable to pretty much any insulin. There is a section of the board that has information for every type of insulin that has been used with cats. There is a version of SLGS for each.

What is worthwhile to know is that the American Animal Hospital Assn has published guidelines for the treatment of diabetes. In 2018, the guidelines changed and they are only recommending either Lantus (glargine) or Prozinc for the treatment of feline diabetes. If you need to convince your vet, print out a copy of the linked guidelines. Usually vets stop arguing if you hand them a copy of a set of guidelines from one of their professional organizations.

The Tight Regulation Protocol (TR) is a dosing method that was developed for use with Lantus and Levemir by a vet from University of Queensland, Jacqui Rand, DVM, and a researcher in Germany, Kirsten Roomp. Kirsten is the person who founded one of the first Lantus boards and was helpful in getting FDMB up to speed with Lantus. TR is based on research that was published in one of the leading veterinary journals. It was groundbreaking at the time due to the number of cats that were newly diagnosed and went into remission. It helped to make Lantus a standard for treating feline diabetes despite it being an insulin developed for humans. (Prozinc is an insulin developed for animals.)

TR and SLGS differ in a number of ways. The reduction points differ -- below 50 with TR, below 90 with SLGS. How long a dose is generally held also differs, 3 days/6 cycles vs 7 days/14 cycles, respectively.

Lantus and Prozinc are quite different pharmacologically. In response to your question, the Modified Prozinc Method is very similar to TR. The difference being that TR is associated with Lantus. There are other sites that refer to what we call MPM as TR which adds a considerable degree of confusion if you try to search the research literature for TR with Prozinc.

As for food, providing the food is low in carbs, the best food for your cat is the food your cat will eat! One consideration, though. If you end up getting an Rx for Lantus/glargine, you cannot use TR if your cat is eating any dry food.

Please keep the questions coming. We're here to help.
 
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Bron and Kyle already gave you a lot of the tips I was thinking of, like always give a treat whether it’s a failed test or not.

2 other things I want to say.

1. Cats pick up on your stress level and that can be a factor. That’s why the humming is a great tip because it keeps you both calm. I always sang a lullaby during testing. They got so used to it, when they heard the song they knew it was test time. easier said than done I know, but try to stay as calm as you can and act like it’s no big deal. We’re just going to do this thing for a minute and it’s all good, you’ll get a treat right after. I always had the treat right there with me so they could see it.

2. I think it’s easy at first to not want to put too much pressure on the lancet because you’re afraid of poking through the ear. You then overcompensate and go too lightly on it. The problem with that is that instead of poking, you make a tiny scratch. It’s happened to me a few times and you can’t get blood out of a scratch because it’s a tiny tear not a hole. Even if you see a tiny bit of blood for a second or so, it will disappear back into the tear and you can’t capture it. I’d suggest you try to apply a bit more pressure on the lancet next time, as if you’re pushing it in. It’s a balancing act and until you do it a few times and learn just what the right amount of pressure feels like, you’ll either get too little or too much blood. Just remember what Bron said and always apply a cotton ball to the spot for a few seconds so it won’t bruise or scab.

Bobo is a black cat and I thought I’d never be able to see the blood on his ear, but I did and it was fine.

you can do this, don’t give up!
 
OMG WE DID IT!! Snow is hiding from me now and hasn't eaten dinner yet but I suppose we have to start somewhere :) I must have read through each of your comments above 5x today just to be sure I was ready and we sang. Her PMPS score was 155.

Is it worth adding the blood glucose testing done by our vet on 7/5 to her spreadsheet? He had her as:
[2u Vetsulin around 8:45am)
@9:45am = 248
@10:45am = 165
@12:45pm = 121
@2:45pm = 204
@4:45pm = 366
@6:45pm = 428
@7:30pm = 380

Should I do blood glucose tests AMPS and PMPS daily from now on? Is there a specific point in time when we move up to more testing throughout the day?

Still working on getting the Lantus but I think the vet will switch us in the next day or so. In the meantime, I'm locating all of the ideal food options from stores nearby bc Snow is SO picky.

I cannot thank you all enough, especially for your patience. I could hug everyone lol
 
CONGRATULATIONS! well done!!!
Yes please add the vets curve and put in the remarks column that it was done at the vet please.
GreySnowman said:
Should I do blood glucose tests AMPS and PMPS daily from now on? Is
Click to expand...
Yes definitely.
GreySnowman said:
Is there a specific point in time when we move up to more testing throughout the day?
Click to expand...
If you can get a test in around +4 each cycle that would be amazing.

Have you given the dose of insulin yet? have you fed yet?
If not I would hold off and see if the BG will rise.
We usually say don’t give the insulin if the BG is under 200.
 
@Bron and Sheba (GA) I had fed and insulin by the time I saw your message but this is good to know!

Snow was 9.8-10lbs before her diagnosis but is 8.4 as of last night. I’m torn between believing the insulin is needed for her to absorb the nutrients she eats vs. I’m not really sure… maybe leaving more food out longer (I pick it up so long as she’s eaten some, once it’s time for the insulin shot).
 
How much insulin did you give?
You need to try and get another test done now to see what is happening, and if the insulin has dropped the BG further. Can you do that?

The insulin is definitely needed for the nutrients to be absorbed.
You can leave the food down until she is finished. And she should be getting at least 2 or 3 snacks during the first 6 hours after each insulin shot.
I will watch for your answers.:)
 
Congrats on the successful test!!! What a huge huge milestone. Took me about a week or two before I ever got one, so many failed attempts. And that was with my wife helping! It would be another few weeks before I could do it solo. Very impressive there Nicole!


Bron and Sheba (GA) said:
We usually say don’t give the insulin if the BG is under 200.
Click to expand...

just to clarify this statement because it confused the hell out of me when I was new: this is specifically for when a person is just starting out and has no data to speak of in the spreadsheet to give an idea of how the insulin is working on the kitty. After you get more data this under 200 rule will no longer apply.

That PMPS of 155 is low enough that I do wonder just how low the 1U of Vetsulin took Snow last night. Cats often go even lower in their BGs during the evening cycle.
 
@Hendrick Cuddleclaw
I probably could have explained that better.
When people are new here on main we say not to shoot if the Preshot is under 200 on a human meter with any insulin until you get data.
When you are using Vetsulin which is a harsher and quicker acting insulin than the depot insulins, you will need to have quite a bit of data to be shooting under 200.
I will tag @Suzanne & Darcy to clarify that as she has been a Vetsulin user
 
@GreySnowman
I prefer glargine and Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menue says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot
Let us know if the vet writes the script for you because you will need U-100 syringes with half unit markings , I can tell you which ones you can use
We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens. GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822
 
Bron and Sheba (GA) said:
How much insulin did you give?
You need to try and get another test done now to see what is happening, and if the insulin has dropped the BG further. Can you do that?

The insulin is definitely needed for the nutrients to be absorbed.
You can leave the food down until she is finished. And she should be getting at least 2 or 3 snacks during the first 6 hours after each insulin shot.
I will watch for your answers.:)
Click to expand...

This is great to know! Esp bc I feel like I’m starving her. She gets hungry an hour or two post shot and I feel so bad.

I didn’t see your message until this morning. I gave her 1u Vetsulin last night (instead of her prescribed 2u). I thought it was interesting that she woke me up meowing by my bedside 2x last night. She hasn’t done this since right before being diagnosed (and this is the 2nd night I lowered the Vetsulin from 2u to 1u).

In any event, I got her AMPS this morning at 218. Other than the treat I gave her, she hasn’t had food bc she’s hiding from me. Once she eats a little, I’ll give her 1u Vetsulin ~30 min after and try to get another BG reading 2 or so hours after that!
 
Diane Tyler's Mom said:
@GreySnowman
I prefer glargine and Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menue says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot
Let us know if the vet writes the script for you because you will need U-100 syringes with half unit markings , I can tell you which ones you can use
We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens. GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822
Click to expand...

thank you @Diane Tyler's Mom !! This is so helpful. Two ish questions:

1. My vet implied I would order the Lantus/glargine and then he would approve it. Is this correct? This seems weird vs. getting a prescription that I then go fill.

2. I also heard the Lantus/glargine only lasts 28 days so am confused about getting multiple pens at the same time. I assume I misheard something along the way!
 
I needed a prescription to order Lantus from Mark's Marine in Canada (great prices btw)

As I understand it, the pens are intended to be tossed in a purse or glovebox or something like that and the manufacturer typically gives a lifespan of 28 days after opened under those conditions.

however, if placed on the middle shelf in your fridge, it has been established that the insulin can remain stable and functional for much much longer. Most members here use every drop in their pens which often takes months.
 
Bron and Sheba (GA) said:
How much insulin did you give?
You need to try and get another test done now to see what is happening, and if the insulin has dropped the BG further. Can you do that?

The insulin is definitely needed for the nutrients to be absorbed.
You can leave the food down until she is finished. And she should be getting at least 2 or 3 snacks during the first 6 hours after each insulin shot.
I will watch for your answers.:)
Click to expand...

Phew… we’re running. I think hah.

I just took Snow’s BG just over 2 hours past her 1u Vetsulin shot and she’s at 85 . This may not be correlated but she hasn’t seemed as ravenous post shot today as she is a lot of times.

Since Snow barely eats, I’ve left her wet food down but she hasn't had a ton overall. Post BG test, I’ve been giving her a piece of white cheddar cheese about the size of a dime. It’s the one treat she’s crazy for.

Per your earlier comment, I will try for another BG test in about 2 hours (+4 from insulin shot).

Finally, since I gave her the insulin a couple of hours late due to her not eating, I assume I should wait until 12 hours from then for the evening shot?


Unrelated but I am so so appreciative @Hendrick Cuddleclaw @Diane Tyler's Mom @Bron and Sheba (GA) @Ale & Bobo & Minnie (GA) @Sienne and Gabby (GA) I don’t have a ton of skills other than my undying love for my cats, however, I am an attorney in the US. If anyone ever has any questions in that realm, I would be elated to be able to help. If it isn’t in my area of expertise, I can at least look into it and make a suggested referral.
 
Well done you!!

Given that she’s 85 at +2, I think it’s wise to test her again at +3. That was a big drop. In order to slow it down, can you give her some medium carb food now? What do you have that she’ll eat? Not too much so she doesn’t get fully but a teaspoon or 2 of food would be good.

I love your offer and I hope never to need it, but will keep it in mind since I don’t really know any lawyers :bighug:
 
With that drop to 85 today you need to reduce the dose to 0.75 Unit, and stay at the new dose unless Snow drops under 90 again or you need to increase again after a week..
Well done catching the 85.
Have you retested again yet?
 
Ok, good to know! Do we do the .75u Vetsulin at her usual 12 hour interval (~9pm), or 12 hours from the last shot (~11:50pm)?

I couldn’t get her at +3 but her BG tested as 96 at +4. She had had about 10 pieces of royal canin dry food about 40 mins before that.

(The goal is to find a med, and low carb food she likes but we haven’t gotten to experiment yet so she’s currently only really getting the royal canin wet food (which is 14% carb) but even that is hit and miss hence the dry food 40 min ago).
 
I feel like this timing issue will keep happening bc Snow doesn’t like to eat after her BG test. Do you think it will be better once we’re on a different insulin like Lantus? (At least in terms of having to wait 30 mins after she eats).

With this in mind, I took her blood glucose again just now (so I can put food down, assuming she won’t touch it for an hour or so) and it’s at 295. Will def wait for closer to the 12 hour mark for her PM insulin shot!
 
I’m getting super concerned about Snow’s weight loss. She’s 8.1lbs. as of today. She was 9.8 on 6/24 and 8.9 on 7/3.

I know there are a lot of moving parts here, but at what point is it too much weight loss? I’m confident in staying the course with this except for her continued weight loss.

Anyone else with thin-cats? Or cats with very little food drive?
 
Has Snow been tested for hyperthyroidism?
How much is she eating?
if she is not eating enough to maintain her body weight, she will lose weight.
Remind me, have you been giving her anything for nausea? She could well be nauseated and that is why she isn’t interested in food.
Is there any food she will eat well?
 
I googled after my last comment and wondered about hyperthyroidism. I just peeked again at her lab results because I don’t recall seeing it when I filled in her spreadsheet; in fact, no tT4 results, except for in the urinalysis panel which seems bizarre.
(Imgur links to the blood test results: https://imgur.com/a/EVRvz1r and urinalysis: https://imgur.com/a/lfAJeXE).

She’s been eating less than 2oz. wet food/day and maybe 15 pieces of dry food. I give her 1/2 of a 3oz can of wet food 2x/day as her bigger meals but she doesn’t finish it. I’d love to give her more it just goes to waste! Prior to 7/3 she had all the dry food she could want all day so I wondered if this was part of the adjustment but she clearly has less of an appetite.
Our best bet seems to be the royal canin dry food in terms of food she will eat well, however, since we started doing the ear pricks, her new routine seems to be blood glucose test —> I put her food out (the can of wet and dry now), but she hides for 30 min to an hour —> she comes out and has maybe 5 bites.

I know Snow used to eat some during the night (bc I could hear her chomping down). I’m wondering if leaving food down for the 1st half of the night would be okay in the short term? I have to take a sleep med in the middle of the night so I could put it up before my mid-night dose so she doesn’t eat for at least 2 hours prior to the AMPS.

I’d love any other ideas
 
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Absolutely you can leave food down for the cycle except for the 2 hours prior. She needs to eat.
2 oz of food a day plus 15 pieces of dry is not nearly enough food.
You didn’t say if you have asked about cerenia or ondansetron.
I would make that a priority…asking the vet for some ondansetron…it I can be given three times a day if needed and is vey effective for nausea.
I think at this point in time, I would give her whatever she will eat, that is more important than just eating low carb food at the moment.
I can see the total T4 was done and it was 1.8 so is normal. She is obviously losing weight because she is not eating enough.
 
Bron and Sheba (GA) said:
Absolutely you can leave food down for the cycle except for the 2 hours prior. She needs to eat.
2 oz of food a day plus 15 pieces of dry is not nearly enough food.
You didn’t say if you have asked about cerenia or ondansetron.
I would make that a priority…asking the vet for some ondansetron…it I can be given three times a day if needed and is vey effective for nausea.
I think at this point in time, I would give her whatever she will eat, that is more important than just eating low carb food at the moment.
I can see the total T4 was done and it was 1.8 so is normal. She is obviously losing weight because she is not eating enough.
Click to expand...

Fabulous—thank you! Food is down for now and I will ask the vet about ondansetron in the morning.
 
Hi all - I wanted to check back in. Before rapid firing for more help, I needed to take the time to read through everything I hadn't gotten to on this forum so that your information made more sense/to avoid dumb questions (though I am grateful for the patience!).

At the height of my anxiety, I didn't realize that Snow doesn't stand fully on the scale portion of her litter box leading to a lower-than-accurate weight reading. *doh* As of this morning, she is at 9.2lbs (woohoo!). This was a huge relief and gives me confidence that the insulin is at least working.

I also have a better understanding of the feeding/insulin/time of action relationship now and have a tighter schedule for Snow (and believe our spreadsheet will be more useful going forward!). Our timing was getting off schedule because I was so afraid of her eating, but for now, at minimum, she'll eat a little dry food if I bring it to her under the bed (if she isn't already eating the wet food I put down on schedule) so we should be able to get back on track there. I also spoke with my vet for a while last night about glargine and am confident he will send the prescription in the next few days.

From here I assume we'll stick to schedule and do regular blood glucose testing to catch trends. In about a week I'll check in regarding Snow's numbers and to see if any adjustment is necessary. Once we have the glargine/lantus in hand and about a week or so of numbers from there, I plan to experiment with low carb wet foods (and hopefullyyyy get her off of the dry food but we shall see).

I would appreciate it if someone could tell me if I'm way off on any of the above. Otherwise hope to be able to check in with some positive news as we go forward. Thanks again!!
 
Try and get a test in during every cycle at around +2 or +3 or +4 to see how low the dose is taking Snow.
Just remind me, are you waiting 30 minutes after feeding before giving the vetsulin?
Did the vet give you some ondansetron?
When you get the Lantus, make sure you post to ask about the starting dose.
The regime of test/feed /shoot is different for Lantus so please check in first.
 
Bron and Sheba (GA) said:
Try and get a test in during every cycle at around +2 or +3 or +4 to see how low the dose is taking Snow.
Just remind me, are you waiting 30 minutes after feeding before giving the vetsulin?
Click to expand...

Yes, we are waiting 30 minutes after eating for her vetsulin injection.

Bron and Sheba (GA) said:
Did the vet give you some ondansetron?
Click to expand...

Vet did not give me ondansetron. We discussed and tbh he didn't seem super into it; however, I did not push it because of my misunderstanding regarding Snow's weight gain. Since her weight is increasing post-diabetes diagnosis, it seems less urgent. Her eating habits are the same as they've always been (she's just a super picky cat).

Bron and Sheba (GA) said:
When you get the Lantus, make sure you post to ask about the starting dose.
The regime of test/feed /shoot is different for Lantus so please check in first.
Click to expand...

I absolutely will! My vet told me to "have GoodRX send him the prescription to approve." I'm fairly sure this is not how that works so I called RiteAid and was told my vet will need an NPI number for the GoodRX coupon to work and only about 20% of vets have NPI numbers. I am going to start tracking down the Canadian pharmacy @Hendrick Cuddleclaw recommended as a backup and assume we're a few more days out from (hopefully) getting Lantus/glargine.

EDIT: In case anyone comes across this in the future, I called GoodRX and am told instead of an NPI number, for vets, the pharmacy can use the DEA number :)
 
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GreySnowman said:
Yes, we are waiting 30 minutes after eating for her vetsulin injection.



Vet did not give me ondansetron. We discussed and tbh he didn't seem super into it; however, I did not push it because of my misunderstanding regarding Snow's weight gain. Since her weight is increasing post-diabetes diagnosis, it seems less urgent. Her eating habits are the same as they've always been (she's just a super picky cat).



I absolutely will! My vet told me to "have GoodRX send him the prescription to approve." I'm fairly sure this is not how that works so I called RiteAid and was told my vet will need an NPI number for the GoodRX coupon to work and only about 20% of vets have NPI numbers. I am going to start tracking down the Canadian pharmacy @Hendrick Cuddleclaw recommended as a backup and assume we're a few more days out from (hopefully) getting Lantus/glargine.

EDIT: In case anyone comes across this in the future, I called GoodRX and am told instead of an NPI number, for vets, the pharmacy can use the DEA number :)
Click to expand...


https://canshipmeds.com/

Specifically, we bought the Basaglar qwikpen 5-pen pack. Ended up being a great price per pen

https://canshipmeds.com/product/Basaglar KwikPen for Pets/drugId/D-12473/
 
Hi all (and a special hello to all the kitties) -

Quickish update. We found a new vet that "specializes" in cats (and reptiles). She convinced me to keep Snow on Vetsulin since Snow's chart looked to be trending down. I disagreed re: her chart but agreed to try Vetsulin for another week. Long story short, it is 3 weeks later and I am picking up her new prescription for Lantus today. Snow has gained back most of her pre-dx weight but her blood sugar is far from controlled.

I have a few questions going forward and would really appreciate any insight:
(Background provided with actual questions in bold)

1. I am still trying to get Snow onto a low-carb wet food. We've tried approx 30 different brand/flavor combinations and I have 40 more new cans sitting here to try. I am nervous I am doing this wrong. She currently will only eat the Royal Canin dry food we've had (the current batch of RC wet food is "bad" to her; this is common). As a solution, I've been giving her 1 slice of nitrate-free deli turkey meat each mealtime (she only will eat Trader Joe's organic brand). My fear is that maybe she is ignoring wet food that she might otherwise like because she's holding out for the turkey? Is there a better protocol here to introduce new food to her? Her diabetes makes me nervous to hold out on feeding in hopes she'll be hungry enough to try (each new) wet food. I open 2 - 3 new cans each mealtime and she hardly smells them before turning away.​

2. I have a trip planned to Morocco from August 20 - 28 for a wedding. My boyfriend's father paid for our flights before Snow's diagnosis. I am scared to leave her and don't have anyone reliable nearby. Should I stay home? My bf is pushing back on this but I would rather lose the boyfriend than my cat. Would a service like Rover be a viable option where I could either have someone come 2x/day for feeding and insulin or maybe even a house-sitter? My anxiety is getting the best of me here.

3. If I do go to Morocco, I assume I should wait until I am back before starting Snow on the Lantus?

4. Could someone remind me where I can find the list of low-carb dry foods? (Just in case)​
 
Are you sure she is not nauseated?
Have you tried the low carb dry foods.
I can’t tell you what to do about your trip, you have to work out what is or important to you.
I would stay with the current insulin if you decide to go on the trip. Do you have a reliable pet sitter? I would encourage you to get some tests in in the pm cycle as well at the moment we don’t know anything about what is happening for 1/2 of the time.
Post 69 of this thread gives information about dry food
https://felinediabetes.com/FDMB/threads/kitty-not-wanting-to-eat-much.263088/
 
Bron and Sheba (GA) said:
Are you sure she is not nauseated?
Have you tried the low carb dry foods.
I can’t tell you what to do about your trip, you have to work out what is or important to you.
I would stay with the current insulin if you decide to go on the trip. Do you have a reliable pet sitter? I would encourage you to get some tests in in the pm cycle as well at the moment we don’t know anything about what is happening for 1/2 of the time.
Post 69 of this thread gives information about dry food
https://felinediabetes.com/FDMB/threads/kitty-not-wanting-to-eat-much.263088/
Click to expand...

Thank you for your response!

Snow has no problem eating her current dry food and the turkey meat I give her without hesitation so I figured that more or less ruled out nausea but am happy to be corrected.

I also appreciate the note on PM testing. Our new vet implied her levels would likely be the same but I should probably know to be skeptical at this point (thanks to all of you)! Esp. after we were prescribed the high carb dry food and Vetsulin delay.

I am really leaning against going on my trip but will call my vet and see if a tech is interested in making a little extra money to come by 2x/day. I haven't ever needed a sitter and am wary of those app services without having a prior relationship. And thank you for the link on dry food--I thought I was getting better at navigating this forum but am still a work in progress.


Edit: Btw, not sure where else to post this but I wanted to share--I was able to find a website that sells single can cat food. I had exhausted my local options. Maybe it would be helpful to someone else: www.thepetbeastro.com
 
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@GreySnowman
If you do switch to Lantus
Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon. Most members use the generic because Lantus is to expensive.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menue says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot
Let us know if the vet writes the script for you because you will need U-100 syringes with half unit markings , I can tell you which ones you can use
We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units ,we adjust the doses by 0.25 units


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens. GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822
49823063143_3437e9e997_o.jpg


You can read all about Lantus here, all the yellow stickys
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there
syringe-in-pen-pic-jpg.45006
 
If you do decide to go on the trip, do not change any of the food over to a lower carb option or change the insulin until you get back. Also post 2 days before you go, if you go, to get a vacation dose:)
 
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