what my vet says??? Help please

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kathpj

kathpj

Member Since 2012
Hi,
I have left my old vet who said I should have Red put down when he was diagnosed with diabetes.
I have been recommended a vet who seems really nice on the telephone, chatted for a long time and is happy for me to home curve him which is great. A lot of expense save. He wants me to do 5 glucose tests for 3+ days before deciding a start dose. All sounds reasonable. What I am unsure about is the type of insulin. He wants to use caninsulin dosed at 0.25 Iu/kg body weight. (As long as the mid day lowest readings are not too low). This is a intermed lente I believe.
When I asked about lantus he said he was confident and used caninsulin often with good results. I am going to take some info about lantus off this site with me but may have to work on him slowly. Guess what Im saying is, I may have to start on his choice, Is this problematic?
I have had to leave putting him on insulin a while due to finances and getting the vet to work with me maybe my only option at this stage. May not be perfect but is the compromise ok?
I look forward to your views,
Thanks, Kath & Red
 
It's great that he is supportive of home testing. However, his choice of insulin is not a great choice for cats. My guess is that he may not be familiar with using lantus and therefore is going with what he knows.

The better insulins for cats are lantus (glargine), levimer or prozinc. If you go to the lantus forum, there is information there you can give to the vet that explains in vet speak why this is a better choice.

Personally, I would insist on using lantus and ask him for a scrip, be sure he writes it for the pens or cartridges, not the vial. Then purchase insulin syringes to use for the pens (DO NOT get the ones that are made for the pens). You may also need a scrip for the syringes too - be sure that he writes - U100 syringes with 1/2 unit markings. And you can do either short or long needle (my personal preference is short needle). You will treat the pen as if it is a small vial.

Also, you don't need to dose by weight. Any of the insulins I list, if you start at 1/2 unit or even 1 unit, that is a good starting dose and what we recommend here. Start low, go slow.

Start with a low dose 1 unit or less and slowly with home testing on board for several days, adjust the insulin in small increments accordingly. Adjustments should be no more than 1/4 to 1/2 unit at a time. Hence the reason you want the syringes with 1/2 unit markings.

viewtopic.php?f=9&t=1581 STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL

viewtopic.php?f=9&t=151 STICKY: LANTUS & LEVEMIR - INFO, PROPER HANDLING, & STORAGE

viewtopic.php?f=9&t=18139 STICKY: LANTUS & LEVEMIR - NEW TO THE GROUP? PLEASE READ...

And there are some more stickies on the forum to read as well.
 
We generally suggest Lantus, (Glargine), Levemir or ProZinc over Canninsulin. There certainly are people who have been able to get their cats regulated or in remission with it, but sometimes, it is harder. If your kitty is one of the ones that react fast to the insulin, and experience a harsh drop with a short cycle, it can be impossible.. But if you are one of the lucky ones whose kitty reacts slower and it lasts longer, it can work. It does take careful monitoring so he doesn't go too low too fast.

Moneywise, what is the difference? Have you done some research? (be sure to price out the pens, not the vials)

I assume you have already switched to wet low carb to figure that difference in glucose levels?

Re the dose, we like to start low - .5 to one unit twice daily.
 
Where are you located? The vet requirements in some countries require that animal-specific insulins be used/tried before trying a human insulin.
 
We are in New Zealand. Im not sure if it is a requirement here or just the vet saying cat insulin is made for cats and he is not up to date like people on this site.
Its quite tricky as you can realise to try and insist. I am going to email him this website address and hope he will look at it.
Who is the vet in Australia that is an expert on sugar cats?
Yes, Red and his sister are now only eating wet canned food. Unfortunately his levels are still at lowest 252.
Haven't looked at difference in cost. This would be important as I am a student on very little income.
Can't bare not to give him a chance. Considering his levels between 252-378 are not that bad. Although I know he does need insulin.
thanks
Kath & Red
 
Hi,
Great news I have spoken again to my vet. All the info from this and Prof Rands website has persuaded him to prescribe lantus for Red. We go and see him tomorrow.

That is a great result. I am still unsure about the vials & pens. I read what you said about getting him to prescribe the pen or cartridge not the vial. Why is this?
I don't want to fail at the last hurdle and show my ignorance!! If we are starting slow I will only need 3ml, that will be enough for ages (I fridge 6 months says Prof Rand)

I understand about the syringes U100 with 1/2 unit markings to draw out of the pen. Is that right?

So if someone can help with my understanding of the packaging, how it comes, that would be great.

Im excited and all ready to go.

Thanks Kath & Red
 
Great news that you vet will go with the Lantus as it's much better than Caninsulin which does not last the full 12hrs. I started on Caninsulin with my cat but got zero improvement until I switched to Lantus.

Because you will not need to give a large dose at all, go with pens or the cartridges as the vials are 10ml and may loose the punch before you barely start using it. The pens are only 3ml and you will be able to use the entire amount with proper handling of the pen.

Lantus is said to be guaranteed for 30days, but that's more for your keeping the pen/vial out of the frig all the time. If you keep it in the frig, you will be fine. When you are home testing, you will know if your container of insulin has lost its punch by your cat's BG numbers no longer looking good.

Yes, you want the U100 syringes with the 1/2 unit markings because you will be better able to measure small doses like .25 and even .1
 
Pen, cartridge, vial are the containers that hold the insulin. Pens and cartridges hold less insulin than a vial.

We recommend getting the pen or cartridge as there will be less potential waste of the insulin. Pens or cartridges typically come in a pack of 5 per box. As long as the pens are unopened they are good until the expiration date. Keep it in the fridge to ensure it stays good.

Once you open the pen, it may not stay viable until you use all the insulin in it. Therefore, while the initial cost of the pens may be higher than the cost of a vial, you will actually save money in the long term, as you will be opening smaller containers (pens) and you get 5 of them, vs. one vial.

Remember you will still need to purchase U100 insulin syringes. DO NOT purchases the needles that are sold for the pens. Get the regular old fashioned syringes and treat the pen the same as a vial.
 
pens vs vials
3 ml vs 10 ml

Insulin starts to age once you start poking it and taking out for shots.

Lantus is "guaranteed" effective for 28 days once you start using it. With careful handling, you can usually go longer but weeks longer - not months.

So --- let's say you are giving 1 u twice per day. In 28 days, you have used 56 units.

The pen cartridge contains 300 units and the vial contains 1000 units.

If you have good luck and get 3 months effective insulin life:

out of a pen -- you have used 168 units and throw away 132 units that went bad.
out of a vial - you have used 168 units and throw away 832 units that went bad.

So -- while a 5-pack of pens costs more to start out -- it lasts longer in the end with less waste.
 
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