Need advice

Discussion in 'Lantus / Levemir / Biosimilars' started by Jenniwood, Feb 27, 2018.

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  1. Jenniwood

    Jenniwood New Member

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    Jan 26, 2018
    Hello!! I'm somewhat new here an I am having a problem with my 10 year old male cat. I just started him on lantus insulin that the vet put him on for his diabetes. She claims this is the best one for him. He has been on the lantus now for a little over a month. The vet first started him on 1 unit twice and day. Plus put him on a new food. The diabetic food from Purina. Plus he also eat Fancy feast canned food. His numbers were still two high so two weeks ago the vet upped him on 2 units twice a day. Since he got raised to the 2 units a day he started scratching an licking his neck so much so that he has sores on his neck an scratch him self bold in one area of his neck. I believe his is having a reaction to the insulin but can't be sure that's what it is. However I know it's not the diabetic food because he started that a month before the lantus insulin. But since I raised him to the 2 units a day this had been happening with his neck. When he was on 1 unit twice a day everything seemed to be fine. So I'm wondering if anyone else has had this happen to there cat using the lantus insulin?? I don't know what I should do?? If I should lower his dose back to 1 unit twice a day or if I should stop giving it to him until his neck heals. I'm just so confused on why this is happening to him. I know he needs the insulin for his diabetes!! I have read so much stuff about diabetes online that my eyes hurt an I'm so over loaded I'm not sure what's what. I haven't came across anything that's says this about the lantus insulin doing this to a cat so I'm worried on what to do. I have been putting Neosporin on his sores trying to help him heal but not having any luck. Does anyone know what I can use to help his neck heals?? I'm new to this whole diabetes thing and I'm so overwhelmed with the whole thing. I just want to do what's right by him. So I'm worried on what to do. His numbers are still in the high 200s so I'm sure the vet is going to raise him again. Also I see red lines in his eyes from time to time but not all the time if that makes sense!! Is this something else I should be worried about with him. I know they say this is related with the diabetes. Will this go away once his numbers go down more?? Any advice anyone can give would be so helpful!! I'm so glad I found this site it helps to know I'm not alone and that I can get help when I need it!! I really hope to hear from someone soon about these two issue I have mentioned. I just wanted to do the right thing. I have read so much stuff online about diabetes that I'm more confused now then I was before. Thanks in advance!! Any advice would be great
     
  2. Juliet

    Juliet Guest

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    Sep 8, 2017
    Firstly, is the Purina a dry food? If so, try and take him off it. That alone could lower his numbers. Fancy Feast is good so long as Classics not gravy.

    Jumping from 1 unit to 2 is a lot. Generally we increase in 0.25 unit intervals.

    If it were my cat I’d drop back to 1 unit and cut out the dry. Are you home testing? This will save you $$ in vet bills and is far safer for your cat. You should test at least before every shot and if possible once again between shots on each cycle (12 hr period between shots).

    This will let you see how low the dose is taking him.
     
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  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Hello and welcome. Are you home testing your kitty's (name?) blood sugars? That's how we tell if he needs his dose increased. We typically increase by much smaller amounts, 0.25 to 0.5 units, depending on the numbers.

    Is the "diabetic" food dry food or wet food? Low carb wet food is best. Even the dry "diabetic" food is not very low carb. But don't change his food without home testing first, as it can make a huge change in the amount of insulin needed.

    Lantus does have an acid base, which seems to sting some cats, but more at larger doses. Levemir is an alternate insulin that does not sting. The Lantus reactions I've seen are more walking away from the shots, not sores developing. Have you tried using any other locations to give the shots?
     
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  4. Juliet

    Juliet Guest

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    Sep 8, 2017
    I think we cross posted.
     
  5. Jenniwood

    Jenniwood New Member

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    Jan 26, 2018
    Thank u for the advice!!! Yes the Purina diabetic food is dry food. The vet claims it's important for him to stay on this food. Why I'm not sure. In the beginning that's all my cat would eat. Nemo my cat is 10 an he has been eating dry food since he was a kitten. At that time 10 years ago I was told by the vet not to feed him wet food that it was like candy to them. However since we found out that he has diabetes I have read so many things online saying that canned cat food was the best thing to feed him. Since I have read that I have been trying to feed him the fancy feast canned food. He is just getting use to eating it so he won't eat alot at a time. I try to give him a little here an there. He will only eat the pate ones because he doesn't get that fact that he can bite the food. So all he does is lick it to death lol. I would love to take him off the diabetic food it's so expensive anyway. However it does have things in it for the urinary track. I'm worried if I take him off of the dry diabetic food that it might cause a problem with his urinary track. I'll try to switch him to the wet diabetes food an see what happens there. I will also lower his units as well an see if that helps with his neck. I do home test but I have to say he doesn't like it to much an he makes it difficult sometimes lol. I have to be honest though an say I do not test him daily like I guess I should. Do u have any ideas on what I can do to make this a little easier on both of us. He hates it an crys when I do it an then I feel bad for him. It's sorta my own fault because in the beginning it wasn't easy for me to do an I kept poking him. Now I have the hang of it but he still remembers what he had to go through an he let's me know it lol. As far as lowering his dose should I just lower to 1 an a half units an do it slow or just take him back to the 1 unit? Thanks again for the advice
     
  6. Jenniwood

    Jenniwood New Member

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    Jan 26, 2018
    Hello my cats name is Nemo!! Yes the diabetic food is dry food. Unfortunately that was all I fed him his whole life was dry food. Back when I got him when he was a kitten I was told by the vet not to feed him anything but dry food. Since then I guess things have changed. I'm slowly trying to get him to eat wet food but it's a new thing for him so he won't eat alot of it. I do feed him a little hear an there. I am home testing!! But not as much as I should I guess. When Nemo and I stated doing the home testing it took a little time to get it right an now it's not something he likes me doing do I have to say I don't do it as often as I should.Do u think that I should lower his dose again an bring him back up slowly?? I have been giving him his insulin in neck area as per the vet. I will definitely try to give it to him somewhere else to see if that works for him with the neck problem. If it continues I will definitely talk to the vet about changing his insulin. It's just so expensive an I live in a fixed income for my lower back I'm on disability. So it was hard enough coming up with the money for his insulin to begin with. Also I would love to take him off the diabetic food that's so expensive as well. The vet claims it's important for him to stay on this food but I have read that this isn't true. My only concern is that the diabetic food has something in it for his urinary tract. Is there something else I can give him for that??? Thanks again for all the advice. There will definitely be some changes.
     
  7. Christie & Ebony

    Christie & Ebony New Member

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    Dec 10, 2017
    So sorry to hear you're having such troubles. Here's a few tips that have worked for Ebony and me:

    My dad (who is also on Lantus) told me that the shot really stings when it's cold (straight from the fridge), so I draw the dose and let the syringe warm up, at least to room temp if not my hand temp, before I shoot. You don't want to wait a long time between drawing up the insulin and shooting, as the syringe has a lubricant that can mix with the Lantus and weaken it, but a few minutes in my hand or under the lamp to warm it a bit doesn't seem to hurt. Also, don't shake the Lantus, and don't leave the vial out after drawing up the syringe. The pharmacist gave me a sample of BD u100 6mm 31g syringes, and Ebony seems to prefer them over the previous 29g 12mm syringes. He's still not thrilled with the shots, but loving on him and warming up his back helps it not sting as much. Our vet, and all the info I've seen online, says to avoid the scruff of the neck and to vary the shooting spots on either side of his spine (not directly on the spine) from shoulder blades to hips. Also, make sure not to get it in his muscles. They say insulin going into the scruff or muscle is nowhere near as effective as going just under the skin (hence the shorter needles, for me). After rubbing on Ebony's back in the general area where I'm planning to shoot, I lift up the skin & fur to make sure I don't hit muscle. The 6mm needle doesn't go through the 2 layers of skin like the 12mm needle sometimes did, so it's easier for me to get his full dose in him. The only problem with these needles is they don't come in 1/2 unit markings, yet, so you might look for the dosing by micrometer sticky. As long as the Lantus is kept in the fridge, it can last around 3-6 months (per the AAHA website and all of this forum), so if you can vary the shooting site so he tolerates it better, the cost should even out a bit. Also, BD has a current rebate going for a box (100) of the 6mm syringes, so that could help you with the cost of the first box (http://www.bd.com/en-us/offerings/capabilities/diabetes-care/pen-needles, then click on the rebate offer on the right).

    As for testing, we had issues with that in the beginning, too. I was even wrapping him up in a towel to make a kitty burrito for a while. But we found that the whole process is a whole lot easier on both of us if I spend 5-10 minutes (or more) loving on him and getting his motor running while I warm up his ear. I have a spot on my computer desk with "his" blanket folded up (so he doesn't slip), under the desk lamp (which helps warm him), with all my supplies in a basket nearby. This gets him high enough that I can easily do the test, and I have everything nearby. We've only been dealing with this for 3 months, and Ebony comes up to me when he hears me sit down or close the vial with his test strips and asks to come up to his spot for loving. We spend time snuggling, and he now lets me know when he's ready to "get on with it" and get his ear tested by changing from curled up position to sphinx position. I no longer have to hold him in place (unless someone is moving around in the kitchen). He likes to know what I'm doing, so I let him sniff each step. He has a preference for me testing on his left ear, so even though he's got a bruise there, that's where we test. The spot on my desk has become his snuggly spot, and if I'm sitting at my computer, he'll often come to me and want up for snuggles and loves, even though twice a day his ear gets "stabbed" (sometimes multiple times) when he's up there.

    For the food, I definitely agree with the others about getting Nemo off the dry as it's much higher carb than your vet thinks. My vet insists on WET (canned) Purina DM (never dry), and since I can afford it right now, I'm humoring her. But PLENTY of others are using non-prescription, low carb wet food and doing just fine. When Ebony was first diagnosed, I found this forum and Dr. Lisa Pierson's nutritional guide for canned cat food, and promptly switched Ebony to Friskies Pate (I bought the 48 pack from Costco). I'm on my 2nd vet as the 1st one wouldn't listen to me at all (he preferred talking to my husband who doesn't deal with all this stuff but was there to get his own questions answered). The 2nd vet changed us from Vetsulin (which was quitting early) to Lantus (which is definitely acting longer), but insists on the expensive Purina (1.25 cans 2x/day). Like I said, I'm humoring her, since I can afford it right now. But the nutritional values are about the same as the Friskies we were using (she had to show me the nutritional guide for the Purina DM before I would even consider it). Ebony isn't terribly picky (thank God), so he eats it, but he refuses to eat the quantity the vet wants (he's underweight) at the schedule the vet wants. So, I offer it to him several times over several hours. The big thing is not to feed in the 2 hours prior to a test so the test isn't skewed by a food spike.

    The higher water content in wet food should help keep Nemo from having urinary tract problems. You can also mix in extra water, if needed. Ebony prefers when I add extra water to his wet food. If Nemo hasn't been actually diagnosed with urinary tract problems, I wouldn't worry about it. If he has, Dr. Lisa has info on that and all kinds of topics on her website, too: http://catinfo.org. It's worth browsing around if you haven't been there, yet.

    Numbers in the 200's are something I'd celebrate. My vet has a goal of Ebony staying under 300, right now. I'd be real hesitant about increasing the dose, especially if your vet wants a full unit increase (most recommendations are 1/4 to 1/2 unit increases). But others on this forum are much better at dosing questions. I've only been dealing with diabetes for 3 months, and Ebony is still unregulated. Sounds like you're doing a lot of research, which is great. Take a deep breath, make sure you're taking care of yourself, and spend lots of time loving on Nemo. I've gotten closer to Ebony through all of this. It takes time to learn what will work best for you and your cat, but you can do it.
     
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  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Buying that food from your vet helps fund his/her kids college fees. Other than that, there is no reason to be on any dry food at all, much less the veterinary food. Take a look at the ingredients. They aren't particularly good. You can always tell the vet your cat doesn't like it. Return it and get a refund. In Camada, I've heard vets get 4 hours of nutrition training at school, given by Hills. Any dry food is also bad for the urinary system. I don't know if you've seent the http://catinfo.org/ which is written by a vet specializing in feline nutrition. She has a page of food for urinary health. Low carb wet food is best, with water added. Low phosphorus can also help. Fancy Feast isn't the best option for phosphorus, but there are plenty of other pate foods out there. My second cat got cystitis one week after Neko got her diabetes diagnosis, so I had to investigate foods that both could eat.

    Are you feeding low carb treats when you poke him to test him? If you do that every time, even if you aren't successful in getting blood, pretty soon they'll associate good things with pokes and learn to look forward to it.
     
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  9. Jenniwood

    Jenniwood New Member

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    Jan 26, 2018
    Thank u for all the wonderful advice. I'm so glad to hear it's not just me with having trouble with the testing. I will definitely try to make it more pleasurable for him. I also have a
    Thank u so much for all the wonderful advice. It's nice to hear I'm not alone with having some difficulty with the home testing.I will definitely try to make it more pleasurable for him. I myself have a big desk in my bedroom an he does like to sit on my lap when I'm at my computer desk. I will definitely try that out!! Sounds like that might work for Nemo too. About the doses I myself though that going up a whole unit was alot too. I like the idea of going up slowly myself !! I hate the fact that I even have to give him the insulin to begin with. I also like the idea of adding some water to his wet food. Nemo will only eat the pate an alot of it seems to be dry. He wouldn't eat the Chuck's even if I tried. He's still figuring it out because he was never fed wet food so he just licks it to death lol. So we are slowly working on getting him to eat canned food. He doesn't eat alot of it so I try to give it to him several times a day but he does seem to be eating more at a time now. Nemo doesn't have any urinary issues so that's one problem I haven't had to deal with thank goodness. I will definitely try that out. I'm going to pet smart today to get him more food so I'll pick up the diabetic canned food an give it a try. Thanks again for all the good advice !!! Have a great day!!
     
  10. Jenniwood

    Jenniwood New Member

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    Jan 26, 2018
    I just read that u wrote about the doseing too that's a great idea I never thought to warm it up a little I'll try that as well. As far as giving it to him in the Scuff I only was given it to him there because that's were the vet said to give it to him. Giving it to him else where sounds like a good idea maybe that's why I'm having this problem with Nemo's neck. I would of never thought that the lantus insulin stings him. Poor Kitty!!! I will definitely try out all your advice they all sound great. I'll keep u posted an let u know if it works for Nemo. Thanks again!!! Have a great day!!
     
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  11. Juliet

    Juliet Guest

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    Sep 8, 2017
    The diabetic food is expensive. Most here feed fancy feast or friskies pate. No dry is good at all. You’ll likely find once you take him off dry then his numbers will come down dramatically. My Silver was insulin free within a month of taking him off dry. It’s high carb=high sugar.
     
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  12. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I would not be surprised if your cat was reacting to the dry diabetic food. Most vets get almost no training in nutrition for any species, let alone specifically for cats. They are painfully ill informed and the most information they get is from people who are selling them prescription food or who are trained by the pet food industry. Cats are obligate carnivores. In other words, they need a diet that is high is protein and good quality protein. Diets that have organ meats or by-products as their major ingredients are not species appropriate. Even less appropriate are the veggies and fruits and grains that are in many cat foods. So, the Fancy Feast pates are a really good choice. The dry, diabetic food -- no so much. In addition, if you're worried about your cat's urinary health, dry food is the worst thing you can give a cat. Cat's have a very limited thirst drive. They typically get their water from live prey (at least in the wild). Adding water to your cat's canned food will help to increase his hydration and it's good for kidney health. Personally, I would tell the vet your cat is having an allergic reaction to the dry food and bring it back or donate it somewhere.

    If this is an allergy, adding omega-3 to your cat's diet may help. There are also allergy products you can get. I'm not at my home computer and don't have the information handy. I'll try to post it when I get home.
     
  13. Jenniwood

    Jenniwood New Member

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    Jan 26, 2018
    Thank you for the advice!! That would be great if u could let me know what I can buy for him. I will definitely look for the Omega-3. Is that something I would by a a pet store?? I look forward to hearing from u with any information u can give. Thanks again.
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Check this food chart for low carb wet food options. It also lists phosphorus if you want to minimize that.

    Omega 3 for pets is usually fish oil. You should be able to buy it in pet food stores, and I've also seen it in vitamin/health stores.
     
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