Asthma & Diabetes-- HELP!

Hi again,

I have posted a few times regarding my cat Lux, but respond sporadically due to my inability to remember to check my inbox and my bad memory

Lux has been diabetic for almost a year now. He is still on the Lantus insulin and we give him 4 units twice a day. He eats the Purina DM Dry food and the EVO wet food brand (low carb/high protein). His glucose is still consistently high, and we suspected he was insulin resistant. Gernerally his numbers are in the high 300's-low 400's, but every so often he will dip low into the 100 range. This is also sporadic and infrequent.

I recently took him to a specialist where he had some chest x-rays done. Lux has had a cough for a long time, and we always assumed it to be allergies. After the x-rays he has now been diagnosed as asthmatic when a heartworm exam came back negative (luckily). Of course the typical treatment is oral steroids, which we cannot do since this will interact negatively with the diabetes. The specialist told me my only real option was to now begin treatment with a kitty inhaler or sorts. The problem with this is the cost. Meds run around $300 for a 1 month supply.

I am already in debt for his diabetes treatment and having to bring him back and forth to the vet and the recent trip to the specialist. This seems like an unrealistic option for me. I of course would never refuse treatment for him and I can't give him up... he's my child.

At this point my only option is to break the lease on my house and move home. I am 24 years old, so while I am young this is not ideal. I am doing everything I can for my little boy and I will do this if I need to. But the bottom line is, I can't afford to pay my rent and bills with his vet and medicine costs.

Does anyone have experience with this? Are there any other options besides the inhaler? I am so overwhelmed and have been stretched so thin this last year. I just don't know what to do anymore.

Any help is greatly appreciated! My rent is due on the first... I am thinking if I need to break my lease it has to be done this week.

 

Inhalers are best. The up front cost of the inhaler device is expensive. The inhaler itself. Once you have a prescription and know the dose, you can order online inexpensively. I am at work so I will have to look when I get home but I believe we're paying around 35-40. Per inhaler for flovent. They learn pretty fast it helps them breath. We taught a semi feral rescue to use one.

 

You can join the feline asthma group on yahoo... Again sorry I can't link it. They can give you the pharmacy like k and may be able to tell you where the least expensive inhaler device can be purchased. The aerokat is recommended but I know the one we used was not that brand and we purchased from a vet and it worked fine.

 

OK its not so bad - you can give oral steroids to a diabetic cat! It just may mean you need to give him a higher dose of insulin to compensate the impact of the steroids.

However we can bring his blood sugar down to help counteract an increase if you stop feeding that Purina DM dry. Its too high in carb and is probably why he is already on 4 units. Most cats on low carb canned are on 1-2 units. Transition him to the wet EVO only.. or if he has to get the dry we can recommend a lower carb one.

Also I advise home testing if you arent already doing it. Lets get a better picture of whats going on there. It will allow you to get a better view of his blood sugar without having frequent vet trips which will save you money!

Sound like a plan? We can help on home testing.

Wendy

 

Thank you so much! I know the initial cost of the inhaler for AeroKat is around $60-70 but the specialist recommended 220 MCG of the flovent and I can't locate that for less than around $275 for an inhaler which I was told would only last about a month

 

Hi Wendy!

I have been doing home testing since March of this year. His numbers have been consistently in the 300-400 range and haven't improved much with 4 units versus 1 unit. Do you have any ideas for a lower carb dry food? The DM is so expensive, but I need to keep dry food out for nibbling because we have another cat in the house. My vet also recommended leaving dry food around in case his glucose dips too low so that he has a resource to fall back on if I am not around and he needs to eat to bring it back up.

I test his glucose twice a day (before feeding/giving insulin) and have been doing curves every other weekend for the most part. His numbers are definitely lower than they are with no insulin, but not where they need to be. A typical curve looks like this (these numbers are from Saturday):

8am (pre feeding/insulin): 404 * 3 1/2 units of Lantus given
1130am: 353
130pm: 395
4pm: 264
630pm: 373
8pm (pre feeding/insulin): 320 *only gave 1 1/2 units of Lantus because I was going out and got nervous
9pm: 344

I usually adjust his insulin depending on his glucose-- normally 3 or 4 units. The specialist recommended we increase to 5 units since he is a big boy (almost 13lbs) and that it should be fine but it does make me nervous to go any higher than 4 units twice daily.

I have only heard/read negatives about giving oral steroids with a diabetic cat and was told that they would likely not feel so great in addition to it conflicting with their diabetes because of how it makes the heartbeat quite quickly and can cause them to feel overworked.

Thank you for the reply and help!

 

It would be much better to get both cats on wet - you dont want a second diabetic cat on your hands!! However Low carb dry: Innova Evo Cat & Kitten 8%, Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.

With home testing you dont need to worry so much about him going low as you will know his general trends.

Do you have a spreadsheet? That would be very useful to see and help us see if there us anything else going on... Heres how http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 Also do you get any nighttime tests in or before bed? Many cats go low at night.

I need to try and rememeber who on here gives oral steroids as well as having a diabetic cat - let me see if I can find them

Wendy

 

Or maybe they were on injectable steroids..

 

Hope is on the flovent and gets one puff a day and the original cost is expensive....get mine at Costco....and if I'm not off on my reading it, the canister gives 120 metered doses and at 1 puff a day that is 4 months. Much better that oral steroids plus Hope has RCM so cannot be on steroids.

 

you don't need oral steroids for asthma - rather you use inhaled steroids for asthma - you can buy it from this site online and no prescription is needed - because the place is located in vanuatu - if you use your credit card you may be charged and exchange rate fee.

However, the overall cost per inhaler is reasonable. and they sell flixotide which is the generic form of flovent

it is called 4 corners pharmacy and here is the link for the inhaler - plus free shipping http://www.4cornerspharmacy.com/p-399-f ... asone.aspx

you want the 250 mcg size this equals 220 flovent.

and the tool you need is the aerokat - http://www.vetrxdirect.com/product/view ... ma-chamber

and if you enter coupon code - homepage - they will take $10 off the total cost, plus free shipping

 

Hello! Wendy asked me to stop by. Our kitty has had asthma for 8 years and has been diabetic for 3. He originally was given injectable steroids which led to the diabetes. Tarragon has severe asthma. We use the aerokat inhaler with Flovent 220 2 puffs twice a day. That doesn't keep it completely away so we also give 5 mg of prednisolone every day. The inhaler is definitely the best route as long as it works well.

A couple of things: the Flovent inhalers are $45 each if you order them from 4cornerspharmacy.com. It takes about a month to get them since it is in Canada. If you need one or two to get you through until you get them in just send me a pm and I can send them to you to get you through. Did they talk to you about using albuterol when your kitty is coughing? You give a puff of albuterol, which is a resume inhaler. That opens up their airway and let's the Flovent get in. The inhaler worked well for us for awhile but Tarragon's asthma has gotten worse so we now also give the prednisolone. While it's not ideal with a diabetic cat, it can be done. We just had to adjust his insulin dose to compensate. Injectable steroids are a definite no because you can't control the dose once it is in.

Don't hesitate to let me know if you have any questions or need anything. Asthma is scary, almost scarier than the diabetes. However it is manageable and doesn't have to be as expensive as it first seems.

Melissa

 

Thanks Melissa.. Is the prednisone oral?

 

It is.

 

http://pets.groups.yahoo.com/group/felineasthma/ this is the asthma group.

My rescue, Foreclosure Pets (we are on fb..ok selfish plug ) we would buy flovent from for corner pharmacy: I think we used Ventrolin http://www.4cornerspharmacy.com/c-7-asthma-allergy.aspx. Flovent is known as Floxitide http://www.4cornerspharmacy.com/p-399-f ... asone.aspx

they came highly recommended from the yahoo group and Darcy was freaked out when I suggested she order from there. When she finally did and realized they were a-ok...we ordered all our stuff for the asthma kitty from there with not a single problem. I will ask her the name of the mask she used. It was NOT an aerokat...it was much less expensive and was ordered through our vet.

 

Melissa - I see you wrote this. 4 corners is not in Canada, they are in Vanuatu which is in the South Pacific. When I ordered from them, I received my order in about 10 days. Maybe there was a mix up when you ordered for it to take so long.

Also, if you purchase the generic brand of Flovent - Flixotide and purchase more than 1 inhaler at a time, the price drops --


Product Price List REMEMBER SHIPPING IS FREE!
1 Flixotide Accuhaler 250mcg (60 Doses)
$0.77 per Dose | $46.00 (USD)
3 Flixotide Accuhalers 250mcg (180 Doses)
$0.57 per Dose | $102.00 (USD)
5 Flixotide Accuhalers 250mcg (300 Doses)
$0.67 per Dose | $202.00 (USD)

Yes, it's still pricy considering, but without insurance, it's cheaper than buying at a US pharmacy.

 

Thanks Hillary. You are right about the location. I was thinking insulin. I order every 6 months for the last 5 years or so and it has always taken around 3 - 4 weeks for me to get my fluxotide. I know others in the yahoo asthma group have also had the same time frame. It might have something to do with where I am in the US but that is an issue for some.

Hillary wrote:

I do want to say that sometimes oral steroids are the only thing that will work. I would definitely only do them in conjunction with an inhaler. Some vets will also prescribe a short term of oral steroids just to get the inflammation down and let the flovent work. You might want to ask about the abuterol. That is the one thing that the kitty needs to open up the airway so that the Flovent can get in. If you join the yahoo asthma group they will stress that as well.

 

Thank you so much for the food recommendations! I will definitely look into those options as they are much cheaper and if they are lower carb than the DM I definitely agree that he should get off of it.

I do know his general trends but the handful of times they have dipped too low randomly keeps me worried I am so concerned that something will happen one day when I am not around and the idea of having the dry food around as a back up puts me at ease-- but you guys have much more experience with this and I am now reconsidering. Unfortunately our second cat has a tendency to throw up from wet food so I'm not sure if we can switch him over completely.

I keep a log but I have not put it into a spreadsheet or anything like that! Thank you for the link! I will work on doing that this week and see if anyone has any thoughts.

Thank you SO much!!

 

I cannot thank you enough for this information! The thought of $300 a month was INSANE to me I have been losing my mind the last 2 days trying to figure out a way to make this work.

So, to be clear (because I am confused!!), the Flixotide from 4corners is the same inhalant (essentially) as the flo-vent? It's just being shipped from another country? Any idea as to why this brand (I assume generic) isn't available in the US?

And this will work with the AeroKat mask ok?

THANK YOU!!

 

Thank you so much! The specialist did mention Abuterol and that it was a rescue inhaler more to be used during an actual asthma attack rather than daily like the flovent. All this time I thought Lux had a bad cough... turns out he was having asthma attacks They happen around once a week. I feel so bad! Poor little guy.

Thank you so, so, so much. I cannot stress it enough.

 

Remember to set up the spreadsheet and let us know if you need help with it. With a food change you might see a drop in BG and we can help advise when and how much to lower insulin if need be.

Wendy

 

The flixotide is the same as Flovent. I'm not sure why it isn't available in the US. My inhaler is actually called Vortex made by Pari. I got it from my vet for about $50. It is the same as an aerokat. The inhaler works fine with it. For the albuterol, my son has asthma and we have stockpiled albuterol inhalers through insurance. Shhhh. Don't tell. Lol. Our vet said that was fine to use and it works well. You just give one puff of albuterol and then wait for about 5 minutes. It dialates the airway. Otherwise the Flovent has a hard time getting in. We order the 250 flixotide, which is the same as 220 Flovent. Tarragon gets two puffs of that twice a day. Vets many times under prescribe the dose on the inhaler. I'm not sure why, but everyone on the yahoo feline asthma group has had the same issue. You never want to go more than 220 x2 puffs twice a day though.

Tarragon's X-rays last year showed that his asthma spirals had gotten much worse and the inhaler alone wasn't cutting it even at the max dose. That's why we also do the oral steroid.

 

Boy, can I relate!!! It's the same with me. Diabetes and asthma plus pancreatitis. My poor darling Izzy. And, like you, I will do anything to keep him with me for as long as I can. I use the Flovent inhaler for Izzy and I'm pretty sure it costs in the neighborhood of $150 to $165--that's for about a three-month supply. As for insulin, I've not had to buy my first replacement yet--got the first one from vet and it was added into my bill so don't remember what it cost. But, I'm thinking it's about $150 for a three-month supply. Now--I know that Canada sells the Flovent for $30 but I don't know how that works. You also can get insulin from Canada. I've been told that it is not legal for them to ship to the US, that one has to go there with a prescription and pick the product up in person. I honestly don't know the correct answer to this. Someone else told me that they could send to the US. IF YOU CAN get it from Canada, then that's the way to go, of course--a huge savings.
For his food I give him Fancy Feast Classic, which is highly recommended, plus Royal Canin Diabetic formula for his dry food. So far things are okay. His glucose had dropped some at his last blood check and I take him back in around 10 September. I'm hoping his BC will be even further lower.
I really understand the financial predicament you are in. I'm in the same state. I live on a very small VA disability pension. Fortunately, my house and car are paid for so I don't have to worry about rent, but believe me, with the vet bills, etc., it is a terrible financial burden. I'm having to put most of his care on one of my credit cards and hope I can pay it off one day. Hate paying that high interest fee. What else can I say but "Hang in there best you can, Kiddo."

 

One thought. My boy was diagnosed as an asthmatic (mild) back in 2011. We assumed it was a hairball, as he was doing the hunching cough.

The x-rays showed the "doughnuts" on his lungs but because the coughs were maybe once a week and fairly mild, our vet was reluctant to prescribe any meds for him and told us to monitor him.

He started having more attacks in March 2013 so we took him in. She prescribed Albuterol (as needed) and Fluticasone (2x a day). After a week, the attacks continued and were worsening.

We took him back in and asked if it was possible he had a seconday chest infection. Vet said it was possible and gave us Orbax. Within three days of being on it, the coughing waned and after finishing the Orbax, he was no longer coughing.

 

Finally got a response on the inhaler device we used. It was not the aeorkat...that one was around $100. We used the feline breath easy. here is a link.

http://www.shopmedvet.com/product/felin ... urnishings

 

My civvie was recently diagnosed with asthma. The yahoo group is great. The 4corners pharmacy has good prices. But the yahoo group can walk you through everything. I'm just now switching from the oral steroid to the inhaler. So I'm no expert yet. Hope all goes well for you!

Debbie

 

Hilary and Maui are right about 4corners pharmacy. My civie was just diagnosed with asthma. I bought his first inhaler at my work pharmacy but I just ordered another one from 4corners. They say it takes 10 to 20 days to get to the US. It took mine 10 days. Their customer service is great. The albuterol I have on hand as a rescue inhaler. Charlie is doing well on the flovent inhaler. You should join the yahoo feline asthma support group. There is also a yahoo feline support group for inhaled meds.
Sandy