Fluffy's remission is over :(

Hey guys Happy and sad to be here. My Fluffy has been diagnosed with diabetes again. His health is in great condition, but he has some mild gingivitis. I've been trying to brush his teeth on the weekends when I visit him since I am a student. My mom will be administering the insulin during the weekdays... I am thankful but worried...

https://docs.google.com/spreadsheets/d/1Mcd_sYQ7gsJJzkSIi0BTiJkzbsO5CXxiB4ciAYCMn_8/edit?usp=sharing

^ Here is my spreadsheet. I think I'll have to use Novolin until I order from Marks Pharmacy from Canada and await for its shipment. It's been a while since I've been here so I need a refresher

Should I choose Lantus or Levemir? And what size needles should I get? (I know there's a link floating on here with a great guide on how to tightly regulate.)

He is eating Fancy Feast Classics, 2 cans in the morning, 1 can in the afternoon. I already have the Relion Micrometer, with strips and lancets. She's gonna go get a new vial of Novolin until the Lantus / Levemir is ordered and arrived.

Thank you so much you guys. You've been so helpful the last time Fluffy was diagnosed. I'm already stressed out with school and hearing this now changes my plans for the future and his accommodations. I'll do everything I can to keep him happy and healthy, he's my first priority. I'd take him to my apartment with me, but they don't allow cats... Hopefully I'll move out to a cat friendly apartment next year when my lease ends.

p.s. I had an old account named Natalie & Fluffy, but I could not get into it bc of the email address.

EDIT: I've been reading that Marks Pharmacy for ordering Lantus is on a waitlist?? Should I consider getting Prozinc? (If I get Prozinc, I have to use U-40 syringes correct?) Where should I purchase Prozinc?

 

I would call your vet about where to getProzinc. The gingivitis is probably the cause of the diabetes coming back. Any infection can do that. I hope Fluffy gets better soon.

 

I don't think getting Lantus or Levemir is a problem any more, but I'll tag @Chris & China .
Chris will know for sure.

 

Squeaker relapsed at 9 months but the good news is, he went back into remission 5 weeks later. I know it is disappointing to experience a relapse but sometimes remission a second time is possible with quick action.

 

I don't know anything about a waitlist from Mark's but if this had anything to do with the potential postal strike, that issue has been settled and no longer threatens our US friends' ability to order from Marks.

 

Due to a high demand, Mark's ran out of Lantus, but that was some time ago. I'm pretty sure the issue has long since resolved itself, but Chris will know for sure. This was separate from the potential postal strike in Canada which has also been resolved.

 

Thank you all so much for the replies! I called my vet and they said they can order Prozinc and to ask if they can also order Lantus or Levemir, but I don't know how long it will take and they're supposed to get back to me soon. Fluffy's BG is high... but I know he can handle it.

I'm glad that whatever Canada was going through has been resolved too! I guess I'll wait for the vet to call back and see what options they have. If Prozinc lasts 6 months, and is about $100 as opposed to Lantus being like 300 or 400, I might have to go with Prozinc, but money fortunately is not an issue.

 

Check out this link: http://www.felinediabetes.com/FDMB/...canadian-pharmacies.49608/page-2#post-1344374.

As of 6/16:
Lantus Solostar pen (box of 5) $149.99 (.0999 cents per unit)
Lantus vial $99.99 (.0999 cents per unit)
Individual pens $49.99 (plus expedited shipping $19.95)

Levemir Flextouch $169.99
Levemir penfill $164.99

Shipping is $25 for vials/5 packs of pens



Edited to add: Also check out the Supply Closet for those selling Lantus or Levemir pens.

 

Thank you all ! I called my vet again and they're going to try and fill out a prescription for Lantus and call me back. I'm really impatient... Fluffy's BG is probably in the 200-300s and I have nothing to give him tonight... should I go ahead and buy some Novolin? I won't be able to go home until tomorrow after noon because of midterms. And I don't want my mom who is unexperienced to administer him tonight or tomorrow morning because she doesn't know how to, and plus I haven't done a curve yet. I'm hoping to even just find somewhere where they sell ProZinc nearby where I live because Novolin was way too harsh on my cat when he was first diagnosed :/

Edit: I'm going to be home tomorrow Thursday afternoon, and then I have to be back at college Tuesday night because I have classes until Friday afternoon. Friday afternoon I'll go back home and I'll be able to stay there until Monday night to watch Fluffy closely.

 

There's no problem with Marks right now but it will take about 4-7 days to get delivery

They are a human pharmacy and only carry the Lantus/Levemir. ProZinc is a veterinary only insulin.

One thing to remember though when you're comparing prices.....ProZinc is a U40 insulin, so a 10ml vial only holds 400 units....Lantus and Levemir are U100 insulins, so a 10ml vial hold 1000 units (or 15o0 units if you get the pens which I highly recommend)

If you buy Lantus or Levemir from Canada, it's actually quite a bit cheaper than using ProZinc, but even if you pay US prices, it's still pretty much equal in price since you're getting 2 1/2 times as much insulin from the "L" insulins compare to ProZinc

 

Thank you so much!!

I gave Fluffy o.5 U of Novolin tonight along with 1 can of cat food His BG was 286. I'll be checking it very early in the morning how it is. My vet is going to call me in the morning and write the prescription for Lantus.

Thank you everyone, especially @Chris & China

 

@donnalea He's had a mild gingivitis for years The vet said there's nothing they can really do to clean his teeth since he's so old it would be very risky to put him under anesthesia, and that they can't really do much about it. Should I just keep brushing his teeth? I'm scared the special cat toothpaste I'm using might have an effect on his levels.

 

Okay!! So the vet called me and they said they will approve the prescription for Lantus, which means when I pick it up tonight, I'm going to send it to Marks Pharmacy and order it.

However, they told me to NOT give him the Lantus, because they need to do a blood glucose curve at the vet before they figure out the dose. Eh... I'm reluctant to do it but they sounded like they were pressuring me I pretty much know what I'm doing haha. I don't know what how his numbers will react because he's never had Lantus, so any tips on how to start off dosing? Or should I let the vet figure out where to start?

Obviously I'm going to be monitoring him VERY closely...

I hate that he's on Novolin but it'll have to do for at least until the Lantus arrives

 

Vet stress can artificially raise BG by 100 or more points (USA) and thus many times curves done at the vet are not representative of BG at home and can result in too high of a dose. Thus, just tell the vet you will do a curve at home and inform the vet of the results. I would start Lantus with a dose of 1/2 unit twice daily

 

<3 I got the prescription and tomorrow morning I'm ordering the Lantus, in the meantime, I'll be reading this extensively: http://www.tillydiabetes.net/en_6_protocol2.htm

Questions:

Any suggestions to what ketone strips I should use? And where to get them and how to use them? :O Gotta be prepared...

 

Keto-diastix are often recommended here. I think Walmart also do Relion ketone test strips (not in the US so can't be sure). I use Bayer Multistix 10SG strips (wider range of tests).

Here's a useful forum sticky on ketone testing:

Are you testing your cat for ketones? If not, DO IT!


Mogs
.

 

@Critter Mom I remember you helped Fluffy and I so much the last time we were here~! Thank you!

 

Nat, You mentioned monitoring closely, but also that your mom would be giving the insulin during the week. Is she going to be home testing Fluffy also?

 

Hi @Shiloh & Rhonda! I'm am teaching her all I know, but she is really new to all of this since I was living at home when Fluffy was first diagnosed more than a year ago before his remission. She was unable to successfully get a blood test until I got home at +5 today, and I also think the insulin was not properly injected this morning when she did it so his numbers may have been high this early afternoon but I don't know for sure if that's why.

If that seems wise, I am going to get him started on an 8 hr regimen until I get the Lantus. (Here's to no sleep!) D:

Also Rhonda, I am staying at home and will be watching him completely this Friday evening, Saturday, Sunday, and until Tuesday very early morning. I have classes Tuesday through Friday (My dad provides rides to me very early morning and around in the afternoon.) Wednesdays however will be tough, since I have classes from 8 am until 8 pm... and in that case, I have to stay at my apartment away from my cat. I'm trying to help her out by preplanning the doses. Very early morning before I leave, I roll up Novolin, extract the dose, get rid of the bubbles... and leave the syringe in the fridge for her to use. I may have to leave prefilled syringes in the fridge, until my mom feels more confident with drawing the correct amount. (I'm hoping that this doesn't affect the effectiveness of the insulin if it's kept in the syringe in the fridge?)

I'm hoping this will all be easier when I get the Lantus so she can just give him 2 doses a day instead of us having to coordinate dosage between 3 times a day :/

(Please let me know if I need to clarify anything, Fluffy's schedule can get confusing haha. I might need to figure out how to rearrange the chart now that I'll be dosing him 3 times a day until the Lantus arrives.)

 

Nat, thanks for the info. I can't advise on the Novolin, having never used it. But it sure seems like you are really on top of this. I was just concerned about starting a long acting insulin like Lantus without the home testing.

ETA: Since you have been through this before, I am sure you know that you can test and shoot half awake!

 

@Shiloh & Rhonda thank you *o* I can't tell you how much time and preparation and research I've done for Fluffy's diabetes when he was first diagnosed D; But I'm still so nervous and now my life is dictated by numbers, I've been so worried for him and I just don't want him to feel uncomfortable in any way haha. These first few weeks are gonna be rough because I have no idea what's he's gonna be like with regular 8 hr intervals for Novolin along with life and schedules, and then when I make the switch to Lantus I will definitely need guidance there!

I guess with what I've been reading so far on Lantus, it looks like it takes time for our kitties to adjust for the dose. I like to get results quickly to make sure I'm doing it right, so this is really going to test my anxiety! :O

 

!!! Oh my goodness, so my mom forgot to tell me that Fluffy was given antibiotics for a possible suspected infection? I have to papers here too from the blood test and it says: "PLT Aggregates Detected" "Band neutrophils suspected" "nRBCs suspected". His PLT readings were a little bit low, but otherwise than that, and the high BG, there is nothing else wrong. She said the vet wanted to make sure this possible infection was gone so he gave Fluffy antibiotics at the same time he took the blood test on Oct 5th, so...

??? I know that infection can actually cause BG to rise? Or the BG rising caused him to be more susceptible to infections? And his kidneys may be starting to get a little weak because he's had diabetes before and he is 16 nearing 17 in March who knows...

EDIT: I made a new post: http://www.felinediabetes.com/FDMB/threads/to-shoot-or-not-to-shoot-infection-affecting-bg.166240/

<3 sorry to blow up everyone's notifications, but you've been so helpful :O!!