From Hypo To Serial Poker, Figuring Bear Out

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EllieRuthanne

EllieRuthanne

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Hello. My name is Ellie and I have a 7 year old diabetic male cat named Bear. He's one of the loves of my life and was diagnosed with diabetes about 9 months to a year ago.

When he was firat diagnosed the vet said he was being resistant to the insulin, so it was gradually increased to where we are today. He is currently on Novalin N and takes 8 units twice a day at 10 am and 10 pm. We started him off on the diabetic dry food from the vet but have recently (about a month ago) switched him to soft food (Fancy Feast Classic). He has been eating half a can twice a day and doing fine. All has been okay until about an hour ago.

My stepdad came in to wake my husband and me up around 3:30 am. Bear was sleeping on the pillow beside him and seemed to be scratching at him. He said he was drooling and jerking. I rushed in and found him stretched out and biting the blanket. He wouldn't let go, but I gently pulled it from him. He wasn't stiff so I cradled him and brought him back to our room. His eyes were wide and he was looking back and forth with full head turns (not shaking his eyes). He let out a couple startled cries but calmed down as I pet him. When I laid him on our bed he stumbled forward and couldn't seem to get his feet to work. I continued petting him and gently laid him down. My first thought was a seizure or drop in his blood sugar.

While my husband looked online, I got him 1/4 cup of basic hard food (I'm not sure of the brand because it's the stuff my mom gets for her two cats to go with their wet food. I think it may be Meow Mix.). He nearly inhaled it. I placed some water in front of him and he dipped his head quickly, but was startled by water instead of food. His pupils retract slightly in the light and his ears are very waxy (which I noted yesterday).

Once he calmed down I pulled him to my chest and he has been laying against me ever since. We don't have a monitor for him (we can't afford it and have used all our medical resources trying to regulate him), but my husband has his monitor. If we check his blood sugat, what levels am I looking for on a human monitor. What could be the cause of all this? He's my heart and soul, my little love. Please help us.

**UPDATE** 6:00 am
We tested him on the ear with with my husband's One Touch Ultra 2 and it read 53. He was still lethargic and not very responsive to calls (which he normally is). We tried feeding him his normal half a can of Fancy Feast, but he was not interested. Instead, my husband brought him a bowl of the hard cat food he had earlier. He devoured it instantly. We'll try testing again in 30 mintes. Our vet opens at 7:30 am.
 
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EllieAviles said:
Hello. My name is Ellie and I have a 7 year old diabetic male cat named Bear. He's one of the loves of my life and was diagnosed with diabetes about 9 months to a year ago.

When he was firat diagnosed the vet said he was being resistant to the insulin, so it was grafually increased to where we are today. He is currently on Novalin N and takes 8 units twice a day at 10 am and 10 pm. We started him off on the diabetic dry food from the vet but have recently (about a month ago) switched him to soft food (Fancy Feast Classic). He has been eating half a can twice a day and doing fine. All has been okay until about an hour ago.

My stepdad came in to wake my husband and me up around 3:30 am. Bear was sleeping on the pillow beside him and seemed to be scratching at him. He said he was drooling and jerking. I rushed in and found him stretched out and biting the blanket. He wouldn't let go, but I gently pulled it from him. He wasn't stiff so I cradled him and brought him back to our room. His eyes were wide and he was looking back and forth with full head turns (not shaking his eyes). He let out a couple startled cries but calmed down as I pet him. When I laid him on our bed he stumbled forward and couldn't seem to get his feet to work. I continued petting him and gently laid him down. My first thought was a seizure or drop in his blood sugar.

While my husband looked online, I got him 1/4 cup of basic hard food (I'm not sure of the brand because it's the stuff my mom gets for her two cats to go with their wet food. I think it may be fancy feast.). He nearly inhaled it. I placed some water in front of him and he dipped his head quickly, but was startled by water instead of food. His pupils retract slightly in the light and his ears are very waxy (which I noted yesterday).

Once he calmed down I pulled him to my chest and he has been laying against me ever since. We don't have a monitor for him (we can't afford it and have used all our medical resources trying to regulate him), but my husband has his monitor. If we check his blood sugat, what levels am I looking for on a human monitor. What could be the cause of all this? He's my heart and soul, my little love. Please help us.
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You want him above 65... please test him right away! It's great that you got him to eat the hard food. Do you have any high carb wet food you can give him? Please read the below... which I copied and pasted from the Stickly from the Health Links forum ( http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/ )...


This document was written for those using a meter calibrated for humans when measuring their kitty's blood glucose. However, users of the AlphaTrak brand blood glucose meter using AlphaTrak brand test strips in their meter please note:

2008 Abbott AlphaTrak User Manual Page 4
  • Hypoglycemia/Hypoglycaemia (low blood sugar) levels are: Below 65 mg/dL (3.6 mmol/L) for adult cats and dogs.

****************************************


GENERAL RULE OF THUMB FOR TREATING HYPOGLYCEMIA

This document may be printed or email Melissa at jur@eee.org for the newest file to keep on your computer.

Your best defense against hypoglycemia is home blood glucose testing. If you’re not already doing so and your cat allows it, I HIGHLY recommend you test before each shot.

Hypoglycemia or low blood sugar is a dangerous condition that must be treated immediately. Also known as insulin shock or insulin reaction, hypoglycemia occurs when there is too much insulin in the body potentially leading to neurological damage and/or death.

Knowing how to respond to a hypoglycemic event whether or not symptoms are present can save the life of your diabetic cat. The following general guidelines are intended for those who home test the blood glucose levels in their cats. These guidelines are not intended to replace the advice given by your Veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness


TREATMENT

During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.

LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry food. the high carbs will help to increase his/her bgs quickly, but remember the effects of dry food usually takes longer to clear kitty's system once the crisis has passed. Feeding a high carb canned food is preferable to feeding a high carb dry food because the effects will clear kitty's system faster. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizing is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer.

After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.

Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next.

BE PREPARED! KNOW THE SYMPTOMS AND KNOW THE TREATMENT!


Copyright © 1998-2010
 
Get some syrup high in sugar such as pancake syrup or mix warm water with sugar to make a syrup, dip your finger into the syrup then rub on the cats gums. The cat probably needs sugar fast. If your test on the human meter is less than 50 and given the symptoms he probably should get to a vet.
 
That sounds like a pretty high dose of insulin, and a small amount of food and calories. I think Fancy Feast is about 90 calories per can and most cats need somewhere around 200 calories a day.
I feed my cats 1 can each in the morning and 1 can each in the evening and thought that was low. He might have had a hypo. I would decrease the insulin and increase the food. I hope he is okay.
 
Thank you all so much. I have updated the post because I didn't notice the replies.

We tested him on the ear with with my husband's One Touch Ultra 2 and it read 53. He was still lethargic and not very responsive to calls (which he normally is). We tried feeding him his normal half a can of Fancy Feast, but he was not interested. Instead, my husband brought him a bowl of the hard cat food he had earlier. He devoured it instantly. We'll try testing again in 30 mintes.

Our vet opens at 7:30 am.SSadly, we don't have the money for a vet visit. I lost my job recently due to cut backs and my husband's work has cut down on his hours.

He's back to laying on my chest and sleeping. When should we test, what numbers am I looking for?
 
Keep giving him something high in sugar, such as wet food mixed with pancake syrup or honey, fancy feast gravy lovers works good as the gravy is high sugar,
Keep testing every 30 minutes , you want to see his numbers higher than 50.
 
You want to keep monitoring until he stays above 50 for two hours without food. But keep feeding him high sugar every half hour until you see something more in the 80 or up range.
 
He stopped eating the hard food on his own (he may be full). Should I give him syrup? If so, how much and which type is best? (I have raw honey and maple syrup. I'm not sure if I have Karo syrup, but I might.) So, if his levels are under 80, continue to give him food/syrup? I'm sorry, I'm just slightly confused and don't want to do something wrong. We'll test him in 6 more minutes.
 
I believe Novalin N's duration is about 8 hours in cats, and that 6:00am test was about 8 hours after you gave his shot at 10:00pm. We would call that the end of the cycle and when the effect of the insulin was close to it's lowest point. I would definitely lower his dose. I'm so glad your stepdad woke up and woke you up. He helped to save Bear's life.
 
yes, if he won't eat food with syrup, put some on finger and rub it on his gums. You want to make sure he stays above 50. so if test is over 80, skip the food but keep testing every 30 minutes until at least 2 hours go by above 50. if less than 80 i would give high sugar after each test.
he might be ok without the vet if you can keep him above 50. this could take all day monitoring him.
 
Dyana said:
I believe Novalin N's duration is about 8 hours in cats, and that 6:00am test was about 8 hours after you gave his shot at 10:00pm. We would call that the end of the cycle and when the effect of the insulin was close to it's lowest point. I would definitely lower his dose. I'm so glad your stepdad woke up and woke you up. He helped to save Bear's life.
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As am I. I'm extremely luck he wasn't on his favorite heating pad alone.

I'll be calling his vet as soon as they open to talk about his dosage. I also need to find a way to get more test strips and I've been worried about what I've read about the Novalin N insulin on here.
 
babyBoo said:
yes, if he won't eat food with syrup, put some on finger and rub it on his gums. You want to make sure he stays above 50. so if test is over 80, skip the food but keep testing every 30 minutes until at least 2 hours go by above 50. if less than 80 i would give high sugar after each test.
he might be ok without the vet if you can keep him above 50. this could take all day monitoring him.
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I'm okay with spending all day monitoring him. And thank you, we're about to test him now.
 
Alright. We just tested again (with my husband's last strip) and it read 94. Thats good, right? So, I don't give him any food and test again in 30 minutes? I'm not sure how to get more strips.
 
Dyana said:
If you can get some money, I think you can buy the Relion meter and the test strips that go with it from Walmart for less than a bottle of test strips for the OneTouch. I used to use the OneTouch and the strips were about $50 for 50. The Relion Prime meter is $9 and a bottle of 50 Relion Prime test stips is $9 Just a suggestion. I don't know if it's the best meter, but it will do for now.
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I was actually just looking that up. I was trying to figure out which meter was good and afordable. This whole experience has shocked me and I plan on following his little butt around and testing him on a regular basis, at least for now.
 
You can go through test stips amazingly quickly. If you can afford it, I would buy 100 strips, and be sure to always buy more before you run out. It's the middle of the night and no test strips or a hypo situation and no test strips that you want to avoid. If your Walmart is open 24 hours and close by, that is even better.
 
Dyana said:
You can go through test stips amazingly quickly. If you can afford it, I would buy 100 strips, and be sure to always buy more before you run out. It's the middle of the night and no test strips or a hypo situation and no test strips that you want to avoid. If your Walmart is open 24 hours and close by, that is even better.
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We do have one and I'm planning on running up very soon to get a new meter and strips. I know this isn't the thread for it, but does anyone have a reasonable meter preference? Personal experience or a brand to avoid, etc? I want to continue testing him, but have to get one first.

Also, should I feed him at his normal 10 am? I plan on calling the vet, but am weary of what they may say.
 
Not sure... but I think I read something about the ReliOn Prime meter not being too accurate... could be wrong here... I know a lot of folks here (including myself) use the ReliOn Confirm... a great meter... and only a few dollars more...
 
I use the Prime and have compared it to my micro (same as Confirm) and found it to be accurate. The only difference is the Prime uses a bit more blood, but the price of the strips is much lower.
 
JohnZ said:
Not sure... but I think I read something about the ReliOn Prime meter not being too accurate... could be wrong here... I know a lot of folks here (including myself) use the ReliOn Confirm... a great meter... and only a few dollars more...
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JohnZ said:
Also... the ReliOn Confirm requires a smaller blood drop... a good thing :)
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I had seen that one while browsing as well. There a positive reviews, but some have claimed it as inaccurate as well. Have you had good experience with it?
 
Sharon14 said:
I use the Prime and have compared it to my micro (same as Confirm) and found it to be accurate. The only difference is the Prime uses a bit more blood, but the price of the strips is much lower.
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The Relion Prime? The strips are nearly half the price, but I got a few errors on my husband's because I couldn't get enough blood and that worries me. But you say you have no problem with accuracy?
 
No problems with the ReliOn Confirm at all... very accurate and consistent... been using it for a couple of years now... only had to change the battery once... :)
 
All human meters will read lower than pet meters. As far as accuracy, I've only used the Micro and the Prime and when I compared results they were similar and consistent. Many here use one or the other of those two meters. My cats ear bleeds easily so I haven't had a problem with getting enough blood, but if you have that problem the cheaper strips may not be worth it if you have to use twice as many.
 
Okay. Update on Bears numbers. With our last strip, at 7:45 am, 4 hours after initial crash and 1.5 hours after first testing of 54, he is at 126. He hasn't eaten in an hour. Thoughts? Is this good?
 
Sounds ready good to me... if you had more strips... it would be good to get another test in... but since you don't I think he's safe...? What does everyone else think?
 
If you can find some 28 gauge lancets they are bigger in width and help to get a bigger blood droplet.
While you're at Walmart, pick up a few cans of some high carb wet food (with gravy) and store it with your hypo kit.
 
I think, if it's going to be a while before you test next, I would offer him a snack of his regular low carb food now, and try to feed small meals frequently throughout the day.
 
Dyana said:
I think, if it's going to be a while before you test next, I would offer him a snack of his regular low carb food now, and try to feed small meals frequently throughout the day.
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I plan on going up, hopefully, within the hour. I was waiting to call his vet once they get in.

He hasn't moved from my chest/stomach since I initially laid down with him. He laid there through his food and his testing. Is it normal for cats to sleep heavily when they've gone through something similar? I'm also concerned about his wobbly state from earlier because he hasn't moved since then for me to determine how steady he is. I also don't want to push him and stress him out.
 
The one time it happened Derek... he did sleep very heavily for quite a few hours afterwards... but was fine and back to his happy self as soon as he woke up. :)
 
JohnZ said:
The one time it happened Derek... he did sleep very heavily for quite a few hours afterwards... but was fine and back to his happy self as soon as he woke up. :)
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Thank you for the reassurance. Everyone has been amazing. I'm torn between moving him and calling the vet then going to Walmart or allowing him to sleep peacefully. I know I need to do the former, but a part of me is terrified to let him out of my site and away from me.
 
Glad you had some help for your Bear and to hear his number is 126 after not eating for an hour. That high dose and then doing diet change on that higher dose is most likely the culprit. Might be worth switching to the ReliOn Confirm / Micro for your DH (dear hubby) and Bear :). A hypo event is very tough on kitty's body so not surprised that he is sound asleep. Just a quick note, ideally you want to give wet food like Dyana suggested when this happens because dry food takes longer to effect BG levels since it has to metabolize so to speak. Here's a Hypo Tool Kit list, I understand funds are tight but get what you can :cat:.

Also, edit your thread title to remove the 911. You can always change it back if you have another emergency :bighug:
 
Yong said:
Glad you had some help for your Bear and to hear his number is 126 after not eating for an hour. That high dose and then doing diet change on that higher dose is most likely the culprit. Might be worth switching to the ReliOn Confirm / Micro for your DH (dear hubby) and Bear :). A hypo event is very tough on kitty's body so not surprised that he is sound asleep. Just a quick note, ideally you want to give wet food like Dyana suggested when this happens because dry food takes longer to effect BG levels since it has to metabolize so to speak. Here's a Hypo Tool Kit list, I understand funds are tight but get what you can :cat:.

Also, edit your thread title to remove the 911. You can always change it back if you have another emergency :bighug:
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Thank you. I'll be sure to read that list ASAP and pick things up here and there. I'm also worried that he may be needing a full can of food twice a day (as one suggested earlier in the night). And I've changed the title. Sorry about that.
 
Just called his vet. The doctor hasn't made it in yet and the one there is in surgery. I left a message and asked to be called back by 10 am to see what I should do about his shot. What is the general rule of thumb? I thought I read that if he is under 200 before eating to not give him his shot? Is that right?
 
No worries, you had a scare this morning :bighug:. You could also divide the meals up through the day like a lot of us do. Correct, general rule of thumb is NO SHOT under 200 until you collect lots of data! ;)
 
Thank you again. His Dr. Haddix (his BFF) had the nurse call me back and said no shot this morning and keep whatever food he will eat down for him to munch on throughout the day until she calls me back personally. I will be picking up a new monitor and strips today so I can test him throughout the day. Is every hour good? Two hours?
 
If you are going to stick around the forum for a bit, let's at least get your Signature set up with some basic info instructed here: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

If you are able to start home testing, minimum of twice a day AMPS and PMPS (morning and evening pre-shot tests) here is our Spreadsheet template. Just need Google account and if you need help setting it up, just ask: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Here is the link for the Hypo info JohnZ pasted above: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Novolin N is a faster acting insulin, so dividing his meals can help reduce the big drops such insulins are known for. Usually hitting nadir (peak insulin / lowest BG) between +4 and +6. Obviously, every cat is different as I believe Bear went low around +8 so the insulin should be starting to wear off in the next 2 hours from then. :cat:

Let him rest a little since he won't be getting insulin today and I think every 3 hours will be fine. If you see his numbers going up, do not give insulin off schedule, just wait until PM shot time :)
 
EllieAviles said:
Thank you again. His Dr. Haddix (his BFF) had the nurse call me back and said no shot this morning and keep whatever food he will eat down for him to munch on throughout the day until she calls me back personally. I will be picking up a new monitor and strips today so I can test him throughout the day. Is every hour good? Two hours?
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With no shot this AM his BG will rise fairly high I think. No need to worry about that. It might make more sense to do a testing curve after his next AM dose to see how that dose affects him. Testing every 2 hours between AM and PM shots should be enough for that.
 
Kris & Teasel said:
With no shot this AM his BG will rise fairly high I think. No need to worry about that. It might make more sense to do a testing curve after his next AM dose to see how that dose affects him. Testing every 2 hours between AM and PM shots should be enough for that.
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That does make sense. Thank you. I'm probably still in overactive superprotective mode. :)
 
Yong said:
If you are going to stick around the forum for a bit, let's at least get your Signature set up with some basic info instructed here: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

If you are able to start home testing, minimum of twice a day AMPS and PMPS (morning and evening pre-shot tests) here is our Spreadsheet template. Just need Google account and if you need help setting it up, just ask: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Here is the link for the Hypo info JohnZ pasted above: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Novolin N is a faster acting insulin, so dividing his meals can help reduce the big drops such insulins are known for. Usually hitting nadir (peak insulin / lowest BG) between +4 and +6. Obviously, every cat is different as I believe Bear went low around +8 so the insulin should be starting to wear off in the next 2 hours from then. :cat:

Let him rest a little since he won't be getting insulin today and I think every 3 hours will be fine. If you see his numbers going up, do not give insulin off schedule, just wait until PM shot time :)
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I absolutely plan on sticking around. I've actually followed the forum for a while when I needed education or to compare brands (that kind of stuff), but I'm here for good. I'll be sure to set up everything and look into the spreadsheet.

Once I can get the monitor, I probably will test him regularly for a bit to get a basic look at his numbers so I know where he stands and I promise I won't freak over high numbers today.

Now, the + numbers. That stands for the amount of hours after insulin was given, right? Is there a thread that explains basic terminology?
 
You might want to also discuss with vet the possibility of switching to a more gentle, longer lasting insulin, such as Lantus.
 
JohnZ said:
You might want to also discuss with vet the possibility of switching to a more gentle, longer lasting insulin, such as Lantus.
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I did mention that to the girl when I left my original message. I'll be sure to ask Dr. Haddix when she calls back or at his next full check up.
 
JohnZ said:
You might want to also discuss with vet the possibility of switching to a more gentle, longer lasting insulin, such as Lantus.
Click to expand...

Also, if you don't mind me asking, how much does a prescription of Lantus run you? Are there discount cards available?
 
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