need to switch insulin

Tess was just diagnose last week. The vet put her on insulin right away, but it was Vetsulin. She is getting 1u twice a day. After I started her on it I founds out about the FDA warning. Long story short, Tess is seeing her new vet tomorrow. I've talked to them and they also only have Vetsulin in stock, but can order or prescribe something else. From the advice I've gotten in the Vetsulin forum I think Lantus is the smart way to go. I've been reading over the stickies to get up to speed n Lantus, but I'm still on a pretty big learning curve.

Since they would have to order it I think we would be better off getting a prescription and ordering online. We would get it just as fast, maybe faster, and it should be cheaper. From what I've seen it seem to come in vials or cartridges. What's the difference? should I ask for one over the other?

As for switching do you just stop giving one and start the other the next cycle? I assume the dosing would be prescribed by the vet, but if they don't use Lantus would they be that familiar with how to convert?

Unfortunately nothing was done about diet. He said Hills Senior Dry was a great food (32% carbs!!!)and to give her a preshot feeding of a little Prescription Diet WD (26% carbs). Since her insulin was based on this diet I couldn't just change over to a low carb diet. When the first dan of WD was gone I switched to EVO (4% carb) and have gradually been increasing the amount of canned for every couple of days. As Tess gets more canned food she eats less of the high carb dry on her own, now she's eating less than half of the dry she used to eat. With just starting insulin last Friday and the change in diet (am I going too fast?) how hard will it be to set a new dose of Lantus. By the time I get it she will probably be eating mainly wet with some dry left out for a snack in between meals. I'd like to change that over to low Carb also.

Any advice on how to proceed is greatly appreciated. Thanks in advance

Ann

 

10 ml bottle:


OptiClick cartirdges:


SoloStar pen:


All can be used with insulin syringes.

The 10 ml bottle is the least cost effective. It may last a month, maybe a little more or less. It's a big waste since you're tossing a more than half full bottle away almost every month and buying another $100 or so bottle. :-Q

The cartridges and SoloStar pens are more cost effective. A box contains five so that is a 5 month supply (use one new cartridge or pen each month). Cost is about $150 or so, which comes out to $30 per cartridge or pen. The prescription has to specify the cartridges or SoloStar pens.

You do not need pen needles. Insulin syringes work just fine.

You can start Lantus right away. No need to skip a dose to let the Vetsulin clear out of your cat.

Most people start at 1 unit twice a day. Cats with special needs may start at a higher dose on the advice of the experts here.

Your vet should be at least willing to learn how to use Lantus and work with you.

 

I'd say Squeem has petty much covered the basics.

Defo go for the pen (you don't actually need the pen just the carts that go in them)
u100 syringes with 1/2 unit markings (Lantus is a u100 insulin, Vetsulin is a u40)

If your vet doesn't know about dosing, would definitely suggest a maximum starting dose of 1u.
Lantus is different to Vetsulin, for one thing you have to build a shed (like a petrol tank)
Once you get it, you could test just before shot time and check what everyone here thinks to administering a 1u dose dependent on the BG reading you get.
This forum is much busier than V/C isg, always lots of beans around to help you.

Reading up in advance will help you alot,as will already hometesting and having a spreadsheet set up.

The more Low carb food you provide the less insulin you need.

Great choice btw :mrgreen:

 

Welcome Ann & Tess to LL. This is an awesome place. Read the stickys at the top. Set up a spreadsheet and start putting your numbers in it. You are home testing? Your diet changes are great. EVO dry is about 7% carbs but dry food is "kitty crack". But you are already getting rid of that.

Ask questions, read other condos (1 daily post per day per cat). Look at other spreadsheets. Format for condos, spreadsheets all in the stickys. Also, there is the Janet & Binky's food chart. It gives a lot of the commercial wet (canned) foods and their carb content. You can look at the old and the new chart.

Again, welcome to LL. And, I use the cartridges. Started with vials and could not afford to toss a 1/2-3/4 full vial. Pens and cartridges are cost effective. Also, as a suggestion, if you don't have a Glucose meter, don't buy the one the vet has. I have it but the strips are 80.00 for 50 strips and you can only get them from the vet. Most here use human meters. I use the ReliOn Ultima and the strips are $39.00/100. I also get my syringes there. I have not had any problems with either.

I'm sure some of our experienced people will check in with you. Good luck.

 

Very important :!: Use only U100 insulin syringes with Lantus. 3/10 cc with half unit markings are best. Here's a thread with member's preferred brands of U100 3/10 cc insulin syringes and where to buy: http://www.felinediabetes.com/phorum5/r ... 22,1959486

If you are currently using U40 insulin syringes with Vetsulin, consider giving them away to someone who can use them. You can post them on the Supply Closet board.

 

Thanks, what is the difference between the cartridge and the pen? What about getting it from the vet versus online?

I'm already testing and have got my spreadsheet set up. Tess's AMPS was 299 and +4 was 144. I wanted to start testing right away as I wanted to start feeding lower carb food. Since i didn't want to wait for an order I checked out CVS as it is my closest drugstore. I chose the True2go meter, $9.99. It has their store brand on it, but you can also get it at Hocks as well as the strips which are only $25/50 there. .5u sample, 4 second results and I even found a full rebated form in the box. I haven't seen any mention of this meter on the forum and I might get a name brand one later, but this is really easy to use and I could get started with it right away.

I know wet food is best, but even if she isn't hungry she wants to see food in the bowl at all times. It's a security thing. Tess was rescued by a woman who "rescued" 49 other cats as well. She's really timid and I don't think she ever got enough to eat. She was 4 when I got her and only weighed 6 lb.

 

Welcome to Lantus Land (LL)!!

The cartridges can come either all by themselves or already fitted into a pen. Fundamentally, they are identical except for the housing. I've bought them both ways. I'm liking the pen better since the insulin is protected inside of the plastic pen housing and it can't roll around either in the refrigerator or when I've got it sitting on the counter while preparing a syringe.

My vet does not supply medications that can be purchased in a pharmacy. Lantus is widely available in pharmacies since it's a human insulin (vs. Vetsulin which is for veterinary use only). I've purchased both mail order (online) from Canada and from the pharmacy. My last cartridge from the online purchase pooped out after 2 weeks. I had purchased the insulin over the summer and I don't think it was sufficiently cold by the time the shipment reached me and, as a result, the insulin lost it's potency. It was much cheaper to buy online, though. Lantus prices vary from city to city. In my locale, prices range from around $180 to well over $200. The price online was around $100.

If you are happy with the meter, that's good. There are a number of people here who had problems with both the CVS and Walgreens' brand meter. It also got a pretty poor review in Consumer Reports. If there is a Walmart near you, their store brand, Relion, is very popular, inexpensive, and the strips are also inexpensive. I use a Bayer Contour and the strips are about the same price you noted on Amazon.

Many people here free feed wet food. I make the wet stuff into 'catsickles' -- I mix food with enough water to make it soupy and pourable and then freeze it in ice cube trays. It's an easy way to reassure Tess about food being in her bowl. I also leave wet food mixed with water in a timed feeder. The wet stuff will hold up fine for hours. Tess' story sounds very sad and she's very lucky to have found you!

As far as starting dose, the current approach outlined in the Tilly Protocol is to base the approximate starting dose on ideal weight. The dose usually works out to somewhere in the neighborhood of 1.0 unit. Do you happen to know Tess' ideal weight? As others have noted, you don't need to let the Vetsulin clear Tess' system. You can stop one insulin and start Lantus. It will, however, take up to 7 days for the depot/"shed" to fill. Hopefully, you've read the sticky about shed so this isn't all new terminology. You might want to print out the Tilly Protocol and share it with your vet. There are also links to research articles on Lantus that you might want to bring along to the vet, as well. If you vet isn't familiar with Lantus, be forewarned. There is a very different mindset to using Lantus. Dosing decisions are not made on pre-shot numbers. Doses are based on the nadir. This will probably take some getting used to on your vet's part (since it sounds like Lantus is foreign territory) as well as on your part.

Please keep asking questions. The front end of the learning curve is overwhelming. We've all been there (and we still keep dumping information on people) and repetition helps! As Barbara suggested, read other peoples condos and spreadsheets. Post every day. We are an international group and there is usually someone around 24/7.

 

welcome to LL, Ann!

I don't have much to add to the great advice you have already been given. Switch soon and come join us, you'll be glad you did!

I never ordered my insulin online because I don't plan ahead well enough to do that. :lol: My vet just called my prescription in to Walgreens and I could usually pick it up the same day.

 

HI Ann & Welcome to lantus land--We all help each other here, and there is always someone on to help you..
You have gotten a lot of info, but here you need to know--Lantus is a gentle insulin that is given every 12 hours. It is easy to use, and you need to be consistant & patient..More kitties go OTJ (off the juice) -into remission here than most other insulins..
You will need to bg test, a few times a day..I guess you know that already.
Starting dose here is 1.0 unit, nd e raise these by 0.25U at a time, when the need arises--We always consult each other & get great advice from those who have experienced it..
Tess already looks like she will do well on lantus--Again, ask questions, look at other peoples posts and spreadsheets, and you will do fine..

 

hello ann! welcome to the group!

as explained, it doesn't matter whether you get pens or cartridges. personally i like pens just because they offer a little protection. if you buy the SoloStar pens you do not need the needles which screw on the end of the pen. use U-100 syringes instead. there's pictures in the starred stickies at the top of this forum. each pen or cartridge could last up to around 6 months. the stickies have more information about how to tell if your lantus is still good.

since you'll be switching from another insulin, kitty's current dose will need to be taken into consideration when determining a starting dose with lantus. lantus has a longer duration than some insulins, but it has a lower potency in most cats.

hope to see you posting often...

 

Hi, Ann- How great for me that all the truly knowledgeable people have already weighed in. I can just add, welcome to Lantus Land! This is the most wonderful source for information and support.

What a beautiful kitty Tess is, and how wonderful that she found you.

 

Consumer Reports Meter review

http://docs.google.com/View?docID=dd5ck ... on=_latest

Hi Ann

welcome to Lantus Land, I noticed there was mention of the Consumer Reports meter review, so I thought it might be handy for you to have a look thru.
You've gotten awesome help in here already, hope you will keep posting your concerns and any more questions you may have.

Looking forward to meeting Tess!

 

Ronnie thanks for the link. I'd already seen the report, but not before I bought the meter. The meter I bought isn't on the list. I think that Sienne was thinking that I had the True Track, very similar name. I saw on Dr. Lisa's page that that wasn't a favorite. I don't think mine is actually a store brand because I've seen it on Hocks too. it came with glucose testing solution so that if I get a questionable reading I can double check. That's comforting to know.

I just checked out the company website. They do make the true Track as well, but it is a different meter using different strips. I may go with a name brand, but this seems to be working well. I'm considering the One touch Ultra Mini or the Bayer Contour

 

True Trak is the least expensive one carried in Canada, I have it and used it for a while till I heard about the ratings.

I now use the One Touch - but has expensive strips...if $$ is an issue - and u want accurate results, the Relion meter is also a popular inexpensive meter in the states. Many people here use that one, and it's ratings are pretty good too. There are a couple of Relion meters, Ultima and Micro, just make sure u get the right strips for either one.

 

Honestly? Not much. The cartridge is designed to go inside an insulin pen, which you don't need. The SoloStar pens are pre-filled with 3ml of Lantus. Both are used with insulin syringes for cats.

You can only buy Lantus from the Human pharmacy. Vets do not sell Human insulins. Your vet can write you a prescription.

You just missed the free Lantus offer but there are ways to keep the cost down. A free prescription drug card is one. See this thread on the old board: http://www.felinediabetes.com/phorum5/r ... 12,1772312 Call around to see what pharmacies in your area charge for Lantus. Some people say that Costco has the best price. Other people buy from online Canadian pharmacies.

 

Got the Script for Lantus!

Just got back from the vet and she said everything we wanted to hear. She said right off the bat that she wanted me to switch to Lantus. Script for Lantus "Just show me what you need." Very much in favor of home testing. While things are changing she'd like to see PS, +1 and +6 on a regular basis for comparison.

I can stop feeding the Hills dry. We'll just have to see how Tess reacts to an empty food dish throughout the day. But she's eating only 1/8 cup anyway, so maybe no problem. This morning she actually ignored the dry and went over to the empty dish for the wet and started licking it to see if there was any more.

Now I've got to order the Lantus and new syringes. I was wondering if we order on the internet is there a problem with shipping in the cold weather we've been having all over the country?

I'm so relieved.

 

Hi Ann,

Welcome.

You can free feed the canned foods. It's very easy.

Just add water and serve. It's safe to leave out for several hours. If you want her to eat at specific times, then a food timer works best. Again, mix water into the canned food, so it stays moist longer (and also ensures Tess gets plenty of water in her body).

And you can freeze the mixture. Put it in a container, ice cube tray or baggie. Once frozen turn out, serve. It will take a couple hours to thaw and be nice and ready for eating. It's a good trick when being out of house for several hours and wanting to make sure kitty gets enough food.

Many people order their insulin online, without issue. Personally, I've only used the people pharmacy, I found Costco was cheapest (and you don't have to be a member).

As for testing, always test BEFORE Shooting this will be your AMPS or PMPS number, then get spot checks in when you can - usually a +2 or 3 and +7 or 8 and if you can get one in before bedtime, then you will start to build up a nice spreadsheet. Also, vary your spot checks, so for example if today you get a +2, tomorrow get +3. It just helps to see what the movement looks like.

Hope this helps and welcome to the group.

 

Omigosh, how do you ever resist her? The wet food does remain edible longer than you'd think, if you want to leave some out for her all the time.

About meters: We use the Accu-chek Aviva, also free with rebate. Strips can get expensive, but www.americandiabeteswholesale.com has decent prices.

 

Tess is pretty cute! What a pose! lol

Hope ur doing ok Ann! Hang in there - things get easier and before long - u'll be paying it forward!

Glad ur here with sweetie pie Tess flip_cat

 

actually, i'd be very concerned about having insulin shipped from canada in this cold weather. i'd be afraid it would freeze enroute.
if it freezes... it's no good and would have to be tossed. :cry:

 

Since I'm still using Vetsulin I posted this there too, but I'd this forum's input too. Since I have posted here am I a member of the forum or do I have to do something else.


Tess is looking a little perkier today. She never looked like anything was distressing her just a little disinterested and quiet. I took away the dry food today (I think she's looking for it, though there is still some wet out) I'm giving her 1 3.5oz can/ day, 4 feedings. She also drank less than 1 cup of water yesterday. When we started measuring last week she was drinking about 1 1/4 cups.

I haven't been able to get a ketone test. She likes her privacy and leaves the box if I come over. Does anyone use the Smart Cat Box? or a combination glucose / ketone meter? Our new vet was fantastic (Pretty much anticipated everything i was going to ask about and / or insist on. ) She didn't seem too concerned about ketone testing w/ Tess's numbers, but wasn't opposed either and said the Smart Cat Box might be a good idea and make testing much easier. But, that would mean another change in Tess's life right now which she really doesn't need.

I'm not going to try ordering Lantus online right now, worried about freezing. I haven't been able to get prices online for the brick and mortar stores, so we're going shopping today. The vet didn't want to make the change before the weekend in case of problems anyway. I've ordered syringes from Hocks, but they probably won't get here by Monday. Not sure if I need a script for them in CA, but the vet said she would give one if I needed it (probably should have had her write one just in case). Hope I can find the ones w/ half unit markings.

What else,oh yeah. Any advice on treats? I like to give her a couple when I test. I'm still getting my head around calculating real carb %. We got some EVO Wild Cravings treats 95% meat and 9% max carbohydrates. What else is a good low carb treat? I've been gathering up all the pouches around the house, some will go into the Hypo emergency kit and the rest either to my sister's cat or thrown out. Although now that I'm learning more about cat nutrition I hate to give that stuff to any cat. Does anyone use Tuna Flakes aka Kitty Caviar? 100% tuna. It's the same as the dried bonito flakes you can get at Japanese grocery stores where it is a lot cheaper.