Not Sure if My Cat Needs Insulin Right Away

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alilblu

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So as I mentioned in the introduction forum, my 14 y/o cat Willow was just diagnosed with diabetes. It will be official pending a urine test.

The vet wants me to use Vetsulin. While the price is great, I'm not sure it's the best choice and I'm not sure I can get it in time. As I'm posting this, it's very late Thursday night (or very early Friday morning) and the vet's office is closed Sunday and Monday. There's no way to get Vetsulin shipped here before Saturday (I was told to order it). I may just have to suck it up and get Lantus locally even though it's six times more expensive.

I'm also concerned about glucose monitoring while on insulin. If I can start insulin Saturday, how am I supposed to check levels Sunday and Monday?

Willow isn't eating which is also bothering me. I'm still waiting to hear if I should give her Cyproheptadine (appetite stimulant) or not. Her diet has been primarily dry food with canned food in the evening. I'm prepared to feed her a canned food diet (pate/loaf - Fancy Feast and/or Friskies), which I've read may be better than prescription dry food.

Any opinions or suggestions would be great. I have looked over much of the information on this site, but it is a lot to understand in a short time.
 
Welcome! First, before the insulin, change her food completely to the low carb wet such as Friskies Pate or Fancy Feast Classic. You can also start testing her blood glucose at home using a human glucose meter. Many of us use the Relion Micro or Confirm from Walmart. As for the insulin, can you call around to the other vets in town and see if they have any? How is she acting? It’s important that she eat, even if you have to syringe feed her. If she’s nauseous though, an anti nausea drug is needed such as cerenia or ondansetron, before the appy stimulant will work properly.
Here’s some info on testing
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

ETALantus is a great insulin. If you decide to go that route, try to find a pharmacy that will sell one pen and after that you can order from Canada where it’s about half the price as in the US.
 
So I did leave out some info in my first post. Willow's blood work also showed kidney failure. Her BUN is 80 (16-36 is normal). Her creatinine was too high for the in-house machine but it is over 8, the normal range is 0.8 - 2.4. Her phosphorus is a tad on the high side and potassium is still within normal but on the low side. There's indications of infection or I guess inflammation (elevated WBC). Thankfully, she's not anemic, yet. Her abdomen looks like she's got a small canteloupe in there and the vet is concerned about cancer. An x-ray came back normal and I'm still looking into an ultrasound. Her abdomen has been like that for a year. The vet said last year that I should have her lose some weight before doing an ultrasound. I knew better, but I had two other sick kitties that were dying (CRF/CKD and cancer) and I could only handle so much. I'm not sure if the big abdomen is cancer or possibly Cushing's, or something else. Her back, where her hind legs are is super thin.

I've switched her to canned food only - Friskies pate for now, but I'm having to force feed. She's interested in eating on her own, but won't. I'm not sure if she's nauseous. She could be, it's hard to say. She lays in front of her water bowl a lot, but she could just be dehydrated. Other than that, I'm not seeing any of the classic signs of nausea. I did try Cyproheptadine under the vet's approval and I will not be doing that again for a while. Overall it seemed to make her worse and then I remembered that it's not good for the kidneys (dumb vet).

I'm doing subq fluids, but am not sure of the correct amount. The vet did say to do 200 ml every other day, but she has a history of recommending a dangerous amount of fluids (she think's it's impossible to overhydrate). I've been doing 100 ml everyday though. I will be checking over in the CRF/CKD group and see what they have to say.

I started a low (half) dose of Epakitin (I already had some leftover). I'm looking to switch to aluminum hydroxide.
I started Methyl B12 at 500 mcg twice daily. There appears to be some improvement in walking ability.

So, is it better to try Lantus over Vetsulin? Do you happen to know the average price in the US for one pen of Lantus? That way I can have something to compare to when I call the pharmacies. No matter which one I use, the vet wants to start at 2 units every 12 hrs.

Overall, I think there is some improvement in Willow. I'm still having trouble getting in the recommended amount of calories. I have enough trouble getting in one 5.5 oz can. Part of the problem is that she wants to kind of stand when I feed her and after the first syringe, her front paws start bending forward and being unable to support her weight. I tried to have her lay down, but she doesn't like that. I don't have enough hands to syringe feed her and help support her weight.

I don't actually expect her to live long. I figure it could be anytime within the next few days to three months. I'm hoping she'll pull through and live another year or more, but I don't expect it. But I do want to give her a fighting chance. She has more fight in her than I thought she would. She's really surprised me.
 
alilblu said:
So I did leave out some info in my first post. Willow's blood work also showed kidney failure. Her BUN is 80 (16-36 is normal). Her creatinine was too high for the in-house machine but it is over 8, the normal range is 0.8 - 2.4. Her phosphorus is a tad on the high side and potassium is still within normal but on the low side. There's indications of infection or I guess inflammation (elevated WBC). Thankfully, she's not anemic, yet. Her abdomen looks like she's got a small canteloupe in there and the vet is concerned about cancer. An x-ray came back normal and I'm still looking into an ultrasound. Her abdomen has been like that for a year. The vet said last year that I should have her lose some weight before doing an ultrasound. I knew better, but I had two other sick kitties that were dying (CRF/CKD and cancer) and I could only handle so much. I'm not sure if the big abdomen is cancer or possibly Cushing's, or something else. Her back, where her hind legs are is super thin.

I've switched her to canned food only - Friskies pate for now, but I'm having to force feed. She's interested in eating on her own, but won't. I'm not sure if she's nauseous. She could be, it's hard to say. She lays in front of her water bowl a lot, but she could just be dehydrated. Other than that, I'm not seeing any of the classic signs of nausea. I did try Cyproheptadine under the vet's approval and I will not be doing that again for a while. Overall it seemed to make her worse and then I remembered that it's not good for the kidneys (dumb vet).

I'm doing subq fluids, but am not sure of the correct amount. The vet did say to do 200 ml every other day, but she has a history of recommending a dangerous amount of fluids (she think's it's impossible to overhydrate). I've been doing 100 ml everyday though. I will be checking over in the CRF/CKD group and see what they have to say.

I started a low (half) dose of Epakitin (I already had some leftover). I'm looking to switch to aluminum hydroxide.
I started Methyl B12 at 500 mcg twice daily. There appears to be some improvement in walking ability.

So, is it better to try Lantus over Vetsulin? Do you happen to know the average price in the US for one pen of Lantus? That way I can have something to compare to when I call the pharmacies. No matter which one I use, the vet wants to start at 2 units every 12 hrs.

Overall, I think there is some improvement in Willow. I'm still having trouble getting in the recommended amount of calories. I have enough trouble getting in one 5.5 oz can. Part of the problem is that she wants to kind of stand when I feed her and after the first syringe, her front paws start bending forward and being unable to support her weight. I tried to have her lay down, but she doesn't like that. I don't have enough hands to syringe feed her and help support her weight.

I don't actually expect her to live long. I figure it could be anytime within the next few days to three months. I'm hoping she'll pull through and live another year or more, but I don't expect it. But I do want to give her a fighting chance. She has more fight in her than I thought she would. She's really surprised me.
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The rule of thumb for fluids is 10 ml per pound of body weight. Your idea of 100 per day rather than 200 every other day is good. So a 10 lb cat would get no more than 100 ml per day. How much does she weigh?

There's a great group on Facebook called Cats with Chronic Renal Failure. She is stage 4 kidney failure so that's probably why she's not eating. A lower carb low phosphorus food is necessary. Friskies may be too high in phosphorus. Here's a food chart. Pick something under 10 percent carb and under 250 phosphorus (under 200 even better). And so switch to aluminum hydroxide... It works better for most cats. Glad to hear the b12 is helping.

My cat uses vetsulin, but lantus is more gentle. In your cats fragile state that's what I would go with. Many on here order their lantus from Canada from Marks Marine pharmacy as it's about half the price.
 
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