New member! Overwhelmed, to say the least.

Emily&Bun

Emily&Bun

Member
Hi all.

My 14 year old girl, Bun, was recently diagnosed with diabetes in mid-January as well as (unofficially) diagnosed with lymphoma in October. We live on a very small island with very, very limited vet care and I say unofficially because she hasn't been biopsied, as that is not an option at any vet clinic where I live. Because we live where we do, things are complicated and are seeming to be not as straightforward as if we lived stateside, where we came from. The treatment for her lymphoma has been steroids, which I am suspicious led to her diabetes diagnosis, and so we're in a weird balancing act of trying to keep her quality of life up without putting her through chemo and all of that.

Anyway, on this little island, the vet only has access to Vetsulin, so that's what we're on. We've been on 3 units twice a day, but today I took her in to get her glucose checked and she was at 544 (on Monday, we were at 179 so I burst into tears because I've been incredibly stressed since her diagnosis). He recommended we go to 4 units, but I'm hesitant. Tonight is also our first night of home testing, I didn't know until today that that's what I should be doing... On this forum, I read to test, then feed, wait 20-30 minutes, and then shoot, so that's what I'll do. 4 units just seems like a LOT.

Her appetite dipped which led me to take her to the vet in the first place where we found out she is diabetic, so she's currently on an appetite stim and her steroid, and now insulin and I feel like after the numbers today that we're failing somehow. My poor girl has been very, very healthy until about October, so to suddenly be medicating her and now poking her with a needle... I don't know. I feel incredibly guilty. She's back to eating very well, drinking a lot and urinating a lot (which I read is typical of diabetes?), and her energy has been wonderful but those numbers today are scaring me. Any suggestions as to what I do about her dose? She's been eating a lot more wet food than dry, should I completely transition her to wet food? She's always been a free-feeder and I don't know how we'll she'd adjust to specific meal times but I'm open to anything at this point. I just want to get this under control and I'm terrified of losing her.

*Also, I'd like to add that there is no 24 hour emergency vet on island. If she goes into hypoglycemia in the night, I have nowhere to take her which is another thing that totally freaks me out.
 
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Hi and welcome to the forum.
First of all please DO NOT increase the dose of insulin. If Bun has dropped to 179 and is now at 544 that means she is bouncing
Here is an explanation on bouncing which is very common in newly diagnosed cats and is not a reason to increase the dose. And it is nothing to worry about.
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
I am going to ask you to set up a spreadsheet and a signature so you can add the blood glucose data and then we can help you with dosing. If you have any trouble with setting up the SS let me know and I will get someone to help you.
Here is the link to the SS and signature. Also in the post is the link to the hypo box. Please set up one so you have the tools ready of Bun drops low. HELP US HELP YOU

3 units is a lot of vetsulin to start a cat on. We recommend starting with 1/2 to 1 unit.
Please do not swap to a low carb diet yet until we can see what the BG numbers are doing as you could drop too low with any swap in food. Hold off on that for now.
Yes you need to be feeding 30 minutes before you give the dose of vetsulin. Always test the BG before you feed so the routine for you is to test the BG, feed, wait 30minutes and then give the dose of insulin.
Personally I would reduce the dose of insulin back to 2 units until we can see what is happening with the BG data. I am going to tag @Suzanne & Darcy a she is a Vetsulin user. She may suggest reducing even further. Let’s see what she says.

Let Bun continue to free feed but make sure she eats well before every dose of insulin and the take the food away for the 2 hours before the preshot BG as we don’t want that BG to be food influenced.
Here is information on using vetsulin
Beginners guild to vetsulin

Well done hometesting the BGs! What type of meter are you using? Keep asking questions :)
 
Thank you! We started her on 1 unit twice a day, then about 2 weeks later, 2 units, and got bumped up to 3 last week. The jump to 4 seems really crazy to me, especially with what you said about bouncing... and also I think we increased her too quickly... Ugh. It's hard to want to follow the vet's instructions but see totally different advice from people who have lived with diabetic kitties.

So my first attempt at testing failed. I warmed up her ear with a sock filled with rice, and tried to use just the lancet at first which she squawked at so we took a break. Next I tried the lancet device (pen?) and poked her twice, and got blood but not enough for the monitor to register. The monitor I'm using is a very generic human one I got at a pharmacy here on island, the "Good Neighbor Pharmacy- True Metrix". I'm very nervous about her associating all of this with stress, so I decided to stop and gave her the 3 units and will try again in a couple of hours to get a reading. I didn't see your reply before her dose, otherwise I would have just given her 2 units, but I will try to get some monitoring done tonight and I definitely will set up that spreadsheet.
 
Are you giving her a treat every time you try and test the BG? Please do so even if you fail. She will soon associate the testing with a treat. My Sheba would come running from the other side of the house when she heard me at the testing equipment because she knew she would get a treat.

Are you pricking in the correct area?
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Yes! Definitely giving her treats after, I started doing that after we started the insulin. And yeah, I lit up her ear so I made sure to get in that spot and I did get a touch of blood but just not a good enough drop for the strip I guess? My coordination needs some work.... lol! Especially nights like tonight when I'm home alone. The good news is that she didn't even flinch when I used the device on her, I just wish I got enough on the test strip!
 
Welcome to the group, I totally understand the overwhelming feeling! I felt like I was drowning, honestly. This place saved me and my boy Hendrick! You're in good hands.
 
Try warming up the ear for a good minute. Are you using a "rice sock"? If you are, hold that inside the ear to provide a surface to press the lancet device against. Floppy ears are hard to get a good poke. Adjust the depth setting of the lancet device if you're not getting blood.
 
@Emily&Bun
Tap on your name up top and add this information about Bun . You will see all members have this information at the end of their posts in gray letters
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Thank you!

Do you happen to have the U-40 syringes with the half unit markings where you live. We use these because we increase or decrease by 0.25 units at a time . You can add where you live to your signature in case members need to give you suggestions on where to get any supplies or food suggestions

Are you using size 26 or 28 lancets to prick the ear with

Do you have a hypo kit in case you need to bring Bun's BG up





Honey

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

Good idea to mark the med and high carb cans with a marker
 
Last edited:
Emily&Bun said:
Hi all.

My 14 year old girl, Bun, was recently diagnosed with diabetes in mid-January as well as (unofficially) diagnosed with lymphoma in October. We live on a very small island with very, very limited vet care and I say unofficially because she hasn't been biopsied, as that is not an option at any vet clinic where I live. Because we live where we do, things are complicated and are seeming to be not as straightforward as if we lived stateside, where we came from. The treatment for her lymphoma has been steroids, which I am suspicious led to her diabetes diagnosis, and so we're in a weird balancing act of trying to keep her quality of life up without putting her through chemo and all of that.

Anyway, on this little island, the vet only has access to Vetsulin, so that's what we're on. We've been on 3 units twice a day, but today I took her in to get her glucose checked and she was at 544 (on Monday, we were at 179 so I burst into tears because I've been incredibly stressed since her diagnosis). He recommended we go to 4 units, but I'm hesitant. Tonight is also our first night of home testing, I didn't know until today that that's what I should be doing... On this forum, I read to test, then feed, wait 20-30 minutes, and then shoot, so that's what I'll do. 4 units just seems like a LOT.

Her appetite dipped which led me to take her to the vet in the first place where we found out she is diabetic, so she's currently on an appetite stim and her steroid, and now insulin and I feel like after the numbers today that we're failing somehow. My poor girl has been very, very healthy until about October, so to suddenly be medicating her and now poking her with a needle... I don't know. I feel incredibly guilty. She's back to eating very well, drinking a lot and urinating a lot (which I read is typical of diabetes?), and her energy has been wonderful but those numbers today are scaring me. Any suggestions as to what I do about her dose? She's been eating a lot more wet food than dry, should I completely transition her to wet food? She's always been a free-feeder and I don't know how we'll she'd adjust to specific meal times but I'm open to anything at this point. I just want to get this under control and I'm terrified of losing her.

*Also, I'd like to add that there is no 24 hour emergency vet on island. If she goes into hypoglycemia in the night, I have nowhere to take her which is another thing that totally freaks me out.
Click to expand...
@Suzanne & Darcy
 
Emily --

You're doing great especially with all of the logistic obstacles. You are not failing Bun.

Vetsulin is a type of insulin that was developed for use with animals. Its other name is Caninsulin. From the name, if you thought it must have been developed for dogs, you'd be correct. It is no longer recommended by the American Animal Hospital Assn for use with cats. It does not have sufficient duration for a cat's fast metabolism. That said, the other animal insulin is Prozinc. If your vet doesn't stock it, it is available by mail from Chewys. The other insulin that's recommended for treating feline diabetes is Lantus (glargine). It's a human insulin. It is available at pretty much any human pharmacy -- it's a popular insulin. (I'm assuming there's a pharmacy on the island.) There are discount coupons available and it is also now available in a generic/biosimilar form.

How did the vet diagnose the lymphoma? How was IBD ruled out? Have you tried Bun on a novel protein diet? The differential diagnosis of lymphoma vs IBD is usually why you need a biopsy or endoscopy. If this is definitely lymphoma, Bun may also need a chemotherapy drug along with prednisolone. As far as the steroid, if steroids are needed for any medical condition, the insulin dose can be managed to work around the influence of the steroid. Your cat may need a larger dose of insulin but if the steroid is necessary, it's an important aspect of your cat's health. Also, cats do not have the same sort of reaction to chemo that humans do. They seem to tolerate it quite well. And, if this is lymphoma, it's an important aspect of treatment. This is information from Cornell Vet School about feline lymphoma.

I would encourage you to slowly transition Bun to a wet food diet. Please make sure you're feeding her a low carb food. We consider low carb as u under 10% although most members feed their cat a diet that's in the neighborhood of 5% carb. This is a chart containing most of the canned foods that are available in the US along with nutritional info including carbs. There is absolutely no need to stop free feeding Bun. In fact, we encourage several smaller meals throughout the day. Depending on your schedule, a timed feeder may be helpful.

Everyone is understandably nervous about the possibility of hypoglycemia. Having supplies on hand will help. You want some high carb food (e.g., Fancy Feast gravy lovers style food -- the gravy is high in carbs) along with serious high carb options like corn syrup, honey, maple syrup, etc. While it's unlikely you will ever need to syringe high carbs, a feeding syringe (no needle) can be helpful to have on hand. FWIW, my cat was diabetic for 6.5 years. Her numbers could unexpected plummet. I never had to take her to an emergency vet. If you are home testing, you have the tools to keep track of your cat's blood glucose levels and to intervene in a timely way. Home testing is the best possible way to keep your cat safe.
 
Diane Tyler's Mom GA said:
@Emily&Bun
Tap on your name up top and add this information about Bun . You will see all members have this information at the end of their posts in gray letters
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Thank you!

Do you happen to have the U-40 syringes with the half unit markings where you live. We use these because we increase or decrease by 0.25 units at a time . You can add where you live to your signature in case members need to give you suggestions on where to get any supplies or food suggestions

Are you using size 26 or 28 lancets to prick the ear with

Do you have a hypo kit in case you need to bring Bun's BG up





Honey

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

Good idea to mark the med and high carb cans with a marker
Click to expand...

I definitely will add all that info, thank you! I do not have the syringes with the half unit markings... Only the U-40's with the whole unit markings. I can poke around to different pharmacies and see if I can find those- my vet supplied me with a box so that's what I have for right now. I'm now using size 28 lancets, and I got it figured out!! I think the lancets I was using were waaay too small (33's lol) so these are much, much better. And we do have honey, I'll have to check the carb content of the wet food we have and stock up if we need to. Thank you for the tips!
 
Sienne and Gabby (GA) said:
Emily --

You're doing great especially with all of the logistic obstacles. You are not failing Bun.

Vetsulin is a type of insulin that was developed for use with animals. Its other name is Caninsulin. From the name, if you thought it must have been developed for dogs, you'd be correct. It is no longer recommended by the American Animal Hospital Assn for use with cats. It does not have sufficient duration for a cat's fast metabolism. That said, the other animal insulin is Prozinc. If your vet doesn't stock it, it is available by mail from Chewys. The other insulin that's recommended for treating feline diabetes is Lantus (glargine). It's a human insulin. It is available at pretty much any human pharmacy -- it's a popular insulin. (I'm assuming there's a pharmacy on the island.) There are discount coupons available and it is also now available in a generic/biosimilar form.

How did the vet diagnose the lymphoma? How was IBD ruled out? Have you tried Bun on a novel protein diet? The differential diagnosis of lymphoma vs IBD is usually why you need a biopsy or endoscopy. If this is definitely lymphoma, Bun may also need a chemotherapy drug along with prednisolone. As far as the steroid, if steroids are needed for any medical condition, the insulin dose can be managed to work around the influence of the steroid. Your cat may need a larger dose of insulin but if the steroid is necessary, it's an important aspect of your cat's health. Also, cats do not have the same sort of reaction to chemo that humans do. They seem to tolerate it quite well. And, if this is lymphoma, it's an important aspect of treatment. This is information from Cornell Vet School about feline lymphoma.

I would encourage you to slowly transition Bun to a wet food diet. Please make sure you're feeding her a low carb food. We consider low carb as u under 10% although most members feed their cat a diet that's in the neighborhood of 5% carb. This is a chart containing most of the canned foods that are available in the US along with nutritional info including carbs. There is absolutely no need to stop free feeding Bun. In fact, we encourage several smaller meals throughout the day. Depending on your schedule, a timed feeder may be helpful.

Everyone is understandably nervous about the possibility of hypoglycemia. Having supplies on hand will help. You want some high carb food (e.g., Fancy Feast gravy lovers style food -- the gravy is high in carbs) along with serious high carb options like corn syrup, honey, maple syrup, etc. While it's unlikely you will ever need to syringe high carbs, a feeding syringe (no needle) can be helpful to have on hand. FWIW, my cat was diabetic for 6.5 years. Her numbers could unexpected plummet. I never had to take her to an emergency vet. If you are home testing, you have the tools to keep track of your cat's blood glucose levels and to intervene in a timely way. Home testing is the best possible way to keep your cat safe.
Click to expand...

Hi, thank you for the reply. Unfortunately, Chewy does not deliver to where I live... But I will ask about Lantus for sure! It's kind of a long story, but to make it short, she hasn't officially been diagnosed with lymphoma. She had a couple of seizures (one in early 2023, one in July of last year, and again in October). When we took her in, the vet took an x-ray and said that he thinks he sees something in her chest, but he does not have a way to perform a biopsy, and neither do the other 2 vet clinics on island (when I say resources are limited where I live, they are LIMITED) and I can't just take her stateside or off island because that opens up a whole other host of problems. But without getting an official diagnosis, we opted out of putting her through chemo and that's why we decided to have her treated with prednisolone only.... and I believe that's what triggered her diabetes, though I can't say that for sure. As far as IBD, that hasn't even been discussed, but I will bring that up at our next appointment as well. I desperately wish we didn't move because vet care where we moved from was infinitely better, but this is what I have to work with and I'm trying to do the best I can :/
 
Also found these
https://www.totaldiabetessupply.com...S8fcxwD0G9FASL6oHleFzDtK-X8eMUTRoCN-UQAvD_BwE


If you can Lantus or one of the generic's and your vet will write a script for you

You would need different syringes for Lantus
If you can get the Lantus or the Generic you would need different syringes
sayU100, 3/10 ml, 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit markings
Let's see if you can get the Lantus first

You can definitely get 5 pens of Lantus or the generic Glargine

You can Check
CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens either Lantus or the generic Glargine , plenty of members use the generic
Just call around and see who has the cheapest price , it's really not that expensive
With the pens just keep them in the fridge middle shelf , they all have the expiration date on them .

Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus

If you use the Good Rx
GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822


GoodRx coupon.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menu says generic glargine 1 carton of 5 3ml pens.


Also
A member said she followed this prescription info exactly and it worked perfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.
upload_2023-12-1_6-57-52-png.68163

upload_2023-12-1_6-59-16-png.68164
 
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