Brittle diabetic, 23 year old siamese. Better than in years.

We have been treating our ancient old cat for diabetes now going on 7 years. The first six months were a nightmare he was on up to 12u of vetsulin and typical sugars were in the 400+ range. We learned and switched his diet to Young Again zero Mature. Boy that worked. After a few days we had to stop insulin for about a year. Went along like that until one random spot check he was back to 400. Oops. Back on vetsulin and continued the YAZM diet.

In the last year or so he started losing ground He quit grooming and seemed to hide out. That went on for the better part of a year. We felt like we were doing everything and he was fading away. His big problem was that he was getting nauseated about once a week and would remain so for about a day almost every week.

For several years he was on about 4-5 units of vetsulin. It seemed like it had a duration of about 12 hours. I keep a spreadsheet and would slide the scale a bit.

I thought that perhaps a change in insulin might be worth a try. Went to walmart for Novolin N. I approached it with kid gloves, starting with a half unit It took probably 3 weeks before he started getting predictable values. Being U100 vs U40 you can't use very much. He was still bothered with nausea But he complains way less with the shot. Perhaps it has a better ph or something.

We had been supplementing his dry food which he seemed to like with canned tuna and Fancy Feast (no grain added) pate`. Occasionally he will he will eat what we treat our other cats eat Friskies classic pate` It has some rice in it so more carbs.

One of our dogs is sensitive to his blood sugar apparently, if we see her following Cash around, it is time to do a spot check Otherwise we follow him 3 or 4 times a day.

We decided to stop the YAZM about a month ago. To see how he does on his catfood and fish. He is very picky If he won't eat them we give him some of the Friskies wet food. If he gets down under 70 he can have Friskies Dry. That is close to pure carbs. He gets maybe 10-12 kibbles of that rarely if needed and he going to go up.

As he has washed the Vetsulin out of his system the amount of Novolin N has changed. Doses range from .5-2.5u Mostly about 1-2u. Some days 1.2 units will hold him until the next day. I had read that Novolin N was way more short acting than Vetsulin It started off that way but now is the same or longer acting.

The big rub with Novolin N. The amounts are so low that I try and measure to the nearest 1/4th u I use .3ml syringes and 31ga needles, a steady hand, a flash light and sometimes a magnifier. If I could get .1ml (10u) needles it would be golden. If you are giving 1u an error of 1/4thu is a 25% change. That part is a headache.

If you are still reading this The best part! Since using only wet high protein wet food
He is much more active doesn't hide out. will sit on our laps and purrs. Actually grooms himself. He looks better now than in the past few years.

His eating is occasionally erratic and I think that affects the blood sugar. If he won't eat what we want him to we move down the list to the other food. We can bring his blood glucose down, but not up.

We changed vets for our 6 dogs and 5 cats. After discussion amongst ourselves We don't want to put him through any heroic care. What are labs going to prove? Maybe that he has impaired renal function, Yeah sure you bet ya, being 23 and a diabetic.

 

Hi and welcome to the forum.
It is wonderful to have a 23 year old kitty, especially a diabetic.
I want to caution you about using Novolin N though. It is not a suitable insulin for cats. It is a harsh, shorter acting insulin that hits hard and fast.
The American Animal Hospital Association recommends Lantus or Prozinc for cats and no longer recommends Novolin Nor Vetsulin which is really a dog insulin.
If you swapped to Lantus I am sure you would find it would make a difference and it is not hard to measure the doses accurately.
As you don’t have a spreadsheet to share I can’t really comment on how it is looking. If you had one that would be great.

If you think he is nauseated, it might be worth asking the vet for some ondansetron (zofran) which can be given up to three times a day. Do you have a hypo kit set up at home in case of low numbers?
What are you feeding him now?

 

Actually I have been a member here for since 2017 No specific welcome required. I don't participate often

Cash is not nauseated at this point. That is in the past. I thought I had mentioned that.

He seems to be tolerating Novolin N and it has good action. His morning BS has averaged 281 over 2 years in the past and is now 240 for the past 6 weeks that he has been taking NovolinN. Whether approved or not. Novolin N works better than Vetsulin for this cat. Have you tried it on felines? The big downside is dosage .5-2.5u using a u100 syringe. and trying to figure out how it works. The big upside is cost, about 7 cents a day for Novolin N. Vs 50c per day for $55 vetsulin 400u I have seen lantus and prozinc priced at over 200 dollars a bottle. Do you see where this going?

Not everyone who loves their cat can afford a 300 dollar bottle of lantus. To say that there are no options is a disservice to cat owners. Evidently in our case we are doing something right.

I have posted spread sheets in the past and religiously keep on. I see my successes and mistakes and issues with the treatment, not really interested in a critique on it.

I would agree that Vetsulin is not a great medication for our diabetic cat. Our old vet was not proactive at all. I bought all my insulin from my vet as recently as this fall.

A Veterinary Ophthalmologist friend told me what kills a lot of diabetic cats (who are being treated) are hypertensive strokes. About the same sort of problems as humans were having until the 1960s, when oral blood pressure meds were being accepted by the PCP's. Back then on humans, normal systolic blood pressure was considered to be you your age plus 100. I am 71 so my normal during that time period might be 171 instead of 120. No wonder there were so many strokes.

I am not testing my cats blood pressure nor administering med for hypertension. When I have done ophthalmoscopy on him, he show hypertensive changes in his fundi vasculature. I don't pretend to know much about cats but human eyes yes. He will probably have a stroke at some point. It is remarkable that he has made it this far, No?

The take home I think with our cat is that food has played a huge role. We are not using any food that is packaged with the word diabetes in it. It only works if your cat eats it.

 

Not true that you have to pay $300 for Lantus. Lantus has a generic version that is a lot less than that. I think with coupons folks have found here you can get it for less than $100 a bottle that would last you over a year. I liked the Lantus pens so I ordered them from Canada and paid with shipping $189 for 5 pens.

 

Thank you for your comment. Glad that it works for you.

We have had to cut back considerably on all costs here because of inflation during the last two years. I am glad that I can still take good care of our pets. Actually better care of our diabetic cat.
Have you tried NovolinN OTC?

At this point I don't know how long I will continue to use the same 10ml bottle. At current consumption it show about a year But like most vials, they recommend replacing it monthly.

Blessings.

 

SOme say it will last a year while others six months. I have used a vial of Lantus for over a year w/o problem. In the future it is best to get generic Lantus (glargine) in pen form since you can very likely use up a pen 3ml pen before it goes bad/ineffective. Use a GoodRx coupon. When using GoodRx make sure you select "insulin generic (glargine)" and "carton" to get the generic glargine pens.

 

Does your current bottle have particles floating in it? If so, it is definitely time to throw it away.

 

I've used NovolinN & it did absolutely nothing for my cat except kept him in high #s & he had many hypos on it as well. If anything it prolonged his chances of getting into remission. I made a vial last up to 6 months kept in the refrigerator. My boy is on Lantus GARGLINE insulin now. I have the pens & one pen has lasted him for 4-6 months. I've also bought vials of it for around $98 & it's lasted for a little over 6 months. I'm not going to do the math but if your buying NovolinN once a month, your paying way more than I am for Lantus. Would you like to share your spreadsheet with us?

 

I was reading the instruction on the injection pen. Basically they want you to waste 2u every time you set it up and prime it. Great way to sell more.

I have no idea but probably would be a QD dosing Their web site shows that the injectors are calibrated in 1u doses. If even remotely similar in activity that would not work for our cat.

I really don't have the budget to spend 4-5x on insulin Well more when when you add in another 300 for veterinary Rx's every year.
Basically he never gets insulin when his bs is below about 220. At near 250 he gets .8-1u. 300 1.2-1.5, 400 2u , if he gets below 70 we offer him high glycemic food. Of course your cat won't be the same. Some days we have given him 1.2u and he has been good all day Still under 200 at bed time but the next morning he was 450 or higher. We want him to eat everything that he can. He weighs about 11 pounds and is slender for his size. He was under 11 pounds when diagnosed 7 years ago.

I didn't write this looking for the magic bullet or really any advice. We're not laymen.

Have to ask: does your 23 yo cat run? Climb ladders? Before he started treatment 7 years ago he was hock walking, developing neuropathy. Maybe it was the grace of God that has spared him.

From drugs.com web site:

4. How to prime Lantus SoloStar

Lantus SoloStar should be primed before each use, this is sometimes called a safety test. This should be done to remove any bubbles, to ensure that the pen is working properly and that the device can administer the dose of insulin required.

• Dial a dose of 2 units by turning the dosage selector clockwise.
• Take off the outer needle cap and keep for re-capping purposes, and remove the inner needle cap which you should discard.
• Hold the pen with the needle pointing upwards, then gently tap the pen to help bring any air bubbles to the top.
• Activate the injection by pressing the injection button watching the needle tip for a drop or stream of insulin to appear. If no liquid appears you may need to repeat the process until insulin is seen on the tip.

 

After 6w have barely made the level go down. in the vial. Won't change bottles unless something changes.

Novolin N is like rocket fuel in my cat.

 

The particles make the insulin longer acting. It is a suspension, so yeah it settles and has to be remixed with each use.. If you want clear you get straight R. Would make care much less practical.

Personally I wouldn't want to use a pen where I don't actually see the amount of injection. Old school and safe.

 

Inside the pen is a removable insulin cartridge. The pen part is not used. The insulin syringe is stuck into the cartridge top (the purple bit) just like a regular vial of insulin. The cartridges can be purchased without the pen.

 

At least in the US, the cartridge in a pen is NOT removable unless you break the plastic. In some countries and in the US when Lantus was first introduced one could buy reusable pens that used disposable cartridges. However, in the USA some afterwards they stopped sell disposable cartridges.
You just insert the needle in the endo of the pen where the pen needle goes and draw out the insulin like you would from a vial except you do NOT inject air into the pen.

 

Unfortunately this thread was not about Lantus. But about the relative success that our diabetic cat has had faced, lots of challenges including age, duration of disease.

Seems like only one person who has responded has actually tried Novolin N non-prescription insulin. Others are just repeating what they heard without personal experience. Perhaps this thread is not for you, shaking your core beliefs.

Am I a bit smug at finding a less expensive way to take good care of this beloved cat? Yeah sure.

When I read tag lines on members here it seems like most diabetic cats live 3-5 years past original diagnosis and are gone by 17, I have had maybe 15 or 20 cats and the oldest cat lasted until 18 She would have been dead two years earlier if it were not for an extraction, done my dentist. Like I mentioned, our diabetic is long lived for reasons that only God knows.

 

The GA in my username means Minnie has passed. I never tried novolin and I wouldn’t have since Lantus and prozync are the better insulin for diabetic cats and the ones recommended by the AAHA. I think you have misinformation for Lantus and I just wanted to clarify it for you. You don’t waste 2 units with each shot. I drew the insulin directly from the pen and never wasted a drop. By getting it from Canada, I was only paying $35 a pen and each pen lasted me over 3 months so the 5 pack I was getting would last me for over a year. Unopened and refrigerated Lantus can last that long. Here we would not recommend skipping insulin if your cat’s bg is 200 as that’s outside the normal range, 80-120, and still requires insulin. Having said all that, I’m very glad to hear your cat is 23 and doing well. You may not want to take any of the feedback we’re giving here but it’s here for you anyway

 

The info that I posted was a cut and paste directly from drugs.com
https://www.drugs.com/medical-answers/you-lantus-pen-lantus-solostar-3544443/ Check it out. Have to ask, were you loading the pen the recommended way?

My readings are seldom fasting. I don't get upset with a 300. Yesterday he was 204/.5u, 190/0u, 167/0u, and 291/1.1u
This morning it was 205/.7u so far today. I want to emphasize that someone else's cat might have totally different needs That is the other reason I don't want to share a spreadsheet.
If a dose is skipped he can be at 600/max the next day.

During the first 6 years I felt lucky if he was consistently under 300 which what our Veterinarian's goal. I am a retired eye doctor and hoped that I could do better. Vetsulin in my animal had a habit of developing a nasty divergent curve. It would either stay high or plummet low, irregardless of the accuracy of blood sugar measurement, spreadsheet data or amount of insulin injected. For instance I would manage the BS to be under 200 it would be okay for 3-5 days then day 6 with the same dosage bonking him starting at 70. I stayed with it as it cost $45/10ml/400u I am not seeing that with Novolin N. The switch was constantly difficult and drifting for the first 3 weeks. If I can keep my bottle fresh it has about a year supply for $25. So if I go 6m then 50. Diabetic cats are not cheap keepers.

 

The link you provided is for human diabetics. If you look at post #11 & #12 it explains how to use & store a Lantus pen for a cat.

 

I am glad you straightened out how to prime the pump for your kitty.

It is a zero issue for me with years of experience using standard syringes and needles. I like to draw up and carefully
inspect before delivery. Makes for no errors.

With our old cat we worry about him not eating, we don't have any easy way for supportive care if he quits eating and has had a 24-36 hour dose of levemir in his system.

Read someplace that our Cash has a human equivalent age of about 106. Not sure if any of you have had any patients over 100 years old. They have to be handled very delicately. You don't want to make them go through any extensive therapy or testing. No heroics. Home care if necessary.

When we started with Novolin N we thought if it works as well as vetsulin then good, If it proves ineffective, it would be a trip to the vet, still with no guarantees

Insulin is either analog human recombinant or porcine, it is all a crap shoot when treating a carnivore. Perhaps veterinary pharmacologists in the future will find something better.