New Member, Miz Kirby, Dx 12/30/22

Hello! I've been devouring the forum all weekend, and thought I would introduce myself (or more accurately, introduce the sugar cat). Miz Kirby was diagnosed going into New Year's weekend. The vet didn't give me any numbers, just said she was definitely diabetic, and we're going in for her initial glucose curve today.

Kirby is a ragdoll (or more likely a mix). She was found as a pregnant stray, so I don't know her actual age, but given her size at the time (2013), I'm guessing she's around 10. I also have her daughter and a third cat (neither diabetic). Kirby was traditionally the fattest (13-14+ pounds), but during December she suddenly lost a bunch of weight and felt super skinny, drank a lot more water, urinated all the time, snuggled less, etc.

By last Thursday her weight had dropped down to 9.6 lbs as measured at the vet office, the vet suggested diabetes, and the (expensive) senior cat full organ system blood panel confirmed it. Once he said the word diabetes I started reading. Immediately stopped the dry food. She had been on Blue, various types but usually the ones aimed at sensitive stomachs, as she had always been a vomit-after-meals cat due to eating so fast and feeling competitive about food with the others. By default I used to do a mix of dry and wet throughout the day, with 4-5 small meals per day to reduce how much she would be taking in at once per a previous vet's advice on dealing with the nervous stomach. Switched to wet-only 3 days ago, doing larger portions 2-3 times per day (the vet here wants feeding 3 oz. wet food twice a day to go with the insulin we'll be starting today, but the cats really hated that so I'm compromising to 3 meals for now). Planning to start doing homemade food a la Dr. Pierson's recipe (a bit of luck -- Kroger has all their overordered holiday turkeys on sale for half price now).

I don't know what's going on, but in just the three days, Kirby has already gained back enough weight (a couple of pounds) that she feels like a normal cat instead of the "oh no, all your bones are barely covered with anything and you feel like you're dying of cancer or something" she had become in a couple of weeks -- she's even already got back a bit of ragdoll belly bulge. She also stopped sucking down water and the rate of filling the water bowl has gone back to normal. The multiple litter boxes that were turning to sawdust so much faster have gone back to more or less the normal rate of usage. She's also back to her ragdoll nature of wanting to be snuggly all the time.

As she is now, I wouldn't have taken her to the vet at all, but we're heading in for the curve in a couple of hours.

I keep seeing mentions in the forums about vet recommendations being too static re insulin dosing. I'm concerned that the vet might tell me to dose her with more than she actually needs, so I really appreciate everyone here sharing their experiences and their cats' numbers -- it gives me a much better idea of questions to ask and documentation to demand. I've set up the spreadsheet and am planning to test regularly to keep an eye on things, and will discuss this and adjusting her dose with the vet today, especially given Kirby's quick bounceback just from ditching the dry food. Wish us luck, and thank you to everyone for being so generous with their experiences and expertise!

 

Hi and welcome to the forum.
Sounds like changing the food has made quite a difference to Kirby. I’m glad you are getting a curve done ….is the curve going to be done before the insulin is started or when the insulin is started ?
The best insulins to get are either Lantus or Prozinc so if the vet suggests anything else, say you want one of those.
As far as the dose goes…if you are feeding a low carb wet diet the starting dose would be 0.5 units twice a day.

Do you have a glucose meter yet? If not I would recommend you get a human meter not a pet meter. The pet meters are very expensive to run and are no better than the human meters. The Numbers are slightly higher …that is all. Most of us use human meters her and out dosing methods are be passed on the human meter.
Once you are hometesting you will not need to go to the vet for a curve.
If you live in the US Walmarts have a ReliOn premier meter for $9 amd 100 test strips for $17.88.
Also get a box of lancets size 26 or 28 gauge and some cotton balls to put behind the ear when testing.

With food we recommend giving a meal before the dose of insulin and then giving a couple of snacks during the first half of all cycles. A snack is a teaspoon it 2 of low carb food.

When you are giving the insulin you test the BG, then feed the meal, then give the insulin.
There is lots more to tell you but I don’t want to overwhelm you.
Let us know how you get on at the vet and the insulin they prescribe.
Bron

 

Welcome to FDMB!

It's great that you've been reading! I agree with everything that Bron said. I want to underscore that if the vet recommends an insulin other than Lantus (glargine) or Prozinc, ask for either of those two types of insulin. The American Animal Hospital Assn guidelines recommend only those two insulins for cats. (I'd bring the paper I linked along with you in case your vet gives you a hard time.) The other insulins are too short acting for a cat's fast metabolism. Also, the name brand Lantus is expensive. There's a generic/biosimilar for glargine that's now available. You may need to call around to see if your pharmacy stocks the biosimilar. Remember, you'll also need syringes (U100 for glargine or U40 for Prozinc and you want syringes with half unit increments) and lancets along with a glucometer.

Once you know which insulin your vet is prescribing, we can direct you to the insulin support group page that has information about the insulin, dosing, etc. Generally, the initial dose is somewhere between 0.5 - 1.0u. Do not be surprised if the vet tells you to bring your cat in regularly for a curve and to only adjust the dose based in his instructions. (As a comparison, I moved from Chicago to Columbus, OH several years after Gabby's diagnosis. I used a cat only practice in both places. The new vet took one look at Gabby's spreadsheet and basically said, "You know what you're doing. Let me know if you have questions.") Most MDs do not ask their patients to check with them if they change their insulin dose. You can do a curve at home and the results will be far more accurate since your cat won't be stressed. Stress raises blood glucose numbers.

One other thought. Please make sure your vet tests your cat today. From what you've indicated, the food change may be controlling the diabetes. There are cats whose numbers drop back into normal range with a change to a low carb diet.

The raw diet information from Lisa Pierson, DVM is great! If you want to make life easier on yourself, you can purchase a pre-mix. This is a commercially available powder that you add to a raw diet to make it nutritionally complete. The one a number of us use is from FoodFurLife and is called EZComplete. All of your cats can be on the same diet. If you've read Dr. Lisa's website, you know that a species appropriate diet is recommended for all cats. It will also make you crazy to try to feed your cats different foods. (FYI - there are food bowls available that are specifically made for cats that scarf and barf. Search on Amazon for cat food slow feed bowl.)

And last, this post on helping us to help you has a lot of good information for getting started.

 

Unclear. He told me to feed her as usual in the morning. I'm thinking his intention is to take a measurement, start insulin, and then watch over the day? I could be wrong, and I'll get more details this morning. I'm going to make sure he is aware of the big change over the weekend.... I'm comfortable with needles (has a cat that needed IV fluids about 10 years ago, and I'm licensed as an acupuncturist), so I'd be a little happier seeing if the blood measures have also changed before dosing her.

Yes, that's the impression I got from scouring the forums.

Not yet, but I am picking one up on my way back from the vet. I figured I would wait just in case the vet has a starter kit or something, but I was going to grab one from Walgreens.

Yes, that's what I'm planning to tell him. I know he'll suggest I come back for them, but just the blood test was almost 200 bucks -- I love my cat but also I'm back in school and disabled due to covid, so I defintiely want to do them myself and just share the results with him. The spreadsheet provided here is really helpful, and I'm bringing it with me to the vet office to show him.

I'm picking up a glucometer and test strips on my way back from vet today. I actually have a couple of boxes of various lancets from when I still had my clinic. I'm thinking I might be able to wholesale those in the future once I know which size works best for her. Going a little woo-woo, part of me is wondering if the blood draw helped stimulate the improvement. In Chinese medicine, bloodletting can stimulate a pretty strong healing response. In western clinical trials (no woo-woo), they showed bloodletting increased sensitivity to insulin in people, so maybe that's true with cats also?

Thank you for the confirmation that snacks are okay! This helps a lot. The way the vet talked, it sounded like he wanted 2 meals 12 hours apart period, so I was thinking about it like intermittent fasting, where no incoming calories is the norm. I'm thinking I can do 2 larger meals before the shots and a smaller meal halfway through to make it less of a giant change from their old eating habits.

Thank you so much, Bron!

Jinx

 

You are correct. You test (no food for the 2 hours prior to a shot), feed, then give insulin. You then want to get some spot checks during the cycle to make sure Miz Kirby stays in safe blood glucose (BG) numbers.

Most of us feed our cats at least throughout the first half of the cycle (i.e., up to nadir -- the lowest point in the cycle) or somewhat beyond. There's no compelling need to restrict food. Again, look at human diabetics. Most people have 3 meals and snacks. Cats in the wild eat when they can.

With lancets, start with a wider gauge (e.g., 28). It takes a couple of weeks for the capillary bed on the edge of the ear to develop. Once your cat's ear is bleeding more easily, you can switch to a thinner lancet (e.g., 30 gauge).

A blood glucose test all by itself should not cost $200. I'm hoping that was for a complete panel. It would be important to make sure there was nothing medically going on and a blood panel would tell you that. My vet charges around $175 for a senior panel.

 

Yeah, when I dropped her off, I gave the receptionist a list of the changes in weight, habits, etc over the weekend (and watched her write it on the chart) and specifically asked that they weigh her again before starting the tests to have an accurate start weight. Receptionist confirmed he would be testing BG before giving any shots.

Thanks for the tip! I'll give the mix a try.

Yes, I was planning to just change them all over. Back in my younger hippie days I used to feed all my cats raw homemade food, so I wouldn't bother trying to feed them different things. Also, I already ordered some lickimats to see how they like them.

Thank you!

 

I don’t know what’s available at Walgreens but most of us use Walmart’s ReliOn which is accurate and has the most affordable test strips. And I assume the panel they did included a fructosamine test, right?

 

Update! I am annoyed at the vet.

They told me she needed to be there for 8 hours, had me bring her at 8 am and pick up at 5:30 pm (so 9.5 hrs), but they stopped testing at 2:17. (Stressed kitty!)

As I mentioned earlier, she'd already gained some weight back over the weekend just from switching food. Officially she went from 11.6 lbs on Thursday afternoon to 12.0 this morning. She had breakfast around 6:30am. At 8:15 her glucose reading was 330 (compared to 431 on Thursday when she looked/felt so skinny and sick). They gave her 2 units of vetsulin a minute later, which dropped her down to 60 by 12:30pm, and she was back up to 294 at 2:17 (they tested hourly instead of every 2 hours). Details from curve in spreadsheet. They prescribed 1 unit of vetsulin twice a day, 12 hours apart. I said I would prefer to use Lantus and it created a huge kerfuffle -- there were three staff people (vet + 2 assistants) in there all telling my why that wasn't the way to go. (Their reasons: Vetsulin "worked a treat and dropped it right down," Lantus is too expensive, Vetsulin is what they tested with today, and one of the assitants didn't know Lantus was something you could use on cats at all.) I told the vet my goal was remission and that I was switching to homemade food, and he said that remission was very unlikely (30% or less) but I should go for homemade food anyway.%But I remember seeing in a clinical study that vetsulin's remission rate was around 345, but Lantus's was significantly higher, like 60-80ish% especially if started immediately after diagnosis. Being ganged up on was too overwhelming for me and at the same time I could hear the other staff making noise about wanting to get out of the clinic because it was the end of the day, so I caved and accepted the vetsulin and I'm angry at myself but also really frustrated with the vet and his assistants for pressuring me so hard. I get that 1 unit won't drop it as low as quickly as the 2 units did, but that was a really fast drop and rise -- leaving her with the higher level for half the day. Also, he didn't even say anything about the fact that just changing to wet food only dropped her level by 100 and caused her to gain half a pound over the weekend.

I guess I need to start with the vetsulin because that's what I have now, but I can switch to Lantus when this runs out in a couple of months? Or should I just wait an extra day and go back and stand my ground for the Lantus? ARGH!

 

@Jinx & Miz Kirby
Hi you might want to read all about vetsulin
https://felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/
All the yellow stickys
I would try and find a new vet that is better informed about diabetes and insulin, this vet has no clue what he's talking about. Vetsulin is actually used for dogs. Vetsulin is a harsh insulin and drops hard and fast
This is from the vetsulin stickys
Changing the Dose

Hold the starting dose for at least a week UNLESS

• your cat won’t eat or you suspect hypoglycemia
• your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

Your kitty dropped below 90 today at the vets you need to reduce the next dost to 1.75 units
Maybe more, I will tag a vetsulin user for you
@FrostD Her name is Melissa
I will also tag Suzanne
@Suzanne & Darcy

What low carb food are you feeding, for example Fancy Feast Classic Pates, Friskies Pate ?

Lantus is expensive in the US but the have a generic now that's so much more affordable

If you do switch to Lantus it is expensive in the US, Many members use the generic
You can have the vet write the script for generic lantus ,many members use it
Here is some info
Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
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



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

You will also need to buy U-100 syringes with half unit markings if you switch to generic lantus

You can also get the syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like: either box
They won't say it half unit on the box but the are . open then and look before you leave the store, can't be ordered on line , need to go into the store
:

 

@Jinx & Miz Kirby
I would suggest you go to Walmart if you have one by you and pick up The Relion Premier Classic for 9 dollars , human meter that's what our numbers are based on
Test strips are 17.88 for 100 strips
Or any human meter, I see you said you were going to Walgreen's


Do you have the U-40 syringes for Vetsukin with the half unit markings ? We adjust the does by 0.25 units at a time. Even though the half unit syringes can only be adjusted by 0.5 they are easier when making adjustments by 0.25 units


Just want to be sure you have your hypo kit in case you need to bring Mix Kirby's BG back up to safe numbers
Be sure to have these at home for your hypo kit



Such as
med and high carb wet food and some honey?


Fancy Feast Gravy Lovers Gourmet Beef Feast in Grav
20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods
And some honey in the house

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

Between 11% and 17% is medium carbs.

18% and over is high carb.

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

A video one of our members posted, she is using a pet meter ,strips too expensive plus you have to code it
A human meter is just fine, most of us use human meters ,that's what our numbers are based on
When you get your meter can you add the name of it to your signature and spreadsheet


VIDEO: How to test your cat's blood sugar

Here is another link to read
This is a link to one of our posts on home testing.

 

@Sienne and Gabby (GA)

@Wendy&Neko

@Bron and Sheba (GA)
I know you are not a vetsulin user, I just tagged
@FrostD and@Suzanne & Darcy

I gave @Jinx & Miz Kirby some information and I just thought you might want to add something to it. Worried about her kitty , already dropped to 60 at her vets today when they did the curve
Thank you Sienne ,Wendy and Bron

 

I'm a pain in the butt with doctors. (I work with them and have no problem pushing back.) If it were me, I'd be back at the clinic and hand the vet and the assistants the following journal article that I linked. (I linked it in my post above, as well.) The article is the guidelines for the treatment of diabetes that was published by the American Animal Hospital Assn. Beginning in 2018, they stopped recommending both Vetsulin and Novolin for the treatment of feline diabetes. They recommend either Lantus (glargine) or Prozinc (see pgs 3-4). The reason for their discontinuing their recommendation is that only Lantus/glargine and Prozinc have the necessary duration given a cat's fast metabolism. Vetsulin and Novolin will drop numbers exactly the way you saw with your cat's curve and then numbers skyrocket back up due to it not having sufficient duration to last 12 hours. If your vet doesn't follow the recommendations of one of his own organizations, I'd be looking for another vet or suggesting that your vet and his staff do some continuing education that's pertinent to feline diabetes. (Like I said, I can be a PITA. You could always suggest that the vet and the 2 assistants give you their cell phone #s so when your cat's numbers tank during the night, weekends, or holidays you can call them at all hours for help since they want you to use an insulin that's not approved by a veterinary organization. Like I said, I'm a PITA and the reaction of your vet's practice is unreasonable and I'm aggravated for you!) And FWIW, outside of the US, Vetsulin is called Caninsulin. It was developed for dogs. Needless to say, cats are not small dogs and the 2 species are metabolically different.

You will likely need to call around to find the biosimilar/generic form of Lantus (i.e., glargine). It's called Semglee. Not all pharmacies stock it. Remember to check places like Costco or Sam's Club. You don't need to be a member to use their pharmacy. Alternatively, many people here purchase their Lantus from Marks Marine Pharmacy in Vancouver, Canada. Their prices are good and they are a reliable mail order pharmacy. You would need to fax or send a PDF of your prescription.

As Diane noted, 2.0u is way too high of a dose. It's especially too high of a dose if you're switching over to a low carb diet. We typically recommend that for a cat being fed a low carb diet, the starting dose should be 0.5u. This is even more the case if you're not regularly home testing yet.

 

What Sienne said here again. You’re the pet owner and you have to advocate for what’s best for your cats. Don’t let their ignorance dictate the treatment. I’ve had to be more than pushy often to get what I knew was best prescribed. “I want to underscore that if the vet recommends an insulin other than Lantus (glargine) or Prozinc, ask for either of those two types of insulin. The American Animal Hospital Assn guidelines recommend only those two insulins for cats. (I'd bring the paper I linked along with you in case your vet gives you a hard time.) The other insulins are too short acting for a cat's fast metabolism. Also, the name brand Lantus is expensive. There's a generic/biosimilar for glargine that's now available.” I’d email this to them. It will make them feel like idiots for not knowing better!

 

Welcome!

So a few thoughts:
- You can see the exact problem with Vetsulin in that curve...I won't beat a dead horse, Sienne gave you good resources. ProZinc generally works well, but Lantus is better.
- if you've already used the Vetsulin, yes you're stuck for a bit. I would try your luck with the vet again tomorrow over the phone and see if you can get just a single pen and some U100 syringes at a human pharmacy. I say just one because there are most cost effective ways to buy it, but you need one to get started and not wait any longer. If there are ketones, use the Vetsulin until you can get Lantus (meaning, don't continue to go without insulin).
- it hasn't been that long since the diet change, she is likely to keep coming down a bit.

As far as Vetsulin dose, you have two options depending on how well you can monitor. You can start with the 0.5U Sienne mentioned, or since they already gave 2U we can see from today's curve that you should go down to 1.5U (Diane mentioned 1.75U and tagged me - she is correct that reduction was earned, but since it was so far below 90 I'd take a larger reduction).

If you cannot test her often during the cycle, I would go with 1U to give you cushion for BG to drop more with the food change.

If you get an unusual preshot, please stall without feeding and post here for help. At this point in time I would call unusual something 275 or lower. If you don't get a reply, see the stickies linked above for options (skip shot, reduced dose, or wait and retest to see if BG gets high enough to shoot full dose(.

 

I wouldn’t wait months. I’d call or go back and stand your ground. Honestly. Vetsulin also called Caninsulin is best for canines not cats and you shouldn’t be mad at yourself, you knew more than they did!

 

Yes, but they had given 2 units. They prescribed 1 unit for me at home, realizing 2 was more than needed. In any case, I decided not to start on the vetsulin at home, pulled up all the references I'd seen earlier to share with the vet about why I don't want to use it, and I'll try to get Lantus tomorrow. I have three coupons to try with local drugstores, but also pulled the numbers for a couple of pharmacies in Windsor, CA (about 85 miles from me) where people frequently cross the border to buy insulin, so I'll call them in the morning as well to see if they carry glargine, any brand. (vs. having to wait for a shipment from Mark's Maritime to clear US customs).

 

Yes, I have a combo of Fancy Feast low and medium carb canned food, medium carb Blue Wilderness canned food, and some medium/high carb canned food from that I don't normally buy but keep a few around. Also on hand are honey and the Blue Wilderness salmon high carb dry food they were eating last week (that can be blended with some warm water in a pinch) if there is a hypoglycemia issue.

I have seen this post with the pictures so many times now, and every time I can't help but laugh. Before covid, I had an acupucunture clinic, and I did lancet pokes to get a few drops of blood on my patients all the time (that's why I already have boxes of lancets sitting around the house). All these reminders have me thinking I'll dig up some half inch acu needles as well, and start a diabetes protocol on the cat. I used to treat diabetes in my human patients all the time, and the protocol for cats is only a few needles.

 

Good for you deciding to go with lantus. You won’t be disappointed.
I feel very angry on your behalf as well. Honestly I’m not sure your vet knows a lot about feline diabetes. And the other person who did not know that Lantus can be given to cats….well it seems to me that that clinic definitely needs some up to date training about FD treatments. As Sienne said, vetsulin was manufactured for dogs and dogs have a slower metabolism to cats…who have faster metabolisms. And cats are not dosed like little dogs.

If you can cross the border to Canada you don’t need a script for lantus.
But please note that you will be using a different syringe for lantus. The syringes you will need for lantus insulin are:
U100 3/10, 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit markings.
The starting dose for lantus if you are feeding a low carb wet diet is 0.5 units twice a day. And you hold that dose for 5 to 7 days to let the depot fill unless the BG drops under 90 in which case you reduce the dose.

 

Here are the Lantus syringes I used to get from Walmart

 

I thought I would follow up to let people know how things turned out.

I called the vet the next morning, said I'd felt pressured and that I really wanted to do Lantus. They said they wouldn't write a prescription, and that I should find a different vet who would be willing to oversee Lantus treatment because he wasn't, as there had only been a couple of studies and it wasn't proven. a) Lies. b) HE SELLS LANTUS ON HIS WEBSTITE! Anyway, they did allow me to treturn the vetsulin. I drove up to Canada and bought a 10mL vial of Lantus for about 60 bucks. I had ordered all the other supplies but then Amazon lost packages etc. So I spent a week and a half doing diet change only until they came and until I could get a blood sample from her (the vet had warned me she was tough to get blood from). Got even madder when I realized (upon finally getting the records) that the vet hadn't even done a UA on her, much less fructosamine. Started with SLGS because I was concerned about being able to get blood samples often enough if I started at a dose based on her weight. At this point, I can pretty reliably get the sample, so I'm transitioning to TR with the hope of getting her to remission. Did the first UA dip using the hydrophobic litter, and no ketones, hoorah! So thank you to all who weighed in here during those first few nerve-wracking days! You made this whole ordeal manageable. I found a cat-only vet practice about 40 minutes away, so I'm going to switch to them to oversee her. And now I'm heading off to the Lantus forum.

 

Such great news!! I’m so happy you pushed back. We have to advocate for what we know it’s best for them. I can’t believe he sells Lantus on his website and wouldn’t prescribe it to you. Who the hell does he sell Lantus to then? You should email him this as an fyi, guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes. Anyway, good riddance and I’m thrilled you found a cat-only vet. Good luck and say hi to the folks on the Lantus forum for us

 

I actually did ask the front desk and assistants if I could email him/the clinic some relevant articles including that one, and they said they don't give out email addresses. Oh well.

 

I would mail it to them, sounds like they just don't want to admit that they are wrong!

 

Or drop it off

 

Jinx, If you are following SLGS you need to reduce the dose after that 78 today.
You mention you are going to transition to TR. If you have done that can you change the information in the signature and the SS to TR please and you wont get that reduction.