Wrong Dose, or Wrong Insulin?

My special boy Chester, who just turned ten, has been fighting diabetes since his diagnosis in late January. His symptoms, as you might expect, were weight loss accompanied by an obsession with water.

His diet consists of Purina DM dry food and a half-can of Purina Pro grain free, morning and night. Occasionally we trade one of the Purina Pro cans for a Fancy Feast flavor high in protein and low in carbs.

My wife and I started him on 1 unit of Vetsulin immediately after diagnosis. Glucose curves at the vet showed little improvement; he was consistently showing in the high 400s, with a nadir around 350. After several steady increases, we started conducting our own glucose readings at home for Chester, to account for stress, and found the numbers to be slightly lower—typically a high around 400 and a nadir around 275.

He’s now been increased to 5 units as of last week. A reading this evening (around hour 8 in the curve, or 4 hours before next injection) showed him still to be in the 350 range. The takeaway seems to be that no matter how much we increase the Vetsulin, it’s not really pushing his curve down substantially. His symptoms remain virtually the same.

I should add that he’s had a rough go of things in the dental realm since diagnosis as well, having lost three of his canines in just five months. We’ve had him treated with an antibiotic each time for about ten days. I recognize this might have affected insulin treatment for those windows of time, but the last round was perhaps two months ago.

Is there sufficient cause for concern that Vetsulin is not going to work for Chester, and we will likely be looking at an insulin change? It’s concerning at least in part because the price of an alternative like Lantus ($300+, as opposed to $55 for Vetsulin) borders on the obscene.

Thanks!

 

has been quiet on this forum for awhile so I'll take a swing at it -- relative newbie, done a lot of reading and consulting with other members here

has anyone suggested transitioning to all wet canned food? most here have found quite a reduction in blood glucose values after doing so, though you must be conservative in switching, not like me, I changed in a day, luckily my Catcat loves the canned pates, and he was on a low dose already

Fancy Feast classic pates are great for the sugarcats (so long as they don't have potassium issues) -- you will see, on the Main Forum, a link to an explanation of the composition of most of the obtainable canned foods --

so glad you are testing at home, seems to be the optimum way of deciding how to care for diabetics -- and this message board has proved a Godsend to many -- welcome !!!!

for most cats, Vetsulin is effective quickly during the cycle, drops the blood glucose rather dramatically at first, is most effective (lowest numbers on meter) around three to five hours after injection

as to dosing advice, I defer to the more experienced members, one or more of whom will probably show up soon

but could be, that another form of insulin might be more effective for you -- personally I'm finding that the vetsulin wears off in my Catcat, well before the 12 hours are up, and the vet and I are discussing transitioning to Lantus

there ARE ways of getting Lantus more economically (never cheaply unless you find some human user who is going to a different formulation, who will GIVE it to you); even so, you will still need a prescription from the vet -- there's also a way to order it from a Canadian pharmacy (a real bricks and mortar one)

 

Candy, I think you covered a lot and really well! I am going to agree that it sounds like the next step would be to transition off the dry food and to an all wet low carb food. Many of us feed Friskies pates of Fancy Feast classic. There is a chart I will get a link to for you. You want to find a wet food on there that is less than 10% in carbs . (3rd column). Making this change while continuing to monitor his glucose levels at home, before each shot to make sure it is safe, and sometime in the lower point of the cycle, would be a good next step.
Though I did not use Vetsulin, I did try to treat my cat with NPH, and it was not successful. It did not last a full 12 hours and I was only able to regulate her on high doses three times a day. I would not change both diet and insulin at the same time, so with your concern for cost in mind, switching food may be the ideal next step.

 

Not many cats do well on Vetsulin I'm afraid, though every cat is different. As Candy stated above, she's hoping to switch Catcat over to Lantus soon, and my own kitty will be making the switch to Prozinc this week. It just doesn't have a long enough duration for cats.

The all-wet food switch will definitely assist in lowering the BG as Candy and Cassandra pointed out, but it may not be enough. If you are still getting high numbers an insulin switch would make sense. Lantus definitely seems to be the best you can get - most members order theirs from a Canadian pharmacy for 1/3 of the price it sells for in the US. You can also pop by the Supply Closet on the forum and see who's selling any Lantus they no longer need for cheap. You could also consider Prozinc which is about $110 online, another great long-lasting insulin. Lots of cats around here have good experiences with both.

My logic is, yes Vetsulin for $55 is cheaper, but if it's not working you're essentially just throwing away money anyway.

 

This is pretty much what I think, also. I tried to treat Alice with NPH, and she spent a couple thousand dollars at the emergency vet in DKA.

That being said, if while @Chester’s Dad is shopping around for a longer-acting insulin, he can start by making a food change for the better, then he will already have that part of the problem worked out by the time new insulin can be acquired.

Here is the pharmacy @Panic mentioned. Mark’s Marine Pharmacy. https://rxcanada4less.com/insulin.html

 

Also please note when shipping insulin through warm climates/seasons, you need to be concerned about if it will stay cold enough long enough. If you have to sign for it, make sure you are home to receive it or it could sit in a post office for days, make sure whomever ships it is storing it with the appropriate cold packs.......

 

Suggestion if someone's not home to receive a package. First, have it sent to your local post office address rather than your address with 'hold for pickup' - get a tracking number and track it. Call the post office and tell them you have a pkg coming that contains insulin and needs to stay chilled, it's addressed to them with hold. My local PO gets a kick out of holding insulin in their fridge for a cat...

 

A tracking number at minimum is a MUST. An estimated delivery window is also extremely helpful. I cannot imagine if insulin were delivered to my door and just left there in the depths of an Oklahoma summer.

Hurrah for technology though! You can get text alerts and all sorts of things.