xpost-welcome ann and tess, vetsulin/lantus questionss

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Ann & Tess GA

Ann & Tess GA

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Hi, I'm a newbie here, Tess was just diagnosed yesterday, Guess what, my vet sent me hame with Vetsulin. That and a a couple other of his responses make me wonder if he's the right choice. She got her first dose this morning and then I came online to get more info. I'm calling the vet about it, what would you advise, try to have her switched right away or get her stabilized first? Anyone know any vets in the SLO County area of CA w/ good expierence with feline diabetes?

My other concerns were that he gave little or no response to home testing and said to keep her on Science diet Senior! Dry food w/ 32% carb???????

Before I saw the product warning I was going to go along as is, I understand not changing too many things at once and that the insulin dose is based upon her diet so I can't change that without the dose being altered as well. I'm feeling a bit at sea here, all advice welcome.
 
Re: Vetsulin Product Alert in Pennsylvania ??

Hello and welcome.

You are right to question your vet about this insulin in light of the FDA warning. Is it possible you could discuss lantus as an option instead?
You may want to introduce yourself on the health forum where many eyes, both who use vetsulin and other insulin choices, can help answer your questions and make you feel more comfortable.( have crossposted you there )


Meanwhile vetsulin is what you have so a couple of questions to help us, to help you...

1-How much insulin are you giving and what were your directions around feeding times etc before the shot

2-What kind of syringes do you have? u40 is what I am thinking you would be sent home with.

3-Are there any other medical issues your baby has, ie: need for a dental, hyper thyroid, been on steroids for allergies?

4-Were ketones discussed at all?

I would certainly push for an insulin switch right off the get go....

I am going to cross post this on health for you...

as to diet, you do not need to feed that food, but you are right, changing too many things at once gets confusing. Once you let us know the starting dose, let's talk about changing that diet up.

Meanwhile hometesting...yes.....best tool you have to know what is happening and how to deal with it.

Have a look at these health links, including hometesting info...
http://felinediabetes.com/FDMB/viewforum.php?f=14

Hang in there, you have landed in a wonderful place and we can help :)
(((hugs)))
 
Welcome, Ann & Tess! I am so glad that you found us.

I am really happy to see that you asked about home testing even though your vet doesn't seem to think it's necessary - it really is btw as I think you realize from your post. I see that you also realize that the dry, high carb food is not a good idea either. Sounds a bit silly coming from me because my Moochie does eat dry food (long story) but wet, low carb food has been proven to be much better for most kitties.

I haven't used Vetsulin but have used PZI - another insulin with a shorter duration and sharper curve. It's not as fast acting or short lived as Vetsulin but is also not as long lasting and able to produce a nice, gentle and shallow curve as either Lantus or Levemir.

I would strongly suggest as well that you look into Lantus and consider asking your vet about prescribing it. Many, many cats are doing much better on the Lantus(glargine) than on the insulins with shorter duration

Have you been home testing Tess? What dose are you shooting and how many times per day?

I am sorry about my California geography ignorance. Where is SLO? Is that San Luis Obispo? We do have many California members but I am not certain of their proximity to you?
 
Hi Ann and Tess :)

I agree with Kimmee about seeing if you can change insulins ASAP. While Vetsulin does work well for some cats, Lantus is far superior IMHO, and in light of the FDA warnings re Vetsulin I don't think it's worth waiting if you can make the switch. I used both Vetsulin (known as Caninsulin here in NZ and other parts of the world) and Lantus with Goo, so I speak from experience. Lantus was a whole lot easier to work with, and aside from that, Goo clearly felt better on lantus.

In the meantime, if you could answer the questions Kimmee has asked that will help us greatly to start with.
 
Thanks for the quick response and welcome!

Tess has no other health problems, she was in to have her teeth cleaned and they did a blood test. We had noticed that she was drinking and peeing more than usual and mentioned it. Her BG was 495. She had been on a 12 hour fast before the test. She has lost some weight, but we had been cutting back on treats because se had gained a little too much. Tess is 12 and now weighs 9.25 lbs and had been 11.

The prescription is for 1 unit twice daily with the 40-u syringe. The vet said to give her a little canned food just before the injection, which we did and also put out her regular dry food about 1/3 cup of Hills Senior. She pretty much inhaled that after we gave her the insulin. The night before we had instructions to only give her a light meal because of the anesthetic. She appears to be intent on making up for the lost meals.

I've printed out the info sheet on Vetsulin and plan to follow those feeding timings for tonight. I also have the list of canned food stats and can see that the Hills WD thatthey recommended is way too high in carbs. I really would like to do as much with diet as we can. But as i said, I was worried about changing that when her dosage was based on a certain diet.

She seems perfectly fine otherwise, still a little edgy after going to the vet, but calming down now. We have an appointment in 2 weeks to have curve BG tests done. I agree that more frequent testing makes a lot more sense. Don't have a problem with doing it, just in figuring out which meter to use and where to get everything. I'll check out the link that you sent.

Thanks again
 
whereabouts in SLO County? I'm out in xxxx and work in xxxx County so not of much use to you but I know there's several others gals here in so cal with us and can try to find someone closer to you perhaps
 
It sounds like you are off to a great start. The big thing I would add is to learn to hometest asap. if there is a member close to you,that would be great :) Having someone show you how makes it all a little easier.

1 unit sounds reasonable as a starting dose- with that and hometesting, changing the food can happen quickly.
You want to have an idea of levels as you make the switch, especially about 3-5 hours after shot , when it is the lowest levels, so that you know whether the dose is too much or too little.

Keep asking questions, nothing too big or too small to ask :)

Do keep an eye on Tess through about 6 hours after shot....her behaviour can indicate much as to how she is feeling. :)

Please keep us posted...paws are crossed for good things for you both.
 
We live in Nipomo which is just north of Santa Maria, just on the south edge of San Luis Obispo county (see why we say SLO), about halfway between LA and SF along the coast. I took a look at the member list and it seems the nearest is in Goleta (Santa Barbara area) about 80 miles south. I've watched several of the videos and am pretty confident that I can do the testing. She does squirm for the shots, but it's only been twice. I had Cleo befor, she had CRF and 2x daily sub q Ringers treatments. This is a much smaller needle.

I'm calling the vet in the morning, wanted to see these responses first and will push to switch the insulin. I seem to be hearing Lantus is preferred what about levemir? differences? Then I need to find a meter. Ordering would take longer, so I'll see what is available locally. Any suggestions? I've spent all day online and my head is swimming with all the choices to be made.

Thanks again.
 
Hi...
Lantus offers quite a good chance of a newly diagnosed achieving remission.
Why don't you pop into the lantus forum, read the stickies and ask some questions.
This is why I am recomending it for you now.
Here is a link with lots of stuff about lantus..
LANTUS & LEVEMIR: More Information

Levemir would be my recommendation if you had already been on insulin for awhile :)

PZI, prozinc, are going through some changes, and I am too unsure of the action of the new prozinc to be able to recommend it now.


Meters, you want one that takes a teeny amount of blood, that has relatively inexpensive strips and that takes a short amount of time to read blood sample.

I love my ascencia contour, 15 seconds, teeny bead of blood necessary.

You are doing great taking in all this. I am so glad you are speaking to your vet asap about a switch.
Lantus is a great starting insulin and there is an excellent forum full of support and info.

I used vetsulin, and my Kitty did become diet controlled on it, but knowing what I now know, and with the concerns about its current manufacturing instability, it is just not a great bet now.

Good luck tomorrow :)

Kimmee
 
Welcome Ann and Tess.

I 100% agree that you should get her onto another insulin asap because of the warning and because vetsulin is simply more difficult to make work well for a cat. I switched my cat, Beau, from vetsulin to levemir last June and can highly recommend it. I believe that both levemir and lantus are equally good choices, but I choose lev because it is will last longer before "going bad" (losing potency) than lantus. That is being disputed now, but at the time I believed lev was less fragile and that I could use a cartridge up whereas lantus had to be thrown out after one month.

Beau went off insulin (diet controlled) after 3 months on lev, but recently needed a few shots of very small doses and I used the same cartridge I started in June and it worked fine.

The key to these, and any insulin, being really successful is the diet change - so you are right to question the vet not addressing that. My vet didn't either so I had continued to feed Iams Weight Control dry for 6 months - and Beau was completely unregulated that whole time.

There are three things I regret about his treatment: 1) not getting rid of dry food right away, 2) not learning to home test right away, and 3) not switching to levemir sooner (I waited about 5 months for various reasons).
 
Unfortunately, this being Saturday the vet was closed. They used to be open Sat. mornings, but that has changed. so I'm stuck till Monday.

I went and got a glucose meter today though and will do the first test in an hour when she is due for her shot. I got a True2go meter at CVS. It has a .5 sample size and 5 second results, and the strips are reasonable. Anyone else use this one? We also bought several cans of EVO wet food. I figured that I can change this to low carb as Tess is only getting a small amount before her insulin and she wasn't getting any canned food before anyway so it shouldn't effect the dosage. So much for the WD.

What is the best way to start switching over? And when do I start? On dry food Tess was a grazer, but when she gets canned food she snarfs it down in a flash. Do i gradually start offering more while leaving the dry out for a snack (maybe cut it with the lower carb EVO as well)? Just how much is a cat meal of wet food anyway? I've seem references to giving 2/3 of breakfast before insulin and the rest later. But 2/3 of what?

She seems to be settling downa nd not minding the insulin much, we'll see how the testing goes tonight.
 
What is the best way to start switching over?
Click to expand...
You mean switching over food, right?

Some cats can go cold turkey off dry - that won't work for most, though, so give more wet and reduce the dry. The faster the better as far as diabetes goes, BUT you must be home testing regularly before doing an overnight or rapid switch. The food switch can really drop the BG numbers - often 100 points or more. I think I started giving Beau full amounts of wet, but leaving less and less dry down. I probably reduced it tablespoon or so at a time until he was getting only 6-8 kibbles per meal pushed into the top of the wet food. If Tess is eating wet food with gusto, you are very lucky!

As for quantity, the *average* cat eats about one 5.5 ox can or two 3 oz cans per day. However, an unregulated diabetic can need up to twice that because they are not utilizing the food well. Insulin is needed to get the glucose the cells use to live into the cell. Without enough insulin the cells are starving. I would feed her as mush as she wants, but not all at once. I feed all my cat, and have for a couple of years, four equal meals a day: when I wake up, before I leave for work, when I come home and before I go to bed. When I am giving insulin it would be at the 1st and 3rd mealtime. I feed, test and shoot within 10-15 mins. The smaller, more frequent meals help to not overwhelm the system with food and help to soften the drop with vetsulin.

I also add a little water to the food - about a half can per can of food. It helps keep them hydrated. My cats don't drink extra water now (they did when eating dry food), except my oldest with hyperthyroid.

FYI, many cats on vetsulin end up at less than 1u bid once the diet is changed to all low carb canned food.
 
I changed Spacey from dry to wet cold turkey. And it didn't affect her bg. She is still high in numbers.
Therefore my advice is to switch her totally as soon as you can. Profited that you do home testings. But I've read you do, so that's okay. ;-)
My cat is on vetsulin as well, and I'm getting crazy. So as soon as she had her dental (next week on Wednesday) I'm switching her to Lantus. With or without my vet's permission.

Oh... I also test, feed, shoot within 10-15 min. She tends to not eat a lot at first and later on (around +2 hrs. after shot) a lot more. So I leave food out for her. After a while they tend to regulate their food-needs by themselves and don't eat it all at once. I wouldn't be too upset if he eats a lot know. Must be starving.
Good quality food will take care of that.

And no, .. I don't have the meter you have. But that's okay I guess. :mrgreen:
 
Success and not. Yesterday I did the first test before Tess's shot 465 with 2 tries to get a good prick, at +3 she was down to 226 also w. 2 tries. Yeah! I thought I had it, but......

This morning I could not get enough blood for a test, 6 lancets and more than 1 try per. she was getting fed up w/the process and I gave up and gave her the shot so no info.

I can see the vein and once I found blood on the tissue under the ear. I'm using thin but not ultra thin lancets and have the setting on the pen at 4 then i tried 5. Could this be going too deep. And if there was blood under the ear why not on top. We did see some blood a couple of time but not enough for a test. Any suggestions?
 
Ann & Tess said:
Success and not. Yesterday I did the first test before Tess's shot 465 with 2 tries to get a good prick, at +3 she was down to 226 also w. 2 tries. Yeah! I thought I had it, but......

This morning I could not get enough blood for a test, 6 lancets and more than 1 try per. she was getting fed up w/the process and I gave up and gave her the shot so no info.

I can see the vein and once I found blood on the tissue under the ear. I'm using thin but not ultra thin lancets and have the setting on the pen at 4 then i tried 5. Could this be going too deep. And if there was blood under the ear why not on top. We did see some blood a couple of time but not enough for a test. Any suggestions?
Click to expand...

Hi Ann,
Don't worry. The second time I had to do the bg test I stabbed her about 20 times before I had enough blood. My fingers were cold, I was in a hurry so nothing really went well. I had to wrestle her even. ;-)
Now, it's good. I make sure the ears are warm, some use a sock, I don't. I also don't use a pen, I'm doing it all by hand. That works great for me. So if you can't get used to the pen, you could consider free hand. Make sure though you stick the needle in at an 45 degree angle. I use 33 gauge lancets (Micro Fine BD). Since I use these, it's even easier.
It's also not that bad that the blood come's out at the other side. You still can use it. ;-)
I'm doing it sometimes (poking her on the inside of the ear) when she lye's in a position that doesn't allow me to use the outer side. No harm done.
My meter excepts very little blood. 0.3 µl is enough. So you can also try a different meter. That would be my last option though due to all related costs.
Good luck!
 
Ann, are you heating her ear first? I use a rice sock (uncooked rice in a cotton sock tied off) heat it in the micro for 30 seconds. I hold that over their ear for about 20-30 seconds and it makes the capillaries dilate so they bleed better. You want to aim between the main vein and the edge of the ear. I freehand the lancet because I have better control and aim over it that way. Also, I have found that there is ONLY one lancet that works (at least in my opinion). It is the BD Ultra Fine II 30 gauge. They are a little pricier, but when you have to use several over just one, and jab at the ear multiple times versus a quick poke, I'll take pricier. I have tried about 4-5 other brands of 30 gauge and they make Beau's ear feel like show leather. The BDs make it feel like butter. I do two quick pkes just next to each other, wait about 3 seconds and then "pilse" my fingers on his ear below it to bring up the drop, if it isn't already forming.

It does get easier for both of you!
 
Hi Ann and welcome to FDMB :-D

Here are some useful links in a thread from the old board:
http://www.felinediabetes.com/phorum5/r ... msg-592792

Lantus pips Lev slightly in research results of kitties that used both within 6 months of diagnosis and went into remission-84% Lantus/82% Levemir.

http://www.tillydiabetes.net/en_6import ... lin_Lantus

Also I'm sure Jill has put the link of the latest study in a sticky in Lantus (the %'s I refer to above)

Some links that may help with hometesting:
http://www.sugarpet.net/bloodtst.html

Sweet spot on cats ear:
http://i106.photobucket.com/albums/m267 ... etspot.jpg
Best place to try and get blood droplet. Yes we used number 4 on penlet (couldn't get hang of free hand, matter of preference)

Rice sock worked for us to as well as giving a surface on which to lay Luckys ear when getting a blood draw.
Also milking the ear-above and below where you have pricked. It may just be that you can't see the blood (stroking rather than squeezing-like a spot-forgive the analogy!)

Agree about changing to longer acting insulin. I just couldn't get the regulation for Lucky with Caninsulin. Wish we had gone to Lantus though had her very tightly regulated on Levemir. We always posted in Lantus anyway (still do :mrgreen: )

Good luck.
 
Things are improving. After she came out of hiding in the linen closet (I forgot that the bonsai club was meeting here today and she saw people through the door, ACK!) I did a test by hand at +7 321 and before the pm shot she was 308, at +4 159.

Thanks Sheila and Ella, doing it by hand worked a whole lot better, although it made me feel worse. My meter came with some 30 gauge lancets and the 45° angel helped too. I tried the warm wash cloth this morning and it annoyed her, so I used the sock this afternoon although it got too hot at 30 sec.,.

I don't think that switching foods will be any problem, she really likes to eat. We started with the EVO canned tonight, 1/4 can. There is still dry food out but she is on;y eating half of that now that she is getting the wet. Probably won't eat even that once she starts getting a full feeding of the wet. If I do decide to keep a little dry out for her to snack on I'll switch over to the EVO as it's only 9.1% carbs.

I got her SS online so you check on it, now for the profile and avatar! We'll see...

Tomorrow we talk to the vet and also possibly find a new vet. I really don't have a lot of confidence in the old one.
 
Hi Anne, sneaking in from work.

Great that your getting the hang of the hometesting. Rice sock-just hold it against the back of your wrist like a babys milk bottle to make sure it's not too hot.

Looking at your ss-good numbers, need to be mindful she hasn't got too steep a drop after shot (maybe a get a +2 to see). If kitties have sharp drops and rises can make them feel quite crappy.

As you've got that 159 on 1u and Tess is still eating dry, you need to be careful as stopping dry may drop her number too low for comfort.Keep an eye on that +4 and maybe get a couple of +5's. Reason is that Nadir (lowest number of the cycle) is usually around +4 using Caninsulin/vetsulin. Helpful if you know where Tess's is.

Have a lool at Sweetgrass's sticky-she gives an example schedule where you use food to control the curve, making it smoother (and hopefully nicer) for kitty.

Good luck finding a new vet. You could post your state on community and see if anyone is near you and can recommend a knowledgeable vet. Or look through the members list and see if there is and then PM them. :-D
 
Am I supposed to be starting new posts every day?

Tess is doing well and loves getting wet food. She seems to be transitioning herself off the dry as I give a little more wet every day. I'm keeping the Hills dry out, but she's eating less than half of what she used to of that.

I'm getting the hang of testing, much better off without the pen. She does flinch when I prick her though. I ordered the BD lancets, maybe those will be a little less painful. The warm sock helps too, but i think it annoys her, keeps shaking her head away from it and squirms more w/ that than the prick. Now to get my DH (I'm even catching on to the lingo) to learn to test. He's OK with giving the shots, but hates the sight of blood.

Now for the vets. I do know another vet here, she had owned the clinic we go to now, but retired for health reasons. Just found out she's out of retirement and has a new clinic nearby.
 
Good to as a new title will catch people's eyes.
Though not as important as other forums because this is a quiet one.
Great your getting there with the home testing.

Some people just use a piece of kitchen towel or such like if the sock isn't for you.
 
I believe the flinching will pass eventually. After the procedure I give her a little snack, except when she's sleepy. ;-)
And you can also loose the sock if that's not working. I'm not using anything like that. Just the needle and that's it.
I try to get her ears warm by rubbing them a bit carefully between my fingers.
Also I touched her ears a lot before I ever did a check so to get her used to me touching her ear. That might help as well?
So she can't associate touching the ears with a poke.
A thinner needle will be most helpful as well. I'm sure.

Good luck with the new old vet. :smile:
 
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