The good news is that I’m not diabetic. The bad news is that my cat is.
The Mighty Fang has been poked, prodded, and otherwise miserated for the past three days to determine why he was drinking and urinating by a ridiculous amount. The final verdict: His blood sugar was way high in the blood test, at a point where a human would have already ended up in the hospital. He was also spilling a lot of sugar into his urine, indicating that it wasn’t just a momentary stress high, though the blood test was so high that was pretty much out of the question anyhow. The good news is that we caught it early, before there was damage to his retinas or kidneys or liver, and before he crashed.
So besides changing his diet to a low-carb diet (accomplished by changing his cat food to canned Nutro Natural Choice, which he loves) we’re starting out with a small dose of insulin twice a day. The photo above is his breakfast after this morning’s shot, which I gave under the vet’s direction. Yeah, the vet shaved a couple of patches of his fur off to give me easier targets to shoot at. Poor baby, he’s looking so patchy! Talking about insulin, that brings us to Big Pharma conspiring to hike the price of insulin. Three drug companies control 100% of the market for insulin, and conspire with each other to hike prices in lockstep. The best insulin on the market right now is one called Lantus. It’s a long-acting insulin that is much smoother than the older insulins, your blood sugar (or your cat’s, in my case) stays steady for far longer, requiring less monitoring and fewer injections to get a stable blood sugar level. My vet warned me that it was expensive. “You’re going to pay $180, $185 a vial. The good news is that he’s a cat, so a vial will last a couple of months.”
So here is what I paid for one vial of insulin: $293.99. When I showed him that bill, my vet was like, “What? That’s insane!”
“But we don’t charge full price!” said the drug companies above. Bull fucking shit. “But we offer discounts!” Not to cat owners, they don’t. There was one $20 discount coupon I could have taken if I’d know about it. That’s *it*.
So why don’t I get a vial of that old school insulin that costs $5/vial? Well, Big Pharma isn’t charging $5/vial for it. They’re charging $80/vial for it now. And it sucks, it’s really hard to get good control with it. And the better insulin, Humulin, that was introduced in the early 80’s for $10/vial? They’re charging $237 for it now. And it’s not as good as Lantus. It’s barely better than the older pork insulin (“Vetsulin”) that is available for $80/vial. And they’re charging $237/vial for it.
How fucked up is our healthcare system that I’m seriously looking at Canadian pharmacy sites… for my CAT?!
Oh, my good news? Well, glucose levels in cats need monitoring just like in humans. It turns out you use exactly the same supplies to do it. It turned out that Walmart sells their own branded version of one of the most highly rated blood sugar testing devices on the market, it requires a tiny blood sample and is as accurate as anything else (i.e., not particularly, but good enough for cats). This evening I got back from Walmart with a boatload of diabetic measuring supplies — lancets, lancet devices, and of course the test meter and the metering sticks, which have an enzyme in them that then reacts with the glucose in blood to set up an electrolytic reaction whose resistance is measured by the device to come up with the final result. The next task was to figure out how to use them. To do that, I wasn’t going to torment my poor cat and his ears — I volunteered myself as the guinea pig instead.
It took me several attempts to figure out how to use the lancet device to prick my fingertip. Then the next attempt didn’t result in a big enough blood droplet to test. Then I realized I needed to press harder on the lancet device before hitting the button, and did so, and blood didn’t really come out well but with some stroking of blood towards the hole a nice bead happened and I touched the tip of the meter strip to it, it sucked it in, and the meter gave me a value that was totally normal. Yay, I’m not diabetic! At least not yet! Stick gauze over the hole, wait a while, done.
Okay, but how the heck do I do this with the ear of a cat?! I need to watch those videos again, grr. Because I can’t see how I can manage to prick TMF’s ear using this device, because his ears are really thin and sort of floppy. The meter works well, doesn’t require much blood at all (turned out the bead I made was way more blood than the meter needed), but the pricking looks like a real prick of a problem. It looks like I’m going to have to watch more videos, ask people on the diabetic cat forum what setting they use on the pricker for their cat’s ears, and otherwise do more research before subjecting The Mighty Fang to my unkind ministrations. Because somehow I suspect The Mighty Fang will be less tolerant of fumbling than I was myself :(.
– Badtux the Diabetic-cat-owned Penguin
Oh yeah, obligatory slam against His Fraudulency Donald the Trump — he said he’d let people import drugs from outside the country and would let Medicare negotiate drug prices. Well, it turns out that campaign promise was as fraudulent as everything else about Deadbeat Donnie. SIGH.
You’re bringing back memories, Tux. The cat my most recent ex-wife had when I met her was diabetic. (Also the portly black model like TMF.) She had been on insulin for years when we got together. My ex could pop the needle into a scruff on the cat’s neck that she pulled up without a second thought. So could her elderly mom when the cat was left in her care. Me, the medical professional, who’s given thousands of insulin injections? No way! During the three or four years we were together before Sirius died of mouth cancer in San Francisco, I might have been able to inject the cat three or four times. I was too tentative in my approach; too slow to stick it in. I’ve given insulin to agitated, struggling dementia patients in nursing homes, no problem. I could see my target with them. They weren’t all covered in fur. The cat would flinch or pull away while I was fumbling. We got along well enough in all other matters (Sirius wasn’t super-friendly) just not the insulin. When my ex would be on the road, the cat just went without her shots.
As for blood sugar testing, we never did that. The cat’s diabetes was well-established and stable, plus she was on a small dose, like 6 or 7 units (also Lantus, IIRC) once a day. Maybe you’ll need closer monitoring while TMF’s diagnosis and dosage is being worked out, but are you sure you’ll have to keep doing it indefinitely?
As for the prices, in a country that values justice and human life (like here and Canada) that wouldn’t happen. Insulin doesn’t cost THAT much to make. As you know, though, human life doesn’t matter for shit in Amerika. Korporations will kill humans for profit. They’re sociopaths. The fact that the Power of the State does not step in to protect PEOPLE from the evils of faceless korporations is another bit of evidence about what a fascist hellscape Amerikkka is.
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The shaved patches of fur on his haunches are for giving me a target that isn’t fur-lined while I get the hang of this injectorating thing.
Yeah, my vet said poke it fast. I gave him the third shot this morning, he didn’t even notice the poke because he was snarfing down his breakfast (he’s a real chow hound, heh), he flinched in annoyance when I pushed the plunger though (that insulin was *cold*!). Thinking I’ll try to warm the insulin in the syringe a little between my fingers for this evening’s shot.
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Wow. My cat Cleo required insulin. Think the most I paid was $129 per vial and the price didn’t change much between September 2011 and October 2015. Cleo was always oblivious to the injections — they bothered me a lot more than they bothered her. Never had any trouble giving them but always felt a twinge of guilt for hurting her even if she didn’t react much.
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Yeah, Tux didn’t really even notice it until I pushed the plunger and that cold insulin hit his underskin! But then, I did it while he was eating breakfast, and he’s a real chow hound — he doesn’t notice much of *anything* while he’s eating :).
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Second Bukko’s observation about stability. If you’ve established a dose and been getting acceptable readings, you can reduce the frequency of the checks by replacing with observation. Given your ability to remote monitor TMF, you should get a pretty good idea of out of norm behavior.
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It helps that cats really aren’t that sensitive to glucose levels in the first place. For a human, you’d aim at below 100. For a cat, they can go all their life at 180 without any of the usual diabetic complications, so we’re aiming at maybe 150. If it wavers +/-30 around that, well, not a big deal.
As far as TMF’s behavior, he mostly sleeps — hey, he’s an old man now, almost 16 years old — so that’s not really a help. The excessive urination is what tipped me off, and I noticed that because I was suddenly having to scoop a *lot* more kitty litter than usual…
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Glad you found out and that Fang will get better!
Things like this piss me off to no end but not as much as the fact that the people who have the power to make it better have no intention of doing anything of the sort.
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A friend likes this https://www.canadavet.com/
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Doesn’t have diabetic supplies. The insulin I’m using is a human insulin that isn’t actually certified for cats, so it’s only carried by human pharmacies. That said, it has been used on a *lot* of cats with excellent results, it’s Good Stuff. But as precious as gold, it seems. SIGH.
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As a human diabetic, retired military so no cost for meds, (thank you Uncle Sam, I seriously wish you all could have my health care package!), I found sampling the side of the finger works well. With a cat, put your finger inside its ear (or outside if you sample the inside, that click is gonna freak out the cat at first) you should’t hit your finger but it should give you a deep enough prick to get your sample.
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Yah, I had that much figured out, I had to figure out a) the depth I needed on the pricker (it has multiple depth settings), and b) that I needed to place the pricker *firmly* on my finger, just setting it there it’ll just bounce off despite being a very sharp little needle. Figuring out the depth setting for the cat’s ear and how to back it is the deal here, so I found a cat diabetes board to get some suggestions. A cat’s ear is not a finger!
BTW, it has to be taken inside the ear, because that’s where the hair isn’t. My cat has hair on the outside of his ears.
Regarding temperature, I’m going to warm it after it’s in the syringe, not before. He’s on a very low dosage right now as we wean his system from being hyperglycemic. Cats are weird, and can get erratic rebounds if you try to take them down too fast. (Cats are weird, period, but cat diabetes is especially so, because some of the rules of human diabetes simply don’t apply).
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also, the temperature change, the delta T, is gonna degrade it according to my pharmacy tech. I keep mine in the fridge, and deal with the pain, which frankly is pretty small, mostly, compare it to a deep stick in the ball of your finger.
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That sounds like what happened to Zizi. We kept him going almost a year by buying him those $5 rotisserie chickens from Safeway as a dietary supplement. He’d eat one of them per week. Saved a bundle compared to high-tech cat food. It seems like I spent most of the savings on cat litter, though.
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