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REP

(21,691 posts)
Sun Apr 27, 2014, 07:17 PM Apr 2014

Vetsulin, Humulin, Lantus - is there any real difference? (except price)

My 12-year-old Maine Coon, Stewart, had started walking on his hocks this week and was unable to jump, so I tested his blood sugar ... 350. So he got to visit the vet, who confirmed that yes, he's diabetic. His numbers weren't terrible (well, compared to what I presented with after my great steroid adventure) but obviously he needs to be on something.

I picked up his prescription today, which was written for Lantus. I love Stewart to pieces, but $238 for insulin seemed outrageous. They wouldn't write for Humulin but told me to come back to their office and they'd sell me Vetsulin. His vet wasn't there, so I couldn't ask her (but I could be charged for the tech to hand me a photocopied sheet about injecting insulin, which gives the wrong injection site).

And now I'm wondering why he can't be put on an oral agent like Tolinase or the newer version of it.

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Curmudgeoness

(18,219 posts)
1. I cannot answer the question you asked
Sun Apr 27, 2014, 07:53 PM
Apr 2014

but I will say that 350 is pretty high. (I am basing this on my good friend who is diabetic---with a diabetic cat). My friend's blood sugar is so high that she is not a candidate for oral insulin and I would guess that your cat may be in that category as well.

On edit: what made you test the cat's blood sugar, and why did you have the instruments to do it?

REP

(21,691 posts)
2. I presented at 670, so 350 doesn't seem that bad ;-)
Sun Apr 27, 2014, 07:59 PM
Apr 2014

Stewart was walking on his hocks, which is a classic sign of neuropathy. I'm diabetic (extremely bad reaction to steroids, and I'm on oral meds) so I have a glucometer.

Cats are able to take oral meds; they don't get insulin-dependent diabetes. Oral meds are not insulin; the drug class I mentioned increases the body's insulin production. Other types of oral hypoglycemic agents improve the body's response to insulin (these are not appropriate for cats - or me - as they are nephrotoxic) or suppress how much glucose the liver releases (I don't think these are used in cats).

Curmudgeoness

(18,219 posts)
5. Well, that idea was shot down.
Sun Apr 27, 2014, 08:27 PM
Apr 2014

My friend actually gives her cat her insulin, since the amount is so tiny for a cat. I figured that you might be diabetic since you had the knowledge and ability to check the cat. If you are on oral meds, that wouldn't work. Oh well. It was worth a try.

IDemo

(16,926 posts)
4. I'm a Lantus user (on myself, not a pet)
Sun Apr 27, 2014, 08:27 PM
Apr 2014

The cost for one vial has skyrocketed over the past year and is approaching $250. The maker is faced with the end of their patent in 2015 and is apparently trying to maximize its profits while it can. Nice, while humans and some animals require it to remain alive.

If you are not averse to shopping at the Wal-place, they have an agreement with Relion to sell Regular and NPH (an intermediate-acting insulin) for $24 and change, about 1/10th the cost of Lantus.

REP

(21,691 posts)
7. Thanks for the tip!
Sun Apr 27, 2014, 10:34 PM
Apr 2014

I hate WalMart but I love Stewart a lot. I haven't been in there in 20 years but if that's the best insulin for him, I'll do it.

That really sucks for humans. I'm T2 and am very lucky to have very good coverage. When there was a massive fuck up in my paperwork and I had to pay the full weight for one of my oral meds, it was over $500 - for a very old and generic hypoglycemic. My pancreas was damaged by steroids, so it's not like I can not take all my meds.

IDemo

(16,926 posts)
8. One thing to bear in mind is that NPH and Lantus aren't equals
Sun Apr 27, 2014, 11:02 PM
Apr 2014

I used to struggle with some pretty horrific night-time low blood sugars when I was on a Regular/NPH regimen. The move to Humalog/Lantus (Glargine in the chart below) was like a miracle cure. The Lantus maintains an even effect over almost all of its dosage period, while the NPH has a noticeable parabolic curve, coming on strong and then tapering off. If it is a very low dose and with an unvarying diet/exercise level from day to day, that may not be such a problem with your kitty.

REP

(21,691 posts)
11. He's on 2 units twice a day
Mon Apr 28, 2014, 01:33 PM
Apr 2014

Based on his spot checks I've done and his fructosamine, it seems he's been averaging around 325 (again, I know this isn't good, but from my own experience of going from "not diabetic" to suddenly "so diabetic I can't see very well" after that course of steroids and averaging over 600, I'm hoping he's not as miserable as I was) and he's not a food-driven cat; in fact, figuring out when he eats has been a challenge to give him his first two shots, which he took like a champ.

We're going to consult with another vet; we've been seeing this one for over a decade but lately there's been issues we're unhappy about and get another opinion about which insulin would be best for him.

I really appreciate a all the information you've given me! I'm sorry it's from experience, especially the part where human insulin users are getting skinned alive for the medicine they need to stay alive. When I told my husband about how much the Lantus cost he was pissed; when I told him squat you told me about why, he was furious.

StatGirl

(518 posts)
3. Check out felinediabetes.com . . .
Sun Apr 27, 2014, 08:23 PM
Apr 2014

I haven't been there for a while, since my kitty died some time ago, and their information is probably newer than mine.

But cat physiology hasn't changed, so I can tell you that Vetsulin, Humulin N, and Lantus are very different in their actions. Of the three, Lantus has the longest action, and therefore is the easiest to work with. The other two can lead to very spiky glucose curves.

My most recent information (several years old) was that Lantus plus a low-carbohydrate, high protein diet was the most likely approach to lead to remission (better than other insulins).

Cats can take the oral meds, but usually they end up not working after a while. If you already are comfortable testing Stewart's blood glucose, I would encourage you to do some research into Lantus plus a diet change.

REP

(21,691 posts)
6. He's already on a special diet for something that's nearly killed him
Sun Apr 27, 2014, 10:28 PM
Apr 2014

He (and his father) have an usual bladder condition that not only leads to blockages, but the lining of the bladder hemorrhaging (the blockages come from the blood clots from the hemorrhages). Stewart nearly bled to death from it once and required transfusions, but since being put on the SO 33 neither he not his father have had an episode, knock wood. It is a high quality diet - not that Hill's crap - and there is a higher protein version.

I wish I could get his meds prescribed under my name - I have excellent coverage

The Velveteen Ocelot

(115,270 posts)
9. I used to have a diabetic cat - the vet prescribed Humulin N.
Sun Apr 27, 2014, 11:49 PM
Apr 2014

This was awhile ago, but I don't remember that it was especially expensive. I gave him a shot twice a day and his diabetes was quite stable for years. He passed away from other causes at the age of 16 (RIP, Teddy).

Sanity Claws

(21,822 posts)
10. My cat has been on Humulin N for about 16 months now
Mon Apr 28, 2014, 12:20 PM
Apr 2014

It costs about $100 a vial. I replace the vial every two months, even though it is not empty yet. It supposedly loses its potency 60 days after opening.

Humulin N is slow released. I really can't compare it to the others you mentioned.

REP

(21,691 posts)
12. Yikes! I can Humulin N for $28! (and not an Rx plan - won't cover my cat)
Mon Apr 28, 2014, 01:41 PM
Apr 2014

Though I'm thinking about asking my doctor to write insulin for me; I am diabetic and am very fortunate to have good coverage.

I don't know if you have Walgreens in your area; that's where I went to get Stewart's script filled and they gave me the price for Humulin. They also have an Rx 'club' that gives a $20 discount on most scripts. Since the vet wouldn't change the Rx, I didn't sign up for it so I don't know all the details, but I will be looking into CostCo and other things because I hope to be giving him shots for YEARS (unless he goes into remission )

Sanity Claws

(21,822 posts)
13. Is this for you or a pet?
Mon Apr 28, 2014, 02:03 PM
Apr 2014

I get Humulin N at Walgreen's and never heard of a Rx club there. What state are you in?

Walgreen's and Duane Reade are the cheapest pharmacies in NYC. I remember pricing Humulin N at Rite Aid and getting sticker shock. IIRC, it was around $140.


REP

(21,691 posts)
15. I'm in CA, and the Walgreens thing is good for pet Rxs
Tue Apr 29, 2014, 01:54 PM
Apr 2014

Stewart has a different surname than I do; somehow the cats took my husband's name when we got married though I didn't Plus the script being from the vet's office made it obvious it wasn't a human Rx (otherwise, I'd filled it under my plan for $0).

I don't know that much about their club thing - my coverage is through Kaiser and so all my Rxs are filled through them - but from the brief overview the pharmacist was giving me (the staff at this Walgreens was amazing - very helpful and incredibly nice), it sounded pretty useful, and the price she gave me of $28/vial might have been for Relion

REP

(21,691 posts)
16. Thanks! He's been excellent about his shots.
Tue Apr 29, 2014, 01:58 PM
Apr 2014

And by excellent, I mean no fuss, no drama, no nothing.

I did use to give SubQ fluids to my neighbor's cat, which is a much bigger needle, so I'm pretty good at sticking sharp things into cats but mostly it is because Stewart is a wonderful and smart boy.

sinkingfeeling

(51,276 posts)
17. For any question about diabetes in dogs, go here....
Mon May 5, 2014, 10:29 AM
May 2014
http://www.k9diabetes.com/forum/index.php?s=da04a1933281f4e72715041a723e8d5e

There's a complete write up about various insulins and their duration times under 'Insulin'.



UPDATE: Sorry, I missed that your pet was a cat.
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