Friends of mine are caring for an older cat with diabetes and his blood sugar is still way too high. I said it sounds like he needs more insulin and maybe a different kind of long-acting. (The Cornell Vet site reports that glargine and detemir have been used successfully in cats as alternatives to veterinary insulin.) The cat eats the veterinary diet for cats with D in measured portions and is always hungry. Any suggestions gratefully received! 
I can provide insulin if they need it.
The veterinary insulin typically used now is much cheaper than what we humans currently use as basal, because it is the stuff we used to use waaaaay back when there were no other basal insulin’s available. It is all the zinc suspension stuff, like Lente and NPH, etc. It’s the stuff I grew up on!
It’s cheap now, so a lot of people use that for pets.
But…the problems we humans had with those old-time zinc suspension basal insulin’s way back still apply to pets using them today.
So if they want some modern basal insulin, I can hook them up!
It would be a better way to go for the cat. And cats don’t need as much as humans, so a vial would last a long time. Like only a couple units a day! So a vial would probably last them over a year.
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Ah, I didn’t realize that, never having used those insulins. The cat is on 8 units of Prozinc insulin twice a day and post-meal BG is as high as 500!! I think fear of hypos due to increased doses is an issue for my friend (though she didn’t say so explicitly).
That would be awesome! I know she is following up with the vet and I hope she lets me know what they decide. Many thanks for your generous offer. 
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The zinc stuff is a little less flat than modern basal’s. It is difficult to handle meals and everything with only that basal.
For cats, Lantus is the preferred insulin. Levemir would be the next choice, and then any of the zinc basal’s would be last choice.
I am not sure what the OTC cost of Lantus would be. She can ask her vet.
But if needed, I could probably come up with a script for Lantus, buy it, and then send it to her.
For Levemir, I have it already. So that would take nothing.
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In case anyone else is interested, here is a comprehensive overview of diabetes management in cats:
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From what I have read, yes, they do, with a slightly higher risk of hypoglycemia for Levemir.
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Ya, I think they are all the same there.
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I had a diabetic type 1 dog for years. Dogs get type 1 and rarely get type 2 and cats get type 2 and rarely type 1. I used to know a lot about dogs and diabetes and when searching for information I ran across a lot of cat info too but didn’t keep it as I had a dog. Cats can be reversible, but usually not after 6 months.
Standard Veterinary Care is far behind on treatment than with humans. But there are nuggets out there if you look. The veterinary hospitals usually have some information on research they’ve done. PubMed also. If I remember correctly there was more about cats than dogs. I’m sure there are some FB cat sites. Just a note, a lot of FB sites are very old school and don’t even like the mention of using the more uncommon but better newer things.
Cats and dogs can wear Libre’s. Luckily my vet was open to it, not all are, especially if they haven’t used it before. Luckily with all the people wearing Libre’s they seem to be loosening up about it. I know at least 3 cat owners get their Libre script filled for their cat at Costco. You can join their free Pharmacy plan (you might have to be a Costco member) and get the 14 day sensors for $39 each. They have a program for the cheaper rates if you don’t have insurance that covers something or have a high copay insurance. Animals qualify. But it is an added on cost. And it can’t replace testing, it can cut down on it sometimes, but not replace.
Same with insulin, you can get the coupons from the manufacturers sometimes. Just use the name and your last name and their age. If you know someone that uses Lantus or one of the others for example, a lot of people do have extras. I’m sure there would be friends, neighbors, family members who would happily donate to the cause. It goes a long way with a cat and is good for years after the expiration. I’m sure Costco sells it cheap under their program. I have an expired Lantus new pen available now, (Mine are expired, I’ve never had a problem using expired insulin,I keep it in the refrig.)
The old insulins are hard to use, hence the high numbers. They try to have enough to deal with meals but not to have them plummet in the middle of the night. You put a Libre on them and you notice the issues right away. The NPH type insulins really have some high peaks and then drop offs. Libre 2 with alarms is great! What I did with my dog was use NPH at a lower dose and Humalog for meals and adjustments. And tested, probably at least once daily to know the LIbre was at least in a useful range. ( More if it was a funky day for her) They eat the same thing, their life is mostly the same, the insulin dose is the same and they can vary widely just like humans. Hence the vets commonly keep animals at 300’s and in fact the recommendations for dogs was between 250-300… and blindness was a given. My dog escaped that.
The Lantus or Levemir would be a better choice at consistency. It’s at least more consistent in nature than the NPH types like Pet insulins. Probably especially splitting as twice a day. There is no reason a cat can’t have more protein as a snack unless they have an already developed kidney issue ( high sugars don’t help that either) We used to give my dog green beans and a small amount of goat yogurt. I bet the cat FB pages probably have some good treat ideas for cats, I’m not sure you would get a cat to eat green beans. But protein can raise the Bg level too, so an adjustment might end up being needed.
Your friends cat is probably hungry all the time. First cats that get diabetes are usually overweight and need to lose some. But also at high sugars even with the extra insulin they really aren’t still utilizing their food completely. They say people get hungrier at higher BG levels too. So the cat is probably hungry still. And it might have been used to treats.
Expectations… This is why a lot of pet websites hate LIbre’s. I know I kept posting about my dog and how great it was to have and the moderators would come back with you still have to test and it can be wildly off etc. I never disagreed with that, you should still test and they can be wildly off. Cats and dogs systems are different than humans, so that adds a variance and we all know how wildly off a Libre can be on a person, especially the first day. The expectation of a lot of the moderators was it should be within a few points of a meter. I didn’t care! Even meters and CGM’s allowance is within 20%, which at 400 is 80 points. It told me the most important things I wanted to know. The trend and if my dog was in the 300’s or 100’s. If it tested at 300 and my dog was at 350, it didn’t really matter in my dogs world as we didn’t want her below 150 or hopefully above 250… I tested whenever I thought there was a need. If she was at 400, she needed a correction.If she was at 100, a snack. She would plummet fast sometimes and I wanted a cushion. It’s kind of like kids. Because they can’t tell you how they are feeling so you use safer numbers. I loved having the alarms on the Libre or I used to have a add on Miao Miao at first with the tomato ap.
That comes to the second problem. They like to keep animals high, really high. No eye blinks at the numbers. A super high percentage of dogs go blind within the first year because of that. Dogs form cataracts really fast at high numbers. I assume it’s the same issue with cats but I don’t know. Sure they don’t live as long as people so the high numbers don’t mean as much. But blindness and kidney issues are still very much a problem. When people could afford it they would get cataract surgery, costing around $3,000. It was common for dogs to go blind in the first 6-12 months because of the no blink at high numbers. But they do start them at a very mild dose and do adjustments very slowly to prevent lows which are obviously a problem for a pet to end up having. Then they do curves for a day, but wait weeks in between or months. But knowing what my dog’s LIbre would tell me about her daily numbers, that could be off for the everyday numbers. So they play it safe and aim for a lot higher numbers…
I included some websites, some are older but still have great information.
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Thank you so much for your comprehensive response and for sharing your experience. 
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My friend’s cat with diabetes (his name is Colter) has just been diagnosed with acromegaly (excessive growth hormone due to a tumor on the pituitary gland.) This is why his diabetes is so difficult to manage despite slowly increasing his insulin dose. There are a couple of of medications that can be used to treat this condition and his owners are trying to find a local pharmacy that can get either one. (Radiation and surgery are specialist treatments that are not available here.) If Colter responds well to the medication, his diabetes may go into remission, which would be awesome!
I passed that hint along to her so my friend will give it a try. My non-D cat Leo loves green beans, also asparagus tips and occasional broccoli floret. 
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@CatLady That would be a wonderful thing if your friend’s cat could get rid of the diabetes! Asparagus was something else I used to cook for her daily!
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Update: Unfortunately the medication is not widely available and is very expensive. So they are continuing to adjust the cat’s insulin.
BTW, Colter loves green beans and my friend now adds them to his regular meals. His glucose curve is better and he is less hungry.
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