Feline Diabetes Canada

Canadian Information

This article provides information on Meters & Test strips, Syringes, Low Carb wet food choices, insulin and supplements for Canada.

IMPORTING DIABETIC SUPPLIES INTO CANADA

In order to import diabetic supplies into Canada, a Customs code must be used in order to avoid paying Canadian Duty & Taxes:

• The Canada Customs Code for importing diabetic test strips and syringes is 3822009010, HST Code 56
• The Canada Customs Code for importing insulin is 3004-31.00.10 – Schedule D Drug
• The code needs to be clearly indicated on all shipping documents
• If you are charged tax and customs duty by mistake, you may obtain a refund by writing to your local Canada Border Services Agency (refunds take about 30-45 days).

 

METERS

Below, in alphabetical order, are some meter choices that have proved to work well and provide accurate results.

AccuChek – Aviva
The AccuChek is an easy to use meter that does though need a larger blood sample than many of the others. It does let you “add” more blood to the sample if not enough was taken with the first (as long as you do so within 5 seconds of the first sample).

Bayer Contour
Like the AccuChek, The Bayer Contour requires a relatively large 0.6ml sample of blood. It is however a good and accurate meter.

Nova Max Plus
The NovaMax Plus meter tests for glucose and also for blood ketones (separate testing strips, which are quite expensive, are used for the ketone testing). A very small blood sample is needed.

ReliOn Micro/ ReliON Confirm
The ReliOn Meters are available at Walmart. Both the Micro and Confirm meters in particular give accurate readings and only need a small blood sample. Both the meters and more importantly the test strips are very reasonably priced

The following two meters have shown problems with false readings for some people. For this reason, it is recommended to choose another meter for testing your cat.

Freestyle Lite
The Freestyle Lite has shown to provide results that are much lower than reality in some cases. It tends to be more accurate towards the lower/normal BG range. In mid-high BG numbers though, it can read significantly lower.

Walgreen “True” line of meters
As with the FS Lite, the “True” meters can read significantly lower than reality, especially for mid to high range numbers.

 

SYRINGES

Some suggested syringes are:

• BD Ultrafine, 3/10cc-0.3ml U100 syringes with half unit markings
– Make certain to get the syringes with half unit markings (they also exist with full unit markings)
– Available without a prescription from any pharmacy
– May be available in packs of 10, more often in boxes of 100
– Only available in short (5/16”) needle lengths
– Best prices are usually found at WalMart or Costco

• Monoject 3/10cc-0.3ml U100 syringes with half unit markings
– May be ordered from American Diabetes Wholesale(ADW) .
– Shipment is done through Bongo : Use the customer service tool on the Bongo link to check shipping and brokerage costs before you place your order.
– Confirm that the syringes that you are buying do have the half unit marks

• ReliOn (Walmart) 3/10cc-0.3ml U100 syringes with hal unit markings
– Syringes may be purchased in US border cities
– SKW 81131-0311-66

U-40 syringes for U-40 insulin are only available from veterinarians in Canada; they may, however, be on-line via ADW or other sources.

• Note: Prescriptions may be required by some US based on-line sources.

FOOD INFORMATION

Important: If your cat is on high carb wet or dry food, please see the sticky Detoxing your Cat from High Carb Food under Starting TR for information on how to transition your cat to 100% low carb wet food safely.

Please see the information in the stickies Calculating Carbs – Carb Calculator under Starting TR, and Choosing the right low carb canned food under Food & Felines in the Knowledge Centre for more information on selecting the best food for your cat.

Below is a list of appropriate low carb foods and their dry matter carb content in %:

Note:  Fancy Feast has been changing recipes – please double check the carbs before buying!

Fancy Feast:
• Beef and Liver Feast, 85g………………….6.8%
• Turkey and Giblets Feast, 85g…..…………6.8%
• Tender Beef Feast, 85g……………….…….9.1%
• Salmon Feast, 85g………………………….9.1%
• Seafood Feast, 85g………………………….9.1%

Hounds & Gatos
• H&G Chicken…………………………………………………..2%
• H&G Lamb/chicken/salmon…………………………….3%
• H&G Lamb/Duck Liver…………………………………….3%

Feline Cuisine:
• Beef Banquet Dinner, 85g,………………….9.1%

Compliments Happy Tails:
• Liver and Chicken Dinner 156g cans………8.2%
• Prime Entrée 156g cans…………….….……8.2%

Compliments Ultra Gourmet:
• Mixed Grill Pate 85g can…………………….9.1%
• Turkey and Giblets Pate………………….…6.8%

Finicky Cat Gourmet Pate:
• Liver and Chicken Dinner 85g……………..9.1%
• Turkey and Giblets Dinner 85g…………….6.8%

Newmans Own Organic 95% – Make sure it is the 95%
• Newmans Own Organic Turkey……………….…….0.8%
• Newmans Own Organic Turkey & Liver………….1.0%
• Newmans Own Organic Chicken & Liver…………1.3%
• Newmans Own Organic Chicken……………………..0.9%

Special Kitty Select:
• Liver and Chicken Dinner, 85g…………….9.1%
• Gourmet Chicken Dinner, 85g……………..6.8%
• Turkey and Giblets Dinner, 85g……………6.8%

Raw Food

Feline’s Choice (a division of Feline’s Pride), a top quality, ready made, bone in raw food is available in Canada.

Acceptable Treats

Pure Bites Turkey and Chicken are good choices for your cat; the Duck is high in fat, and the other flavours are either fish or vegetable.
Benny Bully’s:  Note: The Sweet Potato Chips are NOT suitable for FD cats.

INSULIN

Please see Insulins, Starting Scales & Dosing Criteria under Starting TR in the Knowledge Centre for full information on the different insulins.

OTC/Over the Counter Insulins: Lantus, Levemir & NPH

In Canada, human insulins such as Lantus, Levemir and NPH are available OTC (over-the-counter or without prescription) in any pharmacy. WalMart and CostCo usually have the best prices.

Lantus & Levemir

Lantus and Levemir are long-acting insulins, and are better adapted to cats than NPH, which can cause sharp drops and quick spikes in blood glucose levels.

Both are available in 10ml vials, pens or cartridges.

The 3ml cartridges (sold in packs of 5) are recommended as there is less waste vs. the vial which may lose potency before all insulin is used.

If you are unable to find the cartridges, the pens can be used with 3/10cc-0.3ml U100 syringes with half unit markings: the rubber stopper at the top of the cartridge is clearly visible when you remove the pen cap.

NPH

NPH is available in vials, and is dosed using 3/10cc-0.3ml U100 syringes with half unit markings.

Prescription Insulins: Hypurin Bovine Protamine Zinc, Vet Insulins (Caninsulin, ProZinc, Summit Bovine PZI):

Hypurin Bovine Protamine Zinc

Hypurin Bovine PZI is the only manufactured Bovine PZI insulin available in the world today. It is manufactured in the UK and available in vials only.

Importing Hypurin

A 3-month supply of Hypurin may be imported into Canada for personal use (cost +/-$70 per 10ml vial). See Importing Diabetic Products at the beginning of the sticky for the Custom Codes necessary. Note that Canadian taxes and duties apply to insulin when purchased for veterinary use.

Depending upon where you live in Canada, delivery takes about 3-4 days. Shipping is via FedEx in a Styrofoam cooled by ice packs, and costs around $85. Despite the shipping and custom costs, Hypurin is a cost effective insulin.

The official information and text that allows the import of Hypurin is the following:

Health Canada Personal Use Importation Requirements for Human Drugs (Schedule D Drugs) (drugs derived from Human, Animal or microbial sources, such as insulin and blood based products), see Figure 2. Personal Use Importation Requirements for Human Drugs.

Individuals are permitted to import a single course of treatment or a 90-day supply of a prescription drug based on the directions for use as specified by the prescribing physician. The drug must be shipped/carried in one of the following; hospital or pharmacy dispensed packaging, original retail packaging; or have the original label affixed to it which clearly indicates what the health product is and what it contains.

Health Canada’s Policy states that an “individual” (not a vet) may import scheduled drugs into Canada as long as they are not for resale. It therefore is possible for you, as an individual, to import Hypurin without going through the Health Canada’s Special Access Program (SAP). However, your vet MUST go through the SAP if they are importing Hypurin as they are reselling the insulin. As most vets will not want to deal with the amount of paperwork required by the SAP process, it is important to make sure that they understand that if they provide the prescription, you can import Hypurin yourself (some vets may make you pay a fee for the prescription).

Concerning the amount of Hypurin that you can order at one time, Health Canada states: So as not to interrupt a course of treatment, Health Canada permits enforcement discretion to permit Canadian individuals to import the lesser of a single course of treatment or a 90 day supply of prescribed drugs packaged in pharmacy or hospital dispensed packaging or with other evidence that the patient is under the care of a physician (i.e.: a prescription). The individual can only import for his or her own use or for a dependent (your cat) under that individual’s care or guardianship.

Note that Hypurin does need to be shipped directly to you (and not to your vet) in order for it to be considered for individual use.

The label on the package should note that it is for veterinary use.

For more information or any questions, Fazal Lockhat (416-973-4022- direct line) is the Border Integrity Specialist for Health Canada’s section that handles importing of Schedule D drugs fazal.lockhat@hg-sc.gc.gc .

Ordering Hypurin

Julie Emms at Masters Global, (Toll Free 1-800-969-1152) has handled shipments of Hypurin to Canada, and has all the paperwork necessary for its import (the documentation is included with the shipment).

The prescription that you send her will be kept on file for the year.  Unlike most countries, for Canada you can fax that, rather than having to send the original by post. If it is a renewable prescription (do ask for that), you will be able to re-order without going through your vet.

To start, you can base yourself on one vial per month, or 3 vials for the 90 day “legal” period (ordering more vials at once is cost efficient in terms of shipping costs). It is considered normal to include one extra vial to the order in case a vial is damaged in transit, or you happen to drop a vial at home, as insulin is a life-saving medication that is required daily : Insulin is a life-saving medication that is required on a daily basis.

Again, it is important to make sure that your vet understands that ALL they need to do is to provide the prescription. You will handle the ordering and delivery yourself.

Should your vet want the ordering and delivery to go through them for some reason, they will have to go through the SAP programme, which involves a $50 permit fee for reselling the insulin (along with shipping, duty and vet mark up costs for you!). If your vet insists, this link provides the forms that your vet will need to fill out the SAP Form.

Caninsulin/Vetsulin

Caninsulin is available in vials or in pen form.  While the pen will dose 0.5u increments (unlike the pens for the human insulins, Lantus and Levemir, which dose in 1.0u increments) you will need to use syringes to dose the smaller increments used with TR, if that is what your vet has subscribed.

Caninsulin is a U40 insulin, so does require the conversion if you use 0.3ml U100 syringes with half unit markings to dose it. Please see the Converting U40 insulin to U100 syringes under Useful TR Tools & Tips in the Knowledge Centre for more information.

Summit Compounded Bovine PZI

Summit Vet Compounding Pharmacy compounds a bovine PZI insulin. As it is compounded, differences in batches can occur – it is not as stable as the manufactured Hypurin, there can be differences between batches. Summit Bovine PZI exists in U40 or U100 strengths. There have been problems in the past with Summit when they have been unable to source the pancreatic materials needed to compound the insulin, meaning that it has been unavailable at times.

Please see the Converting U40 insulin to U100 syringes under Useful TR Tools & Tips in the Knowledge Centre for information on how to dose the U40 strength with U100 syringes.

ProZinc

ProZinc, which has been available in the US since 2009 has now in 2015 been made available in Canada also.  It is a vet insulin that was originally created to replace manufactured bovine pzi insulins.

Please note that ProZinc is a U40 insulin, so does require the conversion if you use 0.3ml U100 syringes with half unit markings to dose it. Please see the Converting U40 insulin to U100 syringes under Useful TR Tools & Tips in the Knowledge Centre for more information.

SUPPLEMENTS

Below you will find information on how to order certain supplements that can help our cats.

Many supplements will contain ingredients that are not good for our FD cats, please do check the ingredients before ordering any supplement. They often contain rice powder or hidden sugars.

Good sources of supplements are HerbsPro, Vitacost, (note delivery times may be up to 3 weeks or more for Vitacost).
Specific supplements that have been checked and are recommended are:

• Vitamin B complex Equate Brand : WalMart
• Vitamin E capsule Equate Brand : WalMart
• Salmon Oil: Gold Seal Salmon Oil capsules – Available at most pharmacies
• Taurine: Quest L-Taurine
• For making raw: Windsor Lite salt – Available at most grocery stores.e

Sub-cutaneous Supplies

Buying SubQ fluids can be very expensive… and cost to ship, because of their weight, is expensive also.

It is possible to ask your local pharmacy if they are willing to order subQ fluids for you: the product code for a 500 ml bag of Lactated Ringers – intravenous fluids and electrolyte replenishment, NaCl 0.9% Sodium Cloride, manufactured by Baxters is JB1323 – DIN00060208.

Last update:  Sep 16

 

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