07/07, Lilly, AMPS 603 - can I give Lantus and novolin

Discussion in 'Lantus / Levemir / Biosimilars' started by catman13, Jul 7, 2018.

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  1. catman13

    catman13 Member

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    Jun 29, 2018
    Tested Lilly this AM before the shot and she was at 603.
    Is it okay to give novolin N along with the Lantus in instances like this to kinda quickly drop her blood glucose from 600+?

    Doesn’t have to be a regular thing but just to avoid situations where BG is this high.
     
  2. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Good job getting the SS up and going! :)

    You can give R and Lantus together but you might want to get some more data first to understand just where her onset and her nadir is. it is important to know where her nadir is so that you don't have the nadirs coinciding together. Try to get some +2's to see if the onset is starting there. And when you do use R with the Lantus the first time, put up a question mark so that someone with experience using it can help guide you with the dose. You will need to test her every hour on the hour for about 4-5 hours after using the R to see how she is going to respond to it along with the Lantus. It can make things worse if too much R is giving and they drop more than 100 points, you would set her up to just bounce and stay high. It's a real art of balancing the two.

    Also, it looks like you are missing some pre shot values. Maybe you just forgot to put them on the SS. Please always get a pre- shot number as you never know when she might surprise you and be low.
     
  3. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    The quick but dangerous answer is yes, you can used N and a depot insulin together. The longer answer is you need a lot more data with regard to using Lantus. You also would want to have someone who has considerable experience guiding you when you start out using a basal (Lantus) and bolus (N or R) insulin combination.

    There is considerable risk with combining insulin. The risks are higher with N than with R due to N having a later nadir than R. You do NOT want to have overlapping nadirs since this could easily put a cat into a symptomatic hypoglycemic episode. You have to run curves on both insulins until you have a firm grasp on how the short acting insulin works in combination with a long acting insulin.

    From your first post, you indicated that Lilly was getting 2.5u of N. What you're struggling with is that her dose of Lantus is too low --- you could have started at the same dose of N. Rather than adding N to the mix, it may make more sense if we "fast track" the dose. I'd like to see others' response, but it may make sense to follow TR and increase every 4 - 5 cycles until you see some movement in Lilly's numbers.

     
    Dyana likes this.
  4. catman13

    catman13 Member

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    Jun 29, 2018
    Ok so based on your answers I’d rather go with the TR plan rather than mixing the two.

    I’ll keep track of BG levels and update once I have a better picture ..
    seems that her BG is back down to 433 after 3h.

    Thanks both for the advice ... really helpful
     
  5. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Dec 31, 2009
    Is she still eating dry food?
     
  6. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    After looking at the as I wondered about the dry food too.

    Is lily eating dry food at 22% carb on a regular basis? Or is it just the contraband she gets her paws on?

    A recent experience taught me a very valuable lesson, we were away on vacation and a friend ,house/pet sitted for us, George was recovering from dental surgery, he was very poorly, he's been in remission for two years, since his FD diagnosis he's been on a strict LC wet diet, and so have my 3 other house cats and two outdoor farm cats. Whilst we were away I got the petsitter to feed the outdoor cats kibble, leaving it on a window sill out of reach from George, or so I thought......
    In his recovery his bag was doing really well low blue/green, until one morning when my friend tested him and he was in red numbers, she contacted me in a panic. After talking to her we concluded that when she had let him out into the yard he must have got into the kibble, he was placed under house arrest and low and behold his big returned slowly back to normal without the need for insulin.

    Long story short, even the occasional kibble could be playing havoc with the numbers. In your shoes I would try to transition the other cat onto a low carb wet diet, in the long run it will be healthier for your civie, if he's a real hard core kibble addict, then it might make sense to look at a low carb dry food, there are some out there, then at least it won't mess up Lily's numbers to the same extent.
     
    Jill & Alex (GA) likes this.
  7. catman13

    catman13 Member

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    Jun 29, 2018
    That’s good to know.

    The previous dry food we had was W/D with 47% carbs.. when I found out I switched to nature’s valley instinct which is high in protein and lower in carbs (22%).

    Lilly eats the dry food when she’s hungry but I feed her low carb wet food 3 times a day to avoid having her resorting to the dry food.
     
  8. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    If you can not transition your civvie to wet food, look into Young Again Zero Carbs dry, only available online. It's pricy , it very calorie dense and an average size cat only eats about 1/3 cup daily so it is more economical. It will save you in the long run to get Lilly in better numbers using less insulin.
     
  9. catman13

    catman13 Member

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    Jun 29, 2018
    I’m impressed, I didn’t know there was 0 carb dry food.
    Actually price is a bit cheaper than the instinct that I have now. Thanks!!
     
  10. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    The Young Again isn't really zero carb, but it is low carb....but a lot of people have complained that it really makes their poop stink BAD.

    Another option is Dr. Elsey's Clean Protein (about 5% carbs)….so far I haven't heard anybody have the problems with stinky poo like they do with the YA

    You can get Dr. Elsey's at chewy.com
     
  11. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    It's is less than 1 % so it can be called 0%. I have not had issues with stinky poop.

    ETA: My boys only get 1/2 to 1 tbsp. a day and that is in the middle of the night so I don't have to deal with raw food in the middle of the night.


    PS : If you order it, make sure your do get the Zero one for diabetic cats. There are several formulas.
     
    Last edited: Jul 7, 2018
    Reason for edit: PS
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