Hello from Sashet and his mom

Hello everyone! My own mom actually was quite active on this board some years ago because of her kitty, and now here I am. Sigh. My 17-year-old boy, Sashet (or Sashi) was diagnosed yesterday, though I'd been suspecting it because I was seeing him peeing and eating a ton. Due to my mom's experience I'm not panicked, and I came straight here to open an account and soak in the knowledge.

Question for right now. The BG taken at the vet's yesterday was 400-something, and vet prescribed 2 units of Vetsulin 2x/day. But the bottle he gave me says it's Novolin NPH? (I didn't look at it till I was home.) I also just finally successfully home-tested Sashi right now and got a reading of 330 (using Bayer Contour). Is 2 units twice a day still a good idea? Should I adjust down to start, now that I'm doing my own readings?

Also, he's on 1 ml of Amoxicillin 2x/day because he has a broken front tooth, poor baby. We're not doing the surgery till his BGs are more stable, which the vet wants to recheck in two weeks. Should I worry about readings being off due to the amoxicillin at all, or is that not an issue?

If anyone has advice/suggestions, I'm all ears! Thank you so much from both me & Sashi.

 

I would not give 2 units to a newly diagnosed diabetic. You have no idea at this point how Sashi will respond to the insulin. The one you were prescribed is fast-acting and can cause blood glucose to drop quickly.

Congratulations on getting on board with home testing!! An infection can affect BG, usually raising them. Our protocol is aimed at keeping kitty safe. That's why we strongly recommend:

1. testing before food and giving AM and PM shot to make sure the dose isn't too high for the BG number
2. testing at least once mid-cycle to see how low a dose take the kitty's BG.

 

That's what I thought and why I didn't want to give him the 2 units. It seemed high, and I knew his vet reading might be off too since he was stressed about being there.

Should I start with 1 unit right now? Less? He just ate a few minutes ago, it's past his dinnertime and he let me know it. I did the test before feeding him, but since I was dithering on how much insulin to give him, I decided to let him have dinner.

Also, not sure what testing at least once mid-cycle means--middle of the day? Thanks for understanding all the newb questions.

 

I believe that with a fast-acting insulin like NPH kitty has to have a full meal on board for 30 minutes before giving a dose. Has Sashi actually received a dose of this insulin yet? Did the vet give him 2 units while he was there? If not, I recommend starting tomorrow morning with a 1 unit dose after you tested his BG and he's had a full breakfast in his tummy for 30 minutes.

Cats metabolize insulin quickly so they need to be dosed twice a day at 12 hour intervals to ensure they have some insulin in them most of every 24 hour day. Different insulins have different durations. The longest acting insulins are lantus and levemir which can last 12+ hours in many cats. ProZinc is slightly shorter in duration but will last 10 - 12 hours in most cats. Vetsulin/Caninsulin/NPH are the fastest, shortest acting insulins and have a duration generally of 8 - 10 hours, sometimes less. Mid-cycle simply means half way through the 12 hours between doses. What's more important is something called the nadir or point of peak insulin action which is when we expect BG to be lowest. When this occurs depends on the insulin, so around 6 hours for lantus and levemir, around 5-6 hours for ProZinc and around 4 hours for NPH/Vetsulin/Caninsulin.

If you have more questions, you'll get more eyes on them if you post on the main health forum. I've just given you a glimpse into the world of insulin and dosing.

 

The vet did not give him insulin, only an injection of the antibiotic. Sashi hasn't gotten any of the insulin yet because I wasn't trusting that the vet knows enough about diabetes in cats, tbh. He's a really sweet guy, but he's also not up on a lot of things (have had some other instances with him not really having an answer for pet issues). I have little choice here as I live in the boonies, and in fact this vet is over an hour from me and is the closest one there is, aside from the local large-animal vet whom I'd never go to anyway.

My one other concern about starting in the morning is that I'll be gone most of the day tomorrow. I know there's never an ideal time to start and sooner is better, but is 1 unit of the NPH probably low enough that I can be gone and not worry about any potentially bad response he might have to it? He is acting perfectly normal, happy, purring almost all the time as is usual for him, playful, very interested in food, doesn't even seem to notice his broken tooth. Or at least he doesn't noticeably behave like he's in any pain.

Anyway, thank you so much, @Kris & Teasel! I did post in the main forum after I realized it's the preferred place for health questions. Hope I get more answers there as well.

 

When is the first day you can be home all day? I don't recommend starting any insulin when you can't be there all day to monitor.