I'm new to this and looking for some help.

Discussion in 'Feline Health - (The Main Forum)' started by Karen Mulholland, Dec 29, 2017.

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  1. Karen Mulholland

    Karen Mulholland Member

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    Dec 26, 2017
    My cat, Rocky is an 8 year old, wonderful Tabby. About 5 months ago I noticed he was drinking a lot more than usual and took him the vet. BG read 450:( He had an episode with a urethra blockage when he was 2 and came very close to dying. My vet had suggested feeding Prescription Diet Urinary Care from then on. 6 years later here I am. I mentioned the high carb factor a few times and the doc. did not feel as it would have a significant impact on his BG, which didn't make sense to me. He was started on oral Glipizide which was not helpful, since then he has gone on up to 3 cc Relion Novolin 2 x daily but changed to a mix of Prescription Diet Urinary Care & Purina Pro Plan DM, both dry formulas. His BG readings last Sunday were 450-519. (I started to do home testing because Rocky was completely freaked out when at the vet) I called the vet and he said to increase to 4cc 2 x daily. I was so upset with this issue that thankfully I got on line and starting reading info on wet vs dry foods by Lisa Pierson and the effect on BG which makes total sense. I changed him over on Monday and lowered his insulin to 2 cc 2 x daily with each feeding, 1 can of classic Fancy Feast at each with added water to each serving. He is definitely drinking less and seems better. I don't know if it's too soon to test again, but I'm planning to do it tomorrow and so hope to see better numbers. I'm very nervous about making these changes on my own and would really appreciate some guidance. I am thinking I may need to change vets.
     
  2. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    I'm in the eastern time zone, bed time and I don't use Novolin. It's never too early to test, it won't affect anything else and will give you a better idea of how he is.
     
  3. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Hi,

    I would say testing at home is a fantastic start. I would always suggest testing before given the insulin so you know he isn't too low for the shot. Especially if you have gone to a low carb food vs. the dry food. You will find that the insulin needs will change dramatically and quickly. The 2.0u maybe too much all of a sudden.

    I don't use Novolin either so I can't help with how that insulin works.

    Have you had a chance to check out the different forums and read some of the yellow sticky posts?
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Good job testing at home. Your instincts are right and it's a great thing you switched to the low carb wet food. A dr would never tell a human diabetic patient to eat lots of carbs, not sure why your vet thinks it's OK. Also good call lowering the dose as it can significantly lower bg. What are his numbers like today?
     
  5. JanetNJ

    JanetNJ Well-Known Member

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  6. Lesliejm

    Lesliejm Member

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    Dec 1, 2017
    I changed Mango to a wet food Fancy Feast classic and his blood glucose level went down tremendously that's all it took to get his lowered from the three and four hundred just changing his food the vet also told me to go on those prescription diet they are way way way too high in carbs.
     
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  7. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Karen,

    As a general rule, FDMB advocates testing before every dose of insulin (the preshot test) to make sure that it's safe to actually give the dose. (Note: no food for kitty in the 2 hours prior to preshot BG test - UNLESS he's already running low and needs the food to keep numbers up!) Also for safety we recommend getting at least one BG test per day around expected nadir time (the 'mid-cycle' test performed during the period when the insulin dose's effect is at its strongest) to check that the current dose isn't taking the kitty too low.

    As you've seen on Dr. Pierson's site, it's vital for safety to monitor more closely when changing to a lower carb food. You've already done really well with the food changeover and dose reduction BUT with the lower carb load it is possible for BG levels to continue improving quite substantially for some time after the switch to lower carb food change has been completed (pancreas gets more of a chance to rest and may start producing more insulin). Regular testing will help you build a picture of what's going on in Rocky's body and you'll be able to respond promptly to any change in his insulin needs.

    Novolin N typically has a fairly fast, hard onset early in the cycle. The FDMB guide for this insulin recommends leaving a good window of time between the feed after the preshot test and administering the dose of insulin (c. 1 hour). With the lower carb load in Rocky's new food it's even more important to leave a bit of time so that there will be sufficient glucose in his bloodstream ready for the insulin dose to get to work on. For the time being - and as best your situation will permit - I'd suggest getting BG tests quite soon after the dose is administered (e.g. +1 and +2 hours after the dose is administered), plus a BG check around the expected nadir time for Novolin N (see guide below). If you see a significant drop in BG at +1 or +2 it will give you an early warning to monitor BG closely for the next few hours to make sure that Rocky doesn't go too low.

    Tip: A lot of kitties tend to run a bit lower during the evening. A 'before bed' BG test is always a very good safety measure, and is possibly even more important when the carb load in the diet has been reduced.

    The following forum sticky will help you to learn more about Novolin N plus lots of general guidelines on treating a cat with insulin plus more specific guidelines on home testing and feeding schedules for kitties receiving Novolin N:

    FDMB Beginner's Guide to Novolin/Humulin/NPH

    Insulin doses are measured in International Units (IU). Just to avoid confusion for members reading this thread (myself included!) can you please confirm that you are giving Rocky 2 UNITS of insulin twice a day.

    I am thinking that might be a good plan! ;)

    Know the feeling well. :bighug: Obviously you'll still need to make sure you have full veterinary support for Rocky, but we will do all we can to support and assist you both. When vet shopping, try to find one whose style is more collaborative than prescriptive. A good working partnership with one's vet makes a world of difference.

    I am pleased that Rocky is already feeling the better for the food change. Fingers and paws crossed for further improvements in the very near future. :)


    Mogs
    .
     
  8. Karen Mulholland

    Karen Mulholland Member

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    Dec 26, 2017
    Thank you, I tested today and was blown away to see a reading of 97. Down from the 450-500's last week. Just switched to wet Fancy Feast Classic. My elation was short lived however, as Rocky got into a bag of Cheese Nips left on the floor of my daughters room. Next BG was 396. I was so upset (have gone over this many, many times with kids!). I will do another curve in a few days after carbs have been eliminated. I am looking into getting a timed feeder so he can have food available several times a time when I am at work.
     
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  9. Karen Mulholland

    Karen Mulholland Member

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    Dec 26, 2017
    Thank you, I will test. It's actually getting easier:)
     
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  10. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Aaaaaargh! Contraband!!!!!! :eek:

    Naughty kitteh, Rocky. :p


    Mogs
    .
     
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  11. Karen Mulholland

    Karen Mulholland Member

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  12. Karen Mulholland

    Karen Mulholland Member

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    Dec 26, 2017
    Thank you so much for your input. I assume the nadir time for his type of insulin is 6 hours after the shot as I was told it was a 12 hour formula? Thanks
     
  13. nmveasey

    nmveasey Member

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    Nov 15, 2017
    Progress! It will continue to get easier.
     
  14. Karen Mulholland

    Karen Mulholland Member

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  15. Karen Mulholland

    Karen Mulholland Member

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    Dec 26, 2017
    Yes, I am giving Rocky 2 units of insulin 2 x daily. Thank you for the addition information. I have my reading cut out for me:)
     
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  16. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    In the Novolin guide you should find information on the period where nadir is likely to occur in most cats receiving that insulin. However ... Every Cat Is Different (ECID): some may nadir earlier than the average, some later. The daily BG test data you gather will help you to learn Rocky's pattern of response to Novolin N.

    As you may have noticed, the majority of members here have links to spreadsheets in their forum post signature lines. The spreadsheets are a fantastic tool for tracking and understanding how a cat is responding to insulin treatment and they are a tremendous aid to improving BG regulation.

    If you set up a spreadsheet to record Rocky's BG readings it will help you to learn his individual pattern of response to insulin. It will also help members here to offer you better suggestions on how to improve his regulation. Most important of all, it will help you to keep Rocky safe on insulin. :) Here are the links with instructions on how to set up and understand the spreadsheet:

    Setting up an FDMB Spreadsheet

    Understanding the Spreadsheet Grid

    If you get stuck just holler and we can find someone to do the initial setup for you.


    Mogs
    .
     
  17. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Novolin usually hits it's peek about 4-5 hours after injection. So getting mid cycle tests between 4-6 is best
     
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