Megan is trying to go on a honeymoon....but

My apprx. 12 yr old kitty Megan has been a well regulated diabetic for 7yrs until the past 6 mths. I'll try to take this very long story and get to the point. After a hypo episode (the first since diagnosis 7 yrs ago). The emergency doctor I brought her to, tried 1 unit of Humilin N (which was too much and brought Glucose down to 60). They decided to dilute it down to .25 Humulin N given as 10 units once a day. This did nothing and her BGL went up to 500 and she started losing weight and developing severe neuropathy. My regular vet is not fond of diluted insulin, he says it loses it's effect within a few weeks He tried 1 Unit of Lantus once a day, which after a few days of promising results, she just had another seizure. My question is, does anyone have experience with smaller than 1 unit doses, and how do you measure it, or have you had good results with dilute insulin?

Thanks,

Ruth

 

BD makes syringes with 1/2 unit markings. Hope that helps

dana

 

LIlly, the manufacturer of the Humulin family of insulins (R, N, L, U and combinations of N and R), used to make a diluent but but stopped years ago. I recal that N can be diluted but the mixture is not good for more than a few days.

N and Lantus are typically twice a day insulins with N approaching three times a day. No wonder Megan was not doing good with one a day N.

Many cats are on less than one unit twice daily. You just use syringes marked in 1/2 unit increments and estimate between the 1/2 unit markings. One of my cats is on about 0.2 units N twice daily, another on about 0.3 units U twice daily. One on about 0.4 units Lantus twice daily and another on 0.7 units Lantus twice daily. The other in on about three units Lantus.

 

which insulin are you using? if you are using lantus - have you gone to the lantus ISG? have you read the instructions there?

Many of us on that board do micro-dosing and are very successful with it. come over there and see. also look at my ss and you'll see that I micro-dosed, by following the protocols of lantus.

 

I give one drop of Lantus twice a day. This is how I do it:

1. Draw insulin up to the .25 line
2. Squeeze out 1 drop at a time into the sink - usually it's 3 drops in .25 (depending on the syringe)
3. Draw insulin up to the .25 line again
4. Expell 2 drops
5. Shoot the rest into Boomer!

Easy.

 

Are you testing at home?

 

I haven't had to, til now. I am unemployed at the moment, but once I get a job, I wouldn't be able to do it. She's at the vet right now.

 

I disagree with your logic

You test prior to shots and it takes a minute. You do spot checks when you are home, and do a curve on a day off...

You HAVE needed to test prior to now, you just haven't known it. You have no idea how your cat's bg levels have been on a daily basis. This recent example shows just how important it is to test, and we can help and it doesn't have to make you broke!

Jen

 

Okay. Is there a board on here dedicated to micro-dosing? She need less than a unit each dose.

Thanks,

Ruth

 

Lots of people dose less than a unit, and I think there have been some responses for you on the subject. We can help you with the testing and the dosing...

 

You can get U100 syringes with .5 unit markings.

The PetDiabetesWiki also has an article on small doses: http://petdiabetes.wikia.com/wiki/Small_doses

 

where are you located? if you need help learning how to home test, we can help with that - and there may be someone close by who can help in person too.

do you know how to maneuver through the different boards?

click on board index and you will see the listing of all the boards - the information you need is located in health links - for home testing

and if you are using lantus - please go to that board and read all the starred information there - you need to give lantus twice a day (BID) 12 hours apart and the only way to know for sure how much or how little insulin to use is if you do start to home test, the people on the lantus board can and will help you with micro dosing - but they can only help if you are willing to learn to home test.

And it's not expensive - you can request a free starter kit AND you can pick up an inexpensive meter, strips, etc from Walmart - buy the relion brand -- they also sell the 1/2 unit marked syringes too - about $13 for 100.

by any chance are you testing for ketones? That's done with a ketostix dipped in cat's urine...again can pick this up at pharmacy.

 

I'm in Phoenix. I haven't been checking for Ketones. I've been very fortunate. Megan has been fine for 7 years, with visits to the vet for pre-insulin checks, and a curve done a couple times a year. I know I've been lucky. Well it appears the party is over. She now needs micro-doses, and home testing. My vet mentiond that I need a meter calibrated for cats, yet it sems most people on the board use human meters, I'm trying to sift through all the info, and I am ready explode. If anyone is in Phoenix that can help, I would appreciate it.

Ruth

 

We use human meters here for the most part. They are just fine. I went and got the wal-mart one myself, I'm very happy with it, price and performance wise.

There is a lot of information here, I felt the same way. Take a few deep breaths, slow down a bit, post in Lantus where lots of people will help you learn to test, how to measure the doses, etc.

My guy is moving towards tiny doses and I'm a little nervous about doing it, but the people here have helped me out so much already and Tugger has come so far, I won't let that stop me, I'll figure it out :smile: (I really like the suggestion above for measuring drops, oh how I hope I don't have to do that though)

While you are unemployed is the perfect time to get a handle on things. You'll need to get lots of spot checks to see how his insulin works in his body and learn his patterns. You'll have the time to learn and focus on getting it all routine, so that when you go back to work it will be no problem. You'll know how your cat reacts and you'll know what to do if he goes low and you'll have people to advise you when you don't know what to do.

Lots of smart folks here and everyone working towards the same goal of healthy happy cats =)

 

Deanie is an excellent phoenix resource and I will try to flag her tonight

 

Thank you for all the suggestions. My vet is nice, and is helpng me at no cost after I ended up spending $2000 at the emergency clinic (he was out of town). But he and the 2 vets I've spoken with, don't have much experience with micro-dosing. He is leaning towards Humulin N in small doses. He is testing a 1/2 unit now. The good news is all her other blood work is great for a 12 year old cat and he even did an ultrasound to rule out any underlying conditions. But she has lost a lot of weight and has bad neuropathy. I am aware of using Xobaline, but we need to get her regulated.

 

Hi, Ruth. I'm located in central Phx. I'm kind of busy with work today and tomorrow but we can talk on Thursday if you like. I'll send you a PM with my phone number.

 

What part of Phoenix are you in? There's quite a few of us in the Phoenix area. If you're actually IN Phoenix, Deanie's most likely closest. :smile: (I'm in Chandler.)

You can definitely hometest with a human glucometer.. we've all been doing that on this board for many years. (some for at least a decade!)

 

Thank you. I am in Central Phoenix,and Deanie did contact me.

 

I'm sure most know this already, but I use Freestyle Lite Meter and I buy strips from Ebay - I have been able to get good deals - even with the BUY NOW option. I paid $40 for 100 last week.

 

As this emergency is no longer an emergency - would you mind removing the 911 icon from your original post. This will help others when looking here that this is no longer an emergency situation.

Regarding meters, I had the same discussion with my vet - who at first forbade me to home test and then told me I could only do it with the animal meter. I researched, even called Abbott labs who make alpha track (animal) and freestyle (human) and couldn't get a clear answer as to why alpha track is better for a cat than a human meter.

So, I used the one touch ultra and mini meters and were happy with those.

If cost is an issue - then go to walmart and pick up the relion brand - those are inexpensive meters and strips and require a small amount of blood to test with.

I don't know how easy it will be to micro dose with N. If you are currently using Lantus (and I think you are) - there is no need to change insulins. You can very easily micro dose with lantus - come over to the lantus board and read the posts there.

and start posting yourself and you'll get all the help you need!

 

Hi,

Megan has always been on Humulin N (3 units bid for 7 years). She was adjusted down to 2/2 about 6 months ago. Then she had her first emergency, last month. Once she was stabalized. The Vets at the Emergency clinic gave her 1 unit of Humilin N and her BGL went too low. They then came up with the idea to dilute it, which worked for a couple of days, then just stopped working. My regular Vet discussed her situation with an internist who reccommended Lantus. At the Vet she tested well for 3 days, on the 4th day (when she was scheduled to go home), she crashed. She was only getting 1 unit once a day. And she crashed around noon, after having a BGL pre insulin of over 200. Her Pancreas can't decide if it wants to work or not. That's why we're thinking a shorter acting insulin will be better,since her swings are so sudden. It's really scary, because all incidents happened around noon, and she only got the insulin at 8am. Her pre-inslulin showed she needed it. I'm unemployed now, but when I go back to work, this will create a huge problem. I couldn't live with myself if she had a seizure and I wasn't home.

 

Ok, the reasoning is wrong for going with a shorter acting insulin than lantus. Lantus has a much gentler action, so if your cat is prone to hypos, N is NOT the right insulin.

Do you still have lantus at home?

My suggestion is this
1. work with Deanie as soon as she's available
2. use lantus and not N if you have the lantus
3. give her a day off insulin after a hypo, at least. She needs a day or two for everything to settle down
4. read about hometesting, diet, and the various insulins and how they work - see the faq and the pet diabetes wiki
5. when dosing, dose very small amounts using syringes with 1/2 unit markings. do NOT dilute N with saline. This can only be done at hte time of dosing and is not meant to be done ahead of time.
6. TEST TEST TEST. Test prior to injecting and then get frequent spotchecks to see what is going on.
7. if using lantus, the rules are different than with N regarding dosing, changing doses, etc. so let us know which insulin you decide to go with.

I know this is confusing but honestly, we can help you through this.

 

The Lantus is at the Vet. He has been consulting with a Board Certified Internist. So, I am in a difficult situation. He wants me to use a animal glucometer, you guys all use human, he suggests going back to Humilin, you say Lantus. I don't know how much to fight him on this. He is keeping her at the hospital right now at no charge, due to my unemployment. I just want to scream.... I am going to speak with Deanie tomorrow.

 

I understand completely, I really do.

Being at the vet has pros and cons. The pros are that she'll be closely monitored (is she monitored over night?) but the cons are that vet stress can inflate blood glucose levels, causing them to rise and it to appear like the cat needs more insulin than they really do.

I do not understand the vet's choice of N over lantus, I really don't. There are others who can point you to great studies and documents on the action of lantus.

As for the pet glucometer vs human, there is very little difference in the results of testing done with each, and the cost is way more affordable for a human glucometer. Vets all over north america use human glucometers....

Deanie has a great vet, and is in the medical field herself. I'm certain she'll be able to help you.