? Newbie, wondering about feeding schedule with Novolin N

So as I stated in the introductions, Storm was diagnosed beginning of the month with his level at 442. We started on Novolin N, U100, (we had a surrendered kitty about 6 months ago started on this as well who past; other health complications), and the vet taught us how to give the shots. Big step for me since I hate needles, but for the little ones,....whatever it takes. Started at 2 units for the first week, twice daily and the vet said to feed him right after we give him his shot.

I'm reading here on the board that we should be feeding him well before his shot, (hour or 2 before?). Could someone please provide a little guidance on feeding our big boy. He's 28lbs btw. Also how should we be feeding him throughout the day. Normally he free feeds with dry that is out, but we have been cracking down on the dry food. We have been trying to keep him full with wet food so he stays out of the dry that is out for the other cats, but I'm beginning to think this might not be a good course of action.

Really beating my head against the wall trying to get everyone off the dry or at least make it so Stormy can't get the dry food.

Yesterday Storm was re-tested at the vets and he was down to 391, 5hrs after his AM injection.

I previously posted this in the ISG, but understand from reading that isn't used regularly anymore. Figured more eyes here.

 

You only need to wait at least 30 minutes, that is what I do.

Welcome.
Good insulin are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI. For those two human insulin it is best to get the 5 pack of 3 ml disposable pens via a 10 ml vial. Although per ml the vial is less expensive most cats will not use up a 10 ml vial before the insulin goes bad/becomes ineffective. The human insulin N/NPH is sometimes prescribed but only lasts 8-10 hours. Same for the pet insulin Vetsulin/Caninisulin.
Most of us here test or cats blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
What are you feeding? A low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned

http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/

Here is a link to home testing blood sugarshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

Thanks for the links, Larry.
Yes I have reviewed the list of low carb canned foods and we have a lot of those in our cat food pantry, (or as I call it, their bomb shelter). We rescue and foster for a local shelter so my wife stock piles when she finds canned food on sale.

I have also been reviewing the procedures for testing in home. I understand how helpful it will be to keep Stormy happy/healthy, but it's a very intimidating task to to me.

 

I have one that I just found out has diabetes ..I have done a lot of research. #1 kitty needs to be on high protein low/zero carb food. If you continue to feed a high carb diet it is putting fuel on the fire. After a lot of research I found Young Again zero carb dry cat food. All 6 of my kitties are now on it. one weighs 24 lbs and his sister is the one with diabetes. if you would like goto the young again website it has a lot of info and they are on FB and answer questions and give lot of info and reseach that has been done

 

plus it is important to do at home blood sugar tests to make sure they don't get hypoglycemia

 

Thanks, I have looked into the YA food and with my household, I would go broke. I have been reading up on the home testing and realize that is something I really need to learn to do it. I just so darn intimidated by the home testing. I plan on learning as much as I can and go from there. Thanks !

Oooops! 7pm, time for Big Storm's shot!

 

Newly diagnosed here too, you will be surprised how easy the home testing is! I thought my Hunny would be impossible, but I think he knows I am trying to help him. This forum is awesome, everyone is so helpful and give positive feedback! Read, read, read! I spend lots of time on here taking notes, picking up tips.

 

Thanks, dear. I too am impressed with the forum. I always say, when the wife and I are in the grocery store, we meet the nicest people in the pet food isle. I'm sure it holds true here.

Glad to hear Hunny is good with the home testing. There have been a number of times when we have been rescuing kitties that I think a number of them know we were trying to help them when they were ill/injured.

 

Cats on YA cat food don't actually cost more. They don't eat as much of it as they do the 'grocery store' dry foods, which have stuff cats shouldn't be eating...they crave more of the more common dry foods, because the protein in them isn't as usable. But with the YA, they're internally satisified with what they get from the smaller amounts of ya.

Think of it this way. Us beans love hi-carb foods...we eat them...but we get cravings to eat more. It's what gives us problems with obesity, and diabetes, and a host of other nasty human ills. That's because the high carb content of our junk foods, actually MAKE us hungrier. So we pig out and eat more.

Same goes for our kitties..all the non-essential carbs in grocery store dry foods, make the cats hungrier. So they eat more.

It's just the sticker shock from ordering the bag, that very first time. The costs do balance out.

And then, if you consider the increased dosage of insulin you'll need for your diabetic cat if he gets into the bad stuff, and the possiblity of your OTHER cats becoming diabetic, from eating junk dry, as well as other health problems..you'll be at the very least breaking even with the cost of grocery store type dry foods.

Switching to YA, even for a short time, until you can get all your guys off the dry, would be a good idea. Even if it's short term. I have noticed that Dottie actually eats very little of the dry, (I do make sure she gets at least two meals of wet food into her)...it serves as a stopgap when I am in non-functional mode and can't always supervise food intake closely..(like right now. Having a very rough week of it).

 

Oh I understand the logic of the better food, it's just I have 16 cats upstairs right now. They can go thru a 16lb bag of Pro Plan faster than you would think.

 

Oh my goodness...then if you switch you will REALLY save money in the long run. I can't imagine two or more babies in a large cat household suddenly coming down with diabetes...having only one nearly put me in my grave. I was so disoriented at one point that I felt like a drunk who hadn't slept off a previous night's binge. Had trouble with a pounding heart, and kept feeling like I was going to pass out.

Know what? Since you do have so many cats...why not try for a discount? You never know... Do you have anyone over 65 in your household? Tell em you want your senior citizen's discount.

 

Another somewhat low carb dry food is Evo Cat and Kitten (get the poultry version). It runs about 8-12% calories from carbohydrates.

 

Evo is better on price as well.

 

Thanks, I had them on EVO a few years back before the recall they had on their food, or actually the packaging if memory serves me correct. I did go and buy a 6lb bag on Saturday to try and feed him, but of course everyone else has to have a taste. Still at $48 per 15lb bag with these chow hounds.... I know, hard to put a price on the well being/health.

BTW, Stormy was tested at the vets today and he was down to 319. Raising him up another unit. We're getting there, (he was first tested at 442).

 

I don't know a lot about FD as I am new, however if Stormy is newly diagnosed and I am guessing he is because your avatar says you joined on March 8,2016. I would think raising his dose by one unit is crazy extreme this soon after he has started insulin. I am hoping someone will look at this and respond. Please forgive me if I am in err, I just would want to know if it were me.

 

His first raise was from 2 units to 4 units, now we are up to 5 units twice a day. He first tested at 442, then 391 and yesterday he tested at 319.

As I noted in my introduction, my avatar is of "little" Stormy, we are currently treating "BIG" Stormy, (29lbs). He's a whole lotta kitty!

 

Wow!! That's indeed a whole lotta kitty!!

I am tagging a friend to see what she thinks about the fast way Stormy's dose has been upped. Though with him being 28 lbs that probably does make a difference, though normally you only increase doses in smaller partial units rather than whole units at a time from what I have been learning.

@Sue and Oliver (GA)

 

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His first raise was from 2 units to 4 units, now we are up to 5 units twice a day. He first tested at 442, then 391 and yesterday he tested at 319.

As I noted in my introduction, my avatar is of "little" Stormy, we are currently treating "BIG" Stormy, (29lbs). He's a whole lotta kitty!

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I don't know a lot about FD as I am new, however if Stormy is newly diagnosed and I am guessing he is because your avatar says you joined on March 8,2016. I would think raising his dose by units at a time that fast is crazy extreme this soon after he has started insulin. I am hoping someone will look at this and respond. Please forgive me if I am in err, I just would want to know if it were me.



I am tagging a friend to see what she thinks about the fast way Stormy's dose has been upped. Though with him being 28 lbs that probably does make a difference, though normally you only increase doses in smaller partial units rather than whole units at a time from what I have been learning.

@Sue and Oliver (GA) @Marje and Gracie

 

I'm very fortunate to have a good vet. Been seeing him for 15 yrs now. He mentioned too about going slow, but he even said due to Storm's heft, he felt 2 units was the right move at the time of the first increase.

 

Welcome Dave and Stormy

First, you might want to take a look at Cathie’s kitty, Shaak’s Spreadsheet. She was on Novolin N as well and she is now off insulin and is finishing her OTJ (off the juice) trial. Guess what the first thing Cathie did was? She got rid of the dry food. While I have seen numbers come down when members feed the YA or the “low carb” Evo, I’ve rarely seen a cat go into remission eating it. Some cats are a lot more stubborn about the switch than Shaak was but she isn’t the first cat I’ve seen go into remission just from getting rid of all dry food. Take a look at Scooter’s Spreadsheet. Pretty evident when he kicked the kitty crack habit!

This statement is not actually correct. We have found in many years on this forum that cats actually do better with the % calorie from carbs in the 4-6% range and for some cats, even up to 10% calories from carbs. It allows you to safely get a bit more insulin in the cat to keep the numbers more level. You would have to determine what works best for him but it’s probably going to be in the 4-6% range but you also need to have some higher carb foods around (with gravy) to control low numbers.

With Novolin N, you need to feed him at least 30 minutes before his shot but an hour is better. Novolin N is a very quick acting insulin and you can tell by Shaak’s spreadsheet that it onsets fast...as early as one hour after the shot (and in some cats even faster). The goal is to have enough food on board so that when he onsets, you don’t get enormous drops because fast drops trigger what we call “bouncing”....the liver panics, releases counterregulatory hormones and glucagon, and the numbers go way back up. If you aren’t home testing, your vet will very likely miss the drop in his office and just think the numbers are high. As Cathie found out, feeding multiple smaller meals during the day works much better if you are around to do it. She, like many of us, bought a auto feeder (the PetSafe 5 is popular around “here”) and it’s great to give a small meal if you are out. Most cats take to them quickly.

Even for a heavy cat, that seems like a huge dose increase to me. If it is affordable for you to do, I would encourage you to switch insulins to either Prozinc or lantus/levemir. The latter two are the gold standard insulins for cats and they are long duration but they are, unfortunately, quite pricey these days although many of our members get them through a Canadian pharmacy for a fraction of what they cost in the US.

Well...I have an outstanding vet....love her to death...but she readily admitted that I know much, much more about managing FD than she could ever hope to learn with a very busy practice and lots of animals with different conditions to treat. While we have found in this forum that there are “some” vets out there that have a better understanding of treating FD than others, generally, they just don’t get the kind of experience we do here in dealing with FD. After all, we all live it 24/7 and some of us for years and years. Vets can’t be there to hold your hand through every single number. Most vets these days who have any knowledge of FD will start the cat on lantus or levemir, not Novolin N unless you request it or there is a financial issue.

Please let us know your questions....we all love to help!!!

 

You may also want to look at my kitties spreadsheets. Woody is the first sheet and as you notice I was reducing his insulin dramatically. He was on high carbs, but when I started his SS he was on w/d canned but had to feed dry because he was hypoing. But, the day I couldn't shoot because he was under 200 we went total Friskies pate and he's working to remission. Buzz also went OTJ he moved to Friskies much faster and went into remission quickly.

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My vet was wonderful, he just doesn't know about FD. Upping Woody's dose based on a +10 and during vet stress was enough for me to stop following his advice. I found another vet that at least listens to me.

 

My vet has traveled around the country expanding his knowledge at every opportunity. He's an Air Force vet with his pilots licence and does alot to continue his education. I have known him for over 15yrs and my wife has known him for 20yrs. I'm not saying he's the cream of the crop, but he knows how I feel about our cats and I trust him. Let's leave it at that.

He does know that my wife and I rescue and have a house full, (16 upstairs 2 kittens fostering and 2 adults downstairs), so yes I'm sure that's one reason he started us on the Novolin. I have already discussed the different kinds of insulin with him and he said he has no problem with that, but let's just stay the course right now and get Storm leveled off a bit. Heck, it hasn't even been three weeks, so that does tend to make sense.

He has 2 FD patients that have gone OTJ with diet change alone, so we are really trying to change the household over, but it takes time and some patience. Mine and the kids.

BTW, every time I look at these spread sheets you folks have, they all look Greek to me.

 

We've helped hundreds in the Lantus/Levemir insulin support group of this forum alone go into remission and there was very little, if any, vet involvement other than writing prescriptions. But he is your cat and we are here to help and support you the best we can. Just let us know how we can best help.

 

I get that and really do appreciate the input. I don't mean to offend anyone, but you know what is said about what you read on the internet. Since I'm new and really don't have any experience here, well I feel a bit more comfortable staying the course my vet has started currently.

Like I said it's only been 17 days since the discovery of Storm being diabetic. We have seen improvement in his numbers coming down already and as I learn with the help of my vet and the many members here, my wife and I hope Stormy can be one of those that can go OTJ.

 

I'm a librarian in real life, so I'm usually the first person to shout, "Don't trust everything you see on the internet!" but the advice you'll find from the experienced members here is based off reputable sources--veterinary journals and recommendations that many vets just haven't had a chance to see. Most of these are relatively recent (they came out around 2009-2010), so vets that graduated from school before that may not know the new feline diabetes guidelines. It doesn't mean your vet is a bad vet, or not to be trusted! It just may mean that he doesn't have the most current information on the subject.

Novolin is not a good insulin for cats. It just doesn't last long enough in their systems to be effective. Cats that go into remission on Novolin are usually cats that would have gone into remission on a diet change anyway--so if you've changed over to a low carb, canned diet, and you're still not getting good control in 4-8 weeks, then I would strongly recommend you then switch to a longer acting insulin like Lantus or Levemir that has good results in cats.

I'm attaching a couple documents for you to print out and give to your vet. These 2010 American Animal Hospital Association guidelines outline the basics--it recommends a low carb, canned diet, home testing, and a long acting insulin like Lantus, Levemir, or Prozinc, as well starting dose and some dosing recommendations for the first few weeks of insulin. Your vet is raising the dose too much and too fast--this could lead to a dangerous hypoglycemic episode with your cat. Insulin doses should always be raised in .25-.5u increments. If you do change to a low carb, canned diet, please make sure you testing frequently and lowering the dose as needed.

The first document I've attached below outlines the right dosing and treatment guidelines with Lantus. The second document is a direct comparison of Novolin (isophane) and Lantus (glargine). I would print all of these out to read and review with your vet!

 

If you DO end up seeing lots of bouncing on the dose increase and you think it may be time to switch insulins to a long lasting insulin, I just purchased a box of 5 pens from a Canadian pharmacy. 1500 units of insulin (about two years worth) for $163 and that includes the shipping fees and everything else. I did the math and I was spending way more money having to haul him to the vet once every 7-10 days to fix some type of issue due to his uncontrolled, erratic BG numbers and all the havoc it was wreaking on his system. The American prices are scary and ridiculous indeed ($280 for 10ml vial) but there are options if you do decide to go there.

 

I was also very skeptical about getting advice from the board. I was arguing with myself for weeks thinking how stupid it was for me to take advice from people I knew nothing about. But, when I came home finding my Woody vomiting because he was hypoing I figured I couldn't be hurting him any worse than what I was. I did my first curve on him that weekend, and talk about being exhausted. I saw that he was getting too much insulin. The wonderful, knowledgable people here held my virtual hand and helped me through this. When I took my babies back to the vet the Monday after Woody's vomiting episode and he took the BG and upped his dose 2 units to make it 15 units twice a day I was done.

Both my cats are in remission, not because of the vet, but because of the knowledge all these people have. They followed my spreadsheet and gave excellent input. The decision to follow them was mine, and I will never, ever regret following the advice on this board.

 

This board saved my Gracie’s life in the early days and taught me so much so I could pay it forward. She would not have lived as a FD as healthy and as long as she did without them.

 

For my 2 cents' worth, this board is the best of the best. If not for this board, Dottie would have been dead three days after her surgery. Finding friendly folk ready to roll up their sleeves and dive in to help, was like throwing us a life ring. I like that everyone is extremely creative with their advice..willing to look at each cat as an individual, instead of trying to fit square pegs in round holes. If a cat is lost, everybody mourns as if that cat were theirs. And when a cat succeeds, even occasionally going ...we're as excited as the owner, as well. That makes us a family. Group hug, everyone

 

I do appreciate your dichotomy. My advice to you would be to absorb the input you get both from your vets and from here, and then weigh up both in light of the observations you make and the BG data you acquire for Stormy. Ultimately you need to 'listen' to Stormy.

I would never have heard about Lantus were it not for this board. Saoirse was wretched on the insulin she was first prescribed (Caninsulin/Vetsulin) and if that had been the only treatment option offered to her I would have had to let her go prematurely because, while it may have kept her alive, she would have had no quality of life. Instead, thanks to FDMB, I managed to get her switched to Lantus and she achieved remission less than three months later.

On balance, I've learned much more about cat health issues and discovered much more effective treatments from the members here with day-to-day experience of managing feline diabetes and other conditions than I have from the vets involved in Saoirse's care. I've also learned a tremendous amount from Helen, author of Tanya's Site, and the members of their support group. I'm beyond grateful to everyone who contributes to these communities because they are helping to make my girl's life longer and better. Indeed, Saoirse would have been doing an awful lot better and might have been spared unnecessary discomfort over the last 12 months if I could have got better co-operation from my vets in some areas of her treatment.


Mogs
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If it weren't for this site, I never would have discovered Bandit's old vet was using her own dosing protocol that she developed for her two dogs, and not one for cats! I would have just kept blindly dosing him with dangerous 1u dose increases based off a single weekly curve. And she managed to get everything else right--she prescribed Lantus, taught me how to home test, and put him on a commercial low carb, canned diet. I had to teach his next vet what we were doing because she wasn't encouraging home testing, or the right insulin or diet (but she was on board with the treatments once brought her the information about it), and his old emergency vet was a nightmare when dealing with his diabetes (They were convinced that he wasn't in remission because remission was incredibly "rare" and home testing didn't work, and they got mad at me that I wouldn't let them feed him dry w/d and do in office curves and fructosamine when the reason he was there was a tail injury, NOT his diabetes). Bandit's current vet (now both our regular and emergency vet) is the only vet he's ever seen that has actually gotten all the feline diabetes treatment recommendations correct from the start.

I had to take some breaks at times deal with my own health issues, but it seems I always end up back here because it bothers me so much that the only thing that stands in the way of a lot of diabetic cats doing so much better, and in some cases it's the difference between them living long healthy, normal lives and wasting away and dying, is simply that so many vets don't have current or correct information. I just want so badly for them to get a hold of that information not just to help the cats here, but to help the rest of the diabetic cats and owners in their practice that don't end up here.

 

Agreed with everyone's previous responses. Not much to add to it except that it's always wise to question EVERYTHING you hear, read, or are told. Especially from strange people on the internet. You are correct in thinking that it is irresponsible to blindly follow the advice of complete strangers on the internet regarding the care and wellbeing of your pet without first doing your own research. These people helped me out a lot with Diego. They gave me tons of advice and ideas, and I took that and ran to old Google scholar, or rang my vet, and took it from there. However...if they hadn't have been the ones to first suggest their ideas and advice, I never would have thought of them myself until it may have been too late. It was my veterinarian who almost killed Diego, not these people.