NOVOLIN-N

Ok. So has anyone on here used Novolin -N? Doctor prescribed this, 2 units twice daily with U-40 needles for Mufasa. But on the facebook page, 2 people have already told me its bad.

I talked to the doctor today & he says Novolin is common & prescribes all his diabetic cats that with the U-40.

I talked to the pharmacist & he said there are 3 kinds of Novolin. R, N, & 70/30 (mix of R & N). R works faster, and N stays longer. He didn't see an issue with my cat being treated with it.

I plan on starting Mufasa on the Novolin tomorrow morning with his breakfast.

Should i hold off? What do i do with the stuff i bought?

 

There are others on here who use Novolin N. No insulin is bad but some kitties do better on one versus another. There's no reason not to try it BUT I'd start at only 1 unit twice a day. Are you planning to test blood glucose at home? It's the essential tool in keeping your kitty safe. You might consider waiting a couple of days so you can learn how to test Mufasa before you start giving insulin. Novolin can act fast and drop the BG quite low, especially if the dose is too high.

 

I'm sorry to hear you have been advised that Novolin is not a good insulin for cats. Every cat is different and the best insulin for them is the one that works. Right now we have a kitty in our community who is doing so well on Novolin, we are hopeful for remission in the very near future. We have others using Novolin N and they are doing fine too. In some cats, Novolin N doesn't last as long as some other insulins and it can drop BG fairly quickly but there is no reason not to use it and if per chance it doesn't work for Mufasa, you can always change insulin later.

**IMPORTANT**: Please check the insert in the insulin you purchased to confirm if it is U40 or U100 insulin. I believe Novolin N only comes in U100 strength....at least I am not aware of it being available in U40. This is extremely important because you must use the right syringes for the strength of insulin you are using and using U40 syringes with U100 insulin could lead to a serious overdose without the proper conversion table. If your insulin is U100 and you draw up 2 units using the U40 syringes, you would be giving Mufasa 5 units of insulin which is a huge dose for most cats and definitely too high for a starting dose.

Generally, unless your cat is particularly large, the starting dose would be around 1 unit.

 

Hi Jennifer!
I agree with what the above posters said. We are also on a fast acting insulin, and even if you read in here some people will say my kind of insulin is "not good"... well, 2 months in and my doctor is having us begin watching closely through monitoring for a hypo event because my cat might be close to remission.
There is an entire section of this forum for different brands of insulin. (Novolin falls in the forum I'm in because they are both fast acting.) come poke around in there and read other people's posts and signatures who have also used Novolin.

If you need help or advice on getting set up with testing glucose I can point you in the direction of an excellent video a member here made. It helped me learn to test the easiest. Home testing is a great tool to help manage diabetes - just like you would do for a human. Watching my trends has really made the difference in care for Fabby too. Actually, testing and her new low carb diet are the two biggest factors that have us getting good reviews for progress from the vet in only 2 months. Thank goodness for this forum to help me through the beginning parts though. Just getting started can be a bit overwhelming.

Welcome!

 

Novolin N has worked well for many kitties. However Novolin N is a human type insulin and typically a U100 insulin and as Linda...MtWorfmen's Mom mentioned above you should be using the U100 syringes and not the U40 syringes. Please double check the insulin strength, as I am not aware of Novolin N coming in U40 strength, Using the wrong syringes could definitely cause an overdose which could lead to a serious and costly hypo event.


ETA I looked up more on Novolin N and it is a U100 insulin

"
PATIENT PACKAGE INSERT
Patient Information for Novolin® N

NOVOLIN® N (NO-voe-lin)

NPH,

Human Insulin Isophane Suspension Injection

(recombinant DNA origin) 100 units/mL"


https://www.drugs.com/pro/novolin-n.html


Your vet may be confusing the Novolin N with Vetsulin (Caninsulin) which is a veterinarian only insulin and is a U40 type to be used with U40 syringes.

PLEASE do contact your vet and question his information.

 

Your vet is confusing novalin n with vetsulin. Please have him double check the documentation in the box. Vetsulin is u40, novalin is u100... It's actually a big difference in concentration. Make sure you get u100 syringes.

Novalin is fine to use. After a few months of you find its not effective or lasting long enough then consider a switch. People told me the same about vetsulin and it worked good for my cat. Every cat is different.

 

Thanks for all the advice, everyone. Right now I am extremely scared to do this to my buddy. That is just how I feel. I want to believe the doctor knows what he is doing, but I can't NOT believe everyone who has been going through it. If I take him for second opinion, I have to stress him out again.

I wonder if I can get his medical records from this vet, and send them over to another vet to see what their opinion is.

 

This is what I was thinking after reading all the facebook posts. Another thing I am having an issue with is getting a good blood sample for the meter. My poor baby's ears look sore from me trying to poke them. And now that he knows what I am doing to him when I get this meter and needle out, he is freaking out and not letting me touch his ears. He is not a dummy. I even tried it on myself, and after the 3rd time my finger hurt a bit. And I am not afraid of needles and I feel I have a normal tolerance for pain. Anyways. 1 Unit seems like what I should try and then get the sugar tested.

I can see why everyone says to get the micro ReliOn, now.

 

Thank you. If you could please send me the link to that video, I would appreciate it. I seen 2 videos on Youtube that made it look so easy. But when I actually did it, I was like "OMG".

 

You are intitled to all records. I always have all lab reports emailed to me after a cat goes in. If you simply call some other vets and ask them what insulin they perscribe and if novalin is u40 or u100 they will probably share that info on the phone without requiring an exam.

 

I have a video in my signature showing how I test my cat CC.

The first week it's hard to get a sample because the capillaries haven't grown yet. Make sure you are using 26 or 28 gauge lancets... The 31's are too small. (Bigger the number the smaller the needle point).

Neosporin ointment with pain relief will help the ears.

If kitty squirming you can click the drop onto your fingernail and test from there.

Aim for the sweet spot. It's easier to be accurate without the Lancet device. Just poke.... It's OK if you go all the way through.

 

The BG testing is so important in keeping your boy safe. Many people have had to work on making it less stressful for themselves and for their kitty.

• Keep a good supply of low carb treats and use them liberally.
• Make sure his ear is nice and warm - not a problem in hot weather.
• Try free handing the poke instead of using the spring trigger in the lancet device - a lot of us like to do that because we can aim better, eliminate the device's noise, etc.
• Put firm pressure on the poke area after you've tested to help stop bleeding and reduce bruising.
• Many people put a very thin layer of Neosporin ointment with pain relief on the ear after a poke or at the end of the day.
• Also very important - have a calm, businesslike attitude when it's pokey time. They soak up our stress and if you're nervous it can make it harder. As they say, "Fake it until you feel it."

 

Your vet is probably great with a lot of things but in this case, he is making a huge mistake suggesting use of U40 syringes with U100 insulin. This may have been a case of confusion between Vetsulin and Novolin but regardless, it is a very dangerous mistake.

We are not vets here but we do live, eat, breathe and sleep feline diabetes 24/7 so whether you decide to get a second opinion or not, please do not give even 1u of Novolin using the U40 syringes as that would actually be 2.5u of the Novolin which is far too high for a starting dose. I'd contact the vet to clarify and if he insists his instructions are correct, then I would definitely get a second opinion. Hopefully he will acknowledge his error and correct it.

On the home testing front, your finger has far more nerve endings than Mufasa's ear so kitty will not feel anything comparable to what you felt. It's the process Mufasa is objecting to rather than feeling any pain. With practice and more testing Mufasa's ears will bleed more readily and it will get much easier to test.

 

Hi Jennifer @Jennifer block, can you please confirm that you have read what Janet and Linda posted above?

Novalin is a U100 insulin (100 units insulin per ml) and should NOT be used with U40 syringes (they are for insulin that has 40 units insulin per ml).
If you measure a unit of U100 insulin in a U40 syringe you will be giving 2.5 units of insulin, not one unit...
The package insert should confirm that this insulin is indeed U100 insulin. Please check...

And please do post to let us know all is OK. We worry.

Eliz

 

Make sure to give Mufasa a tasty (low-carb!) treat after each attempt at testing, even if it's unsuccessful!

 

Good morning! It looks like our resident experts found you and have been busy without me. (Which is all good, because they know way more than I do!!!)
First - JanetNJ found you! It was her video that I saw, and used as a reference on how to do it. So scroll back up and look for the little blue link in her signature - it will take you to her excellent video.

I too had a rough time trusting my vet when we were diagnosed. (Mine was mostly due to price gouging, and what I felt was sub-par care - which may have also been an expectation due to cost...) The people here confirmed my concerns with stories of their experiences. Gut instinct is something I've learned to trust over the years. So, I too worked on getting a second opinion on my kitty. It took me a month to find the right one to fit our needs. In the interim I read all I could here, and asked a lot of annoying questions. (And those experts here... I'll be eternally greatful for their patience while I am learning.) Funny part is, I am/was rather resistant at every turn. Lol. First, I was told I should get my spreadsheet going. I had decided, there must be an app that I can use that has more bells and whistles and is just better... so I tried several apps... lol. None did what I felt I needed, so I gave the spreadsheet a try. It really is the best tracking... so it gave me more confidence in the people here who live and breathe feline diabetes. When I had some information compiled I asked for a review and was told to lower Fabby's insulin. I didn't understand why, and why so quickly. I'm not sure a person can be adequately told the "why" when they don't have the experience... so I did lower, but it took me a bit of time to come around. As per my experience, JanetNJ was right again! The lowered dose is more optimal for my cat. So, I write all of this to let you know... your hesitance is normal. You shouldn't go around blindly trusting strangers on the internet. (This is true for all of the internet.) but you can jump in on this site with both feet and ask a lot of questions and read other people's threads and build that trust to gather those here you would consider experts. Then balance this advice with your vet advice (or your 2nd opinion vet) and learn how to best care for your kitty.

You got this!

Side note: @JanetNJ I talk a lot about your video because it helped me so much. Should I tag you every time I'm trying to get a new person to find your video, or is that super annoying? How would you prefer I send people to your video?

 

This is exactly the kind of post a new person needs to read, Fabby's Mom!

 

Funny you say this, cause my aunt was telling me she was reading up on this whole diabetes thing. And she said that a lot of people to give him a treat after testing, so he knows its reward time. I plan on it. What would you consider a low carb treat? Right now we give him Natural Balance pure bites, and the Sheba meat sticks. I forgot what their real name is, but he LOVES LOVES LOVES those.

 

You can tag me. I'm glad it's helpful.

 

The Natural balance pure bites only have one ingredient. Those are excellent!
I do Fancy Feast one ingredient treats because they are individually wrapped and I can keep a few right in her kit. She thinks the treats come from the kit.
However, the Sheba ones have sugar listed right in the ingredient label. (I've become a bit of a carb/sugar control freak for Fabby...) So I personally wouldn't use those.

 

My guy is very fond of the Orijen brand freeze dried meat treats. They come in 4 or 5 flavours but he likes the original (poultry-based) and wild boar the best.

 

I am watching you now!! LOL

 

So, another question. Lets say I get the u-100 needles, should I do the 2 units on the u-100?

 

The general recommendation (unless you have a REALLY fat cat) is to start at 1 unit 2x a day (every 12 hours) and then adjust as needed with your findings.

 

the recommended starting dose for all isulin is 1 unit twice a day 12 hours apart. The type of needle you get corollates to the concentration of your insulin. You need to use the correct syringes with the insulin being used.

A U-100 insulin has 100 units of active insulin in each mL of liquid. You can think of it as being 100 pieces of insulin in each mL of liquid.

A U-40 insulin has 40 units of insulin in each milliliter (mL) of liquid.

This means that the same volume (liquid amount) of a U-100 insulin has 2.5 times more insulin in it than a U-40 insulin. Or, the U-100 insulin is 2.5 times stronger than the U-40 insulin.

 

Hi Jenny!
My Cosmo is currently on Novalin. I'd eventually like to switch him to another kind of insulin, but he's been on this since January when I first started giving him insulin. I haven't tested his glucose throughout this whole time until just recently - about a week or two now. His numbers are kind of all over the place and I haven't gotten a curve (testing throughout the day), but I feel MUCH better even just KNOWING what is happening with him. He doesn't react any differently with different numbers, so the home testing is the only way I know if his numbers are good or off the charts!

I just wanted you to know you're not the only one on Novalin. And trying to figure it all out. Depend on everyone here. They're brilliant. And helpful. And willing to talk you off a ledge.

 

Hey @EmilyH you mentioned your numbers, and I went to peak at your spreadsheet, but it looks like in your signature the link didn't attach. Can you check that out? (If you need help setting the link just ask, I will find instructions or someone who knows. )

 

hahaha because AS you were clicking, I was editing! It's all fixed now. There was a weird thing happening with it.

 

Jennifer, as others have said, it's best to start with a dose of no more than 1 unit, twice a day. And it may be more prudent, initially, to start with just .5 of a unit.
Novalin has a reputation for starting to work fast after being injected, and for dropping the blood glucose quite steeply in the first hours of the cycle. (Though your cat may not be 'typical' in this regard).

Because Novalin starts working quickly it's important to feed the kitty an hour before the insulin shot if possible. That ensures that the cat has food 'on board' for when the insulin starts to work. And also, for cats who are known to regurgitate their food sometimes, it gives you some assurance that the cat is going to keep her food down. ...So, the sequence would be: Test, feed, wait an hour, then give the insulin shot.

Also, we recommend that Novalin kitties only get insulin if their blood glucose, at the time of the pre-shot test, is at least 250 mg/dL (13.8 mmol/L) as measured on a human glucose meter. If using a pet meter then the number would need to be a bit higher than that. That threshold may be brought down a bit if the kitty's hometesting data subsequently indicates that this might be appropriate.

If you can get some tests periodically during the first half of the insulin cycle that may help you to work out when the peak of the cycle (lowest blood glucose number) typically happens.

What are you feeding Mufasa at the moment?
.

 

Lots of great advice already given here so I'm just knit picking at your Signature . Most important things to add: Your insulin is Novolin N and what meter you decide to use. http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

Here is a list of low carb treats in addition to what others have said: http://www.felinediabetes.com/FDMB/threads/list-of-low-carb-healthy-treats.9172/

Dr. Lisa Pierson's Food chart is what many of us use to find low carb foods (less than 10%).
Don't be afraid to ask more questions

 

Update - so I received a voicemail from the doctor that first saw Mufasa back in November when he was first diagnosed diabetic. Her message to me was confirming that I was right that indeed with the novolin I am to use a u-100 needle. With this information I called the vet back and spoke with another doctor who informed me that what she said was correct. And that she does not know why the other doctor prescribed the novolin with the u-40 needle. She also asked if I wanted to still use the novolin, and that is when I told her my concern from everything that I've heard over the past couple days. She is prescribing Mufasa prozinc with the u-40 needle, 2 units a day. I will be picking that all up tomorrow from the vet. I am so glad that I hesitated. That other doctor is going to be talked to and hopefully he will not practice in that vet again. She was really sorry and apologized for the entire practice. I guess he was a new doctor.

 

Do you mean 2 units twice a day? The recommended starting dose for ProZinc is 1 unit twice a day. It's generally slower in onset than Novolin and less likely to cause steep dives to low numbers. However, it's still wise to start at a safe low dose and increase from there in fractions of 0.25 u if the BG numbers warrant.

 

Homemade shredded chicken & baked livers. I mush the livers & mix with the shredded chicken.

 

I wrote down everything buts its in the living room. I cant remember. Im getting a script from the vet tomorrow.

 

I'm so glad you got it sorted out!!! And that this vet will talk to the other one. Hopefully the other vet didn't make the same mistake with other patients

 

Is that all that is in your homemade food? Are you adding any supplements? Not judging, just checking . Text can sound harsh on it's own sometimes. Thankfully we do have emoji's! . Reason I ask is that shredded chicken and livers may not be a balanced diet. Dr. Pierson has a website too that many use for homemade kitty food "recipes": http://catinfo.org/making-cat-food/

 

I have not, and I understand from research and talking with everyone that Taurine and Calcium are very important. I have ordered supplements to add to the meals that I had prepped last night. Then after that, I am going to look into Honest Kitchen.