Using Humilin N

Hi Folks:

Well I nearly lost Scooter last week. On lantus we could not steady his numbers and the diarrhea was hard on him. We (his Vet and I) switched him to humlin N and we have been able to steady his numbers and his appetite is back. I am aware that folks here recommend Lantus or levemir for good reasons. I am choosing to keep Scooter on the humilin N for his sake.

Also I was using the accuchek monitor and switched to relion prime because of cost. I also like that it takes less blood to read. Scooter likes that to. Most days it is one poke and done now. I am reading him more often but so far the humilin is lasting about 9 hours. He only needed to have 1 unit or .5 unit to keep him stable. So my charting will be different.

I also spoke with my pharmacist who said that most of his customers have their cats on humilin N or R. I wonder if there are others who could make suggestions for me. Scooter has been on it for 7 days now.

Linda

 

If it works better for him, then you go with it.

That said, in many cats Humulin lasts roughly 6-8 hours due to their fast metabolism. To optimize the glucose control, you may need to test and shoot every 8 hours and/or diligently pick up the food at 6 hours after a shot, so you don't feed the rise as the insulin wears off. If you would like a TID spreadsheet to use, I have one set up, so let me know.

ProZinc lasts about 10-12 hours in most cats. When you're done with the Humulin N, you might consider it. (Unless, of course, he's off the insulin by then!) It has 40 units per mL, so micro-dosing is a lot easier than with a U-100 insulin that has 100 units per mL.

Be sure to read over the sticky on using N type insulin in this forum; it isn't very active, so if you want, pop over to PZI to get feedback.

 

Yes I would love a spread sheet!

Are you saying that PZI is perhaps the next thing I should use?
Also I shouldn't feed him between 6 and hrs after shot? I have been feeding every 3 hrs FF classics. His numbers are below 200.

 

First, some glucose reference ranges, in case you are unfamiliar with them. These are what the various test numbers may mean when you get them.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

 

Second, if the insulin is wearing off, starting about halfway through your 9 hours, feeding will cause it to go higher. That isn't good for the cat, because damage can occur at higher glucose levels. You might pick up all food at +6 or +7, maybe using a timed feeder.

When you test before a shot, ideally you want about 2 hours with no food, so it reflects the underlying levels as much as possible. I free feed my cats, so if the diabetic eats, she eats. (Life isn't perfect, you know?)

TID spreadsheet template here Remember you may need to save a copy down to your PC, then upload it to your own Google account. (Or do a Save As or Make a Copy - whatever the Tech forum instructions are.)

 

Hi BJM:

Thank you so much for all the information and the spread sheet! I feel much more confident now. I free feed as well since I have more than 2 cats but Jack and Scooter my sugar babies get FF classics all day. That is not to say I don't catch them eating the kibble once in a while.

Do you have an advice on how to get them to pee in an empty litter box for ketone readings? Scooter just won't do it.

I appreciate you taking so much time for my "little old man" out of your day.

Thank you!

Linda

 

The litterbox doesn't need to be empty, just non-absorbent. There are some tips on urine testing in my signature link: Secondary Monitoring Tools.

Your non-diabetic cats should be switched to low carb, too, per Cat Info.

canned is preferable, but if you must feed dry:
Evo cat and Kitten is roughly 8% calories from carbohydrates.
Stella & Chewey's freeze dried can be used and helps transition, as it is meant to be rehydrated, though it may be fed dry.
Young Again 0 Carb (5% the way we calculate it) - internet orders only

 

Just checking - how're you doing?

 

Awe thanks! Well he seems to be doing well. Ever since your post I started to watch and he is less interested in food at about +6 or +7 after insulin. He is responding well and today even played with a toy which brought tears to my eyes and warmth to my heart. One of my tom kittens is holding him down and hurting him at night so I am going to lock the bad boy up at night now. Scooter is unable to fight back since he holds him down at his neck. I assume because he sense's that Scooter is ill. His numbers are remaining between 150 and 250. I realize that is higher but on the lantus I could never seem to regulate him at all he was all over the place. I think I am being honored with a long goodbye but I try not to think of that.

Your help has been so helpful that I hope I can pass it on one day and be as helpful.

Linda

 

You never know what will happen. Dusty, a kitty adopted from a rescue I help, was returned at about 5 pounds on a formerly 9 pound frame and then diagnosed as diabetic. The woman changed her mind and took him back. Due to major arthritis and poor vision, she couldn't test so I offered to make visits and help her. I got her to feed him Fancy Feast Classic pates. After about 4 weeks, he was off insulin - I tested him once at a 31 mg/dL! He has regained most of his weight and is doing great.

Spitzer, on the other hand, had other medical problems - IBD appeared to be part of it. I never got him regulated and when he threw a blood clot to his hind legs, I had to let him go.

Gracie is on ProZinc and doing OK. As she was untreated for a good 8 months and fed cheap grocery store crap (all the former folks could afford), I suspect I''ll be doing this for a good long time, if not forever.

I've had sick cats and yes, the healthy ones may go after them. Feliway diffusers in the common rooms may help. Be sure to clip the younger one's claws to reduce the damage. Active play may reduce some of the stress, too - a good 15-20 minutes, twice per day is recommended.

 

Well I finally had time to fill in the SS you so kindly sent BJM.
Seems I have been in a day dream that Scooter is doing well on Humulin. I just called my pharmacy and the lantus is over 2 hundred dollars a bottle and that is out of my personal price range. So I am going to call about ProZinc tomorrow. Also going to show this chart to his Vet tonight and give her access to it.

Any advice would be great. I am kind of bummed out.

Thanks,
Linda

 

Check DCIN, Diabetic Cats In Need. They also have a page with links to other resources.

Also, you'll want to consider price per unit, not price per vial.

10 mL Lantus is 1,000 units and begins expiring once opened; you may not finish the vial before it becomes less efective when on a low dose
- $200/1000 = $0.2 per unit

3 mL in single pen is 300 units and begins expiring once opened; you generally can finish the pen before it becomes less effective. There are some prescription savings plans out there which may be used for Lantus. Some pharmacies (hospital, maybe Target or CostCo) will break up a 5 pack and sell the pens individually, especially if written for dispense 1 pen. We use the pen like a vial by removing the tip and using a syringe to withdraw the insulin. Also watch your local Craigslist and check expiration date and how it was stored and handled.

10 mL ProZinc is 400 units
- $160 / 400 = $0.40 per unit

 

A couple quick Qs:

Is he done with antibiotics? That may be part of the variability.

Has he had his dental? Dental infection can be treated before getting good control of the diabetes. You want them able to take dental X-rays to check the bone and teeth roots, too.

And you're still feeding the Fancy Feast Classic Pates, or other low carb (<10% calories from carbs) foods from the Cat Info list?

Plus you're shooting every 8 hours?

 

No he has not had his dental it is scheduled for next Monday.
He is still eating fancy feast pates but once a day I catch him at the Science diet kibble the others eat.
No I was shooting twice a day until last night. Today I started the 3 times a day. This morning he was 361 which is slightly better than the 400's from yesterday. I am trying to do a curve today. In process.
Waiting for his Vet to call back after emergency surgery she is doing.
Yes he is done with the antibiotics.

Linda nailbite_smile

 

ProZinc is more expensive than lantus considering that ProZinc only has 40 units of insulin in every ml (u4) insulin) vice Lantus, and N and levemir that have 100 units per ml.

 

Larry - I broke out the cost per unit in my preceeding post.
- Lantus vs ProZinc is roughly $0.2 to $0.4.

 

Hi Folks:

Well he is sick and tired of ear pokes. lol Even if treats are involved. :smile: His curve is done though and I can see that he may need more insulin. The next hour is when I give him a shot and I am thinking maybe 4u which I have never done. He is going to see his Vet on Thurs for a check in on his health and numbers.

Scooter is a purebred Egyptian mow that Jack brought home one day. He has always been a fragile cat and small. He is also now old (16 we think) and diabetic. My fear is surviving the surgery for his teeth. Do you have any advice on this or uping his insulin to 4u?

as always thank you!

Linda

 

My d*mn phone won't load the spreadsheet.

What is the lowest he has gone between shots? Humulin N hits its nadir about +3 to +4.

If he goes below 50 mg/dL, that is too low and too close to hypoglycemia territory.

 

Hi BJM:

the lowest he went was 154 and he did not bounce at all. Any suggestions?

 

Increase the dose only 0.25 units - you don't want to hop over a good dose.

Did you have a chance to read the Humulin N primer in this forum?

 

Okay just gave him what I am guessing is 3.25. a slight bit more than 3.

I will do a two hr check tonight.

Linda

 

Hi Folks:

I have switched Scooter to Levemir based on his swinging numbers and research my Vet did.

Thank you both so much for guiding me to help Scooter thru NPH. I am sure I will have lots of Lev questions to.

Linda

 

Ok, a switch to Levimir for Scooter. Where will you be posting now? The Lantus TR also has a lot of levimir users, and is a very active forum. Not so many people on the Levimir/Detimir forum, so answers may be slow in coming. You could also post over in the Feline Health forum for now. It's all really up to you.

Ah, I searched your posts and see you already went over to the Levimir/Detimir forum and are getting replies from Sheila. Good job.

 

i hope it is ok to ask on this post....if u go to shots every 8 hrs. do all the same rules apply? 3 PS a day? 1 hr b4 food, then shot? then checking the plus 2,4,6, etc. as much as possible? thanks!

 

Yes.