Very high Pre-shot numbers - increase dosage?

Bailey has been on Humulin N for short of a year now. He was well regulated up until recently. His numbers were between 100 and 160 pre-shot and I was giving him 0.5U of insulin twice a day (he is a 10 lbs cat). That was a very low dose and it worked beautifully. We had a summer vacation trips when he was given the same dosage of insulin but once a day by our cat-sitter for one of our trips and no insulin at all for three days for our second trip (end of August). His numbers have been very high since then and I can not get him regulated with 1.5U twice a day now. He also eats like crazy - we will be seeing a vet at the end of the week about that. I am not sure if I should up his dosage because we had lots of Somogyi Rebound issues last winter when I finally went against my vet's suggestions and was decreasing dosage from suggested 2-3 units twice a day to 1 unit and then to 0.5 units. Need to mention that his BG never drops that low for me to suspect rebound; may be because he cries and I feed him about 5 times a day (small meals). Any advice would be very appreciated.

 

Hi Kot,

This is not an active forum as we have few people using N. I'd suggest you repost on Health where there will be more eyes.

http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

Looking at his spreadsheet, he looks like he has been bouncing all over. In January/Februaury he often went down to the 40s. We consider that hypo territory and then suggest the next dose be reduced. Your dropping the dose for those cycles definitely seems like it was a good idea.

I am not sure what to think now. On 9/27 he looks like he dropped low early and then really bounced for the pm test. The last few days are quite confusing. It looks like he is flat and high - sometimes indicative of too much insulin. But I wonder if the insulin is working - how long have you had it?

If you post on Health, I'll watch for you there and others may have more ideas.

 

I didn't know Humulin N could be used! I checked with my pharmacy and checked with the vet and was told I couldn't use it; re: pharmacy stated that it has different proteins in it and is not suitable for feline diabetes II. however I can get Humulin from my primary care doc for free. That's where I got my glucomoter, test strips, and lancets. (free)!!! I want to use the Humulin N because the pro zinc does not seem to be working very well as my cats numbers are still high. Anyone having any advice I surely would appreciate it. My cat only wants wet food whereas before he insisted on having dry food. But I'm slowly decreasing the amount by changing to a smaller bowl. I'm feeding him Fancy Feast Classic pate' variety pack. Anyone living in the Baltimore/Annapolis corridor area please help. I desperately need someone to talk to about this. My vet seems only interested in $$$$$$!!! I'll check back tomorrow for any replies. Thanks.

 

Please post on Health. No one checks this forum regularly.

http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

Are you using ProZinc now? We have more success using it than Humulin. The protocol for ProZinc is in my signature in blue. Perhaps it will be helpful.

 

Humulin NPH isn't as useful in cats as you may have to test, feed, wait 30-60 minutes, then shoot/inject every 8 hours. It generally drops the glucose really fast and severely, then wears off fairly quickly.
You might want to check out BCP PZI, ProZinc, or even Vetsulin/Caninsulin (some folks have success with it; some don't).

 

I live in Baltimore City and use the vet in Arbutus. I also currently use humilin N. It's $25 at Walmart (no prescription required in Maryland), and seems to work just fine. I really don't think ProZinc is 5X better, just 5X more expensive and probably only better, but not 5X. Humilin N used to be the standard treatment for diabetic cats.

 

I also am wondering if your cat has lost any weight lately?

 

As measured how? Show us a curve of tests from pre-shot to pre-shot, testing every 2 hours, to show how it is working in your cat ... which doesn't mean it will work the same way in another cat. It may or may not. On the average, Humulin or Novolin NPH does not last a full 12 hours in the cat, resulting in the glucose being uncontrolled for several hours.

 

At the moment I am scooping out his letterbox 2X daily, right before I give him his shot. I know how much he has peed in the last 12 hours, as well as how much he drank and ate. All of this goes into how I figure on his next dose is going to be. The vet says that this is OK. I would need help if I were going to do a real curve, and that will happen eventually. Doing a blood sugar test on this particular cat by myself is extremely difficult. As far as I can tell, my cat is doing really well on the insulin.

I don't use the "latest and greatest" meds on myself either. Almost always they are more marketing hype than anything better.