From Hypo To Serial Poker, Figuring Bear Out

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That would be a good approach Ellie. All testing will give you more pieces of his puzzle. The meter is how you learn the tune to Bear's 'sugar dance' - the more notes you hear, the better you can dance together! You've already got a good instinct.
 
As Nan mentioned above, you can also feed now and test in 2 hours....wet food should be worn off by then. I would want to test tonight tho' just to know more of his tune....that's just me tho'. Nice thing about this wonderful forum - you can see all sorts of opportunities and paths to take to get to the same place.
 
EllieAviles said:
As am I. I'm extremely luck he wasn't on his favorite heating pad alone.

I'll be calling his vet as soon as they open to talk about his dosage. I also need to find a way to get more test strips and I've been worried about what I've read about the Novalin N insulin on here.
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Hi, I'm so sorry you've gone through all this. When Myrtle was first diagnosed and I started reading this forum, I was concerned about being prescribed Novalin N as well. However, my cat has done really well on this insulin and looks like heading for remission - I think it's just a matter of getting the dose of insulin with the quantity of food right. It's good that you are testing now and will be able to adjust your dose accordingly.
 
I really think you should skip, another hypo so soon could have long term troubles. Also, hypos often kick start the pancreas into producing insulin again as well.

If it were me I'd follow the general feeding recommendation for novolin users rather than the general recommendations for lantus, they are two different insulins. The novalin has a higher kick to it following the shot. I could be wrong but I've never seen novolin users recommend waiting until the shot time to feed. Its usually stressed that feeding one hour before is very important. Your vet recommending it at shot time would scare me into getting a new vet.
 
Nan & Amber said:
I'm going to have to disagree with this-- I say go ahead and feed, two hours is enough time to let the immediate food influence fade, and waiting that long without feeding all day can cause numbers to drop even further, so you'd be skipping anyway. I say, let him have his meal and his meds!



If you don't feed and end up skipping, I think you can give him a break on testing for the night. It's good information to have, but not critical-- he's not going hypo if he doesn't have insulin on board.

Based on your story and the numbers you've gotten in the past couple days, I am going to make a guess that Bear is one of those cats who is very food-sensitive, and that the recent changeover to Fancy Feast has had a dramatic effect on his insulin needs (not uncommon at all). It took a while for him to hypo symptomatically because of the "bouncing" kind of reactions I described above-- for a while, anyway, his body could compensate by dumping glucose into the bloodstream and get his numbers back into a safer area. Until the other day when he slipped below the line (which, yeah, I'd be terrified of it happening again, too! Thank goodness you were able to get to him in time).

I really think skipping tonight and re-starting the whole process tomorrow "fresh" is the best move...
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I thought about the Fancy Feast, too, because he had been on the DM Diabetic food prescribed by the vet forever. I'd been wanting to switch him to soft food, but the husband was unsure until he did his own research. We never gave them bad food, but they used to have dry food down at all times. And, when one ate, they all ate, even if they weren't hungry or just ate five minutes ago.

JohnZ said:
I would hold off on feeding him until then and go with 2 units (not 3)...
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Yeah, when I talked to the doctor she wanted me to do 4 again and I told her I wasn't comfortable with that due to his numbers and we've doubled his food intake. He used to only eat 1/2 a can twice a day. Now he's eating 1 can twice a day. I suggested 2 and then she suggested 3.

Okay... I think I'm going to hold off on meds and food until 7. I'll test and feed no mater what. If he, for some reasons, spikes super high, I'll give him 2 units, but if he stays in the range which I think he will stay in then I'm going to skip it. However, I'm going to go ahead and monitor him every 2 hours just to see how his curve is without the insulin dose and on his normal food. Just so everyone knows the game plan. :)
 
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babyBoo said:
I really think you should skip, another hypo so soon could have long term troubles. Also, hypos often kick start the pancreas into producing insulin again as well.

If it were me I'd follow the general feeding recommendation for novolin users rather than the general recommendations for lantus, they are two different insulins. The novalin has a higher kick to it following the shot. I could be wrong but I've never seen novolin users recommend waiting until the shot time to feed. Its usually stressed that feeding one hour before is very important. Your vet recommending it at shot time would scare me into getting a new vet.
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That startles me because I've always been told to feed and shoot and the same time. I'll do some research and ask them on Monday because the original directions were given when he was diagnosed and put on ProZinc, but they never changed it.

Myrtlesmum said:
Hi, I'm so sorry you've gone through all this. When Myrtle was first diagnosed and I started reading this forum, I was concerned about being prescribed Novalin N as well. However, my cat has done really well on this insulin and looks like heading for remission - I think it's just a matter of getting the dose of insulin with the quantity of food right. It's good that you are testing now and will be able to adjust your dose accordingly.
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You've put my mind to ease a bit on the Novolin N, but it's still scary. Since your kitty takes Novolin N as well, could you weigh in on the feeding time? Do you feed at the same time you give the shot? If not, when do you do each and what did your own vet recommend?
 
Sounds like a good plan!

Squeaky and KT (GA) said:
Nice thing about this wonderful forum - you can see all sorts of opportunities and paths to take to get to the same place.
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Definitely true! Sorry if the different voices make it confusing o_O, but you're doing the right things to keep your kitty safe!

For the faster-acting insulins (Novalin N, Vetsulin, etc.), I know that you always always always want to make sure there is a meal "on board" before shooting, but will defer to others with more experience using those insulins on how much lead time you need.
 
Nan & Amber said:
Sounds like a good plan!



Definitely true! Sorry if the different voices make it confusing o_O, but you're doing the right things to keep your kitty safe!

For the faster-acting insulins (Novalin N, Vetsulin, etc.), I know that you always always always want to make sure there is a meal "on board" before shooting, but will defer to others with more experience using those insulins on how much lead time you need.
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Lol. It was a bit confusing, but it's been so helpful and has helped me work out my own game plan based on Bear and how he is acting.
 
EllieAviles said:
That startles me because I've always been told to feed and shoot and the same time. I'll do some research and ask them on Monday because the original directions were given when he was diagnosed and put on ProZinc, but they never changed it.
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With Prozinc, after you test and get a shootable number, it is ok to feed and immediately give insulin shot. Faster acting insulins like Novolin N, Vetsulin, Caninsulin, you want to test, feed, wait at least 20-30 minutes then give insulin shot. :) Hope this helps.
 
Agreed... definitely sounds like a good plan...

Also agree that food should be on board before shooting with faster acting insulins ... just not before testing... test, feed and shoot... it might make sense to test, feed, wait 30 minutes, then shoot... just to be safe :)
 
I vote for no shot tonight on this BG number. Start fresh tomorrow AM at a dose of 2 u. Test, feed, wait 20-30 minutes. shoot is the way to go with faster acting insulins.
 
Okay, I'll try that the next time he needs his shot. Thanks for the info guys.

Also, here is Bear after you all helped me through the scariest night of my life. This was around 10 AM the night/early morning of, right after the hypo. It was the first time he pulled his head up and focused on me in more than 6 hours. I'm sure he'd say thank you if he could, but I wanted to make sure you all knew how grateful I am for the support and help that night. Since I haven't said it officially, I will now. Thank you. So much!
18518399_1617061774972318_270440826819832157_o.jpg
 
EllieAviles said:
Okay, I'll try that the next time he needs his shot. Thanks for the info guys.

Also, here is Bear after you all helped me through the scariest night of my life. This was around 10 AM the night/early morning of, right after the hypo. It was the first time he pulled his head up and focused on me in more than 6 hours. I'm sure he'd say thank you if he could, but I wanted to make sure you all knew how grateful I am for the support and help that night. Since I haven't said it officially, I will now. Thank you. So much!
18518399_1617061774972318_270440826819832157_o.jpg
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Very handsome boy! :)
 
EllieAviles said:
Okay, I'll try that the next time he needs his shot. Thanks for the info guys.

Also, here is Bear after you all helped me through the scariest night of my life. This was around 10 AM the night/early morning of, right after the hypo. It was the first time he pulled his head up and focused on me in more than 6 hours. I'm sure he'd say thank you if he could, but I wanted to make sure you all knew how grateful I am for the support and help that night. Since I haven't said it officially, I will now. Thank you. So much!
18518399_1617061774972318_270440826819832157_o.jpg
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He's so gorgeous!
 
EllieAviles said:
Okay. That makes sense, but I do have a question.

This is hypothetical, so I know what I may do. If I don't feed him now and test in two hours and he is still below 250, should I go ahead and feed him, don't give him the shot, then continue to test him every two hours to keep track of his curve and see where his numbers go? That's what I feel I should do, but I'm second guessing myself.
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If he's above 200 but below 300 I wouldn't give more than 1 unit.
 
EllieAviles said:
Yeah, when I talked to the doctor she wanted me to do 4 again and I told her I wasn't comfortable with that due to his numbers and we've doubled his food intake. He used to only eat 1/2 a can twice a day. Now he's eating 1 can twice a day.
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I'm glad you've upped his food intake.
 
EllieAviles said:
Okay. I checked his sugar just a minute ago, which is 2 hours from when he should have had his shot. It was 150. I fed him 1 can of Fancy Feast Classics and am skipping his shot. I'll continue to check his sugar every 2 hours just to keep my eye open and see how he does.
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:):cat:
 
* Vetsulin and 'N' (NPH) insulins start working shortly after injection - there's not a lot of 'onset' time. All of the dose works at once which is why it tends to drive numbers down steeply. There needs to be plenty of food on board for the insulin to use properly. You want to be sure kitty doesn't throw up the food before giving the shot. This is why the suggested half hour. That doesn't make them bad insulins, some cats do just fine on it. I started on NPH with my first diabetic. I've gone back to using it at times over the years of my sugarboyz' dance when other medical conditions required closer control of their bg.

* Prozinc has a bit slower and gentler onset. There is more of a 'time release' component giving it a longer cycle but it's action is also finished by the end of the cycle. This needs food available when it starts to work but it's ability to work slower gives a bit of extra time if kitty throws up food.

* Lantus and Levemir are 'depot' insulins. Their onsets are much longer and work quite differently. With those, you have usually a couple of hours to get a good meal in kitty.

The best insulin is what works best for your cat!

Oh I like your brain!
 
Squeaky and KT (GA) said:
* Vetsulin and 'N' (NPH) insulins start working shortly after injection - there's not a lot of 'onset' time. All of the dose works at once which is why it tends to drive numbers down steeply. There needs to be plenty of food on board for the insulin to use properly. You want to be sure kitty doesn't throw up the food before giving the shot. This is why the suggested half hour. That doesn't make them bad insulins, some cats do just fine on it. I started on NPH with my first diabetic. I've gone back to using it at times over the years of my sugarboyz' dance when other medical conditions required closer control of their bg.

* Prozinc has a bit slower and gentler onset. There is more of a 'time release' component giving it a longer cycle but it's action is also finished by the end of the cycle. This needs food available when it starts to work but it's ability to work slower gives a bit of extra time if kitty throws up food.

* Lantus and Levemir are 'depot' insulins. Their onsets are much longer and work quite differently. With those, you have usually a couple of hours to get a good meal in kitty.

The best insulin is what works best for your cat!

Oh I like your brain!
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That's great information, thank you for sharing. When he was first diagnosed we tried the ProZinc (they started him at 2 units, which I'm learning is a high starting point) because they said it had a higher probability for remission. He didn't take to it at all so we switched. He finally started to show lowering numbers on the Humulin N, then we switched to Novolin N due to a drastic difference in price and the promise that they were extremely similar.

And, you like whose brain? Lol.

I just checked his levels again, two hours after eating 1 can of Fancy Feast Classic and he is at 188. He's sleeping now, but his nose is moist and he was very alert. Is this a good number with no insulin? What's the ideal number range for a cat? Does it differ if they are on insulin or off?
 
A well regulated diabetic cat is mostly in the Blue range (100-200) or less, A diabetic cat that stays in the Green range (50-100) without insulin is in remission, and my non- diabetic cat is 2.7-3.1 ( about 50) when I test him pre food.
 
Humulin N and Novolin N are the same insulin, just different manufacturers. Humulin (Eli Lilly) was Walmart's original $25 insulin, Novolin (Novo Nordisk A/S) got the contract 4-5 years ago.

Your brain silly!

Normal range on human meter is 50-120. Not to bad.

HUGS!
 
babyBoo said:
A well regulated diabetic cat is mostly in the Blue range (100-200) or less, A diabetic cat that stays in the Green range (50-100) without insulin is in remission, and my non- diabetic cat is 2.7-3.1 ( about 50) when I test him pre food.
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Interesting. Maybe I should check my other two boys the same time I check Bear's once in a while, just to see how they are fairing?

Do some cats run a bit high? Like, they stay in the blue range without insulin? Or do you think this could be a fallout part of his hypo episode from before?

Squeaky and KT (GA) said:
Humulin N and Novolin N are the same insulin, just different manufacturers. Humulin (Eli Lilly) was Walmart's original $25 insulin, Novolin (Novo Nordisk A/S) got the contract 4-5 years ago.

Your brain silly!

Normal range on human meter is 50-120. Not to bad.

HUGS!
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That's good to know because I questioned the woman at the Wal-Mart pharmacy when I went to pick it up and she honestly had no idea. Her words were something like "I can't guarantee that they are the same, but you should be okay". And thank you. :P
 
EllieAviles said:
Interesting. Maybe I should check my other two boys the same time I check Bear's once in a while, just to see how they are fairing?

Do some cats run a bit high? Like, they stay in the blue range without insulin? Or do you think this could be a fallout part of his hypo episode from before?



That's good to know because I questioned the woman at the Wal-Mart pharmacy when I went to pick it up and she honestly had no idea. Her words were something like "I can't guarantee that they are the same, but you should be okay". And thank you. :p
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My cat is in remission and is often in blue numbers... Although I use a pet meter which runs higher than human meters.


Normal on a pet meter is 68-150. Normal on a human meter is 50 to 120.

Give or take a few numbers.
 
You've put my mind to ease a bit on the Novolin N, but it's still scary. Since your kitty takes Novolin N as well, could you weigh in on the feeding time? Do you feed at the same time you give the shot? If not, when do you do each and what did your own vet recommend?[/QUOTE]

I test, feed and wait about 15-30 minutes to shoot. I generally test, then I let her eat, clear and wash her dish, brush her and then shoot - so I suppose that all works out to about 15 to 30 minutes later. Myrtle is very overweight so she gets 55-60g of wet food per meal (40g Royal Canin Ultralight & 15-20g something fishy - highest protein I can find). I have always shot lower than my vet recommended as I'm absolutely terrified of hypos. I don't shoot if she tests under 150. I'm fairly new to this too and Myrtle started at lower numbers than Bear but you're welcome to look at my spreadsheet of how much I shoot at different bg readings. I just looked at your spreadsheet and 4 units at a preshot test of 250 seems really excessive to me - I would probably shoot 1 - 1.5 units but I'm putting in the disclaimer that I'm not a vet, I've been doing this a short time and I don't know the cat - but that's what I would do if it were my cat.
 
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Okay. Bear's AMPS is 260. Because yesterday's was in the 400s and after 4 units it dropped to the 100s and stayed there I think I'm going to start with 1 unit and see how he does. The vet's 4 or even 3 units feels like way too much. Thoughts?
 
Thank you @JohnZ :P I actually have a spreadsheet question.

I tested Bear at 7:00 AM and he was 260. Then I fed him. He finished around 7:30 AM. Then I waited a half hour before his shot and, just to be safe, tested him again at 8:00 AM. He read 272. The AMPS is the AM Pre Shot number, so, technically, it should be the 272, right? Should I even check him until after he's eaten? Like, in order, feed him, wait half an hour after he is done eating, check his levels, administer shot as needed? Should I even bother checking him until after he's eaten?

Sorry if that didn't make sense.
 
EllieAviles said:
Thank you @JohnZ :p I actually have a spreadsheet question.

I tested Bear at 7:00 AM and he was 260. Then I fed him. He finished around 7:30 AM. Then I waited a half hour before his shot and, just to be safe, tested him again at 8:00 AM. He read 272. The AMPS is the AM Pre Shot number, so, technically, it should be the 272, right? Should I even check him until after he's eaten? Like, in order, feed him, wait half an hour after he is done eating, check his levels, administer shot as needed? Should I even bother checking him until after he's eaten?

Sorry if that didn't make sense.
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Yes... the spreadsheet AMPS should be the 272. No need to check him immediately after he eats... I would test him in a couple of hours... which you probably were planning on doing... good job!
 
EllieAviles said:
Thank you @JohnZ :p I actually have a spreadsheet question.

I tested Bear at 7:00 AM and he was 260. Then I fed him. He finished around 7:30 AM. Then I waited a half hour before his shot and, just to be safe, tested him again at 8:00 AM. He read 272. The AMPS is the AM Pre Shot number, so, technically, it should be the 272, right? Should I even check him until after he's eaten? Like, in order, feed him, wait half an hour after he is done eating, check his levels, administer shot as needed? Should I even bother checking him until after he's eaten?

Sorry if that didn't make sense.
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Your preshot number is taken before food is given. So I would use the 260 number, but really there is no difference between a preshot of 260 and 272. Usually the time between preshot test and shot is a half hour. Test, feed right away, then shoot.
 
JanetNJ said:
Your preshot number is taken before food is given. So I would use the 260 number, but really there is no difference between a preshot of 260 and 272. Usually the time between preshot test and shot is a half hour. Test, feed right away, then shoot.
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Me bad... didn't have my coffee yet! The spreadsheet AMPS of 260 is the correct one to record :(
 
I am going to mention again that I am not a novalin user, but there are somtimes it gets suggested to test feed and wait your 20 or 30 or 60 minutes for the food to digest, then test again before the shot to make sure the sugars are rising. This advice was given to a cat with ketone issues that desperately needed to be lower in sugar levels. The cat was also on three or four shots a day cycles to help with this and shooting rather low numbers at times.

Basically, the second test was to be sure that it wasn't a dropping bg level when the shot was given as the cat was being sort of rushed into lower sugar levels at a close to dangerous pace. So I think the answer to your question of needing a second test, is that yes it is sometimes needed. Myself, I don't know when exactly you would do this. But I would say shooting under 200, it might be a good thing to do with Novalin. but again I actually don't know.
 
JanetNJ said:
Your preshot number is taken before food is given. So I would use the 260 number, but really there is no difference between a preshot of 260 and 272. Usually the time between preshot test and shot is a half hour. Test, feed right away, then shoot.
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That's essentially what I did. I tested, fed, he took a whole 30 minutes to eat all of his food, I waited 30 minutes then gave the shot. Should I not wait? Before this past incident, we had always fed then gave him his shot as he was eating.

JohnZ said:
Me bad... didn't have my coffee yet! The spreadsheet AMPS of 260 is the correct one to record :(
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Lol. All good. It gets confusing.
 
Okay, guys. I know this thread should have ended by now, but I have another question.

If you look at his spreadsheet his AMPS was 260 so I gave him 1 unit. It gradually dropped and stayed in the high 100's for a large majority of the day. Now, his PMPS is 206. Is that too low to give another 1 unit? Since he's in the higher end of the 100's (like 170-190) should I go ahead and give him his 1 unit at 8:00 PM? Maybe decrease it to 0.5 units? The half units are harder because our needles don't have half markings.

Thoughts?
 
I think if I could test, had plenty of strips, plenty of high carb food or high carb syrup; I would most likely give the 1 unit.
 
Also after shooting, take your syringe and practice drawing up a half unit of water and shooting it into the sink a few times. Then when you need todo 1/4 units. 1/2 units, etc it won't seem so difficult.
 
babyBoo said:
Also after shooting, take your syringe and practice drawing up a half unit of water and shooting it into the sink a few times. Then when you need todo 1/4 units. 1/2 units, etc it won't seem so difficult.
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That's a tough one... I thinking maybe give him a little less than 1 unit may be best... as long as you can test him every 2 or 3 hours... as/if necessary... the spreadsheet for today actually looks good...
 
JohnZ said:
That's a tough one... I thinking maybe give him a little less than 1 unit may be best... as long as you can test him every 2 or 3 hours... as/if necessary... the spreadsheet for today actually looks good...
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:) I never thought I would feel happy just by seeing numbers in a blue box, but I am. Lol.
Okay. So, if we guesstimate based off of how he was today and I give him 1 unit, his lowest point should be around 116. And if I test every two hours (another long night, but worth it) and keep an eye on him, he should be okay. ... Right?
 
I would give 1 unit. Test at +2 to see where he's heading. If he's quite a bit lower at +2 that's a warning that you might have to intervene with carbs. The numbers today are really good and there's no big bounce going on.
 
EllieAviles said:
:) I never thought I would feel happy just by seeing numbers in a blue box, but I am. Lol.
Okay. So, if we guesstimate based off of how he was today and I give him 1 unit, his lowest point should be around 116. And if I test every two hours (another long night, but worth it) and keep an eye on him, he should be okay. ... Right?
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Correct... or give him a "skinny" 1 unit... if he's good at +2... you could probably wait until +6 for the next test... the insulin seems to be peaking later in the cycle... although there is limited data... hope that helps...
 
Okay. I've gone ahead with the 1 unit. Sorry, @JohnZ , I didn't see your post in time, but I don't know what a "skinny" 1 unit is. Like you guys mentioned, I do plan to test at +2 and I'll keep a close eye on him. And yeah, these past two days, his lowest has been around +8 or +9, which is when he went hypo on the 17th as well. Is that normal?
 
It would be interesting to hear from experienced Novalin users about +1 tests considering its a faster acting insulin. Myself with lantus, I only really find them useful if I'm shooting a green number. I'm just wondering if a Novalin user's +1 is similar to a lantus users +2.
 
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