Making a switch from Prozinc to Novolin after 3 years

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Wesley and Spicoli, Apr 23, 2020.

  1. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Hi guys! I haven't been around in a few years, but yesterday FINALLY one of the vets at the practice I'm a client at decided it was time to try something different. Spicoli has been wildly unregulated since early on after a diagnosis with chronic pancreatitis, then IBD, and finally asthma.
    So, for the time being we are switching to Novolin N 70/30 from Prozinc. I'm not looking for dosing advice yet (as I have next to no data since the switch), and will be working closely with this vet to try and finally get him back to being regulated. Side note- if we reach 7u and it's still not working we will then be moving to Lantus.
    I know that this insulin is a U100, so that's a little different and it tends to drop the BG faster. I've been warned that it doesn't last the full 12 hr cycle and have done all my reading/research.
    But, I'd like to hear from you guys that have experience with this insulin. Anything else I should be aware of or any tips would be greatly appreciated :)
     
    Deb & Wink likes this.
  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Since the Novolin has a very fast onset, it's recommended that you feed 60 minutes before the shot. So the sequence is pre-shot test, feed, wait 60 minutes, shoot the insulin.

    There is a Sticky Beginner's Guide To Novolin/Humulin/NPH in this forum. If you haven't found it already, it's worth printing out and reading.
     
  3. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    I have found and read it. I guess the only issue with that I have is I start my externship next month at a vet clinic an hour away, working 10s. So the feed, wait, shoot, isn't going to really work with our schedule and that makes me a little nervous. At least not at night but I can make it work in the morning. He was 639 (YIKES) this evening on 2u. We will be making adjustments on Saturday after I get to +6 (I'll be doing a full curve but the vet just wants the +6). I know I could likely make a change before then I just really dont want to piss this Dr off. He's my fav ER doc and has taken on Spicoli as a regular patient (and saved his life quite a few times over the years - not diabetes related), at least till I start somewhere else next month.

    I'm very familiar with everything else diabetes wise - home test religiously, have gravy food/karo on hand, and test for ketones.
     
    Deb & Wink likes this.
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    FYI, as someone whose kitty got to higher doses, if you get up to 7 units, I'd seriously consider Levemir instead of Lantus. Lantus acid base can sting at higher doses, so most caregivers switch to Levemir. Similar action to Lantus, just a couple hours later on average for onset and nadir, and a nice long duration.
     
  5. Bama Kitty Mom (AL)

    Bama Kitty Mom (AL) Member

    Joined:
    Jul 16, 2018
    Novolin N user here. Bama has been on it for nearly 6 years and is currently at 5.25 every 12 hours. He does get rather bouncy. His nadir used to be around the +6 mark but last week I happened to test at +6 and +8 and he was lower at +8. No wonder he'd been so bouncy lately. So, never let your guard down. Get those later in the cycle tests, too. Don't just think he has settled to one nadir point and stays there forever. As for the waiting 1 hour after feeding to shoot. I don't do that. I test then feed. After he's finished most of his meal, I shoot. At most, the wait is a half hour after he starts to eat. Usually he's finished 15 to 20 minutes after beginning his meal. That's with me giving a little at a time, mixing in more water and adding a little dry food to the end. I have tested as early as +1 and haven't found his numbers to be lower at that point. Usually he continues to rise for 2 to 3 hours before I notice the insulin taking effect. I know no one seems to like Novolin N but it is what I can afford.
     
  6. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Mine is a bouncy boy too :)

    And it's nice to know you don't follow to recommended schedule, because when I get home it'll be at the 12 hr mark. I guess I could always take him to work with me, but I don't want to stress him and cause transient hyperglycemia if possible. Time to train the husband!
    So far he doesn't seem to continue to rise post shot, but we are still in the early stages of trying out this insulin.
    And as far as affordability, Jesus, I was spending a TON on Prozinc especially when we got up to 7u BID. This is by far more affordable!!!

    I have to ask, where in Alabama are you? I'm originally from Greenville :)
     
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  7. Bama Kitty Mom (AL)

    Bama Kitty Mom (AL) Member

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    Jul 16, 2018
    I lived in Montgomery as a child but now make my home near Huntsville which makes me practically a Yankee. ;)
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Since the U40 concentration insulins like Prozinc are so much less concentrated, than the U100 insulins, your costs can end up being higher in the end. U40 syringes tend to be pricier too.

    Figure out your per dose cost. Not simply what you pay at the cash register.

    Since more cats go into remission with longer lasting insulins, your long term costs are going to be lower too if you use them, and get your cat diet regulated.

    We have sources, for purchasing Lantus and Levemir from a Canadian pharmacy, where the price is 1/3 to 1/2 the cost in the US.

    A cat that isn't getting the full 12 hour duration from the insulin they are on, is going to bounce a lot more too.

    If you reach the need for 7U of insulin, you'll want to try Levemir instead of Lantus, because at higher doses, the lantus can sting and cause oddly aggressive behavior in a cat.
     
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  9. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    I wonder, has anyone tried using some bicarb when they get to higher doses?
     
    Deb & Wink likes this.
  10. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    Just talked to our vet since Spicoli's numbers have been high since switching and he recommended going ahead and bumping him up from 2u to 3u. He also has a URI currently and we are on day 3 of doxycycline.
    Unfortunately the U100 syringes they gave me only have whole unit markings and are super close together, making it nearly impossible to eyeball .5u, otherwise I'd only do a .5u increase.
    It's gonna be a long night of testing :)
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Guesstimate it, those in-between doses the best you can.
    Did your vet at least give you 3/10 cc volume syringes, and not the 5/10 cc or 1 cc U100 syringes?
     
  12. Wesley and Spicoli

    Wesley and Spicoli Member

    Joined:
    Feb 16, 2017
    It's a 3/10. And I did end up guesstimating it. I'm always hesitant to increase to much to fast :) but I will be purchasing some new syringes in the next few days.
     
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