New. Need help with insulin does

[elmotom]

hi my 8 year old boy just got Dx with diabetes. I will cut right to the questions I need help with. Doctor told me to go to Walmart and get him started on Novolin N u-100 and to get the u-100 syringes. He then told me we are starting him at 0.25 twice a day. My problem is the syringe is marked in units. The question, how many units are in 0.25? The syringe goes up to 50 units. Any info would really help.

 

[Kobe (Dean and Lesley) MO]

Welcome!

Here is some information abount Novolin N insulin and Vetsulin (another shorter-acting insulin). I am going to answer the question you asked, but first you should know that Novolin N is not recommended for cats. Some members on this forum have used it successfully, but Novolin N has a shorter duration time than Lantus or PZI. It can produce a sharp drop in BG for your cat.

 

[Kobe (Dean and Lesley) MO]

hi my 8 year old boy just got Dx with diabetes. I will cut right to the questions I need help with. Doctor told me to go to Walmart and get him started on Novolin N u-100 and to get the u-100 syringes. He then told me we are starting him at 0.25 twice a day. My problem is the syringe is marked in units. The question, how many units are in 0.25? The syringe goes up to 50 units. Any info would really help.

The 0.25 is a quarter of a unit which is extremely difficult to measure with that size syringe! I know from experience.

You want U-100 syringes that have only 30 units with marks for every half unit. Walmart has them, but you have to go inside the store to get them. I will get the info for you that a saw another member post earlier today. It was a great picture.

 

[Kobe (Dean and Lesley) MO]

I copied and pasted this from another member's post from earlier today.

If you are by a Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them
I don't know if you need a vets script though

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line

This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.

 

[Kobe (Dean and Lesley) MO]

This screenshot is from a sticky in the Lantus, Levemir, Biosimilars forum, but they use the same syringes.

 

[squeem3]

A 50 unit insulin syringe is too big for a cat. You want 30 unit syringes and specifically the ones with half unit markings so you can more easily measure 0.25 units.


If you got them from a pharmacy, you can't return the syringes so you'll have to buy a box of 30 unit ones. If you needed a prescription to buy the 50 unit syringes, you'll need a new prescription to buy different ones. See the info above in Diane's post for the Relion brand of syringes from WalMart that are good to use.

This is what 0.25 units looks like in a 30 unit syringe with half unit markings:

It's impossible to measure 0.25 units with a 50 unit syringe.

Novolin N is not a very good insulin to use. Can you tell us more about your cat? What led to the diagnosis, any other health issues, what do you feed, etc?

 

[elmotom]

hi everyone and thank you for all the great info. I will go ahead and get the right syringes today. The pharmacy guy did tell me these would be the wrong needles to measure the 0.25 but was out of the smaller ones. I will go to another Walmart. He told me he has lots of people use Novolin N for cats because it is cheaper and that is why we are starting with the Novolin N.
About cat,
8 years old
was 28lbs lost about 10lbs due to diabetes
not active at all
peeing a ton and just started peeing all over the house
walking on entire back foot I guess its called hocks
drinking water like crazy.

I got all the info on feeding cat before every shot and to keep a eye on him to watch his sugar levels. I have got his blood from his ears the 2 times I did it and he is around 200. The vet checked his urine and said it was very high. I will keep people posted and again thanks for all the great info to help me start this process

 

[squeem3]

Novolin N can be used but it's too short acting in cats. Cheaper is not always better. Not all vets are experienced with diabetes so you may want to consider seeking out a second opinion.

The best insulins to use for cats are Lantus (glargine) or ProZinc. Lantus is an insulin for people and it works very well for cats. There's a way to get the box of five Lantus pens for $35: https://www.felinediabetes.com/FDMB/threads/where-do-people-buy-their-lantus-from.299677/unread One pen will last to the last drop which can be in 2 or 3 months or more. There's actually a few members who are just a few weeks or less into this diabetic journey and they started Lantus right away along with a low carb diet and now their cats are heading into remission

@Suzanne & Darcy can provide more info on ProZinc. ProZinc is a pet insulin so you can't buy it at any local store pharmacy. And you will need different insulin syringes to start, U40 not U100. There is a way to use U100 insulin syringes with ProZinc but there's a conversion and that might be too overwhelming for a newbie to figure out right now.

Did the vet suggest any treatment for walking on the hocks? That is called diabetic neuropathy and is very treatable with methylcobalamin. Life Link Zobaline is one popular brand but there are others. I think @Diane Tyler's Mom GA has the info on an alternative for Zobaline.

What brands and type of food are you feeding? We recommend low carb canned food. There are many brands. Fancy Feast Classic / Gourmet pates is one well known brand. Dry food is not recommended at all because it will just keep blood glucose levels too high, even the prescription dry. No prescription food is needed at all.

 

[Kobe (Dean and Lesley) MO]

He told me he has lots of people use Novolin N for cats because it is cheaper and that is why we are starting with the Novolin N.

My vet prescribed a short acting insulin too because it was cheaper and that's what they had in house. It frequently caused my cat's BG to drop very low very fast. Then it didn't last long enough, so Kobe's BG would go soaring as the insulin's effect didn't last to the end of the cycle. This started a very bad pattern for my cat of high BG and dramatic drops that ultimately led to a hospitalization costing thousands of dollars. I was lucky not to lose Kobe. Obviously, this is just one experience. But, if you explore this forum you will see a lot of cats successfully using PZI, and whole heaps of cats successfully using Lantus. I will let you draw you own conclusions about the number successfully using shorter acting insulins.

I did think that Lantus was very expensive, because that's what I got from Google. I thought each pen was going to be upwards of $200 dollars. But my pens individually were around $22 a piece, and my box of 5 pens was about $90. My trust in Google was destroyed!!! I wish I had asked around on the forum, because some have gotten a box of 5 for $35.

Kobe's first Lantus pen lasted a month and a half, even after I shot close to a third of it into the sink because I was so terrible at measuring.

I don't want to badger you, I am just offering up this information so that you have what you need to make the best decision for your cat.

 

[Diane Tyler's Mom GA]

Did the vet suggest any treatment for walking on the hocks? That is called diabetic neuropathy and is very treatable with methylcobalamin. Life Link Zobaline is one popular brand but there are others. I think @Diane Tyler's Mom GA has the info on an alternative for Zobaline.

This is what you should use for diabetic neuropathy
the Vitacost brand another member told me about
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

Same as Zobaline , but the Zobaline is so expensive as you know
This is the same thing
The only difference is the Zobaline has 200 mcgs of folic acid
So I bought the folic acid at the supermarket and crush it up and added it to the Vitacost brand
If you can't find the 200 mcg get the 400 mcg and cut it in half and crush it up and add it, some members didn't even add the folic acid and the neuropathy improved
The Vitacost brand is a capsule so just open it and pour the powder on the wet food
Has no taste, no need to crush it up, I still give it to Tyler every now and then and he has never tasted it in his food , I always add water to his food and just stir up the methyl B-12 good
I switched to the vitacost brand because the zobaline was too expensive,
Even though the vitacost brand is 5000 mcgs and the zobaline is 3000 mcgs
What they don't need they will pee out because it's water soluble.

The Zobaline is expensive for 60 pills, 30.00 some other places want 33.00
I used to use the Zobaline when I joined, then a member told me about the Vitacost brand .

It took about 2 months for Tyler to get back to walking normal, jumping on to the couch, running around
But every few weeks I did see a slight improvement
Some members didn't even add the folic acid to the vitacost brand and it still helped and the neuropathy was gone

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

14.49 for 100 capsules

 

[elmotom]

Novolin N can be used but it's too short acting in cats. Cheaper is not always better. Not all vets are experienced with diabetes so you may want to consider seeking out a second opinion.

The best insulins to use for cats are Lantus (glargine) or ProZinc. Lantus is an insulin for people and it works very well for cats. There's a way to get the box of five Lantus pens for $35: https://www.felinediabetes.com/FDMB/threads/where-do-people-buy-their-lantus-from.299677/unread One pen will last to the last drop which can be in 2 or 3 months or more. There's actually a few members who are just a few weeks or less into this diabetic journey and they started Lantus right away along with a low carb diet and now their cats are heading into remission

@Suzanne & Darcy can provide more info on ProZinc. ProZinc is a pet insulin so you can't buy it at any local store pharmacy. And you will need different insulin syringes to start, U40 not U100. There is a way to use U100 insulin syringes with ProZinc but there's a conversion and that might be too overwhelming for a newbie to figure out right now.

Did the vet suggest any treatment for walking on the hocks? That is called diabetic neuropathy and is very treatable with methylcobalamin. Life Link Zobaline is one popular brand but there are others. I think @Diane Tyler's Mom GA has the info on an alternative for Zobaline.

What brands and type of food are you feeding? We recommend low carb canned food. There are many brands. Fancy Feast Classic / Gourmet pates is one well known brand. Dry food is not recommended at all because it will just keep blood glucose levels too high, even the prescription dry. No prescription food is needed at all.

so how long do these pens last? A month? a week? I will see the other vet in 3 weeks when i go back and hope to get some better info then I have got so far from them

 

[elmotom]

This is what you should use for diabetic neuropathy
the Vitacost brand another member told me about
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

Same as Zobaline , but the Zobaline is so expensive as you know
This is the same thing
The only difference is the Zobaline has 200 mcgs of folic acid
So I bought the folic acid at the supermarket and crush it up and added it to the Vitacost brand
If you can't find the 200 mcg get the 400 mcg and cut it in half and crush it up and add it, some members didn't even add the folic acid and the neuropathy improved
The Vitacost brand is a capsule so just open it and pour the powder on the wet food
Has no taste, no need to crush it up, I still give it to Tyler every now and then and he has never tasted it in his food , I always add water to his food and just stir up the methyl B-12 good
I switched to the vitacost brand because the zobaline was too expensive,
Even though the vitacost brand is 5000 mcgs and the zobaline is 3000 mcgs
What they don't need they will pee out because it's water soluble.

The Zobaline is expensive for 60 pills, 30.00 some other places want 33.00
I used to use the Zobaline when I joined, then a member told me about the Vitacost brand .

It took about 2 months for Tyler to get back to walking normal, jumping on to the couch, running around
But every few weeks I did see a slight improvement
Some members didn't even add the folic acid to the vitacost brand and it still helped and the neuropathy was gone

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

14.49 for 100 capsules

Thanks for that great info. I will order that now. The vet said that would go away in time and just said is was due to the nerve damage from high blood sugar.

 

[Kobe (Dean and Lesley) MO]

so how long do these pens last? A month? a week?

Each Lantus pen contains 3 mL of insulin solution. Lantus is a U-100 insulin meaning each mL of the insulin solution contains 100 units of insulin. So... each pen has 300 units.

How long those 300 units last depends on how big your cat's dose is.

If kitty's dose is on average 1 U, you'd get 300 doses, 150 days of insulin if you didn't waste a drop (not really possible) so call it around 120 days or 4 months.

For an average dose of 2 units, you could use to pen for 2 months.

For an average dose of 0.5 units, 8 months.

If you look at our member's Spreadsheets, (linked in our signatures), you'll see that cats' insulin needs change. But this should give you an idea of why some say 2 months and others say 6.

I got 1.5 months for our first pen because I was so bad at drawing insulin at 5:30 am half asleep. But $22 for a month and a half of insulin isn't too bad. And I got better at drawing insulin.

That was a lot of math! Whew!

 

[squeem3]

so how long do these pens last? A month? a week? I will see the other vet in 3 weeks when i go back and hope to get some better info then I have got so far from them

A single pen contains 3 ml of insulin and lasts to the last drop This can be 2 or 3 months or more later, depending on your cat's dose. A box contains five pens so you basically have at least a year's worth of insulin ready to use. Some pharmacies may sell a single pen. I think the prescription has to specify a single pen or a box of pens. Keep the pens in the fridge on an interior shelf, not on the fridge door.

You don't need the pen needles. Those are for Human diabetics and just don't work for cats for a variety of reasons. You can use an insulin syringe to draw the insulin out of the pen just like you would with an insulin bottle.

If you go with ProZinc, that only comes in bottles. I'm not sure how long a bottle of ProZinc typically lasts for.

 

[Diane Tyler's Mom GA]

If you are able to get Lantus or the generic see this post, post #3
https://felinediabetes.com/FDMB/threads/where-do-people-buy-their-lantus-from.299677/#post-3259897

 

[Suzanne & Darcy]

I would not use Novolin on my cat as a first line insulin. You need a vial of ProZinc or get some Lantus in a vial or pens (I like the pens.). The American Animal Hospital Association recommends those two insulins for use in cats.

 

[elmotom]

I got the b12 pills and cat had 4 shots so far. So far so good. No change in cat as of yet but I guess takes a couple of weeks to notice anything. I hope soon the peeing everywhere stops. Tonight he will be the first night we keep him in the basement where his litter box is, the peeing on the floor is out of control.

 

[Kobe (Dean and Lesley) MO]

Good evening!

Hopefully your cat starts feeling better soon.

Members who will be helping you need some important information available at a glance. Could you please use your signature to tell us about your cat? Edit Signature

 

[Kobe (Dean and Lesley) MO]

On this forum we test our cats' Blood Glucose before each shot to keep our cats safe while they use their insulin. Some of us also use continuous Glucose monitoring devices that can last up to 14 days. Many of us use a ReliOn Premier Classic Blood Glucose Meter available at Walmart for under $10. A pack of 50 testing strips for the ReliOn Premier is under $10. You need 26 or 28 gauge lancets; a pack of cotton rounds is very helpful.

 

[Diane Tyler's Mom GA]

@elmotom
You need to create your signature
Can you please fill out your signature
Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information. It's at the end of everyone's post in gray letters

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Bexacat or Senvelgo (if applicable) and dates
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


And need to create our spreadsheet where we track our cats BG numbers. Here is the link on how to set it up and will also explain how to use it
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Take a look at any members spreadsheet to see what it looks like

@elmotom

 

[Diane Tyler's Mom GA]

You can also get these U-100 syringes with half unit markings

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
• BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
• Syringes come in 5/64 inch (6mm), ½ inch (8mm) or 5/16 inch (12.7mm) needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest

You can order the U-100 syringes with half unit markings from Amazon without a doctors script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

 

[Diane Tyler's Mom GA]

@elmotom
Are you home testing, if not I suggest you do

Here is the link for the meter and test strips so you don't have to search for them. Most of us use human meters
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart on line



Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. Youcan fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capillaries it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets any brand
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up


Here is a video one of our members made, just ignore when she has to code it, that's because she is using a pet meter ,with a human meter like the Relion no coding is needed
VIDEO: How to test your cat's blood sugar

 

[Diane Tyler's Mom GA]

Here is the link for Novolin N
Please read all about it
https://felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/
@elmotom

 

[Diane Tyler's Mom GA]

Here is some information abount Novolin N insulin

I think you have the wrong link for Novolin N
So I posted it above
@Kobe (Dean and Lesley) MO

 

[Kobe (Dean and Lesley) MO]

Yep! Definitely the wrong link. I fixed it. Thank you Diane.

 

[elmotom]

cat seen new vet and is now in Lantus. 4 units 2 times a day. His sugar was 540 at the vet. He said to check his sugar in 1 week and see where we are at. I hope this helps.

 

[Sienne and Gabby (GA)]

It's good to hear you were able to get a prescription for Lantus. That is a large dose of insulin given that I doubt you've been able to get close to that dose in the less than a month that your cat's been diagnosed. Despite your vet suggesting you don't need to check Elmo's blood glucose for a week, please test him at least 4 times a day. You need to be certain that his numbers are in a range where it's safe to give an injection and you need to be testing a minimum of once during both the AM and PM cycles, somewhere around mid-cycle, to be sure that his numbers haven't dropped dangerously low. Home testing is the only way to ensure that Elmo is safe. Getting information about how Elmo is responding to insulin is no different than what your doctor would tell you about managing your diabetes.

It is likely that Elmo's numbers were high at the vet's office due to stress. I suspect they would be considerably lower when he's home with you.

This is a link to the Lantus forum. There are sticky notes at the top of the page. They go over some basics about the way that Lantus works as well as information about dosing. Please look the information over so you have a feel for how Lantus differs from Novolin. They are very differnent types of insulin.

Are you still feeding Elmo dry food? If so, it is likely quite high in carbs. As you know, carbs will drive up the blood glucose numbers. You may want to consider transitioning him to a low carb, canned food diet. We consider low carb as under 10% carb.

If you set up a spreadsheet, we will be able to help you with dosing questions. There is information on setting up your spreadsheet in this post on helping us to help you.

 

[elmotom]

It's good to hear you were able to get a prescription for Lantus. That is a large dose of insulin given that I doubt you've been able to get close to that dose in the less than a month that your cat's been diagnosed. Despite your vet suggesting you don't need to check Elmo's blood glucose for a week, please test him at least 4 times a day. You need to be certain that his numbers are in a range where it's safe to give an injection and you need to be testing a minimum of once during both the AM and PM cycles, somewhere around mid-cycle, to be sure that his numbers haven't dropped dangerously low. Home testing is the only way to ensure that Elmo is safe. Getting information about how Elmo is responding to insulin is no different than what your doctor would tell you about managing your diabetes.

It is likely that Elmo's numbers were high at the vet's office due to stress. I suspect they would be considerably lower when he's home with you.

This is a link to the Lantus forum. There are sticky notes at the top of the page. They go over some basics about the way that Lantus works as well as information about dosing. Please look the information over so you have a feel for how Lantus differs from Novolin. They are very differnent types of insulin.

Are you still feeding Elmo dry food? If so, it is likely quite high in carbs. As you know, carbs will drive up the blood glucose numbers. You may want to consider transitioning him to a low carb, canned food diet. We consider low carb as under 10% carb.

If you set up a spreadsheet, we will be able to help you with dosing questions. There is information on setting up your spreadsheet in this post on helping us to help you.

thanks for the info. I will check it before every shot to make sure its not really low. I will also check it around 8 hours after he has it to make sure it working. He is going to only have wet food from now on also. I will have my wife do the spreadsheet, I have no idea how to do that and she does. The vet said he will stop peeing everywhere when his sugar is under control, that will be great when that happens. The vet we seen is amazing and really nice guy, he sounded very positive that he will get way better in a few weeks when it is under control. I will have my wife set up a spreadsheet when she has time. Thanks again for all the great info.

 

[Diane Tyler's Mom GA]

@elmotom
Since you switched to Lantus and are no longer feeding dry food, I would add that on your signature.
After you have Novolin N please put a / after that and put Lantus and the date started.
And delete dry food
When your wife sets up our spreadsheet do the same about the insulin
You will see where it asks you at the top of the spreadsheet.
I would definitely read all the yellow stickys on the Lantus forum that Sienne gave you above.
Besides testing at the AMPS and PMPS I would get another test @+6 for both cycles.
The more the better , Each day and night you can test at different times . The Lantus Stickys will explain it

 

[Sienne and Gabby (GA)]

Diane is correct -- you want to try to get a test somewhere around mid-cycle. That would be between +5 to +7 roughly speaking. Will that be possible? A cycle is a 12-hour period. Just so you're aware, not all cats have their low point at mid-cycle. My cat, for example, had an early nadir. She could reach her low point any time from 3 hours after shot time.