So confused

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Mum of two felines

Mum of two felines

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Ok, I have two kitties who are diabetic. The one that was diagnosed in August is regulated. The second fur baby is being really hard. The first SS is his. As you can see when he gets his insulin, 12 units, he crashes into the 20's and 30's. I use the alphatrax 2. I did a 24 hour check on him yesterday through last night and I am continuing to test him every 2 to 3 hours. As you can tell on his SS he tested at 162. He'll need insulin soon. He is on Novalin. What would you do?
 
You need to change the permissions on your spreadsheet...right now we can't see them

Go to the top right corner and hit "Share"..a new box will pop up....go to the bottom right and click on "Advanced" and change it to "anyone with the link" and then "save" it

What are you feeding?
 
Hi there,

I'm sorry to hear you're having problems regulating one of your kitties. I just tried to bring up the spreadsheets but the sharing permission isn't set yet. If you go into each spreadsheet and look at the top right of the screen (on a PC browser) and click on share and then give permission for anyone with the link to VIEW (NB not edit!) the sheet, members will be able to see the information.

I have not used Novolin but I do use an Alphatrak, and 20s and 30s as measured on that meter are dangerously low so your cat must be getting too much insulin. tThe bottom end of the reference range for a non-diabetic is c. 68 mg/dL (3.8mmol/L) on an Alphatrak. I believe that Novolin can drop the blood glucose level hard and fast. Does your vet have an out of hours number you can contact for advice about dosing (and possibly changing to a gentler insulin)?



Mogs
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I am feeding prescription hills w/d canned and I am still feeding some dry because I am in the middle of switching both to canned. I live in a small town of less than 2500. We have 2 vets, both of which doctor large animals more than small pets. I talked to my vet about getting a home monitor, but he said that the readings would be all over the place and wouldn't really help. So, I haven't told him. He uses iPet at his office. When I take my cats in they are usually 60 points higher there than when I get them home to check them. Woody, has had a particularly hard time over the last month and a half. He had a cyst removed from his back, had intestinal issues (which really haven't changed) and then diabetes(which was diagnosed after his surgery for his cyst).
 
OK...I don't use Novolin either, but 12 units is a HUGE dose for any cat unless they've been diagnosed with a high dose condition like acromegaly or IAA

One thing that is VERY obvious is he's on too much insulin....dropping to LO (or anything under 68 on a pet meter) is the sign that they need a reduction in dose. The lower numbers you've been getting on Woody are very dangerous

What dose was he started on, and how were dose increases done? In whole units?

The food you're feeding is also a high carb food that's really not good for diabetics but with him going so dangerously low, it's probably the only thing that's kept him alive

I totally understand the problem with vets...I live in a small town of 1000 with 2 vets that are mostly large animal too. I had to do a lot of calling around before I found a vet over 50 miles away that was willing to give me a good insulin like Lantus for China

Novolin just isn't usually a good insulin for cats, but a lot of vets use it in dogs and think they can treat their feline patients the same way. It tends to hit them hard and drop them fast and then they bounce high again, so it ends up being a vicious cycle
 
I use Vetsulin, which is very similar in action to Novolin. 12 units is A LOT of insulin! Blood glucose levels that are below 68 on an AlphaTrak meter are considered to be too low and potentially dangerous. Do you have a hypo kit? If not, please read these to see what you need and how to treat a hypo.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

If I were you I would call the vet as soon as possible to discuss these low numbers. I really think you need a sizeable dose reduction. Please let us know how things go! :)
 
From your SS I conclude that 10 units is too high. I would reduce to 5-6 units. N is not the best insulin since you get a fast decrease. However, your SS shows that N may be acceptable.
If you change to a low-carb canned then insulin needs may be decreased and thus a lower dose would be the required.
 
I am so glad I found this board!! It was worth waking up every 2 hours Friday night and Saturday morning so I could track what Woody's body was doing. I kept thinking we were in a vicious cycle - me feeding them dry, his number would go up, then I would give him 13, he'd drop eat more dry, numbers would go up, etc.

When he was diagnosed they started on 3 units and kept moving it up by 1 to 2 units until his glucose readings were under 180 at 13 units. That's where we kept them. But, before I started home testing, the only time I could get my kitties out to get checked was after work which was 9 hours after their injection. They both hate car rides and I know it stressed them out. Every time I'd take woody he would be over 220. (Of course with both of them dropping to under 40 I HAD to keep dry out and who knows when they last had a snack,)

This last check at the vet Woody was 226 and the vet told me in crease by 2 units! That would have been 15 units. I kept telling them he kept getting low, because of how he acted and went crazy over his food, but I don't think that registered. That was when I decided I would start doing a 2 hour check around the clock this weekend.

I took off Friday afternoon and started checking him. I am now confident what his body is doing and last night I decided no more 10 units until I start seeing those numbers go up AND no more dry food!!

I woke up last night at +7 and checked him after giving only 5 units and he was at 97!!!!! His AMPS this morning was 167!!!

I am at a crossroad now, his 167 would indicate that another 5 could be given, but his drop at +4 last night at 41 is still too low. I think maybe I'll give 4 units this morning. I know that we may need to move up after he gets this backlog of insulin out of his system, but I will adjust when his numbers start moving up.

And I will make an appointment to sit down to discuss Woody with the vet and show him his spreadsheet and the links on this page. I KNOW this board saved Woody's life!!!

And I am getting the hypo kit together today. The vet gave me NutraCal to give them when they are low, but Karo syrup seems a lot better. I don't know if I can find the treats, but will look high and low.

Thank you guys sooooo much!!!!!!!

Now onto figuring out what we do when we go to the lake this summer. Who do I ask to take care of them!! No family or close friends and the lady who has taken care of them mows lawns all day and won't want to test them. But maybe by then, 4 months out, I'll have Woody under control.
 
Another question, do you think the high insulin dose is causing his loose stools? The Dr.'s wife told me to stop the canned food, but Buzz doesn't have loose stools, but Woody does and boy do they stink! The vet says it's an intestinal issue and we'll have to live with it since it's really hard to regulate.

Oh, and Woody jumped up on the windowsill this a.m. This is the first time he's done that since before Christmas!!! And he's trying his hardest to give kisses! Another first!
 
you are doing a great job --so glad you are testing!!
others will chime in on advice I am still kind of a rookie :)
would your vet give you a script for a different insulin? Lanuts is much more gentle… just a thought
Happy Sunday and WELCOME!!
 
Just saw last post--dry food is NOT a diabetic cats friend--
again…. others will come by with great advice on switching food--
If you switch to all wet low carb (not DM) your insulin requirements will be much lower so very important to test as just the food switch will lower BG levels. Many people e here use fancy feast classic variety only--no gravy stuff-
 
Hi Mum of Two,

I see that both Woody and Buzz have both gone too low again today, even on the reduced doses. As I said above, I've not used Novolin but based on the improvement in Woody's behaviour today I think that it is highly possible that he was overprescribed insulin (often because curves are run at vets' offices when the cats are stressed and therefore a dose that seems OK with vet office numbers may very well be too high for a cat when it's back at home). If a cat starts on too high a dose it can take BG numbers up, not down. Unfortunately it's not unheard of for vets to then give instructions for the dose to be further increased - and often in jumps that are too big. It is possible (and I can only speculate here) that Woody hasn't been feeling great because his system may have been working very hard to produce glucose to compensate for the too-high dose of insulin.

You're still getting dangerously low numbers even after making big reductions to the doses for both cats. Please, for your kitties' safety leave dry food out for them for the time being (and the w/d canned if you have any) until someone here can help you with input on dosing because doses for both cats are still too high. Even if the dry food makes Woody and Buzz run a little higher temporarily it is the only safe thing for you to do right now until you can get the dosing sorted out.

I am very glad that you started to home test.

I have put a request out on the FH board to ask members with Novolin experience to come to this thread to give you help and advice as a matter of urgency. Please can you keep an eye on this thread for responses. I'm very sorry that I don't have the necessary experience to help you further right now but other members do so hang in there.


Mogs
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I agree with others good job cat mama.

For the lake this summer. As much as the kittens hate a car ride, is bringing them along a possible solution. Yes it may cause stress during travel but it is something to consider. Fern was just newly diagnosed when Christmas came around and I had a week long trip to FL. I tried Plan a and b but had to revert to plan C which was taking Fern with me. (I could thankfully). I know he was stressed on the days we actually traveled but he had a great time hanging out on my family's condo Balcony in between.
 
IMPORTANT:
  • You need to keep numbers ABOVE 68 (Alphatrak).
  • If you give insulin start testing at +1.5 and test every 30 minutes until at least +3.5 to make sure that they're not heading down into dangerous numbers again.
  • Intervene with carbs immediately if numbers go below 68. Do not let BG go any lower.
  • Even after you intervene, test every 20-30 minutes until you are absolutely certain that numbers are up and that they are going to STAY UP.
Mogs
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I decided Buzz was not getting his shot tonight! He doesn't need it if he's at 97 one hour before his shot. Test tomorrow morning. Woody I did 5 tonight since his BG was 287 at eating time. I will leave food out for Woody tomorrow if I don't give Buzz his injection and Buzz will get to be in the house. Woody will get to stay in our heated enclosed patio room and enjoy the birds eating from the bird feeder. And, yes, Woody is acting so much better today! even with his dry food being taken away. He's actually jumping on chairs and walking down the hallway to his girl's room.

Thank you for your advice. I am new to this but I am not going to blindly follow a vet. I don't with my own doctors. When something doesn't seem right I go to research it.

I also went to the store and got some Friskies pate. I started with a 1 to 3 ratio. Buzz came back for seconds. Lol
 
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Hi,

FYI I also posted a reply on your other thread.

http://www.felinediabetes.com/FDMB/...my-kitty-is-in-remission.151921/#post-1593293

Please read it ASAP and definitely before giving Woody any more insulin.

-----

I know that you want to feed Woody and Buzz a food that's good for diabetics but first you need to sort out a low enough, safe dose to give Woody. You've proved this weekend without a shadow of doubt that the lower carb food really lowers their BG levels. However Woody's blood glucose levels have been getting very dangerously low every day, even on 3 units of Novolin. I would suggest the following:

1. Go back to feeding the higher carb food. Don't lose heart over any higher numbers over the short term because you know they will improve when you SAFELY get the food and dosing situation sorted out.

2. Ring your vet early today and agree a dose (something less than 3IU) and also a "NO SHOOT" number below which you must not give insulin. Also agree in advance that you will check in daily with the vet to discuss dosing as the controlled food transition progresses.

3. Run a full curve with the higher carb food and the lower dose to get a proper baseline.

4. In a very controlled, slow manner g-r-a-d-u-a-l-l-y start swapping over to the low carb food while monitoring and reducing the insulin dose as Woody's numbers improve, e.g.:

  • Day 1 - Higher carb food, dose less than 3 units and full curve.
  • Day 2 - For all meals, give a mix of 90% high carb and 10% low carb food. Test at both preshots and don't give insulin if the BG is below the NO SHOOT number you agree with your vet. Start testing at +2 to see where cycle is going. Always If low intervene with carbs. Test again at +3, +4 and then as necessary to keep Woody safe.
  • Day 3 onwards - reduce high carb food by 10%, and increase low carb food by 10% (mix them together!). Monitor as above. If BG goes below 68 then the dose is too high now and should be reduced at the next cycle.
Keep switching mix of low and high carb foods by 10% each day. Monitor closely throughout the food transition to keep Woody safe. Reduce dose if numbers go below 68. Keep in regular contact with your vet about dose reductions as the daily carb load decreases. Don't give insulin if preshot BG is below the no shoot number you agree with your vet. Test urine every day for ketones. If trace ketones detected seek advice from your vet ASAP. If ketones are above trace you would need to take your cat to the vet immediately so that the vet can provide treatment to flush them out of the system (so as to prevent DKA).

As I've said before, I'm not a vet and I'm not familiar with Novolin other than I know from my reading here that it can drop numbers hard and fast (and that's what you've been seeing in your cats' spreadsheets). I normally would not have commented on a Novolin thread but I am very, very worried about Woody gettting into very dangerous numbers time and time again. These suggestions are offered on the understanding that they are based on good general principles and that you really need to discuss diet change and dosing with your vet as a matter of extreme urgency.

Sorry if I sound a bit OTT: my intention is to be as helpful to you as I can, I'm just very worried about the dangerously low numbers your cats are seeing.


Mogs
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For people following this thread or reading from the archive - especially if you're using Novolin, (same as Humulin N - different manufacturer), the following forum sticky is highly recommended reading:

Humulin N Primer


Mogs
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Wow!
I'm glad your cat is still alive.
Slow, cautious, small changes as Mogs describes will let you monitor him and keep him safe.
Showing your vet the number may help convince him you are being diligent and careful in caring for your cat.
Once you get down to a safe dose and low carb food, you may find you need to shoot every 8 hours for optimal control. That is a common issue in using NPH, hence the suggestion you may want to consider a different insulin.
You may find that requesting ProZinc, or BCP PZI will work better, as the vet knows something about using an in and out insulin already.
 
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