Novolin dosing advice

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ja9390

ja9390

Member Since 2016
Diego's vet wants him on 2u twice a day. I wanted to slowly get him on it, so we did 1.5u for a while which seemed to be doing well for him. Ever since I've increased his dose by .25u he's been bouncing. Does this stop? Should I taper back down to 1.5u and tell the vet to kiss his orange furry butt? She wanted him on Hills W/D as well but I refused it and said not only could I not afford it, the canned food I'm feeling him has a third of the carbs for a third of the price. She also wants me to drop him off for a curve once he gets to 10 consecutive days at home of having 2u twice a day, said something about in the beginning it's hard to get them regulated and maybe later it will get to where I can do my own curves at home. I'm more than capable of curving him at home now and I'd rather not drop (I can't, and won't) $50 for them to get an inaccurate stressed out reading from him. This is the endocrine specialist by the way.

My internet connection to the computer is out so I can type out his last few days worth of readings on my phone. Last night he was hungry hungry again, back to drinking tons of water and peeing a lot. He also had a BG reading of over 600 for the first time since I've been testing him. I don't want my cat to be 15 years old and blinded by cateracts, lamed by neuropathy and living a miserable life because of some vet.

2/28 -- after he had the 80 at +3 he jumped to 321 at +5

2/29-- amps 455
1.75u 8:20am
Pmps 600+ (the meter wouldn't even register an actual number)
7pm 1.75u
+1.5 - 562
+4 - 396

3/1 -- amps 519
7:45am 1.75 u
 
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I realize that getting him regulated is going to be a process but I really strongly feel like the Novolin isn't working for his particular situation. It worked great at first and now not so much. When I shoot, he is happy as a clam for a couple hours following when it takes him to his lowest point and then he'll continue to creep back up even higher than what we started out with that day and that's when he starts begging me for food and drinking huge amounts of water. Right now it's +3 and he is lounged out on the rug sleeping under my desk. In 5 hours he'll be antsy. With a longer lasting insulin, I will have to get him adjusted to it and have these ups and downs for a while too but at least he won't be running out of a necessary exogenous hormone by hour 8 when I'm still at work.
 
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It often is that early harsh drop that makes Novolin hard to work with, as it often causes a bounce. I wonder about a sliding scale - shooting less than 1.5 on a yellow preshot and 1.5 on a pink/red. Last night 1.75 seems to have caused a harsh drop and a high amps. 1.5 gave you a softer cycle and a lower preshot 12 hours later.

It certainly can be that a less harsh insulin will work better, and it is often easier to deal with.
 
Sue and Oliver (GA) said:
It often is that early harsh drop that makes Novolin hard to work with, as it often causes a bounce. I wonder about a sliding scale - shooting less than 1.5 on a yellow preshot and 1.5 on a pink/red. Last night 1.75 seems to have caused a harsh drop and a high amps. 1.5 gave you a softer cycle and a lower preshot 12 hours later.

It certainly can be that a less harsh insulin will work better, and it is often easier to deal with.
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I'm glad somebody else agrees on that. I need to get him on Lantus as soon as I can. In the meantime I think I will stick with his 1.5u dosages. It seems to flow with him better. Crazy how just a .25u increase can knock him on the floor.
 
Yes, based on your SS dat N insulin does not seem to be working and would ask the vet for a longer-acting insulin like Lantus, Levemir or ProZinc.
 
I agree with the others about changing the insulin...Novolin is not a recommended insulin for cats because it doesn't last long enough in their systems to get good control over BG. Cats' metabolisms are twice as fast as people's or dogs', so while Novolin may last 12 hours in a dog or person, it only lasts 6-8 hours in a cat. So you have 8-12 hours of the day where the insulin is not working to lower your cat's BG levels. You need a longe acting insulin that will give you good control over his BG the entire cycle.

If you're testing at home, you can certainly do the curve yourself and relay the numbers to your vet. Your curve will be more accurate than theirs! They should know this. If not, you can pass them along a copy of the American Animal Hospital Association diabetes guidelines with your insistance to consider your curve numbers. Under "Insulin therapy in the cat", "Precautions and Details" it states "Home monitoring of BG is ideal and strongly encouraged to obtain the most accurate interpretation of glucose relative to clinical signs."
 
I'm at the vet. I checked his blood sugar when I leaned in real close to kiss him and I noticed his breathing sounded a little labored. 600+
 
We are still on Novolin. I reluctantly agreed to give it more of a chance to work. She looked over my data book and said he for sure needs at least 2 units to get him into more stable readings. She is fine with me feeding Friskies now that she knows the carb values of them. She palpated his abdomen when I brought up the fact that he was constipated for almost a week, and could feel no signs of a blockage or any buildup of stool at all, which is great. Told me to continue the canned pumpkin in his food every day and for maintenance I could also use Metamucil flakes. She doesn't think that Miralax is gentle enough and doesn't encourage the use of it, at least for him.

The great news, and the reason why I agreed to keep giving Novolin a chance to work, is that Diego has gained 1 pound in the month since he's been diagnosed and I've been treating him, meaning that his cells are no longer starving and his body is beginning to respond to the insulin. He was a scrawny 7.5 lb baby (Maine Coon mix!) with painful looking dry skin, dry hair, and dandruff. Now he is 8.5lb and his skin looks much healthier. I havent used any supplements. Dandruff is still there but MUCH better than what it was 4 weeks ago. I am a perfectionist. I put in quality work and expect positive results and now I'm finally starting to see some positive results.

We are on 2u now, and she wants him in 10 days to curve him and see where he's at. I will let her have a chance to curve him and then I will ask if I can do the curves with him at home from that point on.
 
Since you are still working with Novolin any way you could shoot T.I.D (three times a day)? Since it is an in and out insulin you would have no shed to worry about and Novolin typically peaks in about 4-5 hours after injection and is completely gone out of his system by about 8 hours leaving him uncovered for the remaining time until the next shot is due...While I haven't used it with any of my own cats (mine are Levemir boys) I have used it at the local shelter where I volunteer. We shot 3 times a day, there and have had fairly good results.
 
MommaOfMuse said:
Since you are still working with Novolin any way you could shoot T.I.D (three times a day)? Since it is an in and out insulin you would have no shed to worry about and Novolin typically peaks in about 4-5 hours after injection and is completely gone out of his system by about 8 hours leaving him uncovered for the remaining time until the next shot is due...While I haven't used it with any of my own cats (mine are Levemir boys) I have used it at the local shelter where I volunteer. We shot 3 times a day, there and have had fairly good results.
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Sadly I cannot. That would require me being home around 3pm which I never am.
 
ja9390 said:
We are still on Novolin. I reluctantly agreed to give it more of a chance to work. She looked over my data book and said he for sure needs at least 2 units to get him into more stable readings. She is fine with me feeding Friskies now that she knows the carb values of them. She palpated his abdomen when I brought up the fact that he was constipated for almost a week, and could feel no signs of a blockage or any buildup of stool at all, which is great. Told me to continue the canned pumpkin in his food every day and for maintenance I could also use Metamucil flakes. She doesn't think that Miralax is gentle enough and doesn't encourage the use of it, at least for him.

The great news, and the reason why I agreed to keep giving Novolin a chance to work, is that Diego has gained 1 pound in the month since he's been diagnosed and I've been treating him, meaning that his cells are no longer starving and his body is beginning to respond to the insulin. He was a scrawny 7.5 lb baby (Maine Coon mix!) with painful looking dry skin, dry hair, and dandruff. Now he is 8.5lb and his skin looks much healthier. I havent used any supplements. Dandruff is still there but MUCH better than what it was 4 weeks ago. I am a perfectionist. I put in quality work and expect positive results and now I'm finally starting to see some positive results.

We are on 2u now, and she wants him in 10 days to curve him and see where he's at. I will let her have a chance to curve him and then I will ask if I can do the curves with him at home from that point on.
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Really happy that your vet is working with you.
 
ja9390 said:
Sadly I cannot. That would require me being home around 3pm which I never am.
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Kind of figured it was a long shot, but thought I might as well at least throw it out there as a consideration. Yeah, it's much easier to do at the shelter since we have someone there just about around the clock.

Mel and The Fur Gang
 
MommaOfMuse said:
Kind of figured it was a long shot, but thought I might as well at least throw it out there as a consideration. Yeah, it's much easier to do at the shelter since we have someone there just about around the clock.

Mel and The Fur Gang
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I definitely would if I could. His number was 266 this morning which was more than welcome after having almost a straight week of being in the 400 and 500s! The 2u is proving quite effective, albeit that was his first dose.
 
It sure makes life easier. Been there through 2 hypos in one month, the first one almost fatal. The second one was the catalyst for vet agreeing to Lantus.
 
It's great that Diego seems to be doing better, but I think you would see even more improvement with him on a better insulin. There is a window of remission with Lantus, so the sooner you start it, the better your chances are and the easier it will be to get him regulated. I wouldn't let him stay on the Novolin for more than 4-6 weeks. I would also use caution with raising the dose--because of the prevelance of hypoglycemia with Novolin, please make sure you're testing frequently when he's peaking mid cycle (I would try and at least get a couple of daily tests in between +2 and +6 in addition to your preshot tests, for both cycles). If he drops too low, he's going to shoot right back up to high numbers later on in the cycle and that high BG will possibly last through the next few cycles, so you need to catch it while it's happening.

If you're having trouble convincing your vet to switch, here is a study released last year that directly compares Lantus to Novolin. The results showed very good control of blood glucose with Lantus and little to no incidents of hypoglycemia, while the cats on Novolin had poor control due to the Novolin wearing off after 8 hours (leaving the cat hyperglycemic for the remaing 4 hours of the day), and increased incidences of dangerous hypoglycemic episodes. I have several other studies from previous years that draw similar conclusions.
 

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Julia & Bandit said:
It's great that Diego seems to be doing better, but I think you would see even more improvement with him on a better insulin. There is a window of remission with Lantus, so the sooner you start it, the better your chances are and the easier it will be to get him regulated. I wouldn't let him stay on the Novolin for more than 4-6 weeks. I would also use caution with raising the dose--because of the prevelance of hypoglycemia with Novolin, please make sure you're testing frequently when he's peaking mid cycle (I would try and at least get a couple of daily tests in between +2 and +6 in addition to your preshot tests, for both cycles). If he drops too low, he's going to shoot right back up to high numbers later on in the cycle and that high BG will possibly last through the next few cycles, so you need to catch it while it's happening.

If you're having trouble convincing your vet to switch, here is a study released last year that directly compares Lantus to Novolin. The results showed very good control of blood glucose with Lantus and little to no incidents of hypoglycemia, while the cats on Novolin had poor control due to the Novolin wearing off after 8 hours (leaving the cat hyperglycemic for the remaing 4 hours of the day), and increased incidences of dangerous hypoglycemic episodes. I have several other studies from previous years that draw similar conclusions.
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Thanks for this. I am confident that she is planning to switch us once we get better control of him. He's had so much go on with his little body all at once, she wants to proceed with this drug for a while before making a switch to an entirely new insulin which operates differently while he has time to adjust. She is a feline endocrine specialist, and a professor at my state's most sought after and competitive school of veterinary medicine. At our first consultation she said that she recommends Lantus. I feel like we're finally in good hands and she wouldn't let anything slip through the cracks with him but I will bring up my desire to get him on Lantus at our next appt.
 
If this is how the Novolin makes him feel then I'm team-Novolin (for now). I am thankful that at least it saved his life. My little 8.5 lb dandruff-free peaceful, sleeping chunk.
 

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ja9390 said:
Thanks for this. I am confident that she is planning to switch us once we get better control of him. He's had so much go on with his little body all at once, she wants to proceed with this drug for a while before making a switch to an entirely new insulin which operates differently while he has time to adjust. She is a feline endocrine specialist, and a professor at my state's most sought after and competitive school of veterinary medicine. At our first consultation she said that she recommends Lantus. I feel like we're finally in good hands and she wouldn't let anything slip through the cracks with him but I will bring up my desire to get him on Lantus at our next appt.
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You would definitely would have better control on Novolin with 3 time a day dosing but since you can't do that you should probably switch to a longer acting insulin.i could dose 3 times a day that is why Novolin worked good with my cat.sometimes Novolin will be out of her system in 6-7hrs but not too often and sometimes last to 10hrs but most makes it to 8hrs.so I had to keep eye on it.had her at 99 and an hr and half later she would be in the 400s!when it goes it goes super fast.
 
Cat girl said:
You would definitely would have better control on Novolin with 3 time a day dosing but since you can't do that you should probably switch to a longer acting insulin.i could dose 3 times a day that is why Novolin worked good with my cat.sometimes Novolin will be out of her system in 6-7hrs but not too often and sometimes last to 10hrs but most makes it to 8hrs.so I had to keep eye on it.had her at 99 and an hr and half later she would be in the 400s!when it goes it goes super fast.
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At least some kind of insulin is better than nothing at all so you are doing him good.hope things get figured out for him.maybe he might start getting better readings with just the Novolin.
 
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