We got Blue today!

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Woot!

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Yay for blue! A lot of us know how hard it can be to get that far. Nice going. And kudos to your for keeping your numbers in the spreadsheet. I hope the blues continue for some more nice nadirs.
 
You have done a nice slow increase. Maybe an increase to 2.75 is in order at this point. Pepper needs to get out of those blacks.
 
It just seems like this isn't the right insulin. She drops mid cycle, but goes up high at every pre shot. I don't want her going super low and hypo and then shoot through the roof again. Is this a normal thing to be afraid of? I don't have any support at home with her treatment. If she hypos while I'm gone, what am I supposed to do?
 
Peppersmom72 said:
It just seems like this isn't the right insulin. She drops mid cycle, but goes up high at every pre shot. I don't want her going super low and hypo and then shoot through the roof again. Is this a normal thing to be afraid of? I don't have any support at home with her treatment. If she hypos while I'm gone, what am I supposed to do?
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A longer acting insulin may indeed help.... Although there no time on your ss that she's close to being too low. If it were my cat I would switch insulin when it's time for a new vial. If your schedule sometimes needs a little time flexibility look into ProZinc.
 
If you're considering an insulin change, ProZinc (although expensive!) would be familiar in its action to you but slower and gentler. It does allow some dose timing and dose changing flexibility that the depot insulins like Lantus and Levemir don't. It's worth considering.

I agree with a dose increase to 2.75 u. You have a long way down to go before her numbers are too low at nadir.
 
Let's get the dose to 2.75. Her high BG readings in the AMPS and PMPS are toxic, literally. If there was a column of blue nadir numbers, we would be more cautious.

I agree to also switch insulins when possible.
Prozinc - Leo liked it, but it has to ship refrigerated, and I had to get it at the vet so what a pain that was
Levemir and Lantus - good depot insulins

Really, if you don't get Pepper into lower numbers soon, her health problems will increase. (Prozinc, Levemir, Lantus) - any of these three will basically lower the AMPS and PMPS numbers, while providing good nadirs.
 
Peppersmom72 said:
It just seems like this isn't the right insulin. She drops mid cycle, but goes up high at every pre shot.
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That's typical of the action profile of Novolin N; it doesn't tend to have a very long duration of effect in cats.

Echo the suggestions about Prozinc, Levemir and Lantus above.

Peppersmom72 said:
is it normal to be so scared with every increase?
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Dose increases always scared the bejeebers out of me! :nailbiting:


Mogs
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Well, that just went out the window, when I thought we were doing good. Pepper WON'T EAT. which means no shot this am. I gave her an appetite stimulant and she finally started eating 15 mins ago. I hope she holds down her food. Has anyone had a pukey furrbaby that you had to leave at home all day after an insulin shot? If so, which insulin were they on? As I stated before, my hubby will feed her, but will not administer a shot and only test when he feels its an emergency. So, its like she is home alone with food. I need an insulin that is gentler on her than the Novulin.

I can't afford $275 for insulin, whichever that one is.
 
Peppersmom72 said:
Well, that just went out the window, when I thought we were doing good. Pepper WON'T EAT. which means no shot this am. I gave her an appetite stimulant and she finally started eating 15 mins ago. I hope she holds down her food. Has anyone had a pukey furrbaby that you had to leave at home all day after an insulin shot? If so, which insulin were they on? As I stated before, my hubby will feed her, but will not administer a shot and only test when he feels its an emergency. So, its like she is home alone with food. I need an insulin that is gentler on her than the Novulin.

I can't afford $275 for insulin, whichever that one is.
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If you decide to try a different insulin, you can buy Lantus from a reputable Canadian pharmacy, Marks Marine Pharmacy in Vancouver. The cost of a 5 pack of Lantus pen cartridges is about $175 or thereabouts. The 5 pack would give you a total of 1500 units of insulin (300 units per cartridge) and, depending on dose, that can last up to a year. The unopened cartridges are good in the fridge until their expiry date which is often 2 years down the line.

Some people on FDMB also buy Lantus pens individually from some of the vendors on the "Supply Closet" forum.
 
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What does depot insulin mean? Also it shows that lantus pens need to be discarded after 28 days after first shot
 
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Peppersmom72 said:
What does depot insulin mean? Also it shows that lantus pens need to be discarded after 28 days after first shot
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If stored in the refrigerator lantus lasts several months. 28 days is if it is not refrigerated. Deposit means the body saves up a little of it like a savings account. If you go to the lantus forum and read the yellow stickies at the top they explain a bit more about that.
 
Peppersmom72 said:
What does depot insulin mean? Also it shows that lantus pens need to be discarded after 28 days after first shot
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Most people here keep their Lantus pen in the fridge and use it upto 6 months, so no worries about the 28-day thing (you know companies need to protect their behinds, particularly with medical stuff).

Depot means that when you inject the insulin (glargine is the name of the one in the Lantus pen) it forms little crystals (sort of) where you inject it. That's the "depot". The depot will then slowly release insulin into the blood stream, over time. This means that with depot insulin you don't just get the effect of the last shot, but you get the effect of the buildup of depot over the last days. This helps smoothe the curves, but also means you can't just "test and adjust the dose" at each shot. You hold a dose over at least 3 days to get an idea what it is doing, and then if needed you raise it a little bit. Think of it as steering an ocean liner rather than sailing a dinghy. More inertia. This means, hopefully, less big ups and big downs -- but it will take a few weeks to get stabilised.

Hope this helps!
 
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