Thinking I should try another insulin?? any advise?

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Karen Mulholland

Karen Mulholland

Member Since 2017
Hello,
It's Karen and Rocky. We are relatively new and have been using Novolin N since 11/09/17. I began home testing 12/09/18. From what I have been directed to read from other members regarding Novolin seems to be true. About 4 hours after am shot Rocky's BG tanks. We have had a few times of really low numbers. I have gradually reduced the dosage from the original 3 units (that was with dry food) to between .25-.5 (since switch to all wet FF classic) 2x daily depending on his BG numbers. I'm thinking I should try .25 once a day from now on because I'm scared of those drops and I have to work from 7-5. I have heard however that perhaps switching to Lantus or Levemir may have a gentler onset and last longer. I will contact my vet and ask for his input, but frankly after not being directed to a wet food diet and directed to increasingly large doses of insulin, I'm not feeling confident. Maybe I should look into a new vet. He is supportive of home testing and willing to speak on the phone which is helping financially. I have also read that the Lantus and Levemir is really expensive, but can be purchased from a Canadian pharmacy at a considerable savings. I would really appreciate some feedback. Thank you. P.S. I have kept his SS up to date.
 
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I don't have Novolin experience. It is a fast onset insulin. (Rocky's spreadsheet looks empty to me, unless I need special Rocky glasses to see it).

Generally we like to see most kitteh on (Lantus, Levemir, or Prozinc). Those are all depot insulins. They have slower onsets, and they have longer lasting nadirs (low BG spots). Plus they have lasting effects past the 12 hour mark. Some cats are lucky and they can be regulated to stay under 250 almost the whole cycle with these depot insulins.

Another insulin supplier - is in the Supply Closet subforum
http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

I have done several Levemir orders thru Alan Hamman. All went well. Good prices. On the last one, he intentionally waited until the weather was not freezing. And he insulated the crud out of the package!
 
Thanks for your response, I will try to get some help with the SS. I go to Google Drive and enter my numbers. When I do that all of the data is there.
When I get this figured out, perhaps you can have a look?
 
Karen Mulholland said:
Thanks for your response, I will try to get some help with the SS. I go to Google Drive and enter my numbers. When I do that all of the data is there.
When I get this figured out, perhaps you can have a look?
Click to expand...
Are you entering them on the SS template itself? Maybe that's the issue - but I'm not techie enough to help. @Chris & China can though.
 
Karen Mulholland said:
Maybe I should look into a new vet. He is supportive of home testing and willing to speak on the phone which is helping financially.
Click to expand...

Personally, I would not "throw away" a vet that is supportive for not being up to speed with FD treatment. Are you otherwise generally happy with him? If he's supportive, that's already a great plus. You can get info on how to treat FD here and bump it back up to him if he's open.

JeffJ said:
Rocky's spreadsheet looks empty to me
Click to expand...

It's empty.

Karen Mulholland said:
I go to Google Drive and enter my numbers.
Click to expand...

If that is what you're doing, my suspicion is that you're entering the numbers on another copy of the SS. When you're on the SS you're entering numbers on, click on the blue "Share" button at the top right. Then "get shareable link" in the little window that opens. Paste that link here in your next message.

Regarding the change of insulin: I don't have experience with the insulin you're using but it does seem clear to me that longer-lasting insulin is more appropriate. I'm currently looking at a couple of cats going from caninsulin to lantus and the change is quite astonishing.

Even if Lantus is expensive, it seems like you're on small doses of your current insulin, and chances are you'll be on small doses of Lantus too. If you were shooting 10ui the price difference might weigh heavier. If you were to shoot 1ui morning and evening with Lantus, assuming you "waste" 1ui with each shot (being generous here), that's 4ui a day. A pen is 300 units. That would mean 75 days. It's just an estimate because we don't know how much insulin you'll be giving, but maybe it helps put the price into perspective. And yes, I've seen that ordering in Canada makes it more affordable for people in the US.
 
JeffJ said:
I don't have Novolin experience. It is a fast onset insulin. (Rocky's spreadsheet looks empty to me, unless I need special Rocky glasses to see it).

Generally we like to see most kitteh on (Lantus, Levemir, or Prozinc). Those are all depot insulins. They have slower onsets, and they have longer lasting nadirs (low BG spots). Plus they have lasting effects past the 12 hour mark. Some cats are lucky and they can be regulated to stay under 250 almost the whole cycle with these depot insulins.

Another insulin supplier - is in the Supply Closet subforum
http://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/

I have done several Levemir orders thru Alan Hamman. All went well. Good prices. On the last one, he intentionally waited until the weather was not freezing. And he insulated the crud out of the package!
Click to expand...

I have PM Marge for help with the SS. I go to google drive, put my numbers in the first of the 3 SS's?? When I look it's there?? I get back to you when this is figured out. Thanks
 
Prozinc is actually an in-and-out insulin, not depot, but it is slower onset and lasts longer than Novalin-N. It taks 1-2 hours for onset, peaks between 5-7 hours and by 12 hours it's usually on its way out. Both Prozinc and the L insulins are good choices, though. Cost for Prozinc might be a little cheaper than the L insulins, but I think (?) you can only get Prozinc through a vet pharmacy (might be wrong on that).
 
Stephanie & Quintus said:
Personally, I would not "throw away" a vet that is supportive for not being up to speed with FD treatment. Are you otherwise generally happy with him? If he's supportive, that's already a great plus. You can get info on how to treat FD here and bump it back up to him if he's open.
https://docs.google.com/spreadsheets/d/1MxJb1v4C1dOEPYVab_kpgcC8nRoc2-M6tpIYPg_UBbQ/edit?usp=sharing


It's empty.



If that is what you're doing, my suspicion is that you're entering the numbers on another copy of the SS. When you're on the SS you're entering numbers on, click on the blue "Share" button at the top right. Then "get shareable link" in the little window that opens. Paste that link here in your next message.

Regarding the change of insulin: I don't have experience with the insulin you're using but it does seem clear to me that longer-lasting insulin is more appropriate. I'm currently looking at a couple of cats going from caninsulin to lantus and the change is quite astonishing.

Even if Lantus is expensive, it seems like you're on small doses of your current insulin, and chances are you'll be on small doses of Lantus too. If you were shooting 10ui the price difference might weigh heavier. If you were to shoot 1ui morning and evening with Lantus, assuming you "waste" 1ui with each shot (being generous here), that's 4ui a day. A pen is 300 units. That would mean 75 days. It's just an estimate because we don't know how much insulin you'll be giving, but maybe it helps put the price into perspective. And yes, I've seen that ordering in Canada makes it more affordable for people in the US.
Click to expand...
https://docs.google.com/spreadsheets/d/1MxJb1v4C1dOEPYVab_kpgcC8nRoc2-M6tpIYPg_UBbQ/edit?usp=sharing
I hope this works, thank you so very much for your help.
 
A 5 pack of Lantus pens from Canada is $180. That will last you minimally a year, so it works out to be about $15 a month (or less). Plus, Lantus has a really good track record for effectiveness in cats, where Novolin does not, so you are getting far more value for the Lantus than the Novolin. The only difference is that the majority of the Lantus cost is being paid up front instead of spread out over many months.

As for your vet, you just need him to write you the script for the Lantus, and that's it. If he gives you resistance, you can point him to the AAHA guidelines where Lantus is recommended over lente insulins (Vetsulin, that has a similar duration of action as Novolin N). I've also attached a couple articles you can bring him. Ask him why he won't give you a script when the current veterinary literature recommends longer acting insulins.
 

Attachments

Karen Mulholland said:
https://docs.google.com/spreadsheets/d/1MxJb1v4C1dOEPYVab_kpgcC8nRoc2-M6tpIYPg_UBbQ/edit?usp=sharing
I hope this works, thank you so very much for your help.
Click to expand...

That's it!

Next step is to fix the link in your signature. Copy that link like you just did. Go here: http://www.felinediabetes.com/FDMB/account/signature

Highlight the text that says "Rocky's Spreadsheet". Click on the link icon (the one that looks like a little chain link). Erase the link that is in there and paste the one you just copied. That should do it.
 
O.K. I did it (I think) only thing ....I did not have to erase anything before pasting in the new one, because it was empty?? Thanks again
 
Julia & Bandit said:
A 5 pack of Lantus pens from Canada is $180. That will last you minimally a year, so it works out to be about $15 a month (or less). Plus, Lantus has a really good track record for effectiveness in cats, where Novolin does not, so you are getting far more value for the Lantus than the Novolin. The only difference is that the majority of the Lantus cost is being paid up front instead of spread out over many months.

As for your vet, you just need him to write you the script for the Lantus, and that's it. If he gives you resistance, you can point him to the AAHA guidelines where Lantus is recommended over lente insulins (Vetsulin, that has a similar duration of action as Novolin N). I've also attached a couple articles you can bring him. Ask him why he won't give you a script when the current veterinary literature recommends longer acting insulins.
Click to expand...

Fantastic, I will. I am more than willing to pay upfront for the Lantus if it will help Rocky. He's a warrior!!! He has been through many challenges and still remains loving and (fresh some times too!!, but there again he is a cat!). Thank you again for your help. I will let you know how it goes. It freaks me out thinking he's at home alone and could have another really low number. I have a feeder set for every two hours to try and help to keep his BG up in case of a drop.
 
Good news! My vet agreed to start Rocky on Lantus:) He said he would rather start it in office, but it was up to me. Rocky goes absolutely berserk when put in the carrier none the less at the vet. It was the main reason why I wanted to home test. I thought all the stress would kill him. He said to start with 1 unit once a day. He is currently on Novolin at .25 units once a day and if number is over 270 at 12 hour mark another .25 So is 1 unit a correct dose?? I'm terrified of having another really low episode and 1 unit seems like a lot even though it's a different insulin. Thank you all for your help.
 
So, one thing you might want to do before you get started is read the TR and SLGS stickies. Try and see which of the dosing methods/protocol you'd be most comfortable with.

I bring this up now because both of them have starting doses built in. So depending on which path you choose, the starting dose might be different.

SLGS is "easier" than TR but makes you go slower. TR is more aggressive but requires more monitoring.
 
Karen Mulholland said:
Also I remember hearing that the Lantus pens were better and would last longer due to the expiration date?
Click to expand...

Lantus pen has less insulin in it than the vial. They keep beyond the expiration date, according to the experience of people here. Store in the fridge. We use such small quantities for our cats that the pen is more than enough.
 
Karen Mulholland said:
He is currently on Novolin at .25 units once a day and if number is over 270 at 12 hour mark another .25 So is 1 unit a correct dose?? I'm terrified of having another really low episode and 1 unit seems like a lot even though it's a different insulin.
Click to expand...

I think I'd start at .25

You can always go up if you need to....You can't take it out once it's been given.
 
Stephanie & Quintus said:
So, one thing you might want to do before you get started is read the TR and SLGS stickies. Try and see which of the dosing methods/protocol you'd be most comfortable with.

I bring this up now because both of them have starting doses built in. So depending on which path you choose, the starting dose might be different.

SLGS is "easier" than TR but makes you go slower. TR is more aggressive but requires more monitoring.
Click to expand...
Thanks Stephanie, I will read them both and see which is the best fit. Your help is very much appreciated. Thanks again:)
 
Stephanie & Quintus said:
Lantus pen has less insulin in it than the vial. They keep beyond the expiration date, according to the experience of people here. Store in the fridge. We use such small quantities for our cats that the pen is more than enough.
Click to expand...
I called my vet back and asked that he write the script for the pen and he agreed. I am going to buy the first one at Walmart and then look into getting subsequent pens from the Canadian pharmacy that others on the board have mentioned. I understand it is much cheaper that way.
 
Julia & Bandit said:
A 5 pack of Lantus pens from Canada is $180. That will last you minimally a year, so it works out to be about $15 a month (or less). Plus, Lantus has a really good track record for effectiveness in cats, where Novolin does not, so you are getting far more value for the Lantus than the Novolin. The only difference is that the majority of the Lantus cost is being paid up front instead of spread out over many months.

As for your vet, you just need him to write you the script for the Lantus, and that's it. If he gives you resistance, you can point him to the AAHA guidelines where Lantus is recommended over lente insulins (Vetsulin, that has a similar duration of action as Novolin N). I've also attached a couple articles you can bring him. Ask him why he won't give you a script when the current veterinary literature recommends longer acting insulins.
Click to expand...


Julia, my vet has agreed to Lantus:) can you please give me the contact information for the Canadian Pharmacy where I can get the Lantus pens for $180. The cheapest I can find around here (Eastern Panhandle of WV) is at Walmart. One pen is $96 dollars. What do I use to inject with? Does the pen come with a syringe/needle?
 
There are needles for the pen but they will only allow you to draw whole units. There is a sticky about syringes if you check it out. You’ll want something like the BD micro-fine 0.3 ml + Demi (half-graduation marks). Make sure they are U-100 syringes and not u-40.
 
All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
B/D

They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 30 or 31 gauge, 6mm or 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)
 
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Stephanie & Quintus said:
There are needles for the pen but they will only allow you to draw whole units. There is a sticky about syringes if you check it out. You’ll want something like the BD micro-fine 0.3 ml + Demi (half-graduation marks). Make sure they are U-100 syringes and not u-40.[/QUOTE

Thanks, I will be sure to get the right ones.
Click to expand...
 
Chris & China said:
All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
B/D

They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 30 or 31 gauge, 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)
Click to expand...

Also according to the sticky, I need to use a human meter. I have an alpha trac, so I assume I should get on from Walmart today??
 
You can use the AT but the strips are more expensive and it will read “higher”, giving “real” numbers. It’s not very important except
- cost
- with low numbers we have different “take action” numbers for human meter or AT
 
Karen Mulholland said:
Chris that would be .25 2x daily correct?
Click to expand...

Yes

Karen Mulholland said:
Also according to the sticky, I need to use a human meter. I have an alpha trac, so I assume I should get on from Walmart today??
Click to expand...

you can use the AlphaTrak if you want to. The reason most of us don't is due to the cost of the strips. Even if I could afford $1 per test, I'd have to hesitate to test as often and I never wanted anything to come between me and my ability to test as much as I wanted to.

The AT strips are about $1 each....the Relion Confirm or Micro are about .36 cents (although you can sometimes get some good deals on Ebay)
 
There's a problem with the linked spreadsheet for Rocky. I got a warning message that the file is now in the file owner's trash and I will shortly lose access to the data. Clicked on another link to his sheet and that seems OK.


Mogs
.
 
Stephanie & Quintus said:
You can use the AT but the strips are more expensive and it will read “higher”, giving “real” numbers. It’s not very important except
- cost
- with low numbers we have different “take action” numbers for human meter or AT
Click to expand...
Thank you, I went ahead and bought a Relion and the strips; here's to another learning curve:)
 
Chris & China said:
Yes



you can use the AlphaTrak if you want to. The reason most of us don't is due to the cost of the strips. Even if I could afford $1 per test, I'd have to hesitate to test as often and I never wanted anything to come between me and my ability to test as much as I wanted to.

The AT strips are about $1 each....the Relion Confirm or Micro are about .36 cents (although you can sometimes get some good deals on Ebay)
Click to expand...

Thank you Chris, I bought a Relion meter and strips at Walmart today and picked up the Lantus pen. I'm planning to begin with the Lantus tomorrow. I'm taking the day off, so I can watch him. The low's with the Novolin were really scary. I'm optimistic that the Lantus will work better. I couldn't do this without all of the support I have gotten. It really does make the world a better place:) Thanks again
 
Another think about Lantus: keep in mind the dose will take a few days to show its magic so don’t be dishearteend if you see higher numbers at first. It will get better.
 
Chris & China said:
Do you understand that you just use regular insulin syringes and pull the insulin out of the pen? You don't use the special "pen needles"
Click to expand...
Yes, Chris I do. The needle only gives 1 unit increments, and I'm starting Rock (I did this a.m.) on .25. I have tried to read all of the info. available on this site. Now the real challenge is to remember all of it:)
 
Oh boy, at the 12p.m. BG he is at 117 AT and 47 Relion. We started at 8 with 274 AT and 261 Relion, 10 180 AT, 117 Relion. I beginning to get nervous. At 8, 10. and 12, 1/3 can FF was given? I will retest in 30 minutes.
 
6a00e5500f82a3883401a73dd73951970d-600wi.jpg
Karen Mulholland said:
Oh boy, at the 12p.m. BG he is at 117 AT and 47 Relion. We started at 8 with 274 AT and 261 Relion, 10 180 AT, 117 Relion. I beginning to get nervous. At 8, 10. and 12, 1/3 can FF was given? I will retest in 30 minutes.
Click to expand...
Karen, hope you're remembering to breathe! Pls post new test asap. If still low you'll need more than the lc ff. :bighug: karo or hc on hand?
6a00e5500f82a3883401a73dd73951970d-600wi.jpg
 
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