Introducing myself and wondering whether to shoot or not to shoot

Status
Not open for further replies.
EmmettsMom

EmmettsMom

Member Since 2020
Hello! I'm a newbie here (first post actually!) but I've been lurking for a while and learning so much from everyone.
My cat, Emmett, was diagnosed in February 2020 and put on 3 units of Novolin n twice a day. He seemed to do well on that dosage for a while but he also has neuropathy that has been getting worse. +6)With his vet closed for COVID I ended up taking him to another vet who did blood work and found his sugar was 250 mid cycle (+6) and told me to up him to 4 units twice a day. I did that and brought him back for blood work a week later - his sugar level was about the same. He told me to up the dose to 5 units. At that point I had been reading this forum daily and I was completely uncomfortable giving him that much without knowing what it was doing to his levels. I went out that night and bought the ReliOn meter and started testing. That's been a little bit of a struggle with him but we are getting there. In addition I switched him over to FF wet food.

Anyway, I've made up his spreadsheet and would love some insight for this morning. Yesterday, he was still trending on the high side all day, so I upped his insulin at night to 4.5. Hindsight is 20/20 and I probably should have stuck with 4U. This morning he was bugging my husband for food around 6am (8am is our usual shot time) so he fed him. I tested at 8am and he was at 172. I'm definitely not comfortable giving him any insulin at the moment and plan to test again at 9. I'm trying to keep his schedule consistent and I'm looking for thoughts/advice on what to do next. I linked his spreadsheet below.

Thanks!
Erica
 
Hi Erica and Emmett and welcome!
Well done getting so organised with the SS and testing ..and the signature!
I'm not experienced with Novolin at all as I haven't used it, but 4 units is a lot of insulin for a fairly newly diagnosed cat.
We recommend going up in 1/4 unit increments not 1/2 or whole unit increments.

Did you stall or feed when you got the 172.?
I wouldn't give Novolin with the preshot that low and not much data. You may be better to skip.
Is there any history of ketones?
Usually when the preshot is lower than normal we stall, don't feed and test again in 20 mins to see if it is rising., and post and ask for help.

Do you feed an hour before you give the shots.?
Here is a link to Novolin
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

I am going to tag a couple of people who can help you. Not sure they will be around soon though.
@Elizabeth and Bertie
@Deb & Wink

Are you testing for ketones? I would until he is regulated. You can buy a bottle of Ketostix from a pharmacy or Walmart.
Also changing over to a low carb diet can drop the BG up to 100 points so you need to test more and may need to adjust the dose.
Novolin is not a good insulin for cats. You would be better swapping to Lantus, Prozinc or Levemir.
Keep asking questions.
Don't forget to also test in the pm cycle...cats often drop lower at night
Bron
 
Last edited:
Welcome!!!:bighug:
I'm sure one of the experienced folks will be around shortly to give you some advice.
Sounds like you're starting out on the right foot. Change of diet to low carb is crucial. Testing is also essential to keep Emmett safe. Keep up the good work!:)
I hope you have a wonderful day:)
 
I've just seen you have given 3.5 units. Please test at +1 and +2 to see that the BG is not dropping and keep testing until the nadir...lowest point the cycle.
I would give a good snack at +1
If the numbers are dropping, post and ask for help. I am just heading to bed so won't be able to assist but I'll tag @Nan & Amber (GA) to keep an eye on you. She doesn't use Novolin either but can help with low BGs.
 
Bron and Sheba (GA) said:
Hi Erica and Emmett and welcome!
Well done getting so organised with the SS and testing ..and the signature!
I'm not experienced with Novolin at all as I haven't used it, but 4 units is a lot of insulin for a fairly newly diagnosed cat.
We recommend going up in 1/4 unit increments not 1/2 or whole unit increments.

Did you stall or feed when you got the 172.?
I wouldn't give Novolin with the preshot that low and not much data. You may be better to skip.
Is there any history of ketones?
Usually when the preshot is lower than normal we stall, don't feed and test again in 20 mins to see if it is rising., and post and ask for help.

Do you feed an hour before you give the shots.?
Here is a link to Novolin
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

I am going to tag a couple of people who can help you. Not sure they will be around soon though.
@Elizabeth and Bertie
@Deb & Wink

Are you testing for ketones? I would until he is regulated. You can buy a bottle of Ketostix from a pharmacy or Walmart.
Also changing over to a low carb diet can drop the BG up to 100 points so you need to test more and may need to adjust the dose.
Novolin is not a good insulin for cats. You would be better swapping to Lantus, Prozinc or Levemir.
Keep asking questions.
Don't forget to also test in the pm cycle...cats often drop lower at night
Bron
Click to expand...

I stalled for two hours. Tested again and got 268. Gave 3.5 units and some food. He had eaten about an hour and a half before getting his first test of 172. Will watch closely and test more than usual. He really hates getting tested but he lets me do it without too much frustration. I'll be poking his ears every 2-3 hours today.

Thank you for your help! I would like to try Lantus, but until I have enough testing data and can actually speak with his regular vet, I'm hesitant to make any changes. I'm hoping that his vet will open back up this week and by then I'll have plenty of testing data to share with him.
 
Hello and welcome!

I will definitely keep an eye on your guys today to make sure sweet Emmett stays out of trouble! Congrats on having everything together with the spreadsheet and all that. I agree with all of Bron's points above.

Quick question: does the 268 in the +2 cell mean that you shot 3.5U at what would normally be your +2? [Edit: posted simultaneously with you, you answered this question already]
 
Bron and Sheba (GA) said:
I've just seen you have given 3.5 units. Please test at +1 and +2 to see that the BG is not dropping and keep testing until the nadir...lowest point the cycle.
I would give a good snack at +1
If the numbers are dropping, post and ask for help. I am just heading to bed so won't be able to assist but I'll tag @Nan & Amber (GA) to keep an eye on you. She doesn't use Novolin either but can help with low BGs.
Click to expand...

Thank you! I'll be testing all day today and updating the spreadsheet.
 
Nan & Amber (GA) said:
Hello and welcome!

I will definitely keep an eye on your guys today to make sure sweet Emmett stays out of trouble! Congrats on having everything together with the spreadsheet and all that. I agree with all of Bron's points above.

Quick question: does the 268 in the +2 cell mean that you shot 3.5U at what would normally be your +2? [Edit: posted simultaneously with you, you answered this question already]
Click to expand...
yes ;) I wasn't sure how to note that - any guidance there? I wanted to record the 172, but technically it wasn't his pre-shot test
 
To avoid confusion, it's best if you move that 268 into the AMPS cell along with the 172. You can stack the two numbers by holding the alt or option key down while hitting return, and then coloring the cell by hand.

No perfect way to do it, but probably the clearest notation for anyone just looking at the spreadsheet would be to have 172, and then stacked below it 268@2hrs. Having that in the AMPS cell implies that you shot after the 268, 2hrs late.
 
Nan & Amber (GA) said:
To avoid confusion, it's best if you move that 268 into the AMPS cell along with the 172. You can stack the two numbers by holding the alt or option key down while hitting return, and then coloring the cell by hand.

No perfect way to do it, but probably the clearest notation for anyone just looking at the spreadsheet would be to have 172, and then stacked below it 268@2hrs. Having that in the AMPS cell implies that you shot after the 268, 2hrs late.
Click to expand...
makes sense - done!
 
Oooh! Just checked Emmett's spreadsheet, and I see you got 127 at +4! That's a nice number, but getting a little low for Novalin N. On this insulin, we want to try to keep the BG above 90 [edit: make that 100, per the Beginner's Guide To Novolin/Humulin/NPH] or so (normal for a cat is roughly 50-120).

Emmett is comfortably above that right now, and is probably pretty close to the Novalin nadir (lowest point of the cycle) at +4, but I would keep an extra close eye on him for the next couple hours. If you get some extra tests in now at +5 and +6 you might possibly catch a low. He'll probably zoom up afterwards, so you can give him a break for the later part of the cycle, but right now you want to monitor.
 
Last edited:
Nan & Amber (GA) said:
Oooh! Just checked Emmett's spreadsheet, and I see you got 127 at +4! That's a nice number, but getting a little low for Novalin N. On this insulin, we want to try to keep the BG above 90 [edit: make that 100, per the Beginner's Guide To Novolin/Humulin/NPH] or so (normal for a cat is roughly 50-120).

Emmett is comfortably above that right now, and is probably pretty close to the Novalin nadir (lowest point of the cycle) at +4, but I would keep an extra close eye on him for the next couple hours. If you get some extra tests in now at +5 and +6 you might possibly catch a low. He'll probably zoom up afterwards, so you can give him a break for the later part of the cycle, but right now you want to monitor.
Click to expand...

Thank you so much for your encouragement! It's been a stressful few weeks. I'm excited to see some lower numbers for him today. I just want him to stabalize. I've been reading the Beginner's Guide to Novolin like it's my job - trying to get a handle on this thing. I'm feeling much more optimistic about this whole testing thing today. He's not a fan, but he's tolerating it (and me!) a little better.
 
Yes, that BG of 90 is a DEFINITE dose reduction for Emmett.

I think you should go down to no more than 3U with the Novolin N. Perhaps even down to 2U.

Why you may ask? Because you switched Emmett to low carb food recently, and that can make a HUGE difference in a cat's BG levels. Let's keep Emmett safe and reduce the dose. 2U is my first recommendation.
EmmettsMom said:
I'm feeling much more optimistic about this whole testing thing today. He's not a fan, but he's tolerating it (and me!) a little better.
Click to expand...
Emmett may not be a "fan" of the testing thing, but it's the best way to keep him safe. Bribes, highly recommend bribes such as something pure meat that he loves. Freeze dried, cooked, even bits of egg or cheese if Emmett likes those. Bribes can be attention or petting or brushing too. Doesn't have to be food.

Novolin usually only has a 6-8 hour duration in most cats. The way to find out what the duration is for Emmett, is to test later in the cycle. Between +8 and +10 or +11 would be helpful. Not every single hour. But some testing around then each day.

p.s. Not much Novolin N experience myself. Never did care for the steep rapid drops it has in cats. Only used it for brief times for 2 cats. I always imagined it as a cat having motion sickness, and being on an endless roller coaster. Can't make them feel very good.
 
Deb & Wink said:
2U is my first recommendation.
Click to expand...

I'd probably go back to 1U and start over, especially with the low carb only diet now. It's a whole lot easier (and safer) to go up in dose if he should need it.

Emmett was started at a very high dose and it was just increased too quickly from there. Now that he's on a low carb diet and as long as there are no ketones in the picture, it's probably the safest thing to do. We have no way of knowing how he'd do at the lower doses but now that you're testing, we can always add more if it's necessary but if you give too much, you can't take it back out again.
 
Chris & China (GA) said:
We have no way of knowing how he'd do at the lower doses but now that you're testing, we can always add more if it's necessary but if you give too much, you can't take it back out again.
Click to expand...
Thanks for the advice - I haven't yet done his morning pre-test BG but I'm already seeing the low carb food make a difference so I'll likely reduce his dose today. I'm nervous about doing any large scale changes without being able to talk to his vet, but I so appreciate the knowledge and experience (and responsiveness!) of the people on this forum so I don't feel like I'm completely in the dark. Keep watching his spreadsheet please -Ii really do appreciate all the feedback.
 
Chris & China (GA) said:
I'd probably go back to 1U and start over, especially with the low carb only diet now. It's a whole lot easier (and safer) to go up in dose if he should need it.
Click to expand...

UPDATE: Just took his BG. It's 8:30am and he's not due for a shot till about 9am. He was at 198 so I 100% agree now that it's smartest to start over with 1U. My question is should I start him with that amount when he hits a BG of 250 or higher like the Novolin guide recommends?
 
Status
Not open for further replies.
Back
Top