? 1/24 Buddy - Novolin to Lantus

Mike V

Mike V

Member Since 2021
Hi all,

My cat Buddy was diagnosed Monday and received a prescription of Novolin, 2U twice a day. He's only been on Novolin from Tuesday to this morning. My original vet I never saw in person, only an assistant, so I visited a new vet who prescribed Lantus.

On Monday he was at 540 at the vet, since then:
Tuesday: 490
Saturday morning: 625
Saturday evening: 471
Sunday (this) morning: 697

On Saturday I started providing him Royal Cain Glyobalance dry food on my new vet's advice, but my understanding is that we may be too early for dry food? So he's back on wet only for now.

The second vet said to use 2U of Lantus, twice a day. His first dose would be tonight. Is 2U OK to start with off from Novolin originally? He weights 10.6 lbs. My new vet had no experience with Novolin. Thank you!
 
Hi Mike,

Welcome to the forum. People here are awesome, but they are very data driven! Without data, most are unconfortable giving suggestions. We can bend your ear with lots of informations, so let me just point a few things:

1 - Initial doses should be conservative and based on cat's weight.
2 - We all want to lower their blood glucose (BG), but we are mostly all very nervous of causing a hypo. So more important than anything else is to find out how low a given dose take your kitty. For that one needs to collect BG at a few different points for a few days, until one can see how cat is responding. Thus, point 1 ...:)
_ Many dry food cat eating, reduce their BG significantly once they switch to low carb wet food. So if you are just changing your kitty from dry to low carb (LC) wet. I would either be quite cobservative with your dose and test often, or give a chance to see kitty's response to change in food first.

Lot os information on the sticky notes on the top of this forum. Is a lot, but I highly reccomend you grab a glass of whatever and go throug them.
 
How you determine the initial dose of Lantus actually depends on which dosing method you opt for. We use two dosing methods that are described in this sticky note. Tight Regulation (TR) is the more aggressive method and was an approach that was researched and published in a leading veterinary journal. The alternative, Start Low Go Slow (SLGS) originated on FDMB and as the name implies, is much less aggressive.

With TR, the initial dose is based on weight (initial dose = .25 x cat's ideal weight in kilograms) and usually is in the neighborhood of 1.0u unless your cat is under- or overweight. Also, to use TR, your cat MUST be on a low carb, canned food diet. With SLGS, the starting dose is 0.5u is your cat is on a low carb, canned food diet. (If your cat is not on this kind of diet, the starting dose is 1.0u).

Lantus dosing is based on the lowest number in the 12-hour cycle, not on pre-shot numbers. So, it's important to test at each pre-shot in order to make sure. your cat is in safe numbers. It's also important to get spot checks to make sure your cat's numbers aren't dropping too low during the cycle. The point at which you reduce the dose differs depending on which dosing method you choose. The methods also differ with respect to how long you wait before increasing the dose.

Since you're just starting Lantus, you'll need to be patient. It takes about 5 - 7 days for the Lantus depot to form. The depot is what makes insulin like Lantus and Levemir different than the other insulins. (I linked information for your reading pleasure!)

I hate to tell you this but the Royal Canin Glycobalance dry food is 29% carbohydrate. This is astronomically high carb food. It's like feeding your diabetic cat cake and ice cream. We recommend food that is low in carbs -- less than 10% and most people here feed in the 5% range. This is a link to a site on feline nutrition. The vet that developed the site has put a great deal of time into studying feline nutrition. She also has a list of the nutritional content of most of the canned foods available in the US. There are lots of options Many of the people here feed Fancy Feast pate style food.

This is my long way of noting that since. our cat is eating dry food, you would be using SLGS and your starting dose would be 1.0u. And please keep testing! I'd also encourage you to think about a different choice of food.
 
Thank you both! I am reading through the stickies and links and will not put dry food back in his diet (stopped this morning after doing further reading and seeing his high number).

He's been eating Fancy Feast pate style since Monday, sorry that wasn't in my first post.

I'll test him more often and I have the Google spreadsheet to help track his numbers.
 
It would be great if you could attach the spreadsheet to your signature. There's also a bit more information that would be helpful to add to. your signature -- otherwise, we'll plague you with the same questions repeatedly. This is a link to a post that will give you all of the instructions you need.

Please let us know if you have questions. We like questions!
 
Thank you I added the spreadsheet, working through that.

He was given his first 1U of Lantus 2H45min ago. 45min ago he tested at 402, when we tested 15min ago it jumped to 496.

He seems lethargic, not meowing when he's pet and acting tired. I'm finding lots of article about how to handle too low numbers, but his numbers are still high, so I'm trying to find out what else I can do!
 
Hi Mike,

Once you know your food is low carb, the other place where you can tweak is by increasing the insulin dose. However, very high numbers can also occur due to bouncing (which is when a kitty go quite low, or decrease BG quite fast, and their body sensors go haywire and dump glucogen in the system). You can look through Hercules spread sheet and see that especially in 2020, when we started, everytime there is a blue or a green number, ho would bounce top a red or black number. To see this though, you need to have at least preshot BG meassures and midcycles measurements. Once you have a spreadsheet going for experienced mebers to have a look at it, they will help you sort out a strategy to try.


Mike V said:
He was given his first 1U of Lantus 2H45min ago. 45min ago he tested at 402, when we tested 15min ago it jumped to 496.
Click to expand...

After food, their Bg will always go up. The "usual" routine in our household is to meassure before shooting and 2 hours later. Usually even 2 hours later the BG will be a bit higher. If it is lower, it is a cycle that you may want to keep an eye out because numbers can decrease quite fast. So the increase you saw is normal :). Unless kitty is quite low at shooting time, most of us don't look at BG until 2 hours past (+2). If it was up as expected I will test again between +5 and +7 to have data on how low he is going, and then again preshot in the PM. If however, kitty starts low before shooting, or I don't see a food bump, then I test more often.

It will get better!
 
Hercule's mum said:
Hi Mike,

Once you know your food is low carb, the other place where you can tweak is by increasing the insulin dose. However, very high numbers can also occur due to bouncing (which is when a kitty go quite low, or decrease BG quite fast, and their body sensors go haywire and dump glucogen in the system). You can look through Hercules spread sheet and see that especially in 2020, when we started, everytime there is a blue or a green number, ho would bounce top a red or black number. To see this though, you need to have at least preshot BG meassures and midcycles measurements. Once you have a spreadsheet going for experienced mebers to have a look at it, they will help you sort out a strategy to try.
Click to expand...

Thank you, I've shared my spreadsheet and looked at yours. Very detailed! I'll look for some other ones, too. Buddy's not had symptoms like throwing up all and seems to have adapted to his new diet quite well.

He's been at 1U of Lantus, from the sticky I'm hoping we can bring him up to 1.25U soon.
 
Mike V said:
Thank you, I've shared my spreadsheet and looked at yours. Very detailed! I'll look for some other ones, too. Buddy's not had symptoms like throwing up all and seems to have adapted to his new diet quite well.

He's been at 1U of Lantus, from the sticky I'm hoping we can bring him up to 1.25U soon.
Click to expand...
Just swinging by to say Hi and welcome! It looks like you are using a pet meter, correct? In that case, you want to make sure to use the Pet Meter SS - it looks like you are using the Human meter SS. The two SSs are slightly different due to the reduction point (i.e., the lime green color-coding). In the spreadsheet instructions, use the Pet Meter template - since you don't have a ton of data, I'd just copy everything over (and then republish and then update the link in your signature :bighug:).

I know a lot of links and info has been thrown at you - just ask questions :bighug: The next thing to do may be to update you signature like suggested above - it's in one of the links Sienne posted - having a signature with relevant info will stop us from asking the same questions over and over :p
 
One thing I want to make sure you've seen is the info on Diabetic Ketoacidosis (DKA). I know you're on info overload, but since you mentioned some symptoms and he's in high numbers want to make sure you're aware. More than likely he just feels crappy from the high numbers, starting insulin, and diet change...but always worth keeping ketone strips on hand.

As we always say, it's a marathon!
 
Hi Mike,
Big Kitty is is the same boat as Buddy. My vet diagnosed him on 10/2/20 and started on 2U of Novalin 2x day. He never dropped out of the black numbers (500+) any AMPS or PMPS and only got into the 300's at peak 6-hrs. Novalin is a very short acting insulin for cats and it took a lot of push from me to get my vet to understand that. Big Kitty got up to 5 Units BID and it still did nothing for his high numbers as you can see in his spreadsheet. My vets suggestion was to increase him to 7 Units of Novalin and I insisted on Lantus after reading a lot on this site and others about the benefits of the long acting insulin. Even though we've been at this for a few months now I feel like we're starting all over again.

He's been more stable on the Lantus since he started last Sunday but I am still waiting for him to get into better numbers. I find it takes a lot of patience and knowledge to understand how to care for a diabetic cat and there is so much to take into consideration. I changed his diet from all kibble, which I know contributed to his diagnosis, to an all wet food low carb diet which he enjoys. Big Kitty was a very big boy (hence his nickname) at 25 lbs. originally and now down to 16 from the weight loss. He enjoys his meals and I am still trying to determine how much his meals effect his numbers and we don't feed any dry anymore. I test as much as I can and do curves often on the weekends.

We're still in those high black numbers but I am still trying to figure out his optimal dose to bring him into a stable number. I did an increase from 3.0 units of Lantus to 3.5 units this week so this is where the patience and knowledge come into play to determine next steps. I am more than thankful I found this site and you will be too. All the best in your journey to help Buddy. He is very handsome!
 
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