New Member - Question about dosage

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newbie123

newbie123

Member Since 2022
My cat Samantha is about 10 years old and currently weighs 10.2 pounds. In December I made a big mistake and started giving her Temptations treats daily and gave her way too many. After about a month I noticed she was much heavier than normal, so I stopped giving her them. About 2 weeks ago she started drinking large amounts of water constantly, which brings me here.
  • On 1/25/22, the vet did blood work and the result was 251.
  • Today, 1/31/22, the vet did a spot glucose check and it was 324. Urine sample also showed high glucose.
  • Vet prescribed Relion-N (Novolin-N). U100. 2 units twice daily, 30 minutes after eating.
My cat has never been a very big eater and I would always leave food out all day. She never finishes a full can of wet food at once and eats some dry food throughout the day. Today, I have started taking her food away and feeding her in the morning and evening, but she still doesn't eat very much. My worry is giving her too much insulin. Is 2 units safe at her weight of 10.2 pounds? If she doesn't eat a full meal am I risking her getting hypoglycemia? Is it safer to start with 1 unit? I don't know if I am overreacting but I just want to make sure I don't hurt her.

Thank you so much for your help and I'm sorry if I didn't provide all of the information needed.
 
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Hi, I am not familiar with Novolin but my understanding it is no longer recommended for cats, some information about it and starting dose can be found here:

https://felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/

You are not overreacting hypoglycemia is scary. The best way to prevent it is to test blood sugar at home. Also if your kitty does not eat a lot prior to her insulin shot it would be better to switch to a different insulin such as Prozinc or a glargine (such as Lantus or Semmeglee). It would be much safer and she would be able to graze or have smaller meals throughout the day.
 
Hi and welcome to you and to Samantha.
You are not overreacting at all and are very sensible to question what the vet has ordered, especially if Samantha is not a big eater.
First of all Novolin N is not a good insulin for cats. It’s a fast acting, harsh insulin.
I would go back to the vet and ask him to change the insulin to either Lantus or Prozinc insulin. Both of these are good insulins for cats and are longer acting and more gentle. With these insulins, the onset of the insulin is not for a couple of hours so you have time for Samantha to eat.
Also with Novolin N you need to wait one hour after feeding before giving the dose of insulin because the cat needs to have a good meal aboard for when the insulin hits.

It is perfectly OK to leave food out for Samamntha all day and all night. Only feeding twice a day is old thinking.

Have you thought about home testing the blood glucose? That is the only way to keep Samantha safe.
You can buy a ReliOn premier meter from Walmart for $9 and a box of 100 test strips for $17.88. You would also need a box of lancets to prick the ear size 26 or 28 gauge. And some cotton rounds to put behind the ear while testing.
Here is a link to HOMETESTING LINKS AND TIPS
Once you start hometesting you would need to take the food up for the two hours preshot as we don’t want the BG to be food influenced.

I am going to give you a link to USING NOVOLIN N but I would advise you to try and swap to a better insulin for cats.
With the dose…..2 units is too high a dose to start with. If you are feeding a dry high carb diet the recommended dose to start is 1 unit. if you are feeding a low carb wet diet, the recommended starting dose is 0.5 units.

What are you feeding Samantha.
HELP US HELP YOU is another useful link which has the hypo kit in it…..make sure you have one set up please
Keep asking questions, we are happy to help
Bron
 
Thank you both so much for taking the time to respond.

I am planning to test her at home but I don't have the meter yet. I will get one as soon as possible. I didn't realize I could use a non-pet meter so that is good to know.

I feed her Meow Mix Original dry food and 1-2 cans of Fancy feast (chicken sliced or gravy lovers). She prefers dry food over wet food but will sometimes finish a whole can and I will give her a second one throughout the day.

I will call my vet in the morning and ask about switching to Lantus. I thought it was a red flag when I didn't see Novolin listed in the forums here under the Insulin section. The vet was very nice but I got the impression that he didn't deal with feline diabetes very often, but I could be wrong. I found this link: https://www.aaha.org/aaha-guidelines/diabetes-management/treatment/insulin-therapies/ which I will send to my vet and hopefully I can get the other kind tomorrow.

In the meantime I feel so bad for her, she is constantly drinking water. And to make matters worse the stress of it all has brought out her feline herpes so she is sneezing and has runny eyes. (I am waiting on another prescription for that). Is it safe to give her 0.5 or 1 unit until I can get the other kind, or would you recommend waiting?
 
newbie123 said:
it safe to give her 0.5 or 1 unit until I can get the other kind, or would you recommend waiting?
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Poor Samantha.
As we don’t know what her blood glucose is, I wouldn’t like to say to give a dose of insulin. If you can get an answer from the vet tomorrow, I would wait. And try and get a meter before you start with the insulin. Don’t let the vet talk you into getting a pet meter to test the BGs. They are expensive and not needed. Also many vets don’t think it is necessary to test the BGs.

The one thing I Would do is go out and buy a bottle of Ketostix today from Walmart or a pharmacy and test her urine for ketones as you are not starting the insulin today. As long as there are no ketones present, you are fine to wait. Keep plenty of water for her to drink and give her plenty of food. If she gets lethargic or won’t eat much, let us know as she may then need to start the insulin, but getting that ketones urine test will tell us if she is Ok to wait.

If possible you would be better swapping her over to a low carb dry food then continue with the high carb Meow Mix dry. I will tag @Diane Tyler's Mom as she knows the low carb dry foods in the US.
Also the gravy lovers is high carb so keep those ones for your hypo kit where you need some high carb food in case of a low number.
Will she eat the FF pâté’s They are low carb?
Have a look at this FOOD CHART and look for foods that are 10% or under carbs. Most of us feed around 4 to 7% carbs and wet food.
The other insulin to avoid is vetsulin which is really meant for dogs but is often prescribed for cats. A lot of vets have very little to do with feline diabetes and they don’t get much training in its treatment at university.
Let us know when you get a result from the ketone urine test.
 
there are low carb options in dry food - Young Again Zero Mature , Dr. Elsey's Clean Protein (chicken flavor) and Wysong Epigen 90 They are all around 5% carbs. They are expensive but of better quality that other dry food (including prescription food).


Here are some treats also
PureBites Freeze-Dried Cat Treats with Chicken Breast 2.3 oz ()https://www.amazon.com/dp/B071P

Also chewys has freeze dried treats also


The freeze dried treats you can get at petsmart, petco and order from chewy. Purebites is popular (cheaper if you buy the dog food ones). My crew like vital essentials it's dehydrated freeze dried raw comes in flavors

freeze dried minnows, made by Vital Essentials. I also buy the ones made for dogs. They're the same as the freeze dried minnows for cats. just cheaper. They also carry other freeze dried treats. I ordered mine through Amazon.

I think the vital essentials are more of a crunchy texture than the purebites

If you cat likes any of these you can buy the bigger bags for dogs they are the same ,you will get more for your money just break then up into smaller pieces
.

You can Google freeze dried treats and see what other ones there are and different flavors
Just make sure that is the only ingredient in them meaning turkey, chicken, minnows etc

Here is another one , I see you can get these in different flavors also just look
You may have to break any freeze dried treats in half if they are too big
https://www.amazon.com/dp/B01B78672I/ref=twister_B08SGXLB53?_encoding=UTF8&psc=1
 
If your vet gives the ok for lantus, it's expensive in the US

A lot if members use semglee
Here is a coupon below
Just call any pharmacy to see if they have the 5 pens, they will last you a year or more
Type in where you live and you will see where you can buy it
Lantus is expensive if you live in the US
https://www.goodrx.com/semglee?dosa...rride=Semglee&quantity=1&sort_type=popularity
Semglee, it is a generic Lantus, and was approved by the FDA last June. The cost is compatible with Lantus from Canada.
Some pharmacy's don't carry it so you would have to call

Some have their vet write the prescription as insulin glargine
 
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Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar

She is using a pet meter, you won't have to use a code when using a human meter
Most if us use human meters
 
Sorry for the delay in responding and thank you both for all of the great information. Both Sammy and I are very grateful!

  • First, I was able to show my vet the new guidelines and he agreed to switch to Lantus at 1 unit, two times per day. Walmart was able to get me the generic version which is labeled as Mylan insulin glargine. $118 per bottle instead of around $300.
  • I bought some of the recommended cat treats and dry food Diane Tyler's Mom recommended above (from Chewy). Waiting for the shipment to come in.
  • I tested her urine with a ketone test strip. From what I can tell the color didn't look very pink at all and didn't seem to change color much.
  • I started her on the generic Lantus yesterday.
  • Still haven't gotten a successful blood test yet. I have poked both ears and one time got close but I was stupid and didn't get the blood in the right spot and the device showed an error. Still trying each day.
I'm still a little worried because of how much water she's drinking still. Last 24hrs I logged about 33 ounces. And as of today about 12 hours in I logged about 20 so far. I know it's bad to be flying blind without blood readings but it seems like her sugar must still be too high. I guess some amount of insulin is better than none? But I worry she is miserable.

Thanks again for all of your help!
 
newbie123 said:
Sorry for the delay in responding and thank you both for all of the great information. Both Sammy and I are very grateful!

  • First, I was able to show my vet the new guidelines and he agreed to switch to Lantus at 1 unit, two times per day. Walmart was able to get me the generic version which is labeled as Mylan insulin glargine. $118 per bottle instead of around $300.
  • I bought some of the recommended cat treats and dry food Diane Tyler's Mom recommended above (from Chewy). Waiting for the shipment to come in.
  • I tested her urine with a ketone test strip. From what I can tell the color didn't look very pink at all and didn't seem to change color much.
  • I started her on the generic Lantus yesterday.
  • Still haven't gotten a successful blood test yet. I have poked both ears and one time got close but I was stupid and didn't get the blood in the right spot and the device showed an error. Still trying each day.
I'm still a little worried because of how much water she's drinking still. Last 24hrs I logged about 33 ounces. And as of today about 12 hours in I logged about 20 so far. I know it's bad to be flying blind without blood readings but it seems like her sugar must still be too high. I guess some amount of insulin is better than none? But I worry she is miserable.

Thanks again for all of your help!
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Well done getting so many things sorted out! That’s early good!
And no ketones is very reassuring. Keep doing a test every few days while she is unregulated and drinking a lot.
Keep trying with the blood testing …you will get there I promise. We all started off like you.

When you have time, can you setup the spreadsheet and signature please. If you have any trouble with the SS let us know and someone will help you.
Don’t worry about her drinking so much. At the moment she needs it, because she is peeing so much. It will settle down when she starts to get better numbers.
 
I have the spreadsheet copied, but no glucose readings yet. I keep getting Er4 on the Relion meter. Based on what I'm reading I think I'm not getting a big enough blood sample. My cat's ear vein is so close to the edge of her ear, I think I hit it. I can see a red circle in her ear around the vein where I injured the area. I tried the rice in a sock trick to heat the ear, and I am now able to draw blood, but I can't get an actual reading. Just the error message.
 
I haven’t used a ReliOn meter but I will ask @Diane Tyler's Mom if she can help you with that error reading
If you put a torch behind the ear, you will be able to see where the vein is so you can miss it…we have all hit it at some point, so don’t worry. If you hold the ear with a cotton round after getting the blood for a moment it helps stop any bruising.
Are you able to link the spreadsheet to your signature. If you can’t, we can help you.
 
newbie123 said:
I have the spreadsheet copied, but no glucose readings yet
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Even though you don't have any data yet to enter on the spreadsheet , I don't see that you attached it to your signature. Do you want someone to help you so it's there and once you get some data you can start entering it in
 
Hello again. I'm sorry if I should be starting a new thread, but I am struggling to give Sammy her shots consistently and looking for guidance.

An update since my last post:
  • I still have not been able to test her blood at home.
  • I took her to the vet on 2/7. Her glucose was 318. The vet said to increase from 1 unit to 2 units.
  • I took her to the vet again on 2/14. Her glucose was 220. The vet said to increase from 2 units to 3 units.
  • This entire time she is still drinking at least 4 cups (32 oz) of water daily.
  • She has also started peeing in the kitchen sometimes. I have 3 litter boxes but I think sometimes if they aren't completely clean or she picks one and the spot she uses isn't clean she will refuse to use it.
  • On the last vet visit, I had them shave a few spots on her to help me with the shots. She is a long haired cat and doesn't have very lose skin so I have a really had time giving her injections.
In the last week or so, it has become almost impossible for me to give her the insulin shot. I think its either because she was shaved or because I hurt her accidentally at some point. As soon as she feels the needle she jumps and starts running. I am using a 31g needle, I have 6mm and 8mm. I have tried holding her but I can't keep her still while also pinching her skin and using the needle. I've tried putting down food and treats, but as soon as she feels it she moves away and hides. I tried putting her in my bed and she started peeing as soon as I tried. Today I wrapped her in a towel in the bathroom and I tried doing it without pushing the needle all the way in but I just got the insulin on her skin. I am really struggling and don't know what to do.
 
newbie123 said:
Hello again. I'm sorry if I should be starting a new thread, but I am struggling to give Sammy her shots consistently and looking for guidance.

An update since my last post:
  • I still have not been able to test her blood at home.
  • I took her to the vet on 2/7. Her glucose was 318. The vet said to increase from 1 unit to 2 units.
  • I took her to the vet again on 2/14. Her glucose was 220. The vet said to increase from 2 units to 3 units.
  • This entire time she is still drinking at least 4 cups (32 oz) of water daily.
  • She has also started peeing in the kitchen sometimes. I have 3 litter boxes but I think sometimes if they aren't completely clean or she picks one and the spot she uses isn't clean she will refuse to use it.
  • On the last vet visit, I had them shave a few spots on her to help me with the shots. She is a long haired cat and doesn't have very lose skin so I have a really had time giving her injections.
In the last week or so, it has become almost impossible for me to give her the insulin shot. I think its either because she was shaved or because I hurt her accidentally at some point. As soon as she feels the needle she jumps and starts running. I am using a 31g needle, I have 6mm and 8mm. I have tried holding her but I can't keep her still while also pinching her skin and using the needle. I've tried putting down food and treats, but as soon as she feels it she moves away and hides. I tried putting her in my bed and she started peeing as soon as I tried. Today I wrapped her in a towel in the bathroom and I tried doing it without pushing the needle all the way in but I just got the insulin on her skin. I am really struggling and don't know what to do.
Click to expand...

Have you had luck with injections? I myself am having similar issues in recent weeks with my diabetic Baby.
 
Lmiller86 said:
Have you had luck with injections? I myself am having similar issues in recent weeks with my diabetic Baby.
Click to expand...

Yes! We are in a much better spot now than when I wrote this post. The main thing I did that helped with the injections is locking her in my bathroom. It's somewhat small so even if she runs she can't go far. I also have a set routine. She still tries to bolt, but I have a few seconds to do the injection.

  • What I do is first lock her in the bathroom and test her blood. I never thought I'd say I could do it, but I can now block her in a corner and get a drop of blood from her ear.
  • Then I feed her Fancy Feast Pate. She doesn't really like it so I sprinkle a little bit of Meow Mix on top. (Note: I had to stop feeding her the Wysong brand, it really messed her up with gastroenteritis, bloody stool, and an expensive vet visit.)
  • Then I measure out her insulin based on her blood reading.
  • Back to the bathroom (Note: She follows me because she knows she will be getting a treat.)
  • I get her treats ready. I give her lysine chews for her feline herpes so I break up 2 into tiny pieces and then also chop up a few Fruitables into small bites).
  • A take a few small pieces of treats and get the syringe. I sit on the floor and try to block her in a corner.
  • I get the needle ready, and then drop the few treat pieces in front of her.
  • While she's eating I quickly give her the shot. If she eats too fast and bolts, I sometimes have to get more treats and start over.
  • After the shot, I put the treat pieces down and let her eat the rest.
Her pre-shot blood readings usually vary between 195-300. I am sometimes afraid of giving her too much insulin so I think she still gets too high. But she no longer is drinking nearly as much water or peeing on the floor. So she is definitely more stable now.
 
Thanks for sharing! I'm glad to hear that things are going well for you and your gorgeous kitty! I probably need to get a bit more assertive with my girl. Maybe cornering her would be a good idea. Insulin is such a blessing but also so much agony for us! Your numbers look pretty good. My vet told me not to get caught up on numbers too much but focus on behavior and pattern.
@newbie123
 
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