4/8 new to group, Alice, recent DKA, how to switch from NPH?

[AliceMeowliss (GA)]

Alice has been on Novolin N and not at all regulated well. She went into DKA Friday and just spent 3 nights at ER vet. She's getting more IV fluids today at her regular vet and being monitored, but they close at 6.
I'm waiting for Lantus from DCIN but my friend has offered me a Lantus pen now. How do you switch insulin types when a cat *hasn't had DKA? And, how do you switch when they *have recently had an emergency like that? Should I switch asap or keep trying the NPH until she's more regulated?

I think I'm trying to ask, if NPH works so much faster and it seems like Lantus builds on itself, can she safely switch? Can two types of insulin be used concurrently (such as in case of emergency)?

I know that she will need BG and ketone tests often and I am fine with that even if it means sleeping on the floor by her side and setting hourly alarms for a few days. I just want to understand what to do.

Thanks!

 

[Jill & Alex (GA)]

And, how do you switch when they *have recently had an emergency like that? Should I switch asap or keep trying the NPH until she's more regulated?

Ask your vet what they prefer. We don't know the particulars of where kitty's at in the recovery process. That info could influence whether it's best to start Lantus right away or continue with N a little longer. Usually, switching insulins isn't a good idea until kitty is over the crisis and ketones can only be seen in the rear-view mirror... especially true with an insulin like Lantus. The effects of Lantus are cumulative meaning it'll take about a week to see what the dose can do when starting out. The effects of N are immediate so depending circumstances, it might be better to remain on N a little longer. If you do switch to Lantus right away, please test for ketones at least once a day. If at all possible, test twice.

How do you switch insulin types when a cat *hasn't had DKA?

Usually, when switching from N to Lantus, we would suggest starting with the same number of units of the 'old' insulin at the next shot time (12 hours after the last). In this case, I'm not seeing enough information/data available to confidently suggest a starting dose. Again, this is something I would discuss with my vet.

Can two types of insulin be used concurrently (such as in case of emergency)?

*Usually* the insulin of choice would be Novolin R or Humulin R when using a second (bolus) insulin with Lantus. Novolin R and Humulin R are different brands of the same insulin. Novolin R can be purchased at WalMart and is much less expensive than Humulin R. HOWEVER, we strongly suggest working with an experienced R user in this forum if it becomes necessary to use two insulins. R can be a great tool when used wisely. On the other hand, it's use can be downright dangerous when one doesn't know what they're doing with it.

I know that she will need BG and ketone tests often and I am fine with that even if it means sleeping on the floor by her side and setting hourly alarms for a few days. I just want to understand what to do.

We can help you with that. I see Kris & Teasel put together an awesome list for you: http://www.felinediabetes.com/FDMB/threads/home-care-after-dka.212964/#post-2359438 in your thread on Health: Home care after DKA??

There are several people who have first hand experience helping their kitties recuperate from DKA. Please post often.

 

[AliceMeowliss (GA)]

Thank you @Jill & Alex (GA) I'm just so worn out and scared about the miles ahead, right now.

I'm sure I'll be panicking and rambling on here a lot. Hah.

I do think with all that in mind I'm not ready to switch her to Lantus at least for a few days. I want her more stable than this.

 

[Jill & Scooter]

I have no advice for you but I hope Alice recovers from her DKA quickly!

 

[Ella & Rusty & Stu(GA)]

Great advice from @Jill & Alex (GA) . I have no experience with DKA, but just wanted to stop in to welcome you and Alice. My first cat's name was Alice. She was a sweetie, and I'm sure your Alice is, too.