6 hour discussion re: Vetsulin, Humulin N

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Leslie & Sophia

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and after trying to hash this out these last couple of weeks, with all the searching, and occasional lengthly or heated discussions with the DH, i coming back to post here...that someday our trials, tribulations and triumphs may uplift or help someone else.

have numbers, if someone would be kind enough to post link to find blank spreadsheets, super appreciations...am also looking for one that would
generate an actual curve on a graph....

so maybe being worn out at this point will help me be better sussinct: Sophia is coming off the Vetsulin and going on a Humulin N trial starting tomorrow. This is a compromise with the three of us, DH, myself and vet. DH is suggesting a trial withdrawl from insulin altogether while testing Sophia the diabetic and testing the others to get an idea of what healthy numbers are supposed to look against a "diabetic" (woopie! sounds like fun! j/k). {We have dogs and cats and different species of birds here/farm enviro}

Upon stopping the Vetsulin (her last shot tonight), she is at 2.0 u of Vetsulin, but started at .8u before efficacy came into question...but it has been more than a year's struggle to find some balance/happy medium for all, of which, i am going to plead the fifth amendment. As the weight started to climb, numbers fickle, discovery of her digging bits of dog food from kennels, etc, as well as other discussions about the care for the animals with the DH, i removed completely the EVO (dry 88% protein) and put her fully on wet foods (venison heart, rump, supplements and canned Evanger's, usually rabbit). This also coincided with the death of our elderly Gordo, whom we tried to woo with any food (free fed) in his last days. He passed at 18 yo on the 5th of this month. Sophia has had bits of dry here an there as she fishes bits of what DH feeds the dogs. Prior, she had free fed on the EVO, with the wet routine, but would generally leave most, if not all, of the dry food in the bowl. I am bending towards free feeding her again in this transition, so as to not super stress her as it seems if the food is there all the time, she doesnt go crazy trying to find some...maybe that will change once she is on a new insulin. (Am pretty sick about the Vetsulin myself, to be honest).

DH is suggesting to stop insulin on trial, but i dont know about this. I am currently testing her daily, on average 3-5 tests.

I am curious why it is that folks are generally steering clear of Humulin N, or advisement leans towards Levemir, etc...if you use or have used Humulin N, i would be interested in your experiences.

i am also curious about what an average cats' BGs are and what they normally oscillate between...

am curious if you use tight regulation with your sugar baby or if you have had a combo of dry/wet food experiences during transitions of any kind.

anyhoo, this bean concludes that being worn out and wanting to be finished does not make one succinct...

hope you are smiling where ever you are, be well, leslie & sophia


overweight, regularly hungry, fresh catnip on demand ;-)
average bg 250, no ketones as of yet
hometested, Ultra, now ReliOn brand
was Vetsulin, have Humulin N.
will plug into spreadsheet next couple of days <3
 
I am wondering why you are changing from one insulin that has had warnings against its use since Dec/09 and switching to an old insulin that would be much harsher than something like Lantus or Levemir.
Lawsuit against Vetsulin Manufacturer
Vetsulin FDAs Warning December 15, 2009

I have not used N but I do use R on occasion for very high numbers along with Levemir:
Humulin Primer Info

For the food, removing ALL dry food will make a difference. Sure you can free feed wet low carb food, but it may be the dry that is keeping numbers higher than you could get on a complete wet diet. I understand how hard it can be to keep the dry away from the diabetic, but it's worth it.

Here is the most current ss instructions I have but others may have a more workable one:
Spreadsheet setup instructions

I think you may want to consider switching to a longer lasting and less harsh insulin - I don't think many are using N, but there are a large amount of people using Lantus and Levemir, with several no longer needing insulin by following the protocol outlined on this site for Lantus/Levemir.
 
Well I can answer what a normall cats BGs range from....got plenty here to experiment with...lol.

I have 11 kitties with only 1 being an OTJ diabetic, but I do test all of them from time to time. On average, my civies run between 45-55. My OTJ diabetic usually runs about the same you can look at his spreadsheet to see how he is doing. But the lowest I have ever seen with any of them is 42 to the highest with the civies being 58

Mel & Max
 
It sounds like you have had quite a journey and that you like to research things - wonderful!. If you have looked at our Insulin Support group forums, you can see that the Vetsulin and Humulin forums are virtually empty. People are using the milder insulins like Lantus, Levemir and PZI with great success. Several people who have already posted have spreadsheets attached to their signatures so you can see that those three insulins tend to give a curve which is less harsh and a "surf" that lasts longer. Our thoughts are that such insulins are easier on the cat and easier to regulate with. Many kitties on those insulins have gone into remission. There are cats who have gone into remission with Humulin, but it is harder on the cat and the human.

Continue to check around the site and read the posts from others. Lulu's2Moms are currently trying to regulate with Humulin and considering moving to one of the milder insulins: viewtopic.php?t=30666
 
Tucker started on Humulin N 5 years ago, he transitioned to PZI and now is on Levemir.

On Levemir Tucker has had very few pancreatitis flares, for a long time on Levemir he stopped having the huge swings going from Hi to Lo and feeling cruddy most of the day. He is now taking a steroid for a brain tumor, so he's starting to swing again, which makes me remember how uncomfortable he was on the shorter duration insulins.

On Humulin, Tucker's insulin lasted about 4-5 hours. He got shot 2 times per day. From 8AM to about 11AM he felt okay, then his numbers started to go back up. By 8PM, well actually most of the afternoon he felt cruddy. 8PM to 11PM felt okay then cruddy until morning.

I was new back then and did not know I could shoot the insulin more than 2 times per day. However, with my work schedule I cannot shoot more often.

I highly recommend Levemir over short duration insulins because your kitty will feel so much better, the cost is higher for the Lev, but the quality of life is better and to me that outweighs cost any day.
 
I know you are exhausted but later could you tell us why N was even an option? There are so many better options for cats..you have put a lot of hard work into this, there is no need to make it harder :(
 
great replies, most of what i anticipated...

Thank you for the Humulin primer and spreadsheet instructions...
i am with you regarding the Levemir; i did notice that Humulin N did not have that many posts and many care-givers were happy with the Levemir. i still have some questions about Levemir to look into such as the duration of efficacy, peak, decline, ect. as we need to find something we can all adhere to long-term. Sophia has had both high and low numbers on the Vetsulin (been an interesting ride!).

She was restricted a few weeks ago to only the wet mix, and, yes, her numbers were better somewhat, and there is also the panic factor: when the dry was left out (EVO 88% protein) she would only eat maybe a tablespoon of it a day, and it was a bit of a security blanket that she had access to some other food (she has hypo'd before, another long story i would like to add as an attachment to my profile somehow). She gets coo-coo without some dry, spending her time on a search and destroy mission. She settles down when she sees there is something there to nibble on. We (DH and i) have had lengthly discussions regarding possibility of stress hormone release regarding her history of panic, which is warranted given her hx/history (another attachment needed...poorly regulated on way too high of a dose for 9 months before i discovered the FDMB: 9u twice a day with regular defecation outside the litterbox. Just happened to catch her hypo-ing when i was off of work). Many thanks to the FDMB as it saved her life more than once.


I appreciate the comment of Humulin being harder on the cat and the human, but at this time, money was also a hot topic with the DH, and with her numbers and behavior, a shorter acting insulin may do her well; unfortunately it is all a grand experiment of which, Sophia has been stellar in enduring. The Humulin was something we could get right away to get her off Vetsulin. Also, she is probably producing some of her own insulin with such low doses (.8u with fresh bottle). She was up to 2.0 because of the hometesting and my seeing the efficacy going sour. I cannot afford Levemir at over $100 a month if i am tossing a bottle every 28 days or so. (Still much to look into...and study up on).

with super appreciation for you all, and the FDMB, i will be back in a bit...blessings, Leslie and Sopia
 
Since your DH wants a trail withdrawal of insulin for a while, I vote that he gets the task of checking the urine for ketones...daily!!! LOL. Seriously though, do check her urine for ketones as often as possible.
 
I will look forward to your spreadsheet, as without those numbers we really can't pass judgement on how the vetsulin worked and guess as to whether N might...

Jen
 
OK I am not sure where you got that idea of Lev costing $100/month! I don't pay that much and my 2 cats combined are getting 72u every day!

That 28days you mentioned relates to Lantus and if it's left out of frig, at room temp. For Lev, the date out of frig is 42days.
Plenty of people use their Lantus and Lev for much much longer, some to the last drop, because it should really be kept in the frig.
Lev is much longer lasting, gentle on the body, and it's one of your better bets to reaching OTJ, or close to it.

I paid $129 for a pack of 5 cartridges, 3ml each cart. I use one cart every 6-10days, depending on the doses my cats need. I have 2 high dose kitties, so your cost would be WAY less! Today's am doses were 22u and 12.5u.

There are other places where people could advise on cheaper costs for Lev, as I am in Canada and the US costs are different.

For the foods, I am sure you can find much more economical foods that are just a healthy, ingredients wise, and still low carb. It could be that your cat just doesn't like the wet food you are offering. None of mine like EVO, but they do love fancy feast and friskies, which are cheaper than the EVO.
If my Shadoe gets even a small mouthful of dry food, you can take it to the bank that her numbers will hit 400 before the end of the day. She is SUPER carb sensitive.

You may well be getting a cheaper insulin, but if it's harsh on the cat, it's not a good choice. You may find a pharmacy that could sell you an individual cartridge or maybe you could even consider using Lantus and purchasing a single Solostar pen. For just a few dollars more, you will have smoother numbers and a much healthier and happier cat because that rollercoaster of numbers has got to feel crappy.

Vetsulin just not safe, and N doesn't last a full cycle; it's like running out of gas before you reach your destination and having to push your car the rest of the way. That sucks!

About panic, maybe others could have some suggestions for you. I recently got a calming collar for my one civvie who is the epitome of stressed and she hates everything and every one. I put that collar on her and I don't know what happened... she is a brand new way nicer and 'calm' cat now.
 
Lots of us free feed wet. You can freeze it and leave it out to thaw. I use an automatic feeder (PetSafe5) that allows 5 separate feedings that you can set by the clock.
 
Couldn't you do it as long as you plan it out? I was thinking she could free feed during the day and night for the hours between shots - just being sure there was food on board before the shot?
 
I didn't use N but no, free feeding was always discouraged as it is important that the cat eat a pretty good amount prior to shot. a snack inbetween perhaps...
 
Humulin N is frustrating... but it's all we have tried. It doesn't last as long as Levemir and Lantus seems to for others, and in the beginning it would drop his bg really fast (and still does if you look at his #s from last night) I worry alot about him going hypo right now because I am giving him insulin when he's low already. He shows signs of remission... and we are thinking about switching to the longer lasting insulin so his pancreas can have longer stretches to heal up.

Maybe we shouldn't, but we do free feed. We have four kitties altogether, and they all got really snipety and grouchy with each other when I tried to do feeding times. They usually love each other and sleep on each other... but feeding times made them competitive. This does not mean their bowls are always full, and they do also have 2 set meal times in which they always beg and eat, but there is usually a little wet food hanging out in the bowls. I also work different hours and I know Lulu looks for food when his #'s are in the low 60's so I worry less about hypo when i am gone if there is food out and available. The auto feeders look cool.. but not in our budget.

Humulin is cheap.. this has kept us trying... but I want my little boy to feel the best he can and also heal if he can. I think we will keep up right now as we are going for another few weeks and if it is still this crazy we will switch then.

Knowing what I know now... I would not choose Humulin... I am just trying to make it work right now (kinda the story of my life) If you have the opportunity now cause you are switching anyway... I would try Levemir... you have tons of support here too.
 
Gayle, good word about the Levemir and costs... will look into that :) Sophia gobbles up the raw/wet stuffs and nibbles about a tablespoon or so of the dry EVO (when she is feelin good!) otherwise she goobles anything she can (thinking poor regulation, oscillation with Vetsulin, etc)...great analogy about the car runnin out of gas! Sophia is very rarely testy about anything...more like a couch potato that i coax with toys, laces and peacock feathers...her favorite activities are eating and napping. I take her outside with me everyday to get her to walk about... she will claw at the food bowl when i pick it up, but again, i think she needs better regulation regarding all this...

Jen, most definately about spreadsheet...working that right now...any word on a ss that would generate actual curves (in a graph)? i am not an Excel genius and will do some doc searches online once i get the classic ss done...asking just in case it has already been discovered...

Dale, LOL! i would love to see that too, but he does what he can, ultimately leaving it up to me...have been using ketone strips again this week, all negative. Not even a hint, thus far...

Sue, thanks for that idea of the freeze and thaw, i would be afraid that she would try to eat it frozen! She is tricky...but would like to look into the auto feeder you mentioned as there are times we just cannot be by her side every hour or two...

Jen, am curious about caveat of not being able to free feed on N...to be honest, i am waffling on free feeding, but have experienced that Sophia is not an eating machine if she is feeling good with nice regulation ...would love to hear more about your thoughts here. Have a feeling that Levemir and tight regulation on feeding, etc, would bring about a happier, healthier Sophia. Probably less stress on the beans, too. Timed feeder looking appealing esp. for those days we work long hours. Also, you asked why N was even an option: 2 out of the 3 votes (DH, vet, myself). But again, am leaning hard toward finding a similar Levemir situation as Gayle...

Gayle, when you say cartridge, is that for a pen or is that a vial?

best wishes, all and thank you so much for being part of the discussion!
 
My Twigie is on N. I first tried Lantus but it did not seem to work well at all. Very little drop in BG. With N I am able to keep her BG below 120. At a PS BG of about 115 I can give her one unit but she only drops to the 80's. From other peoples experience posted here Twigie's response seems very abnorma but it the N works for her.
 
The point behind not free feeding with N, if I remember correctly, is based on a. needing sufficient food in the system prior to giving injection and b. not wanting to mess with the action of N inbetween shots.

Honestly, for the vast majority (exception Larry and a few others), N is just not a nice insulin for cats. The action is so much different than the newer lantus/levemir/pzi that I just cannot imagine why any vet would want to use it. Again, without looking at the trends in your spreadsheet I can't comment on your particular cat.

For your own 'curve' simply chart BG numbers vs time on a piece of paper and connect the dots for your own visual...

Jen
 
Leslie and Sophia,

All I can tell you is that many cats here have gone into remission by using Lantus via the protocol used my the members here, combined with a strict low-carb diet. Published studies confirm this. The cost of treatment for cats in remission is zero. I know it's hard to believe a bunch of strangers on the internet, but if you want to get your cat as healthy as possible, and potentially even OTJ ("off the juice" aka insulin), I hope you will reconsider using the most modern and "steady" insulins. N is not one of them... My fancy NYC vet who has been in practice for 30 years knew very little about treating diabetes in modern times, and has I listened to his advice, I'm certain my cat would have become terribly ill. Today he needs no insulin and is healthier and happier than he's been in a long time. We can only share with you our direct experiences.
 
Hi Leslie and Sophie,

I tried to take a look at Sophie's ss and it's not published yet... not sure what needs to be done to publish. I would love to help in any way that I can. Lulu looks to be going into remission, and this is on Humulin N. I am thinking that his diabetes was made worse by teeth issues... as these have been slowly resolved, his bgs have come down, but I also know that others have made this insulin work.. .or it is what works for them and their kitties.

I think many vets prescribe this insulin because it is what they know. I had a discussion with my vet earlier this month, and this is pretty much what it came down to... NPH is what she's familiar with. We discussed switching him because his curves were so steep... and she did some research over a weekend (and we did too) and recommended lantus... but when I mentioned Levemir she was game to that as well. We are lucky to have a vet who is down to earth and open to discussions... she also is honest about her limitations and always willing to learn thru the experience of others. We have given them lots of info on food etc and they have thanked us. This board has given me the confidence to discuss Lulu's needs with her, and has also helped me language my questions in a way that is nonconfrontive but also straight forward. (Thank you everyone!) When we next visit, I am going to mention the message board... hopefully she will refer others here.

Anyway, I know this can be frustrating, so if I can help I am here.
Amanda
 
While remission should not necessarily be the goal of treating feline diabetes, cats have a much greater chance of achieving remission on either Lantus or Levemir, provided their blood glucose levels are carefully monitored.

Levemir user Sheila, Beau & Jeddie took Beau from 2 years on Vetsulin to remission on Levemir in less than 3 months. I'm not sure what you mean by efficacy of Levemir, if you mean how long it lasts, a flexpen of 300U can last beyond 3 months, as long as it's refrigerated. Peak time of a cycle can vary from 7 to 12 hours. Feel free to ask specific questions in the Levemir ISG. viewforum.php?f=10

If the veterinarian is not open to other options, look for one who is.
 
I get a package that contains 5 cartridges of 3ml each. The pens you mention are also 3ml each. You don't need to have the pen, but they are great if you do any traveling with the insulin.

You can do balanced, planned feeding if you use an auto feeder. You can freeze portions of food if you don't want to leave the wet food out all day, so by the time the feeder turns, the food would be thawed.
 
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