? Andy Update 10/30 334; 2u; 192@+2; 88 +4; 80 +5; 500pmps

[Yvonne & Andy &BJ (GA)]

Since we are trying Novolin for Andy which is new for him, I am asking for some followers comments as we try to tweak his dose. Over the weekend, he was in ER for a UTI/not eating but is doing well now. Today is our 2nd day on Novolin so we have a learning curve. He has been a bouncer since we adopted him and had previously been on Lantus, PZI, Lantus, and now Novolin. Thx for your help.

334 to 192 in 2 hrs - is that a normal drop for Novolin? He tends to bounce when he drops too fast.

 

[Kris & Teasel]

First, this is good reading : http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

Novolin, Humulin, Vetsulin, etc. are in and out insulins that have the ability to drop BG quickly (ie., rapid onset) and low so extra caution in dosing is needed. The drop you saw isn't unusual for this insulin and it could lead to a bounce because of the fast lowering of BG. The recommended safety cushion is to get to high 90s to low 100s at nadir so you reduce the hypo risk. Unlike Lantus you can't push the dosing envelope or aim for a string of low dark greens with these insulins. It's early days for Andy on Novolin but the data you have suggest that 2 u *might* be a bit too much right now. I see that you bumped up the dose last night because of the black. I, personally, would avoid doing that for these reasons:

• the switch to Novolin is very recent and he's still adjusting so consistency is best
• a whole unit difference in dose between AM and PM is a lot and can set off a bounce
• a kitty who is prone to bouncing can become very erratic with variable dosing
• you're already using an insulin that by its action can set the scene for bouncing.

 

[Yvonne & Andy &BJ (GA)]

First, this is good reading : http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

Novolin, Humulin, Vetsulin, etc. are in and out insulins that have the ability to drop BG quickly (ie., rapid onset) and low so extra caution in dosing is needed. The drop you saw isn't unusual for this insulin and it could lead to a bounce because of the fast lowering of BG. The recommended safety cushion is to get to high 90s to low 100s at nadir so you reduce the hypo risk. Unlike Lantus you can't push the dosing envelope or aim for a string of low dark greens with these insulins. It's early days for Andy on Novolin but the data you have suggest that 2 u *might* be a bit too much right now. I see that you bumped up the dose last night because of the black. I, personally, would avoid doing that for these reasons:

• the switch to Novolin is very recent and he's still adjusting so consistency is best
• a whole unit difference in dose between AM and PM is a lot and can set off a bounce
• a kitty who is prone to bouncing can become very erratic with variable dosing
• you're already using an insulin that by its action can set the scene for bouncing.

Thank you for your response. You are correct - I bumped him up to 3u last night due to the black. I was following the vet's protocol to increase but think I will just put that aside as it is too soon to vary so much. I will use the guidelines you suggested. My gut also tells me the 2u was too much. I am worried that this insulin will result in bouncing again for him. The first change they made was to Vetsulin but he was not eating so took him to the ER. That's where they decided to try him on Novolin and they told me to keep the Vetsulin in case the Novolin does not work out. So we will try this to see how it goes. This afternoon I had to go away and was concerned that his bg's were still coming down so gave him some dry dm so his evening #'s will be affected. There are a lot of drs at our practice so you get varied opinions depending on which one is treating - good in some respects but not others. I will be testing within the hour so maybe will need another look later.

 

[Yvonne & Andy &BJ (GA)]

[QUOTE="Yvonne & Big John & Andy, post: 2280678, member: 13671. I will be testing within the hour so maybe will need another look later.[/QUOTE]
As I figured, he was 500 pmps - gave him 2u - will be interesting to see how it goes.