Curve instruction

My love Jackson is over the rainbow bridge
But however, I am assisting a newly diagnosed feline while his human mom moves from her old home to her new home to avoid stress on him. She will be joining the forum very soon. Her cats name is Sampson and he is 17 years of age and Maine coon.
Here’s what I know. * Novalin U100 .5 x2 (7am/7pm)
Tonight’s numbers @4:40 pm EST was *646
Shot given early
@ 5:20 EST watching him close saw little change. Oh my goodness could the last
a wet shot? Checked & was 715
Reshot .5 Novalin & numbers came within range

Now she’s had this handsome cat since he was 6 months old. Her introduction to her cat having feline diabetes was the vet reaching inside the car window showing her how to administer a shot. Selling her alphatrak and supplies. A few basic pointers in an age of COVID-19. So I had to dust off my knowledge that YOU ALL & Jackson so lovingly provided me with and try to help.

Now I’m finding myself doing a curve.
Getting it on paper texting it to her so she can text it to her vet.
Maybe we can get this insulin adjusted properly so his numbers never skyrocket like that. He was getting 2x the insulin he is now and he bordered hypo.
Ok now that I’ve bombarded you. How can I do a curve? I’ll be home ALL day.

 

First off I am so sorry about Jackson. Losing sugar cats are so, so hard. I hope you are doing okay.

On to Mr. Sampson: am I right in reading that she gave a fur shot and then re-shot? That's something we never ever recommend because you simply have no idea how much insulin was administered. Novolin's a harsh insulin too. Make sure she knows to feed 1 full hour before giving insulin, and a test and snack at +1. Any drop below 100 needs a reduction. Novolin is a lot more strict than with rules because of how dangerous it is in cats.

So was he on 1 unit of Novolin and almost hypo'd? And now he's on 0.50 u?

With a curve on Novolin, I would start with a +1 and check every other hour until he starts trending up. I imagine it will happen early in the cycle due to the short duration. Give snacks early, between +1 and +5.

 

Y

doing OK, thank you ever so much for the hug. Onto Sampson it was me that gave him a wet shot. It was me that replaced it. And sugar regulated very quickly. I’m the one taking care of him while his mom is moving. Her introduction to feline diabetes was A COVID-19 masked vet leaning into the car

 

And for the record ...I don’t like novalin for cats.

 

Hi there,

I'm sorry to hear about Jackson, and I can see how very much you miss him.

It's very good of you to help your friend and Sampson.


According to the FDMB beginner's guide to Novolin:

* Withhold food for 2 hours prior to preshot test. (Guide recommends 250mg/dL as 'no shoot, ask for help' number as tested on a human meter (a higher threshold should be set if using a pet meter).
* Feed the cat, then wait 60 minutes ('front-loading' the carbs, ready for the Novolin to work on - Novolin hits really hard and fast).
* Assuming the BG is high enough and the cat has eaten, give the insulin dose.

Novolin hits really hard and fast. I'd suggest the following tests for the curve:

* AMPS (preshot BG test)
* Feed and wait 60 minutes
* Give insulin dose if safe to do so.
* AM+1 Test BG
* AM+2 Test BG
* AM+3 Test BG
* AM+4 Test BG

Then test every 2 hours until the end of the 12 hour cycle.

It's important to have a bit of a safety margin at nadir. If the dose is taking Sampson's BG lower than 100mg/dL as measured on a human meter (higher threshold needed on a pet meter) then the dose needs to be reduced. Discuss this with your friend and their vet.

Safety Note

I echo Elizabeth's warning above: If ANY injection gets messed up then never, never, never give a second one. Wait 12 hours until the next dose is due. As Elizabeth says, you can never know how much insulin the cat may have received.


Mogs
.

 

What a BEAUTIFUL tribute to your Jackson! Helping another sugar kitty. THANK YOU FROM ALL OF US!
We look forward to meeting your friend!
jeanne

 

What a terrible time this is to get a FD diagnosis. Sigh.

I like Mogs suggestion for hourly tests early in the cycle. It'll be really helpful for Sampson to have that info since he's on Novolin. You're a great friend to be helping out!

 

With Novalin it is important to test hourly until past the peak of the cycle, then you can space tests out a bit further (even quite a lot further...)
That's because Novalin 'typically' tends to have early onset, then drops the blood glucose fast, and then has early nadir and a short duration. So, most of the action that you need to know about often happens in the first hours of the cycle. Of course, 'ECID'...

Thank you so much for helping with this kitty.

 

Hi Elizabeth

Novolin can sometimes tank BG levels really early in the cycle - even faster than Caninsulin/Vetsulin - so doing the hourly tests can help to highlight when a kitty might need a little food intervention to slow or reduce the depth of the drop. A while back we had a member called Cathie whose cat, Shaak Ti, was on Novolin. Cathie did an extraordinary job working with this insulin and managing the drops. Shaak achieved remission! But, as Jeanne highlighted above, Novolin treatment can be a bit of a wild ride.


Mogs
.