Does anyone have experience using Novolin R?

[Babbs and Mow]

Hi all,

Could use a little help if anyone has experience with Novolin R. I'm not an expert with the protocol of TR, though I do understand the premise. I'm an old-timer and haven't been around much in some time, though I lurk every now and then. How the town has grown!

This may not be the forum to post this but thought I'd give it a try since TR is loosely what I'm needing to do with my boy.

A little about us (well mostly my boy).
Mow, who's real name is Butthead (We went incognito in case one of my vets was lurking here and I did want to burn any bridges!...but that was a looong time ago.) after doing quite well for the last 10.5 years with FD is now battling CKD and may be in the midst of pancreatitis (we're treating as such anyway). Between the inapitance and possible risk of vomitting, and needing to change his diet to a lower Phos food (He likes k/d and won't eat his usual Wellness right now) that has 6 times the carbs, we're juggling and walking a tight rope at the same time. Upping the dose so his BG's don't go sky high is not an option since I can't predict what he's going to do when I'm at work. Sometimes he eats great other times he goes without much all day....and God forbit he eats well and then vomits as soon as I walk out the door. When he eats really well and doesn't vomit he can be 350-400+ by shot time....not good. Keeping his BG's as low as possible as often as possible (below 200 would be ideal) is even more important right now due to the pancreatitis. This is as a bandaid until things are more stable.

I'd like to know if anyone has used Novolin R to combat spikes in thier kitty's BG levels and what your experiences have been. Curious about what dose/how low of a drop/in what time frame/what duration you experienced with it from start to finish/if your regular insulin was on board at the time you administered the R....and so on.

Using R is all I can come up with to keep his BG's lower when I'm around and can keep an eye on him. Any other ideas would be welcomed.

Thanks much!

 

[Marje and Gracie]

Are you using lantus?

Some of us use Humulin R (same as Novolin only different manufacturer) as a bolus. We have some very experienced members who have used R as a bolus and we could get them to help you. I just recently started using it to keep a bounce from getting too high.

I can tell you that, generally, you start with a very, very low dose to see how your kitty would react to it. It is typically in and out of the system in four hours. You have to administer it at a specific time so the nadir of R and the nadir of the longer duration insulin you are using do not overlap. So you would need to have plenty of data on your cat to know the best time to give it and you have to test every hour to be sure the action of it isn't too much for your kitty. You have to be careful because if it is not administered in the right dose or at the right time, it can cause the BG to dive and then set off a dive/bounce cycle which is counterproductive.

From what I have observed, it doesn't always lower the BG the same amount. I actually started using it to keep numbers from going up so I use it at the onset of a bounce. I don't use it with the primary purpose of bringing numbers down but it does have that effect on Gracie. You can look at her SS and see the results I've been getting which have been pretty good. One thing, though, as you can see, quite often when the R wears off, the numbers go back up but not as high. But again, my goal is just to keep a bounce from going too high at onset of the bounce and it's worked great. Also keep in mind if you look at her SS, that I use levemir, not lantus, and so I've had to customize when I can give it to Gracie based on the data I have on her cycles. In general, you don't want to be using it every cycle....if you are thinking you need to, you probably need to increase the dose of your basal insulin.

I would highly recommend that if you want to use it, that you PM Libby (Libby and Lucy) or Dyana (Dyana and JD). Both are very experienced at using R. I would not use it without the help of one of them.

It can be a great tool but it's important that the person using it has very good data on their cat's BG and knows their cat's onset, duration, and nadir and is fairly experienced in dealing with FD.

 

[Blue]

Hi all,

Could use a little help if anyone has experience with Novolin R. I'm not an expert with the protocol of TR, though I do understand the premise. I'm an old-timer and haven't been around much in some time, though I lurk every now and then. How the town has grown!

This may not be the forum to post this but thought I'd give it a try since TR is loosely what I'm needing to do with my boy.

A little about us (well mostly my boy).
Mow, who's real name is Butthead (We went incognito in case one of my vets was lurking here and I did want to burn any bridges!...but that was a looong time ago.) after doing quite well for the last 10.5 years with FD is now battling CKD and may be in the midst of pancreatitis (we're treating as such anyway). Between the inapitance and possible risk of vomitting, and needing to change his diet to a lower Phos food (He likes k/d and won't eat his usual Wellness right now) that has 6 times the carbs, we're juggling and walking a tight rope at the same time. Upping the dose so his BG's don't go sky high is not an option since I can't predict what he's going to do when I'm at work. Sometimes he eats great other times he goes without much all day....and God forbit he eats well and then vomits as soon as I walk out the door. When he eats really well and doesn't vomit he can be 350-400+ by shot time....not good. Keeping his BG's as low as possible as often as possible (below 200 would be ideal) is even more important right now due to the pancreatitis. This is as a bandaid until things are more stable.

I'd like to know if anyone has used Novolin R to combat spikes in thier kitty's BG levels and what your experiences have been. Curious about what dose/how low of a drop/in what time frame/what duration you experienced with it from start to finish/if your regular insulin was on board at the time you administered the R....and so on.

Using R is all I can come up with to keep his BG's lower when I'm around and can keep an eye on him. Any other ideas would be welcomed.

Thanks much!

Sure I have used R for the spikes and the high BG quite often, as have others.
R's pretty powerful, so it's advised when you first start using R, you go VERY slowly and at a very small dose like 0.1u and then test every hour for the first 4 hours to see how your cat reacts to R.
There's no way to know how your cat will react to R, and you can't base it on the other insulin you are using or the dose or the cat's size, etc.

What's the insulin you are using now and what dose?
Also, what sort of spikes are you getting? Are they spikes or are the numbers just higher now?

At shot time, give your usual basal insulin dose, and 0.1u dose of the R. Test again for the first 4 hours and record how low that dose drops numbers, when, and then note if the numbers start to rise again. Don't worry if the first dose seems to do nothing; just try a 0.25u dose the next time and follow the same testing for 4 hours.

Once you find what dose of R is affective and you see how well it works for your cat, you can then judge how to use it next time and for what BG.

One of my cats would react to a .5u dose of R, but my other did not 'see' any R unless he got a 1u dose.

Always remember that R is very powerful and you can give too much very easily, so start low and work your way up.

 

[Dyana]

Hi Babbs and Mow. I have used R on and off to help J.D.

I have found that J.D. will sometimes go down 300 points on one drop of R (measured to the zero line) if he happens to be breaking from a bounce that cycle, and it happens too fast, and sets up another bounce to high numbers.
Like Marje said, if you can time it right, so that you give at as he is going into a bounce, it can make the bounce less high. I also use Levemir, and almost always, I only give it when I am going to be home the next day, because for some reason it seems to often affect the next cycle too. Maybe it's because it can bring the numbers down to something the levemir can work with and the levemir can take hold for a day or so afterwards. So, because of that, I try to only give R to J.D. if I am going to be home the next day. I don't like giving it on weekdays because of that, but every cat is different.

Just be careful of how much you give because it is very very very powerful stuff and you have to be home to monitor at least the first 4 hours after giving it. Look at my spreadsheet on 12/23 as an example of what J.D. does. Remember that I use Levemir, so giving R at +1.5 was safe because Levemir has it's nadir around +8 typically. Notice how his next cycle that night was affected. This may be just something J.D. does, but that's why I don't give it the night before I have to work the next day.
When using Lantus, I would not give R from +2 after Lantus until the nadir of Lantus at about +5 to +6, because the nadirs will coincide and that could cause Mow to bottom out.

I hope what I wrote helps you a little.

 

[Blue]

If your insulin and dose are still 1.5u BCP PZI, I'd not give any R at all after shot time until you know how your cat reacts.

Every cat has a different nadir on Levemir and Lantus, so without knowing a cat's nadir on their bolus insulin, one can't suggest your using any R at all, even a drop, after shot time.

Every cat has a different sensitivity to R - some even show effects of R on the next day.

One of my cat's nadir was at +10, so I used R with him after shot time if he was rising too high as his curve was more like a mountain, not a valley. I used R to slow his rise, not pull him down.

Another of my cat's nadir was closer to +5, so she would get R ONLY at shot time, never later or the nadir from the R and the nadir from Levemir would occur together and cause a huge drop, in theory.

The safest way to start using R is to shoot at the same time as your PZI, and start at a dose of 1 drop, or 0.1u ... with U100 syringes, as I do not know of use with U40 syringes if that's what you are using.