dose advice- humulin n

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dd & savannah

dd & savannah

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Hi,
Since we've been home from the incident this weekend (wobbly legs, small seizures- not diabetes related) Savannah's numbers have been high.
I've been having a hard time giving her the right amount even the week leading up to her seizures. I have been giving her between .25 and .5 units depending on her numbers. 250 and above she received .5; 200-249 .25; and anything below 200 was nothing. As you can imagine it's pretty difficult to see .25 on the syringe so I am always second-guessing my self when I give her .25. By the way she is on Humulin N. In the past, she gets a very slow curve from N and this is why we have not changed.
Yesterday I did a curve and this is what I got...
7/5
ps am 339 .25 units, no insulin was given the previous night as directed by the vet
+2 362
+4 302
+6 272
+8 323
+10.5 330 I gave her between .25 and .5 here b/c I didn't want it to get any higher.
-because I was awake I checked her 7 hours later (around 1:30 am) and she was 229

7/6
ps am 414 .25- .5 units
+9.5 she is already at 410 so I decided to give her the shot at .5 and will read her sugar for this evening.

Since this summer, I can't tell if she is one of those cats that needs her insulin every 10 hours but in a smaller amount. Or, maybe she needs one shot per day b/c there were several times earlier last week when I gave her .5 in the am and she was only 189 by her pm shot.

Any advice would be greatly appreciated.
Dianne and Savannah
 
Just to add these are my numbers from throughout the night-
7/6 pmps 410 .5 given
+2 336
+4 315
+8 365
7/7 amps 344 .5 given

I was looking at my bottle of Humulin and it is getting low and may have lost its potency. I can't remember when I bought this one. I think I will buy a new bottle to see if it makes a difference.

Thanks,
Dianne and Savannah
 
Dianne, because there is no info in your profile, it is hard for me to give advice that means much. Could you put something in about when diagnosed, other medical conditions, what food you are feeding, and other test results? I know it sounds like a lot of work but without that context it is pretty hard to know what to tell you. Obviously by the recent test results, you have room for a dose increase, but is there a history of hypoglycemia that has made you go to such a small dose?

Jen
 
Hi Dianne,

Jen has asked some good questions, and I'm interested in the answers too, but I'll leave some additional comments now (busy at work, but taking a brief break)

Monday's curve does show a response to the insulin - just need a bit more.

Tuesday's data doesn't show much response to the slightly bigger dose. Could it possibly have been a partial fur shot?

If you were to switch to PZI in U40 concentration, you could do microdoses easier --

Using U40 insulin in U100 syringes -- the conversion is 2.5x

1 unit U40 == 2.5 marks in the U100 syringe

So this lets you dose down to 0.2 much easier.

0.2u = 0.5 mark on U100 syringe
0.4u = 1 mark on U100 syringe
0.6u = 1.5 marks on U100
0.8u = 2 mark on U100
1.0 = 2.5 mark
and so on.

You would just have to make sure that the concentration is U40 (depending where the PZI comes from you can get different strengths, U40, U50 or U100)

The PZI would cost a bit more than Humulin N, but you should also get a better response from Savannah. PZI is the closest insulin genetically to a cat's own naturally produced insulin.

You need a vet's prescription to order PZI.
 
Hi,
I updated my profile. I haven't added any more recent bg numbers to it, I still need to figure out that part.
Today her amps was 344 and her pmps was 320, she received .5 both times.

About 2 years ago, There was one incident when she was at the vet's for a curve (the last time we ever did a curve there) and she dropped to 40 and they had to force feed her!She did not however, display any hypoglycemic symptoms.

The reason I have occasionally given her .25 was because it was suggested when her preshots were between 200-245 b/c I was afraid she could possibly go hypo since I typically leave for work at 6:30 and don't return home until 5. There were times her +6 or 8 would be at 80 and I was just too afraid to give her .5 and risk it.

I'm not sure I want to switch insulins yet only b/c of her recent small seizures.
I will post more numbers soon.
Thx,
Dianne
 
well, if she is in a 200-80 range (for example), that is pretty decent and depending on the shape of the curve, there may or may not be room for improvement if you continue using N. The higher numbers though need to come down, so more data would help us understand what is typical for her if you give 0.5 at those numbers. It may be she needs more at those preshot numbers, but again, the rest of the picture is the shape of the curve (ie how steep, etc).

Does this help?
 
Thanks. I will post more over the next few days. I am going to try and do spot checks today and a curve tomorrow. I bought a new Humulin N and I am trying it today to see if it helps. We have a neurologist appt. in a few weeks (to figure out what caused the seizures) and based on what he says I may decide to switch insulins. I don't want to try anything new yet until she's fully recovered. The good news is that she is doing everything normal again (no wobbliness) but she has not fully regained her strength back when jumping up onto things.
Talk soon!
Dianne
 
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