Dosing advice?

[Kya’s Mom 1983]

Thought we were doing pretty well on her current dose 5.25. Had a pmps of 240 last night. Gave 5.25. Woke up to vomit on her cone this morning. Amps was 535. Was slow to eat when she normally scarfs down her food. Gave her 1/2 tabcerenia for any stomach upset. Gave her regular dose cuz bgwas so high. Tested 30 min later meter just said HI. Never had that before. Looking at the sheet does dosing look ok or do Ineed to lower it back down to something else. Thought shehad been doing good. I haven’t been on the site in a while.

 

[Nan & Amber (GA)]

I'm answering to bump this up in hopes that someone with Novalin experience can answer this.

My thoughts looking at the spreadsheet: I do think the dose is too high right now. Especially last night, when she was at 240 (a good number for her) at pre-shot, getting the full dose of Novalin probably hit her pretty hard. She's bouncing this morning in reaction to how low she (probably) went last night.

I would reduce the dose for safety, not sure by how much though. We usually go in 0.25U increments, but I think I might go farther down, especially if you aren't always able to get tests in between shots to see what she's doing.

 

[Kya’s Mom 1983]

I can reduce dose. I left work early today because so worries about her. Got home tested at +6 got 239. Gave her some chicken she ate that right up gave to her cuz I felt so bad about her going low. Tested again at +7. Went up to 242. If it stays around this. What doseage would you give. Maybe 4.5? Or 4 your guess is as good as mine. Seems to have not had any more vomiting today while I was gone. Seems ok for the most part. I’m hoping to get a ketone reading tonight too

 

[Nan & Amber (GA)]

Does she have any history of ketones? What do you think caused the vomiting?

I do not have any experience with Novalin, and I hesitate to give specific dosing advice under those circumstances. That said, 5U is a large dose for such a hard-hitting insulin (for most cats, on other insulins, I'd say a "typical" dose is 1-3U). So if it were me, I'd probably take the larger reduction, especially if you see another number below 300, and see how she does. The main risk to dosing too low is the risk of ketones, so if she has any history there you might reduce more cautiously.

We do have a guide for Novalin and other similar insulins: BEGINNER'S GUIDE TO HUMULIN N/NOVOLIN N/NPH. You aren't a beginner at this point, but it's always good to go back and read this stuff-- there's a lot of information there!

Curious how you got up to 5.25U? In your spreadsheet, you were still at 1.5U in January 2020, then by this March you were at 5. Was there a separate health issue going on during this time? Insulin needs do change over time, sometimes for no apparent reason, just wondering how it happened.

 

[Kya’s Mom 1983]

No history of ketones. It’s just seemed as the year went by the dose was not working. Every vet visit they would tell me to up it. Which is why it was that high. Tonight’s pmps was 471. I gave her 3 u to see what that does.