Help- Curly and Humulin-N- did I do the right thing?

Status
Not open for further replies.
maggie&curly

maggie&curly

Member
First of all, thank you Cindy and Mousie for the testing supplies- they really came in handy today. Curly was kind of acting weird last night, walking around crying, and not eating his food. Today when I fed the cats he did not come to eat. I put the bowl of food in front of him, but he did not show any interest in it. (my other cat is eating fine so I don't think its the Friskies). I was running late for work and was not sure what to do- usually when he is acting like this his sugar is high. He is normally on Humulin-N 1.5 units every 12 hours. I tried to test him (thank you again, cindy!) but could not get a reading so I gave a reduced dose (just under the 1 unit mark) of his Humulin-N since he wasnt eating (although when I put a bowl of milk down he did start drinking that). After I gave the dose I decided to try one more time and I was able to get a reading, which was 256. I want to make sure that it was okay to give him that 1 unit with him being at that level.

Honestly since I have not had the testing supplies until now I don't know what his usual preshot level is. It used to be 500, but that was when the vet thought he was having rebound high sugars because of too high of a dose so she brought him down to 1.5 units twice daily. He got his last dose last night at around 1:30 a.m. and then the reduced dose today at 11:45 a.m. I am just worried about him and am not sure whether I should try to get someone to go sit with him until I get off work. And unfortunately I was out of the baby food and other goodies that I usually entice him to eat with, although I will pick them up on my way home tonight.

He has reacted like this in the past when a dose or two was missed, and this time I can only think of one dose that was missed due to my work schedule, and he normally does okay as long as he doesn't miss 2 or 3. Which was why I was afraid to just not give him any, since that seems to be what leads to this. Anyway, I am so used to him being super high before his shot that I have no idea if 256 is a good level to shoot at or not.

Also there was that incident last week when he accidentally got an overdose of his insulin- I had run out of syringes and used one that I didn't realize until afterward was a U-40 syringe, but he seemed to do fine. I wonder now if he had some kind of rebound from getting that higher dose?

Now I see the benefits of curves! Thank you again, Cindy and Mousie, I will do a curve on him the next day off that I have. But if anyone can tell me whether he should be okay until I get home it would sure help me. Thanks for any help or advice anyone has to share.
 
Re: Curly-help! did I do the right thing?

Hi Maggie

the only thing that stands out to me, is that he wasn't eating much this morning right?

did you leave plenty of food out? did he eat just before you left?
 
Re: Curly-help! did I do the right thing?

I did leave out full dishes of food and I got him to drink some milk just before I left. He has been drinking water too, just not wanting to eat the regular food. I am hoping that the milk will trigger his appetite.
 
Re: Oops- gave wrong insulin info

Just an FYI, Curly is NOT on Lantus, he is on Humulin-N. I don't know why I got confused on that, but that is the correct insulin that he is on. I don't know if that makes any difference or not to the situation.
 
Re: Curly-help! did I do the right thing?

thats ok,

maybe you could add Humulin N to ur first post subject/title line?

just hit "edit" on the first post in this thread, and adjust the subject/title line, this will help you get more eyes on you ., you can also edit the "Lantus" out of your first post too if u want.
 
Thanks- I did not know you could do that! Have a lot to learn with this new board, especially as I have no working computer right now so I can only post when I am at work. :(
 
Yes, he should be okay, but please ask your vet about switching to Lantus, or Levemir insulin as soon as possible. I have used both Humulin N and Levemir and the difference was dramatic.

Meanwhile breathe easy and relax, we're all here to learn.

First thing you should know is that the objective here is to try to keep that number between 60 and 300 at all times, and between 60 and 200 for as much time as possible. With other insulins that may be much easier than it is with Humulin N.

Humulin N has a typical curve in kitties that's rather fast-acting -- it is fully effective and peaks in about 3 to 5 hours, and wears off very quickly after peak time, usually by 6 hours. So between +6 and +12 your cat has essentially no insulin available, which is very bad.

Also not good is that the drop of blood sugar numbers is very rapid with Humulin N -- it can easily go from 400 down to 40 in just 3 hours. This is also not healthy, and can trigger a rebound. It will likely make the cat feel funny. And it's unsafe since you don't know how far or how fast that drop can go. And since the drop is so dramatic, you may need to wait for a really high number before you dose again, which is also not healthy.

All this said, there are cats who do fine on this insulin, but it's really not a first choice. Elsewhere on this site ( viewtopic.php?f=19&t=303 ) are instructions for safe dosing with Humulin N. Whatever you do, don't raise dose more than half-a-unit at a time.

And try to switch to a better insulin. Also not recommended (by me anyway:) Vetsulin or Caninsulin, Lente, or Humulin R.

Possible: ProZinc or other PZI
Excellent: Levemir or Lantus, aka detemir and glargine.

Cheers,
Steve
 
maggie&curly said:
Thanks- I did not know you could do that! Have a lot to learn with this new board, especially as I have no working computer right now so I can only post when I am at work. :(
Click to expand...


Thanks Steve for stopping in!

Maggie, if you can print this info out at work to bring home, that might be helpful for you
maybe u know someone close by with internet if you need to use it?
 
Thanks for the info! I do need to do a curve on Curly to see exactly what his sugar is doing, but I wonder if the insulin type is the reason why he is not gaining weight and why he has these reactions just from missing a shot. I will definitely look into the Lantus. It seems like that is a popular one, and I think I had been thinking that we were on it because that is what I see so many other cats on here on the board (plus being a medical transcriptionist I hear Lantus alot more than I do Humulin!).

I will print this stuff out, and I am hoping to get a friend to come and look at my computer to see if he can figure out what is wrong with it, and if it is DOA then I may try to look into a cheap basic computer to at least keep me connected to the internet. I need it anyway as I am still working on call and job searching for a full time benefitted position. Meanwhile I think I can read posts on here with my phone, but I am just not sure if I can actually post- but at least I can access the info, at least I hope I can. It has limited web access.

Thanks for all your help- I feel a little better and I will try to keep you posted on how Curly is doing.
 
hi maggie and curly! Ronnie and Luna put a shout out for Humulin N users to pop in here and I just saw it, so here I am. Looks like Steve covered N for you, so I won't go into that. HOWEVER.....I would urge you to look into another insulin and do it AS SOON AS POSSIBLE!! Sorry, don't want to come off to strong here, but Spot was on N for 7 months...I had several gals urging me, no, hounding me, to switch to either Lev or Lantus. Me, being the person I am, thought that if I did this or if I did that, N would begin to work and all would be well with the world. Well, for 7 months, I did this and I did that and nothing worked. I was at my wits end...crying, getting sick to my stomach every time I saw a red number...I finally decided that no matter how much I tried, I was not...well, Spot was not....going to get anywhere with that insulin, and it was time to make a change. After much research and question asking about both Lev and Lantus, I chose Lev and it has been a GOD SEND!! Please take a look at Spot's ss and you will see what I mean. Spot got more green numbers in the first month on Lev then he did in the whole 7 he was on N....and guess what....currently he is on an OTJ trial...it may not stick, but regardless....he has come such a long way and I know that 1) he would not have gotten here on N and 2) I often wonder that if I would have started him on Lev earlier if he would have gotten off the juice earlier. I'll never know that one.
So, that's our story. I hope I've given you something to think about. N MAY work for curly since it has been known to work on some kitties, but it really isn't a very good insulin, as Steve has pointed out. Give Lev and Lantus some research and find out if either one of them would work for you...I think that if you give one of them a try, you may find that you really like them!
 
Thank you so much for sharing your history with your kitty. Curly is back to eating normally, thank goodness. But for months he has just not been bouncing back- his coat looks terrible, his breath always has this weird odor to it and he can't seem to gain weight no matter what I feed him. The vet had thought he was on too much insulin so took his dose down, but I don't think that it is the right insulin for him.

Can I just call my vet and ask to switch to the Lantus or Levemir, or are they going to want me to bring him in to set him up with whatever dose he will be on? I was just wondering if they could convert what dose of Humulin N he is on to what would be comparable with the Lantus, or if they are so different that he would need to go in for the day for them to test him when they switch him over. Also, not that it is a consideration in whether I will switch him, because I want him on whatever is going to work for him, but just curious due to $$ issues is Lantus and/or Levemir more or less expensive than the Humulin? I was a little shocked at how much the Humulin cost, even though it does last us a good 6 months. Will the Lantus or Levemir last as long, or should I have them give us smaller amounts at a time? Anyone who has done this switch, please give me any feedback you can.

Thanks!!
 
Oh and also, how do I decide which one to try? Is it just trial and error? Does one have advantages over the other? Help! Thanks! :)
 
Lantus is relatively fragile, and a new cartridge or vial lasts about 5-6 weeks.

Levemir, while similar in action, is less fragile. We have been able to use the entire amount - a 3ml cartridge lasts Tiggy nearly 4 months.

We just bought a new 5-pack of 3 ml cartridges in Canada for $120 USD (I live in Michigan, so close enough to drive), and the 5 pack should last over a year (we just adopted a second diabetic cat through DCIN here - his name is Rusty)

You will need your vet to write a prescription - do specify the 5-pack of 3ml cartridges whether you decide on Lantus or Levemir. Then shop around - you can either order from Canada online (www.globaldrugsonline.com I think) or some find the best price at Costco or Walmart.
 
Thanks- I was reading that with Lantus you cannot miss a shot. Is Levemir the same? My concern is that I work on call and my hours vary, and I work a good 30 minutes away, so I can't always stick religiously to the 12/12 shot schedule and there have been times when I have had to skip a shot or push it back several hours in order to get him back on track so that he can get both shots the next day. Will this pose a problem with Levemir?

That is alot for the insulin- I thought 60 dollars was a lot for the Humulin! I suppose I could pull it off if I didn't have to have him go into the vet for the switch and if it was going to last me for at least 6 months. But yikes.

Thanks so much for your input!
 
Missing a shot is not the same as pushing one back or forward a few hours.

Lantus or Levemir have a similar action and whatever rules you apply to one you'd probably apply to the other. But your sources on "never skip a shot" are oversimplified. I'd rather say:
"Don't skip a shot on any insulin -- if number is too low to shoot, wait an hour or two."
and
"Lantus and Levemir work best with consistent dose and timing -- if you plan to give erratic and changing doses then PZI is probably a better insulin."

The price of both Lantus and Levemir may be hard from a cash-up-front perspective but both of them, if cared for well, can easily stretch a 5-pack of cartridges or pens to a year or even two. I buy a new Levemir pack every 2 years. If $150 a year is too much to contemplate, you probably haven't been calculating your food or kitty litter bills lately.
 
P.S.

A diabetic cat WELL regulated on Lantus or Levemir, even if they don't reach remission, can easily be kept under 180 BG all day long, meaning no more lakes in the litterbox.

If that doesn't save you more than $150 a year on kitty litter alone, I'll give Jock a bath with my tongue.

And no you will *not* succeed in keeping any cat under 180 all 24 hours with Humulin N. You just won't.
 
Steve, I gues you never told my Twigie that you can't maintain a feline's BG below 180 on N. I have been maintaining her BG below 180 (with exception of a 182 on March 26) for a couple of months now. I just do whet her experience is with N. I will typically shot 0.2 units at a BG of 110. Remember ECID.

Steve & Jock said:
P.S.

A diabetic cat WELL regulated on Lantus or Levemir, even if they don't reach remission, can easily be kept under 180 BG all day long, meaning no more lakes in the litterbox.

If that doesn't save you more than $150 a year on kitty litter alone, I'll give Jock a bath with my tongue.

And no you will *not* succeed in keeping any cat under 180 all 24 hours with Humulin N. You just won't.
Click to expand...
 
Thank you! I can probably handle the cost if I can stretch it out for that long. But you think PZI is better if I am unable to keep to the 12/12 dosing all the time? Is PZI also good? I know anything has to work better than Humulin for Curly but I don't want to put out a big chunk of change on insulin if I might have to switch to something else anyway.

Losing the litter box lakes would be wonderful! LOL! I had been using the Smart Catbox and it was a Godsend for Curly but Ophelia decided she was not loving the seed litter and started using the carpet instead, so its been very frustrating to have to go back to regular litter with his Niagara Falls peeing.

Anyone else on here that uses PZI and gets good results? I really want to see him controlled before we start seeing permanent damage from the diabetes.
 
Maggie, I really can't answer your question on PZI and I know all about the being on call thing, I'm just lucky enough to have my mom living with me. She has learned how to test and shoot, so when I had to work and couldn't give the shots, my mom did.

Now, in regards to the cost. If you can't swing the whole enchalada, there maybe someone who would be willing to sell you a cartridge at a time. If I was you, I would post in that question in supply closet and the Lev/Lantus ISG's if you wanted to take that route. I personally have 4 carts of Lev that I will more than likely be posting on Supply Closet soon (want to hold onto it for a little while longer since Spot is newly OTJ).
 
Some people do succeed in getting 12 hours duration from PZI, and a smaller number even do it (as Larry points out) on Humulin N. Every cat is different, so there's no way for me to say without you trying it.

And yeah, if you buy 5x3ml pens or cartridges instead of a 10ml vial, you can definitely stretch out $150 of Levemir or Lantus for over a year, in my case over 2 years. 5x3ml = 15ml = 1500 units.

at 1 unit BID that's 750 days if you refrigerate and nothing goes wrong with the cartridges. Even if something does, you usually just throw out one half-used cartridge (less than 3ml) and start the next.
 
Status
Not open for further replies.
Back
Top