help! insulin dose increase has made my cat ravenous

[grace]

My 18 year old female was diagnosed with diabetes three weeks ago.
After prescribing 4 units of insulin (Novolin N) BID for two weeks,
my vet checked her glucose level. It was 267, down from 650 before
the insulin. Based on that, he raised her morning dose to 6 units.
Although I feed her before the shot, about two hours after the shot she
gets extremely ravenous and goes right through almost a full can of Hill's
Prescription Diet w/d. I give her all she can eat to prevent hypoglycemia.
Today she threw up and then continued to eat afterward. I feel like she
was doing much better on the 4 units than the 6. She only weighs 6.4 pounds.
I would be very grateful for any advice you can offer me. Thank you.

 

[Sue and Oliver (GA)]

It is likely that your cat has low blood sugar and is wanting to eat to bring up her blood sugar. Six units is a lot of insulin.

Can you test your cat's blood sugar?

Is she acting strangely other than eating?

 

[BJM]

For right this moment tonight (for me, anyway), keep feeding modest amounts frequently to prevent more vomiting - say 2 taplespoons every 15 minutes. Spacing out the food reduces scarf 'n' barf issues.

Now, go to this post on hypos and read it while the cat is eating. If that describes your cat, follow the directions for home care or go to an emergency vet if you need to.

If you don't think you need to go to a vet right away, get prepared just in case you need to make an emergency vet visit.
- locate your nearest veterinary emergency clinic(s)
- map the route/directions so you know how to get there.
- get the phone number and write it down or put it in your cell phone if you have one
- get the carrier prepared in case you need to go

If you don't need to go to the vet, take some time to start reading the main board and the stickies at the top of the Feline Health Forum.

 

[Carl & Polly & Bob (GA)]

Is Novolin called anything else? I googled it and it says it was discontinued in 2010....

Curiously, Novo Norsdisk did not specifically recommend any replacement insulin. Nonetheless, other possible choices within the Novo Nordisk product line include Levemir Insulin and the Novolog product lines.

Is it Levemir?

6 units is a lot, and so is 4 units. But a BG of 650 is crazy high.
Kitty is trying to tell you he needs food most likely because his BG is way low. Let him eat! But try to control portions and feed gradually so he doesn't just throw it up again..

Let us know if anything else seems out of the ordinary too.
Carl

 

[Vicky & Gandalf (GA) & Murrlin]

Is it perhaps Humulin N insulin? Where did you get it - from a pharmacy or from the vet?

Starting dose for a cat on any insulin should be 1U, period. Also, please take advantage of our test kit program, http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=19541&p=193947&view=show#p193947. You can test his blood glucose at home, just like human diabetics do.

We can help you with everything, how to learn home-testing, what the numbers mean and how much insulin your kitty should be getting. Also, we can help with insulin choice, there are better insulins available than either of the "N" types. Few cats do well on them because of their faster metabolism. Better insulins are Lantus or Levemir or Prozinc.

Also diet is very important, but do not change the diet until the dose is lowered to 1U. Diet should be low carb, high protein. The W/D is not low carb and of poor quality protein. I know it's Hill's, but don't believe the hype on them. They are profit driven rather than feline health driven as they claim.

One of the things that's important to understand is that cats get stressed at the vet's office and their BG will spike. That's why it's never good to base insulin dose on what the readings are at the vet's.

 

[Anonymous]

Dearest Grace....or is it dearest Grace's mom?
Please listen to us carefully. We, each and every one has a diabetic cat, and also has learned and cared for many many many diabetic cats on this board.
No matter what the vet said...This dose is TOO MUCH. Your cat is eating to prevent hypoglycemia and even death.

Please let us help you to help your kitty.
First, down that dose to 1 unit.
Next get yourself...or have me send you asap a Newbie Kit. A meter, strips, lancets, rice sockie (to warm ear) and toys of the highest catnip caliber.
You must test your kitties blood glucose yourself at home everyday like thousands of us who came before you do.
And believe me...you and kitty will grow to enjoy this.
Please tell me you are on board for this?
Lori

 

[grace]

My vet gave me the insulin. The box it came in says Novolin N.
The syringes that he gave me work only in two unit increments.
How would I measure out a one unit dose? Is it possible to guess
how much of her 267 glucose level at the vet's may have been
due to stress? My vet told me an acceptable range was 50-150, so
267 doesn't seem all that much higher. If I were to go the home
testing route, is it possible to get the preferred type of insulin
without going through a vet? Is it normal for a vet to be so far out
of synch with the apparent consensus here? Thank you SO MUCH for
your help with this. I want very much to do the right thing for my cat.

 

[Phoebe_TiggyGA_NortonGA]

Your cat is ravenously hungry because of the massive insulin overdose that you are injecting on your vet's bad advice.

Your cat is instinctively eating to "absorb" all this excess insulin.

Go buy some 3/10cc syringes 31gauge with half unit marks like this:
http://www.hocks.com/medical-supplies/d ... count.html

They are available at Walmart, too (Relion brand for $12.58 per 100)

Brand is not critical, but size is --- 3/10cc insulin syringes, 31 gauge needle, half unit markings.

You need to reduce dose IMMEDIATELY. Start over at a low dose like 1 unit or even 0.5 unit. My cat Tiggy, is well regulated on just 0.5u twice per day.

It might be very telling to ask your vet what the typical life expectancy is for a diabetic cat AT HIS CLINIC. He is obviously prescribing massive overdoses, which can cause hypoglycemia, seizures, blindness, coma and death.

Unfortunately, many vets are not current with the best treatment methods for Feline Diabetes.

Where are you located? In Canada, no prescription is needed for Lantus or Levemir - both great insulins for cats. In the U.S., prescription is required, but if you live near another diabetic cat's person, they may be able to sell or give you one cartridge to try.

 

[Sue and Oliver (GA)]

I know it is hard to trust people over the internet. But we deal with diabetic cats every day and our methods have gotten lots of cats into regulation and remission.

50 to 150 is a reasonable range for a cat OFF insulin. (We generally use the numbers 40-120) On insulin, with a beginning diabetic, we would suggest not giving insulin under 200. A regulated cat ON insulin generally is in the 200+ range at preshot and in double digits at midcycle. Our whole protocol is based on keeping the cat safe, starting at a low dose and increasing slowly, as the numbers gotten with home testing indicate. We would say the 260 at the vet is a good number for a beginning diabetic that should indicate a low starting dose - especially when you consider vet stress.

Do you want to post your city and state? There may be a member who lives near you who has a vet who is more up to date with feline diabetes and who could help you with home testing. Vets generally see a couple of diabetic cats a year and may not be up to date on insulin and dosing. They have to treat multiple species with hundreds of different conditions - they can't be experts in everything.

 

[squeem3]

My vet gave me the insulin. The box it came in says Novolin N.

The "N" insulins aren't the best to use for diabetic cats. It's too short acting. Ask your vet about better insulins such as ProZinc or Lantus.

The syringes that he gave me work only in two unit increments.
How would I measure out a one unit dose?

The vet gave you 1 cc insulin syringes which have markings for every 2 units. 1 cc insulin syringes are too large for most diabetic cats:

You want to get 3/10 cc (30 unit) insulin syringes. There are markings for every unit, some even with markings for every half unit.

Are you in the US? You can buy insulin syringes from the local Human pharmacy. A prescription may be required. Call and ask. Some pharmacies are allowed by state law to sell 10 insulin syringes with no prescription required. Again, call your local pharmacy and ask. Brand of insulin syringe doesn't matter. Some cost over $35 while others cost $13 and work just as well.