Help with tonights dose

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mdmelvin1128

mdmelvin1128

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Ok guys I have a newly diagnosed kitty, and the vet has had some trouble getting him regulated. Took him in yesterday, and he stayed all day for them to do a glucose curve. They said that his numbers were still in the 400s all day, and they wanted to bump up his dose a little. I convinced them to let me test him at home, and I did the first test last night about 2 hours after he had insulin. Everything went great, but I got a really low number of 24. I thought that couldn't be right, so I tested the meter, both with the control solution, and with a person. It seemed to be working fine, so I tested the cat again, and got 26. Called the vet, she asked how the cat was acting, I told her fine, and she said the meter must be off, and to just watch the cat. I have a Contour meter, does anyone have any ideas why I got numbers like that on Tigger, but it seemed to be working fine on a person and with control?
 
Re: Help please with BGs

I dont have an answer for you, but I would not give more insulin until you are sure your cats BG is elevated.
 
Re: Help please with BGs

well,,,,if u could give a bit more info...
what insulin are u using?
what is the dose your vet began him on?

It sounds to me like your cat went a bit too low there, and your vet unfortunately telling u the meter is off and to watch him, is not the most sound way to go about monitoring a low number.


are u aware of vet stress? Most kitties will have rising BG numbers while at the vets, bumping up insulin because of high numbers without giving a dose a chance to settle in also is not the best or safest way to treat.
 
Re: Help please with BGs

We are on Humulin R. For the last week it has been 1 unit in the morning, 1 unit at night. I haven't been testing him, but just based on how he seems to feel, he has been doing great. They told me yesterday to bump him up to 2 units twice a day, so that is what I gave him last night before the low number. He just got done eating and he is at 341, so the meter is working fine. Now I really don't want to give him 2 units.
 
Re: Help please with BGs

wait wait wwait. don't give any insulin until we are clear on what one you are using. R is not to be used by most people at home. will let this go then type more in a sec just to make sure you don't give your cat R
 
Re: Help please with BGs

That is what it says is Humulin and then a big yellow R. They started him on Vetsulin, and then weren't happy with the results, and changed him to this.
 
Re: Help please with BGs

ok, can you look at the vial and make sure if it says Humulin R or Humulin N. N is ok to use, R is not. R is a very very very fast acting insulin that is most often used in a critical care type of situation, like when a cat has diabetic ketoacidosis and is in the ER under 24 hour care because they have to get their numbers down quick but in a safe manner using other products too to make sure kitty doesn't bottom out.

there are people here that use it but they use it as a booster type insulin and they only give a drop or two and to cats that have other medical conditions that make them a bit resistant to normal insulin doses, like acromegaly.

sooooooo, if your bottle really does say R, DO NOT GIVE ANY MORE OF IT, call the vet as soon as they open and make sure they realize they gave you what could be a very dangerous insulin in the hands of someone so new to this disease. ask that they get you Humulin N, or better yet, a prescription for Lantus you can get filled at your local walmart.

if by chance your bottle says Humulin N, then that's another story and we can move on to talking about that and other diabetes stuff :)
 
Re: Help please with BGs

Ok, before you posted that, I had called the vet, and she said to give 1 unit and then monitor throughout the day. Now this isn't my normal vet, this is the on call/ weekend vet, but she didn't seem concerned with the bg of 24 last night, said that wasn't possible if the cat was acting fine. I'm concerned, but I did just give him 1 unit...he has been on it over a week and been doing great. I will test him again in a couple of hours and see where he is.
 
Re: Help please with BGs

Hey, glad you found this place.

If that's Humulin R, then your vet should never have let you take it home. It works very very fast, and then is gone too fast. Lovely for fine control if you plan to shoot insulin every hour, but otherwise just dangerous since you don't know the correct dose. For a cat, you want the SLOWEST acting insulin you can find, which is usually glargine or detemir (sold under brand names Lantus or Levemir in your nearest pharmacy, for humans). The slowest-acting veterinary one is now ProZinc, if you're in one of those countries where the vet MUST prescribe a veterinary insulin, but the human ones are even slower and are easier to use in cats, in the long term.

Very glad you tested at home. Your vet sounds very inexperienced with diabetes in cats. You may want to start looking around or asking for detailed help here.

And by the way, a number of 24 after giving a dose of Humulin R was probably correct, and very dangerous. Please don't use it again unless you understand you need to test every 20 minutes with that kind of insulin. Numbers below 40 are dangerously low, especially on such an insulin.

Next time your cat goes to the vet's for a test, she'll be up in the 400s again, but it means very little. Blood sugar varies hour to hour, and on insulin it can vary dramatically. (Especially on fast-acting insulin.) And stress (like going to the vet's) raises blood sugar, sometimes very dramatically.

You need to do that same curve the vet did, on a slower-acting insulin, at home. We can help.

You can do this! Don't worry...

Best,
Steve
 
Re: Help please with BGs

crap! well, what's done is done but after today, you need to fire that vet. i'm sorry but they don't have a clue if they are handing out Humulin R to the public. but on to getting thru today. we need some information so we can help you if kitty drops too low or acts wierd today

do you have plenty of test strips on hand?

and what kinds of food for kitty do you have? and don't freak out or anything but do you have any kind of syrup in the house? karo or pancake or honey?

i see steve's here, good. it's kinda early and i can't seem to find too many others around :)
 
Re: Help please with BGs

I need to run to the store and get strips, I only have a few here. I do have Karo. I also still have a vial of Vetsulin, would I be safer giving that to him until I can get Lantus or something else?
 
Re: Help please with BGs

yes, vetsulin would be safer than R buttttttt, don't give any of it either at this point. we need to get the R out of kitty's system and make sure they are safe.

how long to get strips? you need to be around within 1 hour or so of giving that shot . can you do that? if not, could someone else go get you some strips?
 
Re: Help please with BGs

Agree completely here with Cindy and Steve. Humulin R is NOT an insulin that a vet should send most people home with to use and never as a basal (for daily control) insulin.

I'm so glad that you are testing and yes, Vetsulin would be MUCH better than R once you are sure that the current dose of R is gone.

I normally don't say much bad about vets but IMHO this was a truly irresponsible and dangerous thing for this vet to do.
 
Re: Help please with BGs

I gave him the shot around 9 so another 30 minutes will be an hour. Do I need to test then? I can wait to got get strips after we test.
 
Re: Help please with BGs

Yeah, I'm kind of angry...it seems all they have done is charge me a lot of money and not really help my baby at all.
 
Re: Help please with BGs

ok, here's what i would do. if the store is fairly close, i'd wait about 30 minutes and test him. i'd want to see him over 200 before i left the house. just because R can drop them quickly. if he's under 200 OR the store is too far away, i'd call and have someone else get strips and bring them to me.

if you want you can tell us what big city you are in and maybe one of us are even close enough to help out in some way. don't give exact addresses though. this is the internet. city and stay only is good enough
 
Re: Help please with BGs

No need to panic, yes R is not an appropriate insulin and you should discontinue using it. The good news is you only gave 1 unit and R is a very short acting insulin, so even if you didn't test before the shot he was proably high if he hasn't had a shot in the last 6 hours. So here's what you need to know about R and how it works.....

It begins working within 30 min to 1 hour after the injection so you should probably test the BG during that time to see where it is at. If you then post here someone can tell you if it is ok to wait and test again in a bit or if he is too low. R only lasts about 5 hours and will have it's lowest point at about 3-4 hours after the shot was given so you will want to keep an eye on him at that time and test several times. If he starts going below 100 mg/dl before 4 hours post shot then you need to feed him something with high carbs or rub a little Karo syrup or honey on his lips and gums and test again to see if the number rises. Once you are past 5 hours he likely won't drop much more and will probably rise quite a bit.

So stay calm test often, report here, and take action if you need to. And then see about getting a better insulin before you give any more!
 
Re: Help please with BGs

And just an FYI for you on the legitimate use of R is that it is used by SOME people here as a bolus insulin in conjunction with the log acting insulins mostly, like Lantus(glargine) and Levemir, in very tiny doses to assist in dropping a high blood glucose level very early in a cycle, before the long acting insulin "kicks in", so that it is easier for the basal insulin to do its job. It's only recommended for people who have a lot of data and knowledge about how their basal insulin is affecting their kitty.

Not important for you to know right this moment but there are legitimate home uses of Humulin R - just not this one.
 
Re: Help please with BGs

mdmelvin1128 said:
We are on Humulin R. For the last week it has been 1 unit in the morning, 1 unit at night. I haven't been testing him, but just based on how he seems to feel, he has been doing great. They told me yesterday to bump him up to 2 units twice a day, so that is what I gave him last night before the low number. He just got done eating and he is at 341, so the meter is working fine. Now I really don't want to give him 2 units.
Click to expand...

There is nothing wrong with your meter. There is however something wrong with your vet's advice. This is an instance that should be reported to your state veterinary board. R is no joke, and is incredibly dangerous to use at ANY dose with a standard diabetic cat, and 1 full unit is an irresponsible prescription.

Now that you are testing, and congratulations on that by the way :) --- we can help you with your vetsulin dosing. If you can list your city/state, we can possibly help you find a vet if we've got someone in your area. Looks like maryland from your username?

Monique has given you exactly what I had typed. You've got about 5 hours max to worry, and it's quite likely that the cat's self protection will kick in and his numbers will get very high as a response. Don't panic if they do, that's totally normal.
 
Re: Help please with BGs

Thanks for all of the help...it's crazy when you can trust strangers on the internet over a vet who should be trained and qualified. Can anyone recommend a meter that has cheaper strips than the Contour? When I go, I might just buy a new meter and strips. Does Target sell meters and strips? I'm in Odessa, Tx. I've been using the same vet for years, everyone there knows me, and they work with me on a payment plan, but it does sound like I need a new one.
 
Anyone near Odessa TX?

If you have a walmart, they sell the Relion Micro which is cheap and has cheap strips. Target does sell meters and strips but I don't know that they have a cheap one.
 
Re: Help please with BGs

hey there. i was called over here to check on you.
do you have a starting number of what BG was when you gave the 1 unit of R?
also how is your cat about eating..one of those bottomless pits or a fussy type of cat?

let's get first spot check before leaving house to get more test strips. how many exactly do you have left?

~jojo
 
West Texas info anyone?

There are meters and strips that are cheaper but I'm sure what's available in the Odessa, Tx area. Should be a Walmart somewhere, right? I believe that Relion in their brand and pretty inexpensive.
 
Re: Help please with BGs

mdmelvin1128 said:
Thanks for all of the help...it's crazy when you can trust strangers on the internet over a vet who should be trained and qualified. Can anyone recommend a meter that has cheaper strips than the Contour? When I go, I might just buy a new meter and strips. Does Target sell meters and strips? I'm in Odessa, Tx. I've been using the same vet for years, everyone there knows me, and they work with me on a payment plan, but it does sound like I need a new one.
Click to expand...

Waving HI from Abilene! :thumbup I think you and I are the only ones in West Texas. (Mojo or OHS?)

Wal-Mart's Relion is what a lot of our members use. Apparently the test strips are wonderfully economical. I use the OneTouch Ultra Mini and absolutely love it. There's a free offer at https://www.onetouchdiabetes.com/of...ouch+Ultra+-+Specific&utm_term=onetouch+ultra. Just make sure you fill it out as a if you are the one using it. Plus, I learned you have to be "changing" from a different brand of meter.
 
Re: Help please with BGs

okay, that is looking fine so far.
the deal is because he went so low last night his body is flooded with rebound hormones that are protecting him from today's shot so far.

how long would it take you to get more test strips?
 
Re: Help please with BGs

I have home tested for 4 years and it can be a challenge some times.. Get a second tester and alternate between the two, also make sure it's a meter that requires the minimal amount of blood samples. Never make drastic changes to the dosage amount, always increase in 1/2 units (up or down). Also keep some Korn Syrup around in case your kitty's BG's test really low (anything under 40 is close to hypoglycemic shock).
 
Re: Help please with BGs

mdmelvin1128 said:
Less than an hour probably to get more strips.
Click to expand...

Go ahead and go now if you can. That should be ok.. if you go to walmart, you are looking for relion micro, and matching strips. Also, lancets, if you don't have enough. Get 28, 29 or 30 guage.. anything higher might make it too hard to get blood.
 
contour strips

contour's not a bad meter. i use one, too.
best deal is on ebay. BUT i've been burned so i've learned to use only experienced longtime sellers with high feedback ratings. it is NOT worth it to take a chance on a newer seller. also, only use credit card funding to pay the paypal bill. do not use your checking account. paypal and ebay do not protect your money worth a darn but your credit card company will.
i generally get 100 contour test strips for $30 (including shipping). there are so many auctions just wait if the bidding gets too high.
sometimes i find one touch ultra test strips there for the same price. they also fit the one touch ultra mini, which is cute and what i use as a backup meter.
problem is, even if you win an ebay auction it'll probably be around a week before you get strips. but worth it for future reference.

you're in good hands with the people with R experience. i'm hoping they'll be able to get you thru the weekend with it on a much lower dose at least till you can find a vet to prescribe lantus or levemir.
 
Re: Help please with BGs

Hi Melvin,

You've got great people helping you out and advising. I don't have anything to add.

I do want to tell you that WE all understand the concern about trusting strangers on the internet. I felt the same way almost a year ago. But after getting lots of advice, support and even talking with a couple local members and meeting one, I realized that these people know what they are talking about, care about the well being of my cat and truly want to help.

Just to give you an idea of the people who have posted here already - Jojo is a vet tech and a true lifesaver. She so knows what she's doing and writing about. Cindy is another angel, she facilitates the giving of starter kits (meters/strips) to newbies in need, Monique, Susie, Sherri and Carolyn have all been here for a while and all of these people know what they are talking about and have in-depth knowledge of different insulins, how they work in cats and well just all around helpers and sharers of information, guidance and advice.

Me, I've been here almost a year, received the help from these great people, especially in the beginning when I had my own vet issues. They gave me solid suggestions, which I followed and am so grateful that I did. Now, I try to help out where I can and be a general welcomer.

So, while you are in the midst of dealing with this issue, please feel confident that you've got great people here to help you get this this tense situation and once that's resolved, we can go over next steps and FD 101.
 
Re: Help please with BGs

Covert Ops said:
I have home tested for 4 years and it can be a challenge some times.. Get a second tester and alternate between the two, also make sure it's a meter that requires the minimal amount of blood samples. Never make drastic changes to the dosage amount, always increase in 1/2 units (up or down). Also keep some Korn Syrup around in case your kitty's BG's test really low (anything under 40 is close to hypoglycemic shock).
Click to expand...

Not sure why you are on this rather urgent thread Covert Ops, but your information is lacking. Please do not give dosing advice without regard to knowledge of the insulin.
 
Re: Help please with BGs

Carolyn and Spot said:
Covert Ops said:
I have home tested for 4 years and it can be a challenge some times.. Get a second tester and alternate between the two, also make sure it's a meter that requires the minimal amount of blood samples. Never make drastic changes to the dosage amount, always increase in 1/2 units (up or down). Also keep some Korn Syrup around in case your kitty's BG's test really low (anything under 40 is close to hypoglycemic shock).
Click to expand...

Not sure why you are on this rather urgent thread Covert Ops, but your information is lacking. Please do not give dosing advice without regard to knowledge of the insulin.
Click to expand...

Maybe on the dosage suggesting, sure.. but my other advice is valid. Not all testers are consistent even when calibrated and hypoglycemic shock should be a concern when getting low BG numbers. Am I not allowed to contribute? When I was first dealing with my diabetic cat, I had no help except from my vet. I studied binky's pages and scoured the web. I have gone to a few vet seminars to learn more about this disease because of concern for my cat. Most vets will tell you not to make drastic changes in insulin values but to do them gradually over a day or so and to test during the process.

Thomas Covert
 
Re: Help please with BGs

Suggestion, Covert Opps? Start a new post on Think Tank rather than an argument on an urgent thread here on Health where the bigger concern than testing consistency was testing period because a vet prescribed a dangerous insulin, okay?
 
Re: Help please with BGs

thomas, problem is, R is a different ballgame. for some cats even a drop can make their blood glucose level plummet. so the increments you mentioned could cause some serious damage.
in this case we're hoping that because this cat is in rebound such a large dose will work out okay for the moment, but it should not be given again without some serious assistance from experienced R dosers.
everyone's welcome to contribute. just some insulins really require expertise.

[edited to add: always helps to look up someone giving you dosing advice, to make sure they have experience with the insulin you're using. unfortunately, the new board doesn't give us much room on our profiles but you can normally find some mention of the insulin we're using in our signatures/links at the bottom of our posts.]
 
Re: Help please with BGs

Covert Ops said:
Carolyn and Spot said:
Covert Ops said:
I have home tested for 4 years and it can be a challenge some times.. Get a second tester and alternate between the two, also make sure it's a meter that requires the minimal amount of blood samples. Never make drastic changes to the dosage amount, always increase in 1/2 units (up or down). Also keep some Korn Syrup around in case your kitty's BG's test really low (anything under 40 is close to hypoglycemic shock).
Click to expand...

Not sure why you are on this rather urgent thread Covert Ops, but your information is lacking. Please do not give dosing advice without regard to knowledge of the insulin.
Click to expand...

Maybe on the dosage suggesting, sure.. but my other advice is valid. Not all testers are consistent even when calibrated and hypoglycemic shock should be a concern when getting low BG numbers. Am I not allowed to contribute? When I was first dealing with my diabetic cat, I had no help except from my vet. I studied binky's pages and scoured the web. I have gone to a few vet seminars to learn more about this disease because of concern for my cat. Most vets will tell you not to make drastic changes in insulin values but to do them gradually over a day or so and to test during the process.

Thomas Covert
Click to expand...

i think the concern is just over the general statement about changing doses in 1/2 unit increments. some cats need smaller increment changes and for this thread we're on right now, the insulin shouldn't be being used at all in this instance so general dosing advice given here could cause confusion at this moment in time. when we get them back to using a usable insulin then we can discuss general dosing guidelines. and please remember that tones are a bit short at the moment due to the urgency of the situation. no harm no foul :smile:
 
Re: Help please with BGs

I apologize, I didn't meant to get the thread off track. Where does is say this thread is flagged as an emergency? I didn't notice that.

ps, Sheri .. Thanks for the links to the testers, I have been looking for a new one, and free is always good.
 
Re: Help please with BGs

Thomas, no harm done, it's just the insulin in this thread, Humulin R, should not even be used, let alone at this dose, or increased in 1/2u increments.

That said, anyone who has been testing for 4 years has much to offer new members and we welcome that help. :) I apologize for my abruptness, I have a hard time using my indoor voice :)
 
Re: Help please with BGs

Carolyn and Spot said:
Thomas, no harm done, it's just the insulin in this thread, Humulin R, should not even be used, let alone at this dose, or increased in 1/2u increments.

That said, anyone who has been testing for 4 years has much to offer new members and we welcome that help. :) I apologize for my abruptness, I have a hard time using my indoor voice :)
Click to expand...

I never had any experience with Humulin R, only Lantus and PZI so therefore I should not have been recommending dosage. My main concern was BG values of 24, that is dangerous. I only had my baby go into shock maybe once, and it was scary. And it was because of an inexperienced vet telling me to have him go from 1 to 3 units of Lantus in the same day.
 
Re: Help please with BGs

Glad you got the strips. No real surprise that he's rather high after the R.

I'll leave the Vetsulin suggestions alone because you'll get better help from people who have used it or understand it better than I do.

It's uphill from here I hope, Mandy :)
 
Re: Help please with BGs

Hi Mandy,

PErsonally I would be leery about using vestulin, considering it was recalled. Do you have the lantus in hand? If yes, then I would highly recommend going to the lantus board, posting there and prepare to start using it now.

By now, I mean, when the more experienced folks feel it make sense to give him insulin after the R issue. I'm going to send a message to Jojo and ask her to come back and help.
 
Re: Help please with BGs

I don't have Lantus, all I have is the Humulin, and Vetsulin. I just need to get him through the weekend, and I will talk with my normal vet on Monday, or find a new vet on Monday to give me something better for him.
 
Re: Help please with BGs

I agree that Lantus is the best choice, however I don't think you have any right now, so untill you can get a Rx and pick it up, I think using the Vetsulin is ok. Your testing and you now have strips, yea! Did you get a new meter? Anyway I would suggest picking a time of day you want to start morning and evening 12 hours apart (7am &7pm for example) The way Vetsulin works is first you test his BG then you decide on your dose (usually start at 1U, unless the BG is below 200) then you feed him his meal then you shoot him :lol: (with the insulin). You should then try to at least about 4 hours after the shot (+4) as this is the point at about Vetsulin should have the most effect and his BG is the lowest (nadir) you want to try and have a number near 100. If it is lower you will probably need to decrease your dose at the next shot, if it's much higher then increase (try to do this in small amounts, unless he goes really low) If you have U40 syringes you have to eyeball half units. If using U100 syringes (you can use them and a conversion chart you can measure easier. If you look on the Humalin/Vetsulin/Caninsulin board here on the forum there is thread called N primer or something that will tell you all of this a kind of guide to using Vetsulin. The whole thing is pretty simple, the hook is that it never works out so nicely in practice. I used Caninsulin (European name for Vetsulin) it did provide some relief from the symptoms of diabetes, but was aggrivating and didn't allow for any consistancy in his BG, we eventually switched to Levemir (simular to Lantus) and were very satified, especially since after a while he didn't need insulin at all anymore and is now a diet controlled diabetic cat!
 
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