I'm Ready to Switch Insulin

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Kimmied

Kimmied

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After looking over Hank's SS the numbers are not good. The insulin is wearing off +4-+6, which is what I was hearing would happen. Ok, so I called my pharmacy and got some prices. One pen of Lantus is $74. How would you use a pen on a cat? Also I read that some people draw it out with a syringe. How? The Prozinc is only $128, cheaper than both Lantus and Levimer. Now I got to talk to my husband and then the vet. Oh boy! I hope the vet is on board with me. Any thoughts? I am also ordering the low carb dry food today. Any advice would be greatly appreciated. Thanks.

Kimmie
 
Any of those are better than N. With the pens, you use a syringe and take out the amount you want, so you can dose below one unit.

If your vet insists that N is best, he is way behind the times. If he refuses to give you one of the top three, it might be time to get a new vet?
 
Thank you Sue and Wendy,
I looked at the link which answered a lot of questions that I had. I'm leaning towards the Lantus pen. But may go with the vial, not sure. I'm leaning towards the Lantus because I've read there are more remissions with use of the Lantus. Is this true? Then there's Prozinc. Which would be best for Hank because of his high numbers I'm getting now? I don't want to do too much at one time either; change Hank's food to 0 carb dry food and the insulin? I'm afraid my vet is going to think I haven't given this insulin (Novolin N) a chance and he just changed the dosage that I started Monday AM. Has the new dosage had a chance to adjust? I have told the vet that I feel his high numbers are due to the food he is eating but all he says is "don't change the food. It makes it harder for him to get Hank regulated". I like my vet but I don't think he's ever had anyone question his diabetic protocol. What to do, what to do!!!! Argh!!! I want what's best for Hank. My husband has type II diabetes and uses a Lantus Solo pen once a day before bed. Even he is concerned that the Novolin is wearing off so soon and then Hank's numbers are in the 500's. I haven't tested for Ketones yet. I haven't got the strips yet. Maybe this is something I should do. Hank is acting fine. He's even starting to groom himself again. Help! I'm starting to feel overwhelmed again!!

Kimmie
 
Breathe, Kimmie, breathe. :-D Think of how much you have learned in the past few weeks and how well you are doing with his testing.

If your husband uses Lantus, could he get some for Hank? The pen is better than the vial, as a cat uses so little, and the vial can expire before the insulin is gone. You are right. More studies have been done with Lantus and its remission rate has been documented. ProZinc works well but there haven't been any documented studies done that I know about. The Lantus forum on this site has a protocol that makes it easy to decide how much to dose. You might check it out and read the stickies on the top of that page. It does work best dosing at 12 hour intervals; that is a problem for some people. proZinc is more flexible in terms of dosing.

I have been on this site over 6 years and can't remember any cat going into remission on N. it is just so hard to work with as it has such a short cycle, and raising the dose can lower nadirs while not impacting preshots much. I don't know if your vet is open but this website by a vet explains why low carb is best: www.catinfo.org

If you start a new insulin, you will most likely lower the dose. In a few cycles, you should have some data. Then if you change to lower carb, you can keep Hank safe with regular testing.
 
It is the cost per unit you want to check!

Generally:
1 vial = 10 mL
1 pen = 3 mL

100 units / mL Lantus and Levemir
40 units / mL ProZinc
40, 50, or 100 units per mL for BCP PZI (you can select)
 
:smile: Thanks Sue. Yes, breathing's good. :smile: I have learned a lot in the past 2 weeks but just when I think I'm doing ok with this then other decisions need to be made for Hank's health. I just want to be sure I'm picking the right insulin for Hank. Giving injections 12 hours apart for the most part has not been an issue. I think there have been 2 times I've been late with giving a shot. There isn't any leeway with the 12 hours?
I can get a prescription from my vet if I decide on Lantus pen. How do you decide which is best when the vet has told me also that he doesn't think it's time to switch insulin either? Really, he is a good vet just doesn't like families to go through financial burden over this. This is just what I get the impression of when he talks to me. But I'm doing my homework and I'll talk to my husband and we'll do what's best for Hank. I guess I'll try to talk to the vet in the next couple of days about my concerns. Thank you for your support.

Kimmie
 
BJM,
Hmmm, I'm not sure what you mean? Sam's Pharmacy said $249 for Lantus, $74/pen for Lantus, Prozinc $128. Is this what you mean?

Kimmie
 
Hey Kimmie,

Glad to see that you are ready to switch. I think it will be the better choice for Hank.

Jack was 634 when he was DX'd. So I do know about the high numbers and Lantus.

Nice to see Hank grooming again. That is a good sign indeed.

Hang in there and remember we are all here for you.

All the best!
Kevin
 
We find that kitties do better with some carbs, instead of zero. Something below 10% carbs is what we consider low carb. There are a lot of commercially available wet foods in the 3-6% range. Wet food is better for cats instead of dry food, for more than just diabetes. If you do change the food to low carb, you will likely have to lower the dose.

I kept on asking my vet about using Caninsulin - I had started reading this site. And her answer was "that is what we use here". Caninsulin lasts a little longer than N, but still not long enough. Neko was always sky high before shot time. I finally got a locum vet who got me onto Lantus and said I should go to FDMB for dosing. My vet is now OK with what I do, I gave her copies of my spreadsheet at first as well as the protocol. The question is whether your vet is willing to work with you. I was the first client to do home testing, so they didn't know what to expect. If remission is your goal, there have been scientific studies have bee done that show that your odds are best with Lantus or Levemir.

If Hank is in the 500's, you should be testing daily for ketones. You should be able to get those strips at any pharmacy that sells diabetes supplies.
 
Thanks Kevin, :-D
So talked with my husband and he feels that it's more important to switch his food first. :YMSIGH: What does everyone else think? I'd like switch the insulin first. Guess I didn't convince my husband. :YMSIGH:

Kimmie
 
Six of one, half dozen of the other. It varies per cat. Our Oliver came down 100 points overnight when we switched from high carb to low carb. But it isn't that fast for every cat. Same with the insulin. Some cats show immediate improvement, some take a week to adjust to the insulin. Maybe pick whatever is available first?

Either way, it is imperative you test before each shot and at nadir to see what changes and adapt the dose to match.
 
Yeah, I know now that wet food is best but Hank is a stubborn kitty or maybe set in his ways. I'll switch him to the new dry food and try tricks to switch him to wet. I ordered the Wysong low carb food tonight. Hope he likes it. I ordered the chicken and fish flavors. I have a plan. And yes, I will test, test, test!! Tomorrow I will get the strips to test for ketones and some fish gravel too. Thanks for everyone's thoughts, tips and ideas. They are very much appreciated. :smile:

Kimmie
 
Ok well here's the thing with the low carb dry food. Your kitty may not want anything to do with it.

I had a dry food addicted foster cat (eating only Purina kitten chow). When I offered other dry food, she refused it so I also started to appeal to her thirst by offering a bowl of low carb pate canned food completely hydrated with water right next to the new dry food. It took a day or two for hunger to outweigh her stubbornness (and you do want them to eat while on insulin) but eventually I was finding the bowl of watered-down canned food licked clean when I came home. After three meals with this result, I removed the dry food offering and this kitty has been on wet food ever since. So even the most hard-core, dry food addict CAN be transitioned.
 
Regardless of food type, transitioning slowly helps avoid GI upset (diarrhea, vomiting, inappettance)

Try mixing in 20-25% new food per day. If GI upsets happen, back down a step and go more slowly.
 
Thank you BJM and Robincot,
Good to know. I have offered small amounts of wet food sprinkled with dry crumbs, refused. Then put dry kibble overtop, refused. Then dumped, washed out dish and then served the "prince" before he finally tried some. Talk about stubborn!! I'm still waiting on Wysong to come in the mail. Last night was a bit trying. After the shabogal with trying to get him to eat wet food, he would only eat a few bites of kibble. An hour later no better. Just took a couple bites and stopped. I didn't think that he had enough food in his stomach to give his pm shot so I waited...1 1/2 Hours later.!! Gave Hank his shot but he kept moving but I didn't feel wet fur afterwards. Then took BG at +2 and the count was over 600!! What!!! Argh! Soooooo this morning AMPS was 595 about 45 min before I gave him a shot. Again, he was moving and I couldn't distract him with food since he ate and didn't want anymore. I didn't feel any wet fur afterwards. Test BG at +4 and it's over 600. ARGH!! What am I doing wrong! I have put him in a small bathroom with aquarium gravel, water dish and kitty bed to try and test for ketones. But I don't think it's that cause he's acting, drinking, eating and peeing fine. Is the insulin bad? I just bought it inSept. 18th? It could be me missing the skin. I can't seem to get enough skin to pull up to give a shot. Is there a better way; pull skin out...I don't know. I am anxious when it's time to give an injection. Help!!

Kimmie
 
Its the high carb kibble and Novolin lasts only 6-8 hours in most cats.

Plus, there is bouncing. When the insulin drops the cat quickly or to an unfamiliar level, the body reacts with compensatory hormones which release stored glucose (glycogen). This will raise the glucose level right up ... for as much as 3 days. You just have to wait it out.

It also is possible that 5.5 units is too much and he dropped low overnight and bounced because of that. Try to get tests at +3 to +5 range.

Is there any way you could shoot 3 times a day, at roughly 8 hour intervals?
You would add up the total daily dose, then divide by 3 to get each dose - 11/3 is roughly 3.5 to 3.75 units per shot.

Alternatively, pick up all food at +6, as the Novolin is wearing off.
 
Thank you BJM,
I did a ketone test and it was negative! Thank God! Really Hank is acting fine. Thank you for your input (wisdom). I guess I didn't/don't understand "bounces". Can you explain "bounces"? He ate his dinner and I know I gave him is shot and not a "missfire". So I guess I will try not to fret since you said that it may take 3 days for it to level out. I just thought that beings it was consistently high that that was a sign that Hank had an infection of some sort. Not so I guess. I still want to switch his insulin but will wait to see what new food does. That's what I don't like about the Novolin, it wears off so soon. I guess if I were someone not testing and just adjusting when the vet said, the Novolin would be fine. But I'm not! I see how soon it's wearing off and am not happy with the results! Thanks again for your help to get me through this.

Kimmie
 
I learned it mostly here :smile:

When the insulin drops quickly (ex 100 mg/dL in 2 hours) or to an unfamiliar level (ex glucose was running about 400mg/dL and the insulin dropped it to 250 mg/dL)

the body reacts with compensatory hormones which release stored glucose (glycogen). This can raise the glucose level for as much as 3 days.

Unless you really want to take anatomy, physiology, and pathophysiology classes, this explanation should be enough. All the hormones involved can make it pretty convoluted.
 
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