Insulin advice - should I switch?

[Nancy&Pepper (GA)]

I'm new to this board. My vet prescribed Novolin N for my cat, now he's up to 4 units BID. I just learned to home test his blood glucose and his numbers are really high. His AMPS was 582 and at +6 it was 332. I noticed no one on this board uses Novolin N. Would Levemir or Lantus work better? Also, he does eat some dry food. How do you switch a cat who's already on insulin to all wet? He has some kidney problems as well.

 

[Rachel & Gus]

Hi Nancy. I'm not familiar with Novolin.

Levemir and Lantus are both basil insulins that have to build up in the system over a period of days/weeks (my vet says two weeks) in order to dose correctly. They take patience, but only have to be given twice a day. You can get them at any pharmacy.

The fact that your kitty is eating dry is adding to his higher numbers. Unfortunately they love the dry stuff despite it not being good for them. You can transition him off the dry food very slowly so there isn't a huge upset to his numbers. If you switch to Lantus or Levemir then you will be starting out at a very low dose and moving up if necessary over a period of time. You shouldn't get big drops in blood glucose with these insulins - although some of us experience big drops because of pancreatits and we have our on protocol.

The wet food will also help with kidney issues. My vet has me adding water to my cats food to help with the beginning stages of kidney disease.

 

[Nancy&Pepper (GA)]

Hi Rachel,

Thanks for your reply and your advice. Everyone seems so knowledgeable on this board. The insert in the box says Novolin N is NPH.

 

[Rachel & Gus]

Here is just an overview of the different types of insulins for animals:

http://petdiabetes.wikia.com/wiki/Novolin_N

There is a drop down menu under "Insulin" so you can view the other types.

I'm not sure why your vet prescribed the type of insulin he/she did. Some vets have a preference if they have worked with a particular insulin for a long time - which is okay because that's what they are more familiar with. The vets I've been to are all more familiar with Lantus and they feel more comfortable working with it.

The problem with dry food is that it is high in carbs which raise the BG and when those carbs wear off, the blood glucose can plummet. This is why low carb is important. You want them to remain at a stable blood sugar level throughout the day.

I would definitely keep a log and discuss the numbers you are getting with your vet. It is really important to have a vet that works with you and goes through your chart when you make an appointment. My vet looks everything over and tries to see patterns or problem areas. I used to keep a log of what I feed too. We have ironed out most of the problems so I don't have to go to these great lengths anymore, but it was through detailed notes that I kept and having a knowledgeable vet who was willing to work with me that I got many of the issues resolved.

I hope you are able to get things worked out with your kitty.

 

[Nancy&Pepper (GA)]

Hi,

I have started a log ( I only got my first successful home test yesterday) and I spoke with my vet today. I guess I was just concerned because no one else on the board seemed to be using Novolin. Thanks for your help.

 

[Blue]

Re: Insulin advice - should ,I switch?

The insulin you are using is not a good insulin at all if you want to get your cat regulated. It's a harsh insulin that does not last near long enough; best to switch to Lantus or Levemir, my choice would be Levemir.

The dry food will also prevent you from regulating your cat, so if your cat is already eating wet canned food, remove all the dry food.
You may just find that your cat does not need much insulin at all once you switch to low carb wet food.

 

[Nancy&Pepper (GA)]

I just started reading about all this, but other posts have said that you have to be careful when you remove dry food from the diet of a cat that is already on insulin. He does eat mostly wet, but he also eats some dry during the day. Would it be dangerous to just remove the dry all at once?

 

[Carl & Polly & Bob (GA)]

Yes, you should try to switch insulin. Here is a link to share with your vet, from the American Animal Hospital Association that outlines treatment of feline diabetes.
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
Insulin therapy in the cat

The insulin preparations with the appropriate duration of
action in most diabetic cats are glargine (U-100) or the veterinary-approved human protamine zinc insulin (PZI U-40).

"Glargine" is Lantus. We also include "Detemir" which we refer to as Levemir. NPH is not recommended by the AAHA. It doesn't have a long enough duration.

The document also details proper initial doses which for most cats is 1u twice a day, or less.

In the long run, you would want to remove dry food from the menu completely. What's tricky about that is that it usually will reduce the cat's BG numbers, so if you are using insulin, you usually would need to reduce the dose accordingly. If you just pulled the dry, it could be dangerous. So you have to be monitoring the BG very closely when you remove the dry, so you can reduce the dose as needed.
I would not advise just removing the dry immediately while you are giving 4u doses of NPH.

Carl

 

[Vicky & Gandalf (GA) & Murrlin]

I just started reading about all this, but other posts have said that you have to be careful when you remove dry food from the diet of a cat that is already on insulin. He does eat mostly wet, but he also eats some dry during the day. Would it be dangerous to just remove the dry all at once?

If you are giving 4U of N type insulin, it might be. The high amount of carbs in the dry food is not only preventing the insulin from helping him as well as it could, but it's also contributing to the need for a higher dose. If you remove the dry food completely, his dose of insulin should be lowered. Can you gradually reduce the amount of dry food he gets until he no longer gets any? His insulin dose could be lowered gradually then as well.

If you are considering switching to either Lantus or Levemir, both of them work very well for cats on a low carb diet. So it would be best to get the transition completed by the time you can switch insulins.

Also, hometesting his blood glucose is very very important to learn immediately, especially since you are using a faster acting insulin, but home-testing should be done no matter which insulin is used.