Insulin long or short?

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Linda and Scooter & Jack

Linda and Scooter & Jack

Member Since 2012
Hi Folks:

A year or so ago I found this website on Bing and it literally saved the life of my cat Jack. Rebecca's information was better than the Vets. I would like to say I have the greatest Vet as well. Jack was on insulin for 4 months the went OTJ and has been fine ever since. I do check his BG once a day still. I am so grateful. :razz:

Today however I took my old guy Scooter in for flu like symptoms and his BG is 490. He is also being treated for an infection with clavamoxx. So now I have to decide on insulin. I understand that lantus and levemir are long lasting and that the short lasting ones are not recommended. Is there a reason the humulin and N are unsafe for felines? Which is better lantus or levemir?

I have to make this choice by tomorrow to get him started so any help would be greatly appreciated.

Linda
 
Sorry to hear about Scooter, Linda. We do not suggest using Humulin (N). It tends to be harsh and doesn't last as long as the milder insulins. It is more harder to regulate with. Most cats drop early in the cycle and then go right back up after 6-8 hours. By 12 hours, they are in much higher numbers. People who use it often have to shoot every 8 hours instead of every 12 to keep the cat in safe numbers, and they need to monitor the harsh drops very carefully.

Most people here use Lantus, Levemir or ProZinc. They are milder and longer lasting. Lantus and Levemir are very similar.
 
Thanks Sue!

You are exactly right. He was at 490 around 4 pm and the Vet gave him 3 units of N. It is 10 pm and he is now at 61. I am checking him every hour now since he is so low. I imagine he will go back up on his own in a few hours. He has refused fancy feast this low as well. So begins this roller coaster again but I am not as crazy this time round. With my other cat Jack I felt like a nut case right about now.

Is there a better choice between Lantus and Levimir?

Thanks for your help!
 
chewie said:
Thanks Sue!

You are exactly right. He was at 490 around 4 pm and the Vet gave him 3 units of N. It is 10 pm and he is now at 61. I am checking him every hour now since he is so low....
Click to expand...

The vet gave him too much. With N, you need to check at +3 to +4 hours after the shot to see how low the glucose has gone. If he was only 61 6 hours later, it is likely he was lower earlier.

For future reference:

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- no shot limit for ProZinc, PZI, or other non-depot insulins

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
WOW! Thank you so much for all the help. Having those guidelines is very helpful!

Scooter is doing well this morning after going down to 39 late last night. My ISP crashed so I could no long post. I live in the country so it is hard during storms for my satellite. He is at 168 this morning. I did not give him anymore insulin N. I did give him his next dose of clavamoxx. His urine tested high yesterday but this morning is much lower. So I am going to keep monitoring him all day. My Vet is on call for us as well.

I am glad you all have so much information.

thank you! :smile:
 
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