KT's numbers all over the place - Review SS please

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Squeaky and KT (GA)

Squeaky and KT (GA)

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I've been keeping up with KTs spreadsheet for a few days now that we can test. He's on Humulin N. His numbers are terrible - all over the place. I talked to my vet about it. We don't seem to see eye to eye on the approach.

Food - He says dry Purina DM and canned Iams. I brought up the issues with the carbs in all dry, he said it was MADE for sugarcats.

To control numbers better - his suggestion was to add a third 1.5 unit about 4pm and move the 2.0 at about 10pm. The original dose was 3.0 but when I read everyone here's concern with that large of dose, I cut it down - I got scared I was making him hypo. That's why you see the really varying dose at first. When I realized I was being stOOpid, I settled down to 2.5u to see if we can get it adjusted. It's not working.

He's such an angel about this whole thing and actually DOES come for testing willingly already. I've said since I got him that he was a special gift and filled a hole that I didn't even realize was there....

Spreadsheet is in my signature....I did add 2 columns for shot times.
 
I'm sorry I really can't be much help as I've only had limited experience with N, but at list this will bump you up in the list. :-D
But just knowing what I know of Humulin N I would say your spreadsheet looks pretty standard for that insulin since it hits hard and fast and wears off quickly. That is one of the reason we tend to like the longer lasting, gentler insulin in cats, since cats tend to metabolize insulin at twice the rate of humans.

Mel, Maxwell, Musette, & The Fur Gang.
 
Forgot to add - I asked the vet about changing to another insulin, he just plain said 'no, no reason this one won't work just fine'. I love him to pieces but I'm not comfortable with his approach to this. Unfortunately I can't afford the others here so will have to figure it out with every one's help here. THANK YOU for your help already!
 
Lyresa,
That may be due to it being the insulin he has experience with, or maybe he's had a few successful cases with it.
I'm trying to figure out who to ask specifically. Some members have used it in the past but have switched to one of the long-lasting "Ls" or Pro Zinc.

Carl
 
my first thought when looking at the spreadsheet? typical N response in all honesty, especially so early in the game. N acts fairly quickly and poops out nearly as quick so you usually won't get full 12 hour coverage on it. so high low high low is more typical than with insulins like lantus or levemir. i'm not saying it can't work, it can.

couple other things. make sure you get that test right before giving the insulin. definitely want to make sure it's safe to give it before you give it. that 54 you noted about on the side may have come from the level being low to begin with for instance.

there's not many around anymore with much N experience but i think there's a few with a bit under their belt. let me send a pm to one i'm thinking of right now and see what she has to say.
 
Squeaky and KT said:
Forgot to add - I asked the vet about changing to another insulin, he just plain said 'no, no reason this one won't work just fine'. I love him to pieces but I'm not comfortable with his approach to this. Unfortunately I can't afford the others here so will have to figure it out with every one's help here. THANK YOU for your help already!
Click to expand...

I had a simular problem with the vet that first dx'd Casey. I decide to "shop around" for a new vet and found one that was willing to work with me on what was best for Casey, not the vet.

Roberta
 
Based on the spreadsheet numbers, I would reduce the does to 2 or even 1.5 BID and see if you can get consistent BGs.
Could it be that the amount of canned and dry food is not consistent and that is causing the varying BGs?

just for information, I worked on getting consistent BGs from my Baileyfor seven years and could never et consistent BGs.
 
Boy my gray hairs are showing today. Food - I did NOT buy the food he suggested. I'm feeding him canned FF pates during day but I can't say he's not cleaning up crumbs of the hard Cat chow indoor from brothers suppers. He's not eating very much - maybe a total of 1 1/2 cans of FF a day. He eats 4 tuna hard treats at test time. He hated the shrimp and haven't made it to store for something else.
 
my Casey bear said:
Squeaky and KT said:
Forgot to add - I asked the vet about changing to another insulin, he just plain said 'no, no reason this one won't work just fine'. I love him to pieces but I'm not comfortable with his approach to this. Unfortunately I can't afford the others here so will have to figure it out with every one's help here. THANK YOU for your help already!
Click to expand...

I had a simular problem with the vet that first dx'd Casey. I decide to "shop around" for a new vet and found one that was willing to work with me on what was best for Casey, not the vet.

Roberta
Click to expand...

:oops: :oops: ...I meant the other vets...the next cheapest one charges $45 to walk in the door and $125 for a blood panel. There's 18 others to take care of....
 
Squeaky and KT said:
my Casey bear said:
Squeaky and KT said:
Forgot to add - I asked the vet about changing to another insulin, he just plain said 'no, no reason this one won't work just fine'. I love him to pieces but I'm not comfortable with his approach to this. Unfortunately I can't afford the others here so will have to figure it out with every one's help here. THANK YOU for your help already!
Click to expand...

I had a simular problem with the vet that first dx'd Casey. I decide to "shop around" for a new vet and found one that was willing to work with me on what was best for Casey, not the vet.

Roberta
Click to expand...

:oops: :oops: ...I meant the other vets...the next cheapest one charges $45 to walk in the door and $125 for a blood panel. There's 18 others to take care of....
Click to expand...

Did the original vet run a blood panel already?? I am just asking because if it was already done, you should be able to have those records transfered. I wuond up having to pay as you mentioned, but that was only because the first vet did not check for any other problems. If I had all the tests done at first vet, all I would have had to pay was the $45 office visit.
 
Roberta - Yes and I have a copy of it.... ;-)

So - in reaction to those high numbers, I should REDUCE the amount of insulin? I upped it this evening thinking that was the correct thing to do....
 
Lyresa,
Re-read the dosing advice from Larry and Kitties, which does suggest lowering, and also from Cindy and Mousie who stressed to make sure to test just before shooting.
I wish I could tell you something useful, but I know little to nothing about humulin and how it works vs PZI which is longer lasting.
Carl
 
Lyresa,

I agree with Carl, that you should follow Larry's dosing advice and test before you shot as Cindy stressed.

At looking at KT's SS it seems that he had lower BG#'s when he was getting 2u's, and the higher insulin doses had some higher PS #'s. I do not know if this applies to Humulin, but from what I read, the long-lasting insulins...like the L's has a concern of doses being too high called Somogyi rebound here is a link so you can read what it sayes: http://petdiabetes.wikia.com/wiki/Rebound.

I also found Humulin 101, I do not know if you saw this or not, but here is that link: http://www.felinediabetes.com/FDMB/viewtopic.php?f=19&t=303

Hope these link will help too,

Roberta
 
Hi there

A LONG time ago we used Humulin L which was similar to N but longer lasting.

I would suggest that reducing as Larry suggested might not be a bad idea, hold that dose for 4 days and get more tests around +4 if that is possible because that is when you will likely see the 'nadir' or low point.

Your vet is woefully out of date if he will not consider other insulins, but you know that already. Would it help to get you some links to papers on other insulin types?

Meanwhile, if KT is obviously not feeling great, please be vigilant and try to get some urine ketone tests done every day (insufficient insulin + insufficient food and/or infection can cause ketones).

A couple of days of settling and some earlier test points should help paint a better picture of how the N is working and from there you can make some decisions.
 
NO Ketones - testing with strips every day! Got those strips when I bought the meter, etc. Vet never said anything about them but YOU ALL DID!!! So....I get peed on daily.... :-D
 
Dear Lyresa, and, of course, you too, sweet KT,

Squeaky and KT said:
NO Ketones - testing with strips every day! Got those strips when I bought the meter, etc. Vet never said anything about them but YOU ALL DID!!! So....I get peed on daily.... :-D
Click to expand...
ROFLMAO!!!!!! Use cough syrup cups. Tidier. Trust me. And, no, her ER vet told me it wasn't necessary to catch pee. Giz was DKA at diagnosis. That was the first time I went beyond vet suggestions...


About vets. And, please trust me once again. I will never bash them. Period. Although I nudged a couple, who I will always dearly love, in terms of feline diabetes... They stepped up to the plate.


About being pro-active. You're on the front line, in the sugar trenches, every single day. You're KT's goddess. Period. You have a couple of choices regarding your vet. You, as a parent and client, can demand Lantus (probably more familiar to him than Levemir. Trust me, Nikki's on Levemir, but she graced my heart on Lantus...) Or, you can call around and interview other vets who might be more progressive.


I'm going to explain ECID -- Every Cat Is Different. The only cat food Giz would actually eat was DM dry. I know what it is to be stuck between a rock and an ornery/finicky sugar cat... Is it what I would suggest? No. If it depends on a sugar cat on N? Yes.


If you're changing KT's diet from dry to canned? Reduce his dose. I know N. One Saturday afternoon, I remember watching Giz casually walk over and inhale 1/4 cup of DM dry in one sitting. I remember thinking to myself, Wow! she never eats anything in one sitting. Then, I suddenly realized, oh crap! Tested her and she was 38. Tested her multiple times again within minutes, 40, 43, 38. Never did break out the Karo...

She got a lot of extra pieces of steak that day...


I'm not writing this to scare you, Lyresa. Giz was completely asymptomatic in terms of hypo, but she was flirting with the hypo numbers... N is tricky. You can tell your vet that you've learned that cats metabolize insulin twice as fast humans. You can tell your vet you want a slower acting insulin that would be more cat friendly. You can tell your vet you'd like either Lantus or Levemir. You can do this. I believe in you, Lyresa. I do.

Please understand, I'm not saying N doesn't work for some cats. I'm just saying it's rare...

Much love and countless encouraging hugs for you, your husband, KT, and 17 others,
Deb and Nikki -- and, Giz, who taught me anything is possible...
 
Hi kt,
My cat was dx last wk and the vet changed him from can insulin to protaphane which I believe from looking on the net is what you call N..we are in Sydney Australia. So I will keep u posted with fatty's numbers & doses when he comes home from vet.
Mel
 
We've moved to Lantus since I wrote this thread. His spreadsheet reflects our Humulin N experiences as well as the Lantus. I've learned first hand about Humulin N and it's roller coaster effects. Those aren't fun for kitty's body.
 
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