Need help understanding Novalin N bgl readings

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Susan&Alex

Member Since 2012
I just started consistent home testing on Alex today (diagnosed 3 weeks ago, on Novalin N). Yesterday, he tested at 450 in the vet's office at +5 and was given subq fluids for dehydration. The vet said to increase to 6U from 5U. Here are his numbers today. Is it odd that it is dropping at +8 and +10? The vet said the peak would be at +5. I gave him 6U this morning. He didn't eat much this morning, so I fed him little snacks at times I checked on him.

AMPS 500>
+6 500>
+8 467
+10 357

I don't think it's wise to give him 6U tonight. He seemed to be doing ok with 5U all last week until Saturday when he showed signs of dehydration. I was able to get AM readings on him on Wed. and Thu: 387 and 433, respectively. I think he was on the upswing because of the dehydration.

Two weeks ago when he was on 4U, he went low one morning. He had a weird quiver, so I didn't give him insulin. He tested at 140 at the vet's office a few hours later. I asked about the Somogyi effect then and was totally discounted. The next day, he was over 600...so I was told to increase to 4.5U.

Responses from my first post support that my vet is incompetent, so that's pretty much established!

Susan & Alex
 
When you got the low reading when on 4 units was there anything different like Alex not eating normally or vomiting?
With your limited data is is hard to tell if the dose needs to be increased or decreased.
 
Alex didn't have any issues with not eating or vomiting on 4U. He did on 3U. I just started home testing, so I have little data. Do the decreased readings at the +8 and +10 make sense? I've read that esp. with Novalin N, it's not that long lasting.
 
Alex's PM pre insulin level was 324, so I decided to go with 5U instead of the vet's recommendation of 6U.
 
Novolin N, since it generally lasts 6-8 hours in the cat and may work better if you pick up the food at around 8 hours post shot, or if you divide the total daily insulin into thirds and dose every 8 hours.

It might be that dehydration reduced the absorption of the insulin.
 
With my work schedule, I couldn't dose every 8 hours. Too bad I don't work for Google, where they let you take your animal to work!

The forums here have quite a few cases of Novalin N not working it seems.
 
Susan&Alex said:
With my work schedule, I couldn't dose every 8 hours. Too bad I don't work for Google, where they let you take your animal to work!

The forums here have quite a few cases of Novalin N not working it seems.
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I think you may be better off to get an insulin like Lantus or Levemir.
It does not look like you are having any luck at all with N.
I had horrible numbers with Caninsulin, but once I switched over to a much better and longer lasting insulin, I saw better numbers and a much happier and healthier cat.
 
With my work schedule, I couldn't dose every 8 hours. Too bad I don't work for Google, where they let you take your animal to work!

The forums here have quite a few cases of Novalin N not working it seems.
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It isn't just the forums here. It is a short acting insulin. Cats metabolize insulin quickly; 24 hour human insulins are 12 hour insulins in cats. Novalin N is only going to give you 6-8 hours and then your cat needs more or it will begin to rise in BGs until the next shot. Back when there wasn't better options, it was better than nothing, now there are better options for your kitty that will give it longer lasting insulin and less of the swings between having insulin in its system and having nothing.
 
Pre-insulin this morning, he tested over 500. I backed off the vet's recommendation of 6U and gave 5.5U. Pre-insulin tonight, he's 154. Thank goodness I'm testing him now; I didn't inject him. Tomorrow morning, he'll probably be >500 again.

If he's over 200 in an hour, should I shot him with 1 or 2 units, or just wait until morning? Are people making adjustments like that for cats? I know diabetic people do.
 
Susan&Alex said:
Pre-insulin this morning, he tested over 500. I backed off the vet's recommendation of 6U and gave 5.5U. Pre-insulin tonight, he's 154. Thank goodness I'm testing him now; I didn't inject him. Tomorrow morning, he'll probably be >500 again.

If he's over 200 in an hour, should I shot him with 1 or 2 units, or just wait until morning? Are people making adjustments like that for cats? I know diabetic people do.
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it's great that you are testing now for sure! I hate to think how your cat would suffer if you dosed what the vet said, with N, to a 154!

So, in the morning, how about test him at shot time and see where he is...... it may be a good idea to back down that dose, and test more to see how it's working. You could go with 2units in the morning, then when you test before the shot tomorrow nite, you should be at a higher number than 154.

What about if you post in the morning when you test before the am shot and see what others have to say.
 
Sorry, Blue...I just got your post. Alex tested at 233 an hour later, so I decided to go with 2.5U (given 2 hours late). I was on the fence but envisioned >500 again in the morning if he got no insulin. I'll be testing at intervals after +5.

Following that vet blindly would have been a disaster. 6U at 154?!
 
Susan&Alex said:
Sorry, Blue...I just got your post. Alex tested at 233 an hour later, so I decided to go with 2.5U (given 2 hours late). I was on the fence but envisioned >500 again in the morning if he got no insulin. I'll be testing at intervals after +5.

Following that vet blindly would have been a disaster. 6U at 154?!
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That's OK, I am glad you went with less of a dose.... it would be good if you can get a before bed test, just to make sure the numbers have not dropped too low already, to be sure it's safe to head to sleep.

Now, your 12/12 shot times have changed by shooting late, but since you dropped the dose, and your insulin does not last near 12 hours, you will likely be able to shoot on time or close to it.
Test in the morn at your usual shot time to see what Alex is and then post here so people can help you with deciding what dose and when to shoot.

Once you get a better insulin, you will see great improvements in Alex.
 
I stayed up with Alex for two hours after shooting him to make sure he was ok. I tried to get a reading at +8 and +9, but I'm having trouble getting blood. I warmed his ear, got blood, but it wasn't enough for a reading (I've lost several test strips that way). His blood seems to clot quickly and get lost in his black hair. Sometimes I'll get lucky and get a nice bead. I still don't have the nack for it, but I've got persistence and he's relatively patient except when he wants to eat.

From his behavior, I'd expect low numbers unless there was a big spike after eating. Incidentally, the vet told me you can't relate behavior to bgl's. I seriously question this guy's ability to analyze. Every time Alex tests >500, he's lethargic and doesn't want to eat much. When under 300, he's perky, jumps, and seems content.

I've got until 9:00 (eastern) to get a reading on him before I have to go to work. If it's >200 and <350, I'm thinking 2.0-2.5U. If it's >400, then 3U. I think the high dosage could be making him bounce. (The vet thought he was regulated at 3U in his office originally.) How does that sound?

I'll post again as soon as I get a reading on him.
 
No luck yet on getting a reading, and I've got 1/2 hour before I have to leave for work. He's feeling good, so he's being a tempermental Siamese and having little toleration for my lack of finesse at poking him. If he's feeling bad, his toleration level is very high.

If I can't get a reading on him, I'm thinking of going with 2U. Since I'm off schedule from last night's shot due to being low, I'll be giving it at +10.5. This is the safest I think. Opinions, please!
 
Finally got a reading...487. I can tell he feels lethargic after eating so it must have spiked a lot. He ate a lot; food control is difficult because he's used to eating whatever he wants whenever he wants so he gets an catitude. I ended up giving him 4U. I feel comfortable leaving him for the day.
 
If you are poking on the outer hairy side of the ear, no wonder you have problems.
I have always poked Ollie on the underside of the ear and there is no interference with hairs.

Try the underside of the ear tip; I am positive you will have better luck
 
Drawing blood from the inside of the ear tip was much easier!

Tonight, Alex has the same trend as yesterday. 137 pre-injection at 8pm. I will check him again in two hours and probably give him 2.5U like I did last night at 10pm. I can tell that he feels much better.
 
The idea is, within about 15-30 minutes, to test, feed, shoot, so as the glucose starts entering the body, so is the insulin, and they are matched up. Since you're still on Novolin, which hits faster and harder, 30 minutes may be enough lead time.
 
Susan&Alex said:
Great, I will try that! Thanks, Blue. Do you think I was in the good, safe zone with giving 4U this AM?
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I am glad to hear you are having better results by poking the under side of the ear; I don't know why, but it should be mentioned to others more often, especially with dark haired cats! Even if the ear is darker skin, the hairless surface allows for easier access to the beading blood.

For sure you did fine with the lesser dose yesterday, and I am guessing that dosing with N would be close to how others dose when using PZI? If you get a lower number at shot time, like 137, you sure would not want to give 4u I don't think.

What number did you get at 10pm last nite? You called the 137 your pre-injection number; did you give insulin at 8pm or 10pm? Your pre-injection number / pre-shot number should be 15min before you are giving insulin.

As was said, N is quite harsh and you will see a big drop in numbers early on, it's very important to make sure your cat eats 30min before shot time.

If you are going to shoot at 10pm, feed at 930pm, and test at 945-10pm, just so you know what number your cat has with food fed and insulin being given.
 
I am glad to hear you are having better results by poking the under side of the ear; I don't know why, but it should be mentioned to others more often, especially with dark haired cats! Even if the ear is darker skin, the hairless surface allows for easier access to the beading blood.
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This is a great tip. It must tickle, so I lost a good drop this morning when he shook his head.

What number did you get at 10pm last nite? You called the 137 your pre-injection number; did you give insulin at 8pm or 10pm? Your pre-injection number / pre-shot number should be 15min before you are giving insulin.
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I guess I should have said that it was at +12. I waited until he was 345 two hours later at 10pm.

The 8 am/8 pm schedule was set off track, along with his feeding schedule. This morning, he ate at his normal time, but was not injected until two hours later...which was 10 hours after the last injection. The schedule was set off kilter 2 days ago for the same reason, but everything was fine until tonight. He was 155 at +8 this morning, then I fed him and an hour later he spiked to 497. I'm seeing drops at +10, so I decided to check again at +10....he was >500. Due to the previous night being 137 at +12, I decided to go with 3.5U instead of 4U. Tonight at +11, he was >500 and doesn't want to eat (just drinks a little water). I gave him 5.5U, which is what I did on Sunday when he was in this situation. He should want to eat when it drops.

If you are going to shoot at 10pm, feed at 930pm, and test at 945-10pm, just so you know what number your cat has with food fed and insulin being given.
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You answered one of my issues in your last post, Blue. Tighten the eat to shot time. He won't be happy about that, but it has to be done. Siamese cats like to get their way. The spike this morning from 155 to 497 is amazing.

As was said, N is quite harsh and you will see a big drop in numbers early on, it's very important to make sure your cat eats 30min before shot time.
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I have not tested at +1 or +2 to see the big drop in numbers early on. That's great since it will help his situation this evening.
 
Last night: >500...he did not want to eat...gave 5.5U 1 hour early. He ate the smaller quantity of food I left out prior to 3:00.

This morning: 123 at +11. Very active and hungry; fed 1 hour instead of 1/2 hour pre-insulin since the number is so low. 137 at +12, no insulin given.

Until he's on Lantus, I need to manage him on N. Adjusting insulin to the readings seems to work fairly well. When he was over 500 yesterday morning, I should have adjusted to that number instead of trying a mean dosage of 3.5U.

The vet's dosage went from 3U to 3.5U to 4U to 5U to 6U in 3 weeks. The vet tested him at 140 in the AM after eating (no insulin given) 1 day before he upped it to 3.5U. I should start calling this guy 'Paw Tag'. (My bro had an ER doc that he dubbed 'Toe Tag'.) I've paid out 2K for this roller coaster ride. Two weeks ago, I was taking him to the vet if he didn't want to eat. Now with home testing, I know he's high and he'll rebound after insulin. If I left him for the day, it was a $100 bill.
 
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