New to FDMB but not to diabetes

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All I know about Novalin N is that it is very harsh and brings down BG numbers fast. I agree on the dose reduction tonight. I'm so glad you were testing today. Because of it, you could have just saved his life.
 
Preshot is 311. (Even after all that food and honey!! I thought it would be like 500!) What would you suggest for tonight's shot?
 
I'm surprised too - not only the honey but also the possible bounce. To be super safe, maybe 1.5. If you want to be sure he stays in good ranges, maybe 2. But if you decide on 2, i'd get a before bed test. Like today it is a good warning if the cycle is going south early.

Depends on whether you want to be more aggressive or not. You hold the syringe; you decide.
 
What do you mean by more aggressive? I cant stay up all night testing him but my ultimate goal is to do whatever it takes to get him regulated and even better would be OTJ.
 
Some people push a little harder than others. I am thinking 1.5 is a very safe dose and it's more likely he would stay flatter, maybe in the 200s Two units might be more likely to result in a cycle with lower numbers. No crystal ball here. Just my thoughts. And he's a cat, so all bets could be off.

There is no way to predict, especially when a diet change is in the picture. 1.5 could mean a calmer night. 2 might be fine but could mean you'd have to watch more carefully.

It is really hard to decide how much to reduce. That's why we like to start low and raise as your hometesting suggests. Once he is at higher doses and then starts to fall, it is more of a guessing game.

Not sure if I explained that well.....
 
I think I understand a little better. I am giving him 2 we will see what happens. Thank you!
 
I gave him 2 units at 8 pm I just checked and he is at 77. Is that ok for now or should I give him a little food? Seems like he could be on the same path as this morning.
 
So the 77 was at +3? As long as he stays above 50, he should be good. If he drops that low, try the honey mixed with a little food again.

Hope he stays up for you
 
He was alright. I checked again at +4 and it was 72 so I gave him a little more food. This morning was 331 and I didn't want him to dip down again so I gave him 1.5. Now at +4 he is at 159.
 
Hi Kim,

I snuck a peek at Pet's spreadsheet. It looks like he is doing good at 1.5. Those Greens are nice. It isn't lasting long enough but it would be rare to see N last the full 12 hours. I'd say you are getting the best possible result you can from it.

Are you checking the Supply closet to watch for any free insulin?
 
Hi Sue,

Is the green range the goal? Yes I am looking at the supply closet and I am communicating with someone about their insulin. Can I just switch insulin like one for one ? So if I am giving him 1.5 N and I switched to a different insulin I would still give him 1.5?
 
To be regulated, we generally want a cat in lower 200s at preshot and double digits at nadir, but not below 50.

I would err on the side of caution and maybe try one unit with a new insulin. N works so differently than the other longer lasting ones. 1.75 is getting him into nice ranges so you might end up higher than one unit with another insulin, but it would be nice to move up slowly and carefully It is always easier to raise slowly based on your testing rather than guess how much to reduce. (My two cents)
 
This morning he is at 219 which is less than he has been for preshot yet. Should I lower his insulin from 1.5 to 1?
 
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Yes, I just messaged you back. I ended up giving him 1. I am talking to 2 other people about Lantus too.
 
Lantus is a great insulin and there is a very active forum here to help you may the switchover. If you go with it, get advice from them about the first starting dose. And read all the stickies on their forum. It is dosed very differently than N.

http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/


He is responding well to N- much better than most cats. It is lasting 12 hours overnight, but seems to peter out before pmps. What is the difference between food am/pm. Maybe you can play with those variables.
 
I give him the same amount of food in the am and the pm. Do you have any estimate about how much it costs to ship insulin?
 
Hi Kim,

Gosh but you've had an eventful time! :)

You asked earlier in the thread about the redness on Pete's ears from the home testing. I think that a bit of redness is common at first, and poor little Pete had a bit of a baptism of fire (but thank goodness you were testing him - you kept him safe! :) ).

After you start testing, more capillaries develop at the test site fairly quickly so it becomes easier and faster to get blood droplets for testing. The redness should subside quickly, too.

BTW, when you get a chance it would help members reading your posts if you could add details of your insulin type and meter type in your signature line.

Wishing Pete continued improvements with his food transition. :)
 
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name,
cat's name,
date of Dx (diagnosis)
insulin
meter
general location (city and state/province)
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
 
Yesterday Pete was 405 in the am so I increased his insulin to 1.5. Then last night he was looking good at 260 so I reduced it back down to 1. Now he is at 145... I do not know what do with that... do I give him .5? Do I not give the shot at all?
 
Let me look at his spreadsheet. OK. I've looked.

Stall 30 minutes without feeding and re-test.
- If rising, and below 150 mg/dL, you might give 0.5 units.
- If rising fast and above 150 mg/dL, you might give shoot 1 unit.

If you do not feel comfortable shooting, don't.

If you'll be home to monitor and have Karo syrup or high carb gravied cat food, you can shoot and test about every 2 hours to see how he handles the insulin.
 
Ok. There are a few days missing because I was out of town and he was being cared for at the vet but they didn't give me his numbers.
 
How I analyzed your data:
On 7/24 with a pre-shot of 219, a dose of 1 unit dropped to 81 by +4. That is a drop of 138 mg/dL.

Today, his pre-shot was 145. Usually, we suggest not shooting below 150 mg/dL when using ProZinc NPH. If he dropped by half of the 138, that could get him down around 76 if that same amount of drop happened, hence the 0.5 unit dose option. The amount of drop can vary with the same dose due to other factors such as stress, activity, food changes, illness, etc.
 
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My two cents. I would stall longer, if he hasn't eaten. If he rises to near 200 (maybe 190 +) then yes, .5 If one unit on a yellow gave you an unshootable preshot, then I would lower the dose.

BTW, Julia Rae has posted looking for you on the Health forum.
 
NPH is similar in that respect to ProZinc - do not shoot below 150 mg, 200 if you've little data.
A dose of 0.5 units could be safe, but being home to monitor around +3 to +4 would be helpful so you can see how low the glucose goes.
 
I checked him at 8:45 and it was already up to 305 (how that is possible I do not know) so I gave him 1 and I will be monitoring all day. Since his shot is usually at 8 and he didn't get it til 850 this morning. I do all the +2s and +4s off of the actual time right? (Thank Sue, I am quite offended that she did that but I am addressing the situation)
 
Yes, do the +2/4 from the time of the actual shot.

The fast jump is pretty characteristic of N - when it's gone, it's gone. Just surprised that you got such a long cycle with it (12+ hours). That is unusual.
 
Now his preshot is 584!!!! I don't understand how that could be??? What should I do? I have been giving him 1 unit. Should I give him 1.5.?
 
I would guess he dropped mid cycle and his pmps is a bounce. Or the N just wore off and didn't last

The 1.5 could work but I'd plan to do a before bed and nadir test. If you can't monitor, then I'd play it safe with one
 
Ok, he got sick from being high for too long so I think I will do the 1.5 and then check him tonight. Seems like nadir is 4-5 hours so I guess Ill check at midnight. Thanks again Sue!
 
Ok. And just in case something comes up tonight and you are asleep... I need to be worried if it is below 50 right?
 
If he drops below 50, feed a little bit of his regular food. Retest in 20 minutes. Still dropping -a little of the gravy off higher carb, retest. Still dropping, either mix honey with the gravy or put honey on his gums. You want 3 rising tests before you can relax

Now that you're prepared, he should be fine
 
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