Novolin R dosing recommendations

[Justin & Sebastian]

Looking for people with Novolin R experience who can look at Sebastian's sheet and recommend if I should use it right now to get his BG down and if so, how much and at what frequency.

His Lantus dosage has been up and down, I suspect due to metabolic and systemic issues, and we're currently in a period where his BG is high, Lantus isn't bringing it down, meanwhile his ketones are elevated and his weight is low and not gaining, so I'm thinking we can maybe use to Novolin temporarily to get things in line while we get the Lantus back on track.

 

[Squeaky and KT (GA)]

@Wendy&Neko ...

 

[Larry and Kitties]

Since 5/8 your PS BGs were in the 200's and BG never dropped below 20 and you have a "flat" BG curve, even after increasing the Lantus dose.
Sometime a flat high curve means that the dose is too high. Or it could be the dose is too low and there is something going on that is causing the flat curve even with increasing the dose.
In the past I have used both R and N as booster shot to quickly (compared to Lantus) get BG down when abnormally high. The dose is based on how the cat's BG responds to the booster. One starts low like 1/4 U and work up as needed.
In you case I would start with 1/4 unit or less of R while still also using Lantus and see if you can get a better drop in BG than you are currently seeing with only Lantus

 

[Justin & Sebastian]

means that the dose is too high

So I've never gotten a good explanation of how this makes sense. I understand that if the dose is too high it can subsequently push their BG too low which triggers a bounce but when we're at 10 days now of high numbers, that doesn't seem to be the case.

In you case I would start with 1/4 unit or less of R while still also using Lantus

Okay that's pretty much what I was thinking, start as low as possible, see what happens, adjust from there. I'm not quite there yet with wanting to go that route, just planning.

 

[Justin & Sebastian]

Sometime a flat high curve means that the dose is too high

I was just looking at the numbers again and I'm not really seeing high and flat. The first day or two, 5/9 and 5/10 yeah it was high and flat, but was coming off a dip into the greens so was likely a bounce. But for the past 5 days or so it's looking a lot more like a curve that is just too high.

 

[Wendy&Neko]

R should not be started with out the close support of an experienced R user. It is important to know when not to use R, as well when to use it. Unfortunately, I am about to head out on holiday and am not that person. You do want to be cautious about using R, you don't want to drop more than 100 points from it, or you set up a drop and bounce problem. Some cats only need as much as a drop or 0.1 units. 0.25 units may be too much.

 

[Marje and Gracie]

I agree with Wendy on starting dose. For cats on Lantus/Levemir that are not high dose cats, we typically start at 0.1u until we see how the kitty responds to R. He will be worse off if you give too much and do start the bounce/dive cycle to which she refers.

I also urge you to post for help in the Lantus/Levemir forum so experienced R users who are also experienced with those basal insulin can help you. There are a handful of us but I’m also away right now. I’ll be back tomorrow. But I’ll underscore Wendy’s comment that you should do it with the assistance of one of the experienced R users or else it can be dangerous. There are several caveats for it use.