Novolin R vs Humulin R to manage ketones: Is there a difference?

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Melissa and Rascal

Melissa and Rascal

Member Since 2015
Here's where we were earlier today:
http://www.felinediabetes.com/FDMB/threads/at-er-vet-with-ketosis.159597/

Rascal came home after getting fluids and insulin. They are going to let me manage the rest of the ketosis issue at home with SQ fluids, feedings, and Humulin R. We are Lantus users usually and will go back to that when this is resolved.

My only concern is I went to Walmart to get the Humulin R and they gave me Novolin R instead. They said it was the same thing. Is this really true? Has anyone noticed any differences I should know about?

The vet said to give it about every 6 hours (the Humulin) after testing BG and dose according to a chart she made and to be sure Rascal is eating around then.

Any insights are much appreciated. Thank you!
 
Thanks, guys! It's only for a couple days so I can rid her of the ketones. It's what they would be doing at the hospital but they are letting me do it at home since I monitor BGs closely anyway. Maybe this will actually convince them finally that home testing is a GOOD thing!! Lol!
 
Yes they are the same.

I'm wondering however . . . typically people continue using their depot insulin and the R is in addition. In many cats, especially non-high-dose cats, the R is gone from the system in 3-4 hours.

Make sure you're adding plenty of water - as much as she will tolerate - to her food.

Did the vet give you an R dose to use that they had already established works for Rascal?
 
I'm not sure I'd even attempt to use the R....it's my understanding that you've been using Lantus and haven't increased her dose due to the fact you're not sure if she'll eat...or if she'll keep her food down if she does

I don't think you want to use R if you can't get Rascal to eat when you need her to...I think I'd increase the lantus first but let's see what others have to say
 
I just reread your post and saw the vet had made a chart for R use for you. When we help people use R, we start with a very small dose (0.1u), evaluate the timing so that the cat's blood sugar isn't going to plummet after giving the R, and then the person tests for the following 4 hours so we can see the consequence.

When a vet is using R in the clinic and dealing with ketones, they often have the cat on a glucose drip at the same time. Your situation makes me a little nervous, since it's different than how we usually deal with that here.

If I were you, I'd get a test once an hour for the first 4 hours after giving the R. Just be cautious on this and get to the vet if you have any situation that you can't handle confidently at home.

Here is a good thread on ketones. It's worth taking the time to read.
 
Thanks, everyone! She's home. We've got negative ketones now. She is eating and I'm giving her lots of fluids - SQ and she's getting a good amount mixed in with her food.

We are addressing possible triggering factors like a recurrence of her UTI and/or pancreatitis, and after reading through some comments here and on my other post I have been very carefully using both her Lantus as a base and some Novolin on top to keep the peaks down. I'm testing a lot, but so far so good. The vet didn't even mention using the two together, but then she also doesn't even encourage home testing and I would never do any of this without testing. She just said to use the Novolin instead of the Lantus until the ketones clear and then go back to Lantus, but I quickly found for the time being using the two together seemed to be getting her and keeping her in better numbers. She was up and down too much with Novolin alone.

I am way behind with her SS, and honestly I'm just too exhausted to do anything about it at the moment anyway. How would I do that anyway with two insulins being used at different times?
 
Melissa and Rascal said:
She's home. We've got negative ketones now. She is eating and I'm giving her lots of fluids - SQ and she's getting a good amount mixed in with her food.
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Wonderful!!!
Melissa and Rascal said:
I am way behind with her SS, and honestly I'm just too exhausted to do anything about it at the moment anyway. How would I do that anyway with two insulins being used at different times?
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Try to take care of yourself, too. I know it's hard when kitty's sick, but it'll be worse if you're past the point of exhaustion.

I used R as a bolus and Levemir as the basal insulin. When using R as a bolus, one doesn't want the nadirs of the basal and bolus insulins to coincide. You're also looking for only about a 100 point drop from the R. Using more R tends to yank the numbers down which often results in creating a bounce. All you want to do is gently pull the numbers down... just enough for the Lantus to be able to "grab" onto.

Caregivers use different methods to record basal plus bolus insulins. Here's how I recorded R use on Alex's spreadsheet:

I shot 1.25u Lev at AMPS and 0.1u R at +0.5.
R%20USE_zpswsftnmsv.jpg



Here I shot .01 R at Lev +9.5.
R%20USE%202_zpsxl80i3pe.jpg



You might want to post in the Lantus & Levemir Insulin Support Group for help. You'll find experience using R as a bolus and Lantus as the basal insulin in the group. Several of us also have experience keeping ketones at bay. We have a real good idea of what you're going through, what needs to be done, and will likely be able to answer your questions.

Good luck!



 
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