question about dosage

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I.P.F.

I.P.F.

Member Since 2023
Hello everybody.
Just looking for some advice on how to determine appropriate dosage of insulin for my kitty. I checked him tonight and he was lower than what I expected so I panicked for a moment, but then realized he still in normal level for a non-diabetic kitty (BG was 110 after 3 hours). Right now I have been giving him 6 units and I question if that much is needed. So my question is does insulin drop the BG a certain amount like 1 unit drops it 150. When I check him after a 12 hour period he is usually in the 375-400 range. For example if I check him and he is at 250, should i only give him 3 units then. All this is still new to me.
Thanks everyone in advance.
Jim
 
No, not really. You can’t say 1 unit drops a bg by x points because it’s not an exact science. We base dose on the data you gather for your cat and the dosing methods we use here. I see you managed to get a few more tests in which is good but with that lower bg tonight, I think it’s really important to try to get a preshot in the morning before his shot.

the general advice here is if you’re a beginner and you get a preshot value lower than 200 you have 2 options. You can skip the shot or give a token dose that should be 10-15% of the regular dose. You could also stall without feeding and retest in 20 minutes to see if the bg is going up and make a decision then but that may difficult with your schedule. Tagging a few others here @Bron and Sheba (GA) @Sienne and Gabby (GA)
 
Also, I’m not sure when novolin peaks, but if this was Lantus and my cat, I’d try to get another test in before going to bed to make sure he’s not going to keep going down into dangerous numbers since it’s still early in the cycle. Remember anything below 50 is a take action number and if he goes below 90, he earns a 1/4 unit reduction. We dose by the lowest he goes in a 12 hour cycle. I’d also suggest you give him some food now to slow down the drop. It doesn’t have to be high carb because as you said he’s till I’m safe numbers, just regular low card wet food.
 
We’ve all been rookies and panicked. I remember the first time I got an 80 with Bobo and I rushed to give him high carb food. Afterward I was like, why didn’t I just give him regular food he was still above 50 and pretty safe. it’s odd to see a lower than usual bg. Their bodies also panic and that’s basically what bouncing is!
 
just checked him again and it hit 50. My kitty seems alert and awake. He did lick some syrup but didn't like it. Going to check him again in another hour.
 
Hi Jim. With Novolin N you need to reduce the dose if the BG drops under 90. And because it dropped to 50, I would reduce the dose to 5.5 units moving forward.
Are you testing 1 hour before the dose is due and then feeding the main meal? And waiting 1 hour before giving the insulin?

are you giving snacks during both the cycles? A snack is a teaspoon or 2 of normal low carb food.
 
Most of the time I cannot test AM as I am at work and the wife just gives him a shot after he eats. One my weekends we try and do more. Since I am on my weekend now we have tsted both AM's this morning his reading was 391. As for the process I test him before the shot if i can, then feed him and try and give him the shot right after. I will start waiting to give him the shot for an hour.
 
You definitely need to wait 1 hour after feeding him to give the dose. Novolin N is a harsh and fast acting insulin and you need to make sure Kitty has food in his system before the dose hits.
Are you giving snacks during the cycle as well?
Did you see where you need to reduce the dose to 5.5U?
Do you have a hypo kit set up in case of low numbers.?
I would look at swapping to a more suitable insulin for cats. Novolin N is not a suitable insulin for cats at all.
Lantus or Prozinc are suitable upinsulins for cats and are the 2 insulins recommended by the American Animal Association?
 
With that 50, please do reduce the dose as Bron said to 5.5. You weren’t testing when you upped it to 6 units and now he’s telling you that is too high a dose. Next time if he goes that low, you should rub some honey or Karo on his gums to bring him up. Most cats won’t eat it on their own. I’d also have given him some high carb food along with it. When you do that and he’s that low, best to check him again in 30 minutes instead of an hour. You may see him bounce from that low today.

@Bron and Sheba (GA) here’s his first post https://www.felinediabetes.com/FDMB/threads/7-5-2023-new-member.279232/#post-3086725
 
I see you gave him 3 units this morning. That’s a big reduction. Try to follow our dosing advice here and try not to rush the process. Remember we adjust by 1/4 or 1/2 unit. Even if you were following a vet’s advice they wouldn’t adjust by more than 1 unit at a time. I think since you’re doing this on your own and you don’t know much about feline diabetes and how insulin works, it’s important that you follow our SLGS method as closely as possible. I got Bobo into remission on my own, never saw a vet, but I was here daily and followed every piece of advice and guidance I got from the super experienced members here like Bron.

Here’s the link I posted on your first thread for the novolin forum. It’s important that you read the yellow sticky notes about novolin:
https://felinediabetes.com/FDMB/threads/beginners-guide-to-humulin-n-novolin-n-nph.231593/
 
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I did 3 units this morning and tested him 4 hours later. His latest test is 227 (4 hrs after AM shot). I have started to give him the shot 1 hour after he has eaten. I also have an emergency kit set up just in case. My biggest problem is because I am not home a lot because of my extreme work schedule (Law enforcement) I would rather caution on the side of error and have it a bit high than have him crash and me not being here. I will slowly work my way up now. I am trying to follow the advice the best i can but my work schedule gets in the way. I would love to test more and narrow it down to an exact science. During the day he does have snacks. I think im more worried now that i have him on basically a no carb diet 6 may be way to much. (By the way no one told me to start with 6. I started with 2 and his numbers remained in the 5's so thats why i jumped so high. Live and learn but I will get the hang of this.)
Jim
 
I know. I did the same with Minnie at first. I was like, let me up her 1 unit to see if I get her bg 100 points lower. I did that until I had a hypo and it scared the hell out of me. That’s when I realized there’s a method to dosing since insulin is a hormone and too much of it can kill. I understand about your schedule, btw any chance your wife would be willing to learn how to test him?

I think the best plan is to stick with the 3 units for 7 days. That’s what the SLGS dictates. The only exception is if he falls under 90 again, then he earns a reduction @Bron and Sheba (GA) will confirm if it should be 1/4 or 1/2 unit. If not, we stick with the dose for 7 days then ideally you’d do a curve and we’d see if he might need an increase. I think this is a good time also to transition him to the low carb dry food you bought since you already reduced the dose considerably.
 
Sounds great. I will keep him at 3 units and the wife is going to try and do his BG tonight to learn how. Problem is now that he seems to be getting better the kitty don't wanna sit still, but we will see how it goes tonight. Again, thanks everyone for the help, me and O.P.F. appreciate it.
Jim
 
It’s hard to tell at the moment if that 424 @+10 on 7/12, is from bouncing (from the greens yesterday) or from dropping the dose to 3 units.
Are you saying that you increased the dose yourself, not the vet.? So did you started at 2 units, then how did you get to 6U ? I’m just wanting to know the background.
The only issue with dropping to 3 units is, if it is not enough insulin, Kitty could develop ketones in the urine. So I would be happier if you would buy a bottle of Ketostix from the pharmacy and test the urine every couple of days for ketones. If untreated, ketones can rapidly develop into diabetic ketoacidosis (DKA) and we don’t want that. So testing for ketones is a form of insurance.
How is Kitty’s appetite?
Get your wife to give Kitty a small snack while she tests the BGs to distract Kitty.
 
@Bron and Sheba (GA) if you go to his first thread I posted to his second post you’ll read that he started novolin on his own and has been upping from 2 to 3 to 6 I believe. He got novolin because you don’t need a prescription and wasn’t sure what he was doing that’s why he’s here now. Vet wanted him to euthanize his cat.

here:
“Hello all and thank you for the quick response and I will try and give you as much information as possible so I can receive the best help. As for insulin I give him Novolin N over the counter as the vet refused to prescribe him any insulin and gave me anti-inflammatory drops to help with the neuropathy. I did do a full blood test which covered everything from the vet and he said everything looks excellent except he is diabetic and has neuropathy. (Lets go back to the beginning) When I first went to the vet his BG was 518 and he told me to change O.P.F.'s diet and he sold me some extremely expensive food I'm sure they get a kickback on for promoting it. I controlled his feeding and went back in 2 weeks and the vet tested him again and this time everything was good except his BG which was 578. This was when the vet recommended I put him in their hospital or consider euthanization as the neuropathy would not get better. I told the vet I would consider my options and left and that was when I began my research. It was then I put him on Blood sugar gold but I did not have a BG test kit yet and was waiting for it to come as I had to order it. Once the test kit came (Pet Pro) I tested him and it was 438. The next day I tested him again and it was 534 so I figured the blood sugar gold was not working so it was then I went and bought Novolin N from Walmart. I am also feeding him Fancy feast 0 carbs and I do B12 in the morning and Zoboline at night. For the insulin I started with 2 units and his numbers did nothing. there was zero change. I moved it to 3 units and slight improvements. To make a long story short I found that 6 units seems to be the magical number. Here are some of his numbers on 6 units as I don't want to take up to much time. 322, 356, 224, 224, 158, (I only test him once a day in the evening time.) Today I did a blood glucose curve and these were the times and numbers on 6 units of Novolin N (5:15 - 376) (7:30 - 218) (9:30 - 126) (11:30 - 158) (1:30 - 291) (5:30 - 370). After doing some research online I'm not sure but this matched the graph of a fast metabolism cat. I'm hoping for advice if those numbers look good. Should I increase, decrease, stay the same, pray to god. (One note: He did have a small meal about 1:00 as he was screaming he was starving to death).
Jim”
 
Thanks for that Ale.
Jim I have just read through your introductory post. It is always a good idea to link your previous thread to the current thread so we get continuity and don't miss anything.
I can see your vet was pretty hopeless to say the least, but it isn't a good idea to try and medicate with insulin yourself, when you don't know very much about it. BUt i can see you were in a hard place and wanted to save OPF. I'm very glad you found us here.
If I were you, I would find another vet who knows a bit more about feline diabetes and ask them to swap OPF's insulin to lantus or prozinc. Lantus and Prozinc are much better insulins for cats. Novolin N is not suitable for cats at all.
In the meantime I would stay with 3 U, test as much as you can and test for ketones.
Once the BGs are more under control, the neuropathy should resolve over time.
We can help you with dosing of the lantus.
Keep posting and asking questions
 
I agree with Bron. I’m not sure what state you’re in, but if you can find a different vet, maybe a cat only vet near you? They should be able to prescribe Lantus or prozinc. In the meantime, post here before adjusting the dose again, with the goal of staying at 3 units for at least 7 days so we can see how he does with it. Only exception is if he drops below 90 because then he earns a reduction
 
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