Skipping Insulin Doses

[Bacio]

My kitty (Bacio) was diagnosed 3 weeks ago. His BG was 499. I'm certain I caught his condition early as he was drinking/urinating too much for only a week or so.

Vet started him on Novolin N (I am aware that this is one of the harsher insulins). We started at 2U, tried 3U (we quickly learned this was too much) and went back to 2U.

He was on Hill's Prescription W/D for about 2 weeks. I switched him to Fancy Feast Classics based on recommendations here. He has been eating that for about a week now.

The past few days, 1U or no dose at all has been keeping his numbers pretty normal.

Yesterday, he had no insulin at all and was 80-115 all day. This morning he was 167 so I gave him 1U (based on previous testing #s) he dropped to 48 this afternoon and I gave him some high-carb treats.

Questions:
- What is the lowest preshot BG test # I should still shoot at? This morning for example @ 167, I'm sure he would have gone up after eating without the insulin, but 1U took him pretty low (48).

- Is skipping doses bad? Am I putting him at risk in some way by being irregular with insulin usage? Someone told me yesterday their cat takes a does of insulin every few days and that is normal for them. I had never heard that before.

- Could these low doses/skipped doses be a sign of remission?

 

[Larry and Kitties]

Yes, likely a sign of remission. I would not try to skip doses yet. I would give a smaller than one unit if about 150 at shot time. I would try 1/4 unit if between 200-150 and 1/2 unit if higher.

 

[Chris & China (GA)]

I'm NO expert with Novolin, but I do know that it's dosing is based on how high the Pre-shot is...and most insulins need to be given every 12 hours to get the best results

On days where his pre-shot is lower, you could give a lower dose than 1U....like .5 or .25

 

[Bacio]

Yes, likely a sign of remission. I would not try to skip doses yet. I would give a smaller than one unit if about 150 at shot time. I would try 1/4 unit if between 200-150 and 1/2 unit if higher.

I'm NO expert with Novolin, but I do know that it's dosing is based on how high the Pre-shot is...and most insulins need to be given every 12 hours to get the best results

On days where his pre-shot is lower, you could give a lower dose than 1U....like .5 or .25

Thank you both for the responses! I will try the .5U and see how he does.

I'm not sure how the .25U would be possible to measure correctly on the 3/10 cc syringes...SO tiny!

 

[BJM]

We have a Humulin/Novolin Guideline

 

[Squalliesmom]

I use Vetsulin, which has a similar action to Novolin, and my kitty has been on it a little under 4 months. If you take a look at his spreadsheet you will see that in the past week or so he has had one day where he got no insulin at all, and several days where he only got one small dose. You will also see that he has had several days of very low numbers, where I have had to steer him with food or give Karo syrup. My understanding of this is that his pancreas is trying to supply insulin again; that's why sometimes he gets such a low dose. I don't seem to be able to eyeball a dose any lower than 0.5 so if it looks like he needs less than that I just don't give him any. The days he has started in the 300s are days where he has had a bounce from too much insulin the previous day.

Having said all this, I am in no way endorsing or suggesting this as a treatment plan for your kitty! I figured, though, that it would be a good example of a kitty in a similar circumstance to yours, and maybe put your mind at a little ease for not shooting when Bacio's numbers are too low. The best plan of action would be to contact your vet first thing tomorrow morning and see how he/she wants you to handle it!

 

[Robin&BB]

I'm not sure how the .25U would be possible to measure correctly on the 3/10 cc syringes...SO tiny!

If you get U100 syringes that are marked on the half-unit, this makes it a bit easier to deal with the tinier doses. That's what I'm using now ... And yes, @Larry and Kitties and @Chris & China are spot-on about lowering that dose! Looking at Bacio's spreadsheet, WOW! He's responding so well!

You did a great job today, steering him with a little food when you saw that drop to 48. So even with a reduced dose, if you're planning to shoot when there's a preshot # in the 160s, I'd recommend you still monitor in that +4 to +6 area. (Always best not to assume anything, even with a tiny dose.)
P.S. Welcome to "Dinky-Dose Land!"

 

[Bacio]

I use Vetsulin, which has a similar action to Novolin, and my kitty has been on it a little under 4 months. If you take a look at his spreadsheet you will see that in the past week or so he has had one day where he got no insulin at all, and several days where he only got one small dose. You will also see that he has had several days of very low numbers, where I have had to steer him with food or give Karo syrup. My understanding of this is that his pancreas is trying to supply insulin again; that's why sometimes he gets such a low dose. I don't seem to be able to eyeball a dose any lower than 0.5 so if it looks like he needs less than that I just don't give him any. The days he has started in the 300s are days where he has had a bounce from too much insulin the previous day.

Having said all this, I am in no way endorsing or suggesting this as a treatment plan for your kitty! I figured, though, that it would be a good example of a kitty in a similar circumstance to yours, and maybe put your mind at a little ease for not shooting when Bacio's numbers are too low. The best plan of action would be to contact your vet first thing tomorrow morning and see how he/she wants you to handle it!

Thank you for your reply! Yes, every kitty is unique!

 

[Bacio]

If you get U100 syringes that are marked on the half-unit, this makes it a bit easier to deal with the tinier doses. That's what I'm using now ... And yes, @Larry and Kitties and @Chris & China are spot-on about lowering that dose! Looking at Bacio's spreadsheet, WOW! He's responding so well!

You did a great job today, steering him with a little food when you saw that drop to 48. So even with a reduced dose, if you're planning to shoot when there's a preshot # in the 160s, I'd recommend you still monitor in that +4 to +6 area. (Always best not to assume anything, even with a tiny dose.)
P.S. Welcome to "Dinky-Dose Land!"

Thank you, Robin. I have to say...I have grown to trust the advice of the FDMB community over my vet. To date the suggestions provided here have given me the best results. My vet had suggested a high fiber diet and didn't have anything to say about the "carb effect." The collective experience here is so rich, I'm so thankful to have found it. FD is overwhelming, but community makes it much more manageable.

Thank you for your encouragement. I think the more Q&As and case studies posted to these boards the better for kitty's everywhere!

 

[Cat Ma]

You're doing a terrific job and are learning a lot in a short amount of time! I received far better help here than from my vet when CJ was on Novolin.
Remission is achieved when your cat is OTJ ("off the juice"/off insulin) after two weeks.

 

[Bacio]

You're doing a terrific job and are learning a lot in a short amount of time! I received far better help here than from my vet when CJ was on Novolin.
Remission is achieved when your cat is OTJ ("off the juice"/off insulin) after two weeks.

Thank you Cat Ma! I feel lucky kitty has decided to respond quickly to insulin therapy. He has had one, 1U shot in the last three days and has maintained nice numbers.

I find myself wondering often how people who work full time outside of their home are able to manage a FD diagnosis. Thank god I recently started working from home. Otherwise I just don't know what I would have done!

 

[Robin&BB]

I find myself wondering often how people who work full time outside of their home are able to manage a FD diagnosis. Thank god I recently started working from home. Otherwise I just don't know what I would have done!

I feel the same way you do: Thank goodness I've always been able to work from home. I have a lot of empathy for the people who work on the outside re: the challenges they face in treating their sugar-kitties - and a heck of a lot of real admiration for their ability to manage doing it!

 

[Cat Ma]

Thank you Cat Ma! I feel lucky kitty has decided to respond quickly to insulin therapy. He has had one, 1U shot in the last three days and has maintained nice numbers.

CJ responded quickly to Novolin, too, and went into remission in less than 3 weeks. A change to a low carb diet, as you are doing, helps too. Not every cat responds so well to Novolin but it is reassuring to see how well Bacio is responding.