Too Large of a Dose?

[Margaret]

My Sammy is on 3 units of Humulin every 12 hours and we are still working to get better control. For a while we were getting BG numbers in the 100s when the insulin was at it's peak, and now we aren't getting below 300. He is also now about 15 and a half pounds, whereas he was almost 20 when diagnosed. Could it be that the insulin dose needs to be reduced?

It seems I read somewhere that overshooting the ideal dose could result in higher BG rather than lower -- an overreactive response from the pancreas or liver or something...or does that apply to the other types of "depot" insulins, and not NHP?

Margaret

 

[Dyana]

It would be helpful if you could set up a spreadsheet and attach it to your signature, so people can more easily help you with your question. Are you testing at night too? Usually cats tend to go lower at night time.

 

[BJM]

Any time the cat experiences a very rapid drop or a drop to a significantly number than previously maintaining, the cat may bounce. Some cats bounce a lot; some do not.

Just a note - this forum is not well frequented, so if there is ever an urgent need for response, please post in Feline Health. For safety, print out the directions for handling a hypo near (the top of Feline Health) and stock up an emergency kit of Karo syrup, a couple of cans of high carb gravied food, and an oral syringe.
The general hypo protocol is roughly this:
Test
Get low or diving number (below 50 mg/dL on a human meter)
Feed 1-2 teaspoons of gravy
Wait 20 minutes
Repeat until numbers climbing 3 times in a row and safely past nadir

 

[Margaret]

Maybe I wasn't clear about what is happening. Hypo or anything close has not been a problem, and rapid drop has never been a problem.

The opposite is true -- the insulin takes too long to take an effect, has too little of an effect (and less than it had been having), and doesn't last nearly long enough. I am seeking an answer about this apparent reduction in the effect of the NPH.

Is it possible that the dose of NPH is too large now that he's lost some weight, and that reducing it would give a better effect? Or is he getting accustomed to the insulin and needs the dose increased? I'm having a consult with the vet tomorrow and I'm expecting she may suggest an increase in dose. However, if "overshooting the optimal dose" can cause an opposite reaction, then I wonder if we should be trying a decrease in dose, instead.

If I had more hours in a day or a personal assistant I would try to figure out the spreadsheet -- as it is, I'm pedaling as hard and as fast as I can and still feeling overwhelmed and I don't have time to figure the spreadsheet or Google docs out. I keep a simple Excel table on paper for the BG numbers. I test a lot, including at night.

I'm certain he is not going hypo, so this is not "bouncing" -- he's just not getting into low enough numbers with the current dose. I've done curves and mini-curves, and as I said in my original post, we'd been getting peak insulin BG readings between 100 and 200, and now are not getting below 300 at peak, even after changing to a new bottle, and I'm looking for a reason why.

Does that "overshooting of the optimal dose" ever occur with NPH? Any NPH users have experience with that specifically?

Thanks for any information you can give!

 

[BJM]

Just checking here: How old is the insulin? How has it been stored?

There are conditions which cause insulin resistance which leads to ever increasing doses. And it sometimes does happen that one insulin becomes ineffective over time. You might check into BCP PZI or ProZinc if the vet wants to try a switch.

 

[Margaret]

The insulin has been stored in the refrigerator, and the same is happening with a brand new bottle, just purchased and opened a few days ago.

We may be looking at changing to PZI.

Margaret

 

[bandak]

Margaret,

I'm sort of in the same boat as you and have been freaked out by some of the information given here and on a facebook support page. My approximately 11 yo cat was diagnosed a week and a half ago with bg of 599. We started at 2 units of Humulin 2x/day and retested him Monday afternoon. Numbers went past 600 and didn't register. Vet wanted to go up to 4 units 2x/day. People on the support page freaked me out so I told the vet I would stay at 2 units. Well, we retested yesterday and he was down to 546. So, now I'm doing it the vet's way. Started 4 units last night and I'll go back to retest Friday afternoon. My poor Ziggy is so freaked out by all of the trips to the vet and the injections (even though he gets a few treats before and after) that he runs away from me now any time I get near him or look at him. We're both stressed to the max. In addition I'm caring for my 89 yo mother who has dementia. A "sugar cat" is the last thing I needed!

I hope you get the answers you need and the numbers your kitty needs. This whole thing is overwhelming and there's such a thing as too much information. :shock:

 

[Elizabeth and Bertie]

...This whole thing is overwhelming and there's such a thing as too much information. :shock:

Hello and welcome, Bandak.

I think most of us here were overwhelmed at first.
There's the initial shock of the diagnosis, and then a lot to take in when it comes to learning to take care of a diabetic kitty. But the situation can improve pretty fast for both kitty and care-giver.
Feline diabetes is treatable. And with care a diabetic kitty can live as long and as happily as a non-diabetic kitty.
Yes, it can seem like a steep learning curve intially. But you don't have to do everything all at once.
Take it at your own pace. Baby steps are OK. And remember to breathe...

Ask any questions you want to. There's usually someone here 24/7. And you will soon find yourself part of an extremely friendly and helpful community.

Eliz

 

[bandak]

Thanks for the reply. Sorry I didn't see it sooner. I was too busy researching topics and learning to test my kitty. Thanks to one very patient and understanding member of this and the facebook page who took me under her wing, I'm getting more and more tests in and feeling better about the situation.

I think the overwhelming part was people telling me what I "should" do and one person actually getting annoyed enough at me for "ignoring her advice" that she unfriended me. That turned me off the group for a while until Ruth came into my life and became my lifeline.

People can handle things at different speeds. I need to understand the situation before I can start functioning and being productive. Ruth let me take my baby steps and assured me that every time I got one thing under my belt the next would come easier. She was right.

I've gotten alot of great information here through my researching various topics so I'm not putting down this message board or the facebook group. Not at all! I never would have learned about Fancy Feast pates, freeze dried chicken/turkey treats, how to test my cat and I never would have met my new guardian angel Ruth.

It's all good. Just keep in mind some people take a little longer to get with the program than others. Not because they don't want to or are afraid but merely because of how they process things.