Trying to get used to this

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izombie616

izombie616

Member Since 2017
My Jinx was recently diagnosed and has been on Novolin-n since 10/7. He was getting 3 units every 12 hours. I have been feeding him 2 cans of fancy feast classic chicken at 8am and 8pm when I give the shot. We just saw the vet again today for a glucose check and it was 310 I believe. The vet insists I feed him the Purina DM food from the vets office. From what I've read on here I thought what I was feeding him was ok but I'm just so new to this. The vet has increased his insulin dose to 4 units every 12 hours. Jinx has been moody all week and even peed on the floor once. I'm just trying to do what's best for Jinx and I'm feeling really overwhelmed by it right now. We go back on Saturday again for another glucose check. Jinx did gain one pound since last Saturday, which the vet said he should so I thought we were on the right track but his sugars are still so high.
 
There's a lot to cover here
- You absolutely do not have to feed him one specific food.
- No food for 2 hours before you first test, then shoot insulin. Then you feed.
- Why is the vet checking his glucose? Did you get set up with a meter?
- Peeing outside the box could be a UTI (urinary tract infection) but if he's only done it the one time he might be annoyed at something.
- Basically you should be testing Jinx yourself and with experience you can adjust the dose yourself. Never ever give him insulin without testing first.
There's a lot more to cover but we need to know more. Any other medical conditions, what kind of insulin, what type of meter. What's your situation at home, anyone else helping you? It all matters. You'll get more help as more members log on. For now do not get overwhelmed, this is all completely do-able. And no question is too stupid, we're here to help you and Jinx.
 
Please consider learning to test Jinx's glucose at home (http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/). You will be able to get a better handle on her treatment that way.

Since vet stress can raise blood glucose (BG) levels, her BG may not be as high as 310, and she might be in the mid 200s, which is still diabetic but not awful high. Also, if you were home testing you could see if the Novolin-n is lasting a full 12 hours. There are a few long lasting insulins available. Human insulins include lantus (glargine) and levemir (detemir). There are also pet insulins ProZinc and PZI.

May people here feed Fancy Feast classics. It's fine for diabetics. A lot of cats do not even like the prescription food and won't eat it!
 
Hey there and welcome. :)

I know it's overwhelming but we can try to focus on the right here right now stuff and soon it will become easier.

Like Noah and me I'm trying to get some information first before remarking. Did your vet start kitty on 3U? That seems very high. Sometimes too much insulin can look like too little - see somagi effect (bouncing)
Put basically if kitty gets too much insulin (a hormone) his body will released stored glucose from the cells which raises the bg levels making it look like kitty isn't getting enough. Normal start is 0.50 or 1U and increase in .25u at a time at most every 3 cycles.

I always free fed and lifted food 2 hours before the shot so you don't have to be too fussy about 2 feeds a day, that is fairly old school thinking.

The prescription food is definitely too high carb which is ridiculous if you ask me, why they manufacture diabetic food like that beats me lol what are you currently feeding?
Often when the food is changed that can help reduce the bg by a lot!

I'd never shoot insulin into a human or animal without testing first. This is really important because you just don't know how they are going to react to it, or if they will drop too low or it's not an effective dose. The only safe way to do it is to learn how to test and teach kitty how to be tested. It's not the easiest thing in the world to do. But after a while it does give you a stronger bond. I swear I never thought I'd say that when I was learning but it's true! :smuggrin:
 
The vet told me I would not need to do home testing. I thought that was odd since I work in a hospital lab and we always check sugar levels before they give insulin. A friend brought me a meter today and I have to get strips for it but I'm hoping to be testing at home soon. Jinx was started on 3 units twice a day. Unfortunately my living situation is less than ideal. It's been a rough year. Cats are not allowed where I live, hopefully moving (again) soon where Jinx will be with me. He is currently staying with my grandmother and uncle, who would be more than willing to help with the injections if he were allowed to have needles in the home. Currently I go over twice a day to feed and give the insulin. It's not ideal, but hopefully not too much longer.
 
One of the most stressful things can be getting advice that directly contradicts what your vet told you. That's a long story for another day. Never doubt your abilities but always be sure of what you're doing.
 
izombie616 said:
The vet told me I would not need to do home testing. I thought that was odd since I work in a hospital lab and we always check sugar levels before they give insulin.
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That's not just odd, it's completely incorrect. You're already smart enough to do lab work so you know in your heart how wrong that is. Humans and cats are mammals, the protocols are the same. You haven't done anything wrong, you're getting bad advice.
 
3 units is way too high of a starting dose. The starting dose is 1 unit twice a day and is raised in 0.25-0.5 increments as needed. Sometimes too much insulin can look like not enough.

You absolutely don't need the dm food. Most of us feed fancy feast classic or Friskies pate.

I have a video in my signature showing how I test my cat CC. I would not raise to 4 units! That's more than most cats ever need. I definitely wouldn't give that without testing. If it were my cat I would do 1-2 units and start home testing. See what numbers you get without vet stress and decide on a dose based on several days worth of test results. Get a test before the shot (no food for at least two hours prior to the preshot test) and get a few mid cycle numbers to see how significant the drop is.
 
I was able to check his glucose level tonight before feeding and before injection. The meter just said high and the manual says that means over 600. Hearing what I have on here that 3 units is too high to start with, and reading about the somagyi effect, I don't know whether his sugars are high from that or if that's just what they are. Im not sure what to do right now or what dose I should be giving. If the vets suggestion of 4 units now is too much, do I start over at 1 unit q12 hour? I just want to do what's best for Jinx but I'm not sure what that is right now.
 
You could give the 3 units again and test every 2 or 3 hours to see how well it's working. If he has a big or fast drop, like from over 600 to below 300, in a few hours that could trigger a bounce too.
You could also try 2 units of you feel uneasy about the 3 units.
Whatever you choose it's best to get a test 2-4 hours after the shot if you can. I saw the info about his living arrangements. Could your grandparents test him?
 
The glucose checking Monday morning didn't go well at all. Couldn't get a drop of blood for anything. So much easier on humans. Last night after watching the videos again I was able to check his sugar and it was 236 at 8pm. I wasn't comfortable with the 4 units so I gave him 2 and this morning his sugar was 317 at 8am. Once I'm more comfortable with checking his sugar I will go over and check on my lunch break but until I'm confident I can do it and get back to work in time I can't risk being late. This weekend I should be able to get some readings at better times since Im off work to see what they are in between shots. My concern right now is if his sugars are what they were last night and today what dose to give. At those levels would the 4 units be dangerous? I've never given him the 4 units but I'm worried the vet will yell at me for not following his instructions. And if I'm giving say 2 units each shot do I give him the 2 no matter what his sugar is as long as it's high? I know glucose testing in humans, I know the nurses give insulin when the glucose is over 140. I don't know much about insulin dosing however. I deal with blood, not medicating that blood.
 
Just with those numbers it looks like 2 units is safe enough. I wouldn't give 4. On 3 units he was going over 600.
If your vet gets mad that you've checked his BG before giving insulin, I would explain your background and tell him you refuse to give insulin without checking first. You can show him the readings you got and how they have been working once you get some mid cycle tests. It's hard to argue with the proof but some vets will either way.
See what the others think about the 2 units. From my experience I think the 2 units is a good start but once you can get more tests that will show what's going on during the cycle.
 
izombie616 said:
Couldn't get a drop of blood for anything. So much easier on humans... I can't risk being late... My concern right now is if his sugars are what they were last night and today what dose to give. At those levels would the 4 units be dangerous? ...worried the vet will yell at me
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A few tips for you. I use BD lancets, they're tube shaped as opposed to some that are flat and I find them much easier to handle. The pic at the bottom is a "typical" ear. On a computer you can right click the image and save it for future reference. Sounds like you're on a tight timeline so telling you not to rush it won't help. One day soon you'll discover your own formula for success. It's like moving from the lab to field work but the lights are out. The dosing is the hardest part but a very general guideline is better too high for a day than too low for one minute. This is like saying better to pour gas than pour gas and light it but Jinx going HYPO when you're not there is the very last thing you want. Are you set up with a HYPO toolkit? We can talk about that later. Your vet should not be treating you like a child. It's easy to say move, get another job, do this and that. Actually doing it is not how life works, you're doing good so far. It's a steep learning curve that never ends but getting over the hump is a great feeling.
ear_001.JPG
 
izombie616 said:
I was able to check his sugar and it was 236 at 8pm.
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How long after the last shot?? Was this just before insulin?

Novolin is a fast acting insulin, I'd aim to try and get a test at around +4. That will start to give you some idea of how much the dose is dropping his BG by. This in turn will help you answer the question of 'Is it safe to give XY units?'
If you are able to at the weekend do you think you could run a curve at home??? Cheaper and more reliable than having it done at the vets.

A note on bouncing
TempestsMum said:
Sometimes too much insulin can look like too little - see somagi effect (bouncing)
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(when we talk about bouncing, this is not the same as somogyi effect, which has since been disproven in humans, and never even studied in cats),
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles) (this is taken from the Lantus sticky, not sure if length of bounce is the same with different insulins)
That said too much insulin can indeed look like not enough, in order to figure that out, it'll be necessary to run some curves and get some midcycle tests, teaching your grandmother or uncle how to get those tests will be an invaluable help to you. They wouldn't need to be keeping syringes in the house to do that, so perhaps theres a possibility of you doing the amps and pmps, and them helping you with those midcycle numbers.

Noah & me said:
No food for 2 hours before you first test, then shoot insulin. Then you feed.
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Actually we usually test/feed and then shoot.
This is even more important with a fast acting insulin like novolin, I would make sure kitty is tested, then watch him eat and feed, you really don't want to be injecting a fast acting insulin into a cat that won't eat.


Lastly, I would encourage you to set up a spread sheet for recording the test data, I found this an invaluable tool for me, and also it gave me a way of presenting data to my vet.
Most of us set the spread sheet up and share it with the community, by doing this you'll be able to get the best help possible for your kitty. We are not vets and our advice is data driven, many of us are very accustomed to reading these spread sheets and tailoring the advice accordingly. As you gatther more data it will become an essential tool if you want to receive good advice from experienced members on the board.



Here's a link on how to set one up, (click on the highlighted text below)
Spread Sheet Set up Instructions
 
If you have not set up a spreadsheet; I started with a notebook-pen-paper (better than absolutely nothing), my meter has a memory function that goes back to my first diabetic cat and in an emergency it fits in my pocket, there's a way to allow your vet on-line access to this site's spreadsheet (ask other members), I have an Excel spreadsheet which I would not recommend to anyone (too complicated).
The whole idea is to allow more experienced members to see things not immediately obvious to you or me but without any personal fluff, just numbers. Never doubt the value of data or the sincerity of the people that see it. Numbers are never personal.
 
When someone corrects or clarifies something I just said.
Sometimes I type too fast or I'm out of my depth giving medical information. If another member corrects something, as above with "Actually we usually test/feed and then shoot" I don't get my feelings hurt. I hope that came out right.
 
Noah & me said:
When someone corrects or clarifies something I just said.
Sometimes I type too fast or I'm out of my depth giving medical information. If another member corrects something, as above with "Actually we usually test/feed and then shoot" I don't get my feelings hurt. I hope that came out right.
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:bighug:
That's the ethos of the site, and the beauty of a peer reviewed site, we all make mistakes, even a typo can have bad consequences. I've been corrected myself more than once.
 
Testing at home can seem very daunting, I know, but it really will get easier, the more often you test. Your kitty's ears have to "learn" to bleed and once that happens getting blood becomes a no-brainer, lol. Just make sure to give loads of attention and TREATS, and before long kitty will come to you when it's time for testing! I use a favorite treat that Squallie only gets at test-time. He loves those treats so much, and he knows the only way he gets them is after an ear-poke. Even if the ear-poke is unsuccessful, still go ahead and give Jinx treats, so he learns to associate them with the poke. :):):)
 
Sorry it's been awhile. The testing is getting easier and I also got the reli-on micro meter which takes less blood so it's been better. Jinx's sugars however have not been great. I decided to listen to the vet after the last time I was on here, partly because I was supposed to take jinx in for a sugar check and I didn't want to be yelled at, and partly because I was frustrated and weak. I've done as the vet says and give him 4 units twice a day unless he's under 200 and I feel it's been a mistake. I've had two normal -ish readings total, and then everything from way too low (36) to too high (400+). Hasn't gone over 500 but it's been all over. I've been collecting numbers but have not been able to put them on here yet since I'm usually on my phone and I need to do that on a computer. I've done as the vet says, and it's not getting better. He was over 400 last night and this morning. 36 the night before. I'm not changing anything, he's eating the same food, I just figured I might see some improvement by now. He's moody and has had a few accidents. Where do I go from here?
 
We're not supposed to slag anyone's vet but is this guy really yelling at you? Even if that's an exaggeration and he's just raising his voice either he thinks you're just not getting it or he has another problem. Diabetes doesn't follow a formula from a text book, going from 400 to 36 tells me the dosing may be wrong. I've never used Novolin-n on either cat, maybe another member has a better idea. What kind of accidents, peeing outside the box or painful peeing?
 
No no I don't think he would actually yell but more like make me feel stupid/bad about not following his instructions. And his accidents are him pooping on the floor. He normally is really good about using the cat box but sometimes he will go in a random spot. Its usually runny when he does and I don't think he's doing it on purpose more that he just didn't make it in time.
 
I don't have much experience with Novolin-n but I do know is a fast acting insulin that is usually not recommended to use on cats, unless they want to lower his numbers really fast for some reason, but very much used on dogs, so it sounds like your vet is trying to treat your kitty like a dog.

36 is a dangerously low number specially on a newly diagnosed cat so please read the information on the links below on what is hypoglycemia ( very low sugar levels ), how to treat it and what you should always have at hand in case of an emergency is VERY IMPORTANT

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/
 
The next day after being 35 he was over 400 both times I checked. He was acting fine while 35, and i did check twice to confirm it was 35. I feel he acts worse when the sugars are high though. How would i go about switching insulin?
 
izombie616 said:
The next day after being 35 he was over 400 both times I checked. He was acting fine while 35, and i did check twice to confirm it was 35. I feel he acts worse when the sugars are high though. How would i go about switching insulin?
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A blood glucose of 35 is way too low for a kitty on insulin, and needs to be raised immediately, with gravy-style food, Karo or honey (short-acting), or both! Hypoglycemia can turn deadly, very fast. If you are using a human meter please know you need to take action to raise BG if kitty drops below 50. We have a saying here: Better too high for a day than too low for a moment!

It sounds very much to me like Jinx is on too high a dose, and is doing something we call "bouncing."

" ‘Bouncing’: When the BG drops too fast this may be sensed as ‘dangerous’ by the body whether the cat is actually in danger or not. (‘Too fast’ could mean faster than 100 mg/dL [5.5 mmol/L] per hour - although the ‘trigger’ number varies from cat to cat.) When this happens the body may seek to protect itself by releasing stored glucose, thereby raising the BG to a much higher level. We call this ‘bouncing’ - a common phenomenon - and bouncing can happen when the BG drops too fast and/or too low. As said above, it may be possible to slow down the rate that the BG is dropping by feeding a snack. It may also be that a dose reduction is appropriate."

Bouncing can make your kitty feel pretty crappy, and could potentially be the cause of his loose stools and LB accidents.

Without having a spreadsheet or any reference to base my opinion on, it is impossible for me to suggest with any degree of certainty that this is what's happening, but it would be my first guess. BEGINNER’S GUIDE TO NOVOLIN N & HUMULIN N (NPH) FOR DIABETIC CATS has lots of information on using Novolin N, just click on the blue print to go there. For the same reason, I also am unable to suggest a dose, although the usual starting dose is 1 unit and increasing, if needed, in small increments of 0.25.

You can talk with your vet about changing insulins if you are not happy with the results of the Novolin N. There are several to choose from, both fast-acting and depot types (which usually have a longer duration).
 
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izombie616 said:
The next day after being 35 he was over 400 both times I checked. He was acting fine while 35, and i did check twice to confirm it was 35. I feel he acts worse when the sugars are high though. How would i go about switching insulin?
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Thing is that the problem with 35 is not the next day , is the next minutes or hours after you got the 35 reading, he may go even lower and have a hypo episode, in those cases, we usually feed high carb food or syrup and test 15 minutes later to see if they are still going down or starting to go up, and a few times later till we are sure they are on a safe range (please read the hypo info on the links)

He probably bouced from the very low value to a very high one ( a common reaction) the next day

I'll leave the answer to the changing of insulins to people here that have experience in changing from one insulin to another, maybe you could start a new thread with that specific question
 
We do keep karo syrup in the house for him but he was about to eat dinner so I didn't give him the syrup. I should have rechecked his sugar though. Yesterday morning he was in the high 400s and last night he was 115. This morning he was 95. So I have not given him insulin since yesterday morning. I'm not changing anything so I'm so confused about why his sugars are all over the place :(
 
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