When should insulin be increased?

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Scarlette & Fluffy

Scarlette & Fluffy

Member Since 2022
Today May 5th 2022 7:55 a.m. is the very first successful BG result that I was able to get from Fluffy.
I did a test several times throughout the day and the results are recorded as follows:
R= RELY-ON. AT= ALPHATRAX
His injections occur at 7:30, the vet instructed to do BG 30 mins after eating
Before eating @ 7:55am 586
1:30 - 535. R
5:30 - HI. R
7:00 - HI. R; AT- 710, ATE
POKEY @ 7:30
9:30 - 544 R
I contacted the vet today to let them know what his BG results were and requested a call back from the vet to the front desk explaining that his numbers were over 500. She took the information but I never did get a call back. Fluffy's last visit at the vet on April 28th, the vet indicated that if he was still urinating a lot and drinking a lot that in 10 days which would be Mother's Day May 8th I should automatically increase his NOVOLIN-N to 5U. How many days is it typical that Fluffy's numbers should be this high? Should hIs insulin be increased now? He is currently getting 4U every 12 hours. Should I continue testing his BG every 2 hours and then right before he eats? And how many days should I test in this manner?
 
Hi Scarlette, well done getting your first test in!
Could you please choose either the ReliOn or the alphatrak meter to test the BGs. It is very hard to help you if we are seeing both meters being used. The ReliOn meter is a good meter, I would choose that one.
Can you tell me how many units you are giving at the moment? The spreadsheet says you are using -0.5 and you say in the thread he is getting 4 units. 4 units is a very high dose of Novolin N for a newly diagnosed cat.
What dose did you start on?
As you only have one days data for us to see, I would not agree with increasing the dose yet. It is possible Fluffy is dropping low and then bouncing back up high so we need to see more data.
As far as when to test goes….I would always test before the dose, then test 2 hours later (+2) and +4 and +6 if you can. That will give us good data. Make sure you also do this with the pm cycles as well.

Are you testing first, then feeding then waiting 1 hour before giving the shot? Because Novolin N is such a harsh fast acting insulin you need to make sure you have food aboard and digested before the short is given
Are you testing for ketones every day? I would with the BGs so high at the moment. To do this you will need a bottle of Ketostix from Walmart or a pharmacy and test the urine as per the instructions on the bottle.

What food are you mostly feeding? Are you also giving snacks during the cycles? Don’t feed for the 2 hours before you test for the pre shot BG as we don’t want the Bg to be food influenced.
Novolon N is a totally unsuitable insulin for cats. It is a harsh fast acting insulin. You would be much better getting Fluffy changed over to a more gentle longer lasting insulin such as Lantus or Prozinc. Please ask your vet about doing it. Do you think your vet knows much about feline diabetes?
 
Bron and Sheba (GA) said:
Hi Scarlette, well done getting your first test in!
Could you please choose either the ReliOn or the alphatrak meter to test the BGs. It is very hard to help you if we are seeing both meters being used. The ReliOn meter is a good meter, I would choose that one.
Can you tell me how many units you are giving at the moment? The spreadsheet says you are using -0.5 and you say in the thread he is getting 4 units. 4 units is a very high dose of Novolin N for a newly diagnosed cat.
What dose did you start on?
As you only have one days data for us to see, I would not agree with increasing the dose yet. It is possible Fluffy is dropping low and then bouncing back up high so we need to see more data.
As far as when to test goes….I would always test before the dose, then test 2 hours later (+2) and +4 and +6 if you can. That will give us good data. Make sure you also do this with the pm cycles as well.

Are you testing first, then feeding then waiting 1 hour before giving the shot? Because Novolin N is such a harsh fast acting insulin you need to make sure you have food aboard and digested before the short is given
Are you testing for ketones every day? I would with the BGs so high at the moment. To do this you will need a bottle of Ketostix from Walmart or a pharmacy and test the urine as per the instructions on the bottle.

What food are you mostly feeding? Are you also giving snacks during the cycles? Don’t feed for the 2 hours before you test for the pre shot BG as we don’t want the Bg to be food influenced.
Novolon N is a totally unsuitable insulin for cats. It is a harsh fast acting insulin. You would be much better getting Fluffy changed over to a more gentle longer lasting insulin such as Lantus or Prozinc. Please ask your vet about doing it. Do you think your vet knows much about feline diabetes?
Click to expand...
I will be using ReliOn meter. Fluffy was diagnosed with diabetes on March 18th 2022 with instructions to Dose him at two units every 12 hours. I switched to a different vet and on Apr. 5th the new vet did a fructosamine and increased his dost to 3U. Apr. 28th another trip to vet, dose was increased to 4U with further instructions to increase his dose to 5U on Mother's Day May 8th if he was still urinating a lot and drinking a lot and he is
I did purchase the rely on Ketone test strips and did a test on Wednesday which came out negative skip Thursday and on Friday May 6th will retest for ketones.
Fluffy is primarily getting Fancy Feast seafood and chicken flavors or Friskies Seafood variety, both pate. I have seven cats so I do have a community Bowl for feeding. However, I always put fluffy in the bathroom to feed wet food first as a primary and then per the vet instruction of dosing him 30 minutes after he eats is what I have so far followed. I only put enough food in the community dish to last three or four hours and then I do not replenish the community dish until 7 p.m. and again only putting enough food for consuming in up to 4hrs. This way the dish will have several hours of being empty before the next feeding. I tested him before both feedings and try to follow every two hours after that.

I'm very concerned about all these holes I've poked in his ears, they are starting to look pretty rough, sore.

On Thursday I did call the vet requesting a call back to inform them Fluffy's blood glucose levels are over 500 and to request his insulin be switched to either Lantus or Levemir. As of yet the vet has not returned my call.

The vet is a new vet and I really do not know their level of knowledge about feline diabetes. Other than having access to the community Bowl fluffy has not gotten treats. Although, I did purchase some licky sticks for a reward after he gets his poke in his ears.
 
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Scarlette & Fluffy said:
I'm very concerned about all these holes I've poked in his ears, they are starting to look pretty rough, sore.
Click to expand...
Do you hold a tissue to a cotton round over the prick for a minute after testing? That will stop a lot of the bruising.
Also try rotating the tests around the edge of both ears….not just in the same areas.


Scarlette & Fluffy said:
did purchase the rely on Ketone test strips and did a test on Wednesday which came out negative skip Thursday and on Friday May 6th will retest for ketones.
Click to expand...
Excellent!

Scarlette & Fluffy said:
will be using ReliOn meter. Fluffy was diagnosed with diabetes on March 18th 2022 with instructions to Dose him at two units every 12 hours. I switched to a different vet and on Apr. 5th the new vet did a fructosamine and increased his dost to 3U. Apr. 28th another trip to vet, dose was increased to 4U with further instructions to increase his dose to 5U on Mother's Day May 8th if he was still urinating a lot and drinking a lot and he is
Click to expand...
Increases should be taken in 1/4 unit increments, not 1 unit increments. I unit increments is too much at one time.

Scarlette & Fluffy said:
and then per the vet instruction of dosing him 30 minutes after he eats is what I have so far followed
Click to expand...
Please please feed Fluffy 1 hour (60 minutes) before the dose is due.
Here is the link to BEGINNERS GUIDE TO NOVOLIN N


Scarlette & Fluffy said:
On Thursday I did call the vet requesting a call back to inform them Fluffy's blood glucose levels are over 500 and to request his insulin be switched to either Lantus or Levemir. As of yet the vet has not returned my call.
Click to expand...

It is very possible that Fluffy is dropping low and then bouncing back up high. Please don’t increase the dose until you have some more data which shows what is going on. You will need at least three more days data.
Please push to get the insulin changed to lantus or levemir.
Continue to test for ketones.
 
Bron and Sheba (GA) said:
Do you hold a tissue to a cotton round over the prick for a minute after testing? That will stop a lot of the bruising.
Also try rotating the tests around the edge of both ears….not just in the same areas.



Excellent!


Increases should be taken in 1/4 unit increments, not 1 unit increments. I unit increments is too much at one time.


Please please feed Fluffy 1 hour (60 minutes) before the dose is due.
Here is the link to BEGINNERS GUIDE TO NOVOLIN N




It is very possible that Fluffy is dropping low and then bouncing back up high. Please don’t increase the dose until you have some more data which shows what is going on. You will need at least three more days data.
Please push to get the insulin changed to lantus or levemir.
Continue to test for ketones.
Click to expand...
Okay I will wait 1 hour after he eats to give his injection. Someone suggested that I reduce his insulin to 2 units because he may be bouncing, stating the four units is way too much! Is that something that I should try?
 
Scarlette & Fluffy said:
Okay I will wait 1 hour after he eats to give his injection. Someone suggested that I reduce his insulin to 2 units because he may be bouncing, stating the four units is way too much! Is that something that I should try?
Click to expand...
4 units is a lot of insulin but as you only have 1 days data I can’t really comment about reducing the dose. But I agree he could be bouncing but we won’t know until we see more data.
If you did you would have to make sure you tested daily for ketones.
 
Congratulations on getting that first test! I would definitely not increase any insulin until I gathered more data on what's really going on with Fluffy's BG, as Bron has recommended. I agree about the insulin (Novolin not being good for cats) and am glad that you are asking for a different insulin. Keep on them! They may just not be familiar with using Lantus or Levemir. I'm surprised they didn't mention ProZinc to you instead of Novolin.
 
And the community bowl has dry food in it, right? And what kind of dry is it? It's probably very high carb (because all dry food is high carb except a very few like Dr. Elsey's Clean Protein, which is also quite expensive) so the dry food is also not helping Fluffy's numbers.
 
Scarlette & Fluffy said:
I'm very concerned about all these holes I've poked in his ears, they are starting to look pretty rough, sore.
Click to expand...
A lot of members put pure coconut oil on their ears

I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears, just make sure its pure coconut oi
 
Suzanne & Darcy said:
And the community bowl has dry food in it, right? And what kind of dry is it? It's probably very high carb (because all dry food is high carb except a very few like Dr. Elsey's Clean Protein, which is also quite expensive) so the dry food is also not helping Fluffy's numbers.
Click to expand...
Purina Naturals. Bare in mind that fluffy is one of 7 cats that I have and I cannot lock fluffy away from the others. It is not feasible for me financially to switch everybody over to wet food which is honestly what I would prefer to do but what you want to do and what you are able to do are many times two different things. And doing the best with what I've got is to put one and a half to two cups of food in the community dish which typically is eaten by noon. Fluffy is locked away in the bathroom and given wet food while the other ones are being fed dry food. When fluffy comes out of the bathroom he at times does nibble on the dry food but I don't think that he eats that much of it but again he does have access to it until it's all gone. Then at 7 at night and we repeat.
 
Scarlette & Fluffy said:
Purina Naturals. Bare in mind that fluffy is one of 7 cats that I have and I cannot lock fluffy away from the others. It is not feasible for me financially to switch everybody over to wet food which is honestly what I would prefer to do but what you want to do and what you are able to do are many times two different things. And doing the best with what I've got is to put one and a half to two cups of food in the community dish which typically is eaten by noon. Fluffy is locked away in the bathroom and given wet food while the other ones are being fed dry food. When fluffy comes out of the bathroom he at times does nibble on the dry food but I don't think that he eats that much of it but again he does have access to it until it's all gone. Then at 7 at night and we repeat.
Click to expand...
Hi I just wanted you to be aware that the Purina Cat Chow Naturals is very high in carbs
You need to be withholding food 2 hours prior to testing Fluffy because you don't want his BG number to be food influenced .I know you said you have 7 cats and leave the dry out for them in the community bowl to eat during the day and then repeat this starting this at 7 PM and even though Fluffy does eat Friskies and Fancy Feast pates in a separate room but will still nibble on the dry when let out. This could definitely be contributing to his high numbers




​
Guaranteed Analysis
Nutritional information as published by the cat food manufacturer.*

Protein: (min)
34.0%
Fat: (min)
13.0%
Fiber: (max)
3.0%
Carbs: (est)
32.0%
Ash: (est)
6.0%
Moisture: (max)
12.0%
Dry Matter Analysis
The manufacturer's published guaranteed analysis values normalized for moisture content.

Protein: (min)
39%
Fat: (min)
15%
Fiber: (max)
3%
Carbs: (est)
36%
Ash: (est)
7%
Calories: (est)
342/100g

Here is the link I found this on
https://catfooddb.com/product/purina cat chow/Naturals Original
 
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