BG 3.5. At what point do I give honey?

Hi everyone,
It's 3.5 hours post insulin and my boy's blood sugar has dropped to 3.5.
His Nadal point is usually about 4 hours post injection.
I'm feeling a bit worried and not sure what to do?
Please could someone talk me through this?
Would hugely appreciate help.
Amy

 

Hi Amy,
Given that you are using Alphatrak I'd suggest you give a few drops of honey now (you can put it in a tiny amount of low carb food if you wish).

 

Honey and other simple sugars work fast. You could see an initial effect in as little as 12 - 15 minutes.
It also wears off fairly fast though so you might need to repeat the action.
I'd suggest you try to raise Murphys's blood glucose above 4.5 and try not to let it drop lower than that (to give some margin of safety.)

If Murphy is close to his blood glucose nadir (lowest point) then giving honey once may be sufficient. But don't assume that his +4 will be the nadir: Nadirs can move....

 

Thank you Eliz,
I've given him honey and some higher carb food for longer effect. But he seems really spaced.. He's sitting up but has a very 'out of it' look
Vet just said bring him in for a glucose drip.. Murphy would HATE me if I did that. Determined to manage this at home.
He reaches his lowest point about +4.. so about now.
I'll test in 5 minutes and will report back.
Thank you thank you.

 

5.3

 

5.3 - Phew!

I was just going to say that being 'out of it' could be a symptom of hypoglycemia and was about to suggest that you put a little honey directly onto his gums.... It's good that he's come up now.

 

He may well continue to rise now, Amy.
But DO continue to check his BG to ensure that is the case. A general 'rule of thumb' is to see 3 rising numbers in succession and be past the peak of the cycle.

Well done, you!

 

Oh, and it looks like a dose reduction is needed.

 

I popped it onto his gums rather than food.. I'll take his bg in another 20 minutes and see where we're at.
Do you think this might mean that 1u is too much for him?
Given his diabetes was triggered by depot steroid, I'm wondering if it's coming out of his system?

 

Thank you so much for your help

 

7.1
So pleased it's heading in the right direction.
I'm going to pick my boys up from preschool in a minute, but I'll check again when we're back.
My vet has suggested dropping to 0.5u tonight. Do you think that sounds about right?
Thanks.

 

Also, there's no line on my current syringes to indicate the 0.5 mark.. do you know if it's possible to get syringes that show this amount? It feels like a bit of an approximation otherwise..

 

Yes, it is possible.
Have to dash out to hospital appt but will be back later. (Meanwhile, someone else may give you syringe info; otherwise I'll do that later.)

Again, well done, Amy.

 

11.3 at 1pm.
Hoping he doesn't go in to a bouncing frenzy now, but it's quite likely, isn't it?

 

Amy,

Walmart offers a syringe with .5 unit markings here. You have to ask. I had bad luck with another pharmacy. Basically, you need the syringes with the smallest volume.

Hope that helps!

 

Thank you Lisa
My partner works in the local city, so I've just emailed him to see if he could pop into Boots or an equivalent pharmacy in order to pick some up. Do you know if we would we need a script from the vet though?

 

Is it likely to make him feel really poorly do you think? He's sleeping lots and still looking quite out of it. Poor boy, not a great few days.

 

I think the low level bg combined with the sugar rush and rebound can make them feel a little off.

Please check with someone here (Elizabeth is great) with regards the syringes as there are U40 and U100 syringes and you don't want to start using the wrong one. I think

Here is a link to some online caninsulin 0.5 ml syringes

http://www.vetuk.co.uk/veterinary-s...ninsulin-insulin-syringes-u40-box-of-30-p-295

 

Thank you Yes he's clearly still feeling off and has spiked. He was 18.9 at +11 and then 25.6 pre-injection.
I've still only given him 0.5 however and I hope his bouncing settles asap.
Thank you for the link - it's the u40 that I use, but the ones I've been given don't have a mark for the 0.5 level - was a bit nervous measuring it out this evening.

 

Hi Amy,

If you can't get hold of U40 syringes with half-unit markings (I've just emailed VetUK to see if they supply them (they used to, but maybe not any more....)); then you could consider using U100 syringes with a conversion chart.
These, for example: http://www.vetuk.co.uk/veterinary-s...rofine-0-3ml-insulin-syringes-u100-demi-p-296

Not everyone is comfortable using different syringes and a conversion chart, but if are you OK with it then it can make measuring small doses of U40 insulin a heck of a lot easier, and more accurate. Quite a few folks here have used U40 insulin in U100 syringes.

U40 insulin has 40 units per ml. U100 insulin has 100 units per ml.
That means that one unit of Caninsulin would be drawn to the 2.5 unit mark in a U100 syringe. If you wanted to measure .4 of a unit then that would be drawn to the 1 unit mark in U100 syringe, etc. Here is the link to the conversion chart so you can see how it works:
http://www.felinediabetes.com/insulin-conversions.htm

If you like, I can send you some U100 syringes to try out. Just PM me your address if you would like them.

Try not to worry about Murphy's numbers bouncing up high. It will soon settle down again.

Eliz

 

Don't worry about the exact measurement. I think the key is to just reduce the dose and then try to keep it consistent. I used to use a metal ruler and just measure to the same mark each time.

I think that you can get the unbranded versions of the 0.5 ml from there and other places. I used to have some left over from when I used caninsulin and will try to see if I can find what I have done with them for you.

 

You can use a firm ruler with 32nd marks or millimeter marks, line it up with the syringe and use that as a guide to measure.

 

Thank you, everyone.
He's definitely off. Is increased drinking a sign of being hypo, or recovering from being hypo? He drank loads overnight.. and he only drank loads when he was hyper and went into DKA.
Thank you so much for the syringe testing offer - I'd definitely be happier knowing more exactly as it was tricky being sure with a ruler as the syringe doesn't lie flat to it.

 

He may have bounced. A bounce happens when the glucose drops rapidly and/or drops to an unfamiliar level. Compensatory hormones release stored glycogen (glucose) and boost the numbers up high for as long as 3 days.

 

Thank you BJM, that really helps. He's been around 20 at highest today. Hoping it settles asap for him.. it's making him groggy and his itchiness more irritating to him. Less glycogen release needed.

 

If anyone reads this, I'd be grateful for advice. Can a hypo episode lead to more water drinking?

 

If he's bouncing, the glucose is high. If the glucose is high, he will drink more water to try to flush it out via the kidneys. And he is moderately high.

You need to edit the spreadsheet link in your signature. It is a bit garbled.
Type: Murphy's Spreadsheet
Highlight that.
Click the chain link icon.
Enter this link in the box: https://docs.google.com/spreadsheets/d/1lqLckC55N1gS-LHJek1xFFNpvNS9qnGQGQM7iwaokws/pubhtml
Click Insert.
Click Save.

Also, for those using mmol/L ,enter the numbers on the World tab. A formula on the US mg/dL tab converts it.

Please take the numbers you entered on the US tab and copy them over to the World tab.

After you have done that and before entering any other data, on the US tab, copy a row below where you were working (click on the left of the row, use Ctrl-C, then paste it in the rows that originally had data in them, using Ctrl-V.

 

Amy how is he today? Has his blood glucose settled?

 

Hi there,
Thank you for asking.
He's ok.. BG was 11 last night, gave 0.4u. Was low through the night.. and at 16.1 this morning.
Unfortunately his ear mites drove him insane yesterday and he managed to get his e collar off. He's now got a very sore right ear and right eye. I called the vet as he's simply not happy and he said let's give up on topical treatment and unfortunately I've just given him a 5mg prednilane tablet. So over the next few days I'll try to clear the mites.
Ill have to keep a very close eye on his BG.