? Update 7/15: 84 BG reading, 24 hrs no insulin, hypo yesterday .. whats going on?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Sarah & Wubby, Jul 14, 2018.

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  1. Sarah & Wubby

    Sarah & Wubby New Member

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    Mar 11, 2018
    Hi everyone,

    My cat Wubby has been on insulin since March 15th. Originally, I brought him into the vet multiple times at different times of day to get somewhat of a glucose curve (the vet thought this was less stressful and more accurate than keeping him one full day), and he was prescribed to get 4 units of Vetsulin every 12 hours. These past few days, I noticed him acting a little strange -- he had a slight tremor, but I wasn't sure if I was just seeing things, but I would feed him high carb food and watch him afterward and he would always seem ok shortly after. Today, about 40 minutes after his morning shot at 11 AM, he definitely had a slight shake and meowed in a kind of agitated way when I picked him up (he never does this). I knew this wasn't normal so I fed him his high carb food and called my vet. She advised me to keep offering him the high card food until he seemed normal again, which he did around 40 minutes later.

    I asked my vet if I should be home testing and she told me it was not necessary. However, seeing my baby like that today convinced me that I absolutely have to. I can't stand the stress of not knowing if my baby is in danger. I purchased the ReliOn confirm monitor, lancets, and strips as well as the Neosporin, cotton rounds, and extra treats. The test went easily and my kitty didn't mind (thank goodness). The reading I got today at 8 pm (so +9 hours from his AM shot) was 84. I've been searching all over the forum to try and figure out how to interpret this result and in my panic, I can't seem to find anything. Is this normal??? Should he still get his insulin at 11 pm (in three hours from now?)

    I intend to get started with a spreadsheet and everything now that we will be home testing. Here is his relevant info:

    Wubby, male, Maine Coon, age 14, 13.8lbs
    Food: Friskies flaked tuna or pate, one 1/2 can every 12 hours.
    Insulin: Vetsulin, 4 units, every 12 hours after eating

    Please let me know any additional info you need and what you think I should be doing. I'm feeling so nervous and worried for my kitty right now

    Also sorry I posted this thread originally in the Vestulin section
     
  2. Sarah & Wubby

    Sarah & Wubby New Member

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    Mar 11, 2018
    Sorry just to clarify his reading was 84 mg/dL!
     
  3. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    84 is a safe number, but if it was the only test you got, he may have dropped a lot lower.

    4U of Vetsulin is a HUGE dose....how much was he started on and how quickly was he increased? (and by how much? A whole unit at a time?)
     
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  4. Idjit's mom

    Idjit's mom Well-Known Member

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    Sara, I know you are worried but it's going to be ok. You already caught a low blood sugar event and dealt with it, you are aware that home testing is going to keep Wubby safe.
    I am not qualified to offer dosing advice, but I did go to the Vetsulin Forum and looked through the Beginners Guide (yellow sticky at the top of the page). This information might help. Especially since you do not have much testing data to go on. I have read: Better a day too high than an hour too low.

    Q. It’s time for my cat’s shot, but the BG is a little too low. What now?
    • If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
    • Stalling is waiting - without feeding your cat - for 20+minutes, then retesting to see if the BG has risen to a suitable level.
    • If using a pet meter, such as Alphatrak2, you may want to raise number above 200 mg/dL. (If in doubt seek advice from your vet.)
    • You are looking for a number that is rising, not falling, and is high enough to give insulin.
    • Note: As you gain experience with home testing, and have gathered data to show how your cat responds to insulin, you might consider it safe to reduce the ‘no shoot’ threshold, and to give insulin at lower pre-shot numbers.
    • If you have time, you can repeat the stalling process to see if the cat’s BG reaches a number you can shoot. If in doubt, skip the shot. However if your cat has history of ketones or DKA, or other health issues, or you are concerned, DO post on the Main Health forum for further advice.
    • Ask for help on the forum before giving insulin if you are unsure, as you can never ‘un-shoot’ insulin.

    Q. How low should my cat’s BG drop on Caninsulin/Vetsulin?
    Usually it's best that newcomers aim for a nadir no lower than 90 - 100 mg/dL [5 - 5.6 mmol] at the peak action of the cycle (as measured on a human glucose meter). This insulin can drop the BG quite sharply. Trying not to let the BG drop below this level gives an initial buffer of safety while the caregiver is learning the ropes.
    If you are using a pet meter you may want to keep the nadir higher than is suggested for human meters. (If in doubt seek advice from your vet.)

    Go into the Vetsulin Forum and read that beginners guide, you have some time before preshot and you should do a preshot test anyway.
    Hopefully someone more knowledgeable in this insulin will see your post and help. You can change the title of your thread, to get more attention. Be specific, give the BG (blood glucose measurement) and ask should I shoot? or something like that. You can edit the title to include a question mark in a blue box at the beginning of your title to get more eyes.
     
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  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    From now on, you'll want to make sure he has no food for the 2 hours before "shot times" …..then you will Test, Feed, wait 20 minutes and Shoot.

    Vetsulin isn't a great insulin for most cats....it tends to hit hard and fast, so that's why it's important that you feed first and wait a few minutes before shooting so that there's food on board when it hits the bloodstream.

    You'll want to test again about 3-5 hours after the shot....Vetsulin usually nadirs earlier than the better insulins so that's usually a good time frame to start with to see what's going on with Wubby's blood glucose.

    He will probably be high enough by then to shoot....since Vetsulin tends to hit early, it also tends to wear off quickly so he'll probably be high by PMPS time BUT, I don't think I'd shoot 4U again. For him to have dropped that low, that late in the cycle, it worries me that he may have dropped a lot lower and the 84 was actually "on the way up".

    If he's over 200, I'd suggest dropping back to maybe 2U and starting over now that you're going to be testing. It's better that he run a little too high than risking him dropping too low due to too much insulin.

    I'm just going to warn you now that shooting at 11, you may have trouble finding people online that late at night to help give advice. If there's any way your schedule can handle it, you might want to consider shooting earlier (both AM and PM) so you have a much better chance of having help when you need it.
     
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  6. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    By the way......I'm a sucker for a Maine Coon!! They are such great cats!! LOVE the name too!!

    Here's my fuzz monster (not a sugarcat)
    Cheaser.jpg
     
  7. Sarah & Wubby

    Sarah & Wubby New Member

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    Mar 11, 2018
    Thanks for your help. Yes He was started on 2 Units, then after 2 weeks went up to 3. When we went back to our vet 4 weeks after that (so 6 weeks after starting on 2) he was bumped up to 4 and has been ever since.
     
  8. Sarah & Wubby

    Sarah & Wubby New Member

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    Thanks so much for your reply!! I saw the under 200 mg/dL not to shoot in the guide, but I wasn't sure where the cut off is for too low of a BG that indicates hypoglycemia. Definitely will read the beginners guide again now that I am a little more calm! Thank you!
     
  9. Sarah & Wubby

    Sarah & Wubby New Member

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    Thank you so so much! Yes I am planning to slowly move him to 8 am/8 pm for shooting. Thank you so much for your dosing advice! I will definitely test again closer to the shot and either not shoot if he is still under 200, or take your advice and do two units.

    We have an appointment with out vet on Monday - I am going to show her my bg results and the curve I plan to take tomorrow. Do you have any tips on which insulin I might switch to and how to approach a vet about switching?

    Thanks again soso much for your reply.
     
  10. Sarah & Wubby

    Sarah & Wubby New Member

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    Mar 11, 2018
    Also as an update - did another test now +10.5 hrs after his morning shot. 85 mg/dL, so only up 1 mg/dL from 1.5 hours ago. Just to confirm, this is a healthy level correct? As in I do not need to be doing anything to actively raise his BG right now?

    Thank you so much everyone for your help and kind words.

    Sarah
     
  11. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Hiya Sarah! My buddy Lou was started on Vetsulin after he was diagnosed and he did beautifully. It can be a great insulin, but it's not necessarily great for every cat. In the end, he did well on it in the beginning, but we've since switched him to Basaglar, which is a depot, long-acting insulin similar to Lantus.

    His numbers are truly beautiful right now! No need to intervene. The range on human meters is 50 - 120, so he is right within normal range. Since you are just starting out testing, I would definitely not shoot anything under 200 until you have more data. If Wubby is under 200, I would just skip tonight.

    The great thing about Vetsulin is you don't need to ease into things (usually). I used to shoot Lou 2-3 hours late when I would work a double and go back to his normal time the next morning. Obviously I knew how he reacted and at that time he peaked much later than most cats on Vetsulin. So if you wanted to switch things over, you may not need to wait.

    Was Wubby previous on a high carb diet? If so, switching him to all low carb may be helping decrease his numbers.
     
    Last edited: Jul 14, 2018
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  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Right....that's a perfectly normal number!!

    Lantus, Levemir and ProZinc are generally better insulin's for cats....they're gentler and last longer. (Basaglar is the new bio-similar for Lantus and is dosed in the same way.....it's a little cheaper too)

    It looks like you may need to just skip tonight or give a MUCH smaller dose!
     
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  13. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Hi Sarah and Wubby,
    I was just about to say what Chris has just said......I agree with her. She has given you great advice in her posts.
     
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  14. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    That's increasing too much, too quickly. We suggest doing dose changes in .25 unit increments, never whole units.

    Going up slowly makes sure you don't bypass what could be a "perfect" dose. Insulin is a very potent hormone and going up as quickly as your vet has is crazy (but we hear that a LOT here too!)

    Too much insulin can look like not enough! Too much will drive the blood glucose down too low and the liver will release stored sugars and hormones to bring them back up quickly in a last ditch attempt to save itself.....if you're not testing there's no way to know what's truly going on.
     
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  15. Sarah & Wubby

    Sarah & Wubby New Member

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    Thanks so much for sharing! It so helpful to hear how things have worked out for others. Yes Wubby was previously on a high carb dry food for his whole life :/ He took the switch to wet low carb fairly well and we made the change a couple days before he started insulin (and changed my 17 yr old non diabetic baby to wet as well - so thankful for all of the cat health knowledge on this forum!!)

    His level right now is 87 mg/dL so it looks like he will not be getting this dose tonight! Im so thankful for everyones advice - my vey advised me earlier to shoot as usual tonight even though I told them I wasnt sure that was a good idea. Im so thankful that this community advocates for testing and has been so immediately helpful in guiding me <3
     
  16. Sarah & Wubby

    Sarah & Wubby New Member

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    Thank you so much for all of your detailed advice!! He will not be getting his shot tonight as he is reading in at 87 right now. So thankful I didnt just listen to my vet and give him his dose as usual <3 Your assistance has been invaluable!
     
  17. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    And well done you for going out and getting the meter and testing Wubby's blood glucose!:)
     
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  18. Sarah & Wubby

    Sarah & Wubby New Member

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    Thank you so much for being supportive through this hard time. Helps so much to know someone is following <3
     
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  19. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You probably saved your own cat's life tonight by testing!

    Good job!!!
     
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  20. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    It is tough in the beginning and there is a steep learning curve ....which we have all been through and understand.
    We find many vets do not know a lot about feline diabetes and increase in one unit doses which is too much and most don't recommmend or seem to like home testing which is madness when it is far safer for the cat to test. By the time many cats are showing signs and symptoms of hypoglycaemia they are very low and in danger.
    I was lucky, I had a vet who was very supportive of home testing and he was open to learning more about FD.

    Chris gives great advice and will be able to help you get sorted.
     
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  21. Sarah & Wubby

    Sarah & Wubby New Member

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    Thank you so much Chris, your advice definitely saved my baby's life!! You are amazing!!
     
  22. Sarah & Wubby

    Sarah & Wubby New Member

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    I just did his AMPS (no food 2 hours prior) ... He is at 84. Based on this number I will not shoot at all this morning, is that correct? Is this normal after a hypo incident? After testing I fed him. I plan to do a curve today - does that mean test every 2 hours? The ear pricks have been getting progressively harder, he meows and struggles and sometimes it takes multiple attempts before I can get blood :( I can't imagine doing this every two hours today, but of course will do so if its important for his health. I just feel bad for the little guy.

    Any ideas what may be going on here?? I am positive I am doing the testing correctly, and I did twice in a row and got 84 both times this morning. He is acting normal but I want to make sure I'm doing everything I should be. We have a vet appointment tomorrow but have an emergency vet close by if you think he should go in for a dr's test today?
     
  23. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    You are correct, do not give insulin this morning. This is great news actually! It's possible the change to low carb food may have put him into remission. You do not need to do a curve today since he does not have any insulin in his system. You can spot check if you'd like. If he goes 14 days in normal numbers (50-120), testing at least once a day am and pm, you can consider him diet-controlled.

    My buddy Lou got irritated with pokes in the beginning too, and I figured they were sore because I had to double/triple poke at times as well. I started using Neosporin ointment with pain relief on his ears and it seemed to help immensely. Just a bit on the tips and he handled the pokes better.
     
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  24. JeanW

    JeanW Member

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    Jul 24, 2017
    Just want to add that you've gotten great advice here.

    BG numbers that go too low can be fatal. Home testing is totally very very important!!! But I took my diabetic cat to 4 different vets (!!!) before one of them suggested testing at home (I hadn't yet found this board and knew so much less about it).

    I also love love love Maine Coon cats.
     
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  25. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    I may have missed it but better posted twice than not at all - 'Normal' range for a human meter is 50-120. Anything below 50 (when on insulin) means 'action' to bring up numbers. Sometimes that's just feeding their regular low carb food, other times (steep quick dive) it means give drop of Karo syrup to bring it up above 50.
     
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  26. Sarah & Wubby

    Sarah & Wubby New Member

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    I am so thankful for the informative and supportive community here! We will see what my vet has to say tomorrow - hopefully she is willing to work with me home testing otherwise we will have to go elsewhere. And hopefully they don't give another diabetic kitty momma advice to shoot as usual without testing in the future.
     
  27. Ville

    Ville Member

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    Jul 15, 2018
    Good thing you are home testing! One of the first things our vet told us when Sulo was diagnosed with diabetes was to get a meter for home testing, an advice I'm glad I followed even though it took a while as I had a lot of new information to digest. We were shocked yesterday to find our cat's blood glucose levels so high (against non-expert common sense) and I called the veterinary clinic's emergency and, again, the first thing they told me was to keep testing.
     
  28. Anne Biddle

    Anne Biddle Member

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    Apr 10, 2018
    Truffles did well on vetsulin too. Started with a BG of over 500. Went up gradually to 2.5u has now been off insulin 9 days! I’m really hoping he’s in remission. Hang on in there.
     
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