1 week in.... Gun-shy to give insulin after hypo episode.

Good morning all!
My cat Lou was diagnosed with diabetes last Thursday (6.8.17) after losing a lot of weight. He had absolutely no prior health issues that we were aware of and was on no other medication. We fed him a dry food diet. After the diagnosis, we started him on 2 i/u's of Vetsulin (instead of the recommended 4u) and switched him to a Px diet we received from the vet (RC Glycobalance). After research and finding carb information online, we switched him from the Glycobalance to Fancy Feast (FF) canned food (classic and flaked versions, all 5% carbs or less). I started home-testing his glucose levels on Sunday and overall, he has improved.

Unfortunately (for whatever reason that seems so stupid now), we (my fiance and I) had decided to up his insulin dose to 3 i/us when it seemed warranted. He seemed fine originally, but yesterday (6.16.17), he had a hypoglycemic episode. His only symptoms was insistent meowing (more urgent than usual). I am thankful I was home from work, so I tested him and found his BG at 51. We immediately fed him a can of FF and kept testing/giving syrup, food, and treats as needed to bring his BG up. Obviously I was and am really shaken and I feel like such an idiot. We decided to forgo the insulin dose last night because I had read that Lou may be more sensitive to insulin. I was terrified to give him any dose, even though his BG had gone up to his "normal" preshot amount (330 and 345).

We received a bag of YA Zero Mature in the mail yesterday and put that out for him to graze on. I tested him this morning at 0807, and his BG was 275. I was thinking of giving him 1 i/u of insulin, but I find myself horribly gun-shy, afraid of having a repeat of yesterday. I haven't had an opportunity yet to perform any curves on him to learn how he reacts during the day, so I'm only working on am/pm preshot values for now.

Should I give his body some time to finish bouncing from his hypo episode yesterday, or should I try giving him 1 i/u insulin BID (as I was doing, but with a lower dose) and monitor?

I appreciate any insight you can provide, and I will post this on the insulin forum as well.

Thanks!
Amanda

 

DEFNITELY lower to 1 unit. That is the manufacturers suggested starting dose anyway. It's rather appauling that your vet even suggested 4 units, as most cats never need more than three. The protecal is to start at 1, and if not enough raise it in small increments, no more than .5 units at a time. I honestly feel you dodged a bullet and 4 units could have killed your cat. No lie. 3 units was also a pretty scary low.

Great job testing already and getting that spreadsheet going! It's such a helpful tool!

My cat was also on vetsulin and grazes on YAZ. The food change alone can drop BG by hundreds of points. Any time a person is changing their cats diet from a high carb to low carb diet as you have we suggest significantly lowering the dose.

GO back to 1 unit twice a day. any time you can get a reading at about 5 hours post shot, please do. Vetsulin usually peeks between 4-6 hours post shot.

 

Thanks for your reply Janet! I think I just needed to hear that from someone else (I'm having a hard time trusting my judgement after yesterday). I'll start 1 i/u and try to test at 4-6 when I can!

 

s

Sounds like a plan. This is a pretty active website, with lots of very experienced, knowledgable people.... If you have any questions or are unsure of a dose or just need to talk/vent... there's almost always someone one to help. And for now, if your cat is at 200 or lower, skip the dose until you get more data to see what would be safe. It's always better to be high for a time then to be low for a day. While you're still on, have a look at our info on how to treat a hypo so you can make sure you are really prepared in case something happens.

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