911 hypo numbers help

Hello all,

My husband and I have a 12 year old cat who was diagnosed with diabetes in sep of 2017. It was a rough ride for a while until we landed on a 4.5 unit prozinc insulin regimen. We have been successful for a couple months now and even we’re celebrating good fructosomine test in the optimal range. Shortly after , about 5 days ago we received Phoenix’s lowest BGL we have seen. We continued his regimen. This morning he had a BGL of 94 (9am)which is very low for him and he was almost comotose, in which we dabbed honey in his mouth. Tonight (7pm) he has a BGL of 60. We did not give him his normal 4.5 units of pro zinc. We are worried on how to proceed with the dose that was working. We plan to titrations it down after an early vet call in the morning. Any input would be appreciated.

 

@Chris & China @Bron and Sheba
I have tagged others to help.
You know to use honey. Do you just any high carb canned food, if so, give him a tsp and test again in 20 minutes.

 

What BG meter are you using, pet or human?

 

Hi and welcome.
It sounds like you are home testing the blood sugars which is great. If you could set up a spreadsheet it would make it much easier to help you. Maybe @Idjit's mom could get the link for you as I am on my phone doing this.
Did you give insulin this morning? In the meantime I would not give any more insulin until you see the vet in the morning. 60 and 90 are too low to give Prozinc. I am not very familiar with Prozinc so I will tag @Rachel who might be able to help more.
I would also feed some higher carb food to get the blood sugar up higher. Is Phoenix behaving normally now?
4.5 units is a lot of insulin to give. How did you arrive at that dose.
Keep testing the blood sugars and post the results please.

 

I am also unable to provide a link, an on my Kindle, arghhh. @JanetNJ can you help?

 

Also tagging @Djamila and @Kris & Teasel. Hopefully one of them will be on line.
I think you will need to reduce the dose. Insulin needs change over time. We increase and decrease by 0.25 increments. But I would wait until you see the vet or until one of the ladies that give Prozinc can help you.
Main thing at the moment is to get him into safe numbers where he feels and acts normal.

 

Here's the Instructions on getting the FDMB spreadsheet

 

Hello! It definitely sounds like way too much insulin right now. To clarify, you did NOT give any insulin tonight, right?

If you can get the spreadsheet Chris linked above and maybe get it filled out at least for recent numbers, that will help us a lot. For now, if Phoenix is under 200 in the morning, I don't think I would give a shot. It's hard to give any good info on how to dose without some recent numbers. If you aren't sure about filling out the sheet, even if you could just list out some recent numbers that will help.

I'm on pretty early in the mornings usually...around 5 AM Central Time. I'll try to check in on you in the morning when I get up (what time do you shoot and what time zone?). If you post on this thread or in the Prozinc forum, I should see it since I've got a watch on both so I'll get a notification.

 

I agree with Rachel: do not give insulin if Phoenix is under 200. If you could clarify how many hours ago he got his last dose of insulin that would help, along with any other numbers (and times) you could share from the past few days.

 

AlphaTRAK

 

Acting somewhat normal, just sitting by fireplace. Bgl was 60 at 7:22p, now bgl 119 at 8:50p, only ate about 1/3 of his food - wet purina d/m, he has access to dry Purina (other cat’s food) did not give any insulin tonight. Last dose was this morning, it’s been the 4.5units twice daily, approximately 10-12 hours apart as best we can since May. We test as we notice him being “off” which is not often. Last “off” period was July when his appetite went right out the window.

 

I am glad you did not give insulin tonight. 60 on an Alphatrak meter is very low. 68 is the take action number and you need to be giving some high carb food (wet) or honey to bring the BSL up higher.
The problem with a fructosomine test is that it only gives you the average of the BSLs over the past few weeks. It doesn't tell you if the numbers have been dangerously low or very high at times. Home testing is a far superior way to manage cats diabetes and is far safer! No need to waste your money on the fructosomine test.
Do you test before EVERY insulin shot to check it is safe to give the insulin? And testing some time between +4 and +7 will tell you how low the insulin is taking Phoenix. We change the dose according to the Nadir ( the lowest number that the insulin takes the cat during a cycle) not the preshot number.

Rachel and Djamila who are both very experienced with the use of Prozinc have given you great advice.

Here is information about hypos. Print it off and put on your frig. When you need it, you will want it at hand, not having to look for it in the computer!
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

And here is the link to the Prozinc forum which Rachel mentioned.
http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

 

I definitely agree with everything you are saying. The dose has been incrementally increased in half units since his diagnosis (came on the back of chronic Cholangeohepatitis flare). We home tested more during his zombie cat days as his bgl was mid to high 500s, insulin was increased in half units till his fructosamine was in a satisfactory range according to vet which was very recently at 322. I will try to home test more instead of just his “off” time periods which are not often at all. Vet will be called first thing in the AM, the lack of appetite and diarrhea is concerning, none of my other cats seem to be ill, same for the dog.

 

Eastern, I start feeding all animals around 7A. Thank you all so much, I was thinking this was getting easier but the roller coaster continues!!!

 

Low numbers are far more dangerous than high numbers so please test every day to keep him safe.
He may be nauseated so ask for some cerenia and Ondansetron tablets. Also try a novel protein low carb food in case the diarrhoea is caused by an allergy. Plain boiled pumpkin with nothing else added is very good for diarrhoea. Give a teaspoon up to three times a day in the food.

 

No, I do not test before every shot, only if I or my husband notice something off - left over food, behavioral difference, change in alertness, etc. which is not often at all. I concur that I should be testing as often as feasible to plot the curve better and the outliers surely impacted the average as you already noted with respect to the fructosamine - nix that. Thank you for the links, I will be printing the hypo sheet for my refrigerator, reading the forum more, and making a copy of the spreadsheet for number entry. I am not up to speed on all of the acronyms used in this arena, but as soon as I can navigate around the forum a bit better (on laptop now), I'm sure there's a cheatsheet for that somewhere!

 

The MOST IMPORTANT THING you can do for Phoenix is to test before EVERY shot and at least ONCE during the cycle as I have mentioned. Cats do not usually show any signs they are low until they are very low. I caught Sheba once and she was 26 and showed no sign of a hypo in her manner except she suddenly was starving hungry. I’ve never moved so fast in my life to grab the honey!!
You have come to the right place. This is a very caring community who care about the wellbeing of everyone’s cats.

 

Here is the link to FAQ
http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/

 

Good morning! That's around the time I'm traveling to work, but I'll try to check in on you anyway (no worries, I don't hang out on the forum and drive. I check in at red lights and pull over if needed ). Bron has given you excellent information on testing and I agree totally...testing before every shot is so important!

Please do ask if you have any questions about anything. This forum can be a bit confusing at first but it becomes second nature in no time!

 

I too have tested my cat in the 30s with no sign of hypo. It's best to test before every shot, so you know it's safe to give.

 

Haven’t been able to get a large enough droplet to read on meter, have been trying for 40 minutes with my husband rotating in. We poked one of us to make sure it was still working, it is, but the warm ear, rubbing ears, not working to increase blood flow. He’s up, walking, alert, purring, all appears ok but we will try one more time together before I have to leave for work already late).

 

Just to clarify, I was going to try and work remote and today’s schedule doesn’t jive with that right now. Husband staying home instead so he will be on here trying to update and learn more!

 

If you can’t get a test then you can’t! It happens. I’d skip the shot if you can’t considering how low he’s been.

 

If the ear is warm and you still can't get blood, then he's likely dehydrated.

I agree with Rachel about skipping the shot. Given how low he's been, it's too risky.

Add in a couple of tablespoons of water to his wet food this morning to help his hydration level, and absolutely no dry food. That is a big factor in hydration for cats. When he's at a healthier hydration level, the blood tests are much much easier.

 

Husband took him to vet, he picks him up at 1pm, he’s been given fluids and a GI med based on some short texts I received from my other half. No insulin today, he licked a little of his food this AM but that’s it. More to come after full vet insight.

 

I hope he feels better soon!

 

Hope he's feeling better! Looking forward to your update.

 

Suspected gastroenteritis, slightly elevated liver enzymes, not eating, diarrhea. Was given fluids, anti nausea and antacid meds at vet. Have liquid metronidazole and propectalin paste to give to help with intestinal inflammation, discomfort and diarrhea. Bgl was 211 this morning and he did not eat so I did not give insulin. Been giving the other meds, also filled a script for mirtzapine to stimulate appetite but did not give, will see what vets says now.