911

Acro cat ..i gave him the wrong insulin.
I gave him 13u novolin r.
He normally gets 13u levemir and .5 to 1u novolin r to bring numbers down. .
He was at 400 at 745 and tested again at 810 and he was at 404.

 

Cherie, above your post you will see a 'thread options' click it and you will see edit. Then click 'change prefix' and you will see 911 more people will look at it if you do this. hang on in there

 

Tagging some folks now...hang on .....

 

Brill thanks hun x

 

@Kris & Teasel @JanetNJ

 

@Critter Mom

 

Just posted on your other thread. Get another test 30 min after the injection and you'll need to test him every 30-60 minutes depending on what's going on. Have honey/karo ready and possibly a trip to the ER if he plummets. Does he also have IAA or just Acro?

You're SS is not updated so can't see any data.

 

Cherie, if it's any comfort he may not drop as far and as quickly because of the acro so stay positive.

 

Correct but it the drop could have a delayed reaction especially if there is IAA at play. Let your meter guide you and just be prepared for anything.

 

God bless you, Karen

 

He is just an acro boy ..IAA neg.
I have both honey and karo and already called the nearest emergency..
I will test him again soon and update.
Thank you

 

I only see data from Sept. 2015

 

Ok, please let us know. It's happened before so you're not the first one.

 

Sorry i havent been active in a long time. I am here if you have any queations.

 

Uggggggggggggg.

 

No questions, it's automatic for me to look at an SS before answering any posts. Just focus on the current situation and let us know how he's doing.

 

How far are you from the ER? Even with Acro I'd be nervous with 13u of R on board. Hopefully the super reduced Levemir dose will counter act it.

 

I didnt give him any levemir today. I gave him the novolin then realized what i had done and stopped . Should i give him lev?

 

I wouldn't. Just think of it as a Lev skipped shot. Let me tag @Wendy&Neko but it's a bit early for her yet.

 

Also, i am about 30 min from the ER

 

Did you get another test in yet? How long has it been since you gave the R?

 

Ok just tested. Original test and shot was at 745am. He was at 400.
Tested again at 810.. 404
Now 910am he is only at 394.
I gave him whatever he wanted to eat so maybe that is keeping his numbers up.

 

Do you know what his typical R, onset, nadir and duration is?

 

Not yet.. we were currently working on all of that as he was only officially diagnosed with acro last week. We thought he was because he has been insulin resistant since day 1 but the official badge was just awarded.

 

Spreadsheet attached

 

Ok. You should join and be active in the L&LL group. There are quite a few Acro kitties and some pretty new. My Doodles is IAA only.

 

Im not very fimiliar with IAA mostly because im still clueless on the acro. I have a lot of reading to do..

 

Ok, please join the group and set up the SS that can be linked. Did you just switch to Levemir from Lantus on 1/6?

 

Don't worry about IAA, just mentioned it as it's another reason for high dose kitties.

Really recommend becoming active in the L&LL group, doing an introduction after today is over. @Wendy&Neko and @julie & punkin (ga) are very experienced Acro mom's.

 

Where are you and Gato located? I'd grab another test soon to be safe.

 

What is the L & LL groups.?

 

We are in the states. Michigan

 

It's the Lantus & Levemir Group in this forum. Here is the link. http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/ We have several active Acro members and the group in general is very active.

 

Suki had an acrocat, Crystal, who was on 23u of R along with 60u of Lev at her highest point. So it is not unheard of for an insulin resistant kitty to accept such a high dose of R. Of course though it was a gradual buildup to that 23u.

 

Just tested gato .
+2 his numbers are still high. 331
Although i hate when they are high..im happy they havent plummeted.

 

I think thats the only thing thats keeping me from going crazy...knowing acro cats are usually on crazy high doses of all kinds of insulin.

 

The nadir with Novolin is about 4 to 12 hours so you are only beginning to see the drop in BG. Novolin is an intermediate action insulin so it lasts longer than "R". If he were my cat, I'd take him to the ER to get him on a glucose drip and monitored because trying to use karo and feeding to keep his numbers up could go on for hours and it will get more difficult to stay in front of the numbers as he reaches nadir. He's already dropped 70 points at +2 and you are only beginning to see the effect.

 

Linda she gave Novolin R by mistake so it is the fast acting type

"I gave him 13u novolin r.
He normally gets 13u levemir and .5 to 1u novolin r to bring numbers down. ."


ETA diagnosed as an acro kitty

 

Thanks Mary Ann. Just noticed that. 13u of R is still going to be hard to chase if he starts dropping fast. Some kitties don't drop significantly until about +4 so I'd personally still be hesitant to try to deal with this at home.

 

+3. 260
Starting to drop fast now. Will test again in 30 min

 

You might want to feed him something if you haven't recently. I'd give some MC or LC with a drop of honey.

 

http://www.felinediabetes.com/FDMB/threads/using-novolin-r-with-lantus-dosing-question.147454/

This is from an older post @Marje and Gracie posted:

"We always start at a lower dose of R and see how they do. R doesn't affect every cycle the same so you can't get complacent and think if it only drops her 50 in a cycle, it will always do that. It doesn't. I also sometimes see a very active cycle the cycle after I shoot the R. ECID. And also ECID is when the R onsets and nadirs. It's "typically" active for four hours with the most movement seen at +2 and +3 but again ECID."

And one that @Wendy&Neko posted on the same thread:

Her R onset and nadir are later that Gracie and Tess's. ECID. Starting a small dose is the way to go. Lots of experiments are needed to figure out what dose works. I found the advice of an experienced R member invaluable at the beginning.

Definitely some MC food and continued testing are needed. Hopefully Marje or Wendy will be on soon as they have both used R insulins

 

What are his numbers normally at +3,+4,+5,+6...?

 

She posted the PDF above in this thread. There are not many mid cycle tests. ETA: it's in post 26

 

If he drops again much at the next test I might pack up and head to the ER. Although he's acro there is not a lot of data and even with no levemir shot today his depot is full. 13 u of R is a lot and could turn ugly

 

What is Mc or Lc??

 

+3.5 218

 

LC = low carb and MC is medium carb

 

I agree with Karen. That is a huge dose of R insulin that should be monitored at an ER where they can react quickly if the numbers start to plummet. Since you don't know how the R insulin works with your kitty it is better to be safe than sorry.

 

LC is low carb food (under 10% carbs). MC is medium carb roughly 11-20%. HC is high carb (higher than 20%). He's dropped another 40 points in 30 minutes. I have to agree, it would be best to take him to the ER so he can be monitored and given glucose as needed. The problem with trying to deal with this at home is that you can't fill him up with food because you don't want him to get full and refuse to eat when he really needs to. Karo or honey will only bring the numbers up temporarily and is short lived. 13 times the regular dose is a huge difference and there is no telling whether his reaction time is going to be the same as it usually is with 1u.

 

I would feel more comfortable with you at the ER as well. Just saw Linda's post above and yes, getting enough HC food in him when he continues to drop could be problematic if he gets full and stops eating.

 

The other thing to consider is the large Levemir depot he has. Can you also tell us if you're using a human meter or an Alfa Trak meter?

 

I am using a human meter.
ReliOn micro.
I called the nearest hospital which isnt too far. I will be testing him in 15 min and i will go from there.

 

Ok, just concerned and it's also the Levemir depot too. Glad there is somewhere closer than 30 min if needed. Keep us posted

 

I'm here watching too... Do you have any temptations treats? When my cat went too low I gave her three and her numbers rose 100 points. They seem to last a long time in their system.

 

heard those pill pockets work well too

 

What is a levemir depot? Im sorry i dont know all these things. I havent been on this message board in a long time

 

I dont keep any off diet treats around but i will buy some.

 

Temptations are what got my cat into this mess... She was an adict and we were enablers. Lol

 

The depot is what is in reserve in kitties system. When we shoot levemir or Lantus not all of what we shoot is used all at once, some of it goes into the depot. No apologies needed and glad are asking questions. When all this is behind you, start posting on the L and L forum as there are Acro Cat experts over there and can really help you.

 

Levemir and Lantus are depot insulins, that means some of it is used during the day and some of it is saved in the kittie's system. It can take 3 days to fill a depot to a new dose adjustment. It's hard to explain right now, please read the yellow Stickies in the Lantus forum when this crisis is over.

If you have a moment, it would be good if you could keep your spreadsheet updated.

If you go to the ER, take your meter and Karo or syrup with you on the drive. You may need to pull over and test and give syrup.

For the future, I was always told to keep the R insulin in one place of the refrigerator (I kept it in the door as it was said to not be as fragile as Lantus) and the Levemir in a completely other place in the refrigerator. I always took out one of the insulins and filled that syringe, placed it on the counter, and then put that insulin back, and took out the other insulin and filled that syringe and put that insulin back. It may be a good idea to get into the habit of filling the Levermir syringe first always, and then putting it back and filling the R syringe second.

I agree that often R would affect my kitties next cycle or the next day's cycle. So tomorrow, you will need to be extra careful for the next couple of cycles.

 

+4 208
After having 1 drop of honey and 1/4 can of tuna with water.
Emergency is something i am VERY willing to do but financially something i cant do so i am going to watch him close and go if and when needed. I love my baby more then i could ever describe and i will do whatever it takes to keep him healthy.

 

Once when I was shooting Lantus and Novolin R, I mixed up the syringes too. After that I made two pi

Good tip Dyana.

 

I myself, based on BGs in SS and ones on the 13R posted here, just wait and see what happens.
218@+3.5 is not that low at all and R should peak at about +4.
My Aero Murfee was on 30 units Levemir together with 20 units N.
With 13 units Levemir your SS does not show gong below 200

 

I will for sure. I have been getting help from a group, mostly from one of the moderators on FB but i havent been able to get ahold of her today.

 

Tuna is low carb. I would not fill up his belly with low carb. Do you have any food with gravy in it?

 

Ohhh i will be making a huge change after this. What i did was put the R in the lev box and vice versa.. i always check the bottle before i draw and i didnt for some reason this morning. So stupid.

 

Hang on in there, it's still not life threateningly low and I know some people are worried about Gato refusing food but this is something that is really unlikely to happen in an acro cat (I so wish it would sometimes)

 

To expand on Dyana's tip above to keep the two insulins in different areas of the refrigerator, what I did was the Lantus I kept on the Left side and the Novolin R I kept of the Right side of the refrigerator. I once got the two mixed up too before I started doing that.

 

Lol.. gato has never said no to food and neither have i.. food is my addiction.

 

That makes total sense. Lol
I was going to wrap the R bottle in black electric tape. But i may do both

 

And that can happen so easily, if you're extra sleepy, or distracted. Please regard the R as something that could be dangerous and take all kinds of extra precautions when using it. For instance, I would have tested a lot more, when first starting to use it, but that's hindsight for you.

 

I do have 1 can b ut its grain free. Would that still be ok?

 

The gravy is what has the carbs in it. Let's wait until the next test before opening your only can.

What you do is try to just get the gravy out and feed him mostly the gravy, then he won't be filled up with the food part, should he need to eat later. Can you ask someone, a housemate, family, friends, or neighbor to go get some more high carb food with gravy? Or maybe a neighbor has some on hand.

 

I just dont know how we survived without the internet. So many animals were put down because of lack of help and knowledge. So thankful.
I have 2 pens and 1 vile of lantus insulin that i am no longer using. Do any of you know how i can go about finding someone near me in need of them?
I get them free and would love to help

 

That would be really nice of you to help someone in need. We have a Supply Closet forum, where you can post what you have to give, and you can also donate them to DCIN (Diabetic Cats In Need).

 

I measaged the group. DCIN
thank you

 

Can you read the label? Just want to make sure that there is a carb used to make the gravy and that it is not just a watery food. If you list the percentages, some here (not me) could calculate the carb level of the food.

 

Time for a test.

 

+4.5 188
Since the R is fast acting and it peaks at 4 hours should we be a bit safer now or am i dreaming?
I will continue to test however..

 

When I have had potential low-BG problems like when MurrFee vomited soon after eating and after shooting I syringed mixture of canned food and Kero.
Same when I gave Lightning (usually 1 1/2 units Lantus) Twiggie's 8 units of N by mistake

 

I'm glad he's not dropping as fast as before. I would get another 30 minute test.

 

Oh my goodness.. its so scary. I am trying to stay calm but i am a freak when it comes to the health of my babies...fur and human.. i havent taken my eyes off of him and i think he wants me to leave him the heck alone. Lol

 

I will for sure.

 

Although others above had said what their acro cats have gotten ECID and there is not a lot of data for Gato. I'm glad to see you haven't become complacent and are doing good. With the Lev depot he could continue to trend down for hours.

 

I'm glad to see he has slowed a bit and, hopefully, the R will be waning but it can have a longer duration than four hours so you will have to stay on the testing. In addition, with a 13u levemir depot, you shouldn't discount it even if he hasn't seen numbers below 200, that we know of, and even though you shot no Levemir today.

It takes a lot of testing to know for certain how low a cat has gone on a dose so I, personally, wouldn't assume that there actually haven't been in lower numbers than 200. For that reason, I hope you have a lot of strips and can plan to do some extra testing today.

The way R works, in theory, is it drops the BG down so the Levemir has a lower starting point to work from because levemir is not known for yanking high numbers down. The goal for R is that it drop the BG only 100 mg/dL max over four hours. Experienced R users understand how to use the two insulins so that, gradually, the preshots come down and the levemir can work on its own.

I understand you don't want your baby in high numbers but we are very careful here to teach members how to use levemir, R, and both together. We have some very experienced acro moms here who are among the best at dealing with acro. We would be happy to help you once you are past this.

 

Just a suggestion...
Abort the cycle rather than trying to steer it. Forget low carb and medium carb foods!
Feed high carb foods with syrup or honey mixed in it.


AMPS 400 (13u R - NO Levemir)
+0.5 404
+1.5 394
+2 331
+3 260
+4.5 188
+5 178

 

Thank you.. i still have a lot to learn and am trying my best to help him.
I do have a lot of strips, thankfully.
I have just started this Acro journey and im starting it on the wrong foot.. time to get better organized.

 

You're welcome. I think you've had excellent suggestions to keep a close eye on the BG today with testing and be careful about how much you feed so he doesn't vomit. If he starts to drop quickly again, you should be prepared to go to the ER. Even without shooting the levemir, a 13u depot is a big one.

Once things quiet down today for you both, you might want to post in the Lantus/Levemir insulin support group. I'm going to let two of our most experienced acro members know.

Also, again, after things settle, if you need help doing a spreadsheet, let me know by sending me a private message.

 

+5
178

 

I have a spreadsheet already, i posted it in earlier in this thread. I will for sure be joining more groups i need to educate myself.
Will i go back to his normal shot, maybe no R for his evening ( +12) shot?

 

I will be running to the store in a few and i will grab some regular cat food for him.

 

Please, always make sure you have plenty of high carb food on hand for low number events. Some acros require a lot of high carb to pull their numbers up (more than the usual).

 

Ive never experienced low numbers so i have no idea how to deal with it. I bought karo syrup but i had no other plans but to panic so i will for sure have them here from now on. Will kibble work better then wet?

 

Using wet/canned HC is a better choice because the carbs will clear the system faster than those from kibble, BUT sometimes kibble comes in handy if a kitty refuses to eat any more canned food. Most of them will gobble down a little bit of kibble when all else fails.


Edited to add: When I came to the FDMB I was told to keep a small jar of kibble in the freezer to feed if kitty wouldn't eat anything else.
Having both on hand isn't a bad idea.

 

I will get a sample bag or 2 from the pet store of kibble, they always have those on hand.

 

I used to buy the Friskies Prime Fillets which are something in the range of 29% carbs, if I remember right. I would get at least a half dozen in several different flavors and keep them with your hypo kit.

 

What do i do for gatos evening shot? Should i skip it or just give him a lower dose of the Levemir, depending on his numbers of course

 

+5.5
214
He is going back up..