BG reading of 37 on relion monitor! ...resolved!

My kitty Polly had her first glucose curve at the vets today. She got one unit of lantus this morning about 9am there. She was still lower this evening and the vet said no more insulin tonight and to only do a half unit in the morning. She ate dinner tonight when we got home about 8:30 and when I checked her sugar it was at 37 at 10:45. I know the human meters run lower but I'm still worried. She's not exhibiting any hypo symptoms. But I made her eat a bunch of friskie treats and little more wet food and some milk. This is our first night with her on the insulin. What should we do?!

 

The procedure is this:
Low test (< 50 on human glucometer)
Feed 1-2 teaspoons of gravy or food with a couple drops of Karo or other syrup on it.
Wait 20-30 minutes
Re-test.
If still low, repeat.

Gravy and syrup wear off fast. You want to be past the nadir (roughly +5 to +7 hours post shot), above 50 mg/dL on a human meter.

 

First, retest that number to be sure it's right....

Second, BREATHE and BREATHE again....

Do you have any Karo syrup in the house? Don't give her a huge amount of food yet - hard treats take too long to start working then stay for a long time...

 

I even tested her twice in a row in case I messed the first time and both were 37. I did give her a little honey too with the other stuff I mentioned.

 

So the only insulin she's had is the 1 unit at the vets this morning?

how long has she been on Lantus?

 

• "Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
• (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
• Test again in 15 – 20 min. Depending on the numbers, give more HC food.
• Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
• Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
• Test in an hour and follow the same steps."
  
  From the Lantus sticky on shooting and handling low numbers.

 

@BJM - I can't stay and know you're involved with Chloe's emergency too. Can you stay until someone else with experience joins?

@tiffmaxee - I see you're online, can you stay with her here?

 

Squeaky... She just started lantus today. She's a new diabetic.

 

I can stay.
No insulin since this morning, so we're at +12 or more

How many hours since the shot?

 

Yes. I can stay if you need to leave BJM.

 

What's +7? Sorry I'm new to all this. She had her first and only dose of 1 unit at the vets this morning at 9am.

 

BJ - shot 1 unit at 9am this morning at vet. Nothing tonight so she's way past nadir. This isn't usual...

 

We're just trying to catch up right now so forgive the wierd discussion...

 

You've just got to do the
test,
feed 1-2 teaspoons of high carb,
wait 20 minutes,
repeat cycle until safe and stable or rising.


And I don't need to leave at the moment.

 

I'm wondering if she tested high at the vet due to stress but might not be diabetic.

 

..and I have to get back to hubby...he's down again....

THANKS EVERYONE! This really WILL be OK!

 

We refer to the test times in terms of how long it has been since the shot, because that serves as the context for interpreting the numbers.

You're over 12 hours from the shot, or at least +12. The Lantus dose should be starting to wear off.

 

And since you're in Ohio, too, you're actually +15 from that shot.

 

Here's her #'s from today...all but the first and last readings were done at the vet on their pet monitor...sorry I don't have a spread sheet yet.
7:20 - 300 (relion monitor)
9:10 - 395
10:20 - 365
11:50 - 309
2:10 - 279
4:30 - 130
6:10 - 95
7:10 - 99
7:45 - 96
10:53 - 37 (relion monitor)

 

OK. It looks like the dose is too high for your cat. Normally, the glucose comes down about +5 to +7 hours after the shot then comes back up.

Have you tested again?

 

How was she diagnosed? Did the run a fructosamine? Does she have any other medical issues? How much does she weigh?

 

She was diagnosed when they ran a comp panel and urinalysis on her on Monday. No fructosamine done yet. Her sugar was 417 in that test. No other medical issues. She weighs 8.8 lbs.

 

Its been more than 20 minutes since you gave her the food and treats.
Please get another test.

 

Ok just did another and she's 82 now.

 

Good.
Feed 1-2 teaspoons of regular food
Wait another 20 min and re-test to see if she's holding or rising.
If dropping then, feed 1-2 teaspoons of high carb.

 

We are gonna keep just her(we have 11 kitties) in our bedroom all night with dry food out so she can eat as she needs to. Plus we will hear her if she starts making any odd sounds and can watch her. I get up to go to the bathroom a couple times a night...and I'm kind of a light sleeper too.

 

If you let her eat all that dry food, her glucose will probably skyrocket to unsafe numbers by the morning.

 

Can you leave out low carb canned food? What is her normal food?

 

^- That's a better idea.

 

She won't eat all of it but I have some there just in case.

 

With this kind of a reaction to lantus I bet if you feed all canned food you have a good chance to get her diet controlled and she won't need insulin. Dry food and many canned are loaded with carbs.

 

In the morning, unless she's 200 mg/dL or higher on your meter, I would not give insulin.
And 1 unit was too high at this time.

 

If she is over 200 should she give .50 as her vet said?

 

I plan to get her on a low carb wet food only diet but the vet suggested I feed her as normal for the time being until we figure out her dose and get her under control. I think we will most likely skip her morning dose too unless like you said, it's a really high reading but even then we are only doing the half dose. My vet agreed that one unit may be too much. She even said there's a good chance she might just be a half unit once a day kind of girl.

 

We actually eyeball 0.25 unit doses - magnifiers help if your vision isn't great, like mine.

With that kind of response to insulin, a diet switch first, before using insulin, may cost less in the long run and be safer.

And if you can get the entire clowder switched over to low carb canned, so there's no contraband in the house, she might become diet-controlled very quickly.

 

I've thought about that too - switching the whole brood as a few of my boys are a little "thicker". Lol. It definitely wouldn't hurt that's for sure. We are thinking of even holding off on more insulin til the weekend when we are off work and can really keep an eye on her and maybe even do our own curve since, as I found out today, it isn't the cheapest thing when the vet does it!

 

That sounds like an excellent plan. Switch about 20-25% of the food each day to reduce the chances of GI upsets and food refusals. Continue monitoring the blood glucose. It typically rises some within 2 hours after eating. Several small meals will raise the glucose less than one big one.

 

Ideally I would love to control this with diet because these hypo episodes scare the heck out of me! I hate when my hubby gets them too. Scary stuff for sure. Thanks a million for the help and advice tonight. I'm gonna keep an eye on her and we'll try to get some rest. Hopefully the lantus is wearing off.

 

Snag 1 more test before bed, please, just to make sure she is stable.

(and if she is, I'm crashing, too!)

 

115...we're moving up!

 

Nice safe number. I hope you both are off to bed.

 

She's above 100 and rising. I think she'll be safe until morning. I would leave out the low carb food, not the high carb dry.

Good night.

 

Ok sounds good! Thanks again for your help and support!

 

If you go up to your 1st post, there is a little down arrow on the right and you can edit your post title to remove the 911 and note that it is resolved.

 

so her sugar was 468 at 8:00 this morning. we felt that was unsafely high and so we did a 1/2 unit this morning and fed her as normal(like yesterday before the vets...a can of fancy feast and a little kibble). i think you were right about the carb overload last night BJM...but when i saw 37 on the monitor it freaked me out a bit and i was kind of like - EAT EAT EAT kitty! hopefully she won't get those lows later today since the dose has been halved. we're at work right now, but my hubby thought 468 was too high to not give any insulin. we'll check her BG as soon as we get home later, as that seemed to be when she started dropping yesterday. btw, does anyone know if the fancy feast "chunky" is low carb as well? it looks just like the pate just with a few random chunks in it. seems about the same gravy-wise as the pate too.

 

It seems like the FF Chunky styles are under 10% carbs. Here is a link to a real handy chart that a lot of folks here use to determine % of carbs in various different cat foods (pretty sure it's all canned, freeze dried, frozen, etc, don't think there's any dry food listed there).

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

 

You were right to give her the half dose of insulin. Even if she stays really high I would stick with that dose and not go up until the depot fills. As you eliminate the dry food you will likely see her numbers drop. It may turn out that she will quickly become a diet controlled diabetic but you will need to make sure she doesn't get the wrong food which would mean changing all your cats to canned like you mentioned earlier.

 

ok and just to be sure i'm looking under the "calorie %" column under "C" right?

 

So glad to see things went OK last night, sorry I couldn't stay with you. Yes on the column question - the 'C' column is the carb percentage.

HUGS!

 

tiffmaxee...yes that is my goal to get her controlled with diet alone...that would be wonderful! what does "depot filled" mean? sorry, i'm still learning all the lingo. yeah, we just didn't feel good about leaving her sugar that high this morning. i think the 1/2 unit will be better too. i'm definitely going to start switching to low carb options for my other kitties...some of the boys could stand to slim down a tad! right now i am mainly feeding them blue buffalo chicken morsels but i couldn't find carb info on dr pierson's chart for it so i'm not sure of it's content. i also feed purina pro plan healthy metabolism chicken or turkey - which i don't see those specifically on her list, but there are other pro plans and it's hit or miss. some are higher and some are lower in carbs.

 

thanks squeaky!!!

btw, what does OTJ mean?

 

OTJ = 'Off The Juice' (insulin) and 'diet controlled'. There's a thread over in 'Community' entitled something like 'Beans, Vines and other FDMB lingo' that's got a lot of the acronyms in it AND lots of laughs too. Here's a link to it:

http://www.felinediabetes.com/FDMB/threads/beans-vines-and-other-fdmb-lingo.142450/

 

ok thanks...i need this! ...although i'm slowly picking up on it "off the juice" - i like that! lol

 

A more up to date list is Tanya'scrf.org. Helen was in tge process of putting in current numbers when we last talked and thankfully has added carbs. It is still two years more current than Lisa's list. The pet food companies change their formulas often and most don't post on their site.

Often the pates are lower carbs and those in gravy higher.

When you get a chance read the stickies on SLGS which is the only protocol you can safely use until you nix the dry food and the TR. it explains the depot. Lantus takes time to build in the body which is why we don't increase until we have time to see what a dose will do.

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/

http://www.felinecrf.org/canned_food_usa.htm

 

thanks tiff! ok i skimmed through that acronym link...what is TR? i could't find it. also what is the GA tag for a thread title? i found that GA is 'guardian angel' but how does that fit into a thread header??

btw, the food link didn't have blue buff either...rats! oh well i'll check their website directly to see if i can find anything. *fingers crossed*

 

TR is tight regulation. There's a sticky for it. GA is when an animal has passed away.

 

my hubby just texted me at 11:15...he ran home after a meeting at the hospital by our house and checked polly's sugar and it is 237 now. so hopefully she'll level off nicer today and no crazy dips later, but we shall wait and see. i'll tell him to check it before he heads out again later to see if she's getting goofy low and needs food.

 

When you see it in a header, it's likely the cat crossed just a short time ago. There's one right now entitled 'Terry is in trouble' with a GA in front of it - it was a new person that never even got a 'condo' started before it was too late. We all know that feeling of losing them and how much better it feels when others share that grief...

HUGS!

 

ok he checked again and her sugar is 257. steady at the moment.

squeaky - thanks! and hey i knew what ya meant when you said 'condo' ...woohoo i'm learning!! lol. poor terry though, it's horrible to lose a fur baby and it never gets easier no matter how many you've been through. i still get sad when i think of my passed babies. they were [are] all so special!

 

Each day we post a new thread which are called condos. We list our results there so people can quickly scan to see if someone needs help.

 

are all thread called condos or just the ones for BG results? so everybody starts a new thread everyday to post their kitty's BG readings for that day?

 

Most of us post daily condos. It gets people familiar with you and your kitty and lots of eyes on you in case you need help or others think you need to increase or decrease insulin. When I started I didn't post daily. When I started I didn't know that Max needed an increase or decrease until people suggested it to me. My vet moved much more slowly. Yes each thread is referred to as a condo.

 

They're all 'condo's - like going door to door in a condo complex visiting!

The format we use for daily postings is Date/Kitty Name/AMPS### +1/2/whatever - edit title to add as day progresses. One reason we do it this way is it's quick for us to see when someone's possibly headed for trouble - we keep a bit closer eye on them....may not post but we still check...

 

Ok as soon as I get a chance I'll post her numbers for today. She's been holding steady in the mid 200's so far today.

 

It would also be helpful to start a spreadsheet.

 

I have started one on paper...I'm old school like that lol. But I am going to start one here from the links too.

 

Once you use the google sheets I beg you get rid of the paper. I did.

 

You're probably right about that! But man, they sound like a pain in the butt to start...I gotta download like 3 apps and get a google account and what not...

 

Only download the apps if you want to use your smart phone for access ... on mine (an older phone), the apps don't work.

The Google account is easy, and once you are logged in, and on a computer, you can File, Save a Copy, of the template you choose. It'll go right into the Google Drive folder, no download is needed.