Drop in blood glucose in 2 hours

My cat had a hypo. episode last night. Low reading of 26 was only 2 hours after insulin dose of 5 units. Got him back to 256 four hours later (food and Karo) Today, I did not give him any insulin in the morning. Tested him at 6 PM and his reading was 444. Gave him 4 units 2 hours later (8 PM) Tested at 10:45 PM and he was down to 85. He is on Novolin N. I am so scared that he will go hypo. again. I need some sleep tonight! Anyway, wondered if the drop from 444 to 85 in such a short time seems worriesome. Talked to vet today and he said to keep his dose at 5 units and test several times a day. With such a huge up and down in his readings, I am not sure what to do. He has been on insulin for about six years and he is 16 years old.

 

I would strongly suggest reducing his insulin dose.

After a hypo, your cat will be extra sensitive to insulin. You may want to give him a day off from the insulin, and then start over at 1 unit BID.

5 units is a huge dose.

What are you feeding your kitty?

You may want to change to a more gentle insulin, like Lantus or Levemir. N hits the system pretty hard.

 

Moka is getting mostly canned food (offering Purina weight control dry food in small quantities) He eats only the high protein Fancy Feast. I have discussed a change of insulin with my vet, but since Moka is 16 years old, we are reluctant to make a change. I am going to continue to test his glucose levels and hoping that we can get him regulated again. Thanks!

 

I agree with Phoebe that the dosage needs to be lowered. N can drop a cat's BG levels hard and fast, but this is extreme.

Given you are hometesting, a do-over might be a good idea. When you do that though, be sure to check his urinary ketones with Keto-stix (available at a pharmacy). With a drop in dosage he might have higher numbers for awhile and you don't want him staying high for too long because ketones might (or might not) develop.

I'm not sure that if he were my cat I would start the do-over at 1U, given he's a long-term diabetic. But if I started at something like 2 or 2.5U, I would be prepared to cut back if I saw the continued bouncing.

If he's been on this dose for awhile and you've been hometesting and he's been well regulated, I would say that one of two things might be happening.

1. His pancreas could be starting to function and is producing its own insulin.

2. He could have developed a cancer. Sorry to say that, but I say it given his age and the fact that cancer eats glucose.

Best,

Venita

 

Venita,

Thanks for the advice. Today he tested at 444 before 4 units of insulin. Four hours later, he had dropped to 46. He began to show some symptoms of low glucose, but was willing to eat and seems to feel ok now. Will re-test in a short time.
He also has somewhat loose stools which is rare for him. Might be all the food he ate night before last when he was hypo and got extra treats and food for that. The loose stools started yesterday. Anyway, might have to take him in for another checkup, but will try just 2 units tonight and see what we get. So frustrating and I know he is old, but want to him to be comfortable as long as he can.

Best to you,

Sylvia

 

Please don't feed any dry food at all. Even this so called weight control formula is high in carbs and doesn't help with getting Moka's bg levels under control and certainly isn't helping him to loose weight.

The erratic feeding of the dry food also doesn't help. Maybe that is why he is going so high when you do feed it and then so low when he doesn't happen to get much or any that day(?)

I would take away all the dry and try the 2 units and test, test, test. Do this for a couple of days to see where you are at then.

BTW, age does not have anything to do with switching insulins. He would be much better off on a different insulin that doesn't cause these huge swings. That is harder on him than a switch would be. Lantus and levemir are both gentle insulins and work well. I would consider a switch if I were you.

Also, please read Dr. Lisa's page on feline obesity:

http://www.catinfo.org/?link=felineobesity

Keep us posted!

 

I am switching Moka to Lantus Glargine starting tomorrow at the advice of a vet. Moka gets a small amount of dry food on a consistent basis (not randomly) He prefers the canned food.

 

Good! I am sure he will do well on the Lantus. You can get help on the Lantus Insulin Support Group here on this site. They can walk you through getting Moka used to the insulin.

And also, just know that even a very small amount of dry food will raise bg levels. If I even gave Tigger a tablespoon it would make a big difference and shoot him sky high.

Good luck!

 

Please go to the Lantus Insulin Support Group (use box on bottom right) and read the information posted at the top of the forum.

Start over at 1u BID for the first week or so until your kitty gets used to the new insulin. It builds up a "shed" in the system

 

2nd day on Glargine. Tonight's reading BF injection was 157, so dropped his dosage from 3 1/2 units to 3 per vet's instructions. Did a full curve yesterday and his readings were the best I have seen for him. Beginning to feel optimistic that the change in insulin will be a good thing for him. Thanks so much for all the advice and support I get from all of you. My vet is impressed with my knowledge and that is because of this site!

My vet has had good success with Glargine and she has given us specific instructions on dosage and will follow up on his readings in a week. She is very supportive of my home-testing his levels, so that really helps keep costs down!