? Extreme low BG's all day, need advice for PM shot please

Discussion in 'Lantus / Levemir / Biosimilars' started by Sonia & Leo, Jun 17, 2018.

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  1. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Leo's BG's were extremely low all day, his next shot is due at 8pm, one and a half hours from now. Should we reduce his dose and by how much or should we skip his evening dose?

    US
    Preshot: 49,
    +2: 43
    +3: 43
    +4: 56
    +6: 65
    +8.5: 59
    +10: 47

    World
    Preshot: 2.7
    +2: 2.4
    +2: 2.4
    +4: 3.1
    +6: 3.6
    +8: 3.3
    +10: 2.6
     
  2. Rain7

    Rain7 Member

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    May 20, 2018
    I'm no doctor, but my vet has said that once the sugar gets into the 50's that is when you start to be concerned. His highest reading all day has been 65, with most of the readings being in the 40's and 50's. Those are very low. How is he acting? I personally wouldn't give my cat a shot at all if the readings were that low to begin with, but that is just my opinion.
     
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  3. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Do NOT dose him in the PM. You probably should get him some high carb gravy now. This is a light hypo. I would push him up into the mid-50s or 60s with carbs or carb gravy.

    You should continue to monitor Leo today with BG tests to ensure he does not drop lower into definite hypo numbers.

    I also recommend AMPS and PMPS testing each day. It is hard to tell his recent history in the past week. Leo may require less insulin in the past week.
     
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  4. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    On 5/30/2018 you show a BG = 20.2
    If that is a typo, you may want to fix it.
    If that was a real hypo, I hope you actually gave sugar to bring Leo up. That low range is deadly.

    Some cats give very few symptoms when they hypo. We cannot count on external behavior to determine hypos.
     
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  5. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    @Sonia & Leo

    Please start testing the BG prior to administering insulin.
    You risk Hypo - a serious one potentially due to Leo's dose being rater higher at 4Units+.

    Since you were giving 4.25U for a while now the Lantus depot within Leo's body has grown and might influence his BG for the cycles to come. Sometime large dose depot - such as Leo's - might be affecting the BG even if you skipped the dose.
    Please keep testing.
    Leo's numbers are much lower than it is comfortable. Only taking tests will tell yo what to do at a time.
     
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  6. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    How is Leo acting?
    Is he himself overall?
     
  7. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Thank you for the recommendations. It's been a long terrible scary day. We're going to skip his PM dose and keep testing. We've given him some higher carb food and a bit of syrup. He seems to be acting normal though walking more than usual and wanting to go outside. We only let him out when we're there too. Not long ago he was almost unable to walk and I carried him to and from his litter box.

    Thank you all so much.
     
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  8. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    It was a typo from going back and forth between the US and World spreadsheet but thank you for noticing that.
     
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  9. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    :)
    good call on higher carbs food!

    Just be aware that the high carbs are short lived - i.e. live the body as abruptly as it elevated the BG. If it bumped up his BG now it wont stay high in the future when the syrup leaves the system.

    The HC solid food influence length is vary per cat - some reported that Karo/ Honey or HC foods affected the BG for cycles to come.
    It is not uncommon to see cats lowering after the effect of HC wears off. Take tests to make sure Leo is safe.
    Just pay attention to the trend when you test. If lowering - feed. If stays flat around the same numbers - don't.

    Acting normal, unfortunately, does not mean that the cat is out of Hypo danger. My girl Ducia was totally asymptomatic just before going into full blown Hypo. :eek::blackeye::blackeye:

    After going that low for that long Leo might develop insulin sensitivity and react stronger to the same/ even a reduced dose . Make sure you test and shoot at a safe number.
    :)
     
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  10. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    You might expect a bounce tomorrow - Leo may go real high. I would not dose him extra. Since he has been having some low numbers you may consider dropping down by 0.25 dose. Even on June 10, he was pretty darned low.
     
  11. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    @JeffJ - The 20.2 was not using US numbers. It translates to 384.

    First, you're using TR. Any numbers below 50 warrants a dose reduction. Please remember to reduce Leo's dose tomorrow morning. If you've not seen the sticky on Shooting & Handling Low Numbers, there's information on how to deal with the kind of numbers you were seeing today. Unless you weren't putting in all of the information, you need to be testing and feeding every 15-20 min.

     
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  12. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    @Sienne and Gabby (GA) @JeffJ Thank you both for being there and for all the information. His BG's are creeping up slowly so I will keep testing. Definitely a dose reduction tomorrow.
     
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  13. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Thank you Tanya
     
  14. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Glad I could help. I know we sound like a broken record. It will help you and us if you are able to do more testing. In general I am impressed with your spreadsheet and Leo's good regulation.
     
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  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    First, a safety guideline. Never shoot when the preshot is below 50. If you see a lower number, try stalling without feeding to see if he comes up enough to shoot.

    Good that you skipped tonight. That should help drain the depot.
     
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  16. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    h
    You're right, had I waited, I would have seen the numbers going down. Today has taught me a valuable lesson. Thank you.
     
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