First time BG Curve at home - 58 mg/dl just now

Hi guys-
I'm sorry if I don't have any of the information right here or if I'm saying something wrong. I'm new to all of this and did first BG curve at home today after raising insulin to 4U BID (Lantus). We were to measure before first shot and then 6 hours later, then in another 6 hours just before getting PM shot.

The entire story is that I gave him his pure bites (dehydrated chicken) treats before I remembered we needed to take the curve. Just after getting treats, BG was 270 this AM before meal & AM shot (4U). Just now, 6 hours later, BG is 58. Gave him 1/8 cup dry food and some Fancy Feast broth that I had on hand. Should I check again soon and how do I know to give him/not to give him his PM shot when it's time?

He was initially on 3U Lantus BID but upon doing his first curve his levels were still too high. Please advise, thank you!!!
-Kristen

P.s. Going to test again in a couple minutes

 

I was reading in another thread that <50 mg/dl is the alarm but 58 still seems really low for him. During his first BG curve, his lowest was only about 270, which was his high today.

 

What meter are you using?
Was the 3 units a start dose?

Can you post the numbers for your curve and the times, also what he had to eat and when.

Can you check his reading in 20 minutes and post the number.

 

sounds like 4 u is much too high. Can you show his readings from the last few days? a full unit jump from 3 to 4 is really large!!! I'll let the lantus people comment but most would have advised going from 3 to 3.25 and holding that for several cycles before deciding if another increase was needed.

are you using a human or pet meter?

 

We have the Abbott AlphaTrak. 3U was his starting dose after being diagnosed.

First BG curve numbers were something along the lines of:
1. Pre-shot AM - HIGH
2. Middle of day - 250
3. Pre-shot PM - 375

Will check him again in 20 minutes. Thank you.

 

I wish I could give you numbers, but we haven't been tracking religiously at home. He was just diagnosed a month ago and all of this is very new. Vet suggested we do 3U to start and after 1st BG curve numbers were not where she liked. I agree, the jump was a big one. Would have made more sense to start smaller and see how it progressed.

 

Was diagnosed about a month ago, started on 3U BID and did first BG curve about 2 weeks in.

 

On the alpha track the take action number is 68 so he is a bit low.
Do you have any gravy type food available? The dry will take a while to kick in.

Lantus is a long acting insulin so I will tag some Lantus users to see if they can help.

@Bobbie And Bubba @jayla-n-Drevon are you able to look in?

 

He ate an entire packet of the Fancy Feast mackerel/vegetable gravy & the 1/8 cup of the dry that I had on hand. Will be testing again in about 4 minutes here. Will post results. Going to be getting on a testing schedule here as I'm learning. Didn't have the glucometer until this weekend. Learning as we go. He's been on the 4U BID for about 3 weeks now. Has been acting normally, no problems. Should have known to test early on as it was a large jump. I wonder if that wasn't purposeful as in, go much, much higher and then decrease as needed - but that doesn't seem safe. Sorry to ramble. Am trying to do school work and manage this as well. Plus I hate poking him, feel so bad about it, but try to pet him and make it tolerable.

 

what meter are you using?

 

can you take another reading and let us know the number please? We want to make sure it's not still dropping.

 

Sorry it took a second. 60 mg/dl now 20 minutes after eating.

 

AlphaTrak2

 

Should I offer more gravy type food at this time or just keep watching his numbers? They all eat at 8am and 8pm.

 

ok - test again in another 20 mins as we should start to see the effect of the food, you are around +6? I am in a different time zone so we use the + system to show number of hours since the shot.

 

wow, ok then your cat was pretty low at 58. on alphatrak you don't want the number to drop below 68. You've already given extra food, right? the reading is 60 now, so it's up a tad, but still too low. Yes, give more gravy food and test again in 15 minutes.

 

OK, thanks very much for your help.

 

Hi Kristen,

60 on an Alphatrak is still too low. Give a couple of teaspoons of just the gravy straight away and test again in 10 mins.

Keep honey or karo close at hand to be on the safe side.
.

 

He ate a packet of the Fancy Feast gravy food, should I get another? I don't have any left here and have to go to the store to get it. I'll go get it and run back home, feed him and test again. Should he get a little maple syrup at this point?

 

don't give him the syrup yet, but have it just in case. Test him again after about 15-20 min after the last time.

 

oh good... glad you're here. I don't know about lantus, i was hoping someone would stop by for follow up advice on that. Busy day for hypo's today, eh?

 

I wouldn't wait that long to test with him under 68. He's right in the middle of the cycle, too.

If it were my cat I'd give a teaspoonful of wet food with a small drop of syrup and test again in 10-15 minutes. It is important you don't fill him up because he may need more food during the rest of the cycle to steer him up to safe numbers and keep him there.

Don't leave the house. You need to monitor very closely and frequently for the time being.


Mogs
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PS - if you don't have any wet food in the house give him 1 or 2 kibbles dipped in syrup.

Please confirm that you've given the food and then let us know what food you do have in the house (wet/dry, low/high carb).

 

Do you have a new reading yet?

 

You OK, Kristen?

 

Here is a useful guide for you http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

With Lantus the low numbers can continue for a long time so it is important you don't fill him up with food as you may need to keep on steering the numbers with smaller amounts of higher carb, keep posting those numbers.

 

Agreed, at this point don't leave tests longer than 15 minutes, that's because you are borderline hypo and don't want your kitty dropping any lower.

Later into the cycle it'll get easier....

Reassuring hugs to you. You're doing just fine!

Eliz

 

@OrangeTrioMom ,

Can you give us an update ASAP? ..We need to know how you and your kitty are doing... ((((Hugs))))
.

 

@Alexi, @Elizabeth and Bertie, @JanetNJ -

Are you good people OK to take Kristen through till we know her kitty's stable in safer numbers? I'm not doing so good but I had to respond to the emergency.

.

 

I'll be here.

 

I'm good to stay - hoping some lantus folk can pop by later as that dose needs to come down.

 

I ran to get some more wet food and had my husband watch him. He gave him another pouch of wet food and we measured again about ten minutes ago. It was 45 mg/dl. Gave him Karo syrup on his gums and getting ready to take him to emergency clinic. He's acting normally otherwise.

 

I'm sorry I didn't respond faster you guys, I'm freaking out and rushing around trying to get you the info. We've been giving him the 4U for about 3 weeks now and he's done fine on it, not acting strangely or anything during the day. Is it possible that he was this low and we didn't know it???

 

ok keep rubbing the syrup until you get to the vet as it wears off quickly, good luck, let us know how you get on.

 

good call. I'm glad you got the syrup on him. I was afraid he was going to drop. It's definitly possible that this is not his first hypo. I'm glad you caught it though. When are you taking him to the clinic? You may want to continue giving the syrup on the way there.

 

Right move. Keep testing every 10 minutes - even while you're getting ready to leave. If you do go to the emergency centre bring karo with you & apply to gums.

.

 

Wait... This is a brand new glucometer and I'm wondering if it's coded incorrectly. The code upon inserting the test strip says 14. It's supposed to be 08 for a cat. I'm an idiot. Does it change it that much? I need to re-test with the correct code.

 

You need to check the cat code with each new batch of strips. Yes recode and check right now.

 

Impossible to say one way or the other, hence the need for BG testing.


.

 

My experience with an incorrect code is it doesn't make much difference to the numbers, the code should be the same as on the the test strips.

 

Is 08 the code on the tub of test strips you're using? If yes then you need to recode the meter to show 08. Not sure how much difference there might be - you'll see when you test. (Never been in this situation with my Alphatrak.)

.

 

Good lord.. After more wet food & Karo on the gums, he's at 71 with the correct code. Should I sit tight and keep checking every few minutes?

 

To recode the meter, insert a test strip and when the code number displays start pressing the C button repeatedly until the correct code number appears.

Take the strip out after coding then reinsert to confirm that the new code number is correct.

.

 

I read in the instruction manual that it needs to be coded for the correct animal. There are about 99 codes apparently and the code for cat is 08 (as it says on the tube). With the correct code, he's at 71 right now. I'll check again in a few minutes.

 

whew. Well I wouldn't say you're out of the woods, but that's certainly better than being in the 40's.

 

you have to look on the side of each new bottle of strips... the code number varies from box to box. I've had 08, 36, 37, 38... you have to look each time.

 

Bear in mind he has had syrup and it wears off quickly so he may well drop again.

 

Grab a piece of paper and scribble down brief notes of the test times, BG readings, and what you're feeding as you go along. Nothing fancy, just something to help you keep track.

e.g.

+4.50 - 49 - xxx high carb dry food
+4.75 - 61 - XXX tsps wet food + karo
+5.00 - 71 - no food
+5.25 - 62 - tsp wet low carb food + karo

etc.


.

 

OK. Will check again in a couple of minutes here. I have the glucose reading diary that comes with the kit so I'm tracking it all there but will keep track of the food and syrup given as well. Thank you all so much for your help. This is stressful and it's awesome knowing there are people to go to for help.

 

I'm going to have to start keeping a spreadsheet like you all do. How on earth do you test your kitties so frequently??? Do you have someone help you? He hates sitting still for them and I did them on my own the first couple of times - tore both of his ears.

 

We can take you through everything you need to know but the spreadsheet and so on can wait until he's out of this. Getting the readings does get easier with practice but I'd say you were doing pretty good so far.

 

once they know they are going to get a treat after, it gets much easier. Honestly after the first week my cat didn't even react to it at all.

 

You really are doing fantastic.
You may have saved your cat's life today.

 

I can't keep going any longer, Alexi. I'm so sorry but given current circumstances I'm sure you'll all understand.

My thoughts:

Even with karo any rise in BG thus far hasn't been big and hasn't held yet (alas! no gravy!). With a low like this and a large depot it may require intensive monitoring well into the next cycle.

Try to get someone experienced from the L&L group ASAP to review the situation and give input.

If in any doubt then perhaps best to do the karo on the gums+ER trip. (Always better to err on the side of caution.)

Fingers and paws crossed for all to be well.


Mogs
.

 

My thoughts too, go and get some rest Mogs - I deliberately didn't tag you because I knew you wouldn't have the energy to keep going

 

We'd only test that frequently if a kitty was running low. A fair proportion of us test on average about 4-5 times a day (2 preshot tests, 2 mid-cycle and maybe an extra 'before bed' test in my case).


Mogs
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she's in good hands... we've got this. go take care of yourself.

 

Just took BG reading again - 110 mg/dl (with correct code)

Gave Fancy Feast Broths packet (1.4oz and Karo syrup on gums at 4:00pm). Will measure again in 15.

 

Thank you for all your help, everyone. I really appreciate your coaching through all of this.

 

that's very good news.

 

ok - we could be here some time, how long since insulin now?

 

Got it. Will continue to monitor & test.

 

He had his dose at 8:15 this morning.

 

Thank you Janet! I'm Kristen, by the way. Realize I didn't have my name here, just my user name. I'm so impressed that your kitty went into remission! Congratulations.

 

Sorry but I am in a different time zone completely so need to know number of hours since the shot.

 

Oh, I'm so sorry, I remember you saying that earlier. It's been 8 hours and 15 minutes since his AM dose.

 

thanks, Kristen.

 

Indeed - that's why the scribbled notes help (would go out of your head otherwise).

Members will stay with you both for as long as this takes. I'm sorry I can't stay myself but keeping fingers and paws crossed for all to go smoothly and safely.




Mogs
.

 

Have posted in Lantus forum for help as this situation might run on for a few hours more...

 

I have also posted on the Lantus forum so someone from there should join in at some point.

Kirsten what is important at this point is we see him rising on his own without need for intervention. If you need to intervene that's fine but he has been on big doses for some time and with Lantus there is a cumulative effect of the doses so those doses are still working and will carry on for some time so he may go low again from here. Have you plenty of strips as you are going to need them.

 

Final thoughts:

1. Karo should not be necessary any time BG tests above 70.

2. A dose reduction is needed. Post on L&L board for dosing input before giving another dose of insulin.

3. With the low today your little fella may become more sensitive to insulin and that will need to be taken into consideration for dose reduction and how closely you need to monitor over the nect few days.


Mogs
.

 

113 mg/dl right now. Have not given any food or Karo for approx. 40 min.

 

Approximate details (most recent update)

Preshot number.. 270, 4 units Lantus
Most recent BG at + 8.5? is (a rising number of ) 113, with no food or Karo for approx 40 mins.


Details edited to incorporate new info.

 

ok - can you test again in another 20 mins?

 

This is all great advice, thank you.

1. I understand Karo is a last-resort type intervention. At the time, he was reading 45 mg/dl but then I realized the code on my glucometer was incorrect. I made the change to the correct code and he read 71 mg/dl.

2. I agree that a dose reduction is needed. I will post on the Lantus board.

3. Great point. Thank you again for all your help.

 

Yes, I will.

 

Preshot number was 270 after forgetting we were doing BG curve today and giving 2-3 dehydrated chicken treats.
Yes, most recent BG is 113 after no food for 40 mins.

 

when you realized the code was wrong and retested you had already given the syrup, so it is possible that it was quite lower than 70 a few min earlier. Glad you got the code figured out though.

 

Plain chicken treats with no carbs wouldn't affect the numbers.

 

Will test again in about 10 minutes - I know we're not out of the woods entirely, but thank you for helping me through this. You all are my heroes.

 

Got it... Wasn't sure if that was an issue or not. Thank you!!!

 

Thank you for being here - based on your responses I know you are having a rough day. <3 <3 <3

 

Thank you, Janet!!!! It certainly is no fun but having people who have been there to help you through makes A WORLD of difference.

 

Just checked my SS as I had noted when I did the incorrect code and it made little difference to the numbers. Mogs just lost her precious sweet baby cat so it's amazing she is posting at all, she is awesome!

 

Yes, she is. I am so sorry, Mogs.

Good to know about the code... Still such a crazy thing.

 

Last reading - 103 mg/dl. Last food & sm. amount of Karo syrup 60 minutes ago. Gave him 3 Hill's Crunchy Naturals treats as rewards for the testing.
Will test again in 15 minutes.

 

ok - this could be a long night as he has dropped slightly again

 

You might try to get him to eat another small bit of gravy from the food. He's still in a safe zone, but we want those numbers going up not down.

 

I had a hypo scare early on and these nice folks had my back through it. It's comforting to not feel alone.

 

Hooooo boy...

 

Gave him a couple teaspoons more gravy. +15 min - 91

 

So he's going down again. Will give him a couple more teaspoons of the brothy food.

 

Hi Kirsten, sorry you are getting a baptism by fire. We see it a lot when people start home testing. Good for you on getting that going.

With him over 100, you don't have to test as frequently, he's essentially the same number within meter variance. You could give him some of his regular low carb food. Not too much, we don't want him full in case you need to feed later. You could test in 3/4 of an hour after the last test, maybe as long as an hour. High carb food such as gravy can wear off after two hours, so you want to test around two hours after you gave the first gravy.

As for dose, at this point I would reduce to 3.5 units. Do you have syringes with half unit markings?

 

Hi Wendy!
Thank you for your response. He dropped down to 91 this last time... So I'm not feeling so confident. Gave him a couple more teaspoonfuls of brothy Fancy Feast and will measure again here in about five minutes.

Our syringes do have half unit markings, so it shouldn't be hard to measure that. Thank you for your help!!!
-Kristen

 

I think we are at +9.5 now? @Wendy&Neko He was on 3 units and then raised to 4 units which strikes me as a large dose jump for Lantus and Kirsten has only just started testing, I'm not clear of the timescales on previous or current dose.

Kirsten - can you help us out with some dates?

 

Yes...
He was diagnosed on 8/17/2016 and started on 3U Lantus BID.
First BG curve was done on 9/1/2016. Went something like this:
1. Pre-shot AM - ~470
2. 4 hours post-shot - 250
3. Pre-shot PM - ~350

At that time, he was increased to 4U BID. He has been on that since, so for almost the entire month of September he's been getting 4U BID.

Today was the first time I did a curve at home to check the levels given this new dosage.

 

I am so sorry I just saw this.... looks like you got some expert eyes on you ....
I just want to add to bring my boy up I usually need something around at least 18% carb if it is near his "dive" time--if he is past that something lower (10-15% will work-)

 

+15 min - 100
Gave 2 tsp brothy food

 

+10 hrs post-shot - 105 mg/dl
Gave 2 tsp brothy food