How to treat HYPOS - THEY CAN KILL! Print this out!

GENERAL RULE OF THUMB FOR TREATING HYPOGLYCEMIA

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Your best defense against hypoglycemia is home blood glucose testing. If you’re not already doing so and your cat allows it, I HIGHLY recommend you test before each shot.

Hypoglycemia or low blood sugar is a dangerous condition that must be treated immediately. Also known as insulin shock or insulin reaction, hypoglycemia occurs when there is too much insulin in the body potentially leading to neurological damage and/or death.

Knowing how to respond to a hypoglycemic event whether or not symptoms are present can save the life of your diabetic cat. The following general guidelines are intended for those who home test the blood glucose levels in their cats. These guidelines are not intended to replace the advice given by your Veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness


TREATMENT

During treatment for hypoglycemia, try to test every 15 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a tablespoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.

LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry, feed this first as the high carbs will help to increase his/her bgs quickly. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizuring is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZURING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZURING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer, so it’s a better food to give during a hypoglycemic episode.

After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.

Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizuring the next.

BE PREPARED! KNOW THE SYMPTOMS AND KNOW THE TREATMENT!


Copyright © 1998-2009

 

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and don't forget to stock your "hypo tool box".......

so things in a real hypo toolbox that every DC owner should have:

~a few cans of higher carb wet food. check janet and binky's food charts for something around 18% carbs or higher. many use FF grilled with gravy flavors, cats love them. this is your first and best defense if you are home testing. HC canned will gently guide numbers back up. everyone should always have some cans of this in house.

~either karo (corn syrup) or another monosaccharide (those glucose gel packets are universally available from any pharmacy around the world), honey, maple syrup, cake food icing gel, whatever simple sugar you have. nutrical works too. remember simple sugars do not last long, will have to keep re-giving until past nadir.

~a needle-less feeding type of syringe (free from any vet's).

~high carb dry food. (keeps fresh in sealed glass jar. but remember dry food does not work as fast as high carb wet or karo, and will stick around often far longer than you need/want it to causing the afterward high rebound numbers later to be even worse).

~your cat's favorite cat treats (ie:temptations or pill pockets often work).

~a bulb syringe and lube (for that worst case scenario when rectal glucose needs to be administered).

~print out of hypo instructions posted above. even if you know exactly what to do, it can all escape your brain in a real hypo emergency, or you might not be home and a less experienced caregiver might have to handle this.

~extra test strips (can go through many in a hypo and too often hear of people running out at the worst possible times...just be sure to rotate stock so emergency strips don't end up being expired when they are needed most). suggest also that everyone have a back up meter in house also. one night at 2 am you will be very glad you have one in house.

~the nearest 24 hour vet or ER~ phone number and driving directions. (you do not want to be looking these things up when your cat is in real trouble!).
~along with that either a working car or the number of a cab co. and stash of cash or credit card.

~and a handwritten note to oneself to breathe during the event taped to the chocolate bar that you get to have after the crisis has passed.


everything kept together in one place will also help..ie: a kitchen cabinet with all supplies on one shelf with the hypo instructions and ER phone # and directions taped to inside of cabinet door.


remember the idea here is to be wise and prepared. hopefully you never ever ever have to crack open that bottle of karo, but to not have it, and the other tools, in house when you own a diabetic cat is foolish.


~jojo and bunny(GA) and settledown