Hypo help request

Hello,

I was an idiot and gave my cat her 2 units insulin (Novolin N), when my cat was lower (150), than the limit the vet said. I have liquidized some a/d food. Got some sugar water. Have Karo, bad food, treats etc on hand. She won't eat by her self. How often should I be syringing 3ml sugar water and 3ml a/d? She was at 101, 20 mins for her. 5-600 is normal for her.
Sorry, haven't posted intro yet will do when I stop panicking!
I'm embarrassed to post the spreadsheet, please save the comments for afterwards, I know I have done a horrible job for her the last couple of weeks.
Thank you for any advice you can offer.
Sarah

 

When you say she was at 101, do you mean before her shot, or right now?

And exactly how long ago did you give her shot?

 

She was at 150 when I gave her the shot at 10.30pm. She is at 83 as of 10 mins ago. Pushing sugar water

 

Also, 101 is safe for the moment but by understanding what time it is in relation to when the shot was given, it will help you figure out how long of a night is in front of you.

And try to go ahead and skim this, but hopefully some more experienced members will be along to help as well:
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

Ok we cross posted. What time zone are you in so that I know how long ago your shot was? And 83 is still ok, I wouldn't push it with sugar water a ton yet.

 

@Chris & China are you around to assist? I haven't helped triage low numbers for someone else yet..,

 

How do I find my post again? Want to log in on computer

 

Sorry, didn't think of that, US east coast. It's now 1.20am

 

Click on this: http://www.felinediabetes.com/FDMB/threads/hypo-help-request.170713/#post-1861099

And what meter are you using, human or animal?

Ok so almost 3 hours in. Don't panic yet. And no need to test more than every 20 minutes unless she acts weird.

 

Right now I'm on the Alpha track cos I read it was more accurate at low numbers. Just had diarrhea.

 

Go ahead and test again and post the actual time and the bg number please.

 

OK....on the AlphaTrak, your "time to act" number is 68, but with Novolin, I'd go ahead and give her a little food....mixing a little Karo/honey/syrup (a few drops) will help make it more of a medium carb

 

It's important here to give us the details using the "+ system".....so if you tested and shot at 10:30, that's your PMPS (PM Pre-shot)

If you test again at 12:30, that's +2 (2 hours after the shot).....if you test again at 2am, that's +3.5 (3.5 hours after the shot)

So so far we have:

PMPS 150
+??? 101
+3 83

 

87 at 1.25am. I have ad blended with water, will that do it?

 

OK, +1 174
+2 101
+2.5 83
+3 87

 

A/D is only about 12% carbs.....I'd add a couple drops of Karo/honey/syrup and give him a couple teaspoons

Test again in 30 minutes (after feeding)

 

ok

 

We don't really suggest using sugar water because there's no way to know how "concentrated" each person is going to make it....If you add a cup of sugar to a cup of water, that's one thing....If someone else adds a tablespoon of sugar to a cup of water, that's another

We know more about how Karo/honey/syrup work

 

Thanks so much for jumping in @Chris & China! I am monitoring my own boy in low numbers right now, will you be available to help Sarah for a while?

 

Not too long unfortunately but I'm looking around for help....but I'll be here for at least the next test or two

 

I'll check in as I can. Thanks.

 

Thank you everyone! The vet told me to do 2 cups sugar to one water. I got about 15ml ad+honey into her although she did spit some out.

 

Keeping everything crossed for Whisper too!

 

OK....you'll want to test again 20-30 minutes after you fed....if she's holding her own at that point, don't feed anymore (unless it's a normal feeding time and it should be regular low carb) so you can truly see how she's doing without any extra carbs/sugar

For now, let's just see how she does without any more food

 

Thanks we are closer to our nadir than you, so we will be fine soon.

So I think we have this for you now then

Pmps 150 (2 units novolin n)
+1 174
+2 101
+2.5 83 (sugar water)
+2.75 diarrhea
+3 87 (15ml a/d with water and honey)
+3.5 ?

It is about time for a +3. 5 test I think, unless it took a while to feed. Like Chris said, we areen't out of the woods for you yet, especially since I assume you don't know how long it usually takes to get to your nadir? We want to see rising numbers that are not food-influenced.

 

For future use.....we usually recommend keeping some Fancy Feast Gravy Lovers foods around for times when they drop low....the gravy part is full of carbs and most cats love it!

You just pop the top, put it back down and "squeeze" the gravy into another bowl and feed a teaspoon or two of just the gravy part.....it also keeps them from getting "too full" so they won't eat later if we really need them to

 

+3.75 75 Still going down.

 

Syringe the gravy out of the meaty bits and give her that?

 

Absolutely, if fancy feast gravy lovers is what you have. A teaspoon or two.

 

The Beef Bits in Gravy is 19%.....we usually like to go for something in the low 20's but I think that's a good choice

 

Hello Sarah! Welcome to FDMB!
Don't panic, her BG isn't too low. I also use AlphaTrak.

 

Try not to give too much. It can upset the tummy. I don't know anything about Novolin, so I've sent and SOS for some help.

 

Recap - Current time is almost +4 (2:30 am EST)

PMPS 150 (2 units novolin n)
+1 174
+2 101
+2.5 83 (sugar water)
+2.75 (diarrhea)
+3 87 (15ml a/d with water and honey)
+3.75 75 (feeding 1-2 tsp gravy)

I can't stay on much longer, have to get up for work in 3 hours.

 

Go to bed, @Sandi & Whisper. The cavalry is on the way.

 

Thanks for responding to my SOS @Tricia Cinco(GA) & Harvey !!! I know none of us that's online right now has experience with Novolin, but we all know how to keep a kitty safe!!

You're in good hands @Sarah Price

 

Thanks guys, and Sarah I look forward to "meeting" you and your kitty formally soon. Don't beat yourself up at all, you did great at catching this and everyone can help you get things straightened out in general after this is over.

Good night, all!

 

Will get some of the gravy lovers when I shop next.
Thank you so much for all of your help! She hasn't been this low since I started testing 6 months ago. I'm really worried now

 

How long ago was that 75?

 

25 mins. Gave her the gravy and she just licked some for herself too. Will test again

 

@Tricia Cinco(GA) & Harvey

Here's what we have so far

PMPS 150 (2 units novolin n)
+1 174
+2 101
+2.5 83 (sugar water)
+2.75 (diarrhea)
+3 87 (15ml a/d with water and honey)
+3.75 75 (feeding 1-2 tsp gravy)

 

**** 59

 

+4.25

 

straight honey?

 

From the little I've been able to learn about Novolin, it peaks in 4-6 hours, so we're in the middle of that, roughly. Yes, I'd rub some honey on the gums. It's absorbed faster that way.

 

Retest in 20 minutes. If she'll eat a little more gravy, it's okay to give that, too.

 

Sarah, I'm not trying to scare you, but do you know where the nearest veterinary ER is? Just in case we can't get her to come up?

 

She has gone back to the gravy herself thank God. Is there a recommended way to get the honey on the gums? She's a pissed off cat right now

 

45mins away

 

Well, it's risking skin if you put in on your finger and rub it on her gum, probably. It's very good that she's going for the gravy. Add a little honey to it and see if she'll keep lapping it up. No need to worry about over carbing her. She's made her point and earned a reduction!

 

For future reference, that rule applies to long durations insulins like Lantus or Levemir. With a shorter duration insulin like Novolin, you'd want to slow things down sooner.

Sarah, you know your cat best. Do what you can to calm her down. We need her cooperation if we are to avoid a trip to the ER. Love on her and maybe distract her with her favorite toy?

 

Ignored the gravy with honey of course, but is eating the high carb dry. That ok?

 

Normally, we don't recommend using dry, but this is not a normal situation. If that's what she'll eat, great. What if you drizzle some gravy (minus the honey) on some of it?

 

I was trying to get her numbers up as soon as I realized what I had done, at +1.

 

The gravy is mixed in with a can of Friskies meaty bits so not so easy to separate. She did just eat some with honey though. Will test in 5

 

It's okay if she eats a little of the meat. We just don't want her to get so full she won't eat anything when we need her to.

 

Good. I wasn't criticizing you. Just sharing info as I'm learning more about Novolin. Sorry I'm not more knowledgeable, but I do know about keeping kitties safe.

Do NOT start feeling guilty about this. This is a hard dance, and we all make choices we later think were not the best. Just hang in there.

 

61 +4.5

 

Okay that's flat. That's good. Will she eat a little more of the dry and/or gravy? Not a lot. We don't want to upset her tummy more.

Test again in 20.

 

I'm feeling extremely guilty. I gave her that shot. If we have go to the ER, how do I keep her alive on the drive, keep pulling over and getting honey on her gums. No one to come with me

 

IF you have to go to ER, yes, that's what you'd do. But we don't know if that'll be necessary. At this point, she's responding to what we're doing, so try not to think about that. She will feel your stress, so try to calm both of you down as best you can. It's going to be okay.

 

58 at 4.75. Sorry, I was confident I'd learnt so much from the FB and now it's obvious I didn't know as much as I thought and it's been a bit of a shock. She hasn't eaten in a little bit, should I try and get some honey on her gums?

 

That's still pretty flat, but it's lower than we'd like her to be, so if you can get her to eat some gravy or can get some honey on her gums, that would be good. Then retest in 20.

Don't apologize. This is a scary, complicated disease, and none of us has ever been perfect at handling it. Trust me. You're doing great.

 

Sarah, don't blame yourself.
And Tricia is one of the most experienced people on this board. You are in good hands! Don't worry!

 

The honey didn't go so well, I tried it in a syringe but short of wrapping her in a towel, I'm not sure of another way to make it happen. The towel would just upset her even more. Should I test now or give the gravy a chance to be absorbed a bit?

 

Thank you all so much for your support!!

 

How long since your last test? No point in testing in less than 15-20 minutes, as it takes that long for the carbs to take effect.

 

Yep, she has stayed up most of the night helping me keep Uncle out of trouble

 

You are all amazing! It's been 20 mins after the last test, but I only got a bit of gravy down her about 10 mins ago.

 

Okay, so test again 20 minutes after she had the gravy. I'll be here. I'm on the West Coast, and I'm a night owl.

How are you holding up, Sarah?

How is kitty, other than really ticked off?

 

Does your local vet have an answering service? My vet will meet me at the office in an emergency Shorter drive and less expense plus kitty sees her regular vet
.
.

 

I'm calmer now! She is trying to find a place to hide from me but not succeeding! The first time I saw her hypo, before I was testing, she actually went blind temporally but the Karo brought her back up so compared to then she actually looks really good! God knows how low she was then! Now at 69 at + nearly 5.5. We may just get through this!!

 

I wish! She did talk me through it on the phone the first time it happened though. All the local vets just direct you to the veterinary school and hospital which has an ER.

 

I'm cautiously optimistic that you are over the hump. Do you think she'd eat a little LC or MC at this point? Just something to keep her surfing. I think you could stretch the next test out to 30 minutes.

 

LC or MC? she hasn't eaten anything in a good half hour now. Should I try some more gravy or honey?

 

She just vomited a significant amount

 

Okay. Don't panic. That's from all that high carb stuff. Wait 15 minutes and test her.

 

When she went really low before, she vomited a lot, more solid though, but then went and ate and ate and ate. And was fine afterwards. Keeping my fingers crossed that she'll do the same here! If she doesn't, should I get something down her, or wait till I test?

 

Give her some time to let her tummy settle. If she wants to eat, let her, but otherwise wait until 15-20 minutes before trying to encourage her to eat.

 

Just rubbing karo or honey on her gums will get sugars into her bloodstream. It will work faster then eating it.

 

Your doing great. The first time Callie's bg dropped below 100, I really panicked.

 

Yay! 87 at +6!!! Without eating, so her body is doing it by herself now!

 

Considering 5-700 is her normal, this has been very scary!!!!

 

Great. Test again in 30. Remember, HC can last about 2 hours in the system, so we don't want to let our guard down yet.

 

What's HC, LC and MC?

 

Short for High Carb, Low Carb and Medium Carb

 

Ah! So you mean if she doesn't eat in the next two hours she could drop again?

 

Sorry, Sarah. We use a lot of abbreviations and slang here. LC is typically anything under 10% carbs, MC is 11-19% or so, and HC is 20% and above.

 

She could, but not necessarily. If the insulin is wearing off, she would be rising naturally. What we want to be sure of is that the effect of the gravy, syrup, etc. isn't artificially raising her numbers, because when it wears off (after about 2 hours), she could drop again. So if her next test is at least 30 minutes after the last time she ate and it's the same or higher than her last test, don't feed and test again in 30. If that's good, don't feed and test in an hour. At that point, if she hasn't dropped, she should be safe. Does that make sense?

 

It does! Thank you so much! Should she get in to the vet tomorrow or is there no need since it was me screwing up not a wrong dose issue? Also, if she does eat by herself during that time, do I follow what you describe above still?
She is 86 at +6.5 hours

 

I would pull up any food at this point. I doubt she is going to demand some. How long is it now since she ate last?

 

About an hour. It went down by one point.

 

Okay. So test in one hour. At that time, if she's any higher, I'd say you can offer her food and go to bed. I don't think a vet visit is necessary unless you see anything unusual going on, like more vomiting, not eating, etc. She may have diarrhea from all that high carb stuff -that's normal.

I don't know anything about Novolin dosing, but I'd say she's earned a reduction in dose. If you've been getting your dosing instruction from your vet, you might want to call in the am and ask about reducing. Otherwise, follow the instructions you've been given. If you're unsure, post here and ask for help. Hopefully someone that knows more than I do will be around to help.

If you are nervous at all, it's okay to test in 30, but no later than one hour after the last test. You must be exhausted - it's 5:00 am there, isn't it?

I'll be here until you are comfortable enough to go to bed.

 

Thank you! This all happened because I gave her the shot when I shouldn't have, she had tested too low. I think I read that I shouldn't give her insulin for the next 24 hours, no matter what her BG is, is that correct? Her poor ears are having a hard time producing blood now! There's no way the paw would work for this grumpy old lady!!! I wish I could get the shelter to agree to pay for Lantus, but there is no way! (She's a foster)

 

She is so awkward! I can't get her to eat any wet food on a consistent basis! I'm sure I could get her numbers more stable if I coud get her off that DM dry. I bought some YA to try her with but again, getting the shelter to pay for it...

 

I don't know about that rule. I've never heard it, but as I say, I don't know much about Novolin. Typically, if there has been a symptomatic hypo, you might withhold insulin, but from what you've said, she had no symptoms and wasn't really in the hypo zone.

If she were on Lantus, she'd probably bounce from tonight's hijinks. Don't know if that happens with Novolin or not. I would say to call the vet in the morning and ask for guidance on whether or not to shoot, and how much.

You are amazingly dedicated to a foster kitty! Of course, if you're like the rest of us, you love them all, so I guess I shouldn't be surprised. I can understand the shelter's hesitation, but it is too bad, as it is holding her back from regulation and possible remission.

Have you been to Dr. Lisa's site? She has some advice for getting a kibble addict off the dry stuff. Check it out when you have a chance: http://catinfo.org/docs/TipsForTransitioning1-14-11.pdf

 

Since she went down so low, she will probably be bouncing
Up and down for a few days. You should talk to your vet about lowering her dose a bit. It great that you were home testing. You probably saved her life.

 

Ok, we're at 92 at +7.5. She's not going up very fast, but she is going up. Is she out of the woods now?

 

Yes, I would say she is. You can offer her some of her regular food if you want, but if she doesn't eat it, don't worry. You can go to bed!

 

Thank you so so much for your help!!! I really thought I was going to loose her tonight! Thank you doesn't seem enough! Everybody's support has been amazing and I'm sorry for getting snappy!