Hypoglycemic Issue -- Eating?

I've posted previously about my cat, Spencer and his recent diagnosis of diabetes and stage 2 kidney disease. He is about 16 years old and I feed him wellness (and tried out EVO--thanks Gina).

This was his first week on Lantus (1 unit twice a day). Everything seemed to be going good. His numbers were around 169 before his first shot, then a few hours after it was about 113. Then the following day, it was something similar. I am the only one really up to doing the ear pricking out of the family and I was unable to do so. My sisters gave the insulin without checking. Everything seemed OK.

Saturday morning he wasn't eating as much, so I rushed to check and his numbers were 31! I freaked, he didn't want to eat his food. So I tried giving him some treats, he ate that. I gave him his favorite, dinner ham leftover from Easter (I figure it has sugar but more of a stable protein to sustain the sugar spike). His number went up to 73. Then fed more, went up a bit more in the 90s I believe. I did not give the insulin, obviously but it was still scary.

What is so strange is that this weekend is the best we've seen Spencer for SO long, months and months. His personality is back. He is alert, energetic, funny, and AWAKE! He had a lot of fun outside in the yard, first time in a long time he did more than drink water and lay/sit. He rolled around, investigated his old favorite tree, and walked around a lot. His spirits are back to what they used to be but his legs are still weak so, they can't exactly keep up--doesn't keep him from trying. I see a massive difference in his behavior yet his sugar is low.

I was having trouble getting blood this morning, finally got it and it was 51, about 2-3hours after he ate about half the can. We've feed him again but we're still worried. I'm letting him rest before I test again.

I'm planning on calling the vet in the morning and keep monitoring his levels. Thank goodness for home testing, I'm glad I did research and didn't follow the vet's original recommendation of just doing 2 times a day and making sure he eats--then doing a blood glucose curve in 2 weeks. Could you imagine if I gave him insulin with his sugar low like this?

I'm not sure what's going on. He eats about a can-can and half a day. But sometimes he just eats a can a day. Not sure what to do!

 

You have two issues here, first is the cutoff number, when you give no insulin. Since you are fairly new to testing and are having really nice drops I would set the number at 200, anything below that you can either not shoot or you can set a second cutoff, a point where you will give a reduced token dose. I suggest that number be 150 and the dose half of what you normally give. The reason for the small dose is to prevent a big spike before the next shot. That creates a roller coaster effect that is not fun for your cat.

The second issue is what to do for hypo. Anything below 50 requires testing until the numbers start to go up. When you hit 40 you want to start giving high carb wet food and dry food if necessary. When you get into the 30s and are still dropping I would go to the vet. A lot of people here will say you can handle this at home, but I think it's too much of a risk.

The last ditch hypo treatment, if the cat won't eat or is comatose, is to give either syrup or another sugary substance, I recommend the small tubes of icing gel used for cake decoration, administer it rectally and get to the vet.

Print out Melissa's periodic post about hypos and tape it to your refrigerator door. It will help you recognize signs before there's trouble and it will help you stay calm in an emergency.

 

Do you use the warm rice sock when you test? I find that I get blood the easiest when Tugger's ear is warm and has had a nice massage before the poking commences.

Tugger also gets playful and acts like he feels great when his numbers are low. He likes to play games and is quite kittenish.

It is scary the first time it happens, and wow a 31 would have made me panic. Tugger hasn't gotten that low yet but he responds well to food and I've been lucky enough to catch him when he's dropped early in his cycle. I keep a couple of flavors that he adores just for times when he's acting like he doesn't want to eat, which is rare for my wee little piggy ;-) He usually does quite well with hc gravy on his lc food and lots of ear pokes to be sure he's coming up and staying up... ECID (Every Cat is Different) though. Tugger is NOT the normal I don't think. Oh, and I keep chocolate for myself in those scary moments ;-) We won't talk about how tight my pants are getting :lol:

You've come to the right place for help =) There's lots of great people here who can help you through this!

 

He may need a reduction in dose. Talk to your vet about going to .5 unit BID.

 

It may be that your kitty's pancreas is healing and he may not need insulin for very long.

If your kitty can stay below 200 for an extended period and bring his own blood sugar down during the course of the day with no shots... he'll be on "Honeymoon"

If not on insulin, blood sugar numbers between 50-100 are "Normal" and there is no chance of hypo.

 

This is great news indeed! You are seeing the old Spencer come back now that his BG's are at a better level. Are you still giving Lantus? Have you decreased to 0.75Units bid? What dose are you giving? Sounds like he is doing really good and may continue to get decreases. Keep the spot checks up--the more data you get the easier it will be to see if he earns a decrease in dose.

Would you be able to set up a spreadsheet (ss)? Here is a link that you can follow from the Tech Forum...http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16&start=0

 

He's eating wellness now, not that much of a trouble with eating but his numbers, in the 50s-80s. I was at the hospital for school all day and was unable to call the vet because by the time I was done, they were closed. I left the vet an email and will call in the morning. I can't help but wonder what is going on with him! We're all feeling stressed out about it.

All I can do for now is keep testing and wait til I speak to the vet.

I really appreciate all of the replies.

Thank you.

 

As I said in my pm to you - you may well be coming off the Lantus far faster then you thought - sometimes with a radical change in diet and the quick administration of insulin cats only need a little while to go into diet-controlled remission.

And as I also suggested - you might want to get some control solution for your meter and test it - just to be absolutely sure. It never hurts to test the meter - in fact you should with every single new packet of strips you buy since there is a slight risk that a packet might test high or low (I've had one that tested high). If that happens the manufacturer will usually replace it at no cost.

 

Oh yes, I used the control solution has soon as I got the meter. I checked with the solution before and after the low numbers. And I even tested myself as well (I know my blood sugar averages); all seem to point that the meter is calibrated well. I've continued to check his blood sugar and it is remaining low from 50-90s--no insulin needed. I'm quite surprised; only 5 days on Lantus and switch to low carb wet food.

We've switched to fancy feast low carb option to try. And both cats are actually eating with no issue. My younger cat Sammie is a very picky eater, this is the first time he's asking for wet food since we've made the switch.

Although Spencer is doing well with his diabetes, I am worried about this kidney disease (stage 2) and I know I need to keep him on a low phosphorus food. By looking at the list, it seems the average or the doable (it seems the lowest phosphorus foods are high in carb) is about under 300 for phosphorus while maintaining under 10% carb. Is that still too high? Does anyone know the recommended amount?

Thanks.