Is this bg getting in dangerous territory?

My kitty is still being regulated. Today she has been bouncing around. AMPS 0700 bg was 332 the day was normal evening PMPS was 275 which is normal but at +2 she was at 62. This is the lowest reading we've had since starting vetsulin May 12th. I have been holding back 1/3 of evening feeding and went ahead and fed this. She seems normal but her nadir is 2-3 hrs away. Should I be concerned and since we are going into the night do I need to stay awake to watch for a hypo episode? She is only on .5 cu and the Vet said this was such a low dose a hypo situation was highly unlikely?

Thank you.

 

I wouldn't panic yet, but I definitely would keep testing at least till she's past her nadir. Have you tested her since you fed her the rest of her dinner? S0metimes just a little low carb boost is all they need to "surf" in good numbers.

 

I will be up for a while if you have questions or need help. I will stay with you if you find yourself dealing with a hypo.

 

I haven't tested her since but did feed her some more (a little w/d dry). Her eyes are still dilated somewhat but she did a little grooming and is curled up in her bed. Not real relaxed but the ravenous hunger seems to have subsided.

 

I really appreciate your concern. I'll keep watching her for the next hour or two. I have the Karo and hypo instructions at hand. I think we are doing ok now. How long does it take for food to have an effect?

 

The canned food takes effect pretty quickly. Do you have any gravy food on hand? When was the last time you tested her? It might be a good idea to get another test now.

EDIT: Dry food takes much longer to take effect.

 

I would definitely test again now, that was a fast drop. Over 200 in 2 hours if that test was correct. I would have tested within 30 minutes of that drop after feeding at least MC food.

 

Yes, I'm wondering if it was indeed accurate.

 

I had a similar big drop on December 9th and immediately fed gravy and he would come up a bit 30 minutes later and 30 later drop again. It was over 5 hours of feeding gravy lovers before he stayed up. If the drop is correct you might have a lengthy time ahead of you tonight,. Do you have plenty of test strips.

 

@bbwyo Can you please test again and post the result? Thanks.

 

I actually did retest her on that first 62. I just tested her again +4 and she's at 67. Yes lots of test strips

 

yes I just did she's' at 67.

 

That 67 is a real good sign that she might not drop too low. I would feed some low carb food though, just in case.

 

Normal food is ff w/ 1/3 c prescription w/d. I fed her some of the ff classic at first low reading. then some more of the w/d.. she was ravenous. that has subsided but she's pretty lethargic. will see if she will eat more of the ff. I do have a question The Hypo instructions say that dry food will keep the bg #'s elevated longer. So the wet food is faster but the dry food helps keep numbers from dropping?

 

They will both elevate bg; the wet food is faster acting, the dry may last a bit because it takes longer to process, but it also won't take effect as quickly. Do you have any gravy-style food for hypos?

 

Good! You say her nadir is around +4-+6? Do you know if she gets a full, twelve-hour duration from her Vetsulin?

 

I have the ff classic that has a gravy-like substance in/around it. I've been feeding her that and just fed some more. She seems to be coming around will test again shortly

 

For future reference, it's a good idea to have a few cans of the gravy-style food on hand for hypos. You can feed just the gravy (helps keep kitty from getting too full, in case you need to do a lot of steering with food), which is where most of the carbs are.

 

Back to your original question, is this bg getting into dangerous territory?. A 62 itself can be dangerous, depending on the cat and the meter. But a drop that fast can easily be in the 30's or less in another 15-30 minutes. So if that drop had happened with my cat, I would be scared at that point. If I had got a 67, 2 hours later without using any high carb I would be a lot less scared. At that 4 hour pont, I would expect a low carb meal followed by tests in an hour and then another hour to remain over 60. But I would still test in an hour and two to be safe.

 

I dont know that. I guess I've only tested up to the +5. When I look back at her spreadsheet it does look like she she stays pretty stable and I'm very close to the 12 hr feeding/dosing schedule.

 

So I'm mixing a 6th of a cup of the hi carb w/d in with every meal. The Vet wanted me to go to the W/D 100% but I haven't done that. the 1/3 cup a day amounts to about 1/3 of total calorie intake. I'm trying to understand "if I had got a 67 2 hrs later without using any high carb" you would be less scared?

 

That is a huge drop at just +2.

 

I understand. I have been afraid of her getting really full and wondering how to deal with that tomorrow? Yes feeding only the gravy would have been better. is there anything else like that that I might have on hand?

 

The 67 at +4, without the necessity of feeding HC food, shows that your kitty is staying fairly stable - at the moment. That can change quickly.

 

But she is feeding HC....dry W/D

 

Would exercise have caused some of the drop? I took her out for a walk and play time..she was feeling very good.

 

You're right. I forgot about the dry food! Thank you!

 

Might have contributed to it a bit, yes. Exercise burns calories faster.

 

Basically at +2 I would have started to fear that your cat was heading for big trouble and at +4 I'm not too worried at all, as you didn't need to apply much quick acting high carbs. I would still test in an hour, maybe even 30 minutes.

 

How is she now? This would be a good time to get another test.

 

126 but a very full tummy! What happens next?

 

Okay, don't feed any more, but test her again in about 20-30 minutes. Please post your result.

 

By the way, which one of you is Bev, you or your kitty?

 

I'm Bev Kitty can't type. how do I post multiple tests for +5?

 

Lol, she can't?!?!? So what is your non-typing kitty's name?
Do you mean on your spreadsheet? I just stack them and add a note with the times, if they're not all at the same time.

 

Usually its a good idea if your battling low numbers to keep testing until at least two hours after last food was ate and which hasn't dropped in bg level before you consider your cat safe. Also you want to be an hour or so past the usual nadir point.

 

I'm really sad to say that Kitty is her name. I had too much input. Some people call her Rosie, others Abbie so between the 2 of us Kitty B. works. How does she normalize after this episode? Will the extra food change how she should be fed tomorrow? Do I reduce her dose tomorrow? The Vet told me to stop testing, that it would take 3+ weeks for her body to regulate and then we would start testing. I guess I'll just have to tell her I didn't stop.

 

You're right. That's exactly what we're going to do.

 

Kitty, I love it! She is a beautiful girl.
I don't know why so many vets tell owners not to test. Our cats are like our children - I certainly would not blindly inject a child with a potent hormone like insulin! Kitty may bounce from this, meaning her body may dump a whole lot of glycogen because it goes into a panic, thinking she needs it, so her numbers tomorrow may be high. It can take up to three days sometimes to clear a bounce, so don't be upset if she continues in higher numbers for a few days. And definitely do not increase her dose. Feed her tomorrow just like you would any other time. If her numbers are below 200 tomorrow, stall, don't feed, and post for advice. When in doubt, it's always best to err on the side of caution and skip the dose.

ETA: Some cats can be more sensitive to insulin after a hypo; you may have to reduce her dose. But post first for help.

 

i don't understand "if her numbers are under 200 don't feed" and do you mean if her numbers are under 200 to skip a dose?

 

I mean, if her number are under 200, stall - don't do anything until you post for help. You don't want to feed because you may need to test again in 30 minutes or so, and you don't want that number to be food-influenced.

 

I don't know what protocol the vets are using that think cats can stay safe without testing. There is no way the safety record with such a protocol is reasonable as there are many cat owners posting at sites like this that encounter hypo trouble.

 

Boo's sisters name is Miss Kitty.

 

When we stall, we typically wait about 30 minutes and test again to see if bg has risen enough to go ahead with the normal routine. If not, you can stall again for another 30 minutes. If her bg is high enough that you are comfortable giving her insulin, then you go ahead and feed, and decide if you're going to give a full or reduced dose, or none at all.

 

She said it was such a low dose .5 cu??? Re: Stall I thought numbers under 200 were safe to shoot is this because of the incident tonight?

 

Lol. I wonder how many Mr. Kittys are out there?

I know, it's insane.

 

We don't usually recommend shooting numbers under 200 unless you have a good bit of testing in (and on your spreadsheet for reference).

 

Bev, you can go ahead and test Kitty again now.

 

could the Vetsulin not been mixed enough? I try to watch that it's all consistent but when I was first learning to give shots I would turn the bottle up and some would squirt out. Maybe the potency was effected?

 

Possibly, but doubtful. How do you mix it?

 

163.

 

Those drops happen once in awhile, its why I try and always get a +2. That most likely won't be the last time you experience a drop like that.

 

I used to get drops like that fairly frequently when I used Vetsulin, too.

 

I try to be very gentle. tip back and forth slowly and watch the white stuff swirl a little, then I very gently roll it in my palm a couple of times. I'm wondering if when I tip the vial up to insert the syringe possibly it is more concentrated

 

I was told to repeatedly roll it gently between my palms for a minute or so, so it wouldn't get foamy.

 

So this wouldn't be considered a real hypo event? and what is considered a large drop

 

Awesome! That's without any more food, right?

Well, that was a very big drop, and technically it could still be considered a hypo event because she dropped so low so fast, into numbers she is not used to being in.

 

yes no food since before the 126

 

Okay, test her again in an hour, if her numbers are still good you call it a night!

 

I would consider a drop of 40 or 50 to be a significant drop from 270. Over 100 is a dive. If your cat was feeling lethargic, it is a hypo event. Depending on the cat and meter range, hypos with symptoms can happen under 80. Its just that many cats are symptom free at 40 even, but some experience it higher.

 

Yes, dropping into lower numbers than a cat is used to can create a hypo, even if the numbers are above the technical cut-off, if you know what I mean.

 

Thank you guys so much. I guess it's good to get this under my belt and hopefully be more prepared another time.

 

What exactly is the technical cutoff?

 

On a human meter we would consider anything under 50 to be time to take action.

 

I was just looking at her spreadsheet from yesterday and remember when I got the higher reading of 332 this morning thinking it was strange because she had seemed to be settling in. This same thing could have happened last night except not to this extent. In the morning I may see a similar bounce...right?

 

The high carb dry food should help keep the bg higher and longer than if you used the quicker acting high carbs like karo or fancy feast gravy from gravy lovers cans. It just takes awhile to elevate the bg with it, maybe an hour or more. The karo and gravy can bring the bg numbers up in 20 or 30 minutes. I think the fastest and quickest method if you need it is syrup on the gums. Which works even if your cat is not eating or even unconscious.

 

Again thank you both so much

 

Yes, I think you probably will. May be even higher.

When I was still new to this I was testing when my vet had told me to stop, too. She had my guy on 7 units of Vetsulin twice a day, and wanted me to go to three times a day! Anyway, I kept on testing, and it's a good thing I did because he dropped down to 34, then to 22. I was a wreck! Thank heavens for FDMB! They talked me through it and obviously, everything came out alright. But so scary! And the vet told me to stop testing!!!! No reputable vet should ever discourage home testing. It's the ONLY way to ensure the safety of your beloved kitty!

 

No problem, glad I was still awake and could help. Thanks, @babyBoo, for sticking around and helping, too!

 

Here's a link that has a post by Jill&Alex in it(#17 in the thread) concerning hypos and meter readings. Champagne(the cat) had bad hypo symptoms at about a 70 on the alphatrak meter. Shoeskitty mentioned the alphatrak and relion tests they did on same blood drop was consistant 90 on their alphatrak was 48 on relion.
Basically Jill&Alex wanted to point out that hypo symptoms at higher numbers are not to be ignored just because the meter says it shouldn't be a hypo.

link to post.
http://www.felinediabetes.com/FDMB/...-3-9-2-75-3-8-3-4-7-3-25-4-9-3-50-5-8.178169/

 

Exactly!

 

@babyBoo, what 's your name, by the way?

 

Just tested for last time and now she is at 322??

 

Duane

 

too high is better than too low..right? will be heading to bed. thank you again.

 

Can you get one more test, just to make sure she's holding her own still, without the aid of food?

 

will do. How long should I wait? mid 300's is about as high as she has been going. could I expect her to be much higher than this in the morning? and if so doesn't it seem like she would definitely need the morning insulin shot?

 

Thanks for your help, Duane, it's always easier when you have others helping, too. Mr. (Baby) Boo is so handsome!

 

She could go up into the high 300s or more, potentially. There's really no way to tell. The reason you don't give increased insulin is because you will drop bg too low again which will trigger the whole bounce cycle over again. It just keeps on feeding itself if you keep increasing insulin. She may well be high enough to have her morning shot, but since this dose put her so low tonight, you might want to reduce it.

 

so instead of giving regular dose reduce a bit? or just give normal does don't increase?

 

That's why I said to test her in the morning and then post for dosing help. Without knowing her numbers there's no way to tell. But it's worth considering reducing a bit, since this dose dropped her so low so fast.

 

You can go ahead and test her now, if you would.

 

got it! How much longer do I need to wait before next test? It's been 20 mins

 

403:-( seems like everything we've been working for is out the window!

 

i gave her an extra capsule of Dasquin this evening. Usually just one in am but she was creaking a bit. Would this have had an impact?

 

I know it may seem like that, but it hasn't! Remember, she's had a lot of food and some of it has been hi-carb. And her liver is busily dumping glycogen, thinking it needs to bring her bg up, too. This will all subside, but you need to be patient; it won't go away in just a few hours. But it WILL go away!

I think you can probably go to bed now, I don't think she's going to drop back down, at least not enough to be worrisome. How long till her morning shot?

 

Shouldn't have, I don't think.

 

about 4.5 hrs. normally 7 am . it's 2:33 now

 

Her bg will probably come back down some before then, but don't worry if it doesn't. Better too high for a day than too low for a moment - too low can kill. She may bounce for a few days, or she may clear the bounce sooner, every cat is different and there's no way to predict.

 

well thank you again. I hope you are able to get some sleep now. We will wait and see what another day brings. definitely a pretty steep learning curve with FD

 

Yes, it definitely is that!
You are very welcome. Hope you can get some sleep, too. I'll try to check in on you guys tomorrow and see how you're doing. And try not to let the higher numbers dismay you too much, they will come back down!

 

Wow what a strange cycle. So glad you tested early and caught that

 

Update: 05/26/17 AMPS was 355 at 7 am. talked with Vet this morning before dosing. She advised to go ahead and give shot this morning but to skip evening shots. She said N2CA and that the low #'s were an indication her pancreas were producing at this time of day. Makes sense we exercise thru day and into evening now that days are long and warm. She's very active when she's outside. I'll be watching her closely today but will be very happy if we can go to .5 1x daily. Really appreciate the help last night and so glad things didn't deteriorate like they could have.

 

So glad Kitty is doing well this morning! I hope the once-a-day dosing works for her. Please don't stop testing, though!

 

Never! One thing I don't understand is that I thought Vetsulin only had a 12 hr. active time? But Vet said it depends on cat. Again it's a real learning curve on the meds/animal/FD! Shot at 7 this am getting ready to do another test. She's been outside but in sleeping now. Need to make sure she's sleeping and not something else! Hope you catch up on your sleep. I hope to get a nap today.

 

Lol, I overslept this morning, and later took a little nap, as well!

Most insulins won't last longer than about 12 hours in a cat, especially the fast-acting ones like Vetsulin. Cats have very fast metabolisms, at least three times as fast as a human's! But I hope for yours and Kitty's sake that it works for her. Every Cat Is Different (ECID)!

If there is any way you can take her completely off the dry food she would do better, maybe even become just diet-controlled. The dry is way high in carbs, and will keep her bg numbers high. Just don't do it all at once and make sure you test frequently, because her insulin needs could drop by quite a bit, and I know you don't want another hypo!

 

Thank you again for your help last night, Duane!

 

Yes Duane! Thank you so much. It was a long night. Hope you get some rest today!