Korbel Hypo'd

I know we're not out of the woods yet, but I think she'll be okay.
First of all, this is the first time in 10 years that this has happened!
I have to admit, I've been very lax lately in testing BGs. For about the last 2 years, everytime I test she's been around 200-250, so I haven't tested that often lately-BIG mistake!
She got her shot at about 7am-and ate her breakfast.

Then around 11:30, I was in the kitchen making myself a sandwich and happened to look down the hall and saw her just outside of the door to the cat room-where the litterbox and food are kept. She was sort of collapsed on the floor and trying to stand up but didn't have the strength/coordination, so she looked like she was just sort of swimming.
I went to her and tried to help her to her feet, but she just sort of slunk back down and started meowing incesantly. Then I took her to a spare bedroom where I could lock us in since the dogs are now trying to figure out what's going on. At this point I'm thinking she had a stroke or spinal injury of some kind.

After a few seconds, she can stand but her walking is uneasy-almost like she needs to keep a very wide stance to keep from falling down. Now, this is the first time I start thinking hypo. THen I go grab my glucometer and the battery is dead! The vet is closing in 1/2hr so I'm trying to decide what to do, since she does appear to be coming out of whatever it was. If it's not a hypo, I need to get to the vet. If she's on the upswing from a hypo, I can handle that at home.

After looking around, I finally find some AAA batteries in a remote control. So, I finally get a chance to test her, and the reading is 41-this is after the worst of the symptoms seem to be gone. I tested again and it was 46. THen I find some crunchies for her-she seems like she is starving-she devoured them all down andgave her some more wet food.
Right now, it seems that all the symptoms are gone-her balance and gait seems normal again-her bg is still in the mid to upper 40s.
I'll just keep testing her to make sure her numbers keep going in the correct direction.
Once she gets about 75 or so, I'll run to the store to get some more AAA batteries, since I think I'll be testing her before shots again!
Who knows maybe she's heading for another honeymoon!!!
Jennifer & Korbel

 

After writing that I tested her again, and now 38.
Not much different than the original 41
I gave her some more dry treats and will just keep checking her

 

how long has it been since the insulin was given? how much was given? and what kind do you use?

the 41 and the 38 are virtually the same number but we'd like it to go up some, especially if it has been less than 6 hours since the insulin was given.

 

i'm here too, have'nt completly read intial post. brb.

 

Opps sorry
Now, it's been about 6hrs since the shot and she got 2units of Lantus.
Normally, she has a very flat curve with little to no difference in numbers.

 

wow, i can see where it would be easy to get lax after years of the same #'s. i've often wondered about that. yes, what insulin and how much of it?
thank god for spare batteries. are your strips expy?

 

want to try a smidge of karo, syrup or honey on her gums?

 

Jennifer, I am so glad Korbel is oaky. The old saying....just when you think it is safe to go back in the water.....Thank God you were home. Me thinks Korbel will be tested b.i.d. from now on :roll:

 

yes hope, then the sharks reappear!

 

Strips are still good-but just barely-I'll have to get new ones of those also!
Her symptoms are completely gone now, but bg still 40ish. I wonder how low she really was when she was symptomatic!

I can try a bit of honey on the gums-I have been giving her dry treats which will have more sticking power but not the immediate boost of honey. I'll go do that now.

 

right jenn, and we still don't know if she's done going low. smidge won't hurt.
this is almost a good news/bad news moment huh? dosecreas!

 

I think that's safe to say!
This is almost as exciting as the time I accidentally gave Calypso the shot instead of Korbel. nailbite_smile
I've been lucky that she's been around for 10years, but I guess this is the downside to having a very easy, stable diabetic cat for so long-you get complacent

 

2 scariest times of diabetes? dx, and going into remission...yes?

 

Yes, and I know better!!! She once had a 3 year honeymoon-but that was about 7 yrs ago

 

awww, that gives me hope. tom had a 2.5 year honeymoon after only 30 days. now we're 7 months back on the juice.
what's your latest #?

 

41
She seems to be holding steady at 40.
SHe's losing interest in food-not surprising since she has eaten a lot!
She's also starting to get a little grumpy with me pulling her out from under the bed all of the time!

 

concerning that she is stuck at 40 with all that food and did you smudge the syrup?
don't really like that. do you? keep her away from under anything. for her own good.
can someone get you some fresh strips.

 

since your obviously not a newbie would you object to me asking a couple of lantus folks to look in. or are you more comfortable handling this without. i'm pzi so...thats what i know.

 

I did manage to smudge some honey on her tongue/roof of mouth.
I tested strips with control solution and it was within specs-also tested on myself just to see higher number-got a 137.

I'm not too concerned about the numbers not coming up quickly, but mainly because the symptoms have completely gone away-maybe that's just a false sense of security. But she is night and day from where she was when she had symptoms.

I'm fine with anyone taking a peek.

 

Well good news/bad news

Good news is I just tested her and she is 80/84 (tested 2X)
Bad news is, the sudden sprinting of 2 dogs towards the back bedroom where she is alerted me to the fact that she is now throwing up everything I got her to eat.
It's been years since I've let her have anything dry and I just gave her a lot, I guess it didn't sit well in her stomach!

 

Hi Jennifer! Wow, what a day you're having.

Keep in mind that a long-lasting insulin like Lantus can often produce a prolonged hypoglycemia event. That means that Korbel could bobble up and down for a while before going back up. Small amounts of the gravy-style high carb wet foods are good, because you can keep giving little bits of gravy to keep bumping the numbers without making her get too full. The last thing you want is for her to decide she's full just when you start to get the numbers up, or for her to vomit.

How many hours since the shot has it been now?

I'd like to see her bump to the 50's or 60's. What kinds of food do you have to choose from?

eta: just saw your last post. Hooray for 80's, but not for vomiting. Can you test again in 1/2 hour to see if the # is staying up?

 

For food, I've got wellness. I've got a grocery store literally 2 blocks away, I can be there and back in 10 minutes if I need to.
Fancy Feast has always made both of my cats sick. The only food they've been able to consistantly keep down is wellness.
I tested her again, and she's now 79.

 

79 is good. It's about 7 hours after the shot, right?

For good measure, how about feeding about a tsp of the Wellness with 2-3 drops of Karo mixed into it. Do you think she'll eat that? Then test another 1/2 hour after that. Maybe we'll be able to leave her alone for a while after that.

 

If FF makes Korbel sick, there's no point in doing that. You can add a couple of drops of Karo, honey, etc. to the Wellness. The combo of a simple syrup and LC will bring numbers up and the LC should help to stabilize the numbers. Just feed a very small amount -- a teaspoon or less of LC at a time. (I often will use about 1/8 or 1/16 of a small can.)

 

Yes, it's about 7hrs after the shot.
I can try to get her to eat a bit of wellness with some Karo mixed in.

 

as an FYI. when my cats eat anything out of the ordinary food, they barf it up. twinkie just last night got into a pierogi and some macaroni and barfed it all up. knew something was amiss when higher BG. went looking and sure enough.
beasley found out how to open a lock and lock canister and got into dry dog food and same thing. elbarfo.
so I would assume the dry food was just too much for kitty

 

It is now about 8hrs after the shot.
Just checked her bg, back down to 42
Looks like the jolt from the original honey has worn off and since she didn't keep down the dry stuff, that didn't help
She's now eaten some canned wellness with a bit of Karo mixed in.
I'll check again in about 30min or so

 

good, see you in 30 minutes.

If the # isn't higher next time, you can increase the amount of Karo mixed into the food.

 

Maybe she threw up because she has been eating so much? Wow. That really is a cautionary tale of why, even long time stable cats need testing!

 

Yes, it's a not so subtle reminder!
What gets me is hypo wasn't even on the list of things that went through my mind at first-that's how complacent I'd gotten to her being diabetic....
My first thought was stroke or spinal injury. Then I thought brain tumor (she had horner's syndrome a few years ago-it cleared up on it's own but a brain tumor was a possibility).
I actually didn't think hypo until she started to get some control back.

 

maybe this should go into the annals (?) is that the correct word? Janet and Binky used to keep important and unusual events bookmarked together to use as reference. She wanted to use my story 3 years ago when tom hypo's while i was out of it on ambien but here on the board and kind of lax about following the advice. "like, i'm sure he's fine now, i'm going to bed"
Man, everyone and their mother jumped on that thread to keep me up and going!

This is a Very important reminder to every old timer here to not become complacent.
it should be advertized somehow.

"korbel's story"

 

Tested again and it was 29....
Gave her some honey directly onto the tongue. Then gave her some more canned wellness mixed with Karo. Tested again about 10min later. 39
We're now approaching 9hrs after the shot.
When she had her 3 year honeymoon, her bg was usually around 100. So this is definatly low for her.

 

I would do more honey and test in 15 minutes...

 

10 min probably isn't enough time for the food/honey to get into Korbel's bloodstream. Usually it takes 15 - 20 min.

 

I guess when we're in those low numbers the meter accuracy isn't quite as good, although you'd think it would be more accurate down there...At least you want it to be more accurate down there

 

i really can't believe how serious this became...i thought you were out of the woods. i can almost hear the change in your tone about this.

 

i'm so glad libby and sienne are here. i would never have expected this duration...probably would have said clear and good to go at +7 in the 70's. pzi'ers can't help lantus'ers with hypo's hmm? such a different animal the lantus is.

 

I wouldn't worry about meter accuracy. You're not getting a LO reading. Even if the meter's off by 10 - 20%, you're still in low enough numbers that you want to be able to bump Korbel up.

FWIW, we've seen hypo symptoms persist for 16 hours. With a long acting insulin, the duration of low numbers is long. The good news is that if this were a shorter acting insulin, the drop would have been much more severe. You're doing fine. It's just a little bit of a trial that you have to be on your toes for a long time.

 

I agree with Sienne. Everything is fine, we just need you to stay with it for a while longer. ((((Jennifer)))) you're doing great and you're in control of this.

 

You've done great too Lori! I didn't expect this duration either.

Okay, just tested and she is at 64. I gave a bit more honey on the tongue and got her to eat a bit more wellness + karo. So far she's keeping everything down since getting away from the dried treats.

Test again in 15 or 30 minutes?

 

that's nice of you to say jenn, i'm just sitting back as this unfolds and learning. one day i might be alone with a lantus newbie...gotta know something ;-)

 

So I had a bit of manic laughing when I read that!
It's true though. I think the last time I gave any serious thought to Korbel having a hypo she was probably still on Humulin L. The duration would have only been a few hours, but the drop would have been really bad!

 

better. I think you can wait 30 minutes. Small amounts of food/syrup at a time will hopefully keep her from vomiting again.

How is your supply of test strips? You don't want to run out.

 

I've got 11 left. The pharmacy is open for 2.5more hours. After that it's an hour drive 1way to get to a pharmacy...

 

let's see where she is at the next test. It might not be a bad idea to get some more before the pharmacy closes.

 

That's what I was thinking also. I'll only be gone for about 10 minutes or so, but I know I'd feel a lot better leaving if she is holding around 70 rather than dropping back down again.

 

just as a newbie type here...will this mean no shot in the am or what? reduced shot.
learning here. on pzi we generally skip next shot after real hypo's.

 

I'll wait to see what Libby and Sienne say, but my instinct is to totally skip the am shot and re-evalute tomorrow pm. Unfortunatly, I don't have a number to go with what I shot at before this hypo. I don't know if she was 100 or 200. Since she is so consistant on Lantus, my guess was that I shot low, but like I said, I have no way to know that for sure.
Time for the next test...

 

I believe the process is similar to ProZinc, which is also long acting, and due to insulin sensitivity the following cycle we skip the shot. I'd rather defer to Libby (and Jill if if she stops back) on this. We've also got several more hours of monitoring so lets not get ahead of ourselves.

 

I would wait and see how long this takes to come up before thinking about tomorrow. Definitely no shot tonight, and definitely she doesn't need 2 units anymore. :mrgreen:

 

63
I gave a bit more honey on the tongue and got her to eat another few bites of wellness + karo.
I'm going to run for more test strips while I can.

 

ok, see you when you get back.

 

i'm sorry, i just can't help but think about this happening so unexpectedly if mommie were'nt home. it's the totally unexpected part and the extent of this hypo that gets me.

 

Sorry -- I was thinking in terms of the next shot not necessarily tomorrow.

 

Okay, loaded up with more test strips!

Latest reading is 54 (10.5+hrs)

She's really not very hungry anymore. I got her to eat a little bit off of my finger, but not much. I put a little more honey on her tongue.

 

Yeah, and she's asymptomatic right now. If I hadn't seen her when she collapsed, I wouldn't have tested her and I'd probably be getting ready to give her another shot right about now, and most likely would NOT have tested before I did it.....

 

there's no reason to beat yourself up, Korbel will be ok so now you can just consider it a lesson learned.

Can you test in another 30 minutes?

You're doing a great job keeping her numbers up. I know it is a struggle.

 

Yeah, I'll test her again in another few minutes.
The good news is the dogs are finally leaving her alone, so I think we're safe from vomiting for the time being!

I have 8 or 9 strips left now in the old batch. Do I want to do anything to prepare for the switch? Should I do a few tests on both old and new strips to see how they compare?

 

You could use some control solution with the new strips but I suspect it will be fine.

 

Back down to 39

I gave her a bigger shot of honey directly into the mouth.
I couldn't get her to eat any food, so I gave her a few bites of sliced turkey meat. Hopefully she will keep that down.

What do I do if I can't get her to eat much anymore?
I could force feed her if necessary, I have a few syringes.

 

numbers in the 30's call for another test in 15 minutes. Sorry Korbel.

 

Is there any place nearby where you could get HC canned food -- stuff with gravy? Or could someone pick some up for you? Generally, a cat will eat the gravy and it's not all that filling.

 

She's really starting to get grumpy with me!
Back up to 80
Gave her another 2 bites of turkey meat and got her to eat a fingerfull or 2 of her actual food.
My thought is to skip the direct honey this time since I'd like to see how she holds without the sugar boost, or is it too soon for that yet?

 

Not sure what you mean by HC canned food?

 

sure, give it a try. You should test in another 1/2 hour since this is probably just a sugar boost and might wear off again.

HC canned food - high carb canned food. Most people use the Fancy Feast varieties that have gravy. The gravy gives them a good carb boost without filling them up, and most cats LOVE it and will eat it even if they're full. If FF makes her sick, that might or might not be a good option.

 

Thanks
Pretty much any of the FF has always made her sick.
Other than wellness, I've got cheese and turkey slices that she would probably eat, but those are both more high protein.
I have some wellness dry dog food, which in a pinch would maybe be okay?
I don't have any of the dry crunchies left from earlier-but they made her sick anyways.
The grocery store is open for about another 2 hours or so if I wanted to get more crunchies. Maybe it was just the amount that she ate?

 

usually we stay away from crunchies and use wet food or wet food + syrup. There are some cats here who can't have wheat gluten (which is in most of the gravy foods) so they use low carb wet + syrup, just like you have been doing. I think you're fine, I was just trying to think of a way to entice her to eat a little more carby stuff.

 

Okay thanks
Out of curiosity, is it just wheat gluten or is it gluten in general (wheat, barley, rye) I actually have celiac disease and need to avoid gluten because of that...

Okay, it's been about 30min again, be back in a sec.

 

71
Got her to eat a few more bites of turkey and she ate a few bites of canned food on her own.
I'll test again in 30min.

 

You're doing great!

I don't know the answer to your gluten question. Most people avoid the Fancy Feast (or other food) that contains gluten -- but it's wheat gluten in FF -- because many cats are allergic. I've seen on various food labels that they contain other forms of gluten. Maybe someone with better information on nutrition can answer your question.

 

maybe she's leveling out a little, if that last test was after only low carb food. I hope she'll start to bounce soon.

 

The last test didn't have any honey directly onto her tongue, but it did have some of the canned food mixed with karo from earlier. Although, I didn't actually mix much karo into it.
If this next test is still up around 70 or 80, I'll try getting her to eat a bit of her canned food that has not been mixed with karo.

 

Does she like ice cream?

 

I don't know if they do or not, but I do! They do like yogart though.
I don't have either on hand though. Maybe another trip to the store is due...

 

If Korbel tends to vomit with new foods, I'd stick with the canned food that you know will stay down. I think trying just LC if numbers are staying in the 70s range sounds like a good plan.

 

LOL! It's not a bad idea to get a treat for yourself for once this is finished. :lol: Let's see what the next test is, maybe it won't be necessary to carb her up anymore (I hope, I hope!).

For future reference, next time you're shopping for Wellness, the Sardine Shrimp & Crab is 16% carb. If she'll eat that, it would be good to have on hand for low number situations.

 

67
We are now 12.5hrs post shot.
After the last test (30min ago), I gave her a few bites of turkey and some canned wellness with karo mixed in.
This time I got her to eat just plain canned wellness with no karo.
If in 30min when I test again, she's holding right around 70, would it be safe to say we're out of the woods or could she drop again yet?

 

if she's 70's at the next test, you can probably wait an hour to test again. I don't like to stop testing altogether until we have at least 2-3 rising tests in a row. The 67 is encouraging, though. At least she didn't drop this time.

 

I don't know if I've ever seen that flavor. I know both of my cats will turn and walk away from the salmon one.

 

You're probably going to need to stick with this for a bit longer.

Have you eaten anything?

 

I was holding my breath on that one. The past few times she'd get to ~80, then drop to 70, then drop to the 30s.

 

Yeah, I had dinner about 2hrs ago between tests. But ice cream reallly does sound good!

 

newbie so no help for you but wishing you good luck.

binks & celi

 

Okay so +13 is 52
So, she's dropping again, but not as fast as before. The last 2 times have been without any syrup.
She ate some plain canned food again after this test.
I'll check again in 30 min. If she drops more, I'll get her to eat the food/karo mix again

 

Thanks!

 

sounds good, see you in 30 minutes. you have the routine down now. :smile:

 

56
gave a little food (no syrup)
test again in 30 min

 

don't be afraid to use syrup if you need to. Remember, we don't want her to get too full because we don't know how long we'll have to keep this up.

 

+14 53
Since she's holding at about 50, I just put her in front of her food and she ate a mouthful. I'll check again in 30 min.

Here's a numbers recap if it helps at all. I might have missed some since the times don't match up-I know I was testing more frequently than this.

2units lantus + breakfast
+4.5- noticed symptoms and tested 41/46
+6 41
+6.5 80/84-vomited
+7 79
+8.25 42
+8.5 29
+9.5 64
+10 63
+10.5 54
+11 39-big dose of honey
+11.25 80
+12 71
+12.5 67
+13 52
+13.5 56
+14 53

 

I'm encouraged that she is staying in the 50's. Of course I would like 60's or 70's better, but it's better than 30's.

 

Ditto what Libby said. You're doing a great job.

 

Sorry, I'm a little late posting this, computer is acting up.
So, it's time to switch to the new batch of strips.
14.5+
old strips-52
new strips-55

 

how are you feeling? I'm tired, so I know you must be. How do you feel about adding some Karo again, to try to get Korbel surfing in a range that is more suitable for sleeping? It might still take a while to get her to that range, so some syrup might help.

 

+15 62
I gave her a shot of honey like you suggested.
The 62 was without any syrup though!
Yeah, I'm getting tired. Glad tomorrow is Sunday!
She doesn't seem like she's dropping anymore. I'm thinking test in another hour-give her ear a break!

 

an hour sounds good.

One of these days the insulin has to wear off! We have seen this go on for a long time, though. It's that pesky overlap, it makes Lantus a great insulin for cats, but when you make a mistake it sure does take a long time to get past it.

 

That's what I keep thinking, it has to be almost done!
Thanks for hanging out with me, I really appreciate it! If you're getting really tired, I think we're over the worst of it. I just want to get one more reading for sure and then decide what to do next. If she's holding in the 60s I might call it a night. If she drops at all, then I'll keep going.

 

it's the weekend, I can hang out. I just have to go test/feed my own cat now but I'll be around.

 

+16 84
So at +15 I did give her a tongue-full of honey, so I'm sure some of it is inflated from the sugar.
What do you think?

 

how about this - one more good scoop of food with Karo mixed in and test in 1/2 hour. Then I really, really hope we're done. She has pulled this 80's thing on us before. :roll: Though her numbers do look different now than last time so hopefully she'll stay up.

What time (and time zone) is your shot due tomorrow? Obviously you won't be shooting 2 units again. If she's shootable in the morning, I'm thinking maybe 1 unit.

 

I gave her the food with karo mixed in. You're right, 80's tend to be followed by 30s!

Normally her shot is 5 or 6 in the am (mountain time). Today I slept in and was late with the shot. She's due for her shot in 7hrs (6am MST). I'm tempted to skip the am and do a few random tests tomorrow and re-evaluate for the pm shot.