Korbel this morning

For anyone who missed it Korbel had a hypo yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=24148

So, it is now 24hrs since yesterdays shot. Her bg this morning is 221.
I just gave her breakfast, but I'm going to skip the am shot.
I'll check her a few times today, then decide later on how to procede for the pm shot.
Jennifer & Korbel

 

Hi Jennifer

good job last nite! :YMHUG:

since you have an easier day today, if you would like to take some time to set up a spreadsheet and enter all your collected data, (and that's a lot of data!)
that would be really helpful for everyone to see how it's going with Korbel.

Here are instructions Spreadsheet Set Up

I noticed you mentioned last nite, you would be visiting the Lantus forum later on - we hope to see you there!
And for the record, all this stuff gets easier! But you did really well last nite!

 

You did super yesterday/last night, just wonderfully super. Great work, and congratulations...because now, any "low-ish" numbers will be a breeze for you. LOL.

I'm thinking that when you do give her another shot, to maybe take it all the way back down to 0.5. Give this a 'restart' kind of thing, you know? It may be that you'll need to be at a higher dose, but once the bounce clears (and she's bouncing now), you may be right back where you started...

What do you think? Korbel is your baby, so it's your call. I'm just thinking that maybe starting back at the beginning might be a good idea.

Best-
Michele

 

I'd suggest waiting to see where Korbel's numbers are when it's closer to your usual shot time before you decide on a dose. I'm curious to see if there's more of a bounce coming or if Korbel hangs around this range.

I hope you're doing alright this morning and you're heart rate is back to normal. It was a lot of excitement yesterday!

 

Hi Jennifer,

What a great job you did yesterday! Even though alot of us didn't post any help we were still here following along and praying for you.

I'm so glad that every thing turned out ok and Korbel is doing well.

You will be in good hands in Lantus Land.

Robin

 

that's not a bad number at all, hopefully this will be the extent of her bounce. I can't wait to see the rest of today's numbers!

I hope you got some rest last night.

 

Thanks everyone
Yes, I managed to sleep quite well last night!
This morning, the dogs woke me up at about 6:30 to be let out. They need to learn to sleep in ;-)
Well at what would be +2, she's at 238.
I'll keep doing some readings throughout the day, then hop into the Lantus group to try to figure out what sort of dose for tonight
Honestly both 221 & 238 are numbers I would have shot at (assuming I checked ) But there was no way I was going to do that again this morning!
I'll have to put together a bunch of info with numbers and historical stuff to decide where to go from here.

 

your really pulled an all day hypo girl...that was something eles. and the thing is, halfway thru it i thought it was all over.
i think this experience was such a valuable lesson on a few levels. one of course, the year after year treating of a cat would tend to cause complacency.
and two, good to have experienced lantus peeps to walk you thru a hypo. as a pzi'er, when it poops it poops. it does not go back up for hours and hours.
i'm so glad the lantus peeps came around.
you'd better stick around and spread this valuable message to long time users. after only shooting 8 months now i sometimes am in a hurry and think...oh well, i'll just shoot. never have but i bet in a year from now i will.
hugs,
lori

 

Lori, I think anyone with experience could get someone through a hypo, you know? Not just a particular insulin user (ideal, of course, but not necessary).

I don't want anyone to think "well, I don't use that insulin, so I can't help..." and not come up alongside someone in need and give a hand. Esse's been using lantus a year, Eeyore for 5 months, and if someone who was a PZI'er needed a hand, I'd put mine out there...

Just sayin', you know?

Best-
Michele

 

Michelle i definetly get what your sayin' but this was different, a whole different scenario. read the thread from top to bottom and see how confident we were and how the tone started gradually changing. korbel had been using insulin for 10 years so she was no newbie, she knew how to handle hypo's...so do i....but this was a lantus whopper. and truthfully a lantus hypo is so different than a pzi hypo. i thought it was over at +7 with 70...it sure would have been on pzi. turned out that was just the middle. she had a whole lot more to deal with after that.
just think about it.
it can make a difference which insulin your learned on if a hypo hits.
just sayin.

 

Not sure I understand where you're coming from, Lori. I did read the whole thread (and posted to it).

A hypo is a hypo is a hypo. Treatment is the same, and it's the same parameters for getting through it. Korbel's hypo was sure a whopper, and lengthy, but still, the phsyiology of a hypo is the same from insulin to insulin. I regularly work with DM patients, and have seen them crash, and no matter what the insulin, the treatment is the same...as it is with our fuzzbutt friends. Feed, test, feed, test, feed, test...and on and on until the numbers are steady and in a range where one can 'stand down.' Shoot, I had a patient at the hospital where we resorted to slamming Dextrose 50 into her IV...and she kept crashing all that day and into the next. It happens. I just don't want to see help not offered because someone is not experienced in a particular insulin.

If help is needed, give it; that's my opinion. And with that, I'm done here. Really glad to see Korbel up and at 'em today!

Just saying...

Best-
Michele

 

yep, most of us have walked thru hypo's. i walked thru my own 3 years back. i've walked thru many others. sooo many. and yes it's routine. just sayin i learned yesterday to not trust an +7 or even +8. just sayin it's different. but your right most with experience here could help a newbie with a hypo. still thought it was a good idea to call on lantus to look in.
and i'm not trying to have the last word tho' it looks like it. i guess i was just surprised after all my hypo experiences how different this one went.

 

You're right, it's never a bad idea to get more eyes on a thread that could be serious. I'm glad you felt this was a learning experience for you. Hypo is hypo, fundamentally they are the same, but it's true that Lantus/Levemir hypos *can* go on for a lot longer. Sometimes they don't, so you just have to stay with it. I always look for at least 3 rising numbers after +7, and I mean a fairly significant rise. Ideally I want to wait until I see the bounce starting. When Korbel started holding 80’s on only low carb food and it was about +16, I felt she would stay safe. That's why small amounts of carby stuff (gravy or syrup) is better than feeding 1/2 a can of high carb food all at once. You don't know if you'll be done in 1 hour or 12, and there is nothing worse than having a cat that decides he is full (or vomits) when he is 40 at +13.

I think it’s interesting that Lantus overdoses often result in extended duration more than low numbers.

For someone who has been on Lantus for a while and has worked up to their dose the right way, Lantus is nice and gentle and usually won’t plummet a cat into a symptomatic hypo. In those cases, usually a little low carb or high carb food is plenty to bump them up into nicer numbers. However, a lot of what you’ll see here on Health will be newbies who come from the vet on a higher dose. If you have no history to know if the dose is safe, then it’s best to assume that you have an overdose situation and treat them like this, with small amounts of gravy and lots of testing, and stay with them until you see several consecutive rising numbers. If it’s early in the cycle and numbers are very low and you think it was an overdose (especially if someone says they drew the dose up wrong), then ER is the best place to be. It's incredibly stressful for a newbie who can barely test to be told to test every 15 minutes for many hours, the vet can handle that more easily. Make sense?

I hope everybody can learn. It’s always good to get folks who are experienced with that cat’s insulin to help in a hypo, but I also don’t want anyone to be afraid to jump in if they find themselves alone helping someone.

 

yeah, i'd say be very conservative with advice on an insulin you don't know and try to get the experienced members to post first if possible. but no way would i let a hypo person go it alone if i couldn't find someone using the same insulin to help. just gotta be very careful because there could be insulin-specific advice i didn't know about, so in some cases i'd add a disclaimer that there might be differences related to specific insulins.

especially if we're talking newer members or those with little hypo experience i'd say to try to find someone else first. there have been a few cases of newbies giving bad advice in a sorta-emergency situation and sounding very authoritative when doing it.

another point is to be careful when questioning other members' advice on a hypo thread. if you can, do it via PM instead because we want to keep focus on the person dealing with the hypo rather than history between members.

just saying this stuff generically rather than to anyone specific, coz i've seen it come up in other hypo threads over the years.


jennifer, i was so surprised to read of a symptomatic hypo at those numbers on lantus. pretty unusual. many of us just test for whatever reason and are surprised to catch a number in the 30s! anyway, good job and glad you had fine help.

 

chris a simple shout out in that insulins room and a couple of eyes is all i'm saying. after learning the difference between lantus and pzi type hypo's. i would never walk away.