Low BG last night--See last 9/1 post, Q abt insulin today

Lily was on 5 units ProZinc (reading last Friday was 352 on Alpha Trak 11 hours after 4 units of insulin so we increased to 5 units this week). Insulin given at 5:30am. Vet glucose test at 4pm was 73 on AlphaTrak, 51 on my ReliOn meter. Vet suggested reducing dose to 4.5 units. Gave that at 5pm, with new heart medicine. Just did ReliOn home test (yay!!! Worked the first time). Reading is 36!!! Lily seems fine but should I treat at hypoglycemic? What to do? Any suggestions for tomorrow morning's dose. Thanks!

P.S. Still feeding dry m/d food but added about 1 TBL of Friskies pâté for last night's feeding and tonight's (forgot to do that this morning).

 

Re: Low number...what to do

I'm not familiar with ProZinc dosing, but I'd give Lily a couple teaspoons of high carb wet food if you have it, and test again in 30 minutes. If you don't have high carb food (food with gravy such as fancy feast gravy lovers), add a couple drops of karo, syrup, or honey to Lily's wet food. You want Lily up above 50 on the Relion meter. Post your new number when you get it.

 

Re: Low number...what to do

I'm sorry I can't stay up to help, but yes, treat for hypo. Here is the link to how to treat a hyp: viewtopic.php?f=28&t=15887. I hope someone else will be here soon to guide you through this tonight.

 

Re: Low number...what to do

Thanks Wendy. Wet food with maple syrup being eaten now. Suppose I should have clarified if "fake" syrup (Mrs. Butterworth) would be better. I'll retest in 30 min and post again.

 

Re: Low number...what to do

How many hours after insulin was given did you get that 36? Since we are all in different time zones here, we usually count number of hours after shot time. So, a +1 would be one hour after shot time, etc. Did you give this evening's shot one hour after getting that 51 on your Relion? We suggest always getting a test before shot time and for new people, say that you should only give insulin if BG is 200 or above.

You'll find when switching from dry food to wet, that insulin requirements will go down.

 

Re: Low number...what to do

As long as it's got sugar in it, it'll help bring up those numbers, but they'll come back down just as quickly, so you'll want to retest every 30 until Lily is into the 70's (on the Relion) and then for at least 2-3 hours after you haven't given anything other than a little regular LC food

And yes..Lily has earned a reduction....I'm not familiar with Pro Zinc, but any time they go below 50, they're telling you they're getting too much

Edited to add...On my first low number, I gave about 3 teaspoons of syrup...then I found out that it's only supposed to be a couple of drops

 

Re: Low number...what to do

New number is 41.

 

Re: Low number...what to do

I can't access your spreadsheet, so I have a couple questions for you .
Are you on ET or on the West Coast or ?? You gave insulin at 5pm ( which time zone? )
Here's the thing. Even after her numbers come up after giving the wet food w/ some added carb
You need to keep monitoring until your kitty is past its nadir ( peak time of insulin action) and numbers are rising. ( 2 numbers in a row testing are going up into safe zone)
Sometimes when you give a carb like maple syrup it can be short acting and if your cat is not past nadir and rising, BG levels can go way down again.

I am not familiar w/ prozinc ,so I don't know the typical nadir for that insulin. And I can't see it on your spreadsheet. Can you post your time zone and that information ?
I am familiar w/ riding the low , but w/ a different insulin !

 

Re: Low number...what to do

Test again in another 30, unless she shows symptoms. You are holding steady, not going down anymore. That's good.

 

Re: Low number...what to do

I think I'd keep giving a couple drops every 30 minutes until she's up into the 70's and then keep testing to make sure she doesn't come back down too low. With the 20% variance in meters, 41 is still pretty much the same number

How much syrup did you give this last time?

I can't access the spreadsheet either, so if you can give us your time zone, the time you shot, and how long it's been since shooting each time you post, it'll help us

 

Re: Low number...what to do

I think I've got my spreadsheet working now. Let me know. I'm Central time zone. 51 was at +11. Gave 5 units. 36 was at +5, 41 was at +5.5. I gave just a few drops of syrup with ~2 tsp wet food at +5. The hypo link on this message board suggested dry food might help. Should I mix in additional syrup with her m/d.

 

Re: Low number...what to do

Yes! Spreadsheet works now!!

Always test before shooting! Lily was way too low to give any insulin tonight, so it may be a long night to keep her numbers up. Since she's a new diabetic, we don't suggest you shoot anything below 200 without advice. You're better to stall 30 minutes (don't feed) and use that time to ask for help. We want Lily to be safe first and foremost! The numbers will come down with time

Dry food takes too long to bring the numbers up and stays in the body too long...that's why we suggest having HC food in the house for these situations. I'd keep giving a couple drops until she's above 70


Edited to add....I guess your name should have been a good tip that maybe you were in Wisconsin....LOL

 

Re: Low number...what to do

Yes, SS is working now for me too.
Rookie mistake, you shot too low. Learn for next time, for now focus on your kitty.
It will be a long night. I would right now plan on skipping the next shot.

It can sometimes take more than 30 min for a number to go up after feeding the carb.
Since you may be up a while, you don't want to over feed her. As mentioned, she could go up and come back down again before your cycle is through.
I would hold off on the dry. Dry food my fill her up. So I would also hold off for now. You want to keep her hungry.
Test again if it's been at least 15 min and see.
If no rise, give another tsp of wet w/ drop or two of syrup.
I hate to see too much short term carb go into a cat for her to go up and then down and then bounce next cycle.

Do you have another number yet ?

 

Re: Low number...what to do

While you are up w/ your kitty, a good time to read up on hypos. Maggies Mom Debby already gave you a great link.
Here is Jojo's hypo toolbox kit post.

You can put this together for next time. : ) Everyone goes low sooner or later. The important thing is to be prepared.

You are doing great, btw !

 

Re: Low number...what to do

Gave her another tsp of wet food with maple syrup about 10 mins ago. I will wait another 15 mins and then test again, right?

I am very surprised the vet didn't warn me about the PM insulin dose. The +11 number was taken by the vet's office today. The vet said to reduce the dose from 5 units to 4.5 units (since the week before, 4 units at the +11 time was 279 on the ReliOn meter...379 on their Alpha Trak).

What a way to be introduced to home testing. We're getting some practice tonight, huh?

 

Re: Low number...what to do

Gee I can't believe the Vet said to shoot her. No, wait, sadly I can. :-x

Well I'm glad to read you are having a little sense of humor about your testing practice.
Good to keep from stressing.

Yep. keep the numbers coming.

 

Re: Low number...what to do

You sure are! It's a good thing Lily is evidently being a very good kitty for you!

Keep testing every 30 and posting...and you might want to put on a pot of coffee

IF she's above 200 tomorrow morning, I'd suggest you drop back to no more than 1 unit and start from there. If you're changing her diet over to low carb wet foods, her numbers will most likely continue to come down.

You can always give more insulin if the numbers show you're not giving enough...you can't take it out once it's in the cat...we've all had a cycle or two (or 10) where we've spent a good deal of time testing, feeding, testing, feeding, so you're not alone!

We have a saying here....Better too high for a day than too low for a minute

 

Re: Low number...what to do

Unsuccessful attempt to get any blood using the other ear. Rice sock wasn't as hot as before so that might have contributed. Gave Lily a treat and will give her a minute to sulk before trying again.

 

Re: Low number...what to do

Most cats have one ear that bleeds better than the other, and they also "learn" to bleed after you've done more testing.

What worked better for me than the rice sock was a small pill bottle with warm water in it. It gave me something hard to poke against.

I'm up at least for another couple hours too..China dropped below 50 today and although I reduced her dose, I'm watching her carefully too....Pass the coffee!!....LOL

 

Re: Low number...what to do

Hmm. My beginner's luck is wearing off and Lily is getting perturbed. Can't get a blood drop even from the first ear. Any suggestions?

 

Re: Low number...what to do

Can you give her a nice massage. Massaging the ears can do wonders. I never needed the rice sock w/ Winnie. I just massaged her ears. She liked that.

 

Re: Low number...what to do

And another question. For the lancet pen, are longer dashes a shallower or deeper poke? I've warmed with a rice sock and used lancet pen with a cotton ball on the other side. Should I use something harder to hold against the back?

 

Re: Low number...what to do

The poke should be at a 45 degree angle....with 90 degree's being what you'd do if you wanted to pierce her ears. That being said, for the first several weeks, I considered buying China some matching diamond studs.

I'd try a pill bottle if you have one. Fill it with warm water and put it against your wrist like you would test a baby bottle. Too hot and you'll upset Lily even more

If you can, if you don't get any blood on the first poke, go ahead and try again..really close to the first poke and then "milk" her ear a little. Lots of times the 2nd (or even 3rd) poke together with that first one will "pool" enough blood to get your test in

After 3 pokes, if you still don't get anything, give her a break, but we do want to see some more numbers on Lily to make sure she's headed in the right direction!

In case you haven't seen this:

 

Re: Low number...what to do

Lily says "Tail thwap, tail thwap. Let me go to bed. Why aren't we all going to bed?" Failed attempt #3. Tried the several pokes in one spot and milking it. No luck. Will search for a pill bottle for warm water. Do you usually dial the lancet pen to the middle setting?

Edited: Thanks for the sweet spot diagram. I was poking lower than the sweet spot.

 

Re: Low number...what to do

I'm Pacific time and it's a three-day weekend, so I'll still be up for quite a few more hours for you, if need be. ;-)

When using a lancet device, make sure it's flush/flat against the ear with some backing (I use my finger as a backing because it lets me know if the lancet device is set to too high a depth and pokes through the ear to my finger).

Give her a break for about 15 minutes if she seems to be acting fine yet proving to be difficult for testing. If she's running about and acting fairly "normal," 15 minutes extra should be okay.

 

Re: Low number...what to do

Another tip would be if you're poking on the outside of the ear, try the inside. Sometimes it makes a difference.

It'll get easier..and the testing will become routine for both of you.

Come on up some for your momma Lily...THEN maybe you'll get some sleep....LOL

 

Re: Low number...what to do

When I first started out testing and Mikey's ears were "tougher," the middle setting (3) worked best. As his ears learned to bleed, I was able to lower the setting and now we're at 1. What device specifically are you using to poke? (I've tried out a few of the lancing devices, so I'm familiar with how many of them work "best.")

 

Re: Low number...what to do

Ugh! Not sure what else to try. Failed attempt with warm water bottle held up to ear that bled at the beginning of the night, poked 3 times with the lancet pen in the sweet spot, and 3 times with me just holding the lancet and poking 3 times. Not a drop of blood. Milking didn't help.

 

Re: Low number...what to do

I have poked on the outside so I can give the inside a try. The lancet pen is ReliOn (came with my ReliOn Confirm meter). I don't need much of a drop of blood for the Confirm. But I'm not getting anything. She seemed happier without the pen noise (the pen didn't seem to bother her at first, but the repeated pen clicks, especially when I had to reset it, got her mad).

 

Re: Low number...what to do

How is she doing currently? If she looks and acts "fine," wait a few minutes and try again later. Even try the other ear or the inside of the ear. If all else fails, aim for the vein.

 

Re: Low number...what to do

Also try it with the clear pen cap removed and simply the exposed lancet in the pen device and see if that works better.

 

Re: Low number...what to do

Is the 45 degree angle the advice for the lancet without the pen? And 90 degrees/flush with the skin if I'm using the pen?

 

Re: Low number...what to do

Some people have better luck w/o the lancet pen and poking free hand.

If she is acting ok. Give her a little break. Practice some freehand pokes on some fruit and/or yourself.
If you feel comfortable try that.
Or just plain practice on yourself w/ the lancing device

Are you using a new lancet every time ? Some folks reuse them a few times, but they will get dull.
Make sure you are using a new one, k?

 

Re: Low number...what to do

you can take the lancet out of the pen and try free-handing it..that way no click. It sounds a lot scarier than it is! (I just recently started it and am beating myself up over not doing it sooner...it's proving to be much easier for me)

The other thing is when you can get out to get some, get some 28 or 29 gauge lancets. The ones that come with the lancet pen are 31 and are very tiny. The lower the gauge, the bigger the needle. Until you get Lily's ears to "learn to bleed", this will make it much easier on you.

Look for "alternate site testing" lancets

 

Re: Low number...what to do

Yes, if you're doing it freehand, you want to go at a 45 degree angle. If you're using a device, most of them require it to be flat against the surface.

 

Re: Low number...what to do

By the way, Lily looks fine. Grooming herself and making her fur look pretty (no thanks to my massaging, holding and poking). I have extra lancets I bought per the recommended shopping list on FDMB. I'll go get those and give them a try. Cross your fingers. May try #4, free handed lancet at 45 degrees on inside of ear do the trick.

 

Re: Low number...what to do

It's pretty much the same either way. Picture yourself piercing your cats ears. That would be 90 degrees (straight through the ear) and although it won't cause any permanent damage, it's better to go in with a "slant" at about 45 degrees..but whatever works at this point!

It'll just take some practice. You'll be a pro in no time!

 

Re: Low number...what to do

I did have 26G lancets. I tried that freehand, inside and outside of ear. Grr. No luck. I have got to be piercing the skin because Lily yelps. I even got a flashlight and see the big vein. No luck aiming for that either.

The 26G lancets seem shorter than the 30G I was using. Maybe I'm just imaging that. But it barely pierces my finger and doesn't draw any blood when I try it on me--with the clear plastic cap or on the deepest setting with the blue cap.

 

Re: Low number...what to do

Have you tried "damming" the blood by applying pressure directly underneath where you want to poke before you poke? Then, once you poke, proceed with "milking" it up as you have been doing?

 

Re: Low number...what to do

Thanks for all the great tips everyone. And for staying up with us. Haven't tried damming. I will with Try #5. Here goes.

 

Re: Low number...what to do

At this point, can I still use the meter strip that's been sitting in my meter for 2 hours? Or should I use a fresh one? Wanna get that right before I finally get blood.

 

Re: Low number...what to do

Someone has stayed up with us when we were going through it...we're just "paying it forward"! Once you get more experienced, you'll be helping some other newbie through their first low numbers...that's one of the great things about this board!!

Just curious...have you printed out the information on How to handle low test numbers ?? If not, it's best to have a hard copy somewhere just in case the message board goes down, or your computer has issues

 

Re: Low number...what to do

Use a fresh one "just in case" but you don't necessarily have to toss the one that has been exposed for a few hours. I'll usually set those "questionable" ones aside in a spare/empty container and use as "backups" when I get questionable numbers that I want to test twice. If they're wildly off, I'll toss them and disregard them as "broken," but if they're "close enough," then I won't feel so bad on wasting strips needlessly.

 

Re: Low number...what to do

I think I'd use a new strip....you want nothing to be wrong if you get blood this time

Save the one for sometime when it's not so important that you get it right the "first time"

 

Re: Low number...what to do

When was the last time she ate in relation to the last (successful) test number you got and what did you feed her?

 

Re: Low number...what to do

Kay...best I can tell, it was about 2 hours ago when she got the 41 and she gave a little more food with a drop of syrup after that..but I'm not 100% sure on the feeding.

Last note I can find was 2 tsp plus a couple drops of syrup at +5 when she got the 36 so it may have been 2 1/2 hours ago

 

Re: Low number...what to do

*$%*#$!* Grumble, grumble. Went back to my original rice sock, very warm ear, piercing with 26G lancet in lancet pen on deepest setting, damming blood before the poke. No luck and now Lily is super annoyed almost to the point of growling. And I was staying totally calm and positive.

KPassa--after a 41 test, she ate ~1-2 tsp of Friskies pate with a couple good size drops of maple syrup at 10:45ish central time.

Do you think she's out of the woods and we can retry this all in the (later) morning? Should I be trying anything else? How long should I give her before I try to poke her again? Yikes. I just realized she hasn't been getting any treats for most of these unsuccessful pokes.

She has been patiently laying on the bed despite the frequent pokings. She just picked herself up and moved to the closet, her "leave me alone" space.

 

Re: Low number...what to do

Oops!! That's the important part....LOL

Personally, I'd still like to see at least one more test before you call it a night, just to make 100% sure Lily is climbing and within the "safe zone"

The good thing about having so much time pass since feeding or giving syrup is if you DO get a decent number, it's probably going to be safe to go on to bed..maybe then give her a little more LC food and turn out the lights


You can try poking her paw pad...that's an alternate site to test.

 

Re: Low number...what to do

Tempt her with some more LC food with a bit of syrup. We're not yet sure if she's out of the woods yet, so to speak, so we at least want one more successful test that show her numbers are higher (which at this point, they should hopefully be). Give her (and yourself) a break for now and chill out for about a half hour, yet keep an eye on her in case she starts acting "off." Go pour yourself a glass of wine or eat some chocolate or both. ;-) And try again in a little bit when you're both more relaxed.

 

Re: Low number...what to do

Okay. I'll give it another try. With treats this time.

While I'm doing that, I'll ask another question. Ok, multiple questions. We're almost at +9. Feeding time and +12 will be here before I know it. What do I do at 5am (+12)? I think I need to feed her and give her her new diarrhetic meds. What about her insulin? What if testing proves this challenging at 5am? Vet's office opens at 8am. Should I wait to give insulin until I can talk with the vet???

Here kitty, kitty. Momma's got treats this time...

 

Re: Low number...what to do

What time zone are you in again? For me, it's still early and not even midnight yet. :lol:
ETA: this post occurred at the stroke of midnight for me. haha_smiley

Depending on how high she is at the next test (+hour from last shot) we'll probably have you skip it if she's still below 200 as a newly diagnosed cat. She'll be much higher tomorrow and perhaps even into tomorrow night but it will give you both a break from testing and allow for more experience ProZinc members to be able to chime in with dosing advice. (I use Lantus, so my dosing advice for ProZinc is limited.)

 

Re: Low number...what to do

Also, I just want to say, "great job on the home-testing crash-course!" :thumbup You might not have gotten every test successfully, but the amount you've tried tonight adds up in the scheme of "practice runs" and you've both been real champs when it comes down to it. Trust me when I say it gets easier with time. You've become better skilled and Lily has become better accustomed to the whole process, so look at every "failed" test as just good practice instead.

 

Re: Low number...what to do

Ugh. Still zero luck. I feel like I'm not doing the lancet right or something. Lily's happy with her multiple treats though. I can see the blood. I can poke at the blood. And no blood comes out.

I'm getting in my jammies (it's 2:15am her in Wisconsin), and then I'll try the foot pad method. The video/info here says use the back paw. She hates anyone touching her back paw. Would front paw be ok to try?

And thanks for the smiles. Feeling frustrated and at least it's good to know all these failures might be helpful for something.

 

Re: Low number...what to do

We ask that you don't feed anything for 2 hours prior to testing so the number you're considering shooting isn't influenced by food (now this is where Pro Zinc might be a little different, but I think it's still best to REALLY know the number you're shooting before giving any insulin)

At 5am, if that's your next PS time, try to get a test...if it's over 200, I think I'd go ahead and start with 1 unit (since it's pretty obvious 4.5 is too much, as was 5 units) If it's under 200, you can "stall" (don't feed) and retest in 30 minutes...during that time, post and ask for dose advice. The one thing you have to remember about stalling though is that it will effect your next test...so if you usually test/shoot/feed at 8am and stall until 9am, your PM test would be moved to 9pm. If you do stall, you can "move back" to your chosen schedule 15 minutes per cycle or 30 minutes per day

If you can't get a test, I think I'd skip the shot for AM...he's proved he's got enough insulin on board for a short time anyway and we'd want him to be safe

 

Re: Low number...what to do

Foot pad testing is not an option. At least not right now. Lily has had enough.

I'm going to rest for a couple hours and try the ear prick at 5am when I'm sure she'll be waking me up for her usual morning feeding. More then.

 

Re: Low number...what to do

Hi your last post was a little over an hour ago.
I went off to have a very late dinner. ( yes, I 'm on the East Coast too ! )
Nothing like fresh corn on the cob at 2am :lol:

Anyways...... was wondering if you've tried again or had any luck or fallen asleep ?

She was so low when you shot her that personally I agree w/ KPassa and I would skip the next shot.
Check in w/ numbers tomorrow when some experienced Prozinc users will be around and ask them for some advise. Yes, it is important that you talk to your vet. But check in here cause look what she missed this last time, k?
Even if the numbers are up at next shot time it's ok. Better too high short term, then too low. oh yeah you learned that tonight,eh ? ;-) Anyways..... numbers may be up from all the syrup ( and could come right back down again fast ) and/or from a "bounce".

Numbers often go up after a trip to the lowlands -- a "bounce" aka "rebound" .
The simple version explanation :
When the BG goes too low the pancreas sends a signal out to the liver,kind of an SOS of sorts, and the liver responds and produces glycogen to pump into the system, which in turn raises the BG. The numbers will come back down from the bounce after a couple cycles or three or more depending on the cat . ECID ( Every Cat Is Different ) is a phrase you will hear a lot of around here : ) This will also happen when numbers go below what the cat's body has gotten used to. But that's another story and you're brain is full enough tonight !

You've been doing a great job. :thumbup
Lily is lucky to have you to take care of her.

 

Re: Low number...what to do

Just make sure you leave some food out for her to graze on if you've called it a night! I'm fairly certain at this point in the ProZinc cycle, you'd have seen more obvious signs of hypoglycemia if she continued on that downward trend. The good thing with ProZinc is that it's an "in-and-out" insulin, meaning low numbers don't occur for as long as they can with some of the longer lasting, depot-style insulins (like Lantus), so she's most likely on her way up by now. Use the Secondary Monitoring Tools just to be sure, but I think you two will be fine till morning at this point.

 

Re: Low number...what to do

Oh, yeah. Time difference, duh! :roll: You're already coming up on your normal pre-shot. If you've fed her recently, then don't worry too much about whether or not you've left food out for her between now and an hour to two hours from now. :lol:

 

Re: Low number...what to do

You done good tonight!! Tomorrow's another day (well, tomorrow IS today) and you'll know so much more than you did last night!

I think you're ok to go too....leave some food down and go on to bed

 

Re: Low number...what to do

This is one of the many reasons why I love being on the West Coast. I can stay up "late" if need be and those crazy early-morning East Coasters @-) can take over for me before I need to go to bed. :lol:

 

Re: Low number...what to do

I am happy to report Lily woke me up (45 mins past her usual feeding time) to tell me it was time to eat. Having a few hours of sleep helped us both. Refreshed, I tried to get a blood sample to test glucose and couldn't. Lily is definitely "on to me." So I gave her a treat (remembered this time), fed her the heart pill she needs, and put down her normal food (dry m/d with about a tablespoon of canned Friskies pate-- I am starting over to transition slowly to a good low carb canned food).

I did not give her any insulin as I normally would have done once she finished eating. We are now at +13.5. Any additional thoughts on what to do about insulin for now? Vet's office will be opened in less than 2 hrs.

 

Re: Any ProZinc experts?--Low BG last night ...now what?

If you aren't able to get blood, I'd withhold the shot for now. Call the vet when they open, tell them about your all night party, and see what they think about dosage going forward?

 

Re: Any ProZinc experts?--Low BG last night ...now what?

Whew. Vet's office is closed today and all weekend, but thank goodness vet gave me her cell number. She did not like the very low numbers either. She said I did (you all told me to do) exactly the right thing by withhold the insulin this morning. Thank you for everything! She wants me to withhold insulin for likely the next 24 hours, try to get a blood sample mid-day today (~same time we've been getting readings when we go to the vet). I will call her with those results and we'll re-evaluate from there. If still very low (below 100-150), she thinks we'll skip the next shot too. If above 150, we'll give some lower dose than the 4.5 units I gave last night.

She said I could try the retroillumination technique for finding the blood vessels in the ear.

I'll pick up some HC "gravy" food in case I need it again. And some ketone stixs in case I need those.

 

Re: Any ProZinc experts?--Low BG last night ...now what?

You did so great last night!! Now you're a member of the "up all night" club too!! WELCOME!!....LOL

Another suggestion if Lily is "on to you" would be since you're not going to need to do a lot of tests (since no insulin) is to work on getting her desensitized.

Pick your testing spot. It should be someplace comfortable for you both, but the same spot all the time
Gather your supplies to your spot
Bring Lily there and just rub her ears (even for a second or two if that's all she'll let you) If she'll let you do more, take time to really study her ears..bend them, shine a flashlight through...anything to help get both of you used to where that "sweet spot" is.
Give her a yummy treat! No matter what..even if you can only rub one ear for 1 second..a lot of us use boiled chicken..treats needs to be low carb too

Continue doing it several times without any poking. Eventually she'll learn to associate the testing spot with the treat and won't pay much attention at all to what you're doing with her ears

I think I finally passed out about 5am, but had seen that other members had come on board to help. Happy you got the help you needed, and although it was a long night, it was a SAFE one!

 

Re: Any ProZinc experts?--Low BG last night ...now what?

Oh goodness. Soooo close to a successful test. It took several tries, several pokes and there was a great drop of blood. I wicked up the blood drop but the test strip wasn't pushed into the meter all the way. Aaaa. So I quick switched that one out and inserted a new one...filled it up with blood and got a dreaded error code--E-7 insufficient blood or incorrect sample method...I think it was the latter as I was rushing and maybe it didn't wick up nicely. And now my husband is gone for the day and I've lost my extra set of hands. I'm still hoping to get a sample in the next 1-2 hours, but need to figure out how to do it by myself. As if it wasn't challenging enough.

Thanks for the good suggestions on desensitizing her. I'll try that. I'd really like to get at least one good test in today to make sure she hasn't bounced back into the 200-300s.

 

Re: Low BG last night ...now what?

don't worry about it...Cats bounce...until they don't...LOL

It's totally normal, and if there has to be a silver lining, it does let you know that Mr. Liver is doing it's job..although a little too well! Since Lily's blood glucose went into numbers her body hasn't seen in awhile, her liver "panics". It send out hormones and glucogen to bring that blood glucose back up to where it's "used to"

It can take up to 72 hours for a bounce to clear, so we're always very careful about not raising a dose if there's a chance they're in the middle of a bounce.

As Lily gets better regulated, the bounces will be less high, and clear faster.


For your next test, get everything ready...put the strip into the meter just a little (but don't make it beep). When you get a drop of blood (and if you're using the Relion Confirm, it REALLY takes a tiny tiny drop!!), quickly push the strip in the rest of the way, wait for the beep, and take a quick look at the screen. Mine takes a second or two to go through it's "coding" information. Once the little drop of blood starts flashing on the meter, it's ready

You're doing great!! Soon you'll be poking in your sleep (yes, we do learn how to do that too :lol: :lol:

 

Re: Low BG last night ...now what?

Another trick, that allows you to not rush. Get that big drop of blood onto a fingernail, and let Lily go about her business. Then you can take your time with the strip and meter, and maybe have enough of a drop for two tests if the meter messes you up the first time.

 

Re: Low BG last night ...now what?

Still unsuccessful in getting a reading tonight, but we're making progress with desensitizing. I picked a good spot for testing and Lily seems to be happy there...getting scritches and having her ears touched. She is most upset when she is either confined or I hold onto her ear for more than a second or two after the poke. The poke doesn't seem to annoy her. It's me trying to "milk" the ear or even hold it to see if a blood drop is forming. Oh, and she's not too keen on the hot water bottle or rice sock anymore either. She'll let me hold it there for maybe 5 seconds. Either I have to get faster/better at this or she has to get more tolerant.

I bought a nice small flashlight to illuminate the blood vessels. I really think I'm poking in the right place, the sweet spot, at least some of the time. I can see tiny blood pool spots where I've poked and it's bruised. As I said, she hasn't let me hold her ear for more than a few seconds so I haven't been able to put pressure on it after the poke.

The vet and I spoke at 7PM and decided no insulin tonight either. So 24 hours without insulin. My husband will be able to help try to get a successful sample in the morning and we'll re-evaluate insulin then.

A couple questions as I try to master this elusive home glucose testing success.
1) Can someone explain exactly how to successfully "dam" or "milk"the poked area? Where am I trying to bring blood from (above or below the poke, or is it an inner ear to outer ear thing)?
2) Do I just try to avoid those bruised spots?
3) Will the blood drop form on it's own (eventually)? If I poke and don't see a blood drop--did I poke in the wrong area, or not poke deep enough, or not wait long enough for a drop to form?
4) Lily's a grey domestic short hair. I sometimes feel like I lose the spot where I poked her and can't see what, if any, blood may have formed. I have the ReliOn Confirm so I only need a teensy drop of blood-and yet in that short grey fuzz, it's hard to see. I considered poking from the other side, but can't quite figure out how to do that with Lily's cooperation.
5) What are acceptable treats for diabetic cats? I just found freeze dried chicken treats at the pet store today and those were a huge hit. 80% protein so I feel good about those. Lily likes the Fiber Formula fish-shaped treats but I don't know if those are ok for diabetics. I'd rather have something that I can just keep with my supply stash rather than have to pull out of the fridge/freezer.

I'm looking forward to a good (and early) night's sleep and a break from testing. Again I really can't thank you all enough for your help. If I didn't have this message board, I don't think I would have considered home testing, wouldn't have caught the hypoglycemia last night, and likely would have blindly just given another 4.5 units this morning to a hypo cat. Scary! Thank you to all for paying it forward. Lily says thanks too.

 

Re: Low BG last night ...now what?

Hi again Nicole!

The way I do it is to "dam" at the top of the ear (hold the top of the ear tight) and poke under where I'm "damming" (in the sweet spot). Then if I don't see a drop forming, to "milk" her ear, I go from the very base of her ear, and massage UP towards the tip of her ear. Personally, I use the "Inside" of her ear..there's less hair there to deal with. Also, when I first started, a lot of times I'd have to poke twice right next to each other. The two pokes together would form a better drop.

The other thing that can be helpful is to get a little Neosporin with pain relief Ointment (not cream) and rub a little in. Wipe it off and it'll leave enough of the ointment to help "pool" the blood...think oil and water

yes, as much as possible.

When the ears "learn to bleed", the drop will form quickly all by itself..and most cats have one ear that bleeds better than the other. Make sure you're using the 28 or 29 gauge lancet as this will help a lot at the beginning. If you're poking in that "sweet spot", you're probably just not poking hard enough. There really aren't many pain receptors there, so a lot of it is just getting used to the routine...and truly believing you're not hurting your cat!

If damming and milking don't help, the next time you try it, try to poke twice really close together. You can also shave your cats ears so the fur/fuzz isn't in the way

Here's a list of Low Carb Treats
A lot of us use Freeze Dried chicken, or boil regular chicken and cut it up and refrigerate. The dry treats are almost ALWAYS high carb. Read the ingredients. Corn, Wheat, Rice and Soy are all definite no-no's

Don't worry..you'll be a pro-poker in no time! Lots of us do it in the middle of the night now and don't even wake up....LOL

Enjoy your night "off"!!

 

Re: Low BG last night ...now what?

Thanks Chris.

Yet another question...amazing that there can be so many questions. :lol:

This morning at 5am, my husband fed Lily the usual dry m/d. He forgot to feed the generous tablespoon of canned food or her heart medicine in a pill pocket. I just gave her both of those at 9AM. No insulin this morning. Question is when would be a good time to try to get another BC reading? We've been unsuccessful in getting a BG since Friday evening. I want to make sure if we ARE successful, we have a meaningful result...and I'm not yet familiar with how food and time of day changes that reading.

 

Re: Low BG last night ...now what?

She hasn't had insulin since Friday night either, correct? At this point any test you get should show an "insulin-free" result, at least free of any insulin you've given her. Her body might be producing and using some of her own if her pancreas is helping out.
Usually, if you get a test within a couple hours of eating, the number will reflect an increase from food. So as far as when to test... If you can get a "fasting BG", maybe 3-4 hours after her last meal, you can use that number as a baseline to see what her blood glucose is free of food and insulin.

 

Re: Low BG last night ...now what?

Perfect--thanks Carl. Yes, no insulin since Friday night so I'll try a BG in a couple more hours (3-4 hrs from last meal).

 

Re: Low BG last night ...now what?

You might shave a tiny patch on her ear so you can see better. Some of us with longer haired cats, cats with black ear edges, failing eyesight do this. I did when I was starting out, testing Wink. I don't bother now, since I'm better at the pokies, but it sure helped me in the beginning.

 

Re: Low BG last night ...now what?--UPDATE

Successful BG test!!! Yay! I feel like shouting it from the rooftops. We resorted to the thumb paw pad and she was completely undisturbed by the whole thing. We tried all the great tricks for the ear and just are only getting a teeny drop from the ear...not even enough for the ReliOn Confirm. And Lily is not fond of my milking the blood from her ear.

So, BG is 330, no insulin since Friday night. Vet suggests 3 units every 12 hours. Sound about right?

 

Re: Low BG last night--See last post, Q abt insulin today

Congrats on the blood test!!

As for the dose, I don't think I'd feel comfortable giving that much considering the 36 from the night before last. Lily could very well still be in the middle of a bounce.

I think I'd back WAY off and go with 1 unit. After going that low, they can be even more sensitive for awhile. You can always go back up if 1 unit isn't enough. Once it's inside the cat, you can't take it back out again.

For safety (and hopefully a better night's sleep), I wouldn't give more than that. (but again, I'm not experienced with Pro Zinc other than what I've learned from reading others posts)

No matter what, if you give insulin, do your best to get a +2 and then a "before bed" test. You'll sleep better

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

Welcome to the Vampire Club!


As Chris said, I don't think I'd give the 3U of insulin either if this were my cat. Better to start out with a smaller dose, and work your way up.

Chris gave you several valid reasons for lowering the dose to 1U for now.

 

Re: Low BG last night ...now what?--UPDATE

Congrats on the successful test! There are a few members here who use the paw pad to test, but it's usually not suggested at first because a lot of cats are more sensitive at having their paws touched than their ears. There's also a slightly higher chance of infection due to them using the litter box, but if you're using neosporin, this should go a long way in keeping it from getting infected. :thumbup

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

:lol: Love the Vampire Club.

I haven't given any insulin yet. We're an hour and a half past our usual shot time. Lily isn't eating any dinner. I gave her 2-3 chunks of freeze dried chicken treats at 3 hours ago. She is not interested in the canned or dried food she normally gets. I gave her a few more chicken treats and opened a new flavor of canned food about 45 minutes ago. She ate the treats, licked the top layer of the canned food, and then walked away. She refused her pill pocket with heart meds too. Gotta love my challenging Lily.

Any advice? I don't want to get off schedule. And I don't consider a couple treats and licking the canned food "eating". At least not enough to give insulin.

Help!

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

you can try to sprinkle Parmesan cheese, oregano, ground up treats, crumbled freeze dried chicken, catnip or pretty much anything else that Lily loves on top of her food. ( not high carb of course...If you'd given insulin, it'd be a LOT more important to get her to eat no matter what the carb value, but since you haven't, keep trying to find something that'll spark her appetite) You don't want her to not eat for long though, so if she doesn't come around in a day or so, it might be best to get her to the vet for a check to make sure there's nothing else going on.

A lot of people also have a lot of success sprinking Forti Flora on the food, but you have to order it so that won't help tonight. It's basically the same stuff they put on dry food to make dry so irresistible to cats.

As for the shot, I think I'd go ahead and skip it unless you can get her to eat AND you're able to adjust your schedule since you'd already be at least 90 minutes behind your usual shot times. (but I don't know enough about Pro Zinc to really know what's best. I just know since you're already late, if you can't adjust your shooting/testing schedule, it's better to be high for another night, then low for another minute)

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

If you were using Lantus, I'd say give the shot anyway because she's over 300 and needs it. She just might not be hungry right now but you still want to keep an eye on her to make sure there isn't anything else going on causing the lack of appetite. Unfortunately, I'm not familiar enough with ProZinc to know if you can give a shot without them eating (I think you can, but I'm just not sure). Hopefully someone else with ProZinc experience will be able to advise soon for you.

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

Vet called. We will withhold heart meds tonight (Lily just started them Friday...could be upsetting her system) and I gave her 1 unit of ProZinc. Lack of appetite could be stress, high BG, heart meds or something else. She ate another 5ish pieces of dried chicken treats with the insulin shot.

Thanks for the advice. I'm hoping for a better day tomorrow. Getting her regulated is hard enough but the heart issues complicates it even more.

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

I know some of the heart medications can keep the BG's high and make regulation challenging.

What heart meds is she on?

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

She just started Furosemide (12.5mg) (a diarrhetic) and Enalapril (2.5mg).

 

Re: Low BG last night--See last 9/1 post, Q abt insulin toda

Furosemide, the diuretic, is to reduce the blood volume/pressure and lower the workload on the heart.

Enalapril is an ACE inhibitor, which helps control blood pressure.