LOW BS (26) and we need to travel

Baby just had a low BS of 26. She was drooling and was incontinent on the floor, I believe she had a seizure.

We gave her some Karo syrup and some of the dry diabetic cat food that we have. We didn't give her any high carb food because we didn't have any left from the last time she had a low reading. (5/02)

The big problem that we have right now is that we are getting ready to leave town for the weekend. We are taking her with us and we were planning on giving her something to help her sleep because it severely stresses her out when she rides in the car.

I am not sure what to do right now. We bought children's benadryl to give her and the vet prescribed something but I'm not sure we can afford it. Help!!

 

If you think she had a seizure, it's probably most important that you get her to a vet and have her checked out and maybe stay there while you're gone. You don't want to be on the road and have her have another seizure when there's nothing you can do for her

 

Unfortunately, there's absolutely no way that we can afford for her to stay at the vet over the weekend.

 

Have you tested again to see if she has come up?

 

I think she still needs to be checked out by a vet before travelling. If she's already had a seizure, taking her on the road might well not be safe at this point - you need to know she's out of danger and her BG is in the safe zone and staying there at the very least before driving any distance with her.

And no, I wouldn't give benadryl or anything else that might knock her out at this point. You need to be able to see how she's acting without adding anything that might make her sleepy (or really affect her in any way at all) while she's in hypo numbers and recovering from them.

 

we checked her at 45 minutes and she came up to 49.

 

That's still below 50 so she needs more food and you're going to need to keep testing her for awhile

Since your spreadsheet isn't updated, can you tell us when she last had insulin and how much?

I definitely wouldn't be giving her any type of sedative for the reason's April stated above. It's just not safe

 

The problem with that 49 is that it's going to be mostly the syrup...and she's still under 50. She needs to come up a bit further and then still be rising without the influence of syrup or high carb food.

 

She had insulin at 8:30. .5 unit of Levemir.

Is it better for her to be super stressed out and freaking out for the next three hours or to sedate her?

I'm sorry, but we have to take her and we have to go, as there are quite a lot of people depending on us. If we had a choice, we would not be having her travel.

 

Given that those are the only 2 options, having her stressed is really the only choice you've got. She really shouldn't be sedated right now - if she's had a seizure this recently, you have to be able to see how she's feeling and acting and sedating her is going to suppress her natural actions. And the stress might keep her BG up a bit. Can you test her on the road? And bring syrup and high carb food with you? And can you get a list of ER vets along the route you're taking so that you can get her somewhere fast if she has another seizure or her BG keeps dropping when the syrup wears off? And can you get your regular vet to take a look at her before you leave?

 

How long has it been since the shot? 8:30 doesn't tell us anything since we're all in different time zones but with Levemir's later nadir, I'm concerned she still may have a long way to go

I agree....if those are the only choices, I'd choose to leave her as alert as possible so you can gauge how she's really doing without having anything suppress it.

Make sure you take plenty of supplies with you because you're going to want to test her on the road. Some cats actually go lower with stress! (China's one of them)

If you have to stop by your vet anyway, I'd discuss it with them too

 

I spoke with the vet and he also recommended that we not give her the sedative, so we are not. She is actually doing better in this vehicle than she usually does.

We will test her again next time we stop. Thank you for all of your concern.

 

Please continue to test her as you travel. Her BGs could easily drop again. We'll be watching for updates!

 

Actually, any stress may be helpful in bringing up her glucose.
Pick up some Karo or syrup on your way wherever.
Have a towel you can use to drape her crate to help her be calm.

 

Just wanted to send some vines for Baby's safety. Paws crossed she recovers well and isn't too sensitive to the insulin after her event.

 

I would be VERY careful about giving insulin on the trip. She might be high tonight from stress and syrup, but if this were my cat, I would probably not give any insulin on the trip to avoid going so low on the road. Just my opinion...

 

Her low BS was at +5 after her am shot. We tested her at +7.5 and she was at 122.

I'm really not sure what to do about her shot tonight.

 

It's too early to really say right now, but I'd get a +11 if you can so you'll have an idea of if she's still climbing at PMPS time. She may bounce high or she may stay lower

Either way, it's obvious .5 is too much so she's earned a reduction. The problem is when cats have a symptomatic hypo like Baby did, they can be VERY sensitive to any more insulin, so if you can't test overnight, it's going to be safer to just skip any shot for now

 

She is at 174 now, we are at +10.5.

 

Are you wherever you're going so you can test tonight if you shoot? Or are you still on the road?

 

I just tested her and she is at 190, we're at +12.5

 

Are you at your destination and have the supplies and ability to be up tonight and test if necessary?

 

Yes.

 

You might want to give .25U then ....it looks like she's bouncing off the lows today, but I'd make sure to get some tests in later to make sure she stays safe

 

OK I gave her the .25 unit. Will check her before we go to bed and once or twice more during the night

 

Would you take the 911 off? Over to the right of your subject line from your first post you'll see "Thread Tools" and you can choose to "Edit" from there...just choose "no prefix"

If you run into trouble again, you can add the 911 again

 

Will do. Thank you

 

Just checked her at +4 and she is already down to 83. Not in the danger zone yet but we're only +4. Making sure she has food, wondering what else to do.

 

Hi Sarah,
When does Baby usually reach the peak of the cycle (lowest blood glucose)? How many hours after the shot, usually?

 

Ah, just realised that the SS isn't showing this cycle's data. (Oops...)
That's quite a drop from a preshot of 190.
A little food now may slow that drop. Are you going to be able to continue to test over the coming hours?

 

I don't know usually. I haven't been testing regularly. I know she had her low reading yesterday at +4.

 

Yes I have another alarm set for +6

 

But you gave karo at that point? That would have raised the numbers so we don't know when her blood glucose nadir is.

If you feel able to continue to monitor then you could see how she goes and take appropriate action to raise her blood glucose if necessary.
If you are not able to monitor then you could give a little higher carb food now and see if you can stop her from dropping any further.

Have you given any food since you last tested?

 

I gave her Karo at that point. I have given her food and she has eaten since I tested her 45 minutes ago.

 

OK, the karo should have kicked in by now. But if it were my kitty I wouldn't wait until +6 to test again. Are you able to get another test now..?

And what food did you give?

 

FYI, Be aware that the karo starts working quickly but can also wear off relatively fast.
Food works more slowly but stays in the system longer.

 

I gave her both Karo and dry food. Wanted to raise it quick and keep it up.

 

OK I just checked her again at +5 and she has gone up to 94. I will check her again in two hours.

 

We are at +7 and she is at 92. Feeling much more chipper running all over the room and has discovered the cat on the other side of the door. I'm going to leave her until +11 or so now.

 

At +11 she was 102 so we gave her shot at the normal time. Will check her at +4, +5, and +6 to find her nadir.

She's chipper enough to be very unhappy about getting tested.

 

The nadir can move around a bit, it is more of a time range than a fixed number since the shot.

 

Just tested her at +6 and she is at 30. Gave her high carb food. Will be skipping shot tonight. Wondering where we should go from here, if we should just shoot her once a day or give her higher carb food... I feed her Fancy Feast Classic food, averages 4-5 carbs per can.

 

With a 30, I would test again in 15 to 20 minutes after the last test. You don't want her going any lower.

 

Once you get her through this low, you might want to do a trial to see if she really needs insulin.

 

Do you have another test yet? Because you are not home and may not be familiar with where the nearest ER vet is, like you would at home, I would look into where they are located and how to get there, just in case, while you're waiting between tests.

Having a symptomatic hypo can make a cat extra sensitive to insulin. And, some cats go lower rather than higher when stressed.

I agree with Maggies Mom, that maybe you can do an OTJ trial once this low cycle is through.

Please update us with the latest test.

 

She is at 52 now, so she is trending upward. Will check in 20 minutes again to see where she's at.

How do I do an OTJ trial?

 

Your spreadsheet isn't updated, so I can't really tell her recent history.
I'm going to try to get some other people to chime in on their thoughts. There are lower doses than 0.25, that might be an alternative to a trial, but she has gone very very low two days in a row now.
Let's see what other people have to say first.

 

She is at 69 now.

 

Unfortunately, we have not been checking her sugar regularly. That will change immediately. Its a fairly traumatic experience for all involved, so we have been avoiding it.

 

It might be a case of seeing what Baby does next to decide whether to try a trial or whether to go with a reduced dose. I think skipping tonight would be a good idea - if for no other reason than to let you get some sleep and for her body to recover from the low numbers 2 days in a row and clear out some of the depot from the Levemir. After that, you really need to test her before her regular shot time in the morning - if she's above normal numbers, then maybe reducing the dose to 0.1 might be the way to go to see if she can earn another reduction. I think a lot of people here now try to do the lower dose to give the cat's pancreas as much support as possible for a little longer. I finished up doing a tiny, tiny dose of 0.05 for about a month for Rosa (although I did have to skip a number of shots during that time) as even going from 0.1 to OTJ was too much for her in one attempt but I think that's where you have to be guided by the numbers you're getting to work out what to do next.

If you do finish up going with the trial, then you would generally start with a cycle where you get a green pre-shot number. If you get a number within normal range, then you don't need to test again until the next pre-shot time (though obviously without giving the shot). If you get a number that's a little above normal range, then you can feed low carb food and test again about 3-4 hours later to see if her pancreas is able to bring her numbers down on its own. Once you get to 14 days without insulin and with the numbers being in the normal range, then you can class her as being OTJ.

 

My biggest question is how do you measure insulin doses that small?

Right now she almost always has food in her dish. She gets upset if her dish is empty. When she was first diagnosed, I discovered that her numbers were best if she was fed low carb food twice a day. She is keeps herself to two a day all on her own.

 

Dyana asked for more eyes on your situation. You're skipping tonight, right? I think that's smart. I would continue to test her to make sure she stays over 50 this evening, and I think I would hold off her shot tomorrow morning unless she's over 150-200. If you can post in the morning before you shoot, have someone experienced take a look at her spreadsheet and help you decide if you should shoot or not.

 

Can you get the spreadsheet up to date, please? At least for the past week or two. It's essential for being able to see the whole picture.

 

I have to also wonder if Baby is one of those cats that responds to stress by going low...it's not the usual way they respond, but as I know with China, she's one of them that does it

I agree you should just skip tonight...get a good night's sleep (and yes, update your spreadsheet if you can!) and let's see where she is in the morning.

She may also be one of those I told you about the other day....that go from having a symptomatic hypo to OTJ

 

The spreadsheet is as up to date as it can be. As I said before, I have not been testing her sugars regularly up until now. I will start again.

 

She actually went high during the trip yesterday. Her lows haven't been during stressful times.

 

She was at 102 this morning before Her morning shot would have been. We didn't shoot her this morning.

Where should I go from here?

 

What time would her shot have been?

 

You have 2 options:
- Wait until she's up over 200 mg/dL to shoot
- Use drop dosing as follows:
Using a colored liquid, so you can see it more easily, fill a syringe to 0.5 units.
Slowly squeeze out equal-sized drops, maybe by twisting the plunger, until you can get the same number of drops per 0.5 units every time.

Now, you can draw up more than the amount you need, and squeeze out drops to the dose you want.
You discharge the excess into the sink.

Decreases may be done a drop at a time.

 

I'm glad you skipped, but I'm a little confused on your spreadsheet

You said she was at 102 this morning and you skipped, but it looks like you shot .25 and she dropped to 30? Or is that yesterday morning?

Looks like maybe you have the dates wrong or she got a 102 two mornings in a row?

 

That 102 to 30 is listed under yesterday's date on the spreadsheet. Did she give you exactly 102 two mornings in a row? If so, it looks as though last night's shot and this morning's were both skipped - is that right? Maybe she is ready for a trial, depending on how her numbers look later on today!

 

I'm sorry, I was mistaken. She was at 106 this morning. The spreadsheet is corrected. She is up to 156 right now. We are at +9 right now.

We skipped both last night and this morning's shot.

 

OK...thanks! That makes a lot more sense!!

 

Tested her at +11 and she was 211. Just tested her PMPS and she is at 186. Should I shoot her?

 

Can you snag a +2 if you do shoot?
What you might consider is waiting until morning, then doing 0.25 for just an am dose unless she starts really climbing.

 

Ok, I will skip tonight. She has been so low I don't want to risk it again.

 

Sugar at +2 after not giving her shot is 151.

 

Nice!

 

That's actually good news - it looks like she's brought herself down after eating. Her numbers are a little high for an OTJ trial just yet, but it does look as though she might be on her way - she probably just needs a little more support at a low dose for a while. I think skipping tonight is reasonable - and her depot will be emptying with every skipped shot so you won't have an overlap problem from the bigger depot when you do give a shot at the new, smaller amount.

 

Just be aware that after a symptomatic hypo, a cat can be very sensitive to insulin, so err on the side of too small of a dose when/if you shoot her. Looking at her spreadsheet (great job getting that together!) I wouldn't start with more than 0.25u.

 

We had already started to do the low doses as of friday night after the first hypo. I won't check her overnight because we both need sleep but i will check her before her shot time in the morning. At this point, what numbers should i be looking for AMPS to actually give her shot?

 

Since you have limited data on her, I'd like to see her at around 200 before shooting...and that's only if you're not going to be on the road and will be available to test

We have no way of knowing how sensitive she's going to be to the next shot, so better to let her be a little higher than too low again