Low Numbers When They Should be Climbing

Hello!

My cat Moby and I have been run through the mill a bit these last two weeks. He actually did have a horrible hypo experience last weekend. Turns out, Moby is extremely sensitive to insulin (yes he's on Lantus) and even with a conservative starting point of two units, it completely wrecked him and dropped him to 40.

Today, Moby has been to the vet and has been under observation all day. They started him on one unit of Lantus at around 8:45am this morning. I copied down his #'s and levels below:

8:08 AM Prior to shot 350
8:45 AM Shot - 1 unit Lantus
9:15 AM 30 minutes 440
9:45 AM 1 hour 379
11:20 AM 2.5 hours 379
12:30 PM 4 hours 164
2:00 PM 5 hours 92
2:30 PM 5.5 hours 87
3:00 PM 6 hours 69 (baby food)
3:30 PM 7 hours 69 (another snack)
4:15 PM 7.5 hours 72
4:55 PM 8 hours 75
5:30 PM 9 hours 74 (baby food)
8:00 PM 11 hours 66 (half a meal eaten)

My concern is the last test I did at home. Shouldn't his numbers be climbing? Obviously my kitty is sensitive to insulin, but I'm confused. Did I somehow get a bad strip? Does this happen normally? I fed him some treats and for the past hour he has grazed on DM. I plan on testing again soon but I just needed to ask if anyone has seen this or may have some insight.

I'm TERRIFIED of him going hypo again. My husband who literally resuscitated him when it happened is also pretty scared about it. I don't want to overreact so instead I felt the need to reach out!

Thank you for reading. I'm still new at this process and learning and reading more every day to help my kitty!

 

Hello and welcome Marcie and Moby. It is possible that kitties cycles can do what we call a "slide" all day long. This is especially common if kitty is getting over a bounce. Read the second post here for a description of bouncing.

For what it's worth, 2 units is not a conservative starting dose, unless Moby is very large. We use a weight based formula for deciding a starting dose. How much does Moby weigh? What is his idea weight?

Your signature says you are shooting 1/3 a unit once a day? Normally we try to get a dose that you can inject twice a day. If you have any more data in addition to the above, it would greatly help us if you could enter it into a spreadsheet. This post tells you how. I suspect that the amount of insulin he got today was too much. Are you testing his blood glucose at home?

 

Yes, so, I have read two opinions that the two units/twice a day was too much or that it is conservative. Obviously, it was too much for a 12 lb kitty (that is his ideal weight), because it sent him to the ER for two nights, where he actually bounced twice when they tried 1 unit after his crash. He is 72 hours after a bounce when we tried one unit with vet observation, so I will definitely read that tonight.

The vet did recommend 1/3 unit once a day because of his initial response. I don't really have more data because by the time we learned how to inject, got a schedule, got the food, he was already down for the count and at the ER, so I don't have any other numbers or data. We just started home testing last night. And yes, the one unit was too much, the vet initially said she was only going to give half and then it turns out she gave one... and at this point, I'm just trying to learn and find out who the heck I can trust.

I am researching another vet, but the past ten days have put us $1,800 out of pocket... and I'm just trying to hold my husband and I together and not go careening down into a panic attack. That was probably a little TMI, but... it's honest.

 

P.S. I was rude and did not say this to you, Wendy & Neko! Hello and thank you for your response. I'm a bit stressed! ARGH!

P.P.S. Also I see all these topic subjects with numbers and if I posted in the wrong place, or board, I'm sorry. I just thought it was more appropriate because he was on lantus, and the jargon is really hard for me to grasp, but I'm trying.

 

Been there, done that, as have most of us here. We understand. We just want the best thing for our kitties.

Sounds like 0.5 U would be a better starting dose. Even though 1.25 units would be Moby's starting dose by the formula, some kitties just need less so we adapt.

Getting so you can test at home will definitely save you money.

 

I just tested him again and with half a meal now going through his body he is at 113. I can sleep tonight. I really appreciate your response. The "slide" does help me and I had never seen the bounce post, and that is helpful, too!

 

Hi Marcie,

Just want to add my welcome. After a hypo a cat can become extremely sensitive to insulin. That may be part of what you are seeing today. I think reducing the dose is smart.

In the morning if you have a test of less than 150, you might post and ask for help figuring out if it's safe to shoot. With a newly diagnosed cat we'd encourage that, but I think especially with the response you've seen to the insulin it would be a good idea.

This forum is for all Lantus and Levemir users. Don't worry about the jargon. All groups have some of that. Just post and we'll help you help your sweet Moby.

 

Note that readings between 40-130 mg/dL on a human glucometer, without insulin, are considered normal.
For more details on glucose testing, see my signature link Glucometer Notes.

It may be that with the hypo and the change to lower carb food, you may be able to get him off insulin.

 

Julie, thanks for the feedback. He tested sky high again this morning, 440, but we're going to continue low and since I'm home with a cold, I'm going to test him periodically and log numbers today in between bouts of tea and reading. Thanks for your welcome!

BJM, something else I did not know. I'm hoping we can wean him eventually. Your Glucometer Notes are part of my sick day reading. Thank you!

 

Hello, welcome aboard It would be great if you could add creating a spreadsheet for Moby to your list for today, here is the link http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/ Don't be concerned by the jargon, it is like another language to start off with but I'm sure you'll pick it up quickly, if you don't understand something don't be shy to ask. This is definitely the place for you to trust with Moby's diabetes, the combined knowledge amongst members here blitzes that of any vet - and it comes free

 

Marcie, the high numbers you're seeing today are his body responding to going into low numbers. We call that a bounce - there's more of an explanation of it here.