Mom's cat Francis in HYPO today :(

Mom gave Francis his new dose of 2 units of Lantus this morning at 6am. She thought she missed and no one ever told her not to give a second shot if you're not sure you missed. :roll: She was 99% sure she missed and did it again!!! Went back to bed and then tested him when she woke up again and he was 26.

AMPS (6 AM) 94, Gave 2 units Lantus (x 2)
+3 = 26
20 minutes later=39
25 mins later=50
+4.5=63
+5.25=57

She's been giving him HCW with a glob of syrup rubbed on his gums every 20 minutes.

Her new vet is nasty and told Mom "you can't interupt me" when she called for help. The vets' only comment was to bring him in for a glucose drip but that the vet was leaving at 3pm and would have to transfer Francis to an ER after that.

Mom has spent $700 on Francis in the last two days - she DOESN'T have any more money. She's been through one other hypo and I told her about Nicole and Baby's hypo so she's learned a lot. I think she can do this if he doesn't get dangerously low. What number should she consider bringing him to the ER?

Also - I have appointments today and can't sit here on the computer interpreting for her. I'll be in and out and I'll report your suggestions to her and then report back here when I can.

I'm looking for general feeding guidelines...how often to feed during a hypo so he won't eat too much, but yet stays fed. I'm having her feed him about a tablespoon of HCW with some syrup in it every 20 minutes or so.

How does this sound?

 

viewtopic.php?f=3&t=2833

Traci - if u wont be able to stay online, please print out the link for HYPO

can u put a 911 alert on ur first post please?

 

is 57 the last test done? how long ago?

I sent an alert to your thread here. Hang on Traci.

 

Oh Traci... I'm so sorry to see this again.

I would say more like a Teaspoon of food so Francis doesn't get too full too quickly.

He's *probably* in the nadir range at +5, but we don't know that for a fact since she's just started the Lantus. And on top of the earlier hypo he's going to be extremely sensitive to the insulin.

I would say if he starts dropping again I would hit the ER at 30.

And she needs to be very aware that with the HCW and syrup he is going to bounce high over the next day or so. And not to react to that. And to start all over tomorrow at 1u REGARDLESS of what her vet says. (Perhaps even .5u - others will chime in on that)

 

No advice, just lots of prayers and lovies from Esse and me...

Best-
Michele

 

+6 (12 PM) = 46

This is his mid-point.

WCR-seems fine, grooming, pupils aren't too big. He just hates being tested. He's eating for her. I told her to give more syrup for now.

 

It looks like your Mom is handleing it pretty well.

I would say just keep feeding little bites of the HC, even just spoonfuls of the sauce and perhaps a few drops of the syrup or honey or whatever mixed in it. Then keep testing untill he is over 70 and going upwards at least 2 tests in a row. Then stop feeding and test again to see if stays up there and surfs. She is getting past the nadir point by now so things should start to level off a little. She needs to keep testing today and probably best to skip the evening shot and start over tomorrow. Or just give a very small dose (.5U) to keep him from skyrocketing in Rebound.

Now that she is past the +6 mark and the dose wasn't a huge overdose I don't think you need the ER unless he goes really low again or vomits and won't eat or starts becoming symptomatic.

Sending best wishes, and (((hugs))) to you Traci. I know you are stressed too!

 

And when this crisis is over, I think it's time mom starts interviewing new vets.

For a vet to say this is unconscionable. Especially when this vet prescribed the dose and mom made a mistake and double shot. This is exactly what a vet should be interrupted for! And even told to bring the cat in immediately for treatment.

I know in NJ, the law is if someone comes into the office with an emergency, legally the vets on duty must attend to the emergency and not refer them elsewhere. Even if that means, they have to close later. They get the animal stabilized first, then can say transport to ER/24 hour place.

Sheesh this makes me angry.

Hope mom is doing ok.

 

Hi - I LOVE Maui's new picture!!!

+ 6.75= 80

Mom is still feeding, eating and testing. She will test again in 45 mins. I told her that the 80 may be a false high and not to get too happy.

I am leaving to get my get my nails done and will report back later. I haven't gotten my nails done in a couple years!

Thanks you guys for helping and caring. I think Francis will make it ok. We'll probably need help with dosing for tomorrow.

Love you all! Mom does too!

 

keep us posted when u get back Traci!

 

Hi Guys-

Mom and Francis seem to be out of the woods! Woohoo.

She's going to call me in a minute to give me an update on his numbers, but from what I heard and couldn't write down in the car he was something like 134 and then 156.

I think 2 units is too much Lantus for him. She gave him 2 units yesterday morning and he had tested 109. I bet he hypo'd yesterday too because she was at work and unable to test. When she got home he was in the 300's.

When she calls I'll update his numbers and maybe you guys can guide us as to what dose to give him tonight. Maybe .5 or 1 unit. Stay tuned and thanks so much!

 

Traci... I'm so glad to hear that they are out of the woods.... My thinking while reading this was that your mom could very well have been right about missing the first shot. Right that she missed - but not right in shooting again, of course. I bring this up because she's clearly learned that you do not shoot again if you miss... But that aside, if her kitty did receive only 2 units and this happened, then clearly that is too much.

Personally... if there are no ketones I would want to skip the shot tonight and start over fresh tomorrow with .5u. But please do let us know what the numbers are tonight and, if need be, she can shoot a smidgen so that there is not too much of a roller coaster. My worry about shooting tonight is that Lantus lasts and without a full spreadsheet available with data, who knows what even .5 will do after today's numbers. She doesn't want to be in this same boat tonight and not be able to sleep.

 

Update:

+6.75=80
+7.75=119
+8.75=165
+11.75=162

Mom is not going to give a shot tonight - how do you feel about that?

Also - any ideas about what dose she should give tomorrow morning? Her AM shot is at 6 AM. I think (and I only have about 2 months experience) she should give .5 or 1 unit no matter what his number is.

Any ideas? Maybe I should put this on Lantus too!

PS - No ketones. Somewhere along the line I missed this/she didn't tell me. So that's good news.

 

I think skipping the dose tonight is safe and smart so your mom can get some rest... Many with experience and data logs do shoot at that number but it is not advised to do so for the newly diagnosed or those without data.

Giving .5 in the morning is likely the safest bet unless you or she can post the AM number so that the group can have a look.

Remember... Lantus works with overlap... so the .5 you give in the morning is still working at the PM shot... and then that PM shot is still working the next morning... and so on. That is why sticking with a lower dose of a longer lasting insulin reflect improvement in a couple of days... it doesn't hit like the fast acting ones do. That means that if she gives the .5 tomorrow morning then she may not see a big drop in the day, but should see a lower PM preshot... sticking then with the .5 again will build on that and hopefully give a better cycle and again a lower preshot next time.

Does that make sense? If the right does is 1unit... you can build to that... But your mom should stick with a consistent and safe dose in the beginning.

 

does mom have a computer and internet access? can you get her to sign on or at a minimum create a spreadsheet so we all can see.

And if she can't, can you do this for her and post for her so that we have a spreadsheet with the history to look at? It will be easier and safer to have this data in order to give dosing recommendations.

 

Traci, you poor thing! Your mom has really had a rough ride with this stuff lately. I don't know anything about Lantus so can't help with any details, but wanted to say "hi", and great job on getting through another rough spot! Hope things get steadier soon!!!

 

Ladies-

OMG! Do you think I'd be doing this if she had internet? :lol: Hell no! She'd be doing it and you'd all be dealing with her directly! :lol:

I can send her a blank ss in the mail, but there's no way I'm doing a SS for her cat here...I'm just not ready to commit to that. We live in different states - btw. She lives in CT. I understand that it would be the best way for people to help us - but it's too much for me.

Thanks for caring though.

 

Update:

+15=171

We talked and she's probably going to give him .5 tomorrow morning. It'll be interesting to see what he'll do tomorrow.

 

Traci, you make me laugh... hahahah... I don't blame you for not taking it on... she needs to get a handle on it too.

That last number is quite good... let's hope it stays low. If you happen to be talking to her tonight again, let her know to give some small meals if she can - low carb of course... Don't want to overwork the pancreas by giving too much or too little food.

 

She just switched to Lantus, correct? Personally, I'd never shoot a 94 before I had a accumulated a significant amount of data about how the cat responds to Lantus. I'd have skipped the A.M. shot and then, depending on how the evening number looked, shot 0.5 to 1U and started collecting data. There is often a lag (as in days) before you see the true picture of how Lantus is going to perform in a cat, so I'd have approached it cautiously given the previous hypo(s) on Vetsulin. And I believe you indicated that there's no known history of ketones, correct?

Charlie was a microdose cat and peaked early on Lantus. His curves look more like an N curve (deep and short-lived). I could have never shot him on a 94 (he typically peaked at +3 to +3.5 and could drop 150 points or more in two hours on as little as 0.1U). Chip, on the other hand, is a late-nadir cat and has the surfing response for which Lantus is so well known. I can shoot him at 104 and he'll hang between 80 and 135 all day. So I never assume a given cat will react a certain way and tend to be conservative when starting out, as I've had to deal with both extremes.

Just my two cents, and probably not worth that.

 

Tell me about it! I would NEVER have given him that much or any on an AMPS of 90, but my mother doesn't have enough experience to know what to do. She's been waaaay too aggressive. I'm just the translator here. Just trying to help her out with out losing my mind, you know? She doesn't have the internet so I try to help her out. Hopefully after two hypos she's learned to go slow. One hopes at least!

 

Well, do you think you can say "Hey Mom, let's simplify this. For the next week or two, let's go with a low dose of 0.5U BID, sit on our hands, let the dust settle, and collect data. And if the PS is under 200, call me before shooting and we'll come up with a gameplan. Now Mom, you might see some wonky numbers for awhile. That's okay, it's expected; just stick with the plan, and we'll reevaluate in a week..." ??

I know that puts the onus on you, but really, how much worse could that scenario be that what you're dealing with right now?

Just a thought...

 

:lol: Sounds good to me. I'm sure I'll hear from her tomorrow. I think the .5 dose sounds right after all this hypo drama.

 

Traci:

I wonder if you could convince your mom that getting an internet connection will actually save her money. She may be able to reduce her vet costs and her anxiety by having access to this board. Even if she saved one vet visit, that would be months of internet use. It would also save you a lot of gray hair!

 

Her computer that my brother gave her is busted. She can't afford any more $$$ to attempt to fix it/get a new one. She knows nothing about computers and it will bascially become my second problem if and when she gets one and something goes wrong/she doesn't know how to use it etc. Drives me crazy that there is no one else who can help except a dughter who lives out of state.

 

Re: Update on Mom's cat Francis

To those angels out there who helped me once again during the latest hypo, I'd like you to know that Francis is doing okay. I think Mom "gets it" now...she's going to chill out and be less aggressive with insulin. She shot .5 units today and tonight and she's going to do this for a couple of days to see how it goes. His mid-point numbers are in the 200's, so he'll probably need an increase, but we'll take our time.

Thanks again for the guidance and patience. ;-)

 

I hope you remember to pat yourself on the back and include yourself among the "angels" helping your momma. You're a good daughter to do this for her.

 

Thanks Karen. You're right. Hopefully she's had enough experiences under her belt that she can start to make some better decisions and not need me as much. I've mailed her everything from this board that I think is important - the stickies, the lantus protocol, etc. Maybe she'll get another computer at some point and she'll be able to do this herself.