Need advice on hypo event/follow up protocol

Gita Devi
1 hr
My cat had his first hypo event last Friday. Luckily he had trapped himself behind my desk and the strange noises he made while trying to get out woke me up at 4 a.m.. He was staggering around, wedging himself into small spaces and barely able to keep himself fully upright.

I immediately gave him Karo syrup and a can of FF gravy and checked his BG levels which started to go up. Called my ER vet and brought him in later that morning. They kept him overnight and ran a curve. Sent him home the next day and said to only give him 1 unit (vs. his normal 3) twice a day for a week. He's eating well, but his sugar levels are sky high (mid to upper 400's) and I asked my regular vet about upping his dose to 1.5. She said she didn't want to contradict the ER vet's diagnosis and said to keep him on the 1 unit for 5 days and check his urine for ketones. My thought is why risk having him get DKA?

When he was on the 3 units his BG levels were finally coming down and remaining consistent so I was thinking it was time to lower the dosage when he went hypo.

So - for those of you who have had hypo kitties, is keeping them on a very low dose of insulin for a week the norm?

 

I assume you are home testing, correct? Cats can be more insulin-sensitive after a bad hypo episode, but I have not heard of having to keep them on a lower dose than they need for a week after. If you have test data that shows that the current dose is too low, I do not see why it should not be increased after a few days. What kind of insulin are you using?

 

Good morning. I have not been on the board for long, but I have made it my habit to read as many threads as possible so I could learn. I have never read that lowering the insulin dose for a week following a hypo was good protocol. It's possible that the insulin dose does need to be lowered if hypos are occurring, but not by 2 units and not for only a week. What insulin are you using? You don't have a signature with information on your kitty, or a spreadsheet so members can take a look at the blood sugar level history. There are dedicated insulin support groups (forums) here with members that constantly watch for specific dosing questions. You should start a thread in the specific insulin forum for more eyes and answers.

 

He's on ProZinc. Had been on Lantus for over a year so we decided to switch him back to ProZinc about 2 months ago. I test before every shot, do nadir tests frequently and curves as needed. I maintain a hard copy spread sheet and just never got around to entering one here on the forum. We've gone through somogyi effect while on the Lantus and I had hopes that the ProZinc might work better for him as that was what he was started on and initially responded to so very well that we thought he'd gone into remission. A week after stopping his insulin, his numbers had skyrocketed and it's been an up/down pattern ever since. My vet thought Lantus would work better for him and thinks his normal cycle is actually 16 hours vs. 12, but he gets his shots every 12 hours, along with his meals.

His numbers on the 3 units ProZinc BID had been coming down and starting to stay in the normal range for short periods of time and it was encouraging. Had thought it was time to lower his dose and then he had the hypo.

Just tested for ketones and he's negative, but his glucose was over 2000 mg/DL which is the highest its ever been.

 

Just got an email from my vet and she said to give him 1 unit tonight and then increase to 1.5 units BID starting tomorrow. That's what I had already planned to do so at least we're on the same page.