Newbie and BG is 33. Help

Hi. I'm new to this. My cat was diagnosed 2 weeks ago w/ diabetes w/ BG of 481. For 2 weeks we changed the diet to meat and the level dropped yesterday to 305. Our vet had us start Lantus last night at 3.00 units 2X daily. This morning his AMPS was 160 and we dosed 3.00 units. We just tested him and now his PMPS is 33. We have not dosed him. What should we do? He seems fine but his low BG is concerning to us. Hoping you can help.

Thanks!

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3 units lantus for a newbie? Argh!

Ok, do NOT give insulin, not even a bit.

How is he acting? glassy eyes? staggaring? Staring off into space? Do you have any dry food you can give?

 

Food. Right now.

If he isn't showing any symptoms, you don't have to give a ton of food but I would definitely offer food now.

 

How long after the 3 units did you get the 33? If about 12 hours he will probably be OK. I would test again not assuming that is 15 minutes or more later. If no going down just feed normally.

 

going forward, no insulin if 200 or less, and start over at 1 unit. Yikes!

 

He seems just a little bit out of it but not not out of the ordinary. I am not sure if I would say he has glassy eyes. What kind of food should whe give him? We have some dry cat food.

 

Larry, the 33 is at PMPS.....

 

The 33 was 12 hours after the dose and after he finished eating his all meat p.m. meal.

 

xposted on Lantus forum

 

give him some of the dry and some wet food. 33 is pretty low. Give him a snack and test again in 30 minutes

give him a day or two OFF insulin

Then start over at 1 unit every 12 hours. 3 units was WAY TOO MUCH

Also, does your meat diet include taurine and calcium? Kitties need taurine from organ meat (like hearts) and calcium from bones, since there natural diet would be mice and birds.

http://www.catinfo.org has excellent information about feline nutrition written by a vet -- and includes a recipe and info on making your own cat food.

 

Sorry, I do not understand. I have never posted to a forum before tonight.

 

a lantus overdose can work in the body for longer than a good dose would so do you have any canned cat food that is sliced, diced, shredded, etc??? the gravy it is in is higher carb and will bring him up quick. if he's acting anything out of the norm, i would want that kind of food or some mushy wet food with a dab of syrup in it

agree though, no more insulin right now and when more is needed (bg over 200) start over at a lower dose

 

I'm coming over from the Lantus forum.

If you have any high carb food (anything with gravy) please feed a couple of teaspoons of the high carb. If you don't have high carb, mix some karo syrup, honey, maple syrup, etc., into your cat's regular food and please re-test in 15 min.

Dry food will take too long to work.

 

What Joanna means is that she posted a link to your thread here on the Lantus group to get the attention of Lantus users.

Yikes is right! No insulin please!

 

I would so no to the dry food. You should give 1 tbsp of high carb food and keep retesting every 15 minutes until you start to see an increase. Continue to feed 1 tbsp of high carb if he continues to drop.

3U bid is too much to start off with a new diagnosis.

 

Also, I would not give any Lantus tonight with that low of numbers until you see them increasing and baed on what your shot times are.

 

Hi! Joanna cross posted your posting on another forum for Lantus users to bring more traffic and advice to you. 3 units is way too high. Lantus and kitties like to start low and go slow. Please listen to what advice is given. I have been on this board (my first board too) for 2 months and the people around have great advice and my kitty has greatly benefited from it.

So glad you came by tonight.

 

Unless you have an absolutely enormous cat (oh, probably like 30 lbs.), 3.0u is too high of a starting dose. Lantus starting dose is approximated by weight -- 0.25units per kilogram of your cat's ideal weight. This usually falls in the neighborhood of 1.0u. Are you OK with starting over on the dosing regimen?

If you were in the middle of changing from a high carb diet to low carb food, you need to monitor very carefully since blood glucose (BG) levels can drop due to the change in diet.

For tonight, do you have strips and high carb food?

 

oh sorry, I wrote in shorthand I put a link to your thread over on the Lantus forum, so more people can help out if needed (I know nothing about Lantus so am not much help personally!). Nothing you need to worry about at all, it's just something we do a lot here to get more eyes on posts to be sure you are getting whatever help you need. I added the note just so others would be aware I had done that.

 

agree with Sienne, couple teaspoon, u dont want to overload too fast with food. You may need him to eat more later
retest in 15min.

 

We changed his diet 2 weeks ago and started Lantus last night. Our vet used 0.5 units per kg of his current weight. We have strips and the old dry food for tonight.

Thanks for all of the information and for the link to the info on cat diet. We just fed him a couple of tsp of dry with some wet. We will retest.

I'm a little disgusted with my vet at the moment. He just wanted us to dose 2X a day and bring him back in 2 weeks. He wouldn't show me how to use the Glucose tester. My husband is awsome at research and found this forum and how to test BG on YouTube.

 

The dry food takes a while to effect BG levels and takes forever to work it's way out of the system.

LC (low carb) food plus some syrup will be much quicker at doing the job. It also isn't as filling. Would it be possible for either you or your husband to make a quick trip to a grocery store to pick up any Fancy Feast variety that's in gravy or marinated? We all keep a supply in the house for just this purpose -- the gravy is not filling, cats love the stuff, and it does an amazing job at raising BG levels.

I'm not sure where your vet came up with the starting dose guidelines. We use the Tight Regulation Protocol as a basis for our dosing in the Lantus forum. This protocol is based on research data. The actual articles are linked over on the Lantus ISG if you or your husband are interested.

 

So sorry your vet landed you in this spot. Many of us have had struggles with our vets along the way too, it seems like the expertise just isn't there for many vets, at least compared to what I have seen here on the board. What your vet suggested is fairly standard practice I think (not the dose necessarily, but the blind shooting & no home-testing) - two weeks at home to let a dose settle, and then a curve at the vets. It's hard to find vets who want to do things differently, and actually your vet might be pretty progressive for prescribing Lantus! It's too bad he didn't help you get started home testing, but good for you and your DH (dear husband) for figuring it out!

There a post here on the Health forum about Hypo's - I have found it really useful as a reference to see what #s to worry about how often to test, etc. Just another resource if you think that might help you.

Hope things go well tonite. You are in the right place, there are so many people here with a lot of knowledge & experience to share.

 

sounds like your vet was using the old Rand (Queensland) protocol to determine a starting dose. That protocol is more appropriately used in a hospital setting, when the cat can be constantly monitored, and in fact requires that curves be done for the first three days (because they know the dose is usually an overdose and would require multiple reductions in the first 3 days).

Now Dr. Rand is using a new protocol that starts with 0.25 per kg of IDEAL weight. Much safer for home use. :smile:

You're ok, you're in the right spot now. Do you have a new number yet? If not, please test again now.

 

Hi all--We are going in the right direction and are at 48 now. This is 13 hrs and 45 min. after the last dose. Thanks to everyone, the help has been greatly appreciated. We realize that although we have read a lot in the last two weeks, we still have a lot to learn. Not only do we appreciate the indormation we have received but also the support of everyone.

 

That's great that numbers are heading up. Please give your kitty a few more bites of food and re-test in 30 min. Until we know that the numbers are heading up and are stable at around 90 or better, I would be concerned. BG levels can bobble up and down for quite a while so it's important to know that things have leveled off or are heading up.
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Just so you know, there is likely to be a BIG jump in numbers by your morning shot time. Quite likely, you will see numbers in the 300 - 400 range if no insulin is given tonight. Right now, it is not safe for you to give another shot, no matter what the dose.

 

Poor kitty and mama! We're having to go see the vet tomorrow to increase Arnold's insulin (he was dx a week ago). I hope he gets back to himself soon.

 

Keep testing and posting here. there are a lot of folks who really know their stuff here and can guide you through all the steps of the protocol. There will be someone on hand most if not all night.

Once this crisis is over, tomorrow maybe, start posting in the Lantus Forum (Board index>Insulin User groups>Lantus) I'm pretty new too and it really helps to have these folks take you by the hand. Lots of good advice and good support.

BTDT with the vet. I was going to say it's hard to change, but actually was so pissed off at him I really enjoyed letting loose. :lol:

 

We gave 1 tsp of Karo with some meat at (9:15 CST or 03:15 GMT) 14 hrs 15 min after last insulin dose. We waited 15 minutes and tested and now we are up to 63.

Good news, with all of the practice, I was able to get a BG with 1 stick instead of 4. Bad news, Oliver is starting to get irritated with me.

 

hi - I just wanted to pop in a say hello, welcome aboard, and ever so glad oliver is responding, and numbers are going up. You have found the right place here - there are some very knowledgeable folks here - they have helped me an Mannie immensely. You can have trust in what you are told.

and as a side note: i can relate to what your vet told you, with the initial dose amt - etc. I went through the same thing with mine. good people, but they knew not enough to treat mannie correctly - i have been through 3 hypoglycemic events in the first three months. we too were at a wrong dose for longer than i care to admit. Finally found the board here, and things have improved dramatically.

so - bottom line i guess, you can have faith in, trust in, and believe, what they tell you.

on the testing... i remember my first week - 10 strips/pokes per test and still no blood reads - stressful!. eventually it gets very simple, very easy - and oliver too will understand and know that you are trying to help him. mine now comes and waits for me while i get things ready. bet he will too. cat_pet_icon

welcome aboard!

 

All of this is very good! Please give Oliver treats! Lots of treats and tell him what a good boy he's been.

You're going to have to keep testing for a while longer. The Lantus should be pretty much past it's period of action in another hour or two. I'd encourage you to keep testing every 30 min. (and yes, you have clearly won your merit badge in home testing tonighe!!) and giving a bite or two of food. If the numbers continue to stay at this point, you're good to give just LC. If they drop again, feed the same mix of syrup and LC. Once numbers are over 100, you can rest easy.

I'm not sure whether you want to discuss this experience with your vet. For Oliver's BG to be at 33 12-hours after you gave your morning shot is significant. I'm guessing you weren't testing throughout the morning cycle. I don't want to even try to guesstimate where his numbers were at their lowest. It may be something to discuss with your vet along with the fact that you adjusted the dose and did not shoot tonight.

 

One hour later, BG is 143. Do we need to continue with food and testing? Or are we in good shape for the evening?

 

I think you're good. If it were me, I'd be sure to get in another test before I went to bed. I'd also leave out food for Oliver to snack on during the night. Not a lot of food, just enough in case he gets hungry, which he probably will since his numbers are going to swing.

Like I said earlier, expect a big bounce in numbers. When you have numbers as low as where Oliver was today, the liver will go into panic mode and dump stored glucose into the system. Don't be alarmed. This happens to all of our kitties.

Now that the dust is settling and you can breathe again, understand that Oliver experienced an asymptomatic (as far as we know), hypo. If you read the note here and in Lantus, we all keep high carb food around along with some form of syrup in case we need to steer low numbers. You may want to read those notes and make sure you have all of the materials you need in the house. You did wonderfully in managing this situation.

Please join us over on the Lantus Board. It is a busy place and since we are an international group, there is usually help available 24/7. There are any number of newbies and more seasoned users and we all help one another with situations such as these as well as how to best adapt our dosing protocol to the unique attributes of each cat.

 

Hello,

Just popping in and I read over your thread rather quickly - BUT - when treating hypos, the rule of thumb is three rising numbers, tested at least 30 minutes apart, cresting to over 100 means, usually, you are good.
For my Stormy Blue, however, I always wanted to test at least 5 times with rising numbers, 30 minutes apart even AFTER a 100 crest just to be on the safe side.

Regards,
~M

 

Thanks so much! We received so much great advice and support. It was wonderful that we were able to find this forum. It really reduced the stress of the situation. Thank you for talking us through this. I'm astounded by how active the members of this forum are. We are grateful for everyone's generous commitment to helping others. I'll be checking out the Lantus board to learn more.

 

I'm coming on here late as we were gone today and have been reading your post.

Kudos to your hubby for finding the home testing video and kudos to both of you for carrying through with it - it's the single most important thing in treating our extra sweet kitties - always knowing what the numbers are will benefit their treatment and give you peace of mind .

You did a great job with Oliver here tonight. Am sure he will be fine now - and again, don't be alarmed at a high number in the morning - his liver is just reacting and he'll come back down with insulin.

Again, so glad you were testing - you probably avoided what could have been disastrous.

Welcome to the board - will be watching for you and updates.

Emmy & Dude (& Mittsi too)