PMPS of 70 but full dose of Caninsulin injected

Discussion in 'Feline Health - (The Main Forum)' started by Capoo, Dec 26, 2016.

  1. Capoo

    Capoo Member

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    Jan 15, 2016
    @Sif is a new member, whose cat has been diagnosed one week ago.

    She succeeded her first BG test this evening, the PMPS, and it was 70 mg/ dL.

    The full dose of Caninsulin, 2 IU, was unfortunately injected, and it was one hour ago.
    Now, the BG at +1 is 66.
     
  2. Capoo

    Capoo Member

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  3. Capoo

    Capoo Member

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    Jan 15, 2016
    @Sif : please complete this thread with the current situation
     
  4. Sif

    Sif Member

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    Dec 23, 2016
    Merci beaucoup @Capoo.

    So :
    - 20:32 : 70.1
    - 21:10 : shot 2IU :/ honey (just a little little bit)
    - 22:08 : 66.6. Behaviour still normal. Again a little little bit of honey.

    @Kris & Teasel : I continue here. I will test him again but not every 15 min as he still acts normally. We just succeeded to make him accept the fact that he is tested so I prefer to wait a little bit more to avoid him to be traumatised (I anticipate for the future).

    I will test him again around 23:00. Thank you !
     
  5. Capoo

    Capoo Member

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    @Sif could you please tell us what meter you're using?
     
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  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OK. It has to work for you and your kitty. Do you have food with gravy that I asked about?
     
  7. Sif

    Sif Member

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    Ascensia Contour (I followed the advices of Dr. Lisa Piersen).

    No I just have a can of wet food brought from France, Almo Nature (0,9 % of carb).

    If I well understood the maximum effect of Caninsulin is around 4-6 have after the shot.
     
  8. Critter Mom

    Critter Mom Well-Known Member

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    FOR MEMBERS ASSISTING - VET SUPPORT IS POOR

    From Welcome Thread:
    .
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, you are correct. The full effect is usually around that time and that's when BG is lowest. We call it the nadir (point of lowest BG). You gave the injection a short time ago. Instead of giving your clock time when you give your BG values, it will be easier for all of us to understand if you say it as hours since the injection. The injection is the beginning, or time zero. One hour after is +1, one and a half hours after is +1.5, two hours after is + 2, etc. We are located everywhere and it's too confusing if we need to translate the time from a different time zone. For example I'm in Canada, Capoo is in France, etc.
     
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  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Do you have any dry cat food or dry cat treats?
     
  11. Sif

    Sif Member

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    His usual dry food yes. 20% of carb.
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OK. You might have to use this if you need to get his BG up. Honey acts fast but the effect wears off too fast and if you keep giving it your kitty might get an upset stomach from it. You don't want him to be vomiting!

    Please tell me your injection and test times in the form below:

    PS (pre-injection BG) = 70.1
    Dose at time 0 = 2 units of caninsulin
    BG at +1 = 66.6
    BG at ..... etc.
     
    Last edited: Dec 26, 2016
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  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    How is your kitty doing? Are you near the time to do another BG test?
     
  14. Critter Mom

    Critter Mom Well-Known Member

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    @Capoo, @Kris & Teasel -

    CG needs to feed a meal of HC kibble IMMEDIATELY to abort the cycle. Also give honey on gums to give BG immediate boost.
    Recommend getting cat to vet or ER for safety.

    If vet visit not possible:
    Test every 15 mins & give honey on gums if numbers below 60. Keep doing this till HC kibble gets numbers up and keeps them up.
    Need to keep numbers up till at least +7 - +8. Keep feeding HC kibble at intervals.
    Test throughout cycle right through to next preshot.
    Get CG to post for advice before giving ANY more insulin.

    DOSE NEEDS TO BE REDUCED if any more insulin treatment needed. Nadir not recommended to go below 100 on human meter for cats on Caninsulin.

    Sorry can't write fuller response.


    Mogs
    .
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Thanks, Mogs. CG has called vet as you know. CG is also reluctant to test frequently because she's just learning. I've asked her to test frequently and post for advice.
     
  16. Sif

    Sif Member

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    +1:20 : 46.8
    No symptoms except starving
     
  17. Nan & Amber

    Nan & Amber Well-Known Member

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    That's too low, and increased appetite can be a hypo symptom. High-carb kibble NOW-- don't over-feed because you will need him to eat more later, but get some kibble into him and test again soon (15-20mins)

    Is there a 24-hr vet near you?
     
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  18. Kris & Teasel

    Kris & Teasel Well-Known Member

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    When you wrote +1:20, you meant 1 hour and 20 minutes since the injection, correct? Please verify this for me.

    Also - please go read post #14 from Critter Mom above. She's very knowledgeable and is very worried. Your kitty still has 2+ hours before nadir (lowest BG because of maximum insulin effect) and his BG is already very low. This could become an emergency. Feed a small meal of any sort of kibble you have now. Put a little honey on his gums too.
     
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  19. Nan & Amber

    Nan & Amber Well-Known Member

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    Also-- once you have fed your kitty some kibble, I think we need to start a new thread with this information, unless Capoo is still online. Because it was started a while ago, even if people see the 911 they will think it is "old news", and we can't edit the thread title to reflect this new, more alarming, information.
     
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  20. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I believe Capoo has retired for the night. She's in Paris.
     
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  21. Nan & Amber

    Nan & Amber Well-Known Member

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    It would be best if Sif can start the new thread, so that we don't have the same problem later-- this situation could potentially continue for another 7+ hours, and I'm not sure I will be able to stay up that long. But the kitty comes first-- feed kibble, then test.
     
  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Sif, would you please start a new thread now with the 911 on it? Please also let us know what steps you have taken with your kitty.
     
  23. Sif

    Sif Member

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    An idea of the intervals ? I give him small amounts of kibble and still honey.

    The vet calls me back in a few minutes. She knows he is at 46.8. She told me to feed him and give him honey.
     
  24. Sif

    Sif Member

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    OK!
     
  25. Nan & Amber

    Nan & Amber Well-Known Member

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    Just post the next test as soon as you can.

    Honestly, if it were my cat I would be strongly considering just taking him to the vet now (I'm assuming, given the hour, that your vet is at a 24-hr clinic?). She may not be worried when you call on the phone, but it is your cat, not hers.
     
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  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Usually when we're helping someone in this kind of situation we ask them to test, give a bit of high carb food and test again in 15 minutes. The time between tests can get longer as the kitty gets past the dangerous part of the insulin cycle. you're not there yet. I know you're new to testing BG and didn't want to test as much as this. It's quite important to get the information. Could you manage every 30 minutes?
     
  27. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree with what Nan has said. If you can get your kitty to the vet clinic now both you and he will be better off. If not, you could be trying to keep your kitty from going lower for several hours tonight and if he does go very low it could become a serious emergency.
     
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  28. Sif

    Sif Member

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    @Nan & Amber : sorry I don't have the time to create a new thread, I have to focus on my cat.

    @Kris & Teasel : ok, testing all the 30 minutes. I do it again now.
     
  29. Nan & Amber

    Nan & Amber Well-Known Member

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    Agree, your cat is priority #1 right now!!!!
     
  30. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Have you thought about taking your kitty to the vet clinic?
     
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  31. Sif

    Sif Member

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    +4 66.6 guys !
     
  32. Sif

    Sif Member

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    @Kris & Teasel and @Nan & Amber :
    I meant 4 hours after the shot, he is at 66.6.
    Sorry I can't find the place where you explained to me how to write the informations correctly @Kris & Teasel ...

    So what now ? Next test in 30 minutes ?
     
  33. tiffmaxee

    tiffmaxee Well-Known Member

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    Don't worry about frequent testing. It is very important until the BG is going up and staying up. Feed a small amount of wet food with honey each test and post results.
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Go look at post #12 up above. I'm very glad to know that the 66 was at +4 but he could still drop more until +6 or beyond.
     
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  35. Nan & Amber

    Nan & Amber Well-Known Member

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    OK, better!

    This is a food-influenced number, but it's a good one!

    The general recommendation at this point would be to stop feeding and see if he is rising on his own, but because we are still mid-cycle and because you aren't able to test at a high frequency, I'm more inclined to just keep doling out the kibble and testing as often as you can for the next few hours to make sure he's out of the danger zone.

    Or, what tiffmaxee said!
     
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  36. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Whew! Keep testing and feeding til you see a substantial rise.
     
  37. Sif

    Sif Member

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    Thank you so so so much.......
     
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  38. Sif

    Sif Member

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    Yes yes we were ready for after this one test.

    Epi plays with his ball now !
    I will do more tests + will feed him until we will reach the +6.
     
  39. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Please explain: are you going to the vet clinic or are you staying at home because you think the +4 BG is OK?
     
  40. tiffmaxee

    tiffmaxee Well-Known Member

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    Kris, I don't think she needs to go to the vet. Her cat is acting fine and eating.

    You might need to test beyond +6. He needs to be high enough and then you keep testing for a couple of hours, usually every half hour, to see if he stays up without food. If he is over 80 two hours without food you are okay to stop.
     
  41. Sif

    Sif Member

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    So, when should I stop feeding him ? After +6 ?
    80 even if at the beginning before the shot he was at 70 ?
     
  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you could stop feeding at +6 to be safe. The insulin should start to decline in its effect after that. Keep testing every 30 minutes to about +8 to see if BG stays level or rises slowly.

    Did the vet give you any advice about what the next dose should be? I would not give 2 units again if it was my cat.
     
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  43. Sif

    Sif Member

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    OK!
    No :( I won't do it. But I don't know what to do. She will call me... she said...

    Everything will be opened again tomorrow so I will buy wet low carb. food. I have to know exactly how to proceed with the insulin while I will do the transition from the dry to the wet food (slowly). I must do it slowly because Epi is subject to gastritis....
     
    Last edited: Dec 26, 2016
  44. Sif

    Sif Member

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    BG at + 5 = 77
     
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  45. tiffmaxee

    tiffmaxee Well-Known Member

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    At this point I would try feeding some of his low carb food and check in a half hour. Post then and we will see what to feed. You can't pick an arbitrary time to stop. You move from high carb to low carb to no food providing the numbers stay up.
     
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  46. Sif

    Sif Member

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    Dec 23, 2016
    The vet just called me :
    she said that I could try the half dose of Caninsulin tomorrow morning (1 IU). I said that I will test the BG and then call the emergency number to know what to do. She agreed.
     
  47. tiffmaxee

    tiffmaxee Well-Known Member

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    Did you test again?
     
  48. Sif

    Sif Member

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    At +6 : BG = 59.4
    I did what @tiffmaxee said, just give him a little bit of low carb food.

    So it drops... what should I do with the food ?
     
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  49. tiffmaxee

    tiffmaxee Well-Known Member

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    You need to feed his regular food with some honey.

    Feed just a small amount. You need him to continue eating. Test again in 20 minutes.
     
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  50. Sif

    Sif Member

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    +7 (almost) : BG = 3.3 (still)

    Was almost asleep (like me) but now plays
     
  51. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Same thing - a little more food and test again in 20-30 minutes.
     
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  52. tiffmaxee

    tiffmaxee Well-Known Member

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    Now you see why we can't predict when to stop testing in advance. Up please Sif.
     
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  53. Sif

    Sif Member

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    Yes...
    Do you have an idea of a satisfying BG to reach for now ? (I mean when it will be stable etc)
     
  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You want a safe BG like 90 - 100. The 70 you got this evening was too low for a cat being treated with insulin. For now you need to keep feeding and testing. You want to see the BG start to rise. Then you can try not feeding then testing. If the BG stays level at a good number or rises without food, you can relax until the time for the next dose of insulin.
     
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  55. tiffmaxee

    tiffmaxee Well-Known Member

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    If he stays even around 70 for two hours without any food he will be safe. At this point he is still needing honey so thus may take awhile to happen.

    When things settle down, perhaps tomorrow, it would be good to start a spreadsheet.
     
  56. Sif

    Sif Member

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    At + 8 : BG = 77 mmol/L
    With just food, no honey
     
  57. tiffmaxee

    tiffmaxee Well-Known Member

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    Good. Check in a half hour.
     
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  58. Sif

    Sif Member

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    @tiffmaxee Do I continue to give him the classic food ?
     
  59. tiffmaxee

    tiffmaxee Well-Known Member

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    You can try without.
     
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  60. tiffmaxee

    tiffmaxee Well-Known Member

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    You must be exhausted!
     
  61. Sif

    Sif Member

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    Yes I am, but fortunately you are here to tell me what to do ! I will go to work in 4 hours and something so it has to work now.
     
  62. Sif

    Sif Member

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    At + 8 (sorry, mistake just before) : BG = 82.8
    He just ate 3 of his kibble as a reward.
    What now please ?
     
  63. Sif

    Sif Member

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    Qt + 9 : BG = 68.4
    With 3 kibbles as a reward one hour before.
    Please tell me what to do now
     
  64. StephG

    StephG Well-Known Member

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    Have you tested again since the +8 82.8 and did he have any food other than the 3 kibble reward since the +8 reading?
     
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  65. StephG

    StephG Well-Known Member

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    Posted at the same time. I would give him more food because he's going down again. Test in a half hour if you can.
     
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  66. StephG

    StephG Well-Known Member

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    His number went down but it technically is in the 20% variation that comes with human meters. But it's best to be safe and see 3 increasing numbers before saying it's safe to stop testing. It was mentioned 90-100 is a good number to see after a situation like this.
     
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  67. Sif

    Sif Member

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    Is it possible to see a remission after just 2 weeks and a half of insulin + a control of the food portion ?
     
  68. StephG

    StephG Well-Known Member

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    Might be best start a separate thread for this question...Or we could wait until emergency status is off. I do not know enough about remission. Some cats can be controlled with diet alone. Switching to wet food and controlled meals can keep a cat off insulin.
    Have you posted how he became diabetic on the forum?
    My cat was started with switching to only a low carb wet food and controlled feeding for about 3 weeks before going on insulin. Did you and your vet try this approach or go straight to insulin?
     
    Last edited: Dec 27, 2016
  69. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Is the emergency past now? If so can the OP please remove the "911" from the title. If the emergency still exists, leave it there for now but please remove it when the emergency has passed. Thx.:)
     
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  70. StephG

    StephG Well-Known Member

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    +8 82.8
    +9 68.4 then I suggested a bit more food.
    Waiting for next reading.
     
  71. Sif

    Sif Member

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    Not yet for the emergency... Or at least, the BG is not stable so I still need advices all the 30 min as I test my cat :(

    At + 10 almost : BG = 72 but with food.
    What should I do now please ? Food or not ?

    @StephG : yes, we will see this in another threat :)
     
    Last edited: Dec 27, 2016
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  72. StephG

    StephG Well-Known Member

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    @Sif I'm familiar with the mg/dl but found a conversion chart online, that's around 72 mg/dl right?
    How much food are you giving and is it still the dry kibble or low carb wet?
     
  73. Sif

    Sif Member

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    Yes sorry I corrected !
    Dry kibble (20% carb), just 6-7 of each, each time, and they are small. Should I give him more of it ? Or those highly recommended by the vet but with 7% more of carb than the others ? In this situation it can be good to give them to my cat...
     
  74. Critter Mom

    Critter Mom Well-Known Member

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    Keep testing and steering numbers.

    The crystalline fraction of Caninsulin is at its peak right now. With numbers this low the crystalline insulin could potentially drop numbers further.

    It is possible to see some carryover of BG lowering effect in Caninsulin so there is potentially a risk of this going on into the next cycle.

    NB High preshot BGs after low nadirs like this can be tanked right back down again if even a small dose is given.

    @Sif - I strongly recommend you speak to your vet again to discuss dosing before giving any more insulin. I worry that 1 unit may also be too high.



    Mogs
    .
     
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  75. StephG

    StephG Well-Known Member

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    You will see a bigger increase in numbers with the higher carb food.
    You could try giving him double, like 14 pieces to see if he increases.
    From what I read on cansulin on their stickies it seems like he should be running out of insulin very soon but with a large dose it could last longer than usual.
     
  76. Sif

    Sif Member

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    Ok thank you. EDIT : for your last sentence : especially with the fact that the shot would have been done in one hour now...

    @StephG : even if he is on the diet, I should double the quantity of food that I have to give him now ?
     
  77. StephG

    StephG Well-Known Member

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    I agree with mogs. I would get a few at home tests to see what he's running at home then consult your vet.
     
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  78. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    @Mogs Thanks for popping over here and offering your sage advice. I was trying to respond but dealing with Mittens. Good news over there BTW. :D
     
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  79. StephG

    StephG Well-Known Member

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    Just this time to steer his numbers. Not for every meal.
    You gave him 6-7 pieces after his last reading. You could try increasing that number this time to see if it helps give him a boost.
     
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  80. Capoo

    Capoo Member

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    @Sif : Quel baptême du feu!


    Diagnosed one week ago, first Home test, first hypo episode, first sugar dance in the same week!

    Congratulations for the way you're handling the situation.

    Given that you're awake for a long long time now, I would give to your cat the kibble recommended by your vet, with a lot of carbs. And I would also give more than 6 or 7.

    Of course, I would also skip the shot of the morning, whatever the AM BG is.
     
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  81. Sif

    Sif Member

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    That's also my fault, I did the shot with a low BG.... :(
     
  82. Capoo

    Capoo Member

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    We have all done mistakes, and that's the way we learn!

    But you're really dealing with this situation like a Chef! :bighug::bighug::bighug:
     
  83. StephG

    StephG Well-Known Member

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    It will happen... Don't be too hard on yourself. You're handling it like a boss!
    I would skip the next insulin shot too and try to get readings in when you can do you can see how he reacts to his full meal and no insulin. (There are other factors that can influence the numbers after an event like this but I'll leave that to the pros to explain)
    The caninsulin pros can help you more once they get online.
     
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  84. Sif

    Sif Member

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    Thank you, c'est précieux à cet instant précis !
     
  85. Capoo

    Capoo Member

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    You're welcome.

    And I think that you deserve even more hugs : so I send you a ton of hugs from your native country! :bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  86. StephG

    StephG Well-Known Member

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    Was his last reading of 72 mg/dl 10 or 11 hours after his shot? You said his shot was due in an hour when you replied to critter mom so that would mean his last reading was +11. Making it around 0830 when you got his reading of 72?
     
  87. Sif

    Sif Member

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    +10. We were late when we did the last shot because I was wondering if I had to do it even if the BG was in the normal rate. Usually we do it at 8:45 am and 8:45 pm (Icelandic hours). So for me it was at 7:00 am.... and now it's 8:00 here.
     
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  88. Capoo

    Capoo Member

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    Are you at home this morning? Or is there somebody else this morning who can watch your cat?
     
  89. Sif

    Sif Member

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    I just sent a message to my boss to warn her that I'm probably going to stay longer at home with him...
     
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  90. StephG

    StephG Well-Known Member

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    Have you tested again?
    Please post his latest reading and how much food you gave him after his +10 reading.
     
  91. Capoo

    Capoo Member

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    That's a wise decision!
     
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  92. Sif

    Sif Member

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    Dec 23, 2016
    At + 11 and something : BG = 68.

    What should I do now ? Increase the portion of food or not ? Stop giving him food to see how it goes ?
     
  93. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    And also : at this time (less 20 minutes) of the day, he's supposed to get 2/3 of his food for the morning. Should I do it like that ? (without the insulin 20 minutes after !)
     
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  94. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    I would feed him his normal amount of food that you would give on a normal day. Test after a half hour or an hour. Whichever works best for you.
    Do NOT give insulin.
     
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  95. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    I would do the same as @StephG
     
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  96. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    @Sif have you tested after his meal yet?
     
  97. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    At + 12 and the half and after the normal meal : BG = 70 mmol/L

    He begins to have a lack of space to test the blood and to be annoyed because of this long night of testing...

    Next step please ?
     
  98. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    He's only 70 an hour after you fed him 2/3 of his meal?
    How much is 2/3 of his meal?
    When do you usually give the other third of his meal?
    Do not give insulin. I think you won't need it until at least his pm shot.
     
  99. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    I know the situation with a irritated kitty with sore ears! You can use triple antibiotic ointment with pain relief on his ears to help him. I also put a bit of light pressure (light pinch between my index finger and thumb) on the test area after I get the sample to try to keep it from bruising.
    You both have handled this very well.
     
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  100. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    @Critter Mom any advice on the 70 an hour after 2/3 AM meal?
     

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