? Post hypo dosing advice needed

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Rusty & Smokey

Rusty & Smokey

Member Since 2015
So my sibling came down to have some breakfast and noticed our cat Smokey pacing the kitchen and sniffing everything, not even acknowleding him. He called me down and we checked his bg, which was 20.

We administered some honey and gave him his usual Fancy Feast classic pate food, which he ate quite a bit of.

How soon should we recheck his bg? Did we do this correctly? We're still very anxious, though he is starting to settle down a bit.
 
Add a tablespoon of honey to HC food. Do you have any Fancy Feast Gravy Lovers? Feed just the honey mixed with a good tablespoon of the gravy only.
 
Please post the specific type of FF you have and the exact Special Kitty (more info). I will check for you on the carb count.
 
We onyl have FF in classic pate in poultry and beef flavors. The flavor we gave him is Tender Beef and Chicken Feast.

The Special Kitty we have is Super Supper Dinner.
 
Also, don’t feed too much st once-you don’t want him throwing it back up plus you need him to be hungry in case he needs to eat more later. You’ll need to monitor closely for a while - the good may wear off and his numbers could bobble around for a while.
 
Are you using a human meter or pet meter, what type of insulin are you using, what dose and how long since the shot.

You need to do a retest now to see if the honey is bringing up the numbers. Sugar should bring the numbers up within 15 minutes, but will wear off quickly. That is far too low. Also how far to the nearest ER vet are you?
 
LizzieInTexas said:
Ok, it doesn't look like either of those are high carb. Do you have any Temptation treats?
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We do have Temptations treats. How much should I give him?

Tuxedo Mom said:
Are you using a human meter or pet meter, what type of insulin are you using, what dose and how long since the shot.

You need to do a retest now to see if the honey is bringing up the numbers. Sugar should bring the numbers up within 15 minutes, but will wear off quickly. That is far too low. Also how far to the nearest ER vet are you?
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We are using a human meter. An Arkray Glucocard meter that we got from Diabetic Cats in Need. He is on Lantus, 3 IU twice a day. His last dose was at 9:57 PM last night.

We are about 30 minutes from the nearest ER vet, however we have no funds to take him in, and we don't think they bill there.
 
Rusty said:
We do have Temptations treats. How much should I give him?



We are using a human meter. An Arkray Glucocard meter that we got from Diabetic Cats in Need. He is on Lantus, 3 IU twice a day. His last dose was at 9:57 PM last night.

We are about 30 minutes from the nearest ER vet, however we have no funds to take him in, and we don't think they bill there.
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Have you retested yet?

Not sure what time zone you are in...how many hours since the shot is it right now?


ETA Do you have any dry food...dry food is higher in carbs . You can crush it up and add some water to it to make it digest faster.
 
The honey or syrup should bring the numbers up, but will wear off quickly so retesting is very important. Trying to get some high carb food in as well as the honey will hopefully help keep the numbers up.
 
Rusty said:
8 hours since last shot. Just retested and his BG is up to 48 now.

We only have dry dog food lol
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Give some more honey and any sort of high carb food and retest again in 15 minutes. Glad to see the numbers are starting to come up but you want to get them higher than 50 and staying there. With Lantus, you should have reached the nadir by now, but you need to keep testing until the numbers stay above 50 on their own. The effects of the honey will wear off quicker.


ETA you could give some of the dry dog food. Not good for a regular food but in this case better than nothing :)
 
That's still lower than you want it to be. Give some more food - a teaspoon or so, and retest in 30 minutes.

For future reference, you should have a few cans of FF gravy lovers on hand for situations like this.

How long has Smokey been diabetic? Is he on Lantus?
 
Tuxedo Mom said:
Give some more honey and any sort of high carb food and retest again in 15 minutes. Glad to see the numbers are starting to come up but you want to get them higher than 50 and staying there. With Lantus, you should have reached the nadir by now, but you need to keep testing until the numbers stay above 50 on their own. The effects of the honey will wear off quicker.


ETA you could give some of the dry dog food. Not good for a regular food but in this case better than nothing :)
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Just gave him some dog food mixed with his FF and with some honey. He seems to be perking up a bit, including protesting when we retested him haha.

Tricia Cinco(GA) & Harvey said:
That's still lower than you want it to be. Give some more food - a teaspoon or so, and retest in 30 minutes.

For future reference, you should have a few cans of FF gravy lovers on hand for situations like this.

How long has Smokey been diabetic? Is he on Lantus?
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Smokey has been diabetic since 2015, and yes he is in Lantus. 3 IU twice a day.
 
Dog food is not a great choice for a cat. Don't mean to be critical - many people don't realize it. Best to give him the FF with honey.

Cats are obligate carnivores - they don't have the capacity to properly digest vegetable matter - whereas dogs are more of an omnivore, so cat food is significantly different from dog food.

Please let us know when you get the next test - 20-30 minutes after the last one.
 
Tricia Cinco(GA) & Harvey said:
Dog food is not a great choice for a cat. Don't mean to be critical - many people don't realize it. Best to give him the FF with honey.

Cats are obligate carnivores - they don't have the capacity to properly digest vegetable matter - whereas dogs are more of an omnivore, so cat food is significantly different from dog food.
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Agreed...and I would normally never suggest dog food, but it will give a higher carb "kick" as has been shown when other member's kitties got into their dog food. With a low of 20 there is more of a sense of urgency to get the numbers up and keep them up.

Definitely need to get some higher carb kitty food to keep on hand for this sort of thing. Friskies Indoor Cat ( green lid) is very high in carbs and can be used in this sort of situation. Some cans of food with gravy in them are useful to have as well.
 
If you don't already know, a great source for info on carb % is Dr. Lisa's list. For every day feeding, you want something below 10% carbs, but it's a good idea to have some Medium Carb (11-15%) and High Carb (16 and up) on hand for situations like this. Many members have FF Gravy Lovers on hand, and they strain out the gravy and add that to kitty's normal food, since that's where the carbs are.
 
Rusty & Smokey said:
Happy news! Just retested him and his BG is now at 90! :D
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Great! Now, don't give any more food and retest in 30 minutes. You need to make sure he stays up on his own. We recommend at least two tests over 60 with no food influence to be sure he's safe. That means the test in 30 min and then one more 30-60 minutes later, both without food. This is because the effects of food can wear off in one to two hours, and then the BG can drop again.
 
Good news!! As Tricia said do a couple more retests with no more food to make sure he is staying up.

Be prepared to see some much higher numbers at shot time. This is very normal after a hypo incident. Are you home testing on a regular basis? Hopefully you are, as you can see how important it is. You might consider setting up a spreadsheet and including that when you post. Although Smokey is a long term diabetic having this forum to bounce questions off and ask for insight might be helpful for you. And as you can see there are almost always people here at all times willing to help out. :)

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Now that the crisis has passed, please remove the 911 from your subject line so people don't panic. You can always put it back up if the situation warrants it.

Since you haven't posted here before, I'd like to give you a link to a post we put together to help people get comfortable using this forum. Kind of like an FAQ. http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/ It really helps us to help you if you create a signature block with all the pertinent info, and set up a spreadsheet to track Smokey's numbers. This link tells you how to do that.
 
Good job getting him up over 50. Give your sibling a big hug and kiss for knowing that something was "off " with Smokey and alarming you.

How about when you get a chance you set up a Spread Sheet and signature so that we can help you better. If you need any help with either of those two things, yell.
 
Rusty & Smokey said:
Thank you all so much! We are so glad he's feeling better, though he's still pacing quite a bit, but has stopped obsessively sniffing everything and now acknowledges us if we go near him. :)
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Another comment...since Smokey was at 20 at +8 hours after the shot, there is a possibility that he may have gone even lower earlier. With a serious hypo like you just had some kitties become more sensitive to insulin, so you need to reduce your dose even if the next preshot numbers are very high. The high numbers are normal with a serious hypo as the body's counter-regulatory process releases stored "glucose" in response to the low glucose. This effect can last a day or as long as 3 days with some kitties.
 
That's wonderful. Smokey has earned a reduction with this drop, so please decrease the dose by .25 units. Be aware that when there is a symptomatic hypo, the kitty is often a bit more sensitive to insulin, so you will want to monitor the next couple of cycles as closely as you can. Again, he's not out of the woods until you have two tests without food influence over 60, so don't get complacent. There are many people around to keep an eye out for you and Smokey, so keep us posted!
 
Rusty & Smokey said:
Okay. And yes. He received his last shot at 9:57 PM last night, and it is now 7:12 AM. Our time zone is EST.
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OK so it is about +9.25 hours since the shot. Do you have the preshot number from last night?

I agree with Tricia that skipping the next shot would be prudent. Does Smokey have any history of DKA (diabetic ketoacidosis)


ETA Just saw the DKA post. Are you around all day today. With a previous DKA it is better...if the numbers are safe...to give a small token dose...BUT only if the numbers are safe...or do a later REDUCED shot
 
Tuxedo Mom said:
OK so it is about +9.25 hours since the shot. Do you have the preshot number from last night?

I agree with Tricia that skipping the next shot would be prudent. Does Smokey have any history of DKA (diabetic ketoacidosis)


ETA Just saw the DKA post. Are you around all day today. With a previous DKA it is better...if the numbers are safe...to give a small token dose...BUT only if the numbers are safe...or do a later REDUCED shot
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We unfortunately just started testing him this morning due to the hypo. I know we should have started home testing long ago, but we were so sure we could rely on our vet to help us.

Yes we will be home all day. What would a token dose be? What would safe numbers be"?
 
Rusty & Smokey said:
We unfortunately just started testing him this morning due to the hypo. I know we should have started home testing long ago, but we were so sure we could rely on our vet to help us.

Yes we will be home all day. What would a token dose be? What would safe numbers be"?
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At this point it is hard to say what or when you are safe to give a shot. Normally with the hypo you would be advised to skip all together, but having had an episode of DKA, even though it was awhile back makes it more worrisome about skipping.

Best thing is to keep checking the numbers and posting the results. At your normal shot time we will see where he is at and what the best approach would be. Are you able to change the shot times if necessary or does that mess up your schedule?
 
The past DKA is a big consideration in what you should do next. I like Mary Ann's suggestion to post when it is time and we see what is what.
 
Tuxedo Mom said:
At this point it is hard to say what or when you are safe to give a shot. Normally with the hypo you would be advised to skip all together, but having had an episode of DKA, even though it was awhile back makes it more worrisome about skipping.

Best thing is to keep checking the numbers and posting the results. At your normal shot time we will see where he is at and what the best approach would be. Are you able to change the shot times if necessary or does that mess up your schedule?
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If we absolutely need to, we can change his shot time.
 
Let's just play it by ear.


Summary

Lantus 3 units human meter

DKA episode in 2016

PMPS not done
+8 20 honey &LC food
+8.5 48 honey&kibble
+9 90 no food
+9.5 45 honey & kibble


Does this look correct. You may need to put the 911 back up since the 3 people helping you until now are not going to be available on a regular basis. Tricia had to get some sleep, I am off in 1/2 hour and Bobbie is at work. We want to make sure there are people around to keep track of Smokey's progress.
 
Rusty & Smokey said:
We unfortunately just started testing him this morning due to the hypo. I know we should have started home testing long ago, but we were so sure we could rely on our vet to help us.
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It's okay. Many people have been in this position The important thing is you caught this and are on the ball now.

Keep testing and posting every thirty minutes, as long as he's under 60 and you have to give food to keep him up. The +11.5 number (30 min before next scheduled shot) will help to see if you will be okay to shoot or need to stall. I have to go to bed (4:30 am here) but others will watch over you. As Bobbie said, repost the 911 if you get another test under 60 or get to shot time and aren't sure if it's safe to shoot.
 
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