? Post hypo dosing advice needed

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Rusty & Smokey, Feb 19, 2018.

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  1. Rusty & Smokey

    Rusty & Smokey Member

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    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.
     
  2. Gurkan&Raffy

    Gurkan&Raffy Member

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    Jul 12, 2017
    If FF is HC ; with Honey you ll be able to see an increase in 30 minutes.
     
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  3. Rusty & Smokey

    Rusty & Smokey Member

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    I don't know if his FF is HC or not. He's been eating it though since we offered it to him. We also have Special Kitty canned food for the other two cats in the house,
     
  4. LizzieInTexas

    LizzieInTexas Well-Known Member

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    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.
     
  5. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Retest in 30 min from intake of food. It will take about that much time for the carbs to get into his system.
     
  6. LizzieInTexas

    LizzieInTexas Well-Known Member

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    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.
     
  7. Rusty & Smokey

    Rusty & Smokey Member

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    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.
     
  8. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Ok, it doesn't look like either of those are high carb. Do you have any Temptation treats?
     
  9. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    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.
     
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  10. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    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?
     
  11. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Mix the honey into the FF (small amount of food with the honey).
     
  12. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Please test now. In future, any time you get a number that surprises you, it's a good idea to retest immediately to make sure it's a valid test.
     
  13. Rusty & Smokey

    Rusty & Smokey Member

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    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.
     
  14. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Where are you? We have members all over the world, so we need to know how long ago that shot was. Do you have a spreadsheet set up?
     
  15. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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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.
     
  16. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    If you have honey, that's probably better than Temptations. Do you know how much honey you gave him? Have you retested yet?
     
  17. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    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.
     
  18. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Not to scare you but with a low number like 20 and your kitty showing clinical signs of a hypo it is an urgent situation and if the numbers aren't coming up it could become critical quickly.
     
  19. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    You have help here, and we're all concerned, so please update when you can.
     
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  20. Rusty & Smokey

    Rusty & Smokey Member

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    8 hours since last shot. Just retested and his BG is up to 48 now.

    We only have dry dog food lol
     
  21. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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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 :)
     
  22. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    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?
     
  23. Rusty & Smokey

    Rusty & Smokey Member

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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.

    Smokey has been diabetic since 2015, and yes he is in Lantus. 3 IU twice a day.
     
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  24. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    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.
     
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  25. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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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.
     
  26. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    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.
     
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  27. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    So test him 20-30 minutes after you gave him this food, and please let us know what reading you get. We care and we're on alert to help if you need us.
     
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  28. Rusty & Smokey

    Rusty & Smokey Member

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    Happy news! Just retested him and his BG is now at 90! :D
     
  29. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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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.
     
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  30. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    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/
     
  31. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    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.
     
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  32. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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  33. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    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.
     
  34. Rusty & Smokey

    Rusty & Smokey Member

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    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. :)
     
  35. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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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.
     
  36. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    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!
     
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  37. Rusty & Smokey

    Rusty & Smokey Member

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    Just rechecked his BG. Down to 45. Just let him eat some more FF and kibble. Should we readminister honey?
     
  38. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Give some more honey and retest in 15-20 minutes. The original honey has worn off and the food is either not kicking in fast enough or isn't high carb enough. How many hours since the shot? I am guessing about +10 hours???
     
  39. Rusty & Smokey

    Rusty & Smokey Member

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    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.
     
  40. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    You may need to skip the morning shot, if Smokey doesn't come up significantly. Does he have any history of ketones? If yes, skipping isn't a great option.
     
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  41. Rusty & Smokey

    Rusty & Smokey Member

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    He had an episode of DKA in 2016 and we nearly lost him, but has had no issues with ketones since.
     
  42. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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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
     
  43. Rusty & Smokey

    Rusty & Smokey Member

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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"?
     
  44. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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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?
     
  45. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    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.
     
  46. Rusty & Smokey

    Rusty & Smokey Member

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    If we absolutely need to, we can change his shot time.
     
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  47. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Rusty, put back the 911 again so more eyes are on your thread to help . Once he gets out of the woods again, you can take it down.
     
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  48. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    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.
     
  49. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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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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  50. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Time for another test?
     
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  51. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Not at work, I was going to work out, but I can postphone that and stay for now.
     
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  52. Rusty & Smokey

    Rusty & Smokey Member

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    Just rechecked. BG is now at 69. :) And he's eating with a bit more gusto. We just keep giving him small amounts of Fancy Feast and the doggy kibble. We also did give him more honey at the last recheck.
     
  53. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Glad he came up again. Test again in 30 minutes. He needs to stay up with out food influence for 2 more test to make sure he is out of the woods.
     
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  54. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Trying to keep the information summarized for new members to have a quick view of the situation. If you see any erros let me know.

    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

    +10 69 LC&kibble
     
  55. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    Recheck: BG is at 357, and he is DEFINITELY acting more himself now. No food 30 minutes prior to this recheck.
     
  56. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Now that was a big old bounce! Did you recheck to make sure that 357 was accurate?
     
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  57. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    We did not, as he was getting quite upset (a sign he's feeling a lot better lol!) We will just recheck in another half hour.
     
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  58. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Okay, it's okay to take the 911 down. Post when you get the next test. And when it's time for shot time again, add a question mark to the title thread and ask for help with the dose. Since he went so low and because of the past DKA episode, he should get insulin , but not sure how much. I am going to copy and paste Mary Ann's summery along with the recent number for peeps to see

    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+10 69 LC&kibble
    +10.5 357
     
  59. HWright

    HWright Well-Known Member

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    Jun 19, 2016
    Though I’m not versed well enough in dosage suggestion, dka, you are in best of company to help through this., Rusty. Keep posting and testing etc as suggested.
    Bumping this condo, too, please thank you.
     
  60. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    Recheck: 69. Is it normal to be jumping and dropping like this? And what should we do next? He's due for his breakfast at 9:30.

    EDIT: I may have not gotten the full sample size of blood on the strip. Could that cause a low reading?
     
  61. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    It is possible that the reading at +10.5 hours after the shot was not correct. Sometimes you can get a "wonky" test strip. That is why Bobbie suggested retesting that number since it was so far out of line with the other numbers. I don't know if you should worry about the breakfast or not. Smokey has had lots of extra food the last few hours. Wait an hour and see where the numbers are at that point. You can change your title to ? Post hypo dosing advice needed and get some opinions/advice on whether or when to shoot next.

    You said you were not testing on a regular basis. This hypo today is a good example of why testing is so very important. Testing should always be done before each shot and if possible at least once in between. Lantus usually will have a nadir (lowest number) around +5-+7 hours after shot so trying to get a reading somewhere around that time will be useful. If you have not been testing it is possible that Smokey has been hitting lower numbers before...maybe not as low as today, but enough that the dose needs to be adjusted.

    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
    +10 69 LC&kibble
    +10.5 357 no food Possible bad reading?????
    +11 69


    ETA Just saw your extra comment. If the last test was a very small drop it is possible that it could have given a lower reading than was accurate.
     
  62. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    Recheck: Gave him half a can of FF. BG is now at 188.
     
  63. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    Summary

    Lantus 3 units human meter no regular monitoring no spreadsheet

    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
    +10 69 LC&kibble
    +10.5 357 no food Possible bad reading?????
    +11 69
    AMPS 188 low carb

    It really looks like that 357 reading was a bad reading...sometimes happens with the odd test strip. So this is your normal shot time I am assuming. With that very low hypo and the fact that you have no routinely been doing glucose tests, my advice would be to wait an hour, with no more food given and retest. Post the number when you test. My thoughts are leaning towards giving 1 unit at this point with the readings you have done so far. In some cases it might be advised to skip the shot and let the depot drain, but with Smokey having had DKA in the past it would be better to give some insulin. The numbers should be starting to shoot upward, which is normal after a bad hypo. Hopefully some others will be on soon and give their opinions on which is the best way to proceed.

    @Kris & Teasel @Amy&TrixieCat
     
  64. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    So, should I give the 1 IU shot now or should I wait until we retest?
     
  65. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    Wait an hour to let the food influence wear down and retest. If the number is still going up then my thought is 1 unit at that time. I tagged a couple of other members so hopefully they will give their opinions shortly.


    ETA Poor Smokey has really had his poor ears worn out this morning [​IMG] And you did a great job too [​IMG]
     
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    This is a tough call. The 3 u depot is still acting. I understand the concern about ketones but it was in 2016 so my opinion is that the threat ranks lower than the symptomatic hypo in the last 24 hours. BG was hard to bring up. I think skipping the AM dose to allow some draining of the depot is wise. Now is a good time to get a testing routine started along with the very valuable spreadsheet so we can give the best advice.

    Getting some BG tests today will be useful in deciding on an evening dose. My two cents.
     
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  67. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    I've already downloaded the spreadsheet and have been recording his numbers throughout this episode. How often should we be testing him? And should those readings still be recorded in the +hours post shot entries?
     
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  68. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014

    Thanks for weighing in Kris. I was thinking the same, since the DKA was in 2016, but wanted some other opinions.

    Skipping the AM shot sounds like a good plan with some testing thrown in.
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Good! Are you going to skip the dose this AM? If so, you might want to grab at least 2-3 tests before this evening to see if the depot is doing anything - maybe every 3 hours?

    Re spreadsheet: you'll need to put a link to it in your signature (the light grey text under a post). Here's how:
    • click on your name in the upper right corner of this page then click on "signature" in the drop down menu
    • give some details about your kitty in the text box: date of diagnosis, age, insulin used, glucose meter used, what he eats, any other health issues/meds he has
    • open your SS and copy/paste its URL into the signature text box
    • make sure you've clicked on the "share" button on the SS and "anyone with link can view" so we can see it.
     
  70. Rusty & Smokey

    Rusty & Smokey Member

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    Dec 8, 2015
    Does my signature look right? And does the link work?
     
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  71. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Perfect! Thank you so much! :smuggrin:
     
  72. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    YAH FOR YOU!!! [​IMG]


    Do a few tests through the day to see how Smokey's numbers go. As far as dosing tonight goes it is a wait and see game at this time. I personally would consider starting back at a lower dose and doing some regular testing to see where the dose should be. But let's see what others weigh in with when you get closer to dosing time. Great job keeping Smokey safe today!!
     
  73. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    How often do you suggest we test?
     
  74. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    You have a preshot test even with no shot, so maybe get one at +4 or +6 to see how fast the glucose is rising. Then get one at +11.5 ( 1/2 hour before your usual shot time) and post the number so that you can get some feed back on what to shoot.
     
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  75. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    Okay. Thanks! Will update this thread as the day goes on. :)
     
  76. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    Great!!
     
  77. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    Retest: BG is now 350. He is very unhappy with the frequent testing, and has been noisy, so he's definitely feeling much better.
     
  78. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    Looks like the HC, honey, bouncing and no shot have all caught up. You can give Smokey's ears a break and maybe test in about 5 hours and then 1/2 hour before your shot time. If you want to change your normal shot time a bit back or forward this would be a good time to do it, if a different time makes it easier for you. With the evening shot it is good to be able to get a test in a few hours after the shot to make sure he is not going to dive like he did last night.

    Still not sure what the best dose to shoot for the evening shot is, but let's see what he is doing before it is time.
     
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  79. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hey Rusty! You did awesome today with those low numbers. I am sure you and Smokey could use a pokey break and rest. I think skipping to drain the depot is a good idea especially for how late in the cycle the hypo occurred. Like the others said, a test in what would be the mid cycle if you had shot. All data is good data.

    Just wondering, how long has Smokey been on 3 units? And did you recently change anything with his diet like lowering the carbs?
     
  80. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    He's been on 3 units since January 4th. And there have been some changes in diet. We have stopped feeding him kibble altogether and he now only gets Fancy Feast and a few Temptations treats. We have also removed seafood flavors from his diet, as I read that those can be hard on the kidneys, especially for diabetics. And Smokey has some very very slight kidney damage from his DKA episode in 2016, so that was of greater concern that we remove fish flavors.
     
  81. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    How long has it been since the kibble was removed completely? Many kitties end up with a much reduced need for insulin once they are on a proper low carb wet food diet.

    Do you have any other test numbers...either any you did or any done at the vet just to get an idea of where the numbers have been.


    BTW Temptations are very high in carbs.
     
  82. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    ------
    It's been about a week or so since we removed kibble from his diet.

    Unfortunately we dont' have exact numbers but from his last BG curve at the vet his numbers were mostly in the 300-400 range, as far as I remember
     
  83. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    It can take a few days to a week to see glucose levels drop once kibble has been removed from the diet. That quite possibly could be one of the reasons for the hypo this morning.

    This is important information and good thing @Bobbie And Bubba asked this question. This can have a bearing on what dosing you may want to use tonight.
     
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  84. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Bingo! I had a sneaky suspicion that with a hypo that low and that late in the cycle that something significant had changed. I think the absence of the dry food is a game changer for dosing. My 2 cents worth says to do a restart at 1 unit and start tracking the BG's , one at pre shot, mid cycle and one before bed time in the PM cycle and see where 1 unit takes him. ( of course more testing if numbers drop again)

    Let's see what others think.
     
  85. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014

    I was already thinking about 1 unit before this information about the diet change came up, since there has not been any monitoring going on up until now. With finding out about the recent diet change I think restarting at 1 unit is prudent. Regular monitoring will tell whether this is a workable dose.
     
  86. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    Quick question: Do I get the AMPS and PMPS readings after he eats or before?
     
  87. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You get them before he eats. It’s best to remove all food at least 2 hours before these tests so the BG numbers are not food-inflated.
     
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  88. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree with the 1 unit dose too.
     
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  89. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Hi Rusty,

    Just wanted to check in and see how Smokey is doing. Great job getting him into safe numbers! Thanks for getting your signature and spreadsheet set up. One more piece of info it would be helpful to put in the signature is where you live. You can be as vague as you want - State, region, or whatever - what we really need to know is what timezone you are in.


    As Mary Ann mentioned, Temptations are pretty high carb, best to only give in a hypo situation where kitty won't eat anything else. For testing treats, most of us use either plain cooked chicken cut into bite-sized pieces, or freeze dried meats (chicken or turkey is usually best, since Smokey doesn't get fish). You can get these at most pet stores. It's usually cheaper to buy the ones for dogs (just make sure there's nothing in it but the meat). To keep Smokey cooperative about testing, always give a treat, whether you are successful in getting blood or not. You want him to associate testing with good things. Here is a post with more great tips, like warming the ear, etc.

    How do Smokey's ears look? It's a good idea to get some Neosporin gel with pain relief and rub it on before bed. Just wipe it off in the morning and the ears will heal faster. It also helps the blood to bead better.

    I don't know if you've seen it before, but here is 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/

    One other tip for you: now that you're testing (and that is WONDERFUL!), any time you get a number that doesn't make sense (like that 357), it's a good idea to retest immediately. Sometimes you get a bad strip, or too much blood, etc. You don't want to react to a number that is incorrect, so it's best to be sure it's right.

    I'm so glad you posted this morning and that your sibling was sharp enough to catch that Smokey was in trouble. We like happy endings here!
     
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  90. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    Update time: So I conked out and was unable to do the +5 test. But we got a PMPS and his BG is at 428, which is pretty standard for him. I spoke to his doctor earlier and she suggested reducing his insulin to 2 IU, but some of you here are recommending I cut down to 1 IU. Which would be better?

    He's doing very well! All back to his normal self. :D His ears seem fine, though he's VERY vocal when it's time to test lol! Will look into getting some Neosporin.
     
  91. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The consensus here earlier was 1 u and I recommend you go with that. It’s the usual starting dose for Lantus and that BG of 20 you got was scary low.
     
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  92. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    Thank you! He just got 1 IU now. :) When should we recheck him?
     
  93. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    A before bed test tonight should be enough.
     
  94. Rusty & Smokey

    Rusty & Smokey Member

    Joined:
    Dec 8, 2015
    Before Bed retest: 377. :) Looks like he's in the clear for now. WIll keep everyone updated. Should I just continue to post updates in this thread as we navigate the messy world of BG monitoring?
     
  95. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Good job getting into the testing routine and catching the low numbers.

    You start a new thread tomorrow, and link back to this one so people can see the history.
     
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