Sorry quick question! I shot BEFORE taking a BS!! worry?

Sorry all for bothering you again...

But, while here at my parents it's been hard dealing w/ the cat getting uused to things so I didn't think Id be able to get a BG reading.
So I fed him and since things have been off and hes had some treats I assumed like usually hed be 150-190 and just shot.

Well while he was eating I was able to test his BG and he was at 112!!
He was eating his friskies; ate bout half the can so far.
Should I worry?
Is that too low?
He only gets 1 unit at 7am and 7pm. But im still wondering...
Obviously its about bed time and I am worried if something happens at night I won't know.
Is 112 ok? I am not sure what 'ok' is?

Should I be worried?
We travel back tomorrow afternoon and will be back ino ur own enviornment and routine then so hopefully well be back on track.
HELP!

Thanks
Annie

 

Actually let me rephrase a little...
How fast does the lantus work?
He was eating... and I had shot him and then got his reading about 5-8 mins later...
would it have kicked in that fast and just brought him DOWN to 112?

 

Another question... IF he was to drop to low... because of the insulin while he was too low... how soon would I know/
Like how soon do I need to watch him if it is a concern?
Hes doing fine so far 30 min later... and still eating his food?

 

1) 2 hours or so after the shot, the glucose has generally risen from food

2) Lantus starts to kick in a bit later, so you'll need to test at +2 to see how he's doing (as best you can)

3) if your nadir tests have been over 150, you may be OK.

4) Do you have a hypo kit - high carb gravy food, oral syringe, Karo/glucose/honey? You're visiting, so go check the kitchen. You can make a sugar syrup by dissolving sugar in warm water.

 

Oh so the food shoudl raise his BS before the lantus even kicks in??
That makes me feel better.
I have been home testing but not often.
My vet said I dont need to (i know though I should)
Hes only getting 1 unit, so that's pretty small right?
My BS levels I am getting from him have been as LOW as 166 on the 15th 6 hrs after his AM shot
And as high as 194 on the 19th 1 hour before his PM shot

So tonight he was 112 while eating about 5-10 min after I shot.
How much does 1 unit drop a level?

I am at my parents and don't have a 'kit' but my mom has Karo syrup as do I at home

 

Unfortunately, it varies with the cat.

Generally, the cat will show signs of hunger if he's starting to get low. Since your nadirs so far haven't been below 150, you may be OK, if he's eaten his normal amount.

We want them to eat before shooting to make sure food will be on board to match the insulin.
Edited to add: when you've been having issues with lack of appetite, mentioned earlier today.

Having some high carb, gravy food would be better than the Karo - you might see if any grocery near you is open yet to get some.

 

How low IS safe to shoot anyway??
Is there some sort of chart for that to follow? How do I know?

 

The general rule without past data is not shoot below 200. With data on response it can be a lot lower. I shot a full does when as low as about 100.

 

Generally, new folks should not shoot below 200.

That number is gradually reduced if your testing data support it. There's someone on the Lantus board who shoots low to stay low... with months of data to show it is safe for her cat.

Given the nadirs you have gotten were not below 150 and that a nadir test of 50 earns a dose reduction in new diabetics, you've got about 100 points before he's in any danger of a hypo. If you can get a test in around +3to +4, or so, you can see how fast he is dropping. That'll can show if you're going to need to stay up until 3 am or later, managing his glucose levels.

 

Ok so I will try and test him at 10pm and see where he is...
As long as his levels have gone UP and not down below.... what number? He is ok?

What do I need to watch for until then?
Hes still/been chilling under the bed since its kinda crazy and hectic here.
I've been checking on him since 7 and he's acting pretty much the same as he has been since we got here. No different. Still a little over 1/4 of his can of food left in his dish so he's not scarffing it down.

I dont understand why my vet told me I dont need to test his BG levels AT ALL until we do a curve on the 29th.
Is it because his dose of Lantus is so small that they dont worry?
Because the other day when he was at 160 I called to ask if i shoudl still shoot... and theyre like um, yeah, continue your routine and continue his shots until we do a curve to find out more data later.

 

I disagree with your vet. I don't know why they appear to be so casual about testing. I almost lost my Buster by just following the vet's advice. Hometesting is a must. It's the only way you'll be able to know what's really going on. Especially in the beginning, cats aren't all that consistent with their BG levels. You can't just assume they're going to be at a safe number.

With Lantus, many cats won't really show any signs of hypo until they are very very low & you don't want to get to that point. Normal ranges for cats is 40 -120. You don't need to worry if you're up around 100, but you should test up through about 6 hours after the shot to make sure Moo doesn't drop too low.

 

I just noticed you apologized for bothering us - don't be silly! We're here to help and support you no matter what! I know it's crazy Christmas time and you're travelling, but when things get settled down you might want to set up a spreadsheet for tracking Moos numbers. It will help you to see trends and it's a handy quick reference for people to use when you have questions about dose changes, etc. Let us know if you have troubles with testing and we'll get you through it.

Here's a link that shows how to set it up. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
If you look at people's signatures you can see what it will look like. It's color coded, so that's why you'll see people talking about surfing green or blue numbers, etc. As you have time, I would also highly recommend browsing through other people's condos to see how they handle different situations. Every cat is different, but you can learn a lot and get to know some really wonderful people!

 

Thanks so much!
I actually set up a spread sheet a couple weeks ago. I felt my way through it and figured it out.
I dont test his BS very often so theres not much on there, but what IS on there is blue.
Nothing over 194. Except for his initial test which was his diagnosis which was well over 600!

I am going to try and be better about testing more regularly!
I will test him tonight around 10 again if he lets me and try again around 1am if I am still awake just to try and get a better number.
I plan on doing a curve on Saturday so hopefully that will help alot!

 

if he drops to 50 or lower, then you will want to use the high carb food and/or sugar to bring his numbers up.

and if he does drop to 50 or lower, then he has earned a dose reduction and I suggest that you reduce the next dose from 1.0 to 0.75 (3/4th) or 0.50 (1/2) unit. this is called micro dosing.

You asked if 1 unit is a small/large dose, the answer is it all depends. there are some cats that receive 0.10 unit yes that is 1/10th unit, essentially one drop of insulin. anything less than 1 unit is considered micro dosing and the reason why we suggest getting syringes with 1/2 unit markings, it makes it easier to micro dose when that time comes.

test him as suggested above and if he does drop don't panic, but prepared to feed higher carb food - ie. something with gravy - and just feeding a couple spoons of gravy alone may be enough.

hope this helps.

 

Just retested at +3 and he has dropped to 55....

Will he keep dropping? Or should that be the lowest point? Should I worry?
Should I test again in 2 hours? (if i can stay awake)

Or is that a good number after 3 hours (during this time he had a few treats and basically finished most of his 5.5 can of friskies that was started at 645.

 

This is a fairly fast drop. I don't use Lantus so will go over to that forum to see if I can get you some help. Do you have any high carb food (gravy flavors)?

 

+3 is still pretty early in the cycle. His blood sugar will likely keep dropping for a few more hours, at least until +6. You should feed him; if you don't have any high carb food you can feed him a bit (at least a teaspoon) of regular with a bit of honey. Some people use only a few drops but if I'm scared my cat is dropping fast I might use more, like 1/4 tsp of honey. You will want to test about every 20 to 30 minutes. Don't go to sleep - it's important to keep a close eye in case he drops too low.

 

I dont have any gravy flavors. I am at my parents and they live in a small town out in the country.
NOTHING is open anywhere near by.
They do have honey and karo though.
He just ate at 7, I am not sure he will/want to eat again.

should I try to get him to lick some honey off my fingers?
or rub some on his gums just in case?
I dont know if I can test him every 30! I feel so bad cause I keep sticking his ears!

 

How To Treat Hypos If you haven't had a chance to read through this, you should take a look; it will give you an idea of what to watch for and what kind of numbers you should be concerned about.

It is REALLY important to keep testing - if you can keep on top of this, it won't be a problem, and you'll be a lot more confident the next time you see some low numbers. Sticking his ears doesn't really hurt him, and if he is going to drop very low it could potentially save his life. Keep the honey handy, and don't worry, he'll probably sense he needs the food and be willing to eat if his blood sugar is dropping. Just remember you don't have to offer a lot of food at once - just a little food with a little honey, wait 20 min, then test. The honey works quickly but doesn't last long, so that's why you have to keep testing.

 

He's dropped from 112 to 55 in 3 hours; you've got 2-4 hours before he hits nadir.
Mix a small anount of honey in a teaspoon or 2 of low carb and offer it. Ie start on the hypo instructions.

Its going to be a late night as you'll need to monitor him until he has gotten back on track.

 

It's been about 1/2 hour since you got the 55, I think. Can you retest as soon as possible and let us know what the number is, and what you got him to eat? I don't want to leave you on your own with this so I will be checking to see if you've posted. Usually there are a lot of people offering help, but I guess with the holidays not everyone is on the computer.

 

I just tried to offer him some food w/ honey. He wont eat it.
Hang by and I will try to test him again right now.

 

First, stop feeling bad because you're poking your cat. If this was a child you were keeping safe from the possibility of hypoglycemia, you wouldn't feel bad. In fact, you'd be feeling irresponsible if you didn't test. Your glucometer is the most powerful tool you have to keep your cat safe. Most of our cats begin to realize that testing is necessary and it comes with treats. Insulin makes them feel better. The whole process is one that allows you to have a closer relationship with your cat. They know that we're keeping them safe.

You've got to be testing every 30 min. I would give your cat some low carb food with several drops of Karo or honey. If he won't eat the food with honey/Karo, rub a few drops on his gums and give him a teaspoon or two of plain, LC food. You do not want to overfeed and risk your cat vomiting because he ate too much. You're seeing a fast drop and numbers are likely to keep dropping until somewhere in the middle of the cycle. Since you don't have much data or a spreadsheet we can see, there's no way to know when your cat's nadir is. Your goal is to get him safely past nadir.

Please get a test 30 min. from the 55 (I think that would be your +3.5) and post the numbers. It looks like the numbers so far are:

• PMPS - 112
• +3 - 55

 

Ok so 1055pm and after about 5 sticks (he was not happy) I got a reading of 53

So he has dropped 2.

He is now eating the rest of his food w/ the honey in it.

 

Yes his numbers are
PMPS- 112
+3-55
+3.5- 53 (now eating some food w/honey)

Will attempt a +4 test at 1125p

 

A 53 and a 55 may be considered the same number.

Keep feeding him the mixture - remember, low carb takes about 2 hours to increase the glucose, the honey should kick in faster, but it won't last as long, so the mix is doing doing double duty to boost both the short term and long term glucose levels during this 12 hour cycle.

 

There is no difference between a 55 and a 53. I'm glad he's eating the food with honey. That will help.

It's much easier for us to know where you are in the insulin cycle if you give times in terms of the hours past your shot. If the 55 was at +3, where does the 53 fall in +time?

What you need to keep in mind is that Lantus is a long-acting insulin. Some cats have a late nadir. Numbers could keep dropping until +9, for example. This is why it's important to collect data to know when your cat's nadir is. What you will need to be doing is testing and feeding until you see that numbers are rising substantially.

 

Good! I'm glad you got another reading, and that he ate the food & honey. You need to keep repeating this process for another few hours. Where is he eating, inside the room where he's been under the bed? If he's nervous at all coming out in an unfamiliar environment you might want to just bring the food to him.

Are you warming the ear before you prick? That made a world of difference for me. I just fill a little jar that used to hold spices with hot water and hold it inside the ear for a little while before I prick the ear. Don't worry, cats get used to the whole procedure pretty quickly. Now mine lies on the floor and purrs while I do it!

You're doing well - keep it up.

 

I rub his ear a little bit to warm it up before I stick.

I am feeding him in the bedroom in the middle of the floor.
He is eating out on the floor now, hes not needing it under the bed. The door is shut and everyone is in bed.

Since his 112 and insulin dosage were at 7pm....
His 55 was at +3
His 53 was at +3.5

Ill do the next at +4

Do I need to prepare another dosage of food/honey to feed him again? If so... when?

How long do I need to stay up and test him.

This is going to be long and hard not only becaues I am really tired but I think I have a stomach bug also.

At what time point will I be 'safe' enough out of the woods to go to sleep?

And also based on all this... I am assuming I should SKIP his 7am dosage?

 

Tonight, since you absolutely have to get blood to test, it would be OK to aim for the vein itself on the edge of the ear. If you hit it, it may bleed quite freely, so be prepared to get the test and then blot firmly for a couple minutes to stop it.

 

It's hard to say how long you need to keep this up since every cat is different. With lots of cats, the lowest point is around +6, but like Siene said sometimes it can be later.

You'll have to test before the morning shot and make a decision then. Don't be surprised if his blood sugar is a lot higher in the morning - if the cat's blood sugar goes lower than usual, its liver tries to compensate by dumping a lot into the bloodstream. It can take a few cycles for the numbers to come back down. But again, every cat is different, so when you start doing more testing and get the spreadsheet set up you'll have a better idea of what to expect.

 

So let's say his BS is ALOT higher in the morning...

What # should I shoot at or NOT shoot below? to be safe?
200 like the posts earlier were saying?
If below 200 don't shoot... if above... do?

TOmorrow is our travel day and going to be very busy.


btw. i think i hit the vein on the last stick. That was a lot of blood! Alot more was on me then him lol

 

You'll know it's safe to go to sleep when a couple tests in a row later in the cycle show the numbers going up.

Since you don't have much information at this point, the 200 is probably a good guideline to follow. And if you can test at +2.5 or +3, you'll have an idea of whether it's going to drop a lot again or not.

 

You'll need to stay up to test and feed probably until his +9 to be sure he is rising and high enough he is out of danger.

The feeding to prevent a hypo will likely have him quite high by morning. Hypo tends to make them more sensitive to the insulin, plus you shot him really low, so I'm thinking 0.5 units in the am ... IF he is over 200. But focus on where he is now; morning will happen soon enough.

Um ...if you aren't feeling well, please look up the nearest 24 hour vet and map out directions, just in case you become ill enough you can't continue ,and maybe see if someone else in the house would be willing to stay up with you. Better to have a plan and not need it than the other way around.

 

You'd also asked if you need to feed him again. Yes, keep feeding small amounts and testing until his blood sugar is not dropping any more. You can adjust how much honey you're adding to the mixture by what numbers you get on the next test. If it's still dropping you'll want to put more honey.

 

PMPS = 112
+3 = 55
+3.5 = 53
+4 = 65

 

Good - you're starting to see the carb kicking in. It won't last long, so continue offering the mix following the Hypo instructions.

If you hadn't started to intervene, he could have been in serious trouble; good job! And hang in there.

 

OK, good to see you have been able to keep the numbers from dropping. Just remember that can be from the fast effects of the honey, which will also wear off quickly, so don't stop testing yet. Thanks for posting your numbers so clearly, too.

 

There is no hard and fast rule about how long you need to continue to test. You stop testing when you see a rise in numbers and the numbers stay in a safe range (above the mid-50s) without benefit of high carb for at least 2 consecutive tests, preferably that are an hour apart. The difficulty is that as HC wears off, numbers can drop again. You need to make sure your cat is safe before you go to sleep. Or, you need to be able to set an alarm and know you'll wake up to test. Every time you test, you want to give a teaspoon of low carb plus a few drops of honey.

I would not jump to the conclusion that you can't shoot tomorrow. I'd suggest you look at Gabby's SS. It's in the link is in my signature. You'll see that just because there are low numbers in one cycle, it doesn't mean you don't give the next shot. There's also no information to suggest that your test in the morning will yield an unshootable number. There is the possibility of a bounce. However, not all cat's bounce. If you are unsure what to do in the AM, post and ask for help.

I don't think this is a "hypo." Your cat is experiencing low numbers. (If your cat was in the 30s, I'd be more concerned about hypoglycemia.) These are not dangerously low numbers. You just don't want to let the numbers go unattended because with a 53, you don't have much of a margin of safety. The idea is to keep your cat is a safe range by using food to steer the numbers. The more time your cat spends in these numbers, the greater the opportunity for his pancreas to heal.

 

Sorry your tummy is upset - not good timing. You're doing great working these low numbers. I guess you're getting a crash course in testing tonight!

 

Yeah I feel like I'm being thrown to the wolves!

He just ate another small bit of food w/ honey.

Im going to test again at 12 instead of 1155 just to make the time easier for me.

Anyone know of any good sites online to watch shows or anything that are free to keep me entertained awhile? lol

 

USA and TNToffer some of their shows on line for free.

You must be in a time zone west of me; its almost 1 am in Columbus, OH.

 

PMPS = 112
+3 = 55
+3.5 = 53
+4 = 65
+4.5 = 81


Yeah! We're going up!

 

Hang in - remember the honey doesn't last long.

 

Yeah I am just west of Chicago in IL

 

He still has some food/honey in his bowl but wont eat anymore.
He is curled up on the bed with me.

All of this hiding under the bed at every noise is taking away from his all day nap schedule and I think he's exhausted


Like me!

 

Give him 15-20 minutes to rest, then test & offer more food.

About how much has he eaten of the mix?

My apologies - the sleep disorder is starting to kick in and I'm not going to be able to stay awake much longer.

 

How about holding off on the honey with the next test and see if the numbers hold?

 

Wait I think I am doing something wrong...

Because I tested/shot at 7.
SO right now the 12 midnight reading would be +5 = 81

So Correction.... because the firs couple were on the 15 and the 55 then rounded, let me rephrase/organize this again

PMPS = 112
+3 = 55
+4 = 53
+4.5 = 65
+5 = 81


But yes there is maybe 2 tablespoons worth still in the bowl. He probably ate about 2 also.
He's not eating anymore and I figure I'll just see at next test if we drop or stay the same.

 

Well that gets you that much closer to being out of the woods. I dunno why this always happens when you're super tired. Seems to be the way it goes. Let's hope the numbers hold without honey.

 

You're doing great!

I would not test him in 15-20 minutes since he's rising. I'd wait 30 minutes from the time he finished eating. Then test and see where he is. If he's still coming up, don't give any more karo....give him some LC food so you tell whether he's going to go up on that instead of dropping back down as the karo/honey wears off.

Just a couple other things, too. My kitty has been in the 20s (not that I want her there but she has been) with not one, single sign....and that includes acting like she's hungry. That is why testing is so important. Some cats do not show any signs at all that they are low and do not necessarily ask for food or act hungry so, in the future, don't assume because he's acting ok, you don't need to test.

This is not true with lantus. Unlike PZI or one of the other insulins like Humulin N or R, lantus does not onset for a couple hours so it's ok to test and shoot without them eating before the shot. Most of us feed with the shot just because the kitty is paying attention to eating and not the shot. It's definitely good to have food on board before he onsets but even if he eats 30 mins after you shoot, it's usually ok with lantus. Also, and this is important and you saw it tonight, some cats do not get a food spike at +1 or +2.. You cannot count on the fact that he will always have a food spike and go up before he comes down. Some cats do, some don't, some do occasionally. You'll have to see how his patterns develop,

Good job getting him up.

 

I can stay up until your next test results, then I'm going to have sign off for the night.

He's going in the right direction so far, just stay on him.

Mastering blood testing in a crash course tonight, huh?

 

Do you think it is safe to do the next test at 1 vs 1230?
He is sleeping and I feel so bad and rather wait til the hour then I can do 1am, 2am, then maybe if both are still ok w/out honey I can get some sleep

 

Clarification - if you have a cat with a reduced or erratic appetite (which was mentioned earlier today), or vomiting issues, you do want to be sure they eat, because shooting on an inappetant or vomiting cat can result in hypo. Been there, had that with Spitzer, so I watched him eat 1st, then shot. Generally, it was within 15 minutes of eating.

And I'm thinking any food spike might have been masked by shooting so low.

 

It'll be my 2 am and thats last call for me, this pub is closing for the night!

(On a button I have: "Sleep is for wimps. Happy, healthy, well-rested wimps, but wimps nonethess." ... call me a wimp ) ;-)

 

I'm at the west coast so just checking in to see how you are doing. Have his numbers continued to rise? If he drops from the sugar spike, there might be some other hi carb things in the house that would last longer to raise his bg - things like a bit of cheese, a little square of bread (half inch or so) in a tsp of warm milk. Did you have turkey dinner? A few bits of turkey? Just a few ideas if you need them.

 

OK, I'm back up (work today)

How's it going?

 

Thanks for all of the help and ideas everyone!!

Happy to report we made it through the night fine.

I tested his BS before shooting this AM at 7.

He was at 199. So just to be safe I only gave him .5 instead of his full 1.0

I hope that was the right decision?!

Well... naptime for me!!!

Thanks again everyone!

 

That was fine; erring on the side of caution. You can't get it out once its in! He may bounce from being low like that and it may take 3-5 days for those high numbers to clear. Just grit your teeth and wait it out.

Take home lessons:
1) Always test before you shoot.
2) Always pack your hypo kit when traveling.

 

Wow! You certainly had a ride last night.

It will be helpful when you get home if you could post his spreadsheet and attach it to your signature. This way, everyone will have quick/easy access to it and see what's going on.

As I mentioned, typically a reading of 50 or lower (and yes 55 and 53 count) gets a dose reduction. So, shooting 0.5 (1/2 unit) this morning is a smart idea. Especially because you will be traveling and may not get enough tests in.

Now, if he appears higher for PM, don't change the dose and give more insulin. Or you will have a cat with BG's bouncing all over the place.

I realize that this is scary, especially when it happens outside the home. But you handled it well and made do with honey in lieu of higher carb foods. Good job.

Please get that spreadsheet up, go to the Lantus board - where the lantus experts hang out and they will be happy to help you further.

 

How do you post a spreadsheet?
I just started a spreadsheet so there is VERY little to go by on it.
But I will gladly post what I have.

 

Spreadsheet }nstructions