(Update)Help! 1st Curve and weird numbers-hypo to 9?

Before I get to her readings a quick backstory...Quinn was diagnosed on October 9th but we started insulin on October 15th. One unit of Lantus in the morning and at night. With treatment, I noticed an immediate improvement in Quinn. She drank less, urinated less and was generally more active. However, starting around the 23rd I noticed she was back to drinking more/urinating more (though not as much as prior to taking insulin). She was supposed to go for a curve at the vet on the 22nd but I decided to do it on my own (my vet charges $250 for each curve visit).

Today, (the 26th) is the first free day I've had that I can dedicate to testing Quinn every 2 hours and I am so confused and alarmed by the readings I'm getting. Her pre-shot reading was 3.8 mmol/L. I then gave her one unit of insulin (maybe I shouldn't have?!) and she ate approx. 1.5 oz of Fancy Feast. I then took her glucose reading two hours later and it was 1.7 mmol/L. She appears fine, and continues to eat, but this number seems way too low. I am so confused, help please!

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Hello,

I don't want to alarm you unduly but those readings are low. Can you please edit your subject line to add a '911' icon to attract attention? I'll post on the Lantus forum to try to get some more eyes over here.

The preshot number you got was a very good normal number and not needing insulin. Lantus can drop the blood glucose for quite a long time after the shot. It may be that you'll need to take your kitty to a vet so that glucose can be given by IV. Do please find the details of a vet you can go as that may well become necessary. (In fact, if it were my cat, I'd be going there now.)

How many hours now since the shot? (We're in many different time zones)
And what was the last blood glucose test?

Do you have glucose/karo and high carb cat food? If so I'd suggest giving a bit of both at this point.

Eliz

PS. Welcome to FDMB!

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Me again..
The normal blood glucose range for a cat is approximately 2.6 to 7.2. (Some cats run a little lower or higher).

You do need to bring your cat's blood glucose levels up ASAP.

If this were my cat I'd be giving glucose/karo/honey at this point, and then take the cat to the vet (taking the glucose/honey/karo with me in case it's needed en route).

Eliz

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Your post says this 1.7 is only +2 from shot time? You definitely want to feed a small amount of high carb food (something with gravy in it) and some karo/honey. That is a pretty low number and early in the cycle.

Test again in about 10min. If that much has already passed, test now.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

In order to read numbers quickly, we tend to write them this way:

AMPS: 3.8
+2: 1.7
+2._:

That way the advice giver can quickly see the direction the numbers are going. If you feed something, notate that after the number (so if you feed high carb food and karo after the 1.7 you could just put
+2: 1.7 (HC +karo) to let people see what might be affecting numbers.

Also, don't feed too much in one setting when you are working with low numbers. You don't want your kitty to get too full and not eat when you need her to.

here is some info on low numbers: viewtopic.php?f=9&t=147

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Thanks for your responses. I had a post all written out and lost it :-x I need to test Quinn right away, I'll post again when it's done.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

If you are in the middle of a post and you need to go away from your computer, the forum will time out your session and you need to log back in and you can lose the post. This is an easy way to save your posts:

1. Click in the typing area.

2. Press CTRL-A to select the text.

3. Press CTRL-V to copy the text to the clipboard.

4. If you try to preview/submit the post and the system asks you to log back in to FDMB, log in then go back to your thread. Start a new reply, click in the typing area then press CTRL-V to paste your message text back from the clipboard. Then submit the post as normal.

Hope that helps.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Ok, I just took Quinn's reading and got 1.6. So, her numbers today are:

AMPS: 3.8 (she ate part of a 1.5oz serving of Fancy Feast classic)
+2: 1.7 (she finished the rest of the Fancy Feast)
+4: 1.6

I don't have any Karo syrup or canned food with gravy. Will honey and her old, high carb dry food do for now? She's acting normally, continues to eat and walk around a bit (she's 15 and pretty sedentary).

Thanks for your help!

Sandra

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

It would be better to give her a couple drops or maybe three or four of honey, rather than dry food. You could also use vanilla ice cream in a pinch.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

and dry food takes longer to metabolize.

add honey to her wet food and keep monitoring.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Ok, I just gave her a little bit of honey (had to rub it on her gums as she was not interested in eating it).

Should I wait 'till +6 to test her again or do another test sooner?

Sandra

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Until you see her above 2 and continuing to go up/stay up, you want to keep testing every 15-20 minutes. Anything with a 1.X translates to a US under 40 and we don't want cats under 50.

Rubbing honey on her gums is a perfect way to get it absorbed quickly.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Another alternative is corn syrup, maple syrup, or plain old pancake syrup. A couple of drops on a tsp or two of her regular food will work as high carb food if she will eat. You need to get her above 2.8. Keep feeding her high carb/honey, test 1/2 hour later and if she's still below 2.8, repeat (feed, wait 1/2 hour and test). Once she's above 2.8 you can give her just regular food instead of high carb, but keep testing every 1/2 hour until she's at least 4.0 or above. If she drops back below 2.8, go back to the high carb/honey. The high carb food/honey can wear off after a couple hours and cause the numbers to drop again.

I suggest that you drop her dose to 0.5 unit. In fact, unless she's over 11.0 tonight, I wouldn't give insulin at all. We suggest that new people don't give insulin if kitty is under 11.0 at preshot time (200 is US numbers).

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Numbers are heading up:

+5.75: 2.2 (was 1.6 an hour ago)

Going to give her some more honey and then head out to the store for Fancy Feast with gravy.

Sandra

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Is there anyone else who can go shopping for you. At 2.2 (40), that's really too low and you should be testing again in 1/2 hour.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

I've been trying to test Quinn again for the past 20 minutes but she's having none of it. A lot of hissing and spitting so I'm going to wait until my husband gets home to test again. I'm also having trouble getting blood. I think I prick her in the right spot but nothing to show for it...just one very upset cat.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Husband came home and together we managed to test Quinn again.

+8: 9.0

So, the readings today have been:

AMPS: 3.8 (she ate part of a 1.5oz serving of Fancy Feast classic)
+2: 1.7 (she finished the rest of the Fancy Feast)
+4: 1.6 (rubbed honey on her gums)
+5.75: 2.2 (rubbed honey on her gums)
+8: 9.0

I don't know what to make of this last number?! Is it normal to go so high after being so low? Should I still give her insulin tonight? I was so pumped to do this on my own, but feeling so overwhelmed by this now.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

Re-read all the responses and saw that Wendy (thank you!) recommended not giving Quinn any insulin tonight unless she tests over 11 before her PM shot. So, I guess her 9.0 reading is ok and I can stop freaking out. Going to continue with her regular food, no more honey, and test her again before her shot to determine dose.

Sandra

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

It is normal for them their BGs to go up after they go so low. The liver will release a stored glucose like substance when it "thinks" the BGs have gone too low and it is a life saving process. She will probably be high enough to shoot (give insulin to) tonight, but if you are unsure, post, of course. I would reduce the dose as Wendy said even if she goes really high by tonight's shot time.

 

Re: Help! 1st Curve and weird numbers (Hypo?!)

I would try not to feed between +10 and +12. BGs will go up because of eating food. If you don't feed in the last two hours before shot time, then you can tell if the BGs are rising or falling or staying the same without the influence of food.

 

Re: Help! 1st Curve and weird numbers-hypo to +9?

Thank you Dyana!

Yes, even if Quinn tests over 11.0 tonight I was planning on cutting her dose to 0.5 unit. I think her AMPS number and LOW curve numbers today show that to be the best thing for Quinn (I hope!).

Sandra

 

Re: Help! 1st Curve and weird numbers-hypo to +9?

Sandra

I don't know if you are doing this already but I find that heating the ear before trying to get a reading really helps. Just use a small handful of rice tied in a sock that has been slightly warmed in the microwave and held to the ear for a few seconds/minutes helps the blood to flow much easier. For me that was a game changer. I literally just heat it for 15 seconds but obviously it depends on your microwave and then lightly hold it against both the inside and outside of the ear until it goes pink. Hen take the shot and always give a treat afterwards with lots of loving.

You are doing a great job and it will get easier, you have learnt a lot today and have managed to keep your kitty safe. Congratulations.

 

Re: Help! 1st Curve and weird numbers-hypo to +9?

Just took Quinn's PMPS and her reading is 6.9. Am definitely NOT giving her a dose of insulin.

Readings today:

AMPS: 3.8 1 unit-know now I should NOT have given it to her :cry: (she ate part of a 1.5oz serving of Fancy Feast classic)
+2: 1.7 (she finished the rest of the Fancy Feast)
+4: 1.6 (rubbed honey on her gums)
+5.75: 2.2 (rubbed honey on her gums)
+8: 9.0
(removed food for 2+ hours before PMPS)
PMPS (+12): 6.9 (decided not to give insulin)

When I take her AMPS I assume the same "rule" applies...no insulin if under 11.0? And if she's above 3.6 I don't need to worry about hypo?

Sandra

 

There are some general reference numbers in my signature link Glucometer Notes. More detail instructions and reference levels may be found in the specific Lantus protocols here.

 

Hi Sandra,

I'd suggest being extra vigilant for the next while. Sometimes when cats go low like that, they can become more sensitive to the insulin.

 

Hi Sandra!

Good job handling her low numbers today. Just so you know, it takes about 2 weeks of poking multiple times a day before capillaries grown in the ears and you can count on getting blood every time. You could be doing everything right and still not get blood, but hang in there. The poking is stimulating the growth of the capillaries and you'll have more success before long.

We use US numbers as the common language on FDMB, and most people don't know how to interpret the mmol tests. I'll put the equivalents in blue below:

AMPS: 3.8 (68) 1 unit-know now I should NOT have given it to her :cry: (she ate part of a 1.5oz serving of Fancy Feast classic)
+2: 1.7 (31) (she finished the rest of the Fancy Feast)
+4: 1.6 (29) (rubbed honey on her gums)
+5.75: 2.2 (40)(rubbed honey on her gums)
+8: 9.0 (162)
(removed food for 2+ hours before PMPS)
PMPS (+12): 6.9 (124) (decided not to give insulin)

Everything under 120 is considered normal for a non-diabetic cat. Quinn had extremely low numbers this morning - you were so lucky to catch her and bring her up. Often after getting that low a cat will be extraordinarily sensitive to insulin.

At this point, it would be smart to withhold insulin and see what happens after things settle down and the insulin is out of her system. Sometimes a hypo episode will even result in shocking a cat's pancreas back into producing insulin again, so be patient and let's see what happens before you give insulin again.

Since you didn't shoot insulin in her tonight, I'd just recheck her in the morning and post again in this thread asking for advice on whether you should shoot or not. If she's under 200 (about 8.2) don't shoot.

 

$250 for a curve at the vet's seems very pricey. My vet charges $60-80, depending on the amount of tests done, and the practice he's part of is know for being a bit expensive but worth it for the level of care given.

 

Vet pricing in Toronto is very high. I called another vet in my area and was quoted around the same amount. Quinn's initial vet visit for blood and urine testing cost $460. Then another $300 when we brought her in for her first glucose curve to determine insulin dose. The testing alone is $100 then there's fees for ward care, Dr. care etc...The thought of having to pay another $250 for each subsequent glucose curve visit inspired me to try doing curves on my own. Thank goodness for this website!

 

Hi Julie,

Thank you so much for your response. Being so new to this it's hard to know what to make of her numbers and I appreciate you laying it out for me. I took Quinn's glucose this morning and again at night:

AMPS: 6.3 (113) no insulin
PMPS: 6.9 (124) no insulin

Is it possible she could be in remission so early on (she only started insulin on Oct.15)?

Sandra

 

Yes, it is possible. If you get 14 full days of glucose levels below 130 mg/dL on a human glucometer, your cat will be officially Off The Juice (OTJ).

 

yes, i agree with BJM. It is possible that all she needed was a food change to low carb canned and some insulin support. Also, we've had other situations where a hypo caused a cat to go off of insulin - fortunately, you didn't see any ill effects from those low numbers.

At this point, please check Quinn morning and evening for 2 more weeks just before you feed her. If she stays under 120ish, that's great. That's normal numbers.

If she is over 150 or so, get another blood test 3 hours later. If her pancreas has kicked back on, the eating will stimulate it to put out some insulin, which ought to bring her blood sugar back down into normal numbers.

Can you break her meals up and give her small meals every few hours? that's easier on a healing pancreas.

Thanks for checking back in. If she gets through the next 2 weeks staying in normal numbers, you should know that she is still diabetic forever. she still needs low carb canned food, she needs to avoid steroids unless medically necessary, she shouldn't have meds with sugar in them (like syrup-y meds) if there is any other option. There are a few other directions for kitties that become diet-controlled, but i'll save that for the next post.

I'll watch for you to keep posting, if you continue on this thread. I don't usually check on main health, but since Elizabeth posted an SOS for you on the Lantus TR group, i'm wanting to keep an eye on you and help you figure out what to do next.