My cat who is 14 years old is having a hard fînding a good stable number. She has dropped a ton of weight! Then she started to camp out beside the water bowl. She has always been a reclusive cat so this was clearly out of he normal. When we took her in on Wednesday her numbers where too high for them to register and clearly over 700. They gave her insulin and it dropped down too low and have her glucose. Again the next day but dropped the insulin. Same thing Friday but we brought her home. Tested her this morning and she was at 600. Gave her insulin(3 units). Checked her a bit ago and was 20! We have given her caro syrup. She is eating and drinking fine. She tends to sleep with her head on the water bowl. Vet said to drop her to two tomorrow. We are feeding her wet food that was on a low carb list of ok foods. Just wondered if anyone has experienced such highs and such lows before. Any advice? My poor girl can barely walk.
8 hours after insulin shot hypo then spike
- Thread starter Abbiejoe
- Start date
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ebuckley
Member
Re: Newly diagnosed!
Oh gosh. 20 is very low. Please change your candle icon to the 911 icon so some of the more experienced folks can give you some advice asap.
And in the meantime, can you keep testing every 30 min or so and report her numbers?
Folks here who can give you advice will need to know:
- what kind of insulin you have
- what kind of glucose meter you have (brand/model)
Oh gosh. 20 is very low. Please change your candle icon to the 911 icon so some of the more experienced folks can give you some advice asap.
And in the meantime, can you keep testing every 30 min or so and report her numbers?
Folks here who can give you advice will need to know:
- what kind of insulin you have
- what kind of glucose meter you have (brand/model)
BJM
Very Active Member
Re: Newly diagnosed!
KARO SYRUP NOW.
EMERGENCY VET NEXT ASAP
HAVE SOMEONE ELSE DRIVE WHILE YOU KEEP GIVING SYRUP DROPS
You don't have enough test strips to do the needed monitoring.
3 units is too high; don't do that again.
Not a good insulin for cats. Only lasts 6-8 hours then the glucose shoots right back up.
KARO SYRUP NOW.
EMERGENCY VET NEXT ASAP
HAVE SOMEONE ELSE DRIVE WHILE YOU KEEP GIVING SYRUP DROPS
You don't have enough test strips to do the needed monitoring.
3 units is too high; don't do that again.
Not a good insulin for cats. Only lasts 6-8 hours then the glucose shoots right back up.
rhiannon and shadow (GA)
Very Active Member
Re: Newly diagnosed!
maple syrup is fine.. honey....ice cream?
Is there any shaking? dilated eyes? drooling? definitely need to get to vet for a dextrose drip....
maple syrup is fine.. honey....ice cream?
Is there any shaking? dilated eyes? drooling? definitely need to get to vet for a dextrose drip....
Re: Newly diagnosed!
We called vet at 20 and he just said to give her the syrup. I am going to retest in a bit and get more strips. She is eating now with caro syrup mixed in. We haven't had any spikes other than the morning. She tests at 600 then comes down 5-6 hours later to too low. Then they gave her glucose.
We called vet at 20 and he just said to give her the syrup. I am going to retest in a bit and get more strips. She is eating now with caro syrup mixed in. We haven't had any spikes other than the morning. She tests at 600 then comes down 5-6 hours later to too low. Then they gave her glucose.
BJM
Very Active Member
Re: Newly diagnosed!
Karo wears off fast. Keep giving drops added to the food.
Our normal protocol is
Give syrup/high carb food
Wait 20 min
Re-test
Repeat until rising 2 or more times, past nadir (4 hours after shot for Humulin), and in safe numbers.
ps Your vet is not up to date on treating feline diabetes.
Karo wears off fast. Keep giving drops added to the food.
Our normal protocol is
Give syrup/high carb food
Wait 20 min
Re-test
Repeat until rising 2 or more times, past nadir (4 hours after shot for Humulin), and in safe numbers.
ps Your vet is not up to date on treating feline diabetes.
Shawna & Davidson (GA)
Very Active Member
Re: Newly diagnosed!
Don't necessarily listen to what your vet say...........most don't know half as much as some of the experienced people on here.......Davidson was the same, hugging his water bowl, walking a bit off on his rear legs, sleeping more.........give him the wet food (I used Fancy Feast and Friskies) according to the list found on this site. You'll need to test each 30 min or less if he is that low........go to Walmart and get the test strips and I found that the ReliOn Prime ($15) meter and test strips ($9/50 strips) were the cheapest and it's working well for Davidson. My advise as a newbie is to keep testing, posting and even if it's the middle of the night then there will be people on here to help you..........
Davidson is doing well simply due to the people on here who helped us when we was new to all this, and they continue to guide us each level we reach.
Don't necessarily listen to what your vet say...........most don't know half as much as some of the experienced people on here.......Davidson was the same, hugging his water bowl, walking a bit off on his rear legs, sleeping more.........give him the wet food (I used Fancy Feast and Friskies) according to the list found on this site. You'll need to test each 30 min or less if he is that low........go to Walmart and get the test strips and I found that the ReliOn Prime ($15) meter and test strips ($9/50 strips) were the cheapest and it's working well for Davidson. My advise as a newbie is to keep testing, posting and even if it's the middle of the night then there will be people on here to help you..........
Davidson is doing well simply due to the people on here who helped us when we was new to all this, and they continue to guide us each level we reach.
rhiannon and shadow (GA)
Very Active Member
Re: Newly diagnosed!
How many hours has it been since the shot?
How many hours has it been since the shot?
rhiannon and shadow (GA)
Very Active Member
Re: Newly diagnosed!
yes... I am hoping it's almost time to wear off....
then we should address whether or not 2 units might still be too much....
yes... I am hoping it's almost time to wear off....
then we should address whether or not 2 units might still be too much....
BJM
Very Active Member
Re: Newly diagnosed!
Part of that 52 is from the previous Karo. Maybe another drop or two. I'll feel better when he's closer to 100 mg/dL.
And don't be surprised if the glucose level skyrockets tonight. He went very low and that triggers hormones which release stored glucose (glycogen) for up to 3 days after a hypo episode.
Part of that 52 is from the previous Karo. Maybe another drop or two. I'll feel better when he's closer to 100 mg/dL.
And don't be surprised if the glucose level skyrockets tonight. He went very low and that triggers hormones which release stored glucose (glycogen) for up to 3 days after a hypo episode.
Shawna & Davidson (GA)
Very Active Member
Re: Newly diagnosed!
Suggestion: give your time with the 24 hr clock, that way everyone who is trying to help you will know exactly what hour it is.......
i.e. 08:30 is am and 20:30 is pm
This will help...........
Suggestion: give your time with the 24 hr clock, that way everyone who is trying to help you will know exactly what hour it is.......
i.e. 08:30 is am and 20:30 is pm
This will help...........
Re: Newly diagnosed!
She has had these episodes for the last 3 days. She was diagnosed Wednesday. The vet said to give her 2 units tomorrow instead of 3. I am beginning to think we won't be able to control this. She is either too high or too low. How much and how often should I feed her wet food?
I will do time in 24 hour clock. Thanks!
She has had these episodes for the last 3 days. She was diagnosed Wednesday. The vet said to give her 2 units tomorrow instead of 3. I am beginning to think we won't be able to control this. She is either too high or too low. How much and how often should I feed her wet food?
I will do time in 24 hour clock. Thanks!
BJM
Very Active Member
Re: Newly diagnosed!
Until she is rising steadily, I'd repeat in 20 minutes.
Feed her roughly 0.5 to 1.0 ounces per pound of her weight, divided into 2 or more feedings. Normally, you can leave the canned food down until 2 hours before the next shot. That is so we can see how she is doing without food influencing the numbers
Your vet did not give you a good insulin for cats. It isn't your fault.
The American Animal Hospital Association published diabetes treatment guidelines in 2010.
See my earlier post about some other insulins to consider (NOT Vetsulin/Caninsulin, developed for dogs)
Until she is rising steadily, I'd repeat in 20 minutes.
Feed her roughly 0.5 to 1.0 ounces per pound of her weight, divided into 2 or more feedings. Normally, you can leave the canned food down until 2 hours before the next shot. That is so we can see how she is doing without food influencing the numbers
Your vet did not give you a good insulin for cats. It isn't your fault.
The American Animal Hospital Association published diabetes treatment guidelines in 2010.
See my earlier post about some other insulins to consider (NOT Vetsulin/Caninsulin, developed for dogs)
ebuckley
Member
Re: Newly diagnosed!
Oh, Abbiejoe, you just got off to a really, really rough start. Stick around here for a bit and I bet it will smooth out.
Just as a comparison, I started with a 0.5 unit dose of a gentler insulin than yours (Lantus) for my 7.5 pound Napa. We had to go up to 1.0 units for a while but then we were lucky and started to come back down.
But you are already ahead of me when I started because you are already testing! Good job!
Oh, Abbiejoe, you just got off to a really, really rough start. Stick around here for a bit and I bet it will smooth out.
Just as a comparison, I started with a 0.5 unit dose of a gentler insulin than yours (Lantus) for my 7.5 pound Napa. We had to go up to 1.0 units for a while but then we were lucky and started to come back down.
But you are already ahead of me when I started because you are already testing! Good job!
BJM
Very Active Member
Re: Newly diagnosed!
I would suggest either
a) PZI insulin. Have your vet fax in the RX and then contact them to arrange payment.
or
b) ProZinc insulin. Online pet pharmacies may sell it for less than your vet
If you need to finish using the N type insulin you have, can you test and shoot every 8 hours? And if so, perhaps 1/2 unit every 8 hours is a place to start.
BJM, Gracie, and Spitzer (GA 02/24/2012 due to a blood clot) insulin. Have your vet fax in the RX and then contact them to arrange payment.
b) ProZinc insulin. Online pet pharmacies may sell it for less than your vet
If you need to finish using the N type insulin you have, can you test and shoot every 8 hours? And if so, perhaps 1/2 unit every 8 hours is a place to start.
I would suggest either
a) PZI insulin. Have your vet fax in the RX and then contact them to arrange payment.
or
b) ProZinc insulin. Online pet pharmacies may sell it for less than your vet
If you need to finish using the N type insulin you have, can you test and shoot every 8 hours? And if so, perhaps 1/2 unit every 8 hours is a place to start.
BJM, Gracie, and Spitzer (GA 02/24/2012 due to a blood clot) insulin. Have your vet fax in the RX and then contact them to arrange payment.
b) ProZinc insulin. Online pet pharmacies may sell it for less than your vet
If you need to finish using the N type insulin you have, can you test and shoot every 8 hours? And if so, perhaps 1/2 unit every 8 hours is a place to start.
Dusty Bones
Active Member
Re: Newly diagnosed!
Please be careful with the sugar/syrup though, recently saw a cat on here go hyper (too much sugar) and pass. In my inexperienced eyes I see your insulin dose too high causing your kitty to crash then you're giving him sugar plus his body's natural reflex to release glucose so then he goes sky high, then you give him sugar again and cycle goes on and on. Someone on here with experience using this insulin please advise to lower the dosage!
Please be careful with the sugar/syrup though, recently saw a cat on here go hyper (too much sugar) and pass. In my inexperienced eyes I see your insulin dose too high causing your kitty to crash then you're giving him sugar plus his body's natural reflex to release glucose so then he goes sky high, then you give him sugar again and cycle goes on and on. Someone on here with experience using this insulin please advise to lower the dosage!
BJM
Very Active Member
Re: Newly diagnosed!
Already there. And this person is now home testing, so we KNOW what the glucose level is.
We didn't initially know the glucose level for the one in DKA (diabetic ketoacidosis), so started with syrup and the premise it was a hypo. It was not. And one evening's glucose administration didn't cause the DKA. Plus, that cat was in sustained hyperglycemia for an unknown, probably long, period, plus the person refused to go to an emergency vet. That might have made a difference.
Already there. And this person is now home testing, so we KNOW what the glucose level is.
We didn't initially know the glucose level for the one in DKA (diabetic ketoacidosis), so started with syrup and the premise it was a hypo. It was not. And one evening's glucose administration didn't cause the DKA. Plus, that cat was in sustained hyperglycemia for an unknown, probably long, period, plus the person refused to go to an emergency vet. That might have made a difference.
BJM
Very Active Member
Re: Newly diagnosed!
We have folks record the test data in a grid format, shared on Google Docs, so that we can review them.
You'll need to set up a Google Account if you don't have one.
The, follow the instructions here.
Understanding the spreadsheet/grid:
Each day is 1 row. Each column stores different data for the day.
From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)
Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +5 column
and so on.
Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.
There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.
We separate day and night numbers like that because many cats go lower at night.
It is merely a grid for storing the info; no math required.
We have folks record the test data in a grid format, shared on Google Docs, so that we can review them.
You'll need to set up a Google Account if you don't have one.
The, follow the instructions here.
Understanding the spreadsheet/grid:
Each day is 1 row. Each column stores different data for the day.
From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)
Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +5 column
and so on.
Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.
There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.
We separate day and night numbers like that because many cats go lower at night.
It is merely a grid for storing the info; no math required.
BJM
Very Active Member
Re: Newly diagnosed!
NO!
Test in 30 minutes without feeding (aka "stall")
If and only if she goes over 200, then you may give 0.5 units.
And if/when she does go over 200, you should test at +3 and +4 hours after the shot to see how low that takes her.
And good morning :smile:
NO!
Test in 30 minutes without feeding (aka "stall")
If and only if she goes over 200, then you may give 0.5 units.
And if/when she does go over 200, you should test at +3 and +4 hours after the shot to see how low that takes her.
And good morning :smile:
BJM
Very Active Member
Re: Newly diagnosed!
With food, it will start going up in about 20-30 minutes.
Because of how low she went yesterday, it is possible she may be even more sensitive to insulin than before. We need to be very carefull in what, if any is given.
Do you like and trust your vet, or do you want to consider changing to someone more knowledgeable about feline diabetes? Do you think your vet is willing to become updated in the treatment of feline diabetes? It is likely he does not see many cases of it during the year.
With food, it will start going up in about 20-30 minutes.
Because of how low she went yesterday, it is possible she may be even more sensitive to insulin than before. We need to be very carefull in what, if any is given.
Do you like and trust your vet, or do you want to consider changing to someone more knowledgeable about feline diabetes? Do you think your vet is willing to become updated in the treatment of feline diabetes? It is likely he does not see many cases of it during the year.
ebuckley
Member
Re: Newly diagnosed!
Hi Abbiejoe,
Once you feel ok with things today, you might consider going back to your very first post and removing the 911. If you get into scarey numbers again you can always go back to the first post and put it back on. Also, you can change the subject of your very post anytime (or start a new thread) if you have time sensitive issues (for example, "Tested 20 this afternoon-help!" or "AMPS=127 stalling, need advice") in order to get folks attention.
As BJM indicated, AMPS means "am preshot" and is the blood glucose value that you tested at the time before you plan to give the injection. PMPS is the evening version. This is some of the jargon used here for efficiency. Here is a FAQ about the jargon.
I second BJM's recommendation to start a spreadsheet. As you can see the experienced folks here are so very helpful. The spreadsheet really helps them to help us and will give you so much more confidence going forth.
Hi Abbiejoe,
Once you feel ok with things today, you might consider going back to your very first post and removing the 911. If you get into scarey numbers again you can always go back to the first post and put it back on. Also, you can change the subject of your very post anytime (or start a new thread) if you have time sensitive issues (for example, "Tested 20 this afternoon-help!" or "AMPS=127 stalling, need advice") in order to get folks attention.
As BJM indicated, AMPS means "am preshot" and is the blood glucose value that you tested at the time before you plan to give the injection. PMPS is the evening version. This is some of the jargon used here for efficiency. Here is a FAQ about the jargon.
I second BJM's recommendation to start a spreadsheet. As you can see the experienced folks here are so very helpful. The spreadsheet really helps them to help us and will give you so much more confidence going forth.
BJM
Very Active Member
Re: Newly diagnosed!
Does her breath smell fruity or like nail polish remover? If not, that's a good sign.
Give 1 unit.
In 3 hours, test to see how low she is going. The expected low point is 3-4 hours after the shot. The expected duration of effect is 6 to 8 hours.
Controlling the glucose is a process, not an event. It will take some trial and error to figure out what works for her. Monday, I would demand either PZI or ProZinc insulin, as I noted previously.
Meanshile, please read, and maybe print out, this primer on using N type insulins.
Does her breath smell fruity or like nail polish remover? If not, that's a good sign.
Give 1 unit.
In 3 hours, test to see how low she is going. The expected low point is 3-4 hours after the shot. The expected duration of effect is 6 to 8 hours.
Controlling the glucose is a process, not an event. It will take some trial and error to figure out what works for her. Monday, I would demand either PZI or ProZinc insulin, as I noted previously.
Meanshile, please read, and maybe print out, this primer on using N type insulins.
Re: Newly diagnosed!
I am unable to download the file for the spreadsheet for some reason.
Here is the recap for the day.
07:22 127 no insulin but gave her food
08:30 150
13:51 454 gave her 3 units (too much I know. We thought it would be easier to put more in and just give her a small dose each time. Needed too much pressure then too much went in)
16:00 122
19:02 41 Gave caro and food
20:01 312
Is she spiking because she went hypo and her body is compensating? What should I do about the spike?
I am unable to download the file for the spreadsheet for some reason.
Here is the recap for the day.
07:22 127 no insulin but gave her food
08:30 150
13:51 454 gave her 3 units (too much I know. We thought it would be easier to put more in and just give her a small dose each time. Needed too much pressure then too much went in)
16:00 122
19:02 41 Gave caro and food
20:01 312
Is she spiking because she went hypo and her body is compensating? What should I do about the spike?
BJM
Very Active Member
Re: Newly diagnosed!
Better too high for a day than too low for a moment. Low kills fast; high kills slow.
OK, you've demonstrated, a 2nd time, that 3 units will take her into hypo territory. You might not always be able to get it back up and she could die or have permanent brain damage.
Please - Only draw up as much insulin as you need for that shot; no partial injections.
You want her to be over 200 to shoot. You want her glucose to be rising to shoot. You want to have food going in for about 30 minutes or so before you shoot.
You've seen how fast and how high she'll rise. Therefore, if she tests below 200, stall - wait 30 minutes without food and retest. If she is rising, it will be safe to give some insulin. Drop the dose down to one you can safely monitor that won't put her in danger of dying - like 1 to 2 units. Understand that it wears off in 6 to 8 hours; after that, the glucose will shoot to the moon again. This is why Humulin is not a good insulin for cats - it drops them down abruptly and wears off abruptly and does not last 12 hours in most cats.
Better too high for a day than too low for a moment. Low kills fast; high kills slow.
OK, you've demonstrated, a 2nd time, that 3 units will take her into hypo territory. You might not always be able to get it back up and she could die or have permanent brain damage.
Please - Only draw up as much insulin as you need for that shot; no partial injections.
You want her to be over 200 to shoot. You want her glucose to be rising to shoot. You want to have food going in for about 30 minutes or so before you shoot.
You've seen how fast and how high she'll rise. Therefore, if she tests below 200, stall - wait 30 minutes without food and retest. If she is rising, it will be safe to give some insulin. Drop the dose down to one you can safely monitor that won't put her in danger of dying - like 1 to 2 units. Understand that it wears off in 6 to 8 hours; after that, the glucose will shoot to the moon again. This is why Humulin is not a good insulin for cats - it drops them down abruptly and wears off abruptly and does not last 12 hours in most cats.
Yes, I feel terrible about giving her too much! I will be talking to the vet tomorrow about a different insulin. THanks for the tip about food in before we shoot. We have been doing the opposite. I won't be able to get new insulin until Tuesday. Hopeing it's not terribly high in the morning since its already high tonight.
Trying this to get the hang of it
AMPS- 127
PMPS-454 3 units
+2 - 122
+5 - 41 caro and food
+6 - 312
Trying this to get the hang of it
AMPS- 127
PMPS-454 3 units
+2 - 122
+5 - 41 caro and food
+6 - 312
BJM
Very Active Member
Between the Karo and the insulin wearing off, the glucose jumped up to the 300s. You catching on to the +hours since shot listing we do and that will help others give you feedback.
Because Humulin lasts only 6-8 hours in most cats, would your schedule allow you to shoot roughly every 8 hours (TID)? If you can do that until you get a better insulin, you'll have better success controlling the glucose and keeping it from going so high.
I would try 1 unit every 8 hours to see how well (or not) that worked and tweak from there, until you can get a better insulin. I'm going to guess that cost could be an issue: if so, PZI is pretty inexpensive upfront. Lantus is pricey and has a good reputation for getting cats OFF insulin if used following a tight regulation protocol and low carb over the counter food like Friskies pates.
Because Humulin lasts only 6-8 hours in most cats, would your schedule allow you to shoot roughly every 8 hours (TID)? If you can do that until you get a better insulin, you'll have better success controlling the glucose and keeping it from going so high.
I would try 1 unit every 8 hours to see how well (or not) that worked and tweak from there, until you can get a better insulin. I'm going to guess that cost could be an issue: if so, PZI is pretty inexpensive upfront. Lantus is pricey and has a good reputation for getting cats OFF insulin if used following a tight regulation protocol and low carb over the counter food like Friskies pates.
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