First Curve/First Test - 26

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daysquid

Member Since 2014
I am very new here. Our 12 1/2 year old cat weighting just under 11 pounds was diagnosed with diabetes about a month ago. He is getting 1 unit at 10 am and 1 unit at 10pm and we have switched from total dry foot to Fancy Feast Classic. His blood glucose level at the vet was 600 when he was first diagnosed. We are doing our first curve today and his 12 glucose reading with the Reli-on meter from Walmart registered a 26. Feed back needed. Thank you.
 
26 is way too low. Do you have any Fancy Feast flavors with gravy in them? Karo? Honey? Please feed your cat asap - preferably something with higher carb content. Not sure what you mean by 12 glucose reading? Can you post the entire curve?
 
Gave him so dry food now. HIs lantus shot was at 10am EST and we did his first reading with Reli-On at 12pm EST. And that is when we got the 26.
 
I have asked others to come help. You need to get that number up asap. Dry food will take a little longer to have an effect. Is your cat wobbly or acting strange in any way? Spacey? Lethargic? What is your name and what is your kitty's name?
 
If the shot was 2 hours ago, then the insulin is just starting to have onset. I would give your cat some honey or karo syrup (about 2 or 3 drops) rubbed on his gums, and I would test again in 20 minutes.
This is dangerous. When you are done giving the karo or honey, please get ready to go to the vet, just in case (you may not have to go, but be ready).
 
His name is Frodo. He is acting completely normal. I gave a pill pocket treat but I can rub honey on his gums. Let me do that now. Thanks.
 
You need to get his BG over 50. Keep an eye out for any hypo symptoms, and like Dyana said, please be prepare. Go to the vet if you can't get the number up. It's entirely too low.

You need to be very vigilant and test him every 15-20 minutes until the BG is over 50.

I'll be on the board at work until about 2:30EST, on and off. I'll keep checking in.
 
I have to log off because I am at work. Please give the karo and test again about 20 minutes after that 26 and post the number (Edit the Subject Line in your first post).

Others will be around to help you.

I am concerned that Frodo's numbers will continue to drop, and I really think that if he hasn't gone up into the 50s by the next test, that maybe you should go to a vet where they can give him some dextrose. There is no room for him to go any lower. And the karo or honey will only lift his numbers for a short while. If you are using Lantus, then the strongest action from the insulin is still hours away. Please keep testing, and posting, okay?

I have to log off in like 3 minutes. I will check to see how you made out when I get home. I hope his numbers go up and stay up, but be aware that they may drop again as soon as the karo wears off.
 
How is Frodo acting? I'd be inclined to follow Dyana's lead and go to the emergency vet to get some dextrose in him. If you want to give it another 15 minutes, that's fine, give him some more karo. Get a test then and see where his BG is going.
 
Frodo is acting normal. Since being diagnosed and going on wet foot -- and 1 unit of lantus twice a day -- he is more alert and energetic. Today is no different. He didn't like being tested and went under the bed. But he has since come out. And ever the next test. Went back under the bed -- but then came back out. Gave him honey and he ate more dry food. Will test again shortly. Again, thank you.
 
We are giving him pill pockets. And he is happy to get a little treat. And yes, he will have lots of tests.
He went to the vet last week to try and have the curve there. We brought him in at 8:30 in the morning and he hadn't eaten -- and he doesn't get his insulin shot until 10am. Well they couldn't get him to eat but they did do two glucose tests. One at 8:30 and it was 179 and then they did another at 10:45 and it was 233 (but he had not eaten). I'm hoping this helps you guys in supporting me with this.
 
You shouldn't need to take your kitty to the vet for curves. Since you are hometesting, you can collect your own data and others here will help you analyze it. By all means, feel free to share with your vet, too.

After we get through today, you will want to set up a spreadsheet to more easily track all the great test numbers you're getting. It will greatly help advisors with dosing questions and help you spot trends. Don't worry about it now, but when Frodo is safe, please take some time to set one up and add it to your signature.

Here's the instructions to set up the spreadsheet: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
 
He is at 47 now. And another treat. And yes, I'll be eater to get a spread sheet set up. Thanks.
I really hope to get some feedback on people think is going on.
 
I apologize for all the sloppy posts -- when I reread them I shutter at the errors in spelling and missing words. Just got my hands full here. Any thoughts on when I should test again? Again, lantus 1 unit at 10am -- and then we began the curve --12:00pm was 26; 12:56pm was 36; 1:30pm was 47.
 
You want to keep testing every 20-30 minutes until you get 2 rising numbers without feeding. Since we're still early in the cycle, I would give a smidge more karo/honey and test again in 30min.
 
Hi there,

I'm just now joining the group and see you have a bit of an emergency going on. Can I just recap to be sure I'm understanding everything?

10:00 a.m. EST - Shot 1 unit Lantus
12:00 p.m. EST - 26
12:56 p.m. EST - 36
1:30 p.m. EST - 47

I see you're feeding dry food and a bit of honey. Do you have any other high-carb foods that you can give Frodo to help boost these numbers? For example, once when Jersey went low, I gave her some Twinkies. Others have given their kitties vanilla ice cream (no chocolate). It takes longer for the dry food to raise the glucose numbers, so you want to be sure that you are giving honey/Karo/syrup along with the dry food.

At this point, even though the numbers are rising, it's really early in the cycle. Lantus usually brings kitty to his lowest point at about 5 to 7 hours after the shot. That's a long way away. So.....there's going to be lots of testing for the rest of the day. I know Frodo won't be happy, but we want him to be safe. He'll forgive you later.

Here's what we do: Give high-carb/Karo. Retest in about 20 minutes. If kitty is still below 50, give more high-carb/Karo. Retest in about 20 minutes. You'll need to keep this up for a while until we can be sure the numbers aren't going to drop back down.

Here's some more information for dealing with low numbers:

If your cat is experiencing symptoms, especially if those symptoms are severe, you need to rub Karo syrup, honey, or maple syrup on the gums or, if symptoms are very severe, administer rectally and get your cat to the nearest 24-hour emergency facility. Take the bottle of syrup with you to administer on the way if necessary. (Note that it is rare that we see episodes of symptomatic hypoglycemia with Lantus and even rarer to see severe symptoms. But, you need to know what to do should they occur.)

The symptoms to be concerned about include but are not limited to:

staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
disorientation (yowling, walking in circles, etc.)
twitching
stupor
convulsions or seizures
coma

If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.

DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
Click to expand...

By the way - fantastic job catching that low number today. That tells us Frodo's dose is too high, but we'll worry about a good dose after we get him into a safe range.
 
You will want to keep testing and giving honey to stay above 50, lantus tends to peak at +6hrs from shot. So I would be prepared to keep this up till at least then. Then at that point you want 2 rising numbers above 50 with out food/honey influence.
At some point I would guess there will be a spike due to the dry kibble. As the spike from the dry will take longer to see the effect.
You are doing a great job.
 
Yes. That is accurate. And just gave honey. I will need to get other carb food now that I know this drill. Ugh.
Trying to relax him as he is getting a little annoyed with continually being "captured and retrained."
 
I'm also trying to not interrupt him when he is eating. He is a real grazer -- very little bits and bites throughout the day.
 
Great - I'm glad I got it right. Yes, they do get testy with us on days like today. Can you imagine if you wouldn't have caught that low number, though? :shock: You can give him lots of love later to make up for all the poking.

A lot of people use the Fancy Feast gravy lover's to deal with low numbers. The gravy contains the carbs, so you can give the gravy easily without filling the kitty up. I bought several cans to have in my "hypo kit" and marked them with big black X's so I wouldn't accidentally feed it to Jersey when she was in good numbers.

Let us know what the next reading is. It should be getting close to time, I think.
 
Some of the gravy flavored Fancy Feasts are handy because you can squeeze out the gravy and let him lick that up, rather than fill him with food. The carbs are in the gravy. I am out for a meeting and then lunch, but it looks like you have lots of friends. I'll check back in later.
 
Fantastic! :-D I would hold off on food for the moment and see how well the numbers hold up. Don't go any longer than 20 to 30 minutes without testing, though. I'm hoping the dry food is finally starting to kick in.

Remember - we want two rising numbers now (without food) before backing off on testing.
 
Do I continue with honey and let him eat the dry food? I don't have any gravy -- but will be sending husband to the store later.
 
I wouldn't feed any more at the moment. Let's see if he can hold these numbers up on his own for the next 20 minutes. If he falls back below 50 at the next test, we'll feed some more honey/dry food.
 
Ok. Our posts much have been passing ships. I have pulled the food. I will aim for test every 20-30 minutes. He seems like he is getting used to the tests and not running for cover as much. And that is a very good thing.
 
Definitely a good thing! I always erred on the side of caution with Jersey and tried to test every 20 minutes as opposed to 30. For some kitties, it takes closer to 30 minutes before you can really see the effects of the food. Since I'm not sure how long it takes food to hit Frodo's system, I would go closer to 20 minutes rather than 30. I say that, too, because we're still so early in the cycle. The Lantus should still be packing a punch at this point.

When things slow down a bit for you, you might want to go back and look at your thread from the beginning. With so many back-and-forth posts, it becomes really easy to miss posts. I'm trying to refresh my page often so I don't miss anything. If I do, bring it my attention. ;-)
 
Great. Did I mention what a wonderful job you've done handling all of this?

When did you make the switch from dry food to canned? A lot of times, the food change alone can bring kitty's overall range of numbers down quite a bit. I'm trying now to go back through some of your other posts, but I haven't found anything yet on when you made the switch.
 
Great. I'm guessing either the high-carb dry food has kicked in or this is the beginning of a bounce - or maybe both. We now have a couple of tests above 50, and the numbers are rising. Don't feed and retest in about 45 minutes to an hour. Again - I'm a safety girl, so I would probably shoot for about 45 minutes.
 
Ok. Any many, many thanks again. We had no idea this would be our first experience with a curve.

As for changing the food -- well, let's just say we didn't have a good August. We had to put our younger cat (8 yrs. old) down because she had lymphoma. Unusual tumor in eye socket pushing back into brain. She went on prednisone for final months but it was grim. She was put down on August 13. Five days later we thought Frodo looked like he had lost weight -- and we got the diabetes diagnosis (BG 600). Six months prior his blood work was totally normal. We began feeding fancy feast classic very soon after the diagnosis but not exactly sure when. Maybe a week after diagnosis.

And I will make an entire grocery/drug store list for my husband...
 
Oh, I'm so sorry to hear about your kitty. It's so hard to let them go, even when you know it's the right thing to do. :YMHUG:

Okay, so it's been at least a couple of weeks since you changed food. That means any effects the dry food had on the numbers (with the exception of today) will be gone. (That will be a factor in dosing.)

I think I'm caught up with your previous posts now. I saw the one about meals. I fed Jersey several small meals throughout the day. The only time I did not feed her was 2 hours before each shot time. You don't want the food to influence the pre-shot numbers, so you don't feed during that 2-hour window (unless you're dealing with low numbers). A lot of people try to feed their cats several small meals in the early part of the Lantus cycle (e.g., during this first four or so hours) and less during the second part of the cycle when the insulin is wearing off.
 
You're doing great! I'm sorry I disappeared! I got pulled into something and couldn't get back to my computer. Shelley, thanks for jumping in!!

Once you get through this, you don't want to give Frodo 1u again. You'll want to back his dose down - probably to .5u, but others will be along to give you better dosing advice than I can!

Frodo, hold that number up for your bean now! She worked hard to get your BG up!
 
You've done a wonderful job of getting/keeping Frodo's numbers up. Great catch on the 26! :thumbup
I'm so glad Shelley was able to stay with you.
Sounds like you kept cool too. I freaked, the first time I saw a number below 40. :lol:

You might find that Frodo will spike from the dry food now. Your hubby is going to get some high carb wet, for future drops?
Fancy Feast Gravy Lovers is good, to squeeze out the gravy, without filling his tummy. It will raise numbers a little slower and keep them more level, after the Karo/honey emergency spike.

What would you like us to call you?
 
How you doing now? It's been about 45 minutes, right?

Just to recap:

10:00 a.m. EST - Shot 1 unit Lantus
12:00 p.m. EST - 26
12:56 p.m EST - 36
1:30 p.m. EST - 47
2:00 p.m. EST - 60
2:20 p.m. EST - 94

I know I'm guestimating those last times, but they should be pretty close, I think.

I didn't even ask - did you get a reading before you gave insulin this morning? I'm sure you would have told us what the number was if you had, but I just wanted to make sure.

Hang in there. This has definitely been trial by fire for you.
 
Oops - sorry. I cross-posted with you. ohmygod_smile Since the number is pretty much flat, I would try to test again in about 45 minutes. We should still be at the peak of the insulin action, and the numbers might come back down on us.

Edited to add latest numbers with time since shot:

10:00 a.m. EST - Shot 1u Lantus
12:00 p.m. EST (+2) - 26
12:56 p.m EST (+3) - 36
1:30 p.m. EST (+3.5) - 47
2:00 p.m. EST (+4) - 60
2:20 p.m. EST (+4.25) - 94
3:00 p.m. EST (+5) - 96
 
We really didn't know how serious this first reading was. And I'm only starting to realize it now. I just got off the phone with the vet. I didn't even call to give an update on this curve but more to find out exactly when he was diagnosed -- to be able to give you guys more info. When I explained the morning and our curve, the vet said she practically had a minor heart attack. She repeated over and over how lucky we are. I just got really choked up/teary. I don't think I was able to get into the conversation that we didn't use their recommended cat meter but were using the Reli-on human meter and I know there are some differences. I will want to talk this evening. Do I private message my phone number. Sorry for being so green on a forum. See below vet's instructions:

As for the vet's instructions:
No insulin for now. He may have completely gone into remission. Spot check until Monday.
9:00 AM feed em; pull food at 10; 10:30 glucose check
Repeat cycle at night
And do another test mid-day

IF HE GOES BACK ON INSULIN -- routine should be:
Breakfast at 9:00 — make sure he eats even though he is a grazer. Insulin shot 10; pull the food up. No food at lunch; Dinner at 9:00 -- make sure he eats. 10pm shot. pull food up before we go to bed.

They want to know if he goes over 400 and they said to have honey/karo on hand and if it drops again, start checking again every 30 min.
 
:YMHUG: :YMHUG: :YMHUG:

Yes, that 26 is a very scary, very low number. However, you have been able to steer the numbers with food, and Frodo is safe right now. As long as you keep testing every 30 to 45 minutes, you're going to be able to catch the drop and bring the numbers back up with food.

I'm not sure I completely agree with your vet's advice. As I mentioned, we typically don't feed for two hours before the pre-shot glucose tests (rather than the hour your vet recommended) because we want to make sure the food doesn't influence the numbers. Two hours gives us enough time to be sure the food effects are gone. Also, it's really important to check your kitty's glucose before every shot. That is going to tell you if it's safe to shoot. For instance, if you checked kitty's glucose and it was at 53, you wouldn't give a shot in that case. Most people here will test their kitties, feed their kitties, and then give insulin - all within about 10 to 15 minutes. Many people give the shot while their kitty is eating. (We do want to make sure the cat is going to eat before simply giving the shot.)

I'm sure others will be along soon to give you some advice on feeding and insulin doses (if you have to go back to insulin).
 
Sorry - I was focused on your vet's back-on-insulin directions and completely failed to answer the other part.

As for the vet's instructions:
No insulin for now. He may have completely gone into remission. Spot check until Monday.
9:00 AM feed em; pull food at 10; 10:30 glucose check
Repeat cycle at night
And do another test mid-day
Click to expand...

We consider a cat to be in remission when his numbers stay in the normal range for 2 weeks - which is roughly 50 to 120. (Many cats who are not on insulin actually run even lower than that. For example, Jersey, who went into remission in April, often tests in the 30s and 40s. Since she isn't on insulin, those numbers are safe.)

One good indicator we use is the +3 test. Test Frodo and then feed him. About three hours after you feed him, test him again. If the number is lower than it was right before you fed him, that's a good sign that his pancreas is working and pulling down the numbers on it's own.
 
Got it. You're doing great - and so is Frodo! That 90 is basically flat from the previous test once we take into consideration that meters have a 20% variance. He's been doing really well holding those numbers steady. Right now, we should be right around nadir (the low point in the cycle) - which is usually from 5 to 7 hours after the shot. Are you up for doing another check in 45 minutes? Once we get past nadir, you should be able to slow down on the testing.

You haven't fed since after that 47, right?

Sorry I keep posting the recap. It just helps me keep track of the numbers, and you'll be able to correct me if I get off.

10:00 a.m. EST - Shot 1u Lantus
12:00 p.m. EST (+2) - 26
12:56 p.m EST (+3) - 36
1:30 p.m. EST (+3.5) - 47
2:00 p.m. EST (+4) - 60
2:20 p.m. EST (+4.25) - 94
3:00 p.m. EST (+5) - 96
3:45 p.m. EST (+5.75) - 90
 
I pulled the food after 60. And I'm up for doing testing all night if that's what you told me to do. And recaps are great.
 
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