Still in low range after giving high carb food *4hrs*

E

ETheCat

Member
Hi,

Any thoughts on this?

I made another post earlier with some more details:
https://felinediabetes.com/FDMB/threads/how-to-prevent-bouncing-after-low-glucose.299079/

2.5 Units was giving at 11am at 19.6mmol / 353 mg/dl
3 hours after his dose, he started dipping into the 3-4mmol range (54-72mg/dl)

It's now been 4 hours and he has bounced between mainly beteeen that same 3-4mmol range (54-72mg/dl)

I have given him a fair amount of Fancy Feast Gravy Lovers food, probably 1.5 cans now spread over that time

I'm checking every 15 min, using the Libre 2 app. Bascially going above 4mmol / 72mg/dl for 30 min, and then back to 3mmol 54mg/dl range in the next 30

He isn't showing any visible signs of hypo

At what point if numbers don't rise to a steady level should I consider a visit to the Vet or Emerg Vet?
 
These seem like safe numbers. 2.8 to 5.5 on a human meter per Bhooma on your previous post. And Libre generally reads lower is my understanding.

Do you have a spreadsheet somewhere? You will get more engagement from folks here if you do. It’s much easier to see what’s going on, because from your wording I’m not sure where we are in the cycle.
 
ETheCat said:
Hi, that post was last year when he first came out of remission, he actually ended up going into remission within a few weeks of that.

DKA was now 2 years ago, and 1 year before that post

This is now a new issue, as he was again out of remission about 6-7 weeks ago now
Click to expand...
Ok got it :cat:
 
As long as he’s over 50 he’s not in danger of a hypo when using a human meter. It would really help us help you if you would set up a spreadsheet and a signature.

What are you feeding him? How are you determining his does?
 
Tim & Pookey said:
These seem like safe numbers. 2.8 to 5.5 on a human meter per Bhooma on your previous post. And Libre generally reads lower is my understanding.

Do you have a spreadsheet somewhere? You will get more engagement from folks here if you do. It’s much easier to see what’s going on, because from your wording I’m not sure where we are in the cycle.
Click to expand...

Sorry, I've tried my best to comprehend the spreadsheet but I simply cannot understand it

He was diagnosed originally 2 years ago, went into remission after a few months
1 year ago, he came out of remission, and then went back in after a couple of months
This past Jan, he once again came out of remission, I beleive we are about 7-8 weeks in, started at .5 units 2x a day, and are now at 2.5 units 2x a day as of 1 week
 
ETheCat said:
Sorry, I've tried my best to comprehend the spreadsheet but I simply cannot understand it

He was diagnosed originally 2 years ago, went into remission after a few months
1 year ago, he came out of remission, and then went back in after a couple of months
This past Jan, he once again came out of remission, I beleive we are about 7-8 weeks in, started at .5 units 2x a day, and are now at 2.5 units 2x a day as of 1 week
Click to expand...

All you need to do is plug in the numbers once your spreadsheet is set up. If you can’t set it up we have members that can do that in minutes. What you be interested in that?
 
@ETheCat
Can you set up your signature
Tap on your name up top and then tap on signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
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ETheCat said:
Sorry, I've tried my best to comprehend the spreadsheet but I simply cannot understand it
Click to expand...
There is a link understanding the spreadsheet but I'm going to explain it anyway
About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers


Here is the link anyway
https://felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/
@ETheCat
 
Diane Tyler's Mom GA said:
There is a link understanding the spreadsheet but I'm going to explain it anyway
About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers


Here is the link anyway
https://felinediabetes.com/FDMB/forums/spreadsheets-tech-support-testing-area.6/
@ETheCat
Click to expand...

Do I need to make both for mg/dl and mmol? or is one preffered over the other? My reader is in mmol
 
tiffmaxee said:
All you need to do is plug in the numbers once your spreadsheet is set up. If you can’t set it up we have members that can do that in minutes. What you be interested in that?
Click to expand...

I think someone explained it simply enough for me

How far back should I go?

Newest date first, or last?

My reader is in mmol, do I have to use each tab to do it twice to put both mmol and mg/dl?
 
If you can fill in the last two weeks for now it will help. You don’t have to enter the data twice. The program will do that for you. Most of us are more familiar with US numbers. The last numbers will be the most recent.
 
For future reference, we request that you post just once per day in this forum. It's busy enough that it's too hard to keep track of two posts in one day. You can ask multiple questions in one thread. I will copy that post over here and answer after that.

3-4 mmol/L (54-72) is normal blood sugar range. However, without knowing what dosing method you wish to follow, we cannot help you decide if the numbers today mean you need to take a reduction in dose. Should he go below 50, a call to the vet might be in order. Most of us will give high carb food at that point, and handle low numbers ourselves, but it depends what your comfort level is with that.

For your spreadsheet, let's start with a week's worth of data, two weeks would be ideal. Just enter data on the World tab (mmol/L) and the spreadsheet will convert automatically to the US tab for you. Newest date's data is last, oldest on top.

When this episode is over, please change the "DX: Date" in your signature to DX: "actual date he was diagnosed with diabetes the first time". It's also useful to say he's been on and off insulin a couple times.

Also, since you have people responding to you, and it's not a medical emergency, please remove the 911 from the subject line.
 
From your other post of the day:
ETheCat said:
My cat was originally diagonosed 2 years ago, but went into remission after a couple of months, and last year had a short stiny out of remission but went back in after about 6 weeks.

We are about months into him being diagnosed with diabetes again and have gone from .5u 2x a day to now 2.5u 2x a day - and now it's starting to bring numbers down a great deal, but the other, and now again, he is dipping into low numbers (using Libre 2) about 3.2mmol or 58.27mg/dl

He is 5.4KG (about 12 lbs) and 12 years old

His main food has been DM Chunk Wet Food

For this low glucose events I have given Fancy Feast Gravy Lovers

The other night when it happened and I got his numbers good, I skipped the next dose as it was still under 200mg/dl but he then rose to Hi numbers

So now after that event, he has 2 doses, and is now back in the low numbers.

The dose was 4 hours ago (at the time he was at 19.6mmol / 353 mg/dl), the low numbers started about 2.5hrs after dose

No signs of hypo, but want to keep safe

Do I just keep feeding another tablespoon of the high card food every half hour or so until his numbers stay up?

And then skip the next dose again?
Click to expand...

Once his numbers are over 50, you can feed regular low carb food. if he goes under 50, go to high carb food. You don't need to skip his shot tonight unless you feel he'll be too low to shoot.

The rest of the questions need more data in the spreadsheet for us to answer them.
 
Hi @tiffmaxee @Wendy&Neko I have been filling out his spreadsheet since his dosage change to 2.5 - there is alot to go back so I will do my best and get it all added to the best of my ability

I added a - for the times I skipped dosage because it was too low.

What is the best way to remove the 911?
 
To remove the 911, go to the first post of the day at the top of this thread. On the right hand side is a drop down labelled "Thread Tools". Select Edit Thread then change the prefix to "?" if you still have questions.
 
If you are skipping shooting a lot because you feel the dose is too low to shoot, then reduce the dose by 0.25 units. It is better for him to have two shots a day. Eventually you will have to learn to shoot numbers under 150, once you have the data to do so.

For the times you skipped the shot, please change the dose to "Skip" or "NS" for no shot, so we know it was deliberate, not just a data entry error.
 
Wendy&Neko said:
From your other post of the day:


Once his numbers are over 50, you can feed regular low carb food. if he goes under 50, go to high carb food. You don't need to skip his shot tonight unless you feel he'll be too low to shoot.

The rest of the questions need more data in the spreadsheet for us to answer them.
Click to expand...
Wendy&Neko said:
If you are skipping shooting a lot because you feel the dose is too low to shoot, then reduce the dose by 0.25 units. It is better for him to have two shots a day. Eventually you will have to learn to shoot numbers under 150, once you have the data to do so.

For the times you skipped the shot, please change the dose to "Skip" or "NS" for no shot, so we know it was deliberate, not just a data entry error.
Click to expand...


Thanks, I updated the spreadsheet and title

I'm quite worried about shooting under 200 mg/dl, especially at 2.5 units and since the last 2 times this past week where he has dropped into the red low numbers, I gave his shot at HI (usually 23+mmol / 414mg/dl) and 19.6mmol / 353 mg/dl

The skipped doses were at a reading of 5.1 and 6.3 mmol (92 & 113 mg/dl)
 
Please do what Wendy said
When this episode is over, please change the "DX: Date" in your signature to DX: "actual date he was diagnosed with diabetes the first time". It's also useful to say he's been on and off insulin a couple times.
@ETheCat
 
Please fill out the information on your spreadsheet up top where it asks Dx Date
Current insulin
Dosing method you are following
Meter you are using
@ETheCat
Here is the link to read about the 2 dosing methods
Choose one and add it to your signature and spreadsheet
 
Good you set up the ss. His numbers are really good especially with hc food. What hc did you feed? Do you know the carb percentage of the food? It’s over 15%? We increase in .25 increments usually.
It would be good to add in the comments section what you fed and when.
 
ETheCat said:
How do I know which method my vet has been using?

It's basically been going up by .5 units every 7-10 Days
Click to expand...
That is not SLGS. SLGS has you go up 0.25 units at a time, once a week, until nadirs are in the 90-149 range. Going up by 0.5 units this last time may have meant you jumped over a better dose,. I'd try 2.25 units next.
 
tiffmaxee said:
Good you set up the ss. His numbers are really good especially with hc food. What hc did you feed? Do you know the carb percentage of the food? It’s over 15%? We increase in .25 increments usually.
It would be good to add in the comments section what you fed and when.
Click to expand...

Thank you, I sometimes have a hard time understanding things depending if they are presented in too much detail - @Diane Tyler's Mom GA gave me the simplified info that made it easy to understand

So do we think that staying in the 3-4mmol for the last 7 hours is ok?

The High Carb food I have been giving is the Fancy Feast Gravy lovers, which I saw someone here recommend keeping in stock.

I've only fed the the HC food during the low episode today, and during the low episode on the 10th PM

Everything else is the DM Pro Plan Chunk (Savory Selects) and as of the start date of this new dose, I also switched to 100% wet food with this, instead of his main meals around insulin being the DM Dry Food
 
Wendy&Neko said:
That is not SLGS. SLGS has you go up 0.25 units at a time, once a week, until nadirs are in the 90-149 range. Going up by 0.5 units this last time may have meant you jumped over a better dose,. I'd try 2.25 units next.
Click to expand...

Hi, can you explain what NADIR means, does this mean the peak low after insulin?

At this rate, I will be skipping the PM dose which is coming up in about 2.5 hrs since his numbers are still in that 3-4mmol (52-74 mg/dl) and I will try the 2.25 tomorrow

I'm just hoping to see him come back to normal range soon
 
Why don't you wait until +12 or just before you'd shoot and decide if you are going to give insulin. Some cats really zoom up at the end of the cycle. You'd hate to not shoot if he's going to bounce high. Keeping him in normal blood sugars numbers is what helps reduce the bouncing.

Some basic concepts from the Sticky Note The Basics: New to the Group? Start here!. I strongly recommend you read all those Sticky Notes on the top of this forum.

Learn how YOUR kitty is responding to insulin:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
  • How to do a Curve - a simple explanation
 
Wendy&Neko said:
Why don't you wait until +12 or just before you'd shoot and decide if you are going to give insulin. Some cats really zoom up at the end of the cycle. You'd hate to not shoot if he's going to bounce high. Keeping him in normal blood sugars numbers is what helps reduce the bouncing.

Some basic concepts from the Sticky Note The Basics: New to the Group? Start here!. I strongly recommend you read all those Sticky Notes on the top of this forum.

Learn how YOUR kitty is responding to insulin:



    • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
    • Duration - the length of time insulin continues to lower blood glucose
Click to expand...

Well as luck would have it, after his nap, he ended up ripping off his Libre, and I can't get it replaced until tomorrow morning at the vet.

The good news is over the last half hour or so I saw the numbers at some higher numbers like 5.5-6mmol (approx 100-110mg/dl) but without the Libre I don't feel safe enough to give another dose overnight without a monitor
 
You might want to learn how to use a blood glucose meter as a backup. There is also a FB group for people who Libre's for the pets, and I've heard they have instructions so you can learn to replace it yourself. We have several people who do that here.
 
Wendy&Neko said:
You might want to learn how to use a blood glucose meter as a backup. There is also a FB group for people who Libre's for the pets, and I've heard they have instructions so you can learn to replace it yourself. We have several people who do that here.
Click to expand...

I've tried the route of a testing myself the ear, the paw, using the lancet pen, poking with just a needle tip, it's a nearly impossible task that is incredibly stressful for me and my cat without ever being able to get a reading out of it. The monitor has been a saving grace

My vet clinic replaces it just fine, and it's not something I'd feel comfortable being able to ever get done on my own - as even with their team it's a challenge with 2 people
 
ETheCat said:
The good news is over the last half hour or so I saw the numbers at some higher numbers like 5.5-6mmol (approx 100-110mg/dl) but without the Libre I don't feel safe enough to give another dose overnight without a monitor
Click to expand...
@ETheCat
If you did skip the PM dose (3-13) can you please put NS for no shot in the unit cell or square.
I see you added SLGS method to your spreadsheet can you add it to your signature also.
Just tap on your name up top and tap on signature and add it then tap save
Also on your signature can you add what Wendy said

please change the "DX: Date" in your signature to DX: "actual date he was diagnosed with diabetes the first time". It's also useful to say he's been on and off insulin a couple times. Just like I see you did on your spreadsheet :cat:
@ETheCat
 
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cecile & bella said:
Staci has a "spicy" cat too and she uses the Libre, maybe @Staci & Ivy you can give some tips about that?
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Yes, my cat Ivy is quite spicy as Cecile mentioned! I NEVER thought I would be able to replace a Libre sensor on my cat. But I just knew that if I was going to use it long term I was going to figure out how to do it.
Ivy will not tolerate ear pokes on a continuous basis (I can test her if she's having lows and it's dire that she be tested on a handheld device, but not many times a day, every day).

But she DOES allow me to replace the Libre. It's once every approximately 2 weeks (unless it fails early, which it does, sometimes at midnight or 2 am).
So I have been known to replace a Libre at 2 am when needed. I can't take her somewhere at that hour to get it done. So I rely on myself.

I understand it's not for everyone, and there are members here who are happy to take their cat to the vet to have it done each and every time. (My cat gets more stressed going to the vet, so that didn't work for us either).

So I just want to say it's possible, but it's your choice, of course.

If I can be of any more help, feel free to ask me! :cat:
 
Staci & Ivy said:
Yes, my cat Ivy is quite spicy as Cecile mentioned! I NEVER thought I would be able to replace a Libre sensor on my cat. But I just knew that if I was going to use it long term I was going to figure out how to do it.
Ivy will not tolerate ear pokes on a continuous basis (I can test her if she's having lows and it's dire that she be tested on a handheld device, but not many times a day, every day).

But she DOES allow me to replace the Libre. It's once every approximately 2 weeks (unless it fails early, which it does, sometimes at midnight or 2 am).
So I have been known to replace a Libre at 2 am when needed. I can't take her somewhere at that hour to get it done. So I rely on myself.

I understand it's not for everyone, and there are members here who are happy to take their cat to the vet to have it done each and every time. (My cat gets more stressed going to the vet, so that didn't work for us either).

So I just want to say it's possible, but it's your choice, of course.

If I can be of any more help, feel free to ask me! :cat:
Click to expand...

Thanks for the reply

Are you putting any sort of skin glue to keep it on?

Or any kind of covering or shirt / vest etc?
 
ETheCat said:
Thanks for the reply

Are you putting any sort of skin glue to keep it on?

Or any kind of covering or shirt / vest etc?
Click to expand...
Hi, I use no glue at all. I put a tegaderm (thin adhesive covering) to help keep it on and she does wear a tube top to cover the Libre so she won’t pull it off, which I know she would do.
I used to have a T-shirt on her which she did not like it all and that’s how we migrated to the tube top. Many cats don’t mind a top a T-shirt, and some cats don’t fuss with the Libre at all.

Here is my cat with her top on (I made this top, but you can buy something like it on Amazon inexpensively)
upload_2025-3-14_7-8-33.jpeg
 

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Staci & Ivy said:
Hi, I use no glue at all. I put a tegaderm (thin adhesive covering) to help keep it on and she does wear a tube top to cover the Libre so she won’t pull it off, which I know she would do.
I used to have a T-shirt on her which she did not like it all and that’s how we migrated to the tube top. Many cats don’t mind a top a T-shirt, and some cats don’t fuss with the Libre at all.

Here is my cat with her top on (I made this top, but you can buy something like it on Amazon inexpensively)
View attachment 73101
Click to expand...

Thanks, I was considering something like Tegaderm, I saw alot of libre 2 sticky covers on amazon, but I suppose this is a quick alternative I can get at the pharmacy

I took his dose down to 2.25 over the last fews as was suggested on this thread, and it's mostly been doing well but I find myself in another low dose event tonight

it started going low at +6 and then even lower at +2 and now nearing +10 it's still in the 3mmol (54 mg/dl) range and I've given some high carb foods and even a little honey on gums this time because it temporary hit LO (which I think it 2.2mmol or 39.6mg/dl)

He is just relaxing or even sleeping when his numbers start to get that low, and I'm wondering if it's perhaps the 3-4mmol or 54-72mg/dl is a normal low for him

Trying to confirm with a spot check, but it's very difficult to get done alone, he won't sit for it on ear or paw long enough to get blood on meter
 
@ETheCat
Hi don't know if you saw this but please add this information
I see you added SLGS method to your spreadsheet can you add it to your signature also.
Just tap on your name up top and tap on signature and add it then tap save
Also on your signature can you add what Wendy said

please change the "DX: Date" in your signature to DX: "actual date he was diagnosed with diabetes the first time". It's also useful to say he's been on and off insulin a couple times. Just like I see you did on your spreadsheet up top

This information is the first thing members will look at.
Congrats on the reduction
You should have reduced the dose to 2 units on 3-16 for the PMPS cycle because he dropped under 90 on 3-15 following the SLGS method per your spreadsheet
@ETheCat
 
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