Give shot tonight or not? Low BG levels

Hi all, posting this copied and pasted from my post on the Facebook group (I was told to post on the forum):


Hi all. Quick advice needed. Started my cat on insulin yesterday (lantus 2 units 2x a day), gave him a shot last night and this morning with his meals. His blood test levels at the vets, diagnosing his diabetes, was very high (even through the fructosamine test, very high levels like ~500+). Finally got a successful blood glucose test on him today, for first time (just now). With alphatrak, glucose is showing 85 mg/dL. My vet told me anything under 80 is hypoglycemia. What should I do?? I’m supposed to feed him dinner (friskier pate) in 10 min and give him his nighttime shot. Do I skip the shot tonight since his levels are so low????

Also as side note, he’s not showing symptoms of hypoglycemia right now but should I keep monitoring???

 

Hello and welcome. I moved your post to the Feline Health where we ask new people to post.

Congrats on getting that first blood test. We consider below 68 to be in the hypo range. However, given you are too new to home testing, it would indicate that you should reduce the dose.

I take it you have only given him two shots so far of 2 units each? 2 units is a higher dose than we'd start people with here. 1 units is more of a starting dose here.

Was your kitty diagnosed with any other conditions, like ketones or DKA? The answer to that determines if you should shoot or not tonight.

 

Your recent diet change is going to lower his BG and 2U is already a high starting dose so I'd just skip tonight and start over in the morning with no more than 1U unless he's recently had ketones

You can always go up if you need to. If you give too much, you can't take it out again.

The "take action" number using the AlphaTrak is when they drop below 68 so he's at a nice safe number now, but you don't want to shoot that low until you have a lot more experience and data

 

It will also help us to help you if you'll fill out your Signature and start a spreadsheet. The "Signature" is what you see below our comments that gives some basic information about your cat so we don't have to ask the same questions over and over again.

Our spreadsheet is color coded which makes it easier to see patterns we look for.

Link to useful information about a hypo kit, settling up a spreadsheet, setting up you signature
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

 

Hi, thank you so much for this information. Yes, only has been 2 shots so far, on 2 units each (last night with dinner, then this morning with breakfast). He wasn't diagnosed with any other condition (he was diagnosed this Saturday, 2/13). From the advice I'm getting, I'm understanding I should not shoot tonight? I was thinking to test his BG again in a little bit tonight (he just ate some of his dinner, but less than usual...). Then I was going to skip shot tonight, and call vets office in morning for advice. Do you think this sounds like a good plan of action, or if I should do something differently? I really appreciate the input, especially when I am so new to this.

 

Thanks so much, I'll go ahead and get starting on setting up my signature and spreadsheet. Also thank you for your advice in your prior comment - I will skip tonight's shot, and see where his numbers are at tonight and tomorrow morning. Do you think I should call my vets office in the morning tomorrow, before I try dosing him <1 units in the morning? Or do you think I should be questioning this vet's judgment, since this starting dose was too high?

 

Did you see my question about whether there were ketones detected in his urine or whether he was diagnosed with DKA when he got his diabetes diagnosis?

 

Sorry about this, I forgot to answer this. He wasn't diagnosed with DKA nor were ketones detected

At least, my vet did not tell me anything about either, so I assume this is the case. Is it safe to assume, if vet did not bring it up? Maybe I should ask him when I call him tomorrow?

 

Awesome! Go ahead and skip tonight. I'd still try to get another test tonight, to make sure he's back on his way up.

 

Perfect, thank you so much for your help!! It is invaluable! I will report back tonight what his numbers are. Regardless, do you think I should call my vet in the early morning tomorrow, to ask about what i should adjust his dose to? Before I try to lessen the dose/guess myself?

 

You can ask your vet, or we can help you too. We have a couple dosing methodologies for Lantus, and have seen hundreds of cats follow them and do well.

 

Of course you can ask your vet....or you can just call and say that your cat dropped to the 80's so you're concerned he's getting too much so you feel more comfortable shooting a lower dose for now.....or you can leave your vet out of it and listen to the people here.

It's nice to have your vet on board with things, but a lot of times they either don't want to admit they were wrong or are totally against anybody getting information off the internet.

I never took China back to the vet for her diabetes once I got my Lantus. I chose to listen to the people here who live and breathe this disease.

 

Yes that makes so much sense, that is a really good point. Thank you both for these recommendations. I'll call my vet in the morning and see what he says, when I express concern about the dose being too high/me wanting to go with a lower dose for now. I'm also paying very close attention to what everyone is saying online, because already you all have been so tremendously helpful and informative, I would be struggling so much more if it wasn't for you all.

As an update, I just did another BG measurement just now (1.5 hours after cat ate his dinner, without receiving insulin), and his levels are at 133 mg/dL now. Does my plan to skip dosing tonight until I talk to vet tomorrow, still sound like a good one?

 

When people are new to testing on this forum, we say not to shoot if below 200. So yes, have a peaceful night. He will go higher as the insulin wears off, but rather higher for a night that going low and you fighting to bring his numbers up.

 

That makes complete sense. Thank you so much for all of you help. I will definitely rest easy tonight, knowing this.