? Help with LOW numbers tonight

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Tillie and Valentino, Jan 1, 2021.

  1. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    I didn't put this as an emergency, as after Valentino ate quite a bit of high carb dry food, in 20 minutes his number is 278 up from 52 but he is only at +3.5. I'd say he usually nadirs at +5 or +6. Not sure what to do to keep it up. That is with the Alpha Trak ....I had been using Freestyle Libre but it stopped working suddenly.

    Of course, this happens on New Years' Eve. Any advice you can give would be great. I just think it would normally be heading down but the high carb food helped swiftly. How long do I need to watch ?
     
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Anytime you get a test number that's really unexpected and out of character, it's possible the test strips was bad so you should always re-test immediately.

    If his numbers stay up for 2 hours from the last time you fed anything high carb, it's usually safe to call it a night.

    Next time, try not to panic though. We don't usually like to use kibble because it takes too long to break down and get into the bloodstream. Most of us use something like Fancy Feast Gravy Lovers. What I did was pop the top, put it back down and "squeeze" the gravy into another bowl (it's messy but it works!) Then you give a couple of teaspoons of just the gravy part (that's where most of the carbs are) and then test again in 20-30 minutes to make sure they're coming up. Then you test again 30 minutes later and again an hour after that (for a total of 2 hours from the time you fed the high carb gravy).

    If they drop down again and you have to feed more high carb food, that 2 hour clock starts over.

    We want to just nudge them back up, not send them to the moon.

    Also, you're changing the dose too often and not taking reductions when you should. Lantus needs to be given at the same dose both AM and PM and if you're doing the SLGS method, anytime he drops below 90, his dose needs to be reduced by .25. You need to hold the same dose for 7 days (unless he drops below 90) before you make any dose changes.
     
  3. Tillie and Valentino

    Tillie and Valentino Member

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    Nov 25, 2020
    Oh, thanks so much for replying! I didn't realize that the dry would be that dramatic a shift. He was ravenously hungry suddenly after being very mellow and tried eating stuff off the floor which he really never does. I should have retested though, for sure. I have been using a human meter most of the time so seeing it on the pet meter really shocked me. He seems sort of exhausted now and went to lie down. I will follow the checking procedure you outlined and make sure he's okay. It was early in his cycle too so that really worried me.

    You're right, it's been confusing knowing what to do after he has had these low numbers out of the blue. He is on Prozinc but I know that his needs are coming down now. Do you think I should shoot tomorrow morning at .25 less, or .5 or skip?
     
  4. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Sorry...I'm so used to Lantus but I do see you're on ProZinc.

    He earned a reduction yesterday by dropping to 68 so he should have gone down to 2.5

    If he's high enough in the morning for insulin, I'd go with 2.5 and hold that dose for 7 days.

    You might want to read over the Start Low Go Slow dosing method again to re-familiarize yourself
     
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  5. Tillie and Valentino

    Tillie and Valentino Member

    Joined:
    Nov 25, 2020
    No worries, I so appreciate your help tonight! Tonight I shot 2.5 but I think it was still fairly low when I shot that. Should I go down to 2.25?

    I will read that link regarding the dose protocols, too, thank you!
     
  6. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I had a feeling he would be going low is why I suggested in your other thread doing 2 units am and pm for a few days. You did 2 for only one day then raised it up to 3. Too big of a jump and you didn't give the 2 units enough time to work. I would suggest do 2 units for several days. If it proves to be not enough then raise it to 2.25 and hold the dose. Don't be surprised tomorrow morning if he bounces back up into the high 300's-400's. That's normal after going too low. The highs you're seeing is from bouncing.
     
    Last edited: Jan 1, 2021
  7. Tillie and Valentino

    Tillie and Valentino Member

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    Nov 25, 2020
    You were right on the money @JanetNJ. I guess I was afraid when I saw the hugely high numbers. Thanks for explaining that. I clearly don't know what I'm doing! This is so stressful. He's at 481 right now on AT so no problem giving his 9 am dose. I'll do 2 units and stay there for several days and see how that works, unless of course he still goes low. Does it seem like this sudden need for a new lower dose is related to the acromegaly or the fact that his ear infection is maybe clearing up?
     
  8. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    I'm guessing it's the infection clearing. Infections raise bg.
     
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  9. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    I definitly agree it can be stressful. Lol. He's lucky to have you. :) Bounces can take several cycles to clear.
     
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  10. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Oct 20, 2019
    Could be both. It is thought that if the tumor is active the cats numbers as higher and when inactive you see lower numbers. Infection can also increase numbers.
     
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  11. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Good to see Valentino coming down the dosing scale, though a little scary! Do make sure you have higher carb wet food around. The reason we don't do dry food for lower numbers is not because it's slower to impact the blood sugar numbers (it's not), but rather that it sticks around longer in their system, keeping numbers higher longer than than wet food would.

    If you do take him for SRT, his response could keep you hopping as he goes down dose. Good thing he's on a small dose for an acro.
     
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  12. Tillie and Valentino

    Tillie and Valentino Member

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    Nov 25, 2020
    That's so kind of you to say. It has been a real learning curve. I don't know what I'd do without your good advice on this board and a pretty great vet who actually has treated lots of acromegalic cats.
     
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  13. Tillie and Valentino

    Tillie and Valentino Member

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    Nov 25, 2020
    Oh, good to know on the impact of dry versus high carb wet food. My concern was that it would spike and then come right back down again but luckily not as he still had a couple of hours til his typical nadir.

    I'm taking him for a single high dose of SRT of his pituitary gland and also for his lung mass (which is suspected carcinoma but can't be sure) this coming Tuesday. I do expect him to keep me on my toes ! Because the single-dose is a protocol some places like North Carolina do routinely, my radiologist thinks it will be effective. Also, his is a very mild enlargement of the gland so I'm hoping that this will do the trick. It will be the same price as the 3 including the additional radiation of the lung mass which is a whole other thing.
     
    Last edited: Jan 1, 2021
  14. Tillie and Valentino

    Tillie and Valentino Member

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    Nov 25, 2020
    Thank you for your replies, everyone!
     
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