How low is too low?

I am wondering how low is too low? My vet told me that they would like to see Sami stay above 70 and when she fell into the low 60's a month or so ago I totally freaked out. I was up all night constantly monitoring her and forcing food, milk, and syrup down her to try to get her glucose back up.

I have bee looking at alot of the spreadsheets and have noticed that some cats have been in the 40's and below on a consistant basis. I know that would totally freak me out and I would immediately lower the dose at the next shot time.

I don't know if this would be the appropriate thing to do, and need to know the answer to this before it actually happens and I am frantic.

 

I don't have that answer, but I know when Baby was 28 the other morning, that sent us flying to the ER Vet..
I personally don't want anything under 60-70, but ECID & I am a newbie.

 

I saw that the other day, and I was scared for you. From what I have read you really handled it well. I was completely hysterical when Sami was 61, I probably would have been at the ER too. Hope things start to settle down for you and Baby.

 

First, take a look at the dosing protocol that we use. Pay particular attention to the section on dose reduction. One way that a newly diagnosed cat earns a dose reduction is for BG numbers to be under 50. If you look at others' SSs, you will see that we routinely get numbers in that range. If the cat has been diabetic for over a year, numbers need to be less than 40.

The protocol that we use has substantial research to back it up. The researcher is a vet from the University of Queensland (Jacqui Rand, DVM) who is an expert in feline diabetes and in the use of Lantus (glargine). If these numbers were not safe, her research would never see the light of day nor would people here follow this protocol.

The reason that it was suggested that Baby make the trip to the ER was that this was an overdose. As everyone saw, it took hours for Baby's numbers to rise. This isn't the case with a dose that has been worked up systematically and safely. If you look at Gabby's SS, she had a 38 on Jan. 4th. Her numbers were low (at least when I caught it) for 15 min. Neither Baby nor Gabby had symptoms of hypoglycemia. In fact, there are several people here who have tested their non-diabetic cats or who will test their cats who are in remission and their normal BG levels are certainly below 70 and sometimes in the 40s. Keep tabs on those cats who are in the midst of OTJ trials. You'll see very green numbers!

 

Sienne, you make an excellent point. I wondered why people were pushing for the ER Vet & then when I look at other SS, I see really low #s, people feed HC & go BTB. The overdose is what the issue was...makes complete since. Yes, it took about 17 hours for Baby to even remotely seem out of the woods.

 

Also, check out Maui's spreadsheet (below), you will see how she averaged and when she did drop to her lowest BG, I fed it with some HC gravy and got a dose reduction.

I also for the heck of it, tested my other two non-diabetic cats - they tested at 36 and 46.

Maui off insulin ranges between 70-90.

The non-diabetic range for cats is approximately 60-120. But again each cat is different and some may range higher or lower.

 

Pumpkin had numbers in the 20's and we safely brought him up with HC. When he was going OTJ he had consistently LOW numbers (I mean below 35) and was (of course) not even getting any insulin. Now he (one year OTJ) has settled into numbers in the 60's consistently. I think that if the doses have been well managed and a hypo kit is ready those really low numbers can probably be safely managed at home. But of course if there are signs of hypo and a possibility of insulin overdose is real (i.e. mistaken dose) then by all means listen to your inner voice and get kitty to a vet if you are really worried. Just wanted to say that really low numbers do not automatically mean a cat is in hypo or at risk for hypo.

 

Wow, I might check one of my other non-diabetic cats just to get an idea.

By the way, what is HC - I think it means high carb, but not 100% sure.

Also, I see that you were using a True Results Meter and then switched to a different one. Was there a reason, I saw the errors, was the meter bad. I have a True Results meter and use True Test strips with it. I am thinking about getting a second meter just as a back up and as a double check for accuracy.

 

HC does indeed mean High Carb. And when we refer to it here, we are normally looking for a carb content of 18%. I'm not sure how to direct to you the Janet & Binky's food chart on the new site - I'm sure the regulars can help you out on that list.

It is a great idea to keep up to 10 cans on hand because in cases where kitty goes low, you are pushing the gravy more than the food. It really is the gravy that brings them up more so than the food. Having personally had 2 occasions where I needed to bring Luck's #'s up, running to the store to make sure I had enough HC in for the night was 1 additional stress I didn't need. Stocking up is a good idea. Just make sure everyone in the family that is involved in feeding knows that they are "EMERGENCY" foods only and don't feed on a regular basis. ;-)

 

I just tested my OTJ kitty tonight 2 hours after eating, his BG is 39, he is not on any insulin and he feels just fine (maybe too fine, he and my other cat have tearing through the house like little tornados!)

 

Here's the link to Janet & Binky's Food Charts. There are two lists for canned foods - new and old. Most of the Fancy Feast (FF) varieties are on the old list. The foods have protein, fat, and carbs broken out in terms of their percentage of calories. Fiber and phosphorus amounts are also listed, the latter is important if you have a kitty with kidney issues. In the FAQs is a spreadsheet for calculations of percentages but if you want to use this feature, you need to get "as fed" values -- this is not the guaranteed analysis that is typically presented on the can or website for most products. (This often means calling the manufacturer.) There are also links to gluten free FF foods if your kitty is sensitive or allergic to gluten.

LC (low carb) is considered less than 10% carb
HC (high carb) is 18%or greater
MC is in between

One way to "home brew" medium carb is to mix a bit of gravy from a HC food or even use a few drops of syrup (Karo, honey, etc.) on top of LC food.

 

my non-diabetic kitties usually run in the 40s and 50s. my diet controlled kitty is usually in the 50s and 60s. some kitties run higher. some lower.

however, if you're wondering at what number you should be concerned... it depends on the number and where it falls in the cycle. for instance, a 48 at
NADIR would not concern me as much as a 48 early in the cycle. a 48 at +2 or +3 would require intervention for most kitties because it's too early in the cycle for kitty to be that low.

be sure to look at the LANTUS & LEVEMIR: NEW TO THE GROUP? PLEASE READ... sticky in the Announcement Box at the top of this forum. you'll see an example of a *typical* curve as well as links to onset, nadir, and duration. learning how YOUR kitty responds to insulin will arm you with the knowledge of when to intervene by feeding high carb food. until you get to that point, post kitty's numbers everyday and ask for advice. there are many experienced peeps here to guide you.

 

Thanks for the information. I just know what it feels like to have low blood sugar and it isn't a great feeling. When Sami was at 60, she seemed more sluggish than usual and even when I put food in front of her she didn't want it. I guess that is what made me freak out. I will be picking up some HC food today just to have on hand.

Thanks again for the helpful information.