Low GB not sure what to do

Hi all, my cat Angel has been on basaglar since being diagnosed in October. Yep weeks ago the vet increased her morning insulin from one to two units and keeping the evening dose to one unit. She was keeping at around 300 with this instead of bouncing. On Sunday I had an emergency and took her with me. She wouldn’t eat in the am so I didn’t give her a shot. Since then she has been at 100 in the am and I gave her the insulin. At 9:40 this morning her bg was at 33 so I rubbed Caro syrup on her gums and gave her a bit of food. The vet is closed due to snow. Just checked at noon and only at 56, gave her more food and syrup. My question is should I give her any insulin tomorrow morning if she is under 100? Should I lower it to one unit? I will continue to monitor her throughout the day. Thank you for your help.

 

Unless Angel had a DKA I would skip tomorrow's AM shot if BG is <200. Even if above 200 I wouod not give 2 units.
I recommend that you setup a spreadsheet and record the BG's and dose there. That way we can better give dosing advice.
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

Hi Heather,

I've only just seen this post.

If it's more than 30 minutes since you last tested, please can you check Angel's BG again. You need to make sure that she stays up.

Questions for you:

1. Are you using a human or a pet meter?

2. What local time did you give the morning insulin dose, and what local time is it now where you are?


Mogs
.

 

Thank you! I’m using the alpha trak 2 and it’s EST. I tested her at 8:00 and she is at 477. Should I inject two units in the am if she is still high?

 

Thank you so much! I will definitely work on setting up a spreadsheet. Need a lot of help with getting her stabilized.

 

A spreadsheet will be invaluable because then experienced people on this forum can see Angel's trends and how long you have held the dose.

To help you so others can help you, a signature line would be really helpful as well (with a signature line, you don't have to keep repeating yourself over and over again.) You can check out this link for more info. https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Insulin dosage has a few factors that need to be determined:
1. What is the lowest that she dropped? (This is called the nadir)
2. Is she eating dry food?
3. Is the food she is eating below 10% carbs?
4. Does she have any other health conditions?
5. How much does she weigh?

When increasing and decreasing insulin, it's done slowly , after the insulin has had time to show you what it will do, and in small increments (like .25 u or .5 u) - it's much safer to do it this way. Jumping up too fast could set the kitty up for a hypo event which can kill and NOBODY wants to see that happen!

 

I generally do not give Lantus dosing advice, but I would NOT give 2U in the morning, even if high. Cats are generally more sensitive to insulin after hypos, and additionally that dose was high enough to cause a hypo in the first place.

Tagging @tiffmaxee @Bandit's Mom (I feel bad tagging you two all the time, is there anyone else generally around this time that gives Lantus dose advice?)

 

I agree that 2 is too high as it set Angel up for a hypo.


One thing that may have happened and why Angel is in high numbers is what's called a bounce. When cats go low, sometimes their numbers 'bounce' to the roof (go high) following the low number. When they 'clear the bounce' their numbers then come back down again. Some cats bounce crazy all over the place, others are pretty consistent (Freckles is pretty stable with her numbers). Having that spreadsheet will really help others see what Angel does with the insulin.

 

Hi Heather,

I can help you with setting up a spreadsheet and your signature block. Let me know if you'd like me to. Will only take me a couple of minutes.

1U to 2U is a large increase! We recommend increase in multiples of 0.25U and home testing to keep kitties safe!

The 477 you are seeing now is what we call a bounce. The body's natural reaction to a low number. The liver releases stored glucose and hence that high after a low. It is temporary and clears in 3 days or less (different for every cat).

What do you normally feed Angel?

 

I'm sorry everyone trying to figure out how to use the site. She is at 530 this morning and I did not give her any insulin. she weighs 12 pounds and is on a LC diet. She was doing great with the increase until we had to skip a dose on Sunday morning because she wouldn't eat. I never should have given it to her Monday morning when she was low. If using the basaglar pen how can I start slow dosing?

 

No need to apologize. It is a challenge initially to figure out the site and the spreadsheet - while juggling testing and highs and lows and everything else

It is clear that 2U is too much for her. But we don't know what is the optimal dose. Whether it's 1, 1.25, 1.5? And we cannot tell without data.

How regularly are you testing now? Do you have test data for the last few days? I can set up the SS for you to input the data so we can have some idea of her numbers. Without that we are shooting in the dark by giving dosing advice and we want to keep Angel safe.

We use syringes with half unit markings. We draw the insulin from the pen/vial and shoot with the syringes. Take a look at this link:
https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

 

Thank you for understanding, I will try to create the spreadsheet now and check out the link.

 

I can help you with the SS, if you'd like. Will only take me a minute.

Sorry, I thought Angel and typed Hazel!

 

It's okay, this is the only way I could drag the spreadsheet, it wouldn't allow me to put it into my signature

 

Hi Heather, this is not our format. I will set it up for you. Will send you a PM for the details I need to do so.