*update - second hypo episode, partially resolved? In comments* Charlie first hypo episode

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Macey

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Hi all,

Charlie has been on lantus 2 units for a few weeks now and after his last curve a couple weeks ago, vet recommended I increase to 2.5.

I was nervous so only did 2.25 and spot checked and numbers were on the lower end so never ended up doing 2.5. I’ve kept mainly to 2 units until now because I wanted to wait until I would be home all day to monitor.

so gave his insulin 5am 2 units and 5pm 2.25 (today). He’s been eating only about half his food the last day or so and he gets dry food at 11pm on fri and sat as I’m at work but he’s awaiting dental surgery so doesn’t eat much of the dry.

Noticed about an hour ago that he was stumbling slightly so I checked his sugar (Alphatrak 3) and it was 4mmol. Right after that he went to his food bowl on his own and ate a decent amount but I gave him a small amount of honey on his gums as well. Checked BG again 20-30 min later (7pm) and was 5.2. Just checked now and it’s back down a bit to 4.8. More honey??? What do I do? I only gave him a tiny bit the first time. How much should I give?

Macey & Charlie
 
Hi all,

Charlie has been on lantus 2 units for a few weeks now and after his last curve a couple weeks ago, vet recommended I increase to 2.5.

I was nervous so only did 2.25 and spot checked and numbers were on the lower end so never ended up doing 2.5. I’ve kept mainly to 2 units until now because I wanted to wait until I would be home all day to monitor.

so gave his insulin 5am 2 units and 5pm 2.25 (today). He’s been eating only about half his food the last day or so and he gets dry food at 11pm on fri and sat as I’m at work but he’s awaiting dental surgery so doesn’t eat much of the dry.

Noticed about an hour ago that he was stumbling slightly so I checked his sugar (Alphatrak 3) and it was 4mmol. Right after that he went to his food bowl on his own and ate a decent amount but I gave him a small amount of honey on his gums as well. Checked BG again 20-30 min later (7pm) and was 5.2. Just checked now and it’s back down a bit to 4.8. More honey??? What do I do? I only gave him a tiny bit the first time. How much should I give?

Macey & Charlie
Sorry no one responded back to you yet, hopefully someone I tagged will get back to you in the morning
Tagging more experienced members than I am ,but first I linked your previous post which was your intro post and had asked you
to set up what we call our signature and our spreadsheet in case you want help with dosing here is the link . There are a lot of experienced members here. If it wasn't for me taking there advice I know Tyler wouldn't be in remission since 1-24-21
I'm glad Charlie is on Lantus. So was Tyler
We adjust the doses by 0.25 units at a time and use the U-100 syringes with half unit markings
Here is the link
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help
If you need help setting up our spreadsheet just ask , we have a member who will be happy to do it for you. The blue link I gave you will explain how to set up our spreadsheet and explain how to use it
We don't give times because we are all in different time zones ,look at other members spreadsheets and you will get an idea of what it looks like
If you gave Charlie his insulin at 5 AM and tested him 2 hours later you would tell us @+2 ( meaning 2 hours after giving insulin ) and so on
@Macey

@Bandit's Mom
@Bron and Sheba (GA)
@Wendy&Neko
@Suzanne & Darcy

Macey's kitty also had Stage 2 kidney disease as stated in her intro post
 
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Hi Diane,

I did as you instructed as best I could. I couldn't figure out how to change the colours on the spreadsheet or how to change the hourly increments so i added "notes" when it was not an exact hour post-shot. Also, the labs I entered are from November 19 2023. Please let me know if you can see the document/how to correct anything that needs correcting/if you can see my signature

Thanks for your help,

Macey & Charlie
 
Hi @Macey! Your Signature is fine. The only other thing would be the answer to "is Charlie on any other medications other than insulin?" If not, you don't need to change a thing.

I couldn't figure out how to change the colours on the spreadsheet or how to change the hourly increments so i added "notes" when it was not an exact hour post-shot.

I don't see any "notes". Are you using a phone or a PC? The spreadsheet is a lot easier on a PC, but many people use their phones.

As for changing the increments, you shouldn't need to. If, for example, you usually shoot at 8am and you get another test at 11:15, you'd enter the number in the +3 cell like this "### @ +3.25". 11:30 would be ###@ +3.5, and 11:45 would be ###@ +3.75. We "break up" the hour into 15 minute segments so just use the one closest to the actual time (so like a test done at 11:20 would be entered as ###@ +11.25 since 11:20 is closer to 11:15 than 11:30.) Doing this will require that you do the color coding yourself (any time there's anything more than just a number in the cell, you have to color code that cell yourself)

Did you just start testing 1/1/24 or do you have test numbers for 2023?

Also, the labs I entered are from November 19 2023.

Not sure why, but your labs tab only has one column to enter results in. It should have more like this:
upload_2024-1-2_11-55-39.png

Where the pink circle is, you'd put the date of the lab values. Then you should have several more columns to add new bloodwork values as you get them. That way we can see if values are stable, getting better or getting worse.

Feel free to send me or @Bandit's Mom a private message if you'd like some help. Just click on our name and choose "start conversation"
 

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Macey:

These are instructions from the top of the Lantus board on how to deal with low numbers. I'm surprised that Diane didn't think to link the information.
Sorry for not giving Macey the link it was 2:30 AM when I replied back to her and just didn't think of it ,
@Sienne and Gabby (GA)

Any advice for Macey about her giving Charlie different doses in the AM and PM ?
@Chris & China (GA)

Is this correct about when to reduce on a pet meter for the furure ladies? So Macey knows
68 (3.8) on a pet meter earns a reduction.
 
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he gets dry food at 11pm on fri and sat as I’m at work but he’s awaiting dental surgery so doesn’t eat much of the dry.
Here are the 2 dosing methods for lantus
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

If Charlie eats any dry food you would have to follow the SLGS method
You can always purchase an automatic feeder and fill it with the wet food and set it to open at certain times while your at work

Also some info on auto feeders, add a little water to the wet food
Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1

You can even order the stainless steel inserts for the 5 slot if you don't like your kitty eating out of plastic, from what I have heard plastic could cause acne on some cats
https://www.amazon.com/Cat-Mate-Sta...36-830d-6cc20f385409&pd_rd_i=B0B3MS1MWR&psc=1

If you would like some suggestions on some wet food that is low carbs and low phosphorus for kitties that are diabetic and have kidney disease just ask , and instead of always just using honey to bring his BG up I can suggest some :cat::cat:
@Macey
 
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Here are the 2 dosing methods for lantus
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

If Charlie eats any dry food you would have to follow the SLGS method
You can always purchase an automatic feeder and fill it with the wet food and set it to open at certain times while your at work

Also some info on auto feeders, add a little water to the wet food
Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1

You can even order the stainless steel inserts for the 5 slot if you don't like your kitty eating out of plastic, from what I have heard plastic could cause acne on some cats
https://www.amazon.com/Cat-Mate-Sta...36-830d-6cc20f385409&pd_rd_i=B0B3MS1MWR&psc=1


If you would like some suggestions on some wet food that is low carbs and low phosphorus for kitties that are diabetic and have kidney disease just ask , and instead of always just using honey to bring his BG up I can suggest some :cat::cat:
@Macey

Hi Diane,

Thanks for responding. I will respond in more depth later to everyone including @Chris & China (GA) and @Sienne and Gabby (GA) as I have to go run some errands but I was wondering if anyone can suggest some medium/high carb foods for charlie's "hypo toolbox" mentioned in one of the earlier links? So that I can grab some when I'm out. I am in Canada. And @Diane Tyler's Mom, what were you thinking rather than honey? I have him on hills k/d chicken & vegetable stew mixed with half Weruva "phos focussed". I know a lot of people disagree with the protein content but it has been very difficult to find a food he will eat. Even with these, I have to add some hydracare to the food since he loves the taste. He hasn't eaten a ton since yesterday, I'm not sure if he's not feeling well or is getting bored of his food again (he's done this many times, but my options are much more limited now). I'm going to grab some more Weruva in different flavours and see if alternating every week or so will help. I gave him 2 units for his AM shot and just tested him @ + 10 and his bg was 5.1 mmol so it seems to be holding more steady now although like I said, he hasn't eaten much. I will look into the automatic wet food feeder, he just does'nt tend to like his food cold.
 
I was wondering if anyone can suggest some medium/high carb foods for charlie's "hypo toolbox"
.
Generally, anything "with gravy" or "in sauce" is going to be higher carb. The Fancy Feast Gravy Lovers beef flavor is 20%, and all 4 flavors of the "Tuscany medleys" are 20% or higher
upload_2024-1-2_17-44-28.png


The "Grilled" flavors are mostly Medium carb (and you should have a few cans of both MC and HC)

upload_2024-1-2_17-46-30.png

Those are all Fancy Feast foods but there are lots of other foods you can use. Like I said, anything "with gravy" or "with sauce" is usually going to be higher in carbs than the pates most of us feed.
 

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Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.
 
I gave him 2 units for his AM shot and just tested him @ + 10 and his bg was 5.1 mmol so it seems to be holding more steady now although like I said, he hasn't eaten much. I will look into the automatic wet food feeder, he just does'nt tend to like his food cold.
Hi Macey can you please update your spreadsheet for today with Charlie's AMPS and the +10. Thanks :cat:
Edit so that 5.1 (91.8) was @+10, just in case you're wondering g how I got the US BG number
5.1x 18= 91.8
You said he does eat some kibble at 11PM on Fri and Sat so for now you need to follow the SLGS Method
Just a reminder

SLGS earns a reduction at 5 (90) where as TR earns a reduction at 3.8 (68)

Here are the 2 dosing methods for lantus
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
@Macey

Keep us posted when he will have his dental done :cat:
 
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Hi Macey can you please update your spreadsheet for today with Charlie's AMPS and the +10. Thanks :cat:
Edit so that 5.1 (91.8) was @+10, just in case you're wondering g how I got the US BG number
5.1x 18= 91.8
You said he does eat some kibble at 11PM on Fri and Sat so for now you need to follow the SLGS Method
Just a reminder

SLGS earns a reduction at 5 (90) where as TR earns a reduction at 3.8 (68)

Here are the 2 dosing methods for lantus
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
@Macey

Keep us posted when he will have his dental done :cat:

Hi @Diane, @Chris & China (GA), @Sienne and Gabby (GA)

I've updated charlie's spreadsheet. I went back down to 2 units like he had been on for a while, and his values were still at the lower end, so i did 1.75 tonight and a little over an hour later, I had a feeling that I should check on him while he was napping. He was snoring, which he does occasionally, and when i patted him he didn't wake up. After more vigorous patting and when i went to pick him up, he finally snapped awake after a couple seconds. I thought he was in a coma, it was really scary :(. I checked his BG and it was 3.8. I immediately put some honey on his gums, and mixed more into the "fancy feast Medleys - white meat chicken florentine' that a couple of you guys linked me to. He ate almost the whole can with a tsp or so of honey mixed in and a tiki stick.

I realized that when I was doing his first glucose curve, he was only on Hill's early support kd - chicken and vegetable stew, which when I checked, is very high in carbs (30% I think?). But he got bored of it and so i've been mixing that same food with half weruva phos focused, which APPARENTLY is only 1-3% carbs. So he had a big carb reduction, and i didn't realize it.

I'm going to do more reading up on the stuff that you guys have sent me now (Back to school today, I've just been really busy). and I will be monitoring his sugar much more closely. He was okay for weeks on 2 units so I didn't realize I had to be so diligent because I didn't realize the Weruva was so low in carbs.

What do you guys think are my immediate next steps while I research more? I'm testing his sugar every 30 mins.

Thanks,

Macey
 
You're going to have to manually enter information on the US version of your spreadsheet. It doesn't transfer if you are stacking numbers. Also, if you look at the World template, you need to stack numbers in one cell if they are within the same hour.
 
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