In danger of hypo?

I've never had any hypo issues or scares with Sushi, but this evening's events have me worried:
I fed him around 5:30pm (Hills dry m/d). He didn't eat much at all (maybe 1/8-1/16c?) and I gave him 5u of fresh Lantus insulin right away (I usually give 5-6u). I didn't realize how little he ate until after I gave him the medicine. So I started freaking out. He didn't/wouldn't eat any more, so I resorted to pouring a little (maybe a Tablespoon?) chicken baby food onto his food. Is that okay? This worked like a charm--he ate about 1/4c. All of this before about 6:20. He's been sleeping since then.
Do you think he's in trouble for hypo? What are the symptoms I need to be looking for?

Thanks!
Ashley

 

Hi,

I am too new at this to advise you, but I know what it feels like to have this scare and want you to know you are not alone.

Roberta
and Casey

 

a few questions:
Do you have a HYPO kit? high carb can food, syrup, etc
Do you home test?

This would be a good question for the Lantus support group...I wish I knew how to link this to that site. But I am sure someone with more experience will be along soon.

 

Ashley,
When you say "supplies".... does that include the relion meter and strips you were gonna pick up from walmart?
Carl

 

Please read how to treat a hypo:
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

Is your kitty showing any signs of hypo?

 

If I did this correctly, here are some links about HYPO symptoms and tool kits

http://www.felinediabetes.com/phorum5/read.php?8,925783,925783#msg-925783
http://www.felinediabetes.com/phorum5/read.php?8,1661316,1661798#msg-1661798

 

from this previous thread:
viewtopic.php?f=28&t=48973&p=528840#p528840

it may be time to start home testing.
is there anyone there that could go pick a tester and strips for you?

are you in contact with your vet?
please follow and print the hypo links others have provided, and update when you can.

 

ashley did you get the testing equipment today?

this sounds just like yesterday - it really can't wait. if you didn't get them, can you send someone else out to get them now?

take a look at sushi and tell us exactly what he's doing. breathing, responsive to you, everything - describe his behavior.

 

ok, i just reread what ronnie highlighted - if you bought the meter and strips - right now is the time to test. that's how we're going to know what's next.

so breathe, gather your supplies and come back to us. we'll walk you through it. that will tell us what's going on with sushi. just tired doesn't tell us anything helpful.

 

i'm going to suggest that you stay on one thread for a conversation - we only open one per day so that it's less confusing. i can see you had another one today - maybe it carried on from yesterday, but stay with this one now.

i'm a little confused now because i can't see if you're posting or not - it looks from this thread like you posted 35 minutes ago or so - we are all over the world so telling us your local time isn't helpful.

how many hours ago did you give the shot of insulin?

 

let's refresh when u can, this morning you gave a shot?
how much?
and what time?

and tonight you gave 5u...
was it 12 hours after this morning's?

I ask because in your previous thread you mention its about 8 hours apart?

you'll want to check the hypo links, make sure Sushi eats, unfortunately without any testing, it's hard to say where Sushi is,
so it's important that you monitor for physical changes, and make sure Sushi eats.
but if you do have a meter there, give it a try.

I would also put a call to your vet or the closest E.R, or at least have that info near by.

 

i thought ashley was saying she gave this morning's shot 8 hours after last night's shot and tonight's was 12 hours later, maybe?

ashley?

 

If you don't have a meter, there is no way to know what Sushi's BG is. You are shooting a lot of insulin. Lethargy is a symptom of hypoglycemia. I honestly don't know what to suggest other than if you want to be sure of what's going on, you should take Sushi to an ER and have them get a BG test. You can feed some high carb food but there's no way to know if that is, indeed, needed. This is exactly why we so strongly encourage home testing.

 

Ashley, I really really encourage and suggest you get that meter and strips if you haven't already - please confirm with others if you have it or not.
if there's anyone that can run and get it for you, even better

lot of people watching you, k?


please recap:
you shot at 9am this morning, 6u

and tonight at 5:30 your time, 5u?
right?

 

Oh wow thanks for all of the responses! I didn't mean to cause such a stir...I'm in the midst of responding to all questions, but let me say this really quick:

This info and list of symptoms is what I was looking for. Based on this, I don't think I have anything to be worried about. He is responding well and he seems to be perking up more as time goes by. He's just not eating as well as normal, and he's sleeping more often.

I'm sorry--I thought you might be able to help me assess whether he was in danger by a description of how tonight's feeding/insulin schedule differed from the norm.

 

hey ashley, would you like to talk one on one on the phone. i mail out newbie kits. i can help you get started tonight...you will feel soooo empowered knowing for sure what numbers your baby has.
i can call you
you can call me
lori

 

Ashley - I just walked your shoes 2 weeks ago. I watched KT like a hawk and every nap or little different thing I just KNEW he was going hypo 'cos I couldn't test. I even cut down on his insulin because I believed he was getting low. NOW I KNOW - if it looks like it, I grab the test kit! I wasn't doing him justice at all....

 

Hi all!
Again, I'm so sorry for causing such a stir. I appreciate all of your concern and info!

Tonight's insulin/feeding scenario was different than normal in that Sushi didn't eat as much as he normally does. He barely ate anything and I have him his usual huge 5u dose. I understand that insulin + not enough food = hypo. I thought that I might be able to predict whether he was in danger of hypo by evaluating how much he ate tonight .vs. how much he normally eats .vs. his insulin dose.
>>One big question I have: how much should kitty eat before you give insulin? What is the minimum amount they can eat before receiving insulin without becoming hypo?
I typically feed him -- let him eat and lounge for about 30 minutes -- give him his medicine -- he eats a bit more. So it's like I give him his medicine while he's eating. This is what my vet recommended; what do you think?

Sushi's been in rough shape over the past 36 hours. He hasn't been eating well and he's sleeping more often than usual. I can tell he's doing bad just because I'm his momma. (Those are the only symptoms I've got to go off of; I know it's nothing concrete.)
The main reasons for this are: my ignorance, he's not regulated, I'm not yet home testing & his insulin pooped out.

To answer the schedule questions (I'm Central Time--it's 9:45pm right now):
Normal Schedule -
[AM] 6:30am: Feed 1/2c Hills dry m/d food | 6:45-7ish: Give 5-6u of Lantus
[PM] 5:00pm*: Feed 1/2c Hills dry m/d food | 5:30: Give 5-6u of Lantus
He ususally eats 1/8-1/4c intially and then grazes on the rest until the next feeding.
Yesterday -
[AM] 6:30am: Fed 1/2c Hills dry m/d food | 6:45ish: Gave 6u of pooped out Lantus
[PM] 6:30pm: Fed 1/2c Hills dry m/d food but wouldn't eat; skipped evening dose
Today -
[AM] 8:30am: Ate ~1/4c Hills dry m/d food | 9am: Gave 6u of pooped out Lantus
[PM] 5:30pm: Ate ~1/8-1/16c Hills dry m/d food & 5u of fresh Lantus

No, I don't have a HYPO kit yet.
I DO have supplies to home test now.
Tested for ketones--I'm SHOCKED!! It was between negative and "Trace" (5 mg/dL)! What a relief!! I was sure we were in trouble there!

Sushi still hasn't eaten since 6pm-ish; he usually grazes throughout the evening. Should I push him to eat more or just let him be?
He does seem to be doing better and better! Wahoo!!





*I was not aware that Lantus was a 12 hour insulin. I have a strange schedule; this schedule with 10.5 hours between doses was what my vet and I agreed on. This is an issue I would like to discuss; I'll bring it up once the dust settles.

 

i wish one could 'see' a hypo...or 'know' how the insulin is doing in the body by behavior...if only!
but no, a cat can be in HUGE trouble and acting normal just minutes...a single minute....before seizing.
talk to dear 'ohbell' who's very first test after a month of shooting produced a 29 :shock:
we stayed up half the night getting those numbers back up.
on one unit of insulin.
acting happy and just fine.
i can gaurentee you that cat would be dead or hospitalized by now had mommy not tested.
and the really good news.
that can, named Bean, is off the juice just days after joining.

 

so you do have the meter and strips to test right?
well honey, LETS GET US A NUMBER!
can i walk you thur it...do you think you can do it?

 

Ashley,
You said you now have the supplies for home testing. That is tremendous, and the absolute best thing you could have done for you and for Sushi.
Now, if you look back a couple of posts, you'll see one from Lori asking if you would like to speak with her on the phone, person to person? Please consider sending Lori a PM and exchanging phone numbers. She can guide you thru the home test routine much more easily over the phone. She will take care of you if you can contact her.
You really should test Sushi before giving him his next shot of insulin.

Carl

 

Okay...I will give testing him a whirl in a bit. Lori, I so appreciate your offer! Let me try it first. I'll let you know if I need to talk; what's the latest I would need to get back to you if I wanted to call tonight?

 

i'm in ca. so 10 pm my time....where are you?

 

I'm Central--so I have 2 hours? Or 3?

 

what time is it right now by you?

 

ashley have you seen youtube videos on how to hometest? i guess i'm wondering how you're knowing what to do if lori isn't helping you get started?

 

ashley, i'm so glad sushi wasn't having a hypo event. the reaction you got from all of us is because we know how serious it is to give a cat insulin. why every single vet doesn't have their pets being tested at home is beyond me, because we all know every diabetic human tests multiple times a day!

so don't feel badly for us reacting - that's the way this place works. if someone is having a crisis, others volunteer to help, including staying up all night to hold someone's hand and help them get through it. we'll talk to each other behind the scenes to make sure that a kitty in crisis is covered by someone staying on. for example, ronnie knew i was going to go join my family for dinner and she was staying online til you came back on. someone also did it for us, so we're just giving back for the next cat. it's how we teach you how to take care of your kitty.

so, now that the non-crisis has past - i'm so, so, so incredibly glad you've gotten your testing supplies and are going to let lori help you get testing. it's natural to think you want to get sushi back to normal before you tackle a new thing, but what we all know from experience is that the very biggest, best thing you can do to help him is to start testing. this IS what gets them back to normal. it's a little bit tricky, as i was telling you last night, but truly, you can do it. you have to be absolutely convinced that your kitty needs it to stay alive - and we're all telling you that is absolutely true. if it weren't, we wouldn't all be doing it with our cats and we wouldn't be volunteering to help others on the forum.

what i think people don't truly understand (at least i didn't understand) about insulin is that it's a hormone - not a drug. so a cat can be merrily getting dose A for weeks and without hometesting, all you know is that the cat seems to look fine. but lantus & levemir are both insulins that build up an actual deposit of the insulin within the body that continues acting after the dose has "worn off." you don't need to understand the actual mechanism now, but that's what they do. and because insulin is a hormone (think estrogen when you were 13) a body doesn't always have the same response to it. could go days or weeks along and then BOOM, for whatever reason, well, because it's a hormone, the body responds differently to it. you have to adjust the dose to keep the cat stable. i know i thought that i could control all of that in punkin before i really understood it. i figured it's like a math equation. take one punkin, give same kind & amount of food at same time of day, add x units of insulin = stable punkin blood sugar.

nope. it doesn't work that way. when i finally got that, then i understood why there are sometimes people diabetics who have health problems as a consequence of their diabetes not being under control. so . . . anyway, maybe that was more than you wanted to know, but i'm the kind of person who wants more information, which is why i'm telling you.

and yes, lantus is a 12 hr apart dosage, as much as possible.

glad you're going to let lori help you! you will be so glad and you won't have to worry anymore about what's going in inside of Sushi - you'll KINOW what's going on! you'll be SO relieved!

 

Ashley:

I'm concerned not just about dose but about what could be a huge problem. You've been using insulin that is most likely well past it's prime. You posted the following on the Lantus board last night:

This raises the possibility of Sushi developing ketones. Lethargy is one of the key symptoms of the presence of ketones. Are you testing for ketones? You need to test tonight. Because you are testing for urinary ketones, when you test, the test reflect the status of ketone bodies from several hours prior to the test (i.e., however long it takes for your cat's bladder to fill).

I have to admit, I'm more than a little confused about the age of your Lantus. You posted this in response to a question from Ann/Tess:

 

OKAY! I DID IT!
Sushi was much more tolerant of it than I expected and didn't flench or yelp at all. Here's what happened:
The lancing device allows you to adjust the depth of puncture. I set it on the shallowest setting, assuming it was a cat ear so it wouldn't need a lot of depth. I tried, nothing happened.
So I moved it to the middle setting. I got a teeny tiny drop of blood. I tried massaging Sushi's ear, but I wasn't getting anything. I tried putting the tiny drop onto the test strip. The users manual says "If there is not enough blood, 'E-7' or 'Lo' will be displayed." It didn't display either of those, so I don't think there was enough blood to register. Am I right or wrong?
So I tried it on the deepest setting and bam we got something! But the manual also says "Do not add blood on top of the test strip, as you may receive an inaccurate result." Do you think it's inaccurate? Should I try again?


Our #? 215, 5.25 hours after insulin. What does that mean? :-|


I just took a look at Sushi's ear and he has a little bruise or blood blister! :sad: What do I do?!?

 

Yea! Welcome to the Vampire Club!

The 215 means Sushi isn't hypoglycemic, so that's a relief.

As for the bruising, there's not really anything you can do after the fact, other than put a little Neosporin on it, if you have some. For future BG tests, please put pressure on the spot for a few seconds after the poke so the bleeding stops. Use a dampened cotton ball or tissue. This is not emphasized often enough when we help people learn to test. It will prevent bruising. Many of our cats have been tested on their ears for years and no one could tell!

Good job!

 

you get a drink for yourself and pat yourself on the back for doing it! YAY and WAHOO!

215 is an unremarkable number - and SUPER GREAT that you got it. no crisis there. so let's help you get set up on the next step.

oh yeah, apply pressure to his ear after you've tested so it doesn't bruise. you can apply the neosporin ointment with pain relief (did you pick up some?) and that will take care of his owie. also always give him a treat - a bite of low carb food is perfect.

 

Yes and I've been researching. Not that that makes me any kind of expert...

It's 11:15pm by me right now. Does it sound like I did it right? Do you think we need to talk?


Sorry for the confusion about the Lantus. Hopefully this will help:
Vial 1: early Feb-early May (had some left over I've kept it in my fridge)
Vial 2: early May-today (completely finished)
Vial 3: purchased today
I had a LOT of trouble with my getting my vet to call in a refill and thought I was going to be without insulin since Vial 2 was almost out. I held on to Vial 1, and was wondering if giving Sushi that insulin was better than none at all. But we're (finally) back in business with a fresh new vial as of today.

 

hey it sounds as if you got it! yay, you should be aware that you are now a Vampire. you will be seeking blood at least twice a day...before each shot. you may want yet more blood in between shots....we like to know how low our kitties go during the day.
hopefully your thirst will grow.
great work!

 

YES IT IS!!!

Okay, so we're not in trouble? On a scale of 1 to 10, where do we stand? Can someone tell me exactly what it means?

I CAN'T BELIEVE IT!! flip_cat

Will do!

Arg I forgot! Let me see if I have some around.

Yes!!! I'm not a big drinker, but you don't know how many times I've dreamed of a nice big pina colada (sp?) today!!!

 

well ya did good! the first time is the hardest. it only gets easier.

there's a lot to learn about how lantus works, but you'll have it all in a week or so. the lowest BG is around the middle of the cycle, although it can vary. so +6 is approximately the lowest. that means that sushi will likely (but not always) be increasing from now til the next shot or so. this isn't exact though, every cat is different and it varies within a cat.

a non-diabetic cat is going to be around 50-120 all the time.

organ damage from a cat begins at about 225 of sustained numbers. the meter probably measures up to 600 or so, then will say "high." we start to worry about ketones in a cat who has numbers over approximately 300 for any length of time.

a cat becomes hypoglycemic starting somewhere below 40 - the cat's brain can't survive one minute with no sugar, so we always say it's better to be too high for a day than too low for one minute. the meter probably measures down to about 20, then will say "low."

nearly all dosing decisions on lantus are based upon the lowest point, so we really need to help you get mid-cycle tests as well as right before the shots. the preshot tests tell you if it's safe to shoot insulin into sushi. the mid-cycle test tells us what his dose might need to be changed to. all of them tell us if sushi's staying in safe ranges.

that's the quick overview. i'll find the link you need on understanding lantus, but at least that's a bit

 

here's your homework. after you eat chocolate and have that pina colada!

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

 

Ooookay. Well I am COMPLETELY pooped. I've had more than my fill for today, so I'm turning in!
Thank you all SO much for everything!!!!!

 

hi ashley,

haven't seen a new post from you today, so i'm bumping up this one. i wanted to encourage you to let folks here set you up with a spreadsheet and help you get going on the regular testing so you can keep an eye on sushi. one test is just one moment in time, and it's important for him that you get a better picture of what he's doing. he was fine at that moment you tested last night, but every cat's bg goes up and down with insulin.

i know i'd feel better if i were seeing what sushi was doing today! just don't want you to get complacent based upon one number last night!

hope you slept well last night. we're all here to help you get going today! julie

 

Hi Julie!

Thanks for checking on me. I'm working on a spreadsheet right now. Here are #'s I've collected today:
6:40am (before feeding or insulin): 279
6:45-7am: ate 1/8c dry Hills m/d food - 5u Lantus
7-8am: ate ~1/4c dry Hills m/d food
1:10pm (6 hours after insulin): 235
I haven't had time to read/research what all of this means!! This stuff has kicked my butt--I'm SO TIRED and can't shake it! Can you help me interpret? How is he doing?

Thanks again!
Ashley

 

High Ashley, sorry I missed that you started a new thread last night. I was watching the old one! I posted a reply there last nigh after your first test.

You did great and the testing looks like it is going well today.

We usually start a new condo every day and stick with it. So now you should copy you post this morning and start a new topic. In the subject put "8/4 Sushi AMPS~279 +6~235" without the quotes. We also put a link in from the previous post so people can see what happened before.

To add the link: copy the URL address form this condo (thread or topic, we call them condos, it's where we live w/ our cats). When you are composing the message you will see buttons above the text box, click on the URL button and it will insert then paste the address you had copied between the sets of brackets … [color=#FF0000]paste URL here[/color]

During the day as you do more tests you can go back to the first post in the condo , click edit, and add the new test result to the subject line. That way the new test number will show up on the list in the board and we can see al a glance what is happening. Also if you have any concerns or questions during the day you can edit that first subject. Try to keep the date, Sushi's name and at least the latest test in there though. You can actually type in more that it seem, it will scroll over.

Now to answer you question: 235 isn't bad, but not great. Not a dangerous number, but in the healing range yet. Once you get a nice set of test numbers we can start advising you on how to adjust the dose to get Sushi's numbers down even further. When you can get him off dry food you should see a big differenc. But as we said before, take it slow.

Uhhh, too much info again? :roll: