911 hypo
- Thread starter christoph
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Did you test his blood sugar? I'd try to get him to eat some food and test again in 1/2 hour. Honey can wear off and you want to make sure he stays up.
bsmith
Member Since 2015
Thinking good thoughts for you. From your spreadsheet, it looks like you've been having a rough time.
Does your vet have an after hours number that you can call?
Keep testing. From the Alphatrak test, his numbers look like they've just barely started into the normal level.
Does your vet have an after hours number that you can call?
Keep testing. From the Alphatrak test, his numbers look like they've just barely started into the normal level.
You want to keep him up above 68 on the AlphaTrak or 50 on the Relion. He's not at a dangerous point now, but honey or other high carbs can wear off in 2 hours or less. I'm not familiar with your insulin, but I think since he's 6 hours after his dose the insulin should be starting to wear off. Keep testing every 1/2 hour until he's over 80 on the Relion and then you can go to hourly testing unless he really zooms up. If you feed now, you only need to give a couple of teaspoons. You don't want to fill him up in case you need to feed him later.
Here's a link to the Hypo Instructions in case you need them. I found it was good to have this printed out, if for any reason I lost power or internet.
bsmith
Member Since 2015
BJM's Glucometer Notes really help too.
christoph
Member Since 2015
No after hrs #. Have appt tomorrow. Wondering how much and often to force feed him to keep him in safe #s. It's +6 1/2 hrs on Prozinc. I dumped a lot of sugar with the honey and food with honey so will just stick with food onward. Thanks!
christoph
Member Since 2015
Just tested with Relion....117.....but I gave him a lot of honey. I fed him 20 ml Hills AD just before the episode and another 20 ml AD with honey after the honey got him back. I'll test again 30 min.
I'd keep testing for at least two hours. You want to make sure his numbers are stable a couple hours after you last fed honey. Test every half hour if between 50-80, go to every hour if over 80. If he goes below 50, feed the honey and food combo again. If after two hours his numbers are still rising, you can nap until morning. Post here for advice on what to shoot next. BJ had suggested a dosing scale on your other post, but tonight might change things.
Oops, I just posted as you did. He's over 80, you can probably wait for an hour before testing.
bsmith
Member Since 2015
Too bad on the no after hours number. Just keep testing and feeding like @Wendy&Neko suggested. Keep a good eye on him. (I'm sure you're already doing that.)
I hope your vet appointment is early tomorrow. If not, you might call right after they open to see if they can get you in earlier.
I hope your vet appointment is early tomorrow. If not, you might call right after they open to see if they can get you in earlier.
christoph
Member Since 2015
It's a 1:40 appt, but I'll be calling 1st thing.
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Make sure you mention to the vet that he was showing hypo symptoms. Often we'll see kitties go below 50 but they won't show any signs other than being very hungry. Once you've gone through the process of testing and feeding to get Poncho through low numbers a couple of times, it'll get easier. You don't need an after hours number to do that. However, seizures are a concern. Quick thinking on your part to get him out of it fast.
christoph
Member Since 2015
His next dose is 4 1/2 hrs away. As stated before I had to switch to my Confirm so will be needing advice depending on his BG, but my guess is I'll probably be skipping.....BG will tell
New BG Confirm meter #.....217....
I'll get all the numbers up on SS when the dust settles. Switching to 12 hr SS but might go back to 8hr. Not sure about new vet now re insulin.
New BG Confirm meter #.....217....
I'll get all the numbers up on SS when the dust settles. Switching to 12 hr SS but might go back to 8hr. Not sure about new vet now re insulin.
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Dyana
Member Since 2009
Good catch last night. Cats that have a symptomatic hypo are often extra sensitive to insulin afterwards. If you give him insulin today, you may want to reduce the dose. I don't have experience with the insulin you are using, but others who do will hopefully be along by the time your next shot is due.
christoph
Member Since 2015
I wasn't sure about giving him 1u with BG 139 so checked with vet and she said do it. .5 u might have been right.
christoph
Member Since 2015
He had a fast drop last week at the vets.....real sensitive now. Thanks.
phlika29
Member Since 2014
Yes that blood glucose was very low to shoot 1 unit if you go by BJMS sliding scale. Especially if that was with the alpha trak.
I just wanted to repost it here:
This is BJM sliding scale using the alphatrak meter
So if poncho's blood Glucose was 139 was on the human meter then the suggested dose would have been 0.25. I am getting confused which meter you are using.
I do think you need to stick to a plan of action so that you are well prepared before an event occurs. Could you discuss the sliding scale with your vet over the phone and get an agreement. 1 unit was too much
I just wanted to repost it here:
This is BJM sliding scale using the alphatrak meter
So if poncho's blood Glucose was 139 was on the human meter then the suggested dose would have been 0.25. I am getting confused which meter you are using.
I do think you need to stick to a plan of action so that you are well prepared before an event occurs. Could you discuss the sliding scale with your vet over the phone and get an agreement. 1 unit was too much
christoph
Member Since 2015
His next dose is due now....5 1/2 hrs after Hypo. BG now is 423 on Relion Confirm (vet only gave me enough alphatrak strips until today's appt and last one was used after the incident) So any advice on dose? The vet doesn't get in til 10am, 3 hrs away. I'll call her office and see if they can get a hold of her. I'll make sure she sees the sliding scale info. Go ahead with .75 or wait till I talk to vet? I'm concerned about sensitivity now.
phlika29
Member Since 2014
@Sienne and Gabby I see you are online. Is there any way you could advice on dose. There was a hypo incident last night. Should Chris just reduce by 0.25 to 0.75 prozinc. Sorry to throw you in at the deep end.
christoph
Member Since 2015
Sorry I'm all over the place. Prozinc is slow acting so I'd be at the vets in 3 hrs. I'm going to have to also show the vet his spread sheet and scale. I'm concerned about ketones but afraid to guess the dose. Maybe safe to give .5. I'll wait a bit longer.....vets office is open soon but she wont be there for 2.75 hrs unless they can reach her.
christoph
Member Since 2015
I have a tablespoon left plus some food mixed with honey, plenty of test strips. I'm going to give him .5 I guess. I'm sorry to put you or anyone else on the spot. The vet should be more accessible and should have thought about the 2nd dose more.
phlika29
Member Since 2014
Don't worry I know the desire for someone to just tell you what to do. Unfortunately I am not that experienced. If you are more comfortable with that then go for it. Something is better than nothing. You could give a fat 0.5. Going to the vets will probably raise his levels a little anyway.
I would write a list of all the things you want to discuss eg
The sliding scale
The need to do more blood tests than the vet suggested.
The pain relief
The anti nausea
The sub q's
The alternative insulin
B12 injection
I would write a list of all the things you want to discuss eg
The sliding scale
The need to do more blood tests than the vet suggested.
The pain relief
The anti nausea
The sub q's
The alternative insulin
B12 injection
Meya14
Member Since 2015
Chris,
Since you were having trouble with swings in BS before on the 12 hour dosing (looked like it hit hard, and wore off too fast), you might never get good control with prozinc. It might be worth asking your vet to switch to a longer acting. They work much differently, and keep blood sugar more stable (less 500 going down to 50 sort of business). They also provide a better basal rate for cats prone to ketones.
Since you were having trouble with swings in BS before on the 12 hour dosing (looked like it hit hard, and wore off too fast), you might never get good control with prozinc. It might be worth asking your vet to switch to a longer acting. They work much differently, and keep blood sugar more stable (less 500 going down to 50 sort of business). They also provide a better basal rate for cats prone to ketones.
Elizabeth and Bertie
Member Since 2010
It is possible that one of the long lasting depot insulins may work better for Poncho, and might help the numbers to level out a bit.
There are no guarantees though.
You would probably get longer duration; and if that's the case you should be able to give shots 12 hourly.
But one advantage of Prozinc and PZI insulins is their flexibility with regard to dosing. It's possible to change the dose much more quickly with these insulins, and to use a sliding scale if necessary.
And if Poncho is bouncing from blue numbers he would probably continue to bounce on a different insulin (until his body works out that the blues are an OK place to be).
Big hug to you, Chris.
You're doing a fantastic job in very difficult circumstances.
.
christoph
Member Since 2015
The pic is the last post in the 2/10 Poncho update thread.I agree with meya. I might hold off suggesting the vet study the forumBut agree the knowledge base here is invaluable. Members eat, sleep and breathe diabetes.
The good times will return, you have to just stay strong. But I don't see the picture
christoph
Member Since 2015
I'm assuming a severe hypo incident, even though treated fast and he's brought back, really knocks a cat down the next day. I'm wondering if that is why Poncho is lethargic, unless it's the buprenorphine oral pain med and/or his upper respiratory illness making a comeback.....or everything at once. Could the upper resp illness mess with his insulin to the point of sudden drop in BG? I need to finally get this URI' thing to go away.
dirtybirdsoaps
Member Since 2014
I cant advise on your other concerns, and can't say for certain but when Hidey was taking buprenorphine he was always sleeping, or being extremely lovey and laying in my lap. Im sure having a fast drop in bg hasnt helped him with being lethargic as well.
christoph
Member Since 2015
He's been dealing with it since he was diagnosed jan 15. They just ignored it, saying it was most likely stress (while in ICU 4 days), left eye discharge and sniffles or the dust where we live (a warehouse space). Finally at my request they gave antibiotics, the day before they threw in the towel and took him off insulin.
tiffmaxee
Member Since 2013
I too would hold off on showing your vet the forum just yet. My vet who is the easiest I've read about in terms of not minding my input was a little iffy at first. Now he says he hasn't seen a cat better managed and when I asked him when he wants to see Max again he said 3-4 months. That's when he told me what a good job I'm doing and that he told his current 4th year vet student the same thing. Will they give you ondansetron or cerenia? Max is on his 8th day and I am considering tapering tonight.
julie & punkin (ga)
Member Since 2011
Chris, i think the missing couple of days in the spreadsheet were when Poncho was in the vet hospital, aren't they? would you just mark them as such so it's clear why there's no data. If you have info from those days, it'd be helpful to have something there.
With ketones still recently in the past, you want to continue giving as much insulin as is safe. With a recent hypo that included seizures and obvious symptoms, he's likely to be more sensitive to insulin than he was in the past. You are walking on a tightrope.
I wish you were getting more help from your vet, because this is a really serious situation and as much as everyone here wants to help you, i think you need a pro in this.
The bupe can be making him lethargic. It also could be from him feeling crummy.
Sending Poncho all my healing thoughts!
With ketones still recently in the past, you want to continue giving as much insulin as is safe. With a recent hypo that included seizures and obvious symptoms, he's likely to be more sensitive to insulin than he was in the past. You are walking on a tightrope.
I wish you were getting more help from your vet, because this is a really serious situation and as much as everyone here wants to help you, i think you need a pro in this.
The bupe can be making him lethargic. It also could be from him feeling crummy.
Sending Poncho all my healing thoughts!
christoph
Member Since 2015
I mentioned the website when I showed her the sliding scale. I think she's heard of it. She said the mertazapine works as an anti nausea med so wouldn't give me ondansetron or cerenia. One thing that disturbed me today is that she thinks Poncho needs to be tested for Cushings and that given his age (14) pancreatitis, diabetes, possible Cushings his prognosis isn't good. So we'll see. When I got him home he begged me to open a can of food and he tore into it....most hungry I've seen him. He seems so weak and fragile. It's great you have Max well managed....this is a great forum with people who probably know more about diabetes than many vets.
Will they give you ondansetron or cerenia? Max is on his 8th day and I am considering tapering tonight.
phlika29
Member Since 2014
I think the vet might have suggested that Chris didn't need to test when he first bought him back home.
julie & punkin (ga)
Member Since 2011
Ah, well, of course here on FDMB we all are big on testing, and the sicker a cat is the more essential testing is. We've seen how important the testing is.
I saw your earlier discussion about whether or not the relion is accurate - the thing is that the only essential blood sugar numbers are low ones. It's critical you know if a cat goes low - under 50 on a human glucometer or under 68 on an AT2.
If a cat is high, it doesn't matter if the meter reads 350 or 450 or HI. You know they are high and that's good enough.
So, for your purposes, you're going to save a lot of $$ by using the Relion and be able to get more tests in - and data is critical with every diabetic cat, moreso when the cat is ill like Poncho. I'd stick with the relion. If your vet wants an AT test here and there, give it to her. But overall, i think you can feel ok using the Relion and not worry about its exact accuracy. Does that make sense?
I saw your earlier discussion about whether or not the relion is accurate - the thing is that the only essential blood sugar numbers are low ones. It's critical you know if a cat goes low - under 50 on a human glucometer or under 68 on an AT2.
If a cat is high, it doesn't matter if the meter reads 350 or 450 or HI. You know they are high and that's good enough.
So, for your purposes, you're going to save a lot of $$ by using the Relion and be able to get more tests in - and data is critical with every diabetic cat, moreso when the cat is ill like Poncho. I'd stick with the relion. If your vet wants an AT test here and there, give it to her. But overall, i think you can feel ok using the Relion and not worry about its exact accuracy. Does that make sense?
christoph
Member Since 2015
Yes, that's when I dropped him off at the new vet and they unclogged him and started treatment to deal with his other issues. I'll see if I can get some number for those days. I'll update the SS to reflect those days. I need to go back to the 12 hr one for now so will be updating that too. I think what's really helping Poncho is the potassium laced sub q fluids. I'll post the scale she wants me to use when I get back.
BJM
Member Since 2010
I'm glad you've got him stabilized.
It is really important that the vet see how Poncho reacted to the aborted curve, ie, the dose has to be lower at lower numbers, or Poncho may crash.
The scale I provided seemed close to what he needed using the human glucometer and if you line up the estimates for the AlphaTrak next to them, she can see them side by side.
If she has e-mail, or can get on the internet from her office, getting her the link to your spreadsheet will show her how responsive he can be to the insulin.
What is making her think Cushings is possible? A key sign of that is very, very fragile skin that tears easily. Does Poncho have that? You hadn't mentioned it.
Here's some links and info from our high dose forum ... and Poncho is definitely NOT high dose!
"
http://www.cat-health-guide.org/felinecushingsdisease.html
http://www.cat-lovers-only.com/cushings-disease-in-cats.html
Cushing’s disease is caused by a tumor of either the pituitary or adrenal glands, causing the production of excess cortisol. Cortisol is a naturally-occurring chemical in the body, which helps the body respond to stress such as infection or pain. With Cushing’s disease, however, the body continues producing cortisol even when the stressor has been removed. This causes a number of problems one of which is insulin resistant diabetes.
One particular symptom that helps differentiate this disease from acromegaly so quickly is that Cushing’s causes very thin fragile skin that may tear easily and/or not heal well. Females are most often the target."
It is really important that the vet see how Poncho reacted to the aborted curve, ie, the dose has to be lower at lower numbers, or Poncho may crash.
The scale I provided seemed close to what he needed using the human glucometer and if you line up the estimates for the AlphaTrak next to them, she can see them side by side.
If she has e-mail, or can get on the internet from her office, getting her the link to your spreadsheet will show her how responsive he can be to the insulin.
What is making her think Cushings is possible? A key sign of that is very, very fragile skin that tears easily. Does Poncho have that? You hadn't mentioned it.
Here's some links and info from our high dose forum ... and Poncho is definitely NOT high dose!
"
http://www.cat-health-guide.org/felinecushingsdisease.html
http://www.cat-lovers-only.com/cushings-disease-in-cats.html
Cushing’s disease is caused by a tumor of either the pituitary or adrenal glands, causing the production of excess cortisol. Cortisol is a naturally-occurring chemical in the body, which helps the body respond to stress such as infection or pain. With Cushing’s disease, however, the body continues producing cortisol even when the stressor has been removed. This causes a number of problems one of which is insulin resistant diabetes.
One particular symptom that helps differentiate this disease from acromegaly so quickly is that Cushing’s causes very thin fragile skin that may tear easily and/or not heal well. Females are most often the target."
tiffmaxee
Member Since 2013
Sorry but mirtazapine doesn't work well enough alone for nausea. I don't know why some vets think that it does. People here know more about pancreatitis as well. I don't mean to be disrespectful but have you considered getting another opinion on this? Where do you live?
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