My daughter threw a question at me this morning when I was telling her that the vet said to "watch for clinical symptoms of a low" instead of testing. Well, the times this has happened, Tigger has had NO clinical symptoms. So my daughter said if I hadnt tested, when he was 27, and if I had gone ahead and fed him his normal food, then given him his insulin...it wouldn't taken effect for 2-3 hours anyway, so what would have been the problem with just doing what I usually do with him? I'm still trying to understand that myself.
I'd like to address this and a few other things.
Depot.
If he's got enough insulin to put him at 27 at the end of the cycle, then it's too much insulin and you could see low numbers for several cycles even if you reduce the dose. There is no way, upon getting a 27 at shot time, that I would feed regular food and give a shot and just assume that he would come up enough by onset that he would be ok. Lantus low numbers and hypos can last for over 16 hours. Why chance it? I know he hasn't been on Lantus long so if you haven't read and studied on the
Insulin Depot, I would very strongly urge you to do so today and ask questions. It will make all the difference in the world to managing his insulin and FD.
It would have been much better today to reduce the dose and to consider shooting an 18 hour schedule if the BG was up enough and all HC food had worn off. DKA can occur even if cats are in normal numbers. It doesn't happen often, but it does happen.
She did suggest (like the last vet after the DKA) to keep his feeding schedule more rigid...just twice a day. I asked her "but with a diabetic isn't it better to feed more often, smaller amounts?" and she disagreed with that, and said they get better regulation with a tighter feeding schedule (my words, not hers, but same thing). She said if he's low again in the morning...feed his regular food UNLESS HE'S SHOWING SYMPTOMS (frustrating, because even at 27 he wasn't showing symptoms!) then retest. Once above 50...we could choose to give a reduced dose...or just wait till the PM dose.
Well, our many, many years of experience here contradict feeding only twice a day. Some cats need managed mini meals early in the cycle, some free feed, but most of them have more than two meals a day. I think your vet does not understand how Lantus and levemir work. If he's low again in the morning, please only feed him if he's below 40. But
please do not shoot once he's above 50 without asking for help. If you feed him HC again for another number below 40 and he comes up and you shoot....even a reduced dose....you are likely to end up in the same scenario today because of the depot. Reduced doses usually do not take effect u til later in the cycle or sometimes the next cycle.
If he's in the 40s in the morning, please do not feed. Retest him in 15 mins to see if he's on the way up. If he's not, feed him a tsp of
low carb food and then retest him 30 mins later to see if he's headed up. You might also post for help. The reason we do this is because if you feed a small amount of LC and he comes up above 50, you won't be shooting a big food spike. But posting allows us to talk you through it.
I'm really glad he's ok!
