i have a problem...glucose too low

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mucacopatarica

Member Since 2016
Hi everybody.

I m new here. i have a cat who is diabetic from January and she is on Lantus. Lantus obviously started to work and now i have a problem. She was on 4 units and few days ago her shugar dropped on 2,7 mmol/l through day. Than we (after a conversation with her veterinarian) lowered dose on 3,5 units. Today i mesured her glucose level before i supposed to give her insulin and her gluose is really low again. She have 4,9 mmol/l. I m really afraid to give her insulin now. What should i do? Her veterinarian dont work.

Sorry about my english.
 
I'm no expert and I hope some of those that are will be along to help you soon but personally I would not give any insulin with such a low number especially not 3.5 units. You are right to be cautious. Xx
 
Vet told me that i must give her insulin (last time when i didnt gave her insulin because of that low numbers, her glucose level raised rally high (20mmol/l))
So i gave her 3 units and i will be measuring glucose levels all day....I dont know what else to do. Is it possibe that she is going in to remisson?
 
You really will need to watch her today, I wish one of the other ladies would come on here to help as I don't have much experience. Have you changed her diet? That had a marked effect on my cats blood glucose levels and she is now in remission after only about 6 weeks on insulin.
Please keep posting if you need any help as the day goes on and if you can give your message the prefix 911 people will know you need assistance urgently xx
 
Her diet is unchanged for last 3 months. She is on raw food diet. thank you for your advice about 911. now i will measure again....
 
@mucacopatarica ,
That 4.9 is a normal blood glucose number.
If you have given insulin at this number you will need to take action to ensure that your kitty does not become hypoglycemic. This may involve taking the kitty to a vet so she can get glucose by IV...
 
at 11.30 (1,5 hour after insulin) it was 6,00 mmol/l (1,1 mmol/l higher than an the morning). Next measuring we will have over 15 minutes. But i dont know what to do if measurement will be that low in the evening. Should i gave her lower dose of insulin or what? My vet is telling me that i can not change the dose but i dont believe this is the best solution.
 
Hi, can I just check that I've understood you correctly.

You gave your kitty 3.5 (?) units Lantus at a blood glucose level of 4.9 mmol (?)
And an hour and a half later she is at 6 mmol?

Do you have high carbohydrate food available? D0 you have some honey/glucose available?
.
 
What type of insulin are you using. Some insulins do not have the full effect until +4-+6 hours after the shot.

Sorry just saw that you are using Lantus. Numbers could continue dropping until +7-+8 hours after shot.
 
i gave my cat 3 units (instead of 3,5 units) Lantus at glucose level 4,9 mmol/l after veterinarian told me that i must to give her insuline.
I have honey available....
im so frustrated!
 
Just summarizing:

Lantus 3.0 units Human meter:

PS 4.9 (88US)
+1.5 6.0 (108 US)
+3 4.2 (76 US)


Can you also tell us what type of glucose meter you are using a human type or a pet specific type?

ETA Replied...it is a human meter.
 
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exactly.
i use human tipe meter bacause in Slovenia we have only one pet type meter which is far too expensive...


OK Thank you that makes a difference in what advice we can offer. You should be testing again soon...about 1/2 hour after you last test. Glucose levels can drop a lot in the first 6 hours after giving Lantus. Can you retest and post again please. The numbers right now are okay but you do not want them to drop any lower.
 
When glucose numbers drop too low the kitty's body will produce counter-regulatory hormones which will cause the glucose to "bounce" up higher. This can show as higher numbers for a day or two and does not mean the kitty needs more insulin. Lantus dosing is based on how low the dose gets the numbers. It is possible that even the 3 units dose may be too much. The best thing you can do is set up a spreadsheet with all the data that you have gathered so far, but you can worry about that once we know your kitty is not going to drop too low right now.
 
So far, so good. If you are new to managing your cat's diabetes, you do exactly what you did -- ask for help -- if numbers are below 200 (and you're posting here on Health). We generally recommend that you ask for help before shooting. Since you've shot, it's important to be able to monitor your cat's blood glucose (BG) numbers so you know that the numbers aren't dropping below 50. There is information in this note on Shooting & Handling Low Numbers.
 
I agree with Tuxedo Mom. Right now, we need to make sure your cat stays in safe numbers. I would test again at +4 and if he is lower than the last test, I would try some higher carb food to get him up again. How much depends on how low he is. I will only be here another hour before leaving for work, but others will help you along.

We often find that vets are not familiar with the longer acting human insulins like Lantus and Levimir.
Dosing for Lantus is based on how low the sugars go, not what the pre shot test is, or how high they bounce (go high after going low).

I'll watch for your next test.

Lantus 3.0 units Human meter:

PS 4.9 (88US)
+1.5 6.0 (108 US)
+3 4.2 (76 US)
 
now measurement is 4,5 mmol/l (maybe because before she was sleeping but now she is awake)...do you have any idea what should i do in the evening if her glucose level will be still around 5?
 
now measurement is 4,5 mmol/l (maybe because before she was sleeping but now she is awake)...do you have any idea what should i do in the evening if her glucose level will be still around 5?

Thank you. So the 4.5 (81 US) was done at +3.5 hours after the shot? When was the last time you gave some food? The numbers are holding flat so that is a good sign.

As far as the evening shot we will get some more information from you and hopefully get a spreadsheet set up. It will depend on what the numbers do now and in the time just before the next shot is due.


Summarizing:

Lantus 3.0 units Human meter:

PS 4.9 (88US)
+1.5 6.0 (108 US)
+3 4.2 (76 US)
+3.5 4.5 (81 US)
 
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And we were at 4 unit just last week and it was ok. max 13 mmol/l and min 7mmol/l. i dont know what is going on....
Your cat may be heading for remission. While you've been giving your kitty insulin the pancreas has had a chance to rest and it may be recovering some of its function. It is fantastic that you're home testing. You are doing a great job of monitoring her. :)

et told me that i must give her insulin (last time when i didnt gave her insulin because of that low numbers, her glucose level raised rally high (20mmol/l))
It's impossible without more data to give a really solid answer to this. However, given that your kitty's blood glucose levels seem to be improving so much (getting into the normal range) her liver may be getting a bit 'nervous'. It hasn't seen normal numbers for a while so it might have (wrongly) thought BG was too low and consequently released too much glucose into the bloodstream to compensate and that's a possible reason for why her BG rocketed up to 20mmol/L. It's a phenomenon we refer to here as 'bouncing'.

Question: Has your cat recovered from any illness or infection recently?


Mogs
.
 
i m not totally new. we try to manage our cat diabetes since january. But her glucose level was until this week too high. i dont know what is going on now or how to act in this case.
 
If he does not earn a reduction today, I would try to get a test about 1 hour before shot time, and post that number and ask for advice.
 
So...yes 3,5 hours after insulin she have 4,5 mmol/l. She ate in the morning (at 7.30) Now i will give her lunch. Thank you all for helping me. i was completly frustrated...
 
It might be better not to give her too much to eat for her lunch. You need to make sure that she is not too full-up. If her numbers were to head for the low side later in the cycle you'll need to use food to steer her safely through the rest of the cycle.
 
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Welcome Sara and Tačka :bighug:

You are doing a great job of treating and monitoring your kitty.

You should still do another test at about +4.5 hour to make sure the numbers are not dropping any more. As CritterMom said it may be that Tačka's pancreas is starting to heal and work on its own at times. Setting up a spreadsheet would be very helpful for both yourself and anyone trying to offer advice. Your vet may even like the sheet since it is very easy to see trends.


Here are the instructions for setting it up:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you have any problems there are people here who can help you with it...I know I needed help when I first set mine up. :)
 
Thank you!
Her lunch is always smaller than breakfast and dinner. She ate about 50g of raw chicken now and she looks good at this time. i have a big problem because i dont have high carbohydrate food at home. Even my "wild" street cats eat meat. i must buy some sort of this food. which you recommend?
 
Thank you!
Her lunch is always smaller than breakfast and dinner. She ate about 50g of raw chicken now and she looks good at this time. i have a big problem because i dont have high carbohydrate food at home. Even my "wild" street cats eat meat. i must buy some sort of this food. which you recommend?


Any sort of wet food with gravy or sauce will be higher carb. Also in case the numbers should drop too low it is good to have some honey or syrup on hand...just in case.
 
+4.5 hour 3,6 mmol/l! What now?

Summarizing:

Lantus 3.0 units Human meter:

PS 4.9 (88US)
+1.5 6.0 (108 US)
+3 4.2 (76 US)
+3.5 4.5 (81 US)
+4.5 3.6 (65 US)

Did you feed some of the regular food in the last hour? The numbers are still dropping and could for the next couple of hours. You could give a bit more regular food...maybe another teaspoon... and retest in 1/2 hour and repost the number. You don't want the numbers to drop much further than the 3.6 (65US), but they are still safe numbers right now.

Friskies with gravy would be a good food to use for high carb if that is available there.
 
one hour ago i gave her 50g of raw chicken. now i remembered that i have some chip canned food at home (coshida) should i give her that?
 
one hour ago i gave her 50g of raw chicken. now i remembered that i have some chip canned food at home (coshida) should i give her that?


I would try giving a teaspoon of regular food and retesting in another 1/2 hour to 1 hour. The numbers are really good right now and I don't know if the coshida is a high carb food. As long as the numbers don't drop much more this is a very good range for her to be in and it would be best not to use a higher carb at this point unless they drop more. This is a perfect range of healthy numbers for your Tačka to be in.

All the testing you got today will give great information for your spreadsheet!
 
Oky. Now she ate a little bit of chicken. +5 3.8


Summarizing:

Lantus 3.0 units Human meter:

PS 4.9 (88US)
+1.5 6.0 (108 US)
+3 4.2 (76 US)
+3.5 4.5 (81 US)
+4.5 3.6 (65 US)
+5 3.8 (68 US)

She seems to be holding the numbers fairly well at this point. Lantus generally will have a nadir (lowest number) between +4-+7 hours depending on the kitty. You might want to give a little bit more of her regular food and test again in 1 hour. At this point she is doing a great job of "surfing" the healthy numbers and you are doing a great job of monitoring :)
 
This is the link for setting up a spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

You would use this format:

https://drive.google.com/previewtemplate?id=1JQ136YHkxNhhku9AML_OKGHkrg3Ixe27BWAdWONlnP0&mode=public

in which you can enter the numbers in mmol/L which is the measuring system your meter uses and it will convert on another tab to the US format which is what most of the members here use since they are in the States. That way you will have numbers you ( and I as well) understand and the US members will have numbers they understand so that anyone can help with advice:


If you have trouble setting it up just let us know and there are some members here who are great with spreadsheets. The spreadsheet really helps to see how well the insulin is working and the trends in the daily numbers. With the colour coding it makes it very easy to follow and make decisions on dosing.
 
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