newby and hypo type reaction

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Jessica Martonik

Member Since 2017
my 12yr old baby boy lucian just startus 3u bid lantus. this morning. hes been running 308-346 last few days @+6 hrs post am injection. this morning at breakfast dose he was 223. dr said up to 4u but if 250 stay at 3u. acting slow n just plain off. agraid of the world n walking slow. although numbers arent low he was acting like hypo symptoms. he also has lung cancer for 7 months and is on prednisolone 2.5mg each am. hes acting better now but im worried about him. too new to this and wantimg to know if anyone out there has gone thru something like this. seems a bit better now after eating but concerned he'll drop again. any suggestions? i left a message for his vet already too.
 
Feed some higher carb food. Cats can be symptomatic even if not in hypo numbers because their bodies are perceiving it as a hypo. 3 and 4 units are WAY TOO MUCH.
How long ago was he diagnosed?

Your vet frankly sucks at dosing!!! A newly diagnosed cat should only be dosed at 1 unit, and raised In 0.25 increments.

Please keep testing. Can you retest and post the number?
Are you using a human or pet meter?
 
problem testing alone. he wont let me at all . i can only do w my husband who just left for work. going to have to wing it n watch him. i just want to cry.
 
Many times too much insulin can look like not enough. When the dust settles this morning we will get you set up with one of our spreadsheets and help you devise a plan for an appropriate dose.
 
Jessica Martonik said:
problem testing alone. he wont let me at all . i can only do w my husband who just left for work. going to have to wing it n watch him. i just want to cry.
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Don't panic. It's OK! Is your cat difficult to test? Squirmmy?

Do you have any food higher carb then the dm?

Don't feed too much at once.... If you need to continue to steer you don't want him to fill up.

Maybe give a tablespoon of the dm but add a few drops of honey or Karo syrup or maple syrup to it.
 
How long ago was the injection? Just to be clear you have 3 units this morning, not 4, correct?
 
thank you!! he just came out. perkier than before. gave a lil laro w 1tbs wet dm. hes verbal again n much better. on the mend. still scared. watch all day i guess huh?
 
Dry food is a little longer acting but takes a while to kick in. You could give him a tablespoon of the dry.
 
If your cat is hard to test it may be that you guys are accidentally poking the vein which is causing him pain and that's why he's resistant. Make sure you are testing on the edge and not hitting the vein. Also be sure to give allow carb treat after each test so he associates the test with a treat.
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we always treat after good behavior. works well. he looks for the treat. thanks for the diagram. that may be our problem w the bg...not in the sweet spot.
 
To make testing a bit easier, use a sock filled with rice and warmed in the microwave (I warm mine for 20 seconds). Hold it on Lucian's ear for a few seconds, it will help bring the blood to the surface to make testing quicker.
 
Because there are people from across the world on this board, we refer not to times but to hours since injection. So for example if you gave insulin at 8:00 your time and it's now 9:00 your time, you could refer to it as +1
 
thanks for the tip. I'll definitely try that. hes a pretty good bleeder. just not a fan of bg at all. loves the,treats after tho. he seems to be improving. still a lil slow moving but alert n verbal n perky. more himself. this is so very nerve racking. i thought the cancer was bad but tjis is so much more intense.
 
Jessica Martonik said:
thanks for the tip. I'll definitely try that. hes a pretty good bleeder. just not a fan of bg at all. loves the,treats after tho. he seems to be improving. still a lil slow moving but alert n verbal n perky. more himself. this is so very nerve racking. i thought the cancer was bad but tjis is so much more intense.
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It's less intense when he's not getting too high a dose. ;).

Moving foward please Do no more than 1 unit twice a day until you have more data.
 
we have a 24hr vet 10 min away if needed. just tried to do bg he scratched ran n hid. no good. but hes acting much better now. going to watch him closely n see if my husband can come back home to retest. if not I'll try again when hes calmed down. cant stress him too much or coughing will start and all will be worse. my friend is a vet tech so im calling her too.
 
Jessica Martonik said:
we have a 24hr vet 10 min away if needed. just tried to do bg he scratched ran n hid. no good. but hes acting much better now. going to watch him closely n see if my husband can come back home to retest. if not I'll try again when hes calmed down. cant stress him too much or coughing will start and all will be worse. my friend is a vet tech so im calling her too.
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Ok. I'm glad he's acting more normal.
 
So this is a link to the spreadsheet we use here. It's so helpful because it allows us to share our data with each other so others can offer dosing advice. The spreadsheet updates on real time so as soon as you enter numbers, everyone can see it. It's a Google Sheets document. It's easiest to do on a computer but you can also use a tablet or phone.

Then we share with a link in our signature.

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


To set up a signature click on your name in the upper right corner, select signature. Add info such as your pets name, date diagnosed, insulin type, other health concerns, food you're feeding, and type of meter.


I saw you use alphatrak. I do too... But the strips are really expensive. The cheapest place for them I've found is amazon (although the price fluctuates) and Adwdiabetes.com with a $5 off coupon code.


If this meters price becomes prohibitive, most on the board use a human meter such as Walmart brand Relion Micro or Confirm for which the strips are only $36 for 100. Human meters run lower then pet meters but will still tell you if your cat is high or low.
 
There are a couple of things jumping out at me.

1. Lantus builds up a depot which takes a few days to fill. The first week insulin is started dose should not be raised. 4 units is to much, 3 is probably to much.

2. Lucian is receiving prednisone which can or will raise glucose level. Something you will have to adjust the dose around once more data is collected.

3. Home testing. Try to find 2 times a day hubby will be home to help you test. 6am / 6 pm or 5am / 5pm etc. You can change times later when Lucien is more cooperative.

4. Keep his food the same for now until you can test consistently. Any change such as removing dry if that is what he is used to will create a hypo episode. You can change food safely once you can test regularly.

5. Lucian has lung cancer, I'm so sorry to hear this part. It can make treating the diabetes tricky, you certainly do not want aggravate it. Be cautious and go slow .
 
@ woodswife , thank you for the insight. my husband and I feel the same- that 3 may be too much for him right now. it seems to be the general opinion of others as well. we'll do the pmps tonight and take it from there with his other vet on dosing. there are 3 in his hospital and the one that put him on 3u bid i'm not so keen on. Lucian takes his pred every morning and cerenia almost daily (or every few days depending on cough) so they say it definitely increases his sugar level. my husband and I have been texting/talking all morning. he's trying to get home asap from work but we will have to start to test Lucian 2xs a day. figuring out when until we get Lucian more comfortable with it is going to be key. for all his issues he a loving and strong lil boy. we just want to make his days as comfortable , safe and happy as we can for as long as possible. off to do research on lantus, cycles, and all else I can start to read. i'll post an update after we do the pmps and see what vet says. thanks again! mean so much to know i'm not alone. this site is amazing!
 
Jessica, your husband doesn't have to rush home unless it's time to give insulin. Being that insulin is given every 12 hrs, the 2 most important tests are immediately prior to giving the insulin so you know it's safe to give. For right now I would suggest testing 30-15 minutes before dosing and post here to see what dose to go with.

Then since Lantus is dosed on how low kitty goes during the 12 hr cycle, you want to get a test in somewhere around 5-7 hrs after the shot. Of course the more data there is is best, but you need to get the most critical times in. Once the routine is established and comfortable for everyone, you can build from there.
 
any ideas on how long he can take to be back to himself. he's better than earlier but a bit slow still. he's usually napping at this time of day anyway but since I can't test until my hubs gets home just not sure what else to look for to know hes continuing to improve. can he drop again before pmps? or are we possibly out of the woods as far as that for now? no one might have the answer but it cant' hurt to ask.
 
There isn't an easy answer to that except a test to see what his sugar is. As they say every cat is different. Some show symptoms some don't. With his other condition it take awhile to feel better. Diabetes alone it can take time to feel better. Since his symptoms could have been an episode of to much insulin, keep an eye on his lethargy, walking, any drooling, staggering, woozy, etc. You can provide very small snacks like a teaspoon of wet food every hour if you want. Do not feed 2 hours before insulin shot, you do not want the test food influenced. Most kitties do better on more frequent feedings throughout the day.
 
PM PRE SHOT IS 448 . AM PRE SHOT WAS 223. Waiting for vet to call now about what to dose to do. Yesterday +6 am shot was 308. i'm so confused and scared. just wanted to give update. he's much better overall now. probably because his sugar is so high. could this be rebound or just the food from during the day to keep his sugar up?
 
Jessica Martonik said:
PM PRE SHOT IS 448 . AM PRE SHOT WAS 223. Waiting for vet to call now about what to dose to do. Yesterday +6 am shot was 308. i'm so confused and scared. just wanted to give update. he's much better overall now. probably because his sugar is so high. could this be rebound or just the food from during the day to keep his sugar up?
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Hello Jessica :)
This sounds like a bounce to me. Which is why the pm reading is higher. Unfortunately your vet will likely tell you to raise the insulin, problem is this number isn't a true reading.
If it were me and it was the first week, I'd be staying on a lower dose until I had some information on how his cycles are.

Is it possible you can ask you vet why they chose that starting dose? If it's by weight (my vet did this and my cat hypoed) then they are treating your cat like a dog and he's not.. cats usually start on the lowest dose and work gradually up until they can have 2 safe preshot numbers am and pm.
 
for tonight I gave him the 3u but want to check him again in the amps and see where he is. the dr says I did the wrong thing today in feeding him over the day. his sugar was never going to drop and by feeding him I made his sugar rise to 448 pmps. to say the least she was not super nice and made me feel like a bad parent and irresponsible. did I not understand how the insulin works and read the info they gave me, etc. I know i'm not a bad parent and i'm just nervous and concerned. just want to do the right thing. we're going to check him morning and night each day and see how he does over the next few days. on the weekend when we're both home we can do the am, mid day, and pm test to see how he does. dr also says his episode this morning had nothing to do with his sugar levels and must be something else entirely. I just don't think that's the case here but time will tell. horrible day. but my babe is feeling better and now I have a better idea all around as to what to do. at a minimum we'll do amps/pmps and see where that takes us for him. fingers crossed! sometimes vets are uncompassionate jerks.
 
TempestsMum said:
Hello Jessica :)
This sounds like a bounce to me. Which is why the pm reading is higher. Unfortunately your vet will likely tell you to raise the insulin, problem is this number isn't a true reading.
If it were me and it was the first week, I'd be staying on a lower dose until I had some information on how his cycles are.

Is it possible you can ask you vet why they chose that starting dose? If it's by weight (my vet did this and my cat hypoed) then they are treating your cat like a dog and he's not.. cats usually start on the lowest dose and work gradually up until they can have 2 safe preshot numbers am and pm.
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that was my thought too. they say they chose this does because he was high bg 400+ and on prednisolone they are worried about insulin resistance. they said to increase to 4u but i'm holding at 3u for now because it's likely not a true reading and 4u increase could be damaging this early on. I will check amps/pmps each day and go from there. he may not even need 3u but time will tell. I will keep a close eye on him. so stressful and they were not super helpful. hes 13lbs. i'm so tense. just need to try to decompress and readjust.
 
Jessica Martonik said:
that was my thought too. they say they chose this does because he was high bg 400+ and on prednisolone they are worried about insulin resistance. they said to increase to 4u but i'm holding at 3u for now because it's likely not a true reading and 4u increase could be damaging this early on. I will check amps/pmps each day and go from there. he may not even need 3u but time will tell. I will keep a close eye on him. so stressful and they were not super helpful. hes 13lbs. i'm so tense. just need to try to decompress and readjust.
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I'm concerned about that dose, especially if you suspect he hypoed earlier. This is why people recommend starting low. When a cat hypoes they can be sensitive to insulin and need less for a bit. Especially if you can't test... better he be too high for a time than too low for a moment.
Are you able to test at least +2 or 3 just to see where he's at and I'd definitely want to see nadir just to be on the safe side..?
 
I think his body felt it got lower than it has and so it had a hypo like reaction. but at 223 he was still in a good range. i'm keeping an eye on him and planning to test in a few hours close to nadir just to see where he is. If back to lower levels tomorrow at amps will plan to potentially reduce the dose and go from there. I think we need a few days under our belt and to see his pattern before we'll really know how his body reacts to the insulin. we have an e-vet on call if we need in a pinch. hoping all goes well and we don't enter that territory. been there before with other things. frazzled at the moment but planning to start the spreadsheet tomorrow. good way to track data for him. and good for feedback too.
 
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