HYPOGLYCEMIC - NEED HELP PLEASE

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Tritt3180

Tritt3180

Member Since 2017
Hi friends! I hope someone is awake to help me out...

Ringo went hypoglycemic tonight for the first time. He seems to be acting normal other than very thirsty. Below is how the night has gone since his PMPS:

"P: (1702) Glucose 269mg/dl on a ReliOn glucometer; 1 can I/D (100%); zofran; 2 units pvi; thirsty; @2141 34mg/dl - attempt to syringe feed honey unsuccessful; 1/2 can DM given immediately after mid-check @2141; recheck @2216 51mg/DL (15min after eating ~30% of DM and rubbing a drop of honey on his lip/gums); small hand full Blue Wilderness ""Mature"" given and ate a few pieces immediately before 2216 check; 1/2 cup DM kibble replaced with 1 cup Blue Wilderness kibble in kitchen and 1/2 cup in bedroom; @2230 50mg/DL; @2247 48mg/DL; @2300 60mg/DL; @2317 47mg/DL; @2330 ""Hi""; @2332 68mg/dl; @2335 73mg/DL; @0000 67mg/DL; @1234 74mg/dl; @0055 59mg/dl; @0115 48mg/dl; @0131 42mg/dl; @0145 46mg/dl; @0202 39mg/dl "

I've been putting honey on his gums almost every 15 minutes, or after each check when he won't eat anything else. I tried giving g him some warm milk even after the last check.

I've tried to follow the hypoglycemic outline best I could with what I have. I don't have any suppositories. He is walking around normal even. What else can I do until my vet opens?
 
Critter Mom said:
What time did you give insulin and what dose?
Click to expand...
I gave him 2 units of pvi at 1730 for a glucose of 269. Normally he's OK. The AMPS was 280 and he got 2 units piv then, too.

I have the dog food he used to eat, but he hasn't gone near it since being home. He's smelled it, but then walked away. I'll open a can and try it.

Just checked him again and its 60mg/DL.
 
PMPS: (HUMAN METER READINGS)

1702 - 269 - 1 can I/D (100%); zofran; 2 units pvi [ED: PZI insulin???]; thirsty;
2141 - 34 - attempt to syringe feed honey unsuccessful; 1/2 can DM given immediately after + drop honey on gums
2216 - 51 - (15min after eating ~30% of DM canned and rubbing a drop of honey on his lip/gums); sm handful Blue Wilderness Mature given / ate few pieces immed bfe 2216 check; 1/2 cup DM kibble replaced with 1 cup Blue Wilderness kibble in kitchen and 1/2 cup in bedroom;
2230 - 50 - honey given
2247 - 48 - honey given
2300 - 60 - honey given
2317 - 47 - honey given
2330 Hi [ED: possible duff strip?] - honey given
2332 - 68 - honey given
2335 - 73 - honey given
0000 - 67 - honey given
0034 - 74 - honey given
0055 - 59 - honey given
0115 - 48 - honey given
0131 - 42 - honey given
0145 - 46 - honey given
0202 - 39 - honey given
0230 - 55 - honey given

0249 - 60 - PM+9

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Hang in there. You've done really well to keep his numbers up so far (and this is not an easy situation).

I'm relieved to read that he's now quite well along in the cycle at +9 hrs after PM dose.

>>> If you have any food with gravy, squeeze the gravy off and give Ringo a few teaspoons of it. Slather it on his gums if you have to.

>>> Please then confirm that you've given him the gravy (and the time, too). If you haven't got gravy food tell me straight away.

.
 
That is a lot clearer than mine. Thank you,and sorry it was so jumbled... Typing in a hurry. But yes, PVI insulin, and the HI I believe was a false reading, which is why I took it again.
 
His 0305 glucose was 46mg/dl.

I tried the gravy from the dog food he used to eat. Have to try and remelt it. He fought me. But I got a little on at 0307. Going to melt the rest and try again before the next check. I also put more honey on his gums.
 
Haven't a clue about the beefaroni. Best stick with the cat food and honey.

>> What's the HIGHEST CARB wet cat food you have in the house?

>> Just so I know your situation better, how far away are you from the nearest emergency vet?

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I have DM pate by Purina. I checked his PMPS at 1702, so after he ate... No later than 1730 for the pzi. I am about an hour from the nearest emergency vet. I have a Walmart about 15 min away. I can run and get something else - even gravy. Would just take about a half hour to 45 min to get back home and check him again.
 
The DM is the only wet good we have. I gave him the Blue Wilderness dry food. Its for mature cats, but was the closest we could get without a prescription card in the beginning.
 
(HUMAN METER READINGS)

AMPS: 280 - Dose: 2.0IU PZI

PMPS:
1702 - 269 - 1 can I/D (100%); zofran; 2 units pvi [ED: PZI insulin???]; thirsty;
2141 - 34 - attempt to syringe feed honey unsuccessful; 1/2 can DM given immediately after + drop honey on gums
2216 - 51 - (15min after eating ~30% of DM canned and rubbing a drop of honey on his lip/gums); sm handful Blue Wilderness Mature given / ate few pieces immed bfe 2216 check; 1/2 cup DM kibble replaced with 1 cup Blue Wilderness kibble in kitchen and 1/2 cup in bedroom;
2230 - 50 - honey given
2247 - 48 - honey given
2300 - 60 - honey given
2317 - 47 - honey given
2330 Hi [ED: possible duff strip?] - honey given
2332 - 68 - honey given
2335 - 73 - honey given
0000 - 67 - honey given
0034 - 74 - honey given
0055 - 59 - honey given
0115 - 48 - honey given
0131 - 42 - honey given
0145 - 46 - honey given
0202 - 39 - honey given
0230 - 55 - honey given

0249 - 60 - PM+9
0305 - 46 - PM+9.25 - gave sm amt gravy from dog food + honey
 
Don't leave the house to go to Walmart - he's not holding up his numbers long enough to stay safe till you get back.

>> How long is it since Ringo ate any kibble? Was it DM or Blue Wilderness.

>> What is the carb value of Blue Wilderness kibble?

.
 
(HUMAN METER READINGS)

AMPS: 280 - Dose: 2.0IU PZI

PMPS:
1702 - 269 - 1 can I/D (100%); zofran; 2 units pvi [ED: PZI insulin???]; thirsty;
2141 - 34 - attempt to syringe feed honey unsuccessful; 1/2 can DM given immediately after + drop honey on gums
2216 - 51 - (15min after eating ~30% of DM canned and rubbing a drop of honey on his lip/gums); sm handful Blue Wilderness Mature given / ate few pieces immed bfe 2216 check; 1/2 cup DM kibble replaced with 1 cup Blue Wilderness kibble in kitchen and 1/2 cup in bedroom;
2230 - 50 - honey given
2247 - 48 - honey given
2300 - 60 - honey given
2317 - 47 - honey given
2330 Hi [ED: possible duff strip?] - honey given
2332 - 68 - honey given
2335 - 73 - honey given
0000 - 67 - honey given
0034 - 74 - honey given
0055 - 59 - honey given
0115 - 48 - honey given
0131 - 42 - honey given
0145 - 46 - honey given
0202 - 39 - honey given
0230 - 55 - honey given

0249 - 60 - PM+9
0305 - 46 - PM+9.25 - gave sm amt gravy from dog food + honey
0315 - 48 - ???
0333 - 59 - PM+10 - honey given after [OTHER TESTS AT THIS TIME: 0330 - 98 (error?); 0331 - 61 - working off lowest result as safety precaution]

.
 
I have old treats, but he won't eat anything he used to eat. He likes cheese...

0330 98mg/DL
0331 61mg/DL
0333 59mg/DL honey on gums

0350 54mg/dl
 
Please confirm the TIME that Ringo last had:

>>> DM Kibble - and how much of it he ate.

>>> Blue Wilderness - and how much of it he ate.

>>> DM wet paté - and how much of it he ate.

(Need to really understand this in detail so I can get a better picture of what's happening and have a better idea of what to feed and when - don't want to risk filling Ringo up and him not eating anything at all.)

.
 
FDC1AB36-88C2-4088-8779-118712215A6C.png
The blue buffalo should be about 22% carb so that's the one to feed to get the numbers up
 
@JanetNJ -

The guaranteed analysis on the Blue Wildnerness page is incomplete (no figure for crude ash).

Guaranteed Analysis (from manufacturer website)
Crude Protein 38.0% min;
Crude Fat 14.0% min;
Crude Fiber 5.0% max;
Moisture 10.0% max;
Magnesium 0.14% max; Taurine 0.15% min; Omega 3 Fatty Acids* 0.5% min; Omega 6 Fatty Acids* 3.5% min

As best I can guestimate using the Scheyderweb calculator it comes out in the 20-30% range (using a nominal value of 5% or 10% crude ash). I doubt if it's less than 20%. Do you think this is a fair guestimate?

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DM kibble: maybe a bite here and there between 1/13 and 1/14. Prior, he had eaten >1/2 cup in a day. It us left out to graze, and that he does - sometimes more than others.

BW: I changed out the kibble after 2216 check. He only ate a few pieces after the 2216 check.

DM pate: 1/2 can given at 2145. He ate about 30%.
 
Looks like Ringo hasn't eaten enough this cycle.

How's his nausea been during this cycle?

What dose of Zofran did you give him at PMPS?

Which food do you think he would be more likely to eat right now (DM paté or BW kibble)?

.
 
(HUMAN METER READINGS)

AMPS: 280 - Dose: 2.0IU PZI

PMPS:
1702 - 269 - 1 can I/D (100%); zofran; 2 units pvi [ED: PZI insulin???]; thirsty;
2141 - 34 - attempt to syringe feed honey unsuccessful; 1/2 can DM given immediately after + drop honey on gums
2216 - 51 - (15min after eating ~30% of DM canned and rubbing a drop of honey on his lip/gums); sm handful Blue Wilderness Mature given / ate few pieces immed bfe 2216 check; 1/2 cup DM kibble replaced with 1 cup Blue Wilderness kibble in kitchen and 1/2 cup in bedroom;
2230 - 50 - honey given
2247 - 48 - honey given
2300 - 60 - honey given
2317 - 47 - honey given
2330 Hi [ED: possible duff strip?] - honey given
2332 - 68 - honey given
2335 - 73 - honey given
0000 - 67 - honey given
0034 - 74 - honey given
0055 - 59 - honey given
0115 - 48 - honey given
0131 - 42 - honey given
0145 - 46 - honey given
0202 - 39 - honey given
0230 - 55 - honey given

0249 - 60 - PM+9
0305 - 46 - PM+9.25 - gave sm amt gravy from dog food + honey
0315 - 48 - ???
0333 - 59 - PM+10 - honey given after [OTHER TESTS AT THIS TIME: 0330 - 98 (error?); 0331 - 61 - working off lowest result as safety precaution]
0350 - 54
0400 - 57

.
 
Yikes! What a night!

So, it looks like he's now had three readings (0333 59, 0350 54, 0400 57) over 50. I don't know PZI action (though this cycle strikes me as unusual) and I can't access your spreadsheet for some reason so I don't want to jump in with advice here, but I think that's a good sign!
 
@JanetNJ -

For info, Ringo has had nausea issues (hence the Zofran).

Bearing in mind how hard it has been to keep his numbers up this cycle with honey I am waiting to hear back from @Tritt3180 to see what he's most likely to eat (and whether he can get another dose of meds).

The DM wet food with a little honey mixed through would probably get carbs into his system faster than the kibble and get his numbers up a bit more. Some dry kibble after that might keep them up better. It would be easier to assist feed the wet food if that's required to get some food into Ringo right now.

.
 
Critter Mom said:
@JanetNJ -

For info, Ringo has had nausea issues (hence the Zofran).

Bearing in mind how hard it has been to keep his numbers up this cycle with honey I am waiting to hear back from @Tritt3180 to see what he's most likely to eat (and whether he can get another dose of meds).

The DM wet food with a little honey mixed through would probably get carbs into his system faster than the kibble and get his numbers up a bit more. Some dry kibble after that might keep them up better. It would be easier to assist feed the wet food if that's required to get some food into Ringo right now.

.
Click to expand...
Exactly. Honey with a kibble chaser.
 
He had been off his zofran for 3 days before I got more. The vet closest to us ordered it online, but it isn't here yet. His other vet farther away had it in stock and we got some, but not until he vomited at home on 1/10. I got the zofran and started it that night twice/day. He is on 2mg q12°. I don't remember the exact time I gave it though. I just wrote down I gave it. He still sometimes makes the gagging face if i push him to eat a lot for his insulin. He won't eat anything. I have all the food out right now, and he just turns his nose up to it. I have homemade chicken soup in the fridge... Maybe he'll eat that?

0415 109mg/DL right ear
0416 78mg/DL right ear
0417 73mg/DL right ear
0418 73 mg/DL left ear
 
Critter Mom said:
@JanetNJ -

For info, Ringo has had nausea issues (hence the Zofran).

Bearing in mind how hard it has been to keep his numbers up this cycle with honey I am waiting to hear back from @Tritt3180 to see what he's most likely to eat (and whether he can get another dose of meds).

The DM wet food with a little honey mixed through would probably get carbs into his system faster than the kibble and get his numbers up a bit more. Some dry kibble after that might keep them up better. It would be easier to assist feed the wet food if that's required to get some food into Ringo right now.

.
Click to expand...
His zofran was around 1700, so he'll be due at 0500. I'll give it asap!
 
Nan & Amber said:
Yikes! What a night!

So, it looks like he's now had three readings (0333 59, 0350 54, 0400 57) over 50. I don't know PZI action (though this cycle strikes me as unusual) and I can't access your spreadsheet for some reason so I don't want to jump in with advice here, but I think that's a good sign!
Click to expand...
The peak for pzi is @ 6hours post administration. He got it no later than 1730 last night. He would be due at 5:30 this morning if his numbers were high enough.
 
Give the Zofran now and syringe a little water to get it down OK.

>>> DEFINITELY HOLD OFF ON THE INSULIN - he's too low to give any more!!!!


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Also:

>> Do you have a feeding syringe in the house?

>> Do you have any appetite stimulant meds in the house? (Cyproheptadine or mirtazapine)

.
 
He's drinking on his own fine. He won't let me put a syringe near his face. I definitely won't give him any insulin this morning! I will have to go to work, though, and leave in 3 hours... His vet (far away) opens at 0630, so I'll have to leave in 2 to get there in time. I have him mirtazipine on 1/13 in the morning.
 
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