Help, maybe? BG 47

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Toulouse & O’Malley

Toulouse & O’Malley

Member Since 2018
Hi all, I’m very new here. I just posted an intro post last night and also this post in the main health: http://www.felinediabetes.com/FDMB/threads/question-about-first-ever-test.191793/

Last night Toulouse tested 99, and then 124, so I skipped his insulin for the evening. I tested him this morning three times and got 200 (7:45), 208 (8:06), and 278 (8:23). He was eating and acting normal, playful even, so I gave him 1u of PZI after I got the 278 (around 9 am). Tested 3 hours later (11:59) and he was at 42! I gave some more food and a few forbidden treats, and tested 15 mins later (12:17), and he was at 47. I think he seems okay, no symptoms, but am obviously worried. He is resting, which makes it hard to tell, but I think maybe it’s just because he’s a cat and it’s mid-day. He’s grooming himself now, and eats when I put small amounts of food in front of him, but isn’t ravenous and seeking out food. I have Karo, but am hesitant to give any if he seems to be acting okay. I will test again soon.
 
You still have a few hours ahead before you reach the typical PZI nadir (lowest BG) time. You did the right thing giving some carbs. Here’s the drill:
  • retest in 30 minutes after that 57 result
  • if he’s dropped again, give a teaspoon or so of gravy from high carb wet food or add a little karo to a tsp of regular low carb food
  • wait 30 minutes and retest
  • if he’s still below 50 repeat the high carb snack
  • if he’s above 50 withhold snack, wait 30 minutes and retest
  • if he’s holding above 50 still, no snack, wait an hour and retest
  • if he’s dropping again, back to carbs snack, wait, retest
  • after a couple of uneventful tests an hour apart he should be out of the woods.
Drop his dose down to 0.5 u tonight. It can always be increased later.
 
Kris & Teasel said:
You still have a few hours ahead before you reach the typical PZI nadir (lowest BG) time. You did the right thing giving some carbs. Here’s the drill:
  • retest in 30 minutes after that 57 result
  • if he’s dropped again, give a teaspoon or so of gravy from high carb wet food or add a little karo to a tsp of regular low carb food
  • wait 30 minutes and retest
  • if he’s still below 50 repeat the high carb snack
  • if he’s above 50 withhold snack, wait 30 minutes and retest
  • if he’s holding above 50 still, no snack, wait an hour and retest
  • if he’s dropping again, back to carbs snack, wait, retest
  • after a couple of uneventful tests an hour apart he should be out of the woods.
Drop his dose down to 0.5 u tonight. It can always be increased later.
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Thank you so so much for your help! I was worried about him being so low with nadir possibly still hours away. He is up to 75 now!
 
Kris & Teasel said:
Baptism by fire! o_O Make sure you drop his dose to 0.5 u tonight. It seems 1 u is too high and after low numbers like today’s they can be more insulin sensitive.
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Thank you! I will definitely drop him to 0.5u tonight. To be honest, I’m a little paranoid to give him any, after this morning’s numbers, but I’m just a natural born worrier anyway. I work full time and am usually gone all day, and I’m afraid of not being here if this keeps happening. I will try to do some tests overnight tonight though, after trying him at 0.5u, and see how he does with that. I do have to go back to work tomorrow. :( I’m definitely thinking it’s probably a good idea to keep his dose lower for now, until I’ve got more testing under my belt and more information on what’s typical for him. Poor guy I feel so bad for constantly pricking his ears. He’s been pretty good though, except for first thing this morning when he really wanted his breakfast.
 
His BG levels haven’t been all that high even at diagnosis. If he eats only low carb wet food he might need only a tiny dose and maybe not for long. Is he getting any kibble at all? I ask because removing that from his diet can have a significant lowering effect on his BG.

Try 0.5 u tonight and aim to get a test or two in this evening with the last one just before your bed time. Those plus your AM pre shot test tomorrow will tell us whether he needs even less than 0.5 u or no dose at all. The next lower dose would be an eyeballed 0.25 u. If you have half unit marks on your syringes that’s not too hard to do.
 
Kris & Teasel said:
His BG levels haven’t been all that high even at diagnosis. If he eats only low carb wet food he might need only a tiny dose and maybe not for long. Is he getting any kibble at all? I ask because removing that from his diet can have a significant lowering effect on his BG.

Try 0.5 u tonight and aim to get a test or two in this evening with the last one just before your bed time. Those plus your AM pre shot test tomorrow will tell us whether he needs even less than 0.5 u or no dose at all. The next lower dose would be an eyeballed 0.25 u. If you have half unit marks on your syringes that’s not too hard to do.
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He does still get some dry kibble. My goal is to get him off of it, but I didn’t want to make too many changes too quickly. As of a month ago, before I got him, he was undiagnosed, and being free fed dry kibble. When I got him he was very thin and I was practically free feeding him canned food, with some access to the dry still. After having him for a week (three weeks ago) he was switched to the low carb canned (DM), and now I’m trying to wean him off of the dry. My vet also started him on the PZI at 1u, and then increased it to 2u, all of this in the past month! Poor guy. In hindsight I think it would have been better to give the low carb diet some time to work, before even starting on insulin. Unfortunately I didn’t know a few weeks ago what I’ve read and learned just in this last week.

Tested at 2:08 (+5 hours) and he’s up to 93!
 
Toulouse & O’Malley said:
He does still get some dry kibble. My goal is to get him off of it, but I didn’t want to make too many changes too quickly. As of a month ago, before I got him, he was undiagnosed, and being free fed dry kibble. When I got him he was very thin and I was practically free feeding him canned food, with some access to the dry still. After having him for a week (three weeks ago) he was switched to the low carb canned (DM), and now I’m trying to wean him off of the dry. My vet also started him on the PZI at 1u, and then increased it to 2u, all of this in the past month! Poor guy. In hindsight I think it would have been better to give the low carb diet some time to work, before even starting on insulin. Unfortunately I didn’t know a few weeks ago what I’ve read and learned just in this last week.

Tested at 2:08 (+5 hours) and he’s up to 93!
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You get him off the dry dm and he may not need insulin at all. Or maybe just a tiny 0.25
 
Kris & Teasel said:
Excellent! It'll be interesting to see what his evening pre shot is. That will determine whether 0.5 u is safe or not.
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He is at 198 at +11 just now. Normally I would be feeding him now and giving him his pm shot about 30 mins later. I’m a little nervous after today’s numbers though to shoot him at 198, even though it would only be 0.5u. I can stall and test again in 15-20 mins. Would it be awful if I skipped again?
 
Toulouse & O’Malley said:
He is at 198 at +11 just now. Normally I would be feeding him now and giving him his pm shot about 30 mins later. I’m a little nervous after today’s numbers though to shoot him at 198, even though it would only be 0.5u. I can stall and test again in 15-20 mins. Would it be awful if I skipped again?
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Tested again 20 mins later and he was up to 242. That seems like a big leap in a short amount of time. He is eating now. I know at that number I should go ahead and shoot him, but I’m still worried.

Is there any chance I’m not testing correctly? I’m doing my best to poke him along the very edge of his ear. Sometimes I get a bigger drop of blood than other times, but if the meter reads it and gives back a number, can I assume it got enough of a sample? His poor ears are looking a bit bruised. I feel so bad for him. :(
 
Toulouse & O’Malley said:
Tested again 20 mins later and he was up to 242. That seems like a big leap in a short amount of time. He is eating now. I know at that number I should go ahead and shoot him, but I’m still worried.

Is there any chance I’m not testing correctly? I’m doing my best to poke him along the very edge of his ear. Sometimes I get a bigger drop of blood than other times, but if the meter reads it and gives back a number, can I assume it got enough of a sample? His poor ears are looking a bit bruised. I feel so bad for him. :(
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It's really not odd to go up that much the last hour as the previous dose wore off.
 
Toulouse & O’Malley said:
Tested again 20 mins later and he was up to 242. That seems like a big leap in a short amount of time. He is eating now. I know at that number I should go ahead and shoot him, but I’m still worried.

Is there any chance I’m not testing correctly? I’m doing my best to poke him along the very edge of his ear. Sometimes I get a bigger drop of blood than other times, but if the meter reads it and gives back a number, can I assume it got enough of a sample? His poor ears are looking a bit bruised. I feel so bad for him. :(
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Will he let you get a sample from his paws, that’s what I do
 
Toulouse & O’Malley said:
His poor ears are looking a bit bruised. I feel so bad for him. :(
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I try to switch ears between each test and places on his ear. I also use neosporin on his ears and apply a little pressure after. It’s amazing how fast cats heal. The other day Diamond’s ears looked like hell too. By the next day they were fine.
 
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