Bob's first (nearly) hypo!

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Tilou

Tilou

Member Since 2018
Apologies in advance for the long post...

Just had a very stressful couple of hours trying to get Bob's BG back up from a potential hypo.

After a good day yesterday - following a few days of illness, including vomiting - he seemed to be back on track to being his usual self. He was even very active this morning and for the first time in months was jumping up onto the furniture.

However, he's also become very aware of what the blood tests are and goes into full feral fighting mode the moment he sees me with the meter, so it's been very difficult to test before his shots. I've basically been winging it, giving his shots (1u Lantus) by monitoring his food and water intake.

Unfortunately today I've been caught out - as Bob hardly ate anything for breakfast and I realised he was very lethargic this afternoon, so much so that he actually didn't react at all when I took a blood test. When the result came out at 5.6 mmol (using Freestyle strips in an AT pet meter, so I understand that the reading might be slightly out) I gave him some of his old favourite food (non-diabetic) to boost his levels up, but he only licked the sauce and wouldn't eat the meat.

As this is the lowest he's been and he was obviously feeling unwell, I also took the extra precaution of rubbing some honey on his gums. But half an hour later when I retested he'd dropped to 5.1.

As he was resisting my attempts with the honey, I made up a solution with water and maple syrup in a feeding syringe and got some into his mouth. The next test showed a slight rise and he was a bit more reactive but didn't want to eat the food I'd given him.

As our other cat has hardly any teeth, I keep a supply of liquid food sachets (although they are mostly protein based, with minimal sugars/carbs), so tempted Bob with some of that - only to have him throw the whole lot up again a few minutes later!

I've now cooked up some chicken and he's eaten about a tablespoon of that. I retested again just over an hour ago and he'd risen to 6.5. He's now sleeping (and snoring!), so I'm going to use my last proper AT strip to get a precise reading of where he's at.

Based on previous readings, he's past his peak time for the 1u he had this morning and I obviously won't be giving him a shot tonight.

Any tips of how to get a poorly cat to eat much appreciated.
 
Not yet. He hasn't been out all afternoon and now its too dark for me to see when he does go out. I'll have to watch him in the morning and follow him to get a urine sample.

His BG is back up to 11.1 and he's kept the chicken down. He's sleeping comfortably at the moment.

I'm going to stay up late and monitor him.
 
Hello Tilou and Bob, ca va?
Just to put your mind at rest - today's numbers were not Hypo, lower, much lower than both of you used to handle, but safe. So, deep breath and relax - you are ok and might even want to reconsider withholding tonight's dose.
 
I understand that must have been scary, when I first saw a 4 for Quintus I freaked out! I just also wanted to add those numbers are not that worrisome on an AT. Not to say low numbers shouldn't be taken seriously, but when I chatted with my vet after that first "low" he told me that really dicey territory is around 2. Again: we take action before that. But knowing how much "wriggle room" there still was allowed me to stop panicking completely when I saw a 3 on the meter. (Look at Quintus's SS, I also use mmol/l and an AT.)
 
Tanya and Ducia said:
Hello Tilou and Bob, ca va?
Just to put your mind at rest - today's numbers were not Hypo, lower, much lower than both of you used to handle, but safe. So, deep breath and relax - you are ok and might even want to reconsider withholding tonight's dose.
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Hello, we are fine - the numbers and Bob's demeanour was a bit frightening. I was also worried about the numbers being lower as I was using the cheaper Freestyle strips. Bob's now gone out after having some more chicken. Yes, I'll be withholding his dose tonight.
 
Are you following SLGS or TR or haven’t decided yet? Are you feeding any dry food? On an AT the number to be concerned is 68 (US). I don’t know what that is on the world chart. Any number than you are used to is unsettling though. Are you giving a treat adter each test? That can help when eating well. If his appetite picks up I might reconsider skipping tonight depending on the PMPS number.
 
Stephanie & Quintus said:
I understand that must have been scary, when I first saw a 4 for Quintus I freaked out! I just also wanted to add those numbers are not that worrisome on an AT. Not to say low numbers shouldn't be taken seriously, but when I chatted with my vet after that first "low" he told me that really dicey territory is around 2. Again: we take action before that. But knowing how much "wriggle room" there still was allowed me to stop panicking completely when I saw a 3 on the meter. (Look at Quintus's SS, I also use mmol/l and an AT.)
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We did panic - which was strange because DH is diabetic and has hypos regularly, but of course he's more easily dealt with than a cat, lol.

Thanks for the heads up re the numbers. Because I'm using the Freestyle strips I was concerned the readings weren't spot on and his BG was perhaps lower than the readings.

My main concern now is Bob's vomiting and not eating. I suspect a fur ball, but I think it'll be a trip to the vet if he's not over it on Monday.
 
Bob was in perfectly safe numbers today. Thought lower numbers than he is used to, so might have felt "off" for that reason. The take action number on an AT is 68 (US) or 3.8 (World). I would NOT withold insulin tonight. Especially if there is any chance ketones are in the picture. Many cats look uncomfortable when they first see normal numbers again. Neko hid under the bed at her first greens.

If you are worried about cost, how about using Freestyle strips in a Freestyle (human) meter. Our dosing methods use numbers from human meters.
 
tiffmaxee said:
Are you following SLGS or TR or haven’t decided yet? Are you feeding any dry food? On an AT the number to be concerned is 68 (US). I don’t know what that is on the world chart. Any number than you are used to is unsettling though. Are you giving a treat adter each test? That can help when eating well. If his appetite picks up I might reconsider skipping tonight depending on the PMPS number.
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SLGS and, yes, Bob does have a modicum of dried diabetes biscuits, so I have to take that into consideration. He's never been a "treats" cat - just begs for a pea sized knob of butter when I'm in the kitchen but won't eat it at any other time But at the moment he's totally off his food, so I have withheld his dose.
 
if he is off his food and not getting insulin you absolutely want to be testing for ketones -- not sure if this was covered higher up in the thread. how long since he last ate?

ETA: a cat not eating, furthermore a diabetic cat, is really serious. they can get fatty liver after just 24h of fasting. ketones can show up too, if the cat is diabetic. both these conditions will make the cat even less likely to eat because he feels nauseous and crappy. pay attention!
 
by the way: lower numbers = often decreased appetite. the cells aren't starving as much. you might just need to stimulate him a bit more to eat until he gets used to those lower numbers. could you update your spreadsheet so we can see where he's at now, even if you didn't give the shot? (write NS in the box when you didn't shoot)
 
Stephanie & Quintus said:
if he is off his food and not getting insulin you absolutely want to be testing for ketones -- not sure if this was covered higher up in the thread. how long since he last ate?

ETA: a cat not eating, furthermore a diabetic cat, is really serious. they can get fatty liver after just 24h of fasting. ketones can show up too, if the cat is diabetic. both these conditions will make the cat even less likely to eat because he feels nauseous and crappy. pay attention!
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He's just wolfed down a bowl of food! I'm just waiting for him to settle to do a test.

Again, thanks for all the info - much appreciated x
 
Update: AMPS test shows Bob is up at 30.2 after eating some Animonda diabetic chicken pate, plus a small portion of Almo Nature shredded chicken with shrimps, for breakfast. No vomiting since he ate a tablespoon of some real cooked chicken last night. Very lively now - had to abandon trying to get a test from his ear and revert back to paw pad!

Given him 1u shot and will retest in about five hours (as his peak is around six hours when eating normally) unless I see anything untoward.

Missed his toilet visit to the garden this morning to collect a urine sample for ketones, so will put my stalking hat on when he heads out later today.

He's currently sleeping soundly (& snoring loudly).

Thanks to everyone for their support and advice :bighug:
 
Just for next time: try and get the PS test before feeding, so that it's not food-influenced. Also, if you're moving around the shot time (assuming you did so today) you will want to record that in your spreadsheet, as cycles shorter or longer than 12 hours will influence the potency of the insulin dose.

Good luck for the ketone stalking trip!!
 
Stephanie & Quintus said:
if he is off his food and not getting insulin you absolutely want to be testing for ketones -- not sure if this was covered higher up in the thread. how long since he last ate?

ETA: a cat not eating, furthermore a diabetic cat, is really serious. they can get fatty liver after just 24h of fasting. ketones can show up too, if the cat is diabetic. both these conditions will make the cat even less likely to eat because he feels nauseous and crappy. pay attention!
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Fatty liver disease is much more likely in an over-weight cat, than a slender or normal weight cat. Also, 24 hours is not usually sufficient to cause it. However, you are right that it is a danger and one must be on the lookout for it.
 
Bob was so high this morning for a couple of reasons. First, his little body is not used to the normal (but safe) number he got yesterday, so he bounced. Second, you skipped insulin, though you didn't need to. I hope he comes down soon.

I had asked about SLGS vs TR. because the point at which a dose is reduced is when you see a number below 90 (5.0). It's still a safe number.
 
A week on since I started this thread and Bob had had a good week (even brought me in a mouse!)... until he started with his cold-like symptoms again yesterday and had been sick yesterday and again today. As a result of not keeping down his food today he's hit a new low this evening of 4.1 and as its not something he's used to is feeling the effects.

Amazingly we were alerted to something not being right by our other cat, Joey, who joined Bob in his bed and started kicking and nudging him (something he never does as they have a very fractious relationship!). As Joey always fusses around my DH when he's having a hypo, I immediately checked Bob's BG and got the low reading.

My only concern is Bob's vomiting as I can't find a cause for it (ketones are fine).
 
Good for Joey. Atta Boy:cat: What a keeper!
I'm so glad Bob's ketones are negative.
Has his T4 (thyroid) been tested recently? Maybe someone already asked that.
Was the mouse gift around the time he started throwing up? I hope no one around you is using poison for mice.

Sending feel much better soon vines, to Bob.
 
Joey is a star!
I don't think Bob has had a thyroid test - would that be part of a blood test? I'll check his one taken at the vet.
He presented the mouse intact, although he does eat them occasionally but thankfully there's no-one near us who would be using poison.
Thanks for the response and advice, always appreciated ;)
 
What a great addition to your hypo kit: JOEY!!! That is amazing. I have heard about dogs that detect seizures in their human who has epilepsy.

Glad Bob doesn't usually eat his prey. Worms are a consideration with them eating their kill.

As Dyana said, it is the T4 thyroid test that has to be preformed separately from a senior panels. How old is Bob? The average age for hyper thyroid is around 12 years of age.
 
Bobbie And Bubba said:
What a great addition to your hypo kit: JOEY!!! That is amazing. I have heard about dogs that detect seizures in their human who has epilepsy.

Glad Bob doesn't usually eat his prey. Worms are a consideration with them eating their kill.

As Dyana said, it is the T4 thyroid test that has to be preformed separately from a senior panels. How old is Bob? The average age for hyper thyroid is around 12 years of age.
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Bob is about 14, so a hyper thyroid is possible. What other symptoms does it present?
 
Bobbie And Bubba said:
Besides eating like crazy, weight loss and they may act a bit nervous or on edge and vomiting, and severe dandruff. My civvie cat had all those symptoms.
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Wow. Bob does eat like crazy (but always has done - hence his original weight gain that led to diabetes). His weight loss was attributed to the diabetes and he is now stabilised at 6kg. He has a little dandruff on his back end, although not evident all the time. As for acting crazy, he's always been like that, lol. He's not really a nervous cat - loves people - but has become very clingy recently.

I'll monitor the situation.
 
Bobbie And Bubba said:
Oh, bingo! I forgot, becoming very needy and clingy is another one of the symptoms; I forgot that one!
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Ah, that's not so good to hear - although it's difficult with Bob because he has displayed many of the symptoms, individually, during all the years we've had him.

It's like the vomiting - he's consistently (two or three times every year) had these flu or cold like symptoms: sneezing, runny eyes and nose, that are accompanied by him vomiting and being off his his food. It normally subsides within a couple of days. Any longer than 48 hours and we've taken him to the vet, whose treated him with antibiotics - but never given an explanation as to what might cause it.

That's how his diabetes diagnosis was missed last November (despite my telling the vet about his excessive drinking and loss of bladder control). As it was accompanied by his cold symptoms he was treated for that. I'm really no longer confident in our vet and he's the only one anywhere near us.

I really feel like I'm letting Bob down and am upset that he's not improving with his insulin, new food regime etc, but instead seem to be hopelessly watching his health take a downward turn.

Sorry to offload this on here. I'm at my wits end.
 
No worries with venting: we've all been there and had to do that. ;)

I see you skipped last night's shot. If you were able to monitor, I would have shot. He was 153 at +10 and had you gotten a PMPS he would have been higher. The sooner he gets used to being in normal numbers the better he will feel too. You will need to get comfortable shooting lower numbers. You have enough daytime data to be able to shoot 150 and over. I know it is scary the first time , but remember, he is likely to bounce up in numbers just from not being used to lower numbers .

Someone here will be able to assist you when you shoot a number you are not comfortable with. :bighug:
 
Bobbie And Bubba said:
No worries with venting: we've all been there and had to do that. ;)

I see you skipped last night's shot. If you were able to monitor, I would have shot. He was 153 at +10 and had you gotten a PMPS he would have been higher. The sooner he gets used to being in normal numbers the better he will feel too. You will need to get comfortable shooting lower numbers. You have enough daytime data to be able to shoot 150 and over. I know it is scary the first time , but remember, he is likely to bounce up in numbers just from not being used to lower numbers .

Someone here will be able to assist you when you shoot a number you are not comfortable with. :bighug:
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Thank you :)

I'm not confident about shooting on low numbers. I've just done Bob's PMPS and he's down at 4.3 (77?) and he's only eaten a teaspoon of diabetic food (which he's kept down so far) so I'm worried he'll hypo in the night.

He's curled up sleeping and I can't get him interested in eating.

It's like a bad dream :(
 
That would be quite a low number to shoot. I wouldn’t worry about him going hypo during the night if you don’t shoot.
Are you shooting or skipping? Or waiting and restesting without feeding?
 
Stephanie & Quintus said:
FWIW I think some of the morning blacks you’ve been seeing recently might be bounces (combined with no insulin during PM cycle). He might be having a hard time getting used to those lower numbers!
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I agree with that in lieu of 2 skipped PM shots and being 623 at AMPS then bringing himself back down to 77 for a PMPS.

It's ideal to be able to get two shots 12 hours apart in each day but without any data shooting lower number and not a lot of data in the PM cycles it's hard to know if 1u is too much .
 
I've got Bob to eat some Kattovit Sensitive (not diabetic, so has carbs!) and he's kept it down. Also just been out with him (in the dark!) to collect urine sample and no ketones - phew! Am going to get another BG before bed to see about whether to shoot.

Once again many thanks for all your support :kiss:
 
Tanya and Ducia said:
@Tilou
How is Bob doing now?
Had he eaten after throwing up and are there any BG test after that 67 (3.7) @+1?
I hope he had and doing fine.

Please let us know how you guys are doing.
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Hi - Bob seems to be fine now. He went out and wouldn't come back in the house. When he did he ate a little but wouldn't let me test him (ran back outside!). He's now cosied up in his bed (as are we at last). I'll get a test in the morning. I presume his BG must have risen as the effects of his morning shot has finally worn off as he's showing no signs of being low now.
 
Just my gut feeling so you might want to get another pair of eyes (and a brain) on the idea but I’d try lowering the dose, given he was still falling at +13. 0.75? You might get higher numbers during the day but with a bit of luck you might get a shootable PMPS.

Also, in this kind of situation, if there is any way you can get a « before sleep » test in, it could give precious information, even when you don’t shoot. That +13 is super interesting, already.

Will check in later to see how things are this morning!
 
Stephanie & Quintus said:
Just my gut feeling so you might want to get another pair of eyes (and a brain) on the idea but I’d try lowering the dose, given he was still falling at +13. 0.75? You might get higher numbers during the day but with a bit of luck you might get a shootable PMPS.

Also, in this kind of situation, if there is any way you can get a « before sleep » test in, it could give precious information, even when you don’t shoot. That +13 is super interesting, already.

Will check in later to see how things are this morning!
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Good morning

Well its been an interesting night. Bob slept from 1am to 4am then woke me up for food - but barely took anything before heading out for his morning patrol.

He then woke me again at 6am. Same routine. Then at 7am. Wouldn't touch any food or kibbles. Just sat looking at the bowl. Then went out again before coming up on the bed about 20 mins ago.

I've taken the opportunity of getting a blood test (very little resistance, unlike at 1am this morning!) and he's at 13.

He's well hydrated as he's been drinking fairly consistently, but something's stopping him from eating.

He's fast asleep (and snoring loudly!) but normally when I start rattling the pots in the kitchen he'll make an appearance. He loves to get some poitrine (bacon) from our breakfast plates on a Sunday, so this will be the test as to whether he'll eat anything.

Also, as he regularly goes off his food when he gets his sneezy cold symptoms, am wondering if he can't smell the food. So I'm going to try him with a tin of Cosma mackerel. If that fails he'll be at the vet tomorrow (nothing available today unfortunately).

DH (himself a very unstable diabetic) is not keen to give him a shot at 13 with no food intake, so think we'll see if he eats anything and if so, test again, and give a small amount if BG rises.

I agree that smaller doses may be the way forward. DH has been saying that since we had this problem last weekend but the black numbers have given me a moral dilemma each time as to what to do :(
 
I agree with not giving a full dose at 13 with no food. For perspective, when I started out with Quintus, 10-15 was what I was aiming for! I wouldn’t give nothing, however, but 0.25 maybe (unless he eats). I’m with you u for the vet tomorrow, being off one’s food (particularly when diabetic and a cat) is not to be taken lightly.

Fingers crossed!
 
Stephanie & Quintus said:
I agree with not giving a full dose at 13 with no food. For perspective, when I started out with Quintus, 10-15 was what I was aiming for! I wouldn’t give nothing, however, but 0.25 maybe (unless he eats). I’m with you u for the vet tomorrow, being off one’s food (particularly when diabetic and a cat) is not to be taken lightly.

Fingers crossed!
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We're totally on the same wavelength. Our aim since diagnosis has been to keep Bob in that range, rather than try to hit the low end of the scale - mainly due to his inconsistent eating habits.

It should also be noted that Bob has never been able to bring up fur balls and this can be the cause of his not eating too. It's so complicated! He also doesn't meow - never has done. He can growl and do the cat fight yowl, but that's it.

As an outdoors cat - and one that was feral when he arrived here - it's very difficult to keep him to a routine and tbh we don't want to restrict him.

When he first came here he spent the first few years confined to a large cage-like pen that we built into the side of the house (with access to our living area) as we had to keep him separate from our other 7 totally domesticated cats, as Bob was so ferocious that he went for the kill if he got hold of any of them. We had a couple of close shaves!

To go out into the garden properly (we have a couple of acres here, all fenced in) we taught him to walk on a lead. Then, as our other cats started to head OTRB, we began to introduce a couple of our old matriarch cats to him and eventually we were able to integrate him with our remaining 4 cats, of which Joey is the last surviving one. Even now, though, it is a fractious relationship!

It's been a long road and we'd like Bob to have that freedom for whatever time he has left.

But, yes, it'll be vets tomorrow :woot:
 
With that 3.7 (67) last night, Bob has said the 1.0 unit dose is too high. He has earned a dose reduction down to 0.75 units. Hopefully with a lower dose, you won't find yourself skipping as many shots.

Typically cats undergoing anesthesia, so not able to eat, get 1/2 dose. Not all insulin injected goes to combat the carbs in his food.
 
Update: Bob has eaten a small portion of cooked chicken at lunchtime and a morsel of pork from our dinner this evening... and managed to keep the food down. He's showing an interest in the food we sit down with but isn't bothering with his own food bowl.

He's still got the remnants of a runny nose (but no sneezing). He's keeping hydrated by fairly regular visits to the water bowl and has been sitting outside in the sunshine a lot.

I haven't hassled him for blood tests but will be taking one shortly to see how he's doing and get an idea of what we can give him in the way of insulin tonight.

We will be taking him to the vet tomorrow - unless he shows a miracle recovery and starts eating normally tonight (which I doubt he will).

Hopefully the vet can find out what the problem is. One noticeable thing - Bob hasn't headed out to eat grass today like he did yesterday, so suggests whatever was causing him to do that yesterday is not bothering him today (I suspect a fur ball).
 
Hi,
thank you for the update!
Tilou said:
He's showing an interest in the food we sit down with but isn't bothering with his own food bowl
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Are we talking crappy commercial canned food v. homemade French cuisine? I wouldn't bother either...;)
No food + no insulin+ undiagnosed(yet) cold like symptoms isn't good. the 236 after no shot is not too high but still it is reason enough to start testing for ketones in his urine. Do yo u have testing strips? Ketones can develop very quickly and the earlier are caught the better the chances for recovery. I'd also take in some mid day tests whenever possible - even WO shot.
 
Tanya and Ducia said:
Hi,
thank you for the update!

Are we talking crappy commercial canned food v. homemade French cuisine? I wouldn't bother either...;)
No food + no insulin+ undiagnosed(yet) cold like symptoms isn't good. the 236 after no shot is not too high but still it is reason enough to start testing for ketones in his urine. Do yo u have testing strips? Ketones can develop very quickly and the earlier are caught the better the chances for recovery. I'd also take in some mid day tests whenever possible - even WO shot.
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On this occasion it was homemade food, although he has now just eaten a tiny bit of his diabetic commercial wet food.

Yes, I have ketone testing strips and have tested him - all ok.

I'm going to give him a shot at 9pm (French time) - probably about 0.75 of a unit just in case he doesn't eat through the night again. I shall know with a test in the morning where we stand.

He's become very lively since he's eaten - so obviously feeling better for it.
 
Just a thought on the below:
Tilou said:
had these flu or cold like symptoms: sneezing, runny eyes and nose, that are accompanied by him vomiting and being off his his food.
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My civvie came to me with a runny eye. We tried all kinds of AB to no avail. It will come and it will go and he will also have sneezing fits when it first comes back. Finally, one vet said it could be reoccurring herpes infection that comes and goes. Stress can bring them on. But, he doesn't go off his feed with his episodes and or vomit ( well not for that reason, more like scarf and barf) But ECID.

While he's at the vets it would be worth a T4 thyroid test. Vomiting can be a sign of that.


ETA: Herpes virus, not infection.
 
Bobbie And Bubba said:
Just a thought on the below:

My civvie came to me wiIth a runny eye. We tried all kinds of AB to no avail. It will come and it will go and he will also have sneezing fits when it first comes back. Finally, one vet said it could be reoccurring herpes infection that comes and goes. Stress can bring them on. But, he doesn't go off his feed with his episodes and or vomit ( well not for that reason, more like scarf and barf) But ECID.

While he's at the vets it would be worth a T4 thyroid test. Vomiting can be a sign of that.


ETA: Herpes virus, not infection.
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That's spooky. I've been suspicious of it being a recurring herpes virus for some time, as when I checked the symptoms on a couple of sites they both suggested it as the cause.

It would fit with Bob's profile. We got him as an adult stray (feral) cat so he'd had no kitten immunisations. Our Joey, when he was an 8 week old kitten, came from a rather disreputable pet shop (our daughter rescued him) and was very poorly with a virus.

Over the years and despite all our cats being immunised annually, from time to time they would develop the sneezy cold-like runny eyes symptoms, which could last several days - except Joey, who would have a 24 hour period of sneezing and that was that.

Joey had the sneezes about a fortnight ago - just for one day. Since then Bob has developed the full blown "infection". I suspect Joey is a carrier of the virus.

Interestingly, Bob's symptoms have disappeared over the course of today and he's now looking to eat and is happily catnapping instead of sitting moping, which is a good sign.

I shall keep you updated.

Update: Bob has just polished off a whole bowl of pork (with rind/fat). If he keeps it down that'll be a substantial feed after the small morsels from earlier.
 
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