? Odd occurrence...

Status
Not open for further replies.
B

Britty & Gingy

Member Since 2019
My cat was diagnosed about a month ago and has been relatively steady these past few weeks with regular dosing. This morning when I tested his blood glucose, he was at 1.1 on my alpha traks. I immediately made sure he ate, following him around the house with his food. I decided against giving him his dose as it was well past his normal shot time (and we wouldn't be able to regulate at the hour as we work). I tested again and he was at 5.8 a few hours later at 4:30 pm. We still were not going to dose him until 8:30 pm so we tried feeding him again. He actually ended up finding a mouse in our house and eating it around 6 pm! We just caught him at the end of his meal... Anyway, we tested again at 8:30 and he was back down to 2.3! It had actually gone down again... and we had not administered insulin since 11 pm the night before! I have never heard of this happening before. Any ideas? He has only been on his insulin for about a month, it's not likely that he's in remission because then his levels would be good and not low right? Will be taking another test soon. He is eating more (regular wet) food right now so I am expecting his levels to go back up. I am so confused. Maybe it was just a reading error. The strip I used before didn't even read the first time so maybe it was just wonky.
Any info appreciated! Thank you!
 
First of all welcome to FDMB from a fellow Ontario resident.

Are you sure the meter is set to the right code? Check to make sure the code on the meter and the code on the vial of strips is the same. If the code is correct, I would change the battery in the meter as sometimes a battery getting low but not yet indicating a problem can produce anomalous readings. At 1.1 on the AT2 I would expect a cat to be in obvious distress or a coma which obviously is not the case with Ginger.

Any time you get a strange reading, it's a good idea to double check but this seems odd that you'd have a couple of low readings in a row and without insulin being given in almost 24 hours. Do you have the volume turned up so the meter beeps when a sufficient blood sample has been sipped by the strip? It's been my experience with the AT2 that it won't read until the strip has sufficient blood and the sample needed is very small but anything is possible.
You might want to consider getting a back up meter. A human meter works just fine albeit with a slightly lower BG normal range. You can often get a free meter in the pharmacy with the purchase of 100 strips. Something to consider just in case there is something wrong with your current meter.

As far as his shot tonight is concerned, if the code is not the problem and you can't change out the battery, I don't think I'd risk giving insulin given the readings you've had today. I am not sure if you have been testing before every shot or not but mid cycle tests are also important to see how low the dose is taking Ginger. If you have not been getting mid cycle tests, I suggest you start as she may have been going much lower than you are aware indicating the dose of insulin may be too high.
 
MrWorfMen's Mom said:
First of all welcome to FDMB from a fellow Ontario resident.

Are you sure the meter is set to the right code? Check to make sure the code on the meter and the code on the vial of strips is the same. If the code is correct, I would change the battery in the meter as sometimes a battery getting low but not yet indicating a problem can produce anomalous readings. At 1.1 on the AT2 I would expect a cat to be in obvious distress or a coma which obviously is not the case with Ginger.

Any time you get a strange reading, it's a good idea to double check but this seems odd that you'd have a couple of low readings in a row and without insulin being given in almost 24 hours. Do you have the volume turned up so the meter beeps when a sufficient blood sample has been sipped by the strip? It's been my experience with the AT2 that it won't read until the strip has sufficient blood and the sample needed is very small but anything is possible.
You might want to consider getting a back up meter. A human meter works just fine albeit with a slightly lower BG normal range. You can often get a free meter in the pharmacy with the purchase of 100 strips. Something to consider just in case there is something wrong with your current meter.

As far as his shot tonight is concerned, if the code is not the problem and you can't change out the battery, I don't think I'd risk giving insulin given the readings you've had today. I am not sure if you have been testing before every shot or not but mid cycle tests are also important to see how low the dose is taking Ginger. If you have not been getting mid cycle tests, I suggest you start as she may have been going much lower than you are aware indicating the dose of insulin may be too high.
Click to expand...

Yes, we switched the code when we got new strips and are on our last 5 strips of the package. the battery we changed last week and it hadnt been a problem since. He has had a few lower readings before with no signs of distress other than laziness which is rather normal for him. I have been thinking of switching to the human meter anyway since the test strips for the alphatrax is so expensive. I have decided not to give the insulin and will check his blood again before I head to bed just to see. I was planning on doing a proper curve tomorrow but might postpone until I know he has had a few proper doses. Kinda still getting used to this whole thing. Hope to know what the hell Im doing soon. lol
 
If you are getting readings lower than 3.9 on the alphatrak you need to reduce the dose of insulin.
If you get a reading lower than 3.9 again you need to feed some high carb food and or some honey to bring the BSL up higher. Then test again 20 minutes later to see the BSL has risen.
It is great you are home testing. Keep getting tests during the cycle to see how low the insulin is taking Ginger. Do you test before every insulin shot?
 
Bron and Sheba said:
Here is a link to managing a hypo and what to look for. They can be deadly so please don’t be complacent about them. :)
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
Click to expand...

Please do print this out - hypos do need special attention and although there are sometimes people on this board to guide you through, that may not always be the case, so you need to understand what's happening and how to manage it correctly.
 
Brittany Haines said:
He has had a few lower readings before with no signs of distress
Click to expand...
Some cats do not show signs of hypoglycemia until it is becomes critical and they suddenly have a seizure so I would strongly recommend you get a human meter and test your cat before giving any more insulin.
Your signature indicates Ginger was diagnosed in May 2019. It appears that should read "March". :)
Just curious as to whether Ginger may have been eating kibble or some other high carb food prior to diagnosis. There are cats who go into remission with a diet change to low carb wet food so please do test to make sure it is safe to give insulin before proceeding to dose her further and also to grab some mid cycle tests to see how low the insulin is taking BG. A starting dose of 2u is double what most cats start at and from the readings you are getting, appears it's likely too high a dose.
 
Last edited:
Diana&Tom said:
Please do print this out
Click to expand...
Even if you can recite it word for word print out the HYPO guidelines and keep it on the side of the fridge.
In any emergency you can post a thread with the "911" prefix in the thread's title. Depending on the time of day you'll get a varying amount of responses.
Lots of Canadians here, I'm also in Ontario. I set my meter to metric like you (and the rest of the planet!) and to convert to imperial multiply the numbers by 18.
1.1!!! My meter wouldn't go below 3.0. If it was a talking meter for the visually impaired it would say "Your cat is now dead" and both my cats were dead plenty of times. Not all meters are the same, strips expire, counterfeit batteries sit in a warehouse in China for years. Welcome to Crazy Town.
Keep posting, no detail is insignificant and there's no such thing as a stupid question here. :)
 
Thank you for responses! My vet gave me a similar guideline to put on my fridge when he was first diagnosed. Not as detailed though so I will definitely get this printed too thanks!
So another weird thing that happened which makes me hope that maybe he is in remission... is that after all that, the 1.1, 5.8, 2.2 he went up to 10.6 after another meal and then without another dose of insulin went down to 8.3 still not in the clear but I haven't seen his number go down without the insulin since his diagnosis. We gave him some this morning and I only just got home from work and will check soon but good sign maybe?

Bron and Sheba said:
If you are getting readings lower than 3.9 on the alphatrak you need to reduce the dose of insulin.
If you get a reading lower than 3.9 again you need to feed some high carb food and or some honey to bring the BSL up higher. Then test again 20 minutes later to see the BSL has risen.
It is great you are home testing. Keep getting tests during the cycle to see how low the insulin is taking Ginger. Do you test before every insulin shot?
Click to expand...


We started dhim at 2 units then his levels were too low so we lowered to 1 unit and his numbers were a bit too high (16-18) so the vet suggested trying 2 again and he had been good ( steady 4.5-7) until that 1.1.
 
MrWorfMen's Mom said:
Just curious as to whether Ginger may have been eating kibble or some other high carb food prior to diagnosis. There are cats who go into remission with a diet change to low carb wet food so please do test to make sure it is safe to give insulin before proceeding to dose her further and also to grab some mid cycle tests to see how low the insulin is taking BG. A starting dose of 2u is double what most cats start at and from the readings you are getting, appears it's likely too high a dose.
Click to expand...

He was on a mix of 70% dry, 30% wet, yes and them immediate switch to DM wet food only. I do make sure to test before every dose and for the most part, he has been steady. I was told by my vet that even if he is doing well (4.4-9) to give him his dose at the usual time so that his body gets use to it. The reason he is on 2 units is that the vet said that it is our only chance of putting him into remission. I plan on doing a proper curve test on Friday when I will be home all day.
 
Brittany Haines said:
We started dhim at 2 units then his levels were too low so we lowered to 1 unit and his numbers were a bit too high (16-18) so the vet suggested trying 2 again and he had been good ( steady 4.5-7) until that 1.1.
Click to expand...

There are lots of doses between 1U and 2U....We recommended doing dose changes in .25 unit increments. There may be a dose in between that's both safe and effective (if it's necessary)

Keep testing....if he gets a Pre-shot test over 120 (6.7), feed him and test again at +3

It will also help if you'll start recording your test results on our spreadsheet. We're very data driven here and depend on our spreadsheet to give you the best advice possible.

Here's the Instructions on setting up our spreadsheet
 
Noah & me (GA) said:
Even if you can recite it word for word print out the HYPO guidelines and keep it on the side of the fridge.
In any emergency you can post a thread with the "911" prefix in the thread's title. Depending on the time of day you'll get a varying amount of responses.
Lots of Canadians here, I'm also in Ontario. I set my meter to metric like you (and the rest of the planet!) and to convert to imperial multiply the numbers by 18.
1.1!!! My meter wouldn't go below 3.0. If it was a talking meter for the visually impaired it would say "Your cat is now dead" and both my cats were dead plenty of times. Not all meters are the same, strips expire, counterfeit batteries sit in a warehouse in China for years. Welcome to Crazy Town.
Keep posting, no detail is insignificant and there's no such thing as a stupid question here. :)
Click to expand...

Lmao! I have gotten 'low' before too. I do wonder if the glucometer is off but will be getting a human glucometer tomorrow I hope. Will test against the two.
 
Chris & China (GA) said:
Sounds like your vet doesn't know what he's talking about and is risking his life. We have lots of cats that go into remission here....there's no "magic" dose that guarantee's a cat goes into remission.
Click to expand...

Very fair. I think maybe what he meant by that is that his only successes were on 2u? Regardless, I will be keeping more of a diligent eye on him and using my own judgment.
 
Are you using the Lantus pen to inject insulin or syringes? Using syringes allows you to do decreases in smaller increments (0.25u at a time) so you can find a good dose that keeps BG under control but doesn't push Ginger's BG too low.

I have the utmost respect for vets and think they have a very difficult job but sometimes I have to scratch my head and this is one of those times. To tell you to dose your cat with 2u at a BG of 4.4 on the AT2 meter without requiring you to do more intense monitoring during mid cycles is unsafe particularly given the low readings you have been getting of late. You do not have to risk your cat's life to get them into remission.

A curve will tell you what is going on THAT day. It doesn't tell you what is usually happening day to day and everyday is NOT the same.

For the safety of your cat, please get some mid cycle tests and lower the dose of insulin until you do get some mid cycle tests.
 
MrWorfMen's Mom said:
Are you using the Lantus pen to inject insulin or syringes? Using syringes allows you to do decreases in smaller increments (0.25u at a time) so you can find a good dose that keeps BG under control but doesn't push Ginger's BG too low.

I have the utmost respect for vets and think they have a very difficult job but sometimes I have to scratch my head and this is one of those times. To tell you to dose your cat with 2u at a BG of 4.4 on the AT2 meter without requiring you to do more intense monitoring during mid cycles is unsafe particularly given the low readings you have been getting of late. You do not have to risk your cat's life to get them into remission.

A curve will tell you what is going on THAT day. It doesn't tell you what is usually happening day to day and everyday is NOT the same.

For the safety of your cat, please get some mid cycle tests and lower the dose of insulin until you do get some mid cycle tests.
Click to expand...

Thank you for the advice I will do that for sure! Also, yes I am using the lantus pen so 1 and 2 units are my only options.
 
You can get syringes with half unit markings at any WalMart….they're $12.58/100

You can also get them online at places like American Diabetes Wholesale.

You want to get 3/10ml, 31 gauge, 6 or 8mm insulin syringes with half unit markings (and if you get them at WalMart, ALL their 3/10ml syringes have half unit markings no matter what they tell you)

You just pull the cap off the pen and insert the syringe into the rubber stopper and pull the insulin out! It also saves you lots of insulin since you're "supposed" to prime the pen and waste the first 2 units each time.
 
Britty & Ginge are in Canada. You can get syringes in Walmart but they will be almost $40.00 for 100. We can't get the syringes Chris mentioned here. You can get BD Ultra Fine with the same specs as Chris provided about size and gauge but you have to make sure they have the half unit markings.

ETA Are you by any chance in the Toronto area or nearby? If so I have some syringes here you are welcome to.
 
Walmart? Isn't that where people who live in those "houses" on wheels shop?
I use Monoject but I'm hoarding them for my wife's B12 injections. Bend over Honey Bunch. :rolleyes:
 
I agree with what everyone is saying. You need to buy the syringes ( making sure you get the correct ones) and you will be able to give much safer doses to Ginger.
If the 2 units sent the BSL to 1.1 sooner or later it will happen again. Don’t risk it. Using syringes is easy and as Chris said there are several doses in between 1 unit and 2 units.
As said above doing a curve one day isn’t necessarily the same as a curve the next day. BSL change day to day. Have a look at a few spreadsheets. If you would like to set up a SS we will be able to help you.
 
MrWorfMen's Mom said:
Britty & Ginge are in Canada. You can get syringes in Walmart but they will be almost $40.00 for 100. We can't get the syringes Chris mentioned here. You can get BD Ultra Fine with the same specs as Chris provided about size and gauge but you have to make sure they have the half unit markings.

ETA Are you by any chance in the Toronto area or nearby? If so I have some syringes here you are welcome to.
Click to expand...

I am actually about an hour away from Toronto, near Guelph. I have been seeing some more regular numbers since this post and wonder if my glucometer was being weird. I have purchased a human glucometer since and am testing the numbers with the two of them. I think once my pen is finished I will look into the syringes though. I am doing 2 units right now so I still have an option to go lower if need be. Thank you very much for the offer!
 
Bron and Sheba said:
I agree with what everyone is saying. You need to buy the syringes ( making sure you get the correct ones) and you will be able to give much safer doses to Ginger.
If the 2 units sent the BSL to 1.1 sooner or later it will happen again. Don’t risk it. Using syringes is easy and as Chris said there are several doses in between 1 unit and 2 units.
As said above doing a curve one day isn’t necessarily the same as a curve the next day. BSL change day to day. Have a look at a few spreadsheets. If you would like to set up a SS we will be able to help you.
Click to expand...


That does sound like a better option, having multiple levels of dosing I mean. Once this pen is used up I will likely be switching. I am currently looking at converting my spreadsheet onto the one on here. Hope to figure it out soon haha
 
You've been given great advice by these folks. I agree with the recommendation to switch to syringes immediately. You'll certainly need doses between 1u and 2 u (1.0 u, 1.25 u, 1.50 u, 1.75 u, 2.0 u) and U100 syringes with half unit marks are needed for that. I buy mine from my vet at a cost of about $35 CAD for a box of 100. I've seen them in human pharmacies for a higher price - $40 to $50 per 100 range.

Take the needle section off the pen and you'll see the pale grey rubber seal of the cartridge inside. That's where you insert the syringe needle. Also, in case you didn't know, you can buy Lantus over the counter in Ontario pharmacies. A box of 5 cartridges (the cylinder inside the pen that holds the insulin) will cost about $100 - $110 CAD depending on where you buy them. You’ll be able to use up each 3 mL cartridge well before the insulin loses its potency and the rest of the 5 pack will be good in your fridge until its expiry date - usually 2 years or so down the road. FWIW - my vet didn’t know that Lantus was available OTC in Ontario pharmacies. I bought my first cartridge from the clinic and paid $48 for it!
 
Last edited:
Status
Not open for further replies.
Back
Top