Dosing after fasting?

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Cake

Cake

Member Since 2019
Hi everyone,
I'm still pretty new to treating my cat who was diagnosed in August.
I'm feeding fancy feast twice daily and using an accu-check guide.

Yesterday I brought my cat into the vet for a teeth cleaning wherein she was anesthetized.
This required that she fast until dinner time when I brought her home.
The vet suggested I continue dosing and feeding her per normal which is usually 1 Unit of ProZinc, but her BG was at 60 when I tested, which is the lowest reading I've had.
I fed her and gave her a smaller dose than normal (.25Units), I was conflicted with the vets advice and my own gut feeling.
This made her go hypo (low point 37 no symptoms, I kept an eye on her for the next 5 hours, her BG eventually went up to 71 ~4hrs later).

Can anesthesia effect BG? Or was she just starving? I know she'd been fasting, but 60 seems really low for a diabetic cat.
I tested her again this morning and she was up to 222. I don't really know how to interpret what happened last night.
 
Rhubarb had her teeth done before starting insulin, and had low sugars for the one test before going back up to her normal (2018). So it does seem like something can affect it. Not all cats are affected the same way though.
 
Hi and welcome to FDMB. Cake is absolutely adorable, love the avatar! I am unable to answer your question about the reason for the BG drop Cake experienced, but I'm sure others will chime in though.

@Marje and Gracie
@MrWorfMen's Mom

Since you are here and hopefully will continue to visit and post, to ask questions and let us know how Cake is doing, would you please create a signature and set up the spreadsheet so we can see her info and testing data?

Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

Another thing that will help us help you is to set up a spreadsheet like the one we use here. You will see how the trends and patterns emerge, and members can review her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Also, you can review this document for newer members:
New? How You Can Help Us Help You!

Best wishes going forward with Cake's diabetic treatment, I hope to see you posting on the board often.
 
Idjit's mom said:
Hi and welcome to FDMB. Cake is absolutely adorable, love the avatar! I am unable to answer your question about the reason for the BG drop Cake experienced, but I'm sure others will chime in though.

@Marje and Gracie
@MrWorfMen's Mom

Since you are here and hopefully will continue to visit and post, to ask questions and let us know how Cake is doing, would you please create a signature and set up the spreadsheet so we can see her info and testing data?

Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

Another thing that will help us help you is to set up a spreadsheet like the one we use here. You will see how the trends and patterns emerge, and members can review her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Also, you can review this document for newer members:
New? How You Can Help Us Help You!

Best wishes going forward with Cake's diabetic treatment, I hope to see you posting on the board often.
Click to expand...

Sadly I'm at work and this is a placeholder image I found! I wish my kitty was this funny [fixed now ;) ]
I'll be sure to set that up very soon, thank you! :)
 
majandra said:
Rhubarb had her teeth done before starting insulin, and had low sugars for the one test before going back up to her normal (2018). So it does seem like something can affect it. Not all cats are affected the same way though.
Click to expand...
No kidding, it's reassuring that this is a shared experience. I couldn't find very much if any information on google.
 
Hi and welcome to FDMB. OMG! That is such a cute pic! She is adorable!

You would not see BG drop that soon as a result of a dental cleaning. That would be from the fasting and lack of food in the system for an extended period of time that likely lowered BG overall. We recommend not giving insulin for any BG reading under 200 unless you have lots of data to know it's safe to do so and I wouldn't consider it safe to be shooting at a BG of 60 wth ProZinc even with lots of data. The excessively low reading later on was a result of the insulin pulling her BG down from an already low normal reading.

Cake may be more sensitive to insulin following that low so do get some tests when you can to track her BG. I would expect if the teeth were causing any elevation of BG that you would start seeing some changes in BG over the period of a few days to a week.

I'd suggest you keep THIS document about dealing with low BG handy somewhere in case her BG does start coming down. Her dose of insulin may need to be adjusted.

The vet should have been more specific and it never ceases to amaze me how many do not tell their clients to not shoot unless BG is high enough. :rolleyes:
 
MrWorfMen's Mom said:
Hi and welcome to FDMB. OMG! That is such a cute pic! She is adorable!

You would not see BG drop that soon as a result of a dental cleaning. That would be from the fasting and lack of food in the system for an extended period of time that likely lowered BG overall. We recommend not giving insulin for any BG reading under 200 unless you have lots of data to know it's safe to do so and I wouldn't consider it safe to be shooting at a BG of 60 wth ProZinc even with lots of data. The excessively low reading later on was a result of the insulin pulling her BG down from an already low normal reading.

Cake may be more sensitive to insulin following that low so do get some tests when you can to track her BG. I would expect if the teeth were causing any elevation of BG that you would start seeing some changes in BG over the period of a few days to a week.

I'd suggest you keep THIS document about dealing with low BG handy somewhere in case her BG does start coming down. Her dose of insulin may need to be adjusted.

The vet should have been more specific and it never ceases to amaze me how many do not tell their clients to not shoot unless BG is high enough. :rolleyes:
Click to expand...

Thank you so much for your help!! I had no idea that not shooting was an option when BG is already low. I had an inkling that was the way to go but...Sheesh! Thanks again.
 
Cake said:
Yakima County, so the middle of nowhere haha!
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Not so nowhere. You and Cake are there, so it's definitely a place of importance. Eastern WA is just different from the hustle & bustle of the very narrow strip of activity on the other side of the Cascades. ;)
 
Yes....depending on the anesthesia used, it can cause the BG to drop as it is wearing off. We’ve had many, many members who have experienced this over the years after their FD kitty has had anesthesia. Many have not been able to give the evening shot due to low numbers.

However, about 4+ years ago, the US finally started allowing the use of Alfaxalone as a veterinary anesthesia. I am very fortunate to have a board certified veterinary anesthesiologist here and she used it in my sweet Gracie for a dental. Alfaxalone does not result in a drop in the BG. It’s been used in Europe and Canada for some time and our Canadian members have often found that the BG is more stable after anesthesia.
 
Idjit's mom said:
Not so nowhere. You and Cake are there, so it's definitely a place of importance. Eastern WA is just different from the hustle & bustle of the very narrow strip of activity on the other side of the Cascades. ;)
Click to expand...
Aw well, that's true :3!! We also get some really hot/clear summers, which I appreciate.
 
Marje and Gracie said:
Yes....depending on the anesthesia used, it can cause the BG to drop as it is wearing off. We’ve had many, many members who have experienced this over the years after their FD kitty has had anesthesia. Many have not been able to give the evening shot due to low numbers.

However, about 4+ years ago, the US finally started allowing the use of Alfaxalone as a veterinary anesthesia. I am very fortunate to have a board certified veterinary anesthesiologist here and she used it in my sweet Gracie for a dental. Alfaxalone does not result in a drop in the BG. It’s been used in Europe and Canada for some time and our Canadian members have often found that the BG is more stable after anesthesia.
Click to expand...
I wish I had been the one to pick her up, my husband went in my place. I would have been able to ask if there was going to be any changes.
I'll have to inquire about what happened next time we visit, although I'm getting a bit disillusioned in our vet.
 
Cake said:
I wish I had been the one to pick her up, my husband went in my place. I would have been able to ask if there was going to be any changes.
I'll have to inquire about what happened next time we visit, although I'm getting a bit disillusioned in our vet.
Click to expand...
I’m not sure your vet would have been aware that many anesthesias can drop the BG in a diabetic cat. Most don’t deal enough with it to know that. And it seems many vets are so comfortable with their tried and true anesthesia protocols, that they don’t take the time to learn new ones. I’m not saying that applies here but when I discussed it with our anesthesiologist, she speaks nationally and internationally, she said it is really slow getting vets to change their anesthesia protocols.
 
Marje and Gracie said:
I’m not sure your vet would have been aware that many anesthesias can drop the BG in a diabetic cat. Most don’t deal enough with it to know that. And it seems many vets are so comfortable with their tried and true anesthesia protocols, that they don’t take the time to learn new ones. I’m not saying that applies here but when I discussed it with our anesthesiologist, she speaks nationally and internationally, she said it is really slow getting vets to change their anesthesia protocols.
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Oh I see! I doubt I'll be able to convince the clinic to change anything, but at least I can discuss the aftermath with the vet when we go in to do our draw/glucose curve. I'll see what advice she gives then :)
 
Cake said:
Oh I see! I doubt I'll be able to convince the clinic to change anything, but at least I can discuss the aftermath with the vet when we go in to do our draw/glucose curve. I'll see what advice she gives then :)
Click to expand...
And my comments aren’t a criticism of your vet. It just seems the way of things right now and it’s really not uncommon. I’m sure she’s great!
 
CandyH & Catcat said:
not nowhere -- it's halfway between me and son & family in Kennewick
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Ah well, I lived out of state in the city before I moved here with my spouse. I don’t even have a car yet! But it’s reassuring that there are other people here in WA state :D
 
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