Help hypo advice

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Audrey and Thor

Audrey and Thor

Member Since 2020
Thor had a hypo earlier he was so agitated I couldn’t even test him. I gave him Karo and some hi carb food. His last two tests were 159 and 178 (20 minutes apart) but he is still acting agitated. He’s had a couple hypo’s before but has recovered quickly. My thought is to continue testing to make sure his BG is good should I be doing something else?
 
Hi Audrey, it’s great to hear he’s feeling better. I know it sounds like a pain that we keep asking for the ss to be updated but the reality is no one here wants to give the wrong advice when a cat’s health is on the line and the only way to be able to give good and correct advice is to look at those numbers in the ss. Most members here will be reluctant to guide you unless they can see an updated ss because they don’t want to steer you wrong when it comes to your beloved fur baby


I agree with Nan 170 is a pretty good number but without a test your hypo is based on behavior alone :(
 
Aleluia Grugru & Minnie said:
Hi Audrey, it’s great to hear he’s feeling better. I know it sounds like a pain that we keep asking for the ss to be updated but the reality is no one here wants to give the wrong advice when a cat’s health is on the line and the only way to be able to give good and correct advice is to look at those numbers in the ss. Most members here will be reluctant to guide you unless they can see an updated ss because they don’t want to steer you wrong when it comes to your beloved fur baby


I agree with Nan 170 is a pretty good number but without a test your hypo is based on behavior alone :(
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I know, but I’m very familiar with his hypo symptoms. Of course now, 2 1/2 hours after the initial emergency he’s at 440 but he feels much better. I will keep testing this evening and get his SS up to date.
 
Thanks for updating the spreadsheet!

In answer to your question, I think you definitely need to reduce the dose. He is high at most of his pre-shots, but I strongly suspect that he's going low in the middle of cycles even more than you have been catching-- and you've caught several hypo numbers on 2U.

He's been asking for a reduction from that dose for a while, and he was very emphatic today. Even though he's back up high, I would listen to him and reduce.

It would also be helpful if you're able to catch some spot checks here and there to get an idea of where he's actually getting to between shots. Those tests are just as important as pre-shot tests, even though they have a different purpose (pre-shot: is it safe to shoot?, spot-checks: how low is this dose taking him?).
 
Nan & Amber (GA) said:
Thanks for updating the spreadsheet!

In answer to your question, I think you definitely need to reduce the dose. He is high at most of his pre-shots, but I strongly suspect that he's going low in the middle of cycles even more than you have been catching-- and you've caught several hypo numbers on 2U.

He's been asking for a reduction from that dose for a while, and he was very emphatic today. Even though he's back up high, I would listen to him and reduce.

It would also be helpful if you're able to catch some spot checks here and there to get an idea of where he's actually getting to between shots. Those tests are just as important as pre-shot tests, even though they have a different purpose (pre-shot: is it safe to shoot?, spot-checks: how low is this dose taking him?).
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I was thinking a smaller dose too because of how low he has gone during the last couple of curves. But then he’s so high most of the time. I really am trying hard and don’t want to let him down.
 
Audrey and Thor said:
I was thinking a smaller dose too because of how low he has gone during the last couple of curves. But then he’s so high most of the time. I really am trying hard and don’t want to let him down.
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Of course! And he's trying to help out by giving you some signals :cat:

It's not uncommon for too much insulin to look like too little, in exactly the pattern you are seeing-- they go low (usually when you're not looking :confused:), then they zoom back up high. You may find that reducing the dose actually helps bring his pre-shot numbers down.

No matter what, though, after today's events, you should reduce as a safety measure.
 
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Sounds good to me. I'm also going to tag @Deb & Wink and @Panic here for some opinions on that dose, as it's a large reduction from where you were. Personally I'm in favor of this in the current situation (several low numbers and possible symptomatic hypos with currently-limited between cycle testing), but they have more Prozinc experience and might have some other thoughts.

I did not have a chance to say this before, but Thor sure is a cutie-pie!!!!
 
Nan & Amber (GA) said:
Sounds good to me. I'm also going to tag @Deb & Wink and @Panic here for some opinions on that dose, as it's a large reduction from where you were. Personally I'm in favor of this in the current situation (several low numbers and possible symptomatic hypos with currently-limited between cycle testing), but they have more Prozinc experience and might have some other thoughts.

I did not have a chance to say this before, but Thor sure is a cutie-pie!!!!
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He’s so sweet and patient with everything. Just a note: a couple of the lows I caught during curves he wasn’t having symptoms. He is sure keeping me guessing.
 
Audrey and Thor said:
Just a note: a couple of the lows I caught during curves he wasn’t having symptoms. He is sure keeping me guessing.
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I think more times than not kitties don't show symptoms when they're running low, that's why you can't always go by looks. If they're symptomatic it's usually indicative of a more dangerous hypo, at least from what I've seen.

Well he's certainly earned a reduction from that 56 back on the 13th. Like Nan said you're probably seeing all those high numbers and not realizing that they're bounces from low numbers in the middle of the cycle that you're not catching. Can you start getting +2 (AM and PM) and at least one mid-cycle test? Kitties go even lower during the night and you've gotten no tests then.

I'd say at least drop to 1.5u, not sure if 1u is too much a decrease. Deb might say otherwise (she's better at dosing suggestions than me!).
 
What Elizabeth said about the +2 and at least 1 mid-cycle test is spot on. Testing isn't just for pre-shots or curves. Right now, you have data at the beginning of the cycle, but not much in between. We need to have you fill in the SS in between those "bookends" in order to see what is going on.

You want to find a dose that you can give to Thor each cycle, without his BG numbers being too low at pre-shot, so that you need to skip.
That frequent skipping of the dose, tells us the 2U is too high.
The BG level of 56 at +8 on 6/13/20 also tells us the dose is too high.

With an Alphatrak, you don't want the nadirs falling much below 90-100 when using the SLGS (Start Low, Go Slow) dosing method.
With an Alphatrak, a BG level < 68 mg/dL means take action, and bring up those BG levels with some food. That is headed towards hypo territory, and you don't want to go there.

ANYTIME that Thor drops into those neon green BG levels, that is way too low, and a dose reduction is in order. And you hold the dose reduction, until the bounce has cleared and the BG levels tell you the reduced dose isn't working.

When Thor has been in the yellows or blue BG ranges at pre-shot, he bounces up to the black or red BG ranges for the next cycle. He probably dropped too low later in the cycle, and you aren't catching it.

Let's go with the 1U for now. And hold it steady for at LEAST 3-6 cycles and maybe a bit longer, to make sure that Thor clears the bounce before you decide to increase the dose again. Please, ask here first, before you decide to increase the dose. If Thor drops into those neon green BG ranges during any point in time, that is an automatic dose reduction of 0.25U.

Are the Alphatrak test strips too expensive for you to test more often? Is that the reason there are not many mid-cycle tests?
 
Deb & Wink said:
What Elizabeth said about the +2 and at least 1 mid-cycle test is spot on. Testing isn't just for pre-shots or curves. Right now, you have data at the beginning of the cycle, but not much in between. We need to have you fill in the SS in between those "bookends" in order to see what is going on.

You want to find a dose that you can give to Thor each cycle, without his BG numbers being too low at pre-shot, so that you need to skip.
That frequent skipping of the dose, tells us the 2U is too high.
The BG level of 56 at +8 on 6/13/20 also tells us the dose is too high.

With an Alphatrak, you don't want the nadirs falling much below 90-100 when using the SLGS (Start Low, Go Slow) dosing method.
With an Alphatrak, a BG level < 68 mg/dL means take action, and bring up those BG levels with some food. That is headed towards hypo territory, and you don't want to go there.

ANYTIME that Thor drops into those neon green BG levels, that is way too low, and a dose reduction is in order. And you hold the dose reduction, until the bounce has cleared and the BG levels tell you the reduced dose isn't working.

When Thor has been in the yellows or blue BG ranges at pre-shot, he bounces up to the black or red BG ranges for the next cycle. He probably dropped too low later in the cycle, and you aren't catching it.

Let's go with the 1U for now. And hold it steady for at LEAST 3-6 cycles and maybe a bit longer, to make sure that Thor clears the bounce before you decide to increase the dose again. Please, ask here first, before you decide to increase the dose. If Thor drops into those neon green BG ranges during any point in time, that is an automatic dose reduction of 0.25U.

Are the Alphatrak test strips too expensive for you to test more often? Is that the reason there are not many mid-cycle tests?
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The reason there aren’t mid-cycle tests often is because I work 12 hours shifts. Most days I’m either at work or sleeping to go back to work.
 
12 hour shifts are brutal, especially when those shifts are for day, after day, after day. (Or night after night after night).

And then on your days off, you need to do all the other things in life that need doing, like grocery shopping, the laundry, cleaning the kitchen, taking the car to the mechanic for repair, .................................... You name it. Life is full.

Hope at least Thor takes a nap and snuggles with you, while you are regaining your energy in your time off.

So if you are working 12 hour shifts, does that mean that Thor's shots are not 12 hours apart?
 
Deb & Wink said:
12 hour shifts are brutal, especially when those shifts are for day, after day, after day. (Or night after night after night).

And then on your days off, you need to do all the other things in life that need doing, like grocery shopping, the laundry, cleaning the kitchen, taking the car to the mechanic for repair, .................................... You name it. Life is full.

Hope at least Thor takes a nap and snuggles with you, while you are regaining your energy in your time off.

So if you are working 12 hour shifts, does that mean that Thor's shots are not 12 hours apart?
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I will try to get more tests on my days off. On work days his shots tend to be about 6:45 am and 5:20 pm. Sometimes the husband is home and can do them on time. We are trying hard!
 
Audrey and Thor said:
I will try to get more tests on my days off. On work days his shots tend to be about 6:45 am and 5:20 pm. Sometimes the husband is home and can do them on time. We are trying hard!
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That' fine Audrey. We know you are trying hard, to take care of Thor the best you can with your work schedule.

So, roughly 10.5 ( and 13.5 shot schedule most days. If you could indicate that on the SS somehow, that will help us in the future, and we won't ask the same dumb question again.

Next dumb question from me Audrey. Is the shorter cycle time, the AM cycle? I think so, but I'm tired and my brain is fried, ready to be tossed in with some biscuits and sausage gravy and call it a meal. So not thinking as clearly this late at night.

There is the option for customizing your spreadsheet, like @Patty & Teal'c did for her erratic work schedule. Some days, she doesn't know if she is coming home from work or needs to turn back around and go back to work already.

She noted her days off, and what days and hours she was working, in a column she added.
Link to Teal's SS is here. https://docs.google.com/spreadsheet...4cwwRKqnxsKsCQq6KJ2gHt1yN8/edit#gid=978897233

So you can see what she did.
 
It helps me keep it all straight. This way everyone knows what is going on and since my husband won't test it also clears up those days that I have to test an hour before shot. Not a perfect way to have to do things but its not a perfect world and we do the best we can depending on our circumstance. I too work some 12 hour shifts and do understand how hard it can be. That's why husband has to give some shots, which I hate. I tell him how much and pray he does as told because he has not always listened to me and has done his own thing, but that's another story.
 
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