Jasmine's first low

[Kim and Jasmine]

Hi all. We are just barely 1 month into this and for the most part, Jasmine's BG has been 200's-300's using Contour Next One meter. She is on Lantus 1.5u. Very rarely has she gone below 200. Last night's pmps was 385. This morning amps was 56! I did not give her insulin. I fed her and monitored again approx 45 min later was 76, and an hour after that was 152. My sister who has diabetic ex-husband and daughter, scolded me and said I should've given Jasmine the Lantus because her BG will spike high without it. Is this true? Should I have given it to her anyway? This is all still new to me. She is due for a vet check up this week and given her previous numbers, I thought I was going to have to increase her dose. I will be continuing to monitor her throughout the day.

 

[Ale & Bobo & Minnie (GA)]

Hi all. We are just barely 1 month into this and for the most part, Jasmine's BG has been 200's-300's using Contour Next One meter. She is on Lantus 1.5u. Very rarely has she gone below 200. Last night's pmps was 385. This morning amps was 56! I did not give her insulin. I fed her and monitored again approx 45 min later was 76, and an hour after that was 152. My sister who has diabetic ex-husband and daughter, scolded me and said I should've given Jasmine the Lantus because her BG will spike high without it. Is this true? Should I have given it to her anyway? This is all still new to me. She is due for a vet check up this week and given her previous numbers, I thought I was going to have to increase her dose. I will be continuing to monitor her throughout the day.

Hi Kim and welcome!

Absolutely not. If she was 56 at her amps that means she likely went much lower overnight and you don’t want to risk a hypo. Do you have a hypo kit ready? High carb foods and Karo or honey at hand? I’m glad she’s going up and yes, she may go higher today but it’s best to err on the side of caution and high is better than too low. According to the dosing protocols we use here, she earned a reduction of .25 so I’d suggest that her next shot be 1.25. She’s basically telling you that 1.5 is too high for her right now.

a few questions for you, what kind of food are you feeding her and are you testing always without food before you give her the insulin shots? She should not have eaten anything 2 hours before those am and pm tests. Lastly, do you happen to have 1/2 unit marked syringes so it’s easier to go down to 1.25?

here are a few things you can do to help us help you better, please read the link and if you could set up your signature, that would be super helpful!

Start Here

welcome again and I’m really happy you’re home testing! That’s the only way to make sure Jasmine is safe

 

[Sienne and Gabby (GA)]

Respectfully, I disagree with @Aleluia Grugru & Minnie. Rather, it depends.

With Lantus, it is possible to shoot low numbers. I would shoot anything above 50. However, and this is a BIG however, you need to have the data to do so. We would rarely tell someone who is relatively new to managing their cat's diabetes to shoot that low of a number especially if they didn't have an experienced member available to guide them.

There are a number of things you can do to help us help you learn this process. There is a post that outlines setting up both a spreadsheet so we can watch Jasmine's progress along with you as well as what will be helpful to include in your spreadsheet. This is the link to that post. There is also a great deal of information about Lantus and it's use in the sticky notes at the top of the Lantus board. I would encourage you to get your spreadsheet and signature set up if you want to post on the Lantus board.

 

[Ale & Bobo & Minnie (GA)]

Respectfully, I disagree with @Aleluia Grugru & Minnie. Rather, it depends.

With Lantus, it is possible to shoot low numbers. I would shoot anything above 50. However, and this is a BIG however, you need to have the data to do so. We would rarely tell someone who is relatively new to managing their cat's diabetes to shoot that low of a number especially if they didn't have an experienced member available to guide them.

There are a number of things you can do to help us help you learn this process. There is a post that outlines setting up both a spreadsheet so we can watch Jasmine's progress along with you as well as what will be helpful to include in your spreadsheet. This is the link to that post. There is also a great deal of information about Lantus and it's use in the sticky notes at the top of the Lantus board. I would encourage you to get your spreadsheet and signature set up if you want to post on the Lantus board.

I agree with you. My response was based on the fact she’s new at this. A more experienced member, like you pointed out, with enough data about their cat could act differently. You also have the option of a token dose, but again I think she did the right thing being new at this and being cautious.

to be honest, even though I’ve been at this much longer, 56 is too close to 50 for comfort for me and I’d have skipped as well. It’s easier with humans who can tell you they don’t feel good and know what to do to get their own bodies to a safe place. A cat can’t and that also adds to it. Of course, as we all say here ECID Every Cat Is Different. Just like people!

 

[Kim and Jasmine]

Just took her BG and now it is 345! Ugh. That is 6 hours post breakfast. Yes I monitor her before eating and no she doesn't have food more than 2 hours prior to testing. Yes I have a kit ready. That is my biggest fear, her dropping so low while we are all asleep. Thank God she is ok. So do I still reduce her dose when she is due later? I did recently make a spreadsheet from a facebook group that helped me. Is there a way to transfer it here? One more question... I notice that Jasmine is much more spunkier when her BG is high like in the 300's. Is that normal??

 

[Kim and Jasmine]

Forgot to answer what she is eating. She is getting fancy feast and tiki cat. Freeze dried chicken treats. My cats eat 4x/day. And can anyone recommend a good probiotic? She occasionally has diarrhea and soft poop and oh boy has her poop been stinking since only wet food! lol

 

[Elizabeth and Bertie]

This morning amps was 56! I did not give her insulin.

I think you made absolutely the right choice in the circumstances, with the experience you have, and with the information you had available. I'd have done exactly the same.

There are a number of reasons why a preshot number might be low. And without blood glucose data it's not possible to determine the cause of the lower number. 'Maybe' the dose is too high. 'Maybe' her body is healing and responding better to the insulin. 'Maybe' her pancreas is producing some insulin of its own. 'Maybe' she threw up her food somewhere and the blood glucose is lower because of that. And 'maybe' it's just a random 'one off' occurrence and the reason will remain a mystery... And 'maybe' it's any number of other reasons that I've not thought of at the moment. ...Whatever the possible reason this would seem to 'not' be a good time to raise the insulin dose...

Please don't worry that the number is higher now. These things happen and are all part of the journey. It's just 'one day'. There will be lots of 'tomorrows'...

Kim, are you regularly getting some mid-cycle tests, and what numbers are you seeing then?
And have you changed the diet to lower carb recently?

Eliz

 

[Ale & Bobo & Minnie (GA)]

Elizabeth is right. You’ll see higher numbers today and that’s okay. I would still reduce the dose to 1.25. We advise to do that anytime a cat goes under 90 at any point in time during a cycle when you follow the SLGS method. I believe under TR, you’d reduce only if you get a number below 50. Do you know enough about them and do you know which one you’re following? I assumed SLGS but please let me know if that’s not the case.

I think you’d have to manually transfer the data to the ss template we use here. I feel like someone said that before in another thread but tagging @Chris & China (GA) who is our ss wizard and can answer that!

The probiotic a lot of us use here for stool maintenance is S Boulardii. There are a ton of different brands on Amazon. I went with Jarrow because it was a mid price range and it had good reviews. I’d start with 1/4 capsule once a day and then increase to twice a day if needed. It does take a week or two to start to work in their body, like most probiotics.

 

[Kim and Jasmine]

Elizabeth is right. You’ll see higher numbers today and that’s okay. I would still reduce the dose to 1.25. We advise to do that anytime a cat goes under 90 at any point in time during a cycle when you follow the SLGS method. I believe under TR, you’d reduce only if you get a number below 50. Do you know enough about them and do you know which one you’re following? I assumed SLGS but please let me know if that’s not the case.

I think you’d have to manually transfer the data to the ss template we use here. I feel like someone said that before in another thread but tagging @Chris & China (GA) who is our ss wizard and can answer that!

The probiotic a lot of us use here for stool maintenance is S Boulardii. There are a ton of different brands on Amazon. I went with Jarrow because it was a mid price range and it had good reviews. I’d start with 1/4 capsule once a day and then increase to twice a day if needed. It does take a week or two to start to work in their body, like most probiotics.

Elizabeth is right. You’ll see higher numbers today and that’s okay. I would still reduce the dose to 1.25. We advise to do that anytime a cat goes under 90 at any point in time during a cycle when you follow the SLGS method. I believe under TR, you’d reduce only if you get a number below 50. Do you know enough about them and do you know which one you’re following? I assumed SLGS but please let me know if that’s not the case.

I think you’d have to manually transfer the data to the ss template we use here. I feel like someone said that before in another thread but tagging @Chris & China (GA) who is our ss wizard and can answer that!

The probiotic a lot of us use here for stool maintenance is S Boulardii. There are a ton of different brands on Amazon. I went with Jarrow because it was a mid price range and it had good reviews. I’d start with 1/4 capsule once a day and then increase to twice a day if needed. It does take a week or two to start to work in their body, like most probiotics.

May be a dumb question, but what is SLGS and TR?

 

[Ale & Bobo & Minnie (GA)]

May be a dumb question, but what is SLGS and TR?

Not at all. I thought it was another language when I was asked to indicate that in my spreadsheet lol!

check out the section in this link that talks about approaches to regulation. TR is a bit more aggressive and requires more testing. It also has lower thresholds for dose decreases. It’s a matter of what you’re comfortable with.

Protocols for Lantus

 

[Sienne and Gabby (GA)]

We use two different approaches to Lantus and Levemir dosing -- Tight Regulation (TR) or Start Low Go Slow (SLGS). Each has it's strengths. Fundamentally, people choose based on lifestyle or if their kitty is eating any dry food, there isn't a choice. If dry food is in the diet, you're confined to SLGS. Both methods have gotten cats into remission. One benefit that TR has that SLGS doesn't is that it's based on published research and your vet may be familiar with it.

 

[Ale & Bobo & Minnie (GA)]

And I don’t think we answered the question about her behavior being spunkier when she’s in high numbers. Do you mean in the 300’s versus 100’s or lower? Like how was she this am at 56? Some cats may start so show slight signs of hypo behavior at higher numbers than others. Minnie had been down at 48 and acted perfectly fine, but maybe Jasmine starts to feel lethargic at a higher number. Can you elaborate a bit on what you mean by lower numbers? Thanks!!

 

[Elizabeth and Bertie]

I notice that Jasmine is much more spunkier when her BG is high like in the 300's. Is that normal??

Ah, I just noticed what @Aleluia Grugru & Minnie posted in the comment above, about your your kitty being spunkier in higher numbers. ..If I've understood your meaning correctly, this is not actually that unusual at first. And I wonder if it's just because the kitties get used to the higher blood glucose levels, and that it can feel strange to some of them when they first experience lower levels. Cats' bodies do seem to get used to higher blood glucose levels and this appears to be able to become their 'new normal', especially if they have been in high blood glucose levels for a long time. This is evident when we see some kitties 'bounce' (rebound) even when their blood glucose drops into lower ranges that aren't even that low and certainly aren't dangerous.
Kitties can also feel a bit strange (or so it seems) when the blood glucose fluctuates wildly, swinging from highs to lows and back again.

 

[Ale & Bobo & Minnie (GA)]

Ah, I just noticed what @Aleluia Grugru & Minnie posted in the comment above, about your your kitty being spunkier in higher numbers. ..If I've understood your meaning correctly, this is not actually that unusual at first. And I wonder if it's just because the kitties get used to the higher blood glucose levels, and that it can feel strange to some of them when they first experience lower levels. Cats' bodies do seem to get used to higher blood glucose levels and this appears to be able to become their 'new normal', especially if they have been in high blood glucose levels for a long time. This is evident when we see some kitties 'bounce' (rebound) even when their blood glucose drops into lower ranges that aren't even that low and certainly aren't dangerous.
Kitties can also feel a bit strange (or so it seems) when the blood glucose fluctuates wildly, swinging from highs to lows and back again.

Thank you Eliz!