Help, new lower number, do I administer insulin?

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Douglas_my ginger cat

Douglas_my ginger cat

Member Since 2020
Hi, I've just taken Douglas' bg and its 11.3. Its never been this low as a pre shot reading. Do I still give insulin? Ive just given him his usual food and usual administer the insulin about 29 mins after he finishes eating.

This is brand new territory for me (but great for numbers!)

Please help!
 
Douglas is right on the no-shoot threshold.

How are you positioned for testing over the next 12 hours?


Mogs
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Douglas_my ginger cat said:
What's a bounce?
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When a cat that is used to high numbers starts seeing lower ones (like the blue yesterday), often there's a reaction in which the cat's body dumps sugar to zoom the BG back up to familiar levels.

What I'm worried about is the possibility that he's currently coming back down off the bounce. Sometimes they have a bit of downward momentum, so you have to be careful about shooting insulin so it doesn't coincide.

We don't really know what he's doing, though. That's why I'm thinking a short stall-- basically, just another test a half hour after the last test. Usually we do it without having fed, not sure if that will be possible on the Caninsulin schedule-- did he get his evening meal yet? [edit: whoops! I see that he has, so scratch that question. We still might get some info from a second test, but we'll have to take food into account.]
 
Nan & Amber (GA) said:
When a cat that is used to high numbers starts seeing lower ones (like the blue yesterday), often there's a reaction in which the cat's body dumps sugar to zoom the BG back up to familiar levels.

What I'm worried about is the possibility that he's currently coming back down off the bounce. Sometimes they have a bit of downward momentum, so you have to be careful about shooting insulin so it doesn't coincide.

We don't really know what he's doing, though. That's why I'm thinking a short stall-- basically, just another test a half hour after the last test. Usually we do it without having fed, not sure if that will be possible on the Caninsulin schedule-- did he get his evening meal yet?
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Yea, I feed him as normal but he's only eaten half of it. I don't think he's a fan of the purina stuff so gonna order some different food this evening for him.
 
I say it doesn't hurt to get another test 30mins after the last one (i.e., right around your usual shot time). If he's a lot higher, then he was probably on the way up anyway and he's probably safe to shoot. If he's lower, I'd probably skip. In between is where it gets iffy, but we can figure that out when we get there.

How late (in + numbers) could you possibly stay up with work, if you had to?
 
Nan & Amber (GA) said:
Mogs, I'm wondering if a short stall might be in order here, just to see what direction Douglas is heading? I'm worried with Caninsulin and the AT2 reading, plus the high numbers this morning after the blue yesterday-- Douglas may be breaking a bounce tonight...
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A short stall is a good idea, Nan, but I'm very much leaning more towards a skip. There's not much data yet - particularly mid-cycle - and the difficulty with Vetsulin is that sometimes giving even a tiny token dose (e.g. 0.5IU) still has the potential to drop numbers like a rock at the beginning of the cycle. Just need to determine Douglas' ketone status before proceeding making final suggestion.

@Douglas_my ginger cat -

Does Douglas have any history of testing positive for ketones, or of DKA episodes?


Mogs
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Critter Mom said:
A short stall is a good idea, Nan, but I'm very much leaning more towards a skip. There's not much data yet - particularly mid-cycle - and the difficulty with Vetsulin is that sometimes giving even a tiny token dose (e.g. 0.5IU) still has the potential to drop numbers like a rock at the beginning of the cycle. Just need to determine Douglas' ketone status before proceeding making final suggestion.

@Douglas_my ginger cat -

Does Douglas have any history of testing positive for ketones, or of DKA episodes?


Mogs
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Douglas had a urine test prior to his diagnosis, ketones were negative but this was done in July.

Nan & Amber (GA) said:
How late (in + numbers) could you possibly stay up with work, if you had to?
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I could do a test at midnight which would usually be +4.5?


If I skip, what do I need to do additional or not? Should I do some extra bg tests?
 
I’d definitely say test again now and see how the land lies - he may have rocketed up enough to warrant a token dose but the safest thing would be to skip... better too high for a day than too low for a minute (you get the gist).

Whatever you decide, it would be useful to get a couple more tests before you go to bed - it’s all useful data.
 
I asked about the ketones because some cats are more prone to them so if Douglas had a history of throwing ketones or recent DKA, because he's still fairly high most of the day it would probably have been better to give a token dose but you'd have needed to monitor him right the way through the lowest part of the cycle for safety (not enough mid-cycle data yet upon which to gauge how low he's going regularly).

My suggestion would be to skip tonight's dose.

Thoughts, people?


Mogs
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Thank you guys! I think this was the first time that I actually panicked about hypo. I didn't expect such low numbers. In fact I think it took a good 10 secs after his bg number to appear that it was so low. We had a little struggle with this bg so I'm so happy I persevered and got the reading. Had I not, i would've administered and gone to bed nime the wiser.

I will skip tonights dose. Dont worry @Critter Mom, Douglas got his tuna treat and I pretended to administer the injection (adding some desensitising work in there while I can!). And I'll take a few reading before bedtime.

I have a GluciNavii on its way with an additional 100 test strips so I'll be testing my arse off when that arrives.

Again, thank you so much. Its absolutely amazing how quick you all respond. Incredibly helpful and supportive. Thank you xx
 
Critter Mom said:
If you do skip I hope that Douglas will still get his tuna treat. :)


Mogs
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Seconded!!!!! [ETA: oh good, already taken care of while I was typing the rest of this message!]

I think a skip is probably the safest move here, and definitely a test or two tonight to see where he's going and to start to get a handle on what's going on with him. There are lots of possibilities, the simplest among them:

1) yesterday's blue number was kind of unusual, he bounced up, and now he's breaking the bounce (right now he's going down)

2) yesterday's blue number is something he does during lots of cycles when you aren't able to test, right now he's on the way up from whatever low he hit today

Since your work/sleep schedule probably doesn't give you a lot of opportunity to test mid cycle, sometimes these kinds of days can help you do some detective work (in addition to the safety reasons for getting a couple more tests).
 
Well handled! Go and get yourself a nice G&T / glass of wine (delete as appropriate).

Glad to hear you’re getting a human meter. It will change the way you look at testing, ie you’ll test more to get more info as it won’t break the bank.

Tonight’s experience shows exactly why everyone should always test before each shot as a minimum. Bear in mind that 11 is the PS no-shoot number at least until you have a lot more data.
 
Diana&Tom said:
Going back up wasn’t unexpected but I see you’ve got a rather nice pink this morning! Yay! This is interesting...
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I know, first pink ever since testing.

Funnily enough, my vet had emailed me during my panic last night. Basically saying we should up to 3 IU but we can discuss after my curve tomorrow.

I think Douglas not eating much of the purima has possibly contributed to these varied numbers. Although I have finally found a food he actually doesnt like so new stuff on its way hopefully by end of week (along with the GlucoNavii).

Actually, I have a question, if I start using the GlucoNavii for every day but AT2 for vet curves, do I record this all on one sheet or have a seperate sheet for the human meter (if I remember correctly there were 2 different spreadsheets for human and animal meters)?
 
Yes def hold off increasing dose until after the curve... it was looking recently that you might need to increase but the waters are muddied if food has changed or is changing... as I was saying yesterday, one change at a time.

As for your query re meters - very good point - I’m not sure about separate spreadsheets (someone else will know) but it’s quite possible as the different meters might show a different picture and potentially confuse advice-givers. If you do continue with the same ss you would need to make a note on it about the switch and make a clear distinction, maybe leave a gap to indicate a break in the previous way of recording.

TBH if it was me, I’d get to grips with the new meter and stick with it. It just makes things simpler and less confusing all round. You could tell the vet that you simply can’t afford Alphatrak strips. It’s your decision to test in the first place, not an instruction from the vet (if I remember rightly?). But that’s just me; if you have a system in place that works for you, that’s great.
 
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Douglas_my ginger cat said:
Hi, I've just taken Douglas' bg and its 11.3. Its never been this low as a pre shot reading.
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Oooh, well that 11.3 is an interesting development...
And what's more, the blood glucose went up during the evening but then dropped a bit again by this morning despite the skipped shot... Hmmm....

Low numbers at the end/beginning of a Caninsulin cycle are always of interest because they are not the norm... Caninsulin typically has a short duration and often wears off after 8 - 10 hours. So, high preshot numbers are often 'part of the territory' with Caninsulin. If a preshot number is low then there is usually some kind of reason for that.
A common reason is that the cat's pancreas is starting to produce more insulin of its own and is able to extend the duration of the cycle.
Less common is that a cat gets particularly good duration with Caninsulin.
Another 'possible' reason is that the insulin dose is too high and is extending the insulin cycle, but while this is 'possible' with Caninsulin it is quite a rare occurrence.
Another 'possible' is that the blood glucose dropped much lower earlier in the cycle and is now rising from that but is still relatively low by the next preshot. But with Caninsulin it is more usual that a low blood glucose early in the cycle will cause the blood glucose to rise or bounce quite quickly, it doesn't tend to drift up slowly.
Another 'possible' reason is that it's just a random lower number, but I don't think that's the case here.
Whatever the reason at this point, it is nice to see Douglas in these improving numbers... :cat:

How is the testing going? Are you and Douglas getting more comfortable with that?

Douglas_my ginger cat said:
Douglas got his tuna treat and I pretended to administer the injection (adding some desensitising work in there while I can!).
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Oh, good girl! :D
 
Elizabeth and Bertie said:
How is the testing going? Are you and Douglas getting more comfortable with that?
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Testing is going ok. He is a trooper but makes little 'ouch' noises when I prick his ear. It's an extremely cute noise but makes my heart break that little bit more.

So many reasons for these drop in numbers! With all these 'possibles' what do you think is my next best step? Shall we see how the glucose curve goes tomorrow?
 
I'll let the experts respond to your last question but just had to say a big well done for getting Douglas to let you test him so nicely & well - all credit to you! Mac is a terror to get blood from so I'm dreading the next BG curve which due on Saturday - I'm now off to buy some tuna in water to try that next !! (Hmmm wonder if a few drops of Gin would work better?? Only joking I'd never give him alcohol !!)
 
Gill & Mac (UK) said:
I'm now off to buy some tuna in water to try that next !! (Hmmm wonder if a few drops of Gin would work better?? Only joking I'd never give him alcohol !!)
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Little bit of whiskey on the gums......

Not sure where you are getting your tuna from but M&S have some tuna in spring water in their clearance (still well within date) for 85p per tin. That's were I stocked up and the tuna is good. Made a nice tuna jacket with it too (that was for me) :D
 
Douglas_my ginger cat said:
Little bit of whiskey on the gums......

Not sure where you are getting your tuna from but M&S have some tuna in spring water in their clearance (still well within date) for 85p per tin. That's were I stocked up and the tuna is good. Made a nice tuna jacket with it too (that was for me) :D
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[Rushes off to M&S and buys ten tins of tuna only to find cat turns up nose... tuna jackets are ok but I prefer baked beans ;) ]
 
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