10/18 Ruby AMPS 391, +6 62, +7 73, +8 73 +10 69 and diarrhea, PMBG 88 Hallelujah!

Katherine&Ruby

Member Since 2020
Ruby is doing well today. The Mirtazapine and Cerenia yesterday seem to have stimulated her appetite and she is eating and drinking well. Ketones are still neg/trace. Her poop this afternoon was a little wet but improving over her diarrhea yesterday.

Should I be concerned about this dramatic drop from this morning to her +6?
 
@PerfumedCatMom
Katherine – are you there?

Can you give Ruby a bit of high carb food or a couple of drops of karo or honey?
If you have no high carb wet food in the house, put a couple of drops of karo on a piece of kibble.
Can you get another test in as well? Trying to find out if the 62 is the result of a wonky strip.
 
The forum is experiencing a bit of a slowdown at the moment.
Giving you the information from the Hypo link in case you cannot access. The bold in mine. I've changed the blood glucose numbers to an AlphaTrak.
GENERAL RULE OF THUMB FOR TREATING HYPOGLYCEMIA

Hypoglycemia or low blood sugar is a dangerous condition that must be treated immediately. Also known as insulin shock or insulin reaction, hypoglycemia occurs when there is too much insulin in the body potentially leading to neurological damage and/or death.

Knowing how to respond to a hypoglycemic event whether or not symptoms are present can save the life of your diabetic cat. The following general guidelines are intended for those who home test the blood glucose levels in their cats. These guidelines are not intended to replace the advice given by your Veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness


TREATMENT

During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number below 68 on an AlphaTrak give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.


LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry food. the high carbs will help to increase his/her bgs quickly, but remember the effects of dry food usually takes longer to clear kitty's system once the crisis has passed. Feeding a high carb canned food is preferable to feeding a high carb dry food because the effects will clear kitty's system faster. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizing is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer.

After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.

Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next.

BE PREPARED! KNOW THE SYMPTOMS AND KNOW THE TREATMENT!​
 
@PerfumedCatMom
Katherine – are you there?

Can you give Ruby a bit of high carb food or a couple of drops of karo or honey?
If you have no high carb wet food in the house, put a couple of drops of karo on a piece of kibble.
Can you get another test in as well? Trying to find out if the 62 is the result of a wonky strip.
Hi, sorry for the delay in getting back to you. Sprang into action as soon as I saw your message. I have some of her old Solid Gold Let's Stay Indoors dry food left (35% carbs) and put that in front of her. She might have eaten two or three kibbles. I put some FF Broth on it and then she lapped up a lot of the juice, ate some bits of tuna and a few more kibbles. I rubbed a drop of honey on her chin that she is cleaning off at this moment.

I will test again in about a half hour.

THANK YOU for your help, @Red & Rover (GA)!
 
Phew.

The dry takes longer to enter the system. The honey does not last long.
Can you get another test in now to see which way she is headed?
 
She knows something is up so she is hiding under the couch now but I will try to coax her out and test again. Will post the results.
 
She doesn't have any symptoms. She's not ravenously hungry nor is she acting disoriented.
Good. No symptoms does not mean complacency, however. Cats can go from having no symptoms to seizures in seconds.

And congratulations. Ruby has earned a reduction by going below 90 (as per SLGS). Your new dose is 1.75 units but I'm wondering if it should be more. I'll let other, more experienced, dosing people weigh in on that.
 
Good. No symptoms does not mean complacency, however. Cats can go from having no symptoms to seizures in seconds.

And congratulations. Ruby has earned a reduction by going below 90 (as per SLGS). Your new dose is 1.75 units but I'm wondering if it should be more. I'll let other, more experienced, dosing people weigh in on that.

Whew hew! I found some Hill's MD, which is not HC but MC and she is chowing down on that right now. Hopefully that will have some good effect on her BG.
 
Another test is very important. Need to figure out if Ruby is heading up or down. As soon as you can please. Sorry about the odiferous litter box.

Katherine – Elizabeth will stay with you for the next short while. I have to run out quickly.
 
Test every 15-20 minutes until you get her over 68. If she is still not over 68 you need to give her more honey/syrup with the MC since you don't have HC. Be sure to put up a few cans asap for next time.
 
Found some canned Science Diet Adult Entree in the closet that the vet gave me and only realized now that it's HC. So I have some on hand now. Tried to make her eat some of it but she had a 1/4 can of the m/d so isn't interested.

Will try to test her again in a few minutes.
 
Glad she's not dropping but still pretty low. I am not familiar with Alphatrak numbers past 68 being the take-action number but I expect she'll be better off being over 80-90. Can you keep feeding/checking every 20-30 min until she gets that high? Then hold off food and check in 30 to see if she's holding her own. Sorry I can't be of more help.
 
Glad she's not dropping but still pretty low. I am not familiar with Alphatrak numbers past 68 being the take-action number but I expect she'll be better off being over 80-90. Can you keep feeding/checking every 20-30 min until she gets that high? Then hold off food and check in 30 to see if she's holding her own. Sorry I can't be of more help.
OMG, you've been such great help! I wish I could get her to eat but she's turning her nose up at everything since 3 PM (about 1 ½ hours ago).
 
Hi Katherine. I'm back.

We would really like to see Ruby start to rise.
Any more of that tuna left? Perhaps with a drop of honey on top?
Or a bit of the FF broth with honey added?

It is important to not fill her up with food during a low numbers situation. It is easier to get a hungry cat to eat.
 
See if she will eat out of your raised hand. Animals don't like lowering their heads lower than their bodies if they are nauseous.
 
I think Ruby is very stressed by my very bad testing. Her poor ears are covered in scabs. It might account for why she's not eating anymore. I am going to check back in around +11.5 and see if I should give her her dose and how much.
 
Is it possible to get just one more test? It is important to make sure that she is on her way up and not heading back down. As you saw on the 12th, her +10 test of 329 was lower than her +8 test of 345. Sometimes Lantus has a longer duration.

Neosporin with pain relief ointment (not the cream) will help with her ears.
 
I think Ruby is very stressed by my very bad testing. Her poor ears are covered in scabs. It might account for why she's not eating anymore. I am going to check back in around +11.5 and see if I should give her her dose and how much.
Have you tried applying some vaseline/other ointment after testing?
 
She's had a lot of different foods today - may have caused a little upset tummy there.

Just keep an eye on her this evening. Congratulations on the reduction - although the way she earned it is quite the ordeal isn't it?

Will she eat Fancy Feast gravy style foods? Many of them are medium and high carb. I've got quite a variety on had for Luci's dives.

Didn't know if you had the link for the food chart or not - so here it is just in case :)

https://catinfo.org/chart/index.php
 
She's had a lot of different foods today - may have caused a little upset tummy there.

Just keep an eye on her this evening. Congratulations on the reduction - although the way she earned it is quite the ordeal isn't it?

Will she eat Fancy Feast gravy style foods? Many of them are medium and high carb. I've got quite a variety on had for Luci's dives.

Didn't know if you had the link for the food chart or not - so here it is just in case :)

https://catinfo.org/chart/index.php
If she doesn't go back up past 100 by her PM shot, should I not give her insulin?
 
I’m not sure even 150 would be a safe number to shoot the full 1.75.

I'm expecting a bounce...that's why I'm wondering how many tests can be obtained between now and PMPS - then make the decision based on that. Katherine and Ruby are new to this and newbies really shouldn't shoot below 200 ....need more time to gather data and find out how their cats are responding.

Ruby is also new to that low number she saw today...I'm just wondering how long before her liver starts to unload...and she's going to bounce to the moon...

Since no one puts their location in the avatar/info I can't tell where she's at...US vs ? I just don't know what we're dealing with here based on the last BG...:rolleyes:
 
Yes and she was at 136 yesterday at amps and she skipped. Now with diarrhea and no appetite I am not sure if skipping is necessay or if sky high a 1/4 dose.
 
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