Help needed! Possible hypo scare last night, now to proceed today?

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mosi_yazhi

mosi_yazhi

Member Since 2021
Hey, guys! I'm Wendy!

I'm new here. I PROMISE, a proper signature, introductory post and a spreadsheet is coming! But for right now, I need help deciding what amount of insulin to give my cat/if I should give her any. We had a bit of a hypo scare last night, and I need advice on how to proceed.

Olivia
18 years old, female, calico
Indoors cat
Diagnosed April 22, 2021
Started insulin April 27, 2021
Vetsulin
1 unit, twice a day
Accu-check Guide Me
Currently on Clavamox for UTI
Vet says she might need to have teeth pulled?

She's currently on the tail end of a two-week Clavamox script for a UTI that was diagnosed at the same time as her diabetes diagnosis.

The vet initially had her on 2units twice a day in the beginning, but then knocked it down to 1unit, twice a day once I relayed the pre-shot/dinner BG numbers I was finding to him.

I haven't done a full curve on her, because the Clavamox (amoxicillin) has been wrecking havoc on her digestive system and at times her appetite, so I figured I better hold off doing a full-scale curve until shes done with the antibiotics and things level out. (Even though she doesnt always have the BEST appetit for designated meal times, she'll typically still graze on whatever is left in her bowl until 2 hours before her next test/shot. But the Clavamox has also been giving her diarrhea, so I feel like shes maybe not absorbing it as efficiently)

This is a breathtaking case of stupidity on my part - 'I know just enough about this to think I know what I'm doing, but not enough to actually KNOW' and a little too much faith in my vet, perhaps.

I've been checking her bg since her diagnosis, and aside from her first initial test (367), they're usually in the 120-150-ish range before feeding time, and before her shot. Yes, I've been shooting her the full 1unit at those numbers, which I now realize is a bit ‍♀️‍♀️‍♀️

Last night, before dinner, she read at 104, and I was like, "Wow, that's lower than what she usually is... maybe I should only give her half a dose!"

And, yeah. Yeeeeah. Her numbers dipped low.

7:30pm - 104 bg. Pre-test before dinner.

8:00pm - Dinner. Half a can Friskies paté 5% carb something or other.

8:30pm - .5u insulin

10:30pm - 60bg. She was acting especially lethargic and listless so I decided to test, and I had a real 'OH CRAP!' moment, knowing we're not at the insulin peak yet. Administered some honey, and then popped open a can of gravy lovers Friskies for her to lick at.

11:30pm - 56bg. In freakout mode. Gave her a little more honey, and a little of the forbidden dry food.

12:15am - 133bg. Feel a bit better, she seems to have pepped up a bit, but still keeping an eye on her incase it was just the honey and it wears off.

1:30am - 143bg. Feel even more better that she numbers seem to be trending up. She is MAD about all the extra ear pokes tonight. We settle in on opposite sides of the couch in a tense Mexican stand off.

3:30am - 211bg. Been 7 hours since the shot, figure she's through the storm. Camp out on the couch with her to have a restless sleep, low-key dreading what tomorrow's numbers will look like after all the dry food and gravy.

7:30am - 166bg. Breakfast. 9lives 3% chicken paté.

Am now at a loss what to do. I was panic reading this site last night and saw some people saying after a hypo scare, the bg might be elevated for a few days/to be careful of dosage, but I'm not sure what to do.

No history of ketones, but again, we're new to this game, and she's still technically on meds for a UTI and the vet thinks she needs to have a few teeth removed besides, because he thinks they're going. I feel like this is maybe enough warrant for concern about skipping this morning's dose entirely?

She's a little tuckered out after last night's events, and is currently snoozing on the couch with me as I type this.
 
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10:42am

I gave her .25u insulin, like the barest few drops, since she was at 166bg this morning before breakfast, and I felt like I had to give her SOMETHING.

I'm terrified of her getting ketones because of her UTI and teeth.

IDK if that was the right thing to do, but no one is replying and I'm worried about giving it to her so late that it effects the PM cycle and I have to be up all night again.

I'm so stressed out. Can someone just reply to let me know if they even see this post? I understand that this is a small message board and everyone has lives outside their cats, but I just need to know I didnt set up my account wrong or something where no one can see this.
 
Hi, sorry no replies yet, doesn't look like any members familiar with Vetsulin around at the moment.

I'm not a Vetsulin user either. Has she eaten anything since breakfast? Can you grab a test right now to see what her current number is please.
 
Shelley & Jess said:
Hi, sorry no replies yet, doesn't look like any members familiar with Vetsulin around at the moment.

I'm not a Vetsulin user either. Has she eaten anything since breakfast? Can you grab a test right now to see what her current number is please.
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Oh, god, thank you for replying!

Right now, as of 11:10am, she is at 135.

She didnt finish all of her breakfast this morning, but I saw her go back and nibble at it a bit earlier. I've given her some freeze dried chicken treats that shes enthusiastically devoured.
 
Can you monitor closely today? Again, I haven't used Vetsulin but I'll stay with you and keep an eye out for members with more experience.
 
Shelley & Jess said:
Can you monitor closely today? Again, I haven't used Vetsulin but I'll stay with you and keep an eye out for members with more experience.
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I'll try.

I actually live extremely rurally and was planning on making a mad dash the next town over (1hr drive, 1 way) to get more testing strips (running low-ish) and ketone testers.

(I swear to god, this pack of 50 strips I bought just evaporated overnight ‍♀️)

She just ate more of the 3% 9lives.

Thank you thank you thank you!
 
Shelley & Jess said:
How many strips do you have left?
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Looks like 13 strips left!

How often should I test her today, with the assumption I might not make it to the store until tomorrow? Or what's your ballpark idea when she might be in the clear for today?

Unfortunately I can go later at night due to a curfew where I live due to the pandemic.
 
My understanding is that Vetsulin onsets faster than the Prozinc I'm familiar with. They're both in-and-out insulins though.

I'd like you to try and catch the onset and see what kind of drop (if any) she's got going and if it looks like things might be moving too fast we can always carb her up and abort the cycle.
 
First of all, are you feeding 30 minutes before giving her insulin? If not, please do. Caninsulin hits hard and fast, and usually doesn't last long. So if you've seen those numbers at preshots, she might have been even lower.
When you get a number in the 60 or 50's on Caninsulin you need to test every 20 minutes or so. An hour is too long.

And get some more strips! 50 doesn't last long. Buy as many as you can afford :oops:

Caninsulin hits nadir early around +3/+5 but every cat is different. And because it hits so hard, food needs to be on board and you need to make sure it stays down :p so test, feed 30 minutes prior and then give her the shot.

BTW, feel free to correct me, Deb and Janet :bighug:
 
Shelley & Jess said:
My understanding is that Vetsulin onsets faster than the Prozinc I'm familiar with. They're both in-and-out insulins though.

I'd like you to try and catch the onset and see what kind of drop (if any) she's got going and if it looks like things might be moving too fast we can always carb her up and abort the cycle.
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Ok. Can you give me like, a time frame of when to test, then? Like, I know when you're doing a curve you test every 2-3 hours? Should I test that often today or like, EVERY hour?
 
The first part is usually the critical one, so I'd test a lot during the first part. But I'm a freak at testing. Can you get more strips today?
 
SashaV said:
First of all, are you feeding 30 minutes before giving her insulin? If not, please do. Caninsulin hits hard and fast, and usually doesn't last long. So if you've seen those numbers at preshots, she might have been even lower.
When you get a number in the 60 or 50's on Caninsulin you need to test every 20 minutes or so. An hour is too long.

And get some more strips! 50 doesn't last long. Buy as many as you can afford :oops:

Caninsulin hits nadir early around +3/+5 but every cat is different. And because it hits so hard, food needs to be on board and you need to make sure it stays down :p so test, feed 30 minutes prior and then give her the shot.

BTW, feel free to correct me, Deb and Janet :bighug:
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Yeah, I usually wait about half an hour after shes started eating to give her her insulin.

Before all this she was a free fed baby, and grazed a little bit at a time whenever she was hungry, so I think shes still in that mindset. Testing happens around 7 am/pm, food gets set down shortly after, and then shot 30 minutes later. If there's food left in the bowl after, I try to encourage her to finish throughout the day, before the PM cycle starts (2 hours before)

When I bought the strips, I didnt know the full scope of having to curve, etc, and I didnt forsee sucking so much at taking samples. I just thought "50 strips, twice a day, this will last 25 days! =D"

I'm such a dummy.
 
SashaV said:
The first part is usually the critical one, so I'd test a lot during the first part. But I'm a freak at testing. Can you get more strips today?
Click to expand...

The store is 1 hour trip away, 1 hour back, and I have to be home by 10pm (pandemic curfew).

So if I go, it has to be by 7:30 at the latest. She starts the PM cycle around 7. Do you think it might be safe to go at around 5pm?
 
mosi_yazhi said:
The store is 1 hour trip away, 1 hour back, and I have to be home by 10pm (pandemic curfew).

So if I go, it has to be by 7:30 at the latest. She starts the PM cycle around 7. Do you think it might be safe to go at around 5pm?
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Test her before you go, if she's below 100 stay and watch if she's on her way up. If not, stay home.

You're not a dummy, I did the exact same thing :D
Now I'm at 300 strips in a month. Probably a lot more these days, but I found the cheapest ones :p:D

@Shelley & Jess what do you think about leaving? Any other suggestions to make it as safe as possible?
 
SashaV said:
Any other suggestions to make it as safe as possible?
Click to expand...

This is a tough one without more data. You gave a reduced dose but we still have a 59 pt drop in an hour. You don't have many test strips.
I'd feed a teaspoon of HC wet, try and slow things down a bit.
 
Shelley & Jess said:
This is a tough one without more data. You gave a reduced dose but we still have a 59 pt drop in an hour. You don't have many test strips.
I'd feed a teaspoon of HC wet, try and slow things down a bit.
Click to expand...
But not going means no strips..

Wendy, are you alone? Can someone help you get the strips while you stay home?
 
SashaV said:
But not going means no strips..

Wendy, are you alone? Can someone help you get the strips while you stay home?
Click to expand...

Unfortunately I am alone.

She finished all the gravy out of this can, left the meaty bits behind. Should I open another can and see if she goes for it?
 
Yikes only +2.

Do you have honey, karo anything like that? Not because you need it right now, just want to make sure you have if, if it becomes necessary.
So the 135 is an hour ago, and +1. So you're down to 11 strips now.
 
Good decision to shoot .25, but I think you should consider to skip if below 200. Specially in the beginning. I mean we keep the threshold higher with caninsulin..
 
SashaV said:
Good decision to shoot .25, but I think you should consider to skip if below 200. Specially in the beginning. I mean we keep the threshold higher with caninsulin..
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I wish I hadn't given her the dose at all, I feel so bad, especially after the whole ordeal last night!

I need to do a proper curve and get that spreadsheet up so y'all can look at it and tell me if her usual dose of 1u is too much. Now seeing the numbers what what the vetsulin does, I wonder if maybe she needs a much much lower dose, and she was just bouncing or something?

Tonight's her last dose of the Clavamox, so hopefully I'll have a better idea of her actual numbers once her appetit returns and her diarrhea stops.
 
mosi_yazhi said:
I wish I hadn't given her the dose at all, I feel so bad, especially after the whole ordeal last night!

I need to do a proper curve and get that spreadsheet up so y'all can look at it and tell me if her usual dose of 1u is too much. Now seeing the numbers what what the vetsulin does, I wonder if maybe she needs a much much lower dose, and she was just bouncing or something?

Tonight's her last dose of the Clavamox, so hopefully I'll have a better idea of her actual numbers once her appetit returns and her diarrhea stops.
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Do not feel bad! Really! We've all been exactly where you are.
Bounces go up, not down. I definitely think 1U is too much.
Was she diagnosed based on blood glucose, fructosamin and urine glucose?
She doesn't seem to go that high, so you might not be at this for long.... so you could be in for a nasty fight for a short while. And that's good news! Hang in there.
Do you need help setting up your spreadsheet? We have someone who can help you, and it won't take her long.
 
7:45am - 166bg

10:42am - .25uinsulin

11:10am - 135bg

12:12pm - 76bg

1:05pm - 64bg​

1:53pm - 101bg

\o/

Might just be the honey. But she also had more gravy. Obviously gonna keep checking, but my lord, my adrenal glands couldn't take it if she dipped lower ugh!
 
I remember my first low(er) numbers (they weren't even that low, still in the blue range) - I was running around the house in an absolute tizzy!!
 
SashaV said:
Do not feel bad! Really! We've all been exactly where you are.
Bounces go up, not down. I definitely think 1U is too much.
Was she diagnosed based on blood glucose, fructosamin and urine glucose?
She doesn't seem to go that high, so you might not be at this for long.... so you could be in for a nasty fight for a short while. And that's good news! Hang in there.
Do you need help setting up your spreadsheet? We have someone who can help you, and it won't take her long.
Click to expand...

Bouncing in the sense of - it's a self perpetuating cycle. Like, shes at 130 or something, I shoot 1u, her system freaks out and releases more glucose, which brings her up to 130 or something again, and the cycle repeats?

I would LOVE help with making a spreadsheet, though, yes, please!

I'm pretty sure it was a fructosamin? The one where they test every 2 weeks, and it's like an A1C for cats, basically. I have her papers here somewhere, and that has the name of the test, I just cant find them right now.

I suspect that the reason she became diabetic is due to stress? Because apparently that can happen?

The last few members of my family got their covid vaccinations, and so they've been coming for extended visits after being apart for a whole year... which is great, except they bring their large, indoor dog with them. Hes not aggressive, intact hes a total cupcake, but Olivia is still skittish, being elderly.

They've come by for visits before, but only for a couple days at a time. Olivia never really had to deal with the dog being here for what amounts to WEEKS. I think that's what set her off.

If the reason for the onset is stress, might she go into remission a little easier?
 
Shelley & Jess said:
I remember my first low(er) numbers (they weren't even that low, still in the blue range) - I was running around the house in an absolute tizzy!!
Click to expand...

That was me last night.

"Karo, karo, I know we have Karo somewhere! I know I bought Karo to make fake blood for Halloween! ... Oh, crap, this is probably expired! Crapcrapcrapcrap -- ok, she ate all of the gravy out of this can, I should open a new one! WAIT, maybe I should just MAKE her gravy! That way she can have all the gravy she wants! YES, GENIUS!"

/she doesnt eat the gravy

".... WAIT DIDN'T I READ THAT HONEY WORKS, TOO? And I still have dry food! Maybe if I pour it hot water she'll have an easier time eating it and get more of it down!"

There were some truly ghastly concoctions made last night. Obviously, we only have one brain cell between us, and shes usually the one in posession of it lol
 
mosi_yazhi said:
Bouncing in the sense of - it's a self perpetuating cycle. Like, shes at 130 or something, I shoot 1u, her system freaks out and releases more glucose, which brings her up to 130 or something again, and the cycle repeats?

I would LOVE help with making a spreadsheet, though, yes, please!

I'm pretty sure it was a fructosamin? The one where they test every 2 weeks, and it's like an A1C for cats, basically. I have her papers here somewhere, and that has the name of the test, I just cant find them right now.

I suspect that the reason she became diabetic is due to stress? Because apparently that can happen?

The last few members of my family got their covid vaccinations, and so they've been coming for extended visits after being apart for a whole year... which is great, except they bring their large, indoor dog with them. Hes not aggressive, intact hes a total cupcake, but Olivia is still skittish, being elderly.

They've come by for visits before, but only for a couple days at a time. Olivia never really had to deal with the dog being here for what amounts to WEEKS. I think that's what set her off.

If the reason for the onset is stress, might she go into remission a little easier?
Click to expand...
Bouncing is the body's reaction to lower numbers than it is used to. So if the cat is usually in the 300 range, 150 is low and may trigger a bounce.

I've never heard of stress as a cause though... has she ever had a steroid shot? Or oral treatment? Stress raises their blood glucose temporarily. But I don't know for sure.

@Bandit's Mom can help you with a spreadsheet. Bhooma is in Mumbai so she is a sleep right now, but she'll be here tomorrow morning. Keep an eye on your private messages, she'll need some informations from you to set it up.

Aaaaw her name is Olivia? What a great name! Where are you from? Canada or the UK?
I'm sure Deb and Janet will have lots of information for you, follow their advice. And keep an eye on her, honey and karo doesn't last very long, so she can take another dive. When she has been in good numbers two hours without help from you with food and honey, you can leave to get more strips.

Did you change her food recently?
Deb or Janet should be here soon, but if by any chance they don't show up, I'd skip until you get their advice
 
7:45am - 166bg

10:42am - .25uinsulin

11:10am - 135bg

12:12pm - 76bg

1:05pm - 64bg

1:53pm - 101bg​

2:32pm - 143bg

Hasn't eaten anything since I last checked.

Y'all tell me when I'm free to run to the next town for more strips!
 
SashaV said:
Bouncing is the body's reaction to lower numbers than it is used to. So if the cat is usually in the 300 range, 150 is low and may trigger a bounce.

I've never heard of stress as a cause though... has she ever had a steroid shot? Or oral treatment? Stress raises their blood glucose temporarily. But I don't know for sure.

@Bandit's Mom can help you with a spreadsheet. Bhooma is in Mumbai so she is a sleep right now, but she'll be here tomorrow morning. Keep an eye on your private messages, she'll need some informations from you to set it up.

Aaaaw her name is Olivia? What a great name! Where are you from? Canada or the UK?
I'm sure Deb and Janet will have lots of information for you, follow their advice. And keep an eye on her, honey and karo doesn't last very long, so she can take another dive. When she has been in good numbers two hours without help from you with food and honey, you can leave to get more strips.

Did you change her food recently?
Deb or Janet should be here soon, but if by any chance they don't show up, I'd skip until you get their advice
Click to expand...

She had dental work done years ago, and she was temporarily put on steroids even further back for some feline chin acne that got nasty, but really nothing lately, aside from the UTI flare up last month, which she was prescribed the Clavamox for.

I changed her food as soon as I got the diabetes diagnosis, her and my other cat Sophie. Olivia lived her whole life basically on Meow Mix. She never really took to canned when she was younger, so I never thought about it/tried to push it. She seems to be tolerating it now, though, because I think it's hard for her to chew the dry with the bad tooth. The vet tried to sell me on the DM Purina stuff, but I found the spreadsheet for the low carb, supermarket recommendations here. Shes been eating a lot of Fancy Feast, Friskies and 9lives patés since her diagnosis, usually at 6% carbs or lower.

We're from the US, actually! In Arizonan on the Navajo Reservation to be exact :D
 
mosi_yazhi said:
7:45am - 166bg

10:42am - .25uinsulin

11:10am - 135bg

12:12pm - 76bg

1:05pm - 64bg

1:53pm - 101bg​

2:32pm - 143bg

Hasn't eaten anything since I last checked.

Y'all tell me when I'm free to run to the next town for more strips!
Click to expand...
Would you mind updating this to include the food you gave and what it was (karo, honey, MC, HC)?

She's rising without food for awhile so you should be ok to leave.

Without a spreadsheet or more data - I would be skipping with any preshot under 225. I personally don't like to see numbers under 80/90 on Vetsulin, those can be more dangerous since it drops hard and fast. Technically she earned a 0.25U reduction since she went below 90, but I'd like to see whatever data you have. 1U is definitely too much.

I skimmed - did you recently transition to low carb diet? Is there any history of ketones/DKA?

Guidance for tonight in case I'm not back on - give 0.25U only if above 225. Below that, skip. If you give a shot I'd test hourly from +1 to +5 if you can, so we can see when onset and possibly nadir are.

Edit: I changed threshold from 200 to 225. Given the food interventions you had to do today and not much data, 200 might even be a bit risky to shoot. 225 should be a bit more comfortable.
 
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Ah! The diet change. It's entirely possible that might be enough to not need insulin.

Once you get the spreadsheet up and running, please be sure to add any food, med changes, etc.

My guess is that we'll want you to do a 0.1U or drop dose for a little while instead of going cold turkey, but need more data.
 
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