? Hypo Management

C

Cath C

Member Since 2021
Really sorry to be a bother to everyone

We were sent home today after an episode of DKA - this is our first time managing diabetes

We've been discharged on day 3 after his DKA, he initially was getting fed from an NG tube but all of that has been removed now

He was given 2u of Lantus 6hrs and 40 minutes ago

We were given a Freestyle Libre Meter to monitor his BG levels
Nurse has explained that target range is between 144 -90, anything below 90 we need to start treating with sugar
Anything at 61 or below is dangerously low' This is really causing me lots of confusions is that every where I look - a different range is quoted

We've been struggling with a string of low BG running at 57, which we've treated with syrup, it did improve to 99, then drifted back down again to 61, then went up with syrup to 73 and has drifted back down again all within a span of 10-15 minutes

The difficulty is that the syrup wears off quickly and we want to get something a bit more starchy into him so it can last for longer
This is his first day home - he is turning his nose to everything - even his favorite dreamies treats, tuna, gravy - you name it


We've spoken with nurse over the phone about this and she said keep on doing what we're doing and also no lantus for tonight'

My main worry now is that we cant get him to eat something sustaining and we cant get the BG to sustain
Really worried about what my options are - we live far away from our vet' My main concern is that if we still cant get on top of this by the time the vet closes then we are really stuck.

We're keeping a close eye on him now - pretty much scanning him every 5 minutes
I know that this Freestyle Libre there is a 15 minutes delay also

We werent given any lancets or BG testing devices to take home (My plan was to buy one today but obviously this hypo going on now - I dont feel its safe for me to leave for the shop)



Thanks so much everyone!
 
Hi and welcome Cath and kitty (can you tell us his name please.
You are doing the right thing monitoring the blood glucose (BG) and giving some syrup.
You can also give honey or Karo which you can rub on the gums if he won’t eat. Just a couple of drops of honey will help bring up the BG.
Honey wears off after about an hour or a bit longer so it is not surprising that the BG drops again.
6hours and 40 minutes ago is probably around nadir (lowest point) so hopefully it will start to rise soon.
I’ll post this and write more.
 
I'm glad you found your way here from the Facebook group.

He was on a feeding tube.... And they took it out.... But he's still not eating. I'm confused why they removed the tube then. Can you ask for an appetite stimulant? It's going to be really important he eats in order to keep the ketones away.

The other important thing is going to be monitoring ketones at home. You can get ketone reading urine strips at the Parmacy. I personally used a blood ketone reader because it was just easier since my cat wasnt easy to catch in the litterbox.
 
What time of the day is it where you live.?
It sounds as if he needs some antinausea medication to help him to eat.
Can you ask the vet to give you some cerenia or/and ondansetron tonight please as it is really really important he eats if he is just recovering from DKA.
He needs an antinausea medication before he has an appetite stimulant medication.
Also can someone go out to the pharmacy and buy a bottle of Ketostix to test this urine for ketones…this is also really important after DKA.

I’m going to ask @Bandit's Mom to set up a spreadsheet for you so you can entrees the BGs you have so far so that we can help you more.
 
Thank you to everyone for such a efficient reply'
Truly so grateful for everyone's generous support'

Our little boy's name is Roger, he is 11 years old now, he came to our lives as a rescue kitty and we've hand reared him as a baby' Since then I've been in an accident which has affected my back and left me with various mobility problems ' it's been very stressful at times, struggling to bend down or hold him still like I was able to many years ago' it's frustrating not being able to do certain tasks that he needs - it's really a two man job in order to properly feed him

Nurse has rang me back to say that they have some appetite stimulant medications available for us to pick up' family is running that errand right now

Yes the NG tube was removed at the clinic' I was apprehensive because I anticipated that oral intake would be a problem' I would have really liked to be able to prepare better with various items and hypo boxes and syringes before he came home'
 
Would any one be able to advise on how is best to dose for tonight? He is given his Lantus 12 hourly' He is a recent DKA kitty also' we will definitely check his BG before shooting but my concern is what to do if hasn't eaten if the ketones come back?
 
Cath C said:
Would any one be able to advise on how is best to dose for tonight? He is given his Lantus 12 hourly' He is a recent DKA kitty also' we will definitely check his BG before shooting but my concern is what to do if hasn't eaten if the ketones come back?
Click to expand...

Are you able to get any antinausea medications before the next dose is due? Ask the vet to give you some when the family pick up the appetite stimulant
Which country are you in?
Can you get some Ketostix before tonight to test the urine?
 
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Cath C said:
Would any one be able to advise on how is best to dose for tonight? He is given his Lantus 12 hourly' He is a recent DKA kitty also' we will definitely check his BG before shooting but my concern is what to do if hasn't eaten if the ketones come back?
Click to expand...
@Bandit's Mom is going to contact you about setting up Rogers SS. It is very hard to give any dosing advice if we don’t have a SS. So if you could enter the numbers when Bhooma sets it up that would be great, thanks.
I think we have to try and get him to be eating some food before we can give him any insulin, although we don’t really want to skip any doses with DKA so recently in the picture.
Also if you have the Ketostix and we can see if there are any ketones, that is also very helpful.
Do you have any food at all that you think he would eat? It doesn’t matter if it is not a low carb food at the moment. The important thing is that he eats. That trumps everything else. So if you think he will eat some dry food, or some BBQ chicken, or cheese or a favourite of his, let him have it.
 
I’m guessing you are east coast if in the US. Ask for cerenia and an RX for ondansetron, a human drug, both for nausea. Was the tube due to DKA or something else?
 
Hello there, Djoko has been on several libre devices (at least 10). I found that there are not always. They give you a good sense of where the BG is at (e.g. 200 vs 300) but the value is not nearly as accurate as the strips. It happened several times where the libre would indicate that Djoko is in hypo and we would test him and he was far from it. In some cases, the values were similar. I know that the Libre is supposed to indicate where the BG will be in 10 minutes but I would recommend to still test with a glucometer before making a decision e.g. giving syrup, shoot, not shoot. Good luck!
 
Cath C said:
Really sorry to be a bother to everyone

We were sent home today after an episode of DKA - this is our first time managing diabetes

We've been discharged on day 3 after his DKA, he initially was getting fed from an NG tube but all of that has been removed now

He was given 2u of Lantus 6hrs and 40 minutes ago

We were given a Freestyle Libre Meter to monitor his BG levels
Nurse has explained that target range is between 144 -90, anything below 90 we need to start treating with sugar
Anything at 61 or below is dangerously low' This is really causing me lots of confusions is that every where I look - a different range is quoted

We've been struggling with a string of low BG running at 57, which we've treated with syrup, it did improve to 99, then drifted back down again to 61, then went up with syrup to 73 and has drifted back down again all within a span of 10-15 minutes

The difficulty is that the syrup wears off quickly and we want to get something a bit more starchy into him so it can last for longer
This is his first day home - he is turning his nose to everything - even his favorite dreamies treats, tuna, gravy - you name it


We've spoken with nurse over the phone about this and she said keep on doing what we're doing and also no lantus for tonight'

My main worry now is that we cant get him to eat something sustaining and we cant get the BG to sustain
Really worried about what my options are - we live far away from our vet' My main concern is that if we still cant get on top of this by the time the vet closes then we are really stuck.

We're keeping a close eye on him now - pretty much scanning him every 5 minutes
I know that this Freestyle Libre there is a 15 minutes delay also

We werent given any lancets or BG testing devices to take home (My plan was to buy one today but obviously this hypo going on now - I dont feel its safe for me to leave for the shop)



Thanks so much everyone!
Click to expand...
Hi Cath, just want to welcome you and Roger. You are in the right place to get all the help and support you need. Good luck on getting him the anti-nausea meds. This will help him to eat. :bighug::bighug:
 
It’s a shame that they didn’t place an esophageal feeding tube which stays in place and would be good for several weeks to a month (although frequently you don’t need them that long as they improve so quickly with proper nutrition.). The NG feeding tubes are not appropriate for home use and that’s why they would have pulled it before you brought him home. Those go down the nose (very uncomfortable from what the vets have told me.)
Best wishes for your baby. I hope you have some syringes to feed him if he won’t eat. Will he eat baby food do you think? Did they give you any food to take home? Hills AD is a very concentrated source of calories and most cats like it a lot.
 
For now try to get him to eat anything you can. It's more important to eat rather than worry about carbs right now. Try chicken, tuna, gravy food. Anything you can get in him
 
Try to offer him the things he likes the most When Diego was not willing to eat because of nausea we offered him a piece of pate and it worked.
 
Is all okay? If so please remove the 911. If you need more help then please tell us what you need. Thank you.:bighug:
 
I've removed the 911 for now. Cath, if it's an emergency again, you can add the 911 back. Just go to the first post you did, and on the top right is a Thread Tools drop down memory where you can edit the thread and change the prefix back. Hope everything is OK.
 
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