Hypo event? BG 43 from libre sensor and 34 from paw prick

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Lara & Bernie

Lara & Bernie

Member Since 2021
Bernie has been out of the hospital less than a week. We had a DKA event which was pretty rough. He know has a feeding tube. His sugars have not been right since we got home. Food changed to Glycobalance and Nadirs are happening around +10 hrs.

He has no symptoms of Hypo and has eaten half a can of food since the first reading below 50 1 hour ago and i was able to get some honey on his gums.

What else can I do to get his BG up? I have some dry kibble that he would probably eat.

Help.
This sugar kitty momma is freaking out.
 
Are you still using the feeding tube or is he eating ok for you? . What type of food did you give him?
What is the BG now?
Can you update the SS when you have time please?
 
feeding tube is there for medications right now as he is eating ok.

I just gave him 1/2 can of glycobalance and about 1/4 tsp of honey. He is fighting me on the honey. also about 10 pieces of Young Again Maature 0 kibble
 
Lara & Bernie said:
feeding tube is there for medications right now as he is eating ok.

I just gave him 1/2 can of glycobalance and about 1/4 tsp of honey. He is fighting me on the honey. also about 10 pieces of Young Again Maature 0 kibble
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Will he let you run the honey on his gums?
What is the latest BG test! And when was that taken?
 
i was not able to get a lot of honey on his gums. about a1/4 tsp

latest BG on libre sensor is 81 (just now). It was 62 (7 min ago) and 48 (20 min ago)
 
Lara, did the vet give you any instructions about caring for Bernie when you came home? .
After DKA there are a few things that you need to do when caring for Bernie so that he recovers fully without complications.
  • You need to be feeding 1 and a 1/2 times as many calories as he would normally eat each day. So you would feed the two main meals and then give snacks every couple of hours during the day and evening except for the two hours preshot.
  • Don’t skip doses of insulin. If the BG is not high enough, stall, dont feed and test again in 20minutes to see if the BG is rising. Post and ask for help. It is very important not to skip insulin doses.
  • Test every day for ketones either with Ketostix, testing the urine, or with a blood ketone meter. This is very important. Post the results of the ketone tests in the remarks column of the SS as well as the thread please.
  • Give extra fluids.
  • If Bernie is not eating, you may need to give some antinausea medications. Post DKA kitties are often nauseated.
With that drop to 43 (34) Bernie has earned a reduction in dose. I don’t think the SS is up to date so I’m not sure what the current dose is, but you will reduce the dose by 0.25 units
 
It’s ok for him to sleep. That is a safe bg. I would give him a little lc if he will eat it and test in 30.
 
Lara & Bernie said:
30 min later and it is only at 89. Is it ok for him to sleep?
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You will need to keep testing for two hours after you gave the high carb food. He can sleep but you will need to do a couple of more tests, sorry.
He is in safe numbers, but they can wobble up and down after dropping low and being given high carb food.
 
Bron and Sheba (GA) said:
Lara, did the vet give you any instructions about caring for Bernie when you came home? .
After DKA there are a few things that you need to do when caring for Bernie so that he recovers fully without complications.
  • You need to be feeding 1 and a 1/2 times as many calories as he would normally eat each day. So you would feed the two main meals and then give snacks every couple of hours during the day and evening except for the two hours preshot.
  • Don’t skip doses of insulin. If the BG is not high enough, stall, dont feed and test again in 20minutes to see if the BG is rising. Post and ask for help. It is very important not to skip insulin doses.
  • Test every day for ketones either with Ketostix, testing the urine, or with a blood ketone meter. This is very important. Post the results of the ketone tests in the remarks column of the SS as well as the thread please.
  • Give extra fluids.
  • If Bernie is not eating, you may need to give some antinausea medications. Post DKA kitties are often nauseated.
With that drop to 43 (34) Bernie has earned a reduction in dose. I don’t think the SS is up to date so I’m not sure what the current dose is, but you will reduce the dose by 0.25 units
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Thank you for this information. They sent me home with prescription food and instructions on feeding, but it wasn't 1/5 of his normal calories. They also told me no snack. I need to update his SS tomorrow. We reduced insulin from 2 Units to 1.5 tonight, but his BG was only around 160. I think that I did this to him as he didn't eat his full meal and I pulled it up after 2 hrs as instructed by the vet.

I am giving him anti nausea med through the feeding tube each morning and appetite stimulant in the ear each morning as well.

Urine ketones were 0 last night. I didn't know to check every day. I will start that today. Is a blood ketone meter better?

getting extra 50-60 mL of water with meds through feeding tube split between morning and evening meds. Should I add more at mid-day?
 
Lara & Bernie said:
Thank you for this information. They sent me home with prescription food and instructions on feeding, but it wasn't 1/5 of his normal calories. They also told me no snack. I need to update his SS tomorrow. We reduced insulin from 2 Units to 1.5 tonight, but his BG was only around 160. I think that I did this to him as he didn't eat his full meal and I pulled it up after 2 hrs as instructed by the vet.
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Hi Lara ….you need to feed 1 and a half times as much food as you normally……not 1/5. So he needs a lot more food than normal. I can’t believe they told you no snacks! Please do give snacks every couple of hours.
The recipe for DKA is not enough insulin, not enough food and an infection or inflammation in the body. So to treat that you need to make sure he is getting enough insulin, getting plenty of food and any infection or inflammation is being treated.


*****PLEASE DISREGARD THIS PARAGRAPH AND READ POST 18 for DOSE INFORMATION (Maybe you need to keep to the 1.5 dose of insulin but make sure he is eating enough food. Give those all important snacks. You can always increase the amount of carbs if you need to to give that amount of insulin. We need to make sure he is getting enough insulin to keep those ketones away. Are you able to test closely if we keep to the same dose.?)


Lara & Bernie said:
Urine ketones were 0 last night. I didn't know to check every day. I will start that today. Is a blood ketone meter better?
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That is good the ketones were negative last night. Yes please test every day. By testing every day, we can see if the insulin dose and the amount of food is enough.
The urine test is fine. The blood ketone meter gives a more up to date test but is more expensive. It is up to you which one you use. If you have trouble getting a urine sample, the blood meter is handy


Lara & Bernie said:
am giving him anti nausea med through the feeding tube each morning and appetite stimulant in the ear each morning as well.
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That is good! Post DKAkittes are often nauseated and need that support.

Lara & Bernie said:
getting extra 50-60 mL of water with meds through feeding tube split between morning and evening meds. Should I add more at mid-day?
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that would be a good idea. Fluids help to flush out any ketones so a midday lot would be great
 
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Lara was the paw prick with the alphatrak meter?
Where are you up to in the cycle now?
Have you done another test yet?
 
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*****Lara, I think because Bernie dropped down to 43 on the libre and 34 on the meter (I’m not sure if you are using an alphatrak meter or a human meter) I think you need to reduce the dose to 1.25 units at the next preshot.
please test for ketones.
 
I do not know the size of feeding tube. I would discuss with vet about putting a type of glucose/sugar/honey in tube. Generally if you can put meds in you would be able to put a sugar solution down the tube if hypoglycemic. Probably not honey, what ever is used should be flushed with water to clear tube. As a nurse I would do this but please talk to vet as to what and how much, do not want to clog tube. An option for future. Not a cat expert. Good luck
 
Sugars were at 400 this morning before food. Thank you all for your help. I am feeding him the moment his sugars dip below 100. I didn't use the feeding tube for hunny as I could not flush it with really warm water to clean it out. Urine ketones today were none. all BGs are done with the Free style libre meter either with blood or scan.
 
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