Cat's first hypo episode

SamsonsMom

SamsonsMom

Member Since 2017
Hi All, I'll keep this brief but I've been successfully treating my diabetic cat Samson with Lantus for I don't even know, maybe seven years. He's had one or two high blood sugar incidents but never a hypo episode until last night. I don't want to go into details but it was severe and he almost died. Was stable within 2-3 min of emergency vet putting in an IV (with glucose I guess). He stayed overnight for monitoring and was happy as a clam when I picked him up this morning. Vet gave him his morning dose of insulin this AM based on a sugar reading about about 400.

About 4 hours later I go to test his sugar and he's hypo again. stumbling. I stabilized him with honey and forced wet food slurry. I am out of my depths with this one... can anyone advise on how to administer his insulin for the time being til he stabilizes? When I test his sugar tonight how high should it be for me to give insulin dose? IE, if it's 250 or less should I skip the dose?

I am in contact with his vet but looking for advice here, too. Thanks!
 
I’m sorry you and Samson have been through this.
After a cat has had a symptomatic hypo, they can be very sensitive to insulin and you need to proceed very cautiously.
Do you know if the vet gave a reduced dose……..and the dose is not based on the preshot BG but the nadir..

Looking at the SS I can see you are not testing during the cycles at all during the PM cycle. The pm cycle is just as important as the am cycle. Cats often drop lower at night and unless you are testing, you will have no idea.
It looks as if you rarely test as there are only 5 tests for this year.
Are you following either of the dosing methods for Lantus..?
I would strongly advise you to look at the two methods, which are at the top of the L and L page and choose one and follow it.
I would also be testing before every dose and again during every cycle. This is the only way you can keep Samson safe.
Where are you up to in the cycle now? Do you have any tests you can add to the SS so we can see what is happening.
You will definitely need to be reducing the dose, but we need to see BG data to be able to help you.
I’m not sure your vet knows a lot about FD in cats,if he gave the same dose after a symptomatic hypo.
On 11/4 you got 36 at +6 and did not reduce the dose……….you must reduce the dose if the BG drops under 50 for tight regulation or 90 if using SLGS method.
Bron
 
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@Bron and Sheba (GA) thank you! Samson was stable for many years so I didn't keep up with the spreadsheet. I will be more diligent about it now obviously. My main question is why he is still hypo pretty much all day today and how I should proceed with his dose tonight if at all. I don't know which method I use, he usually has taken 2.5-3 units of Lantus every 12 hours with his food
 
SamsonsMom said:
@Bron and Sheba (GA) thank you! Samson was stable for many years so I didn't keep up with the spreadsheet. I will be more diligent about it now obviously. My main question is why he is still hypo pretty much all day today and how I should proceed with his dose tonight if at all. I don't know which method I use, he usually has taken 2.5-3 units of Lantus every 12 hours with his food
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Can you take some tests during this current cycle so we can see what he is doing.?
Lantus has a depot which can effect up the 6 cycles.I would say the depot is over full. He is getting too much insulin…that is why he is still symptomatic.
Are you giving him lots of food during the cycle?. Not just before the dose?
He needs some higher carb foods to bring the BG up higher.
When did you last test him?

How many hours until the next dose is due?

I see you have written down 10, for +4 5 and 6……are you saying the BG is 10? If so PLEASE RUB SOME HONEY ON HIS GUMS NOW AND TEST AGAIN IN 20 mins
 
SamsonsMom said:
yup I just added some figures to the spreadsheet. His next dose in due in 3 hours (7:30 pm my time) I'll take another reading in about 10 min and add it to the SS
I have been force feeding him wet food, he is not wanting to eat @Bron and Sheba (GA)
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Was the reading 10? If so that is dangerously low….please rub honey or Karo on his gums now
Is he sympathetic at the moment? You may need to take him back to the vet for a glucose drip again.
 
@Bron and Sheba (GA) yes and just took another reading, still at 10. I have been giving wet food all day since he came home. I just gave some more, and rubbed honey. He is not symptomatic at the moment I'm watching him like a hawk
 
SamsonsMom said:
@Bron and Sheba (GA) yes and just took another reading, still at 10. I have been giving wet food all day since he came home. I just gave some more, and rubbed honey. He is not symptomatic at the moment I'm watching him like a hawk
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How much honey did you rub on? You will need to do that again.
And any food you give him, make sure it is high carb….has gravy in it.
Do not give any insulin for the next dose….you need to skip the dose. Please acknowledge you have understood this…thanks
 
@Bron and Sheba (GA) understood! I'll keep posting on the SS every hour, too. I gave about half a TBSP of honey. I also brought him his wet food bowl to his bed and fed him out of a teaspoon, he ate hungrily about 3 tsp
 
SamsonsMom said:
@Bron and Sheba (GA) understood! I'll keep posting on the SS every hour, too. I gave about half a TBSP of honey. I also brought him his wet food bowl to his bed and fed him out of a teaspoon, he ate hungrily about 3 tsp
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I’m glad he ate for you..thanks good.
Can you tell me what type of food you are feeding him?do you know how many carbs are in it.
It is important that you feed high carb food only at the moment as we need to get that BG up over 50 …..below that is not safe.
At the moment, you need to be testing the BG every 20 minutes. An hour is too long. We need to make sure Samson is on the way back up , not going back down.
Can you post every 20 minutes please.? And please keep in touch with us as we will be watching for your posts.
And I would rub another couple of drops of honey on his gums. Not too much as we don’t want him to be sick.
IF HE STARTS TO GET SYMPTOMATIC PLEASE TAKE HIM TO THE VET STRAIGHT AWAY. BUT DONT LET THEM GIVE HIM ANY INSULIN
 
@Bron and Sheba (GA) roger that. Thank you so much for the guidance!!! Sure, I will post every 20 min. He seems better but the numbers aren't going up so far. The food is Fancy Feast mousse - chicken. he just ate a bit of dry food from the vet as well
 
SamsonsMom said:
@Bron and Sheba (GA) roger that. Thank you so much for the guidance!!! Sure, I will post every 20 min. He seems better but the numbers aren't going up so far. The food is Fancy Feast mousse - chicken. he just ate a bit of dry food from the vet as well
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I can’t see on the list how many carbs are in the FF mousse but I doubt it is high carb….but I could be wrong.
After all this has settled down, you need to go out and buy some high carb canned food and have it at home in case of a hypo.
Look at this list food list
In the meantime, to make the food high carb, you can add a couple of drops of honey to the food
 
Also when you get a chance, can you put in the numbers you have for yesterday….if you have any and also write in the remarks column of the SS, that Samson had the symptomatic hypo and was treated at the vets etc and that the vet gave the dose of insulin this morning. Thanks. Then anyone looking at the SS knows what’s happened
 
Back up to 82! and he is still eating (and purring more). Thank you everyone - I will retest and and post again in the morning! will need to ask what dose if any to give of insulin...
 
SamsonsMom said:
Back up to 82! and he is still eating (and purring more). Thank you everyone - I will retest and and post again in the morning! will need to ask what dose if any to give of insulin...
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I would keep offering snacks of low carb food during the PM cycle.
Don’t be surprised if the BG shoots up high. That just means Samson is bouncing after all those extreme lows he has had over the last two days.
Im not sure I will be online when you post for the dose in the morning but I will ask a few others to watch out for you.
Can you get a test in an hour before AMPS so you have time to get the new dose? And will you be around to test in the morning after the dose?
 
SamsonsMom said:
thank you so much everyone! Yes i'll post a couple more tests tonight :) very grateful for all the help
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Thanks!!
I’m going to ask @Bandit's Mom if she can have a look at your SS and put lines across to separate the years as it can be confusing. She will probably send you a PM so watch out for it.
I’m so glad Samson is in safer numbers.
Please continue to post each day so we can help you get sorted into a better and safer routine for Samson
 
When you get a chance and things settle down
We do a new post everyday ,you might want to do that so we can follow Samson progress and in case you need help
This is how you need to post on the lantus board
Example
11-9 Samson AMPS- # then any other tests you do after that such as 240 @+3/ 189 @+6 and so on until you get to his PMPS -# and any other tests after that

We always link the post from the day before to the new post in case we need to go back and look at it , if you need help just ask

PLEASE READ THE DOSING METHODS and choose one it's IMPORTANT on how you will proceed with Samson's doses going forward
Here is the link
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

@SamsonsMom
 
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Here is the food chart also
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/to look for medium and high carb foods when he drops to low and you have to bring his BG up instead of dry food


Here are some med and high carb foods you should always have enough of
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs
Or any others that you see on the food chart I gave you
@SamsonsMom
 
As Bron asked above
Also when you get a chance, can you put in the numbers you have for yesterday….if you have any and also write in the remarks column of the SS, that Samson had the symptomatic hypo and was treated at the vets etc and that the vet gave the dose of insulin this morning. Thanks. Then anyone looking at the SS knows what’s happened
@SamsonsMom
 
@Bandit's Mom
Hi Bhooma also when you get access to her SS can you add what is supposed to be up top meaning Date Diagnosed, Insulin ,Meter and about the dosing question
We have asked her to pick one ,none as of yet
Thanks Bhooma :cat:
 
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