Restarting insulin after hypo event

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NyCatMom

NyCatMom

Member Since 2020
Hello Everyone,

Please ignore the spreadsheet attached to my profile. It was for a cat that passed away and I am looking for advice on my 100 yr old mothers cat, Nina.

Nina is 17 years old and was diagnosed with diabetes back in 2012 but went into remission with a low carb diet until late November of this year. She started losing weight and drinking more. On a routine exam her BG was 431, urine +3 sugar but no ketones. The vet suggested starting her on Lantus 1 unit twice daily. I did pre shot testing and she was consistently in the 350 to 425 range but on day three she went hypo. I found her staggering, yowling, drooling, panting and immediately gave her Karo syrup before running off to the vet. They got her to eat and her blood sugar was 107 when released. The ER vet thinks she is very sensitive to insulin. I bundled her off to our regular vet yesterday and her bloodwork is at the same levels as in her check up. I've home tested her and she's in the 350s all day.

The vet would like me to restart insulin again. Lantus at a half unit once daily but is toying with the idea of switching to Vetsulin. I'm terrified to give her another shot. My vet had asked me to run a curve after five days when we first started the Lantus but I'm sorry I wasn't more vigilant on testing from day 1.

So, other than testing throughout the day once I restart Lantus, any other advice? Does the proposed move to another insulin make sense?

Nina is the only creature my mom recognizes at thus point in her life. I'd like to keep them both happy and healthy.
 
Moving to Vetsulin does not make sense, it’s a harsher insulin with faster drops. I would start low on the dose.

How long was Nina on Lantus? How long has she been off it now? It is possible to put two spreadsheets in your signature if you want detailed help.
 
Thank you. I will try to figure how to add the second spreadsheet this evening.

Nina was on 3.5 days of Lantus. After her day 4 morning dose she went hypo. She's been off insulin for 2 days. Our vet would like me to restart tomorrow morning with only a morning dose at only a half unit. No night time dosing at this point.
 
OK, she didn't have time for the Lantus depot to fully build. I think starting lower (maybe 0.25 units) but twice daily would be much better than once a day with a higher dose. Are you still using the AT meter?
 
Wendy&Neko said:
OK, she didn't have time for the Lantus depot to fully build. I think starting lower (maybe 0.25 units) but twice daily would be much better than once a day with a higher dose. Are you still using the AT meter?
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Yes, I still have a ton of strips left on the AT meter. I'm also using the syringes with the half unit marks. I chickened out this morning and didn't give her insulin as I have a doctors appointment this afternoon and won't be around to monitor or test. Definitely, starting tomorrow since I have no plans for the weekend.
 
Red & Rover (GA) said:
Is it possible that both you and your mum gave a shot?
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No, mom has severe dementia and mobility issues. There is no way she could get to the refrigerator to get the Lantus or fill a syringe. We don't have an aide in when the family is around so no one other than me gave her a shot. The aides sometimes gave me a hand with my old sugar cat, if I was late coming home but not with Nina yet.

Nina had a dental back in September and in her pre procedure testing her blood sugar was all over the place which is when we suspected she was coming out of remission. Her teeth were bad so there was some hope once she recovered from her extractions she might stabilize but that didn't happen.
 
How often would you be testing at this point? The vet was recommending three times a day with a curve on day 7. Is that enough to start?
 
I see you have a second spreadsheet in there now. Do you think you could modify the signature to indicate which one is which? You can also rename the spreadsheet itself to name it after the cat.

If you want to follow SLGS for dosing, then the preshots plus some mid cycle tests will work, followed by that curve on day 7.
 
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