Recovery from hypo

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rowena

rowena

Member Since 2019
My almost 13yo Misty had a hypo on Saturday night. Her usual dose of glargine was 4.5u twice a day and she’d been on that since November 2020. We gradually got to the point from diagnosis in August 2019. I cannot home test because she is feisty. The vet I took her to in the middle of the night has sedated her each time they’ve tested her (twice a day). They have restarted her on 2u twice a day and suggested she stay on that until Wednesday and re-test her. She is getting a libre monitor tomorrow at her regular vet. I’m wanting the libre to make sure she doesn’t go low, but I’m not confident she will keep it on or be unstressed with it on. My question is whether I would need to wait a week to see how the 2u is going because of the nature of glargine or will Wednesday be sufficient? If the libre comes off I may need to take her to the vet for a test. I do have a monitor and I will try, but she is difficult and I could only attempt it while she’s eating. A second question is about the scar tissue on her scruff. This is where I’ve been shooting. It has formed quite a lump about the size of a fist. I started shooting a bit lower down where there is no scar tissue. Could this have made the glargine more powerful and contributed to the low? Thanks for your time.
 
Hi Rowena and welcome to you and Misty. I see you live in Australia…so do I. I think we have spoken before when you first joined.
I’m glad you are getting a libre freestyle meter put on so you can monitor the BG. If the meter is put high on her back area, hopefully she won’t notice it.
I would not wait to put the meter on her. I would do it as soon as possible. It should only take three days for the depot to fill again. It was probably over full when she had the hypo.
What sort of hand meter do you have? It is fine to feed her some low carb while you test her if that is the only way you can do it.
I am going to ask @Bandit's Mom if she can help you set up our spreadsheet so you can enter all the data from the libre and hopefully some tests you can do yourself.

Do you have a hypo kit set up? HELPUS HELP YOU has the hypo kit information in it plus other useful information.

rowena said:
second question is about the scar tissue on her scruff. This is where I’ve been shooting. It has formed quite a lump about the size of a fist. I started shooting a bit lower down where there is no scar tissue. Could this have made the glargine more powerful and contributed to the low? Thanks for your time.
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I would change to a different spot and try and rotate the shots so you don’t get that scar tissue again. I will post a diagram of where you can shoot below.
The scruff could have started to have an absorption problem if it was scared…I’m not sure. But the other spots are perfectly safe to shoot from. We just need to now establish what is a safe dose for her.

Are you feeding a low carb diet? And are you giving snacks during all the cycles?
Here is some AUSTRALIAN INFORMATION which may be helpful.



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Also HOMETESTING HINTS https://felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

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Thanks so much for your reply. I think I may have just hit the vein because she bled a lot. Lesson learned. She was 6.5 hours post 2u and the reading was 1.7. I retested and it was 1.9. I realised the strips are out of date by a year. I tested myself and I was 5.7. I haven’t eaten much today. Misty has not eaten much either apparently. She was ravenous, which is how I managed to test her. She is on low carb food. FF pate. They were giving her chicken at the vet. They gave her royal canin glycobalance but she wasn’t keen. Do I need to urgently go and buy new strips? How wrong would they be? I need to read up on the libre tonight and look at the spreadsheet. My brain is scrambled, but I will try.
 
We don’t know how accurate the test strip was but I would give her a feed of something higher carb if you have it and test again in 20 minutes. If you tested 5.7 they may be accurate and 1.7 is very low. Do you have any honey. I would rub a few drops on her gums now.
 
As a super quick review, Misty dropped to 1.6 at +3 on 4u the other day, and spent more than 24 hours at the ER vet on a glucose drip. Even after all night on the drip, she was only about 2.7.
Before releasing her today, the vets gave her 2u, and now she is hypo'ing again, only much later in the cycle.
 
KarenRamboConan said:
As a super quick review, Misty dropped to 1.6 at +3 on 4u the other day, and spent more than 24 hours at the ER vet on a glucose drip. Even after all night on the drip, she was only about 2.7.
Before releasing her today, the vets gave her 2u, and now she is hypo'ing again, only much later in the cycle.
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Thanks Karen for that information. And the vets said to just check her next Wednesday :banghead:
We can see she has posted on fb again. Do you know if she has retested or given some honey and high carb food?
 
Getting the information from the fb page. Misty was on a glucose drip and had her first dose of 2 units yesterday afternoon at 4.30 pm and again at 9.30 am this morning, both at the vet before discharge. She is now at +9. Last BG was 2 and Misty is not letting Rowena test again. Advised to keep feeding her and test when able.
 
Bron and Sheba (GA) said:
Getting the information from the fb page. Misty was on a glucose drip and had her first dose of 2 units yesterday afternoon at 4.30 pm and again at 9.30 am this morning, both at the vet before discharge. She is now at +9. Last BG was 2 and Misty is not letting Rowena test again. Advised to keep feeding her and test when able.
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Hello all, sorry it had taken me so long to reply. I was getting my children in bed (single mum). Misty seems brighter now. She got out of her Hiding spot and got onto the bed.
I am using a human meter (contour next).
I am about to give her some more food and attempt another test. I will let you know how we go.
I will then attempt the spreadsheet. I’m a bit of a technophobe and I keep forgetting my password or to hit the stay logged in button.
Thank you so much for your time and caring.
 
rowena said:
Hello all, sorry it had taken me so long to reply. I was getting my children in bed (single mum). Misty seems brighter now. She got out of her Hiding spot and got onto the bed.
I am using a human meter (contour next).
I am about to give her some more food and attempt another test. I will let you know how we go.
I will then attempt the spreadsheet. I’m a bit of a technophobe and I keep forgetting my password or to hit the stay logged in button.
Thank you so much for your time and caring.
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Thanks Rowena for updating us. We have been worried and are glad to hear from you.
I’m going to ask @Bandit's Mom to help you with the spreadsheet. She can set it up in a few minutes. She will contact you for a few details.
Well done getting those tests in earlier. Misty is lucky to have you caring for her.
Will watch out for the next BG.
 
I also forgot to mention that I free feed Misty and she usually has 3.5 or 4 cans of FF pate a day plus a small fish pouch on which I was putting zobaline. Maybe she doesn’t need that any more.
 
rowena said:
I just retested and she is 6.5. Much better. It is now +12.
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That’s much better. Please skip the pm dose.
Post in the morning with the AMPS so you can ask for advice Re the dose to give.
So your AMPS will be around 9.30am (our time) is that correct.?

rowena said:
I also forgot to mention that I free feed Misty and she usually has 3.5 or 4 cans of FF pate a day plus a small fish pouch on which I was putting zobaline. Maybe she doesn’t need that any more.
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I would keep feeding her as you are. She is not overweight is she?
 
Bron and Sheba (GA) said:
That’s much better. Please skip the pm dose.
Post in the morning with the AMPS so you can ask for advice Re the dose to give.
So your AMPS will be around 9.30am (our time) is that correct.?


I would keep feeding her as you are. She is not overweight is she?
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She is due at the vet at 9.30 to have the libre fitted. I could attempt to test her before I leave home. I don’t think I will give insulin.
She is a big girl at over 7kgs. When she was diagnosed in Aug 2019 her weight had dropped significantly to about 4kg from memory. Initially I was free feeding her then and that amounted to 6 FF tins a day! Much better now.
I also noticed after my CKD cat died in November, that Misty hardly ever drinks. I have been adding bits of water (not much) to her food given my experience losing 2 cats to CKD.
 
That’s a good idea to add water to her food. I add water to my non diabetic cats food too.
It might be a bit rushed if you have to be at the vet at 9.30 am to give the insulin before you go unless you want to move the schedule back earlier.
If you get the libre on at 9.30 am we can see how she goes during the day and decide a dose, if any for the pm dose. How does that sound ?
Can you put the BG data into the SS as you go along during the day tomorrow please?
I can’t see your SS. Bhooma said she had set it up for you.
 
Bron and Sheba (GA) said:
That’s a good idea to add water to her food. I add water to my non diabetic cats food too.
It might be a bit rushed if you have to be at the vet at 9.30 am to give the insulin before you go unless you want to move the schedule back earlier.
If you get the libre on at 9.30 am we can see how she goes during the day and decide a dose, if any for the pm dose. How does that sound ?
Can you put the BG data into the SS as you go along during the day tomorrow please?
I can’t see your SS. Bhooma said she had set it up for you.
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She has set it up. I haven’t had a chance to look at it properly. I’ve had to get my kids’ things ready for school tomorrow (labelling etc) and write up a summary of what happened for the vet tomorrow. The emergency vet said she’d send a report through tonight by email, but I have little faith in that. I’ve been let down before and we can’t go in with the cat to talk to the vet, so I typed it out in case. Misty will have to be sedated at the vet to have the libre fitted, so I don’t know what time that will happen.
I just had a thought about the sequence of events. Misty was given 2u at 4.30pm Sunday when her level was 12.1, then at 9.30am Monday (+17) her level was 11.8 and that was with her on a glucose drip. She was given 2u at 9.30am, taken off the drip and by 4pm (+6.5) she was at 1.7. It seems to me she probably didn’t need the insulin at all.
Also for my own lifestyle the best time for me to give her insulin is 7.30am or so, and that was her normal time before all this. Should I try to test her around then? At what level would I consider giving insulin? It’s now approaching midnight, so I’m going to bed. Thanks again.
 
Wait now.... Misty was only 11.8 while ON a glucose drip, a full 17 hours after her last insulin shot?? And they gave her 2u of insulin and THEN took her off the drip...? ‍:banghead:
 
That’s my understanding. Maybe I got it wrong. A lot has happened. She was 29 on the drip on Sunday morning. Maybe they took her off it then to see how she would be.
 
rowena said:
Also for my own lifestyle the best time for me to give her insulin is 7.30am or so, and that was her normal time before all this. Should I try to test her around then? At what level would I consider giving insulin? It’s now approaching midnight, so I’m going to bed. Thanks again.
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If you want to test before you go to the vet, that would be good data. But I would not give any insulin this morning. I would get the libre on, see how the BGs go during the day and then if needed a dose can be decided for the time you choose for the schedule this evening.
 
Bron and Sheba (GA) said:
If you want to test before you go to the vet, that would be good data. But I would not give any insulin this morning. I would get the libre on, see how the BGs go during the day and then if needed a dose can be decided for the time you choose for the schedule this evening.
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I couldn’t test because she wouldn’t eat. She did get out of bed and come downstairs and go outside for a while, but then she went upstairs into her hidey hole.
I re-checked my notes and she was 11.2 on Sunday morning and I’ve written that she was disconnected from the drip at that time, so it seems they shouldn’t have given her the insulin.
I’m hoping she’s just not eating because she’s been through a lot a feels nauseous.
I’ve just dropped her at the vet. She sure wasn’t happy getting in the cage and car again! But she sure was affectionate last night. More than ever before. I have to wait a few hours for them to call me. Off for a coffee.
Thanks so much once again. I’m overwhelmed with the help I’ve received. She would be dead without this online community.
 
Thanks for the update. You have had a lot to contend with the last few days with. Misty, the vets and getting your kids ready for the new school year.
When you get a chance, can you add the type of meter you are using to the signature and then link the SS to the signature and then hopefully we can see it. If you have any trouble within it at all, tag Bhooma and she will help to do it. She lives in India and should be around in about 3 hours from now.
Then when you have time, if you could add all the BGs you have from the vet and then at home into the SS that will give anyone helping you a good idea what has been happening over the last few days. The remarks column is there for anything you would like to add.

If she is not eating this morning, it might be an idea to ask the vet for an antinausea medication such as cerenia or ondansetron. We don’t want her to not eat well. That will cause other problems.
Also I would suggest getting a bottle of Ketostix from a pharmacy so you can check there are no ketones in the urine. It’s unlikely after such low numbers but with her not eating today and not getting any insulin….it would be good to know that ketones are not in the picture.
You just need to collect a urine sample from Misty, dip the test strip into the urine and then read the result against the colours on the side of the bottle. You may actually have some at home if you haven’t been home testing her but checking the glucose in the urine at times.
I hope you are enjoying your coffee …..please let us know how things go with the vet. We’ll be watching for an update :)
 
Bron and Sheba (GA) said:
Thanks for the update. You have had a lot to contend with the last few days with. Misty, the vets and getting your kids ready for the new school year.
When you get a chance, can you add the type of meter you are using to the signature and then link the SS to the signature and then hopefully we can see it. If you have any trouble within it at all, tag Bhooma and she will help to do it. She lives in India and should be around in about 3 hours from now.
Then when you have time, if you could add all the BGs you have from the vet and then at home into the SS that will give anyone helping you a good idea what has been happening over the last few days. The remarks column is there for anything you would like to add.

If she is not eating this morning, it might be an idea to ask the vet for an antinausea medication such as cerenia or ondansetron. We don’t want her to not eat well. That will cause other problems.
Also I would suggest getting a bottle of Ketostix from a pharmacy so you can check there are no ketones in the urine. It’s unlikely after such low numbers but with her not eating today and not getting any insulin….it would be good to know that ketones are not in the picture.
You just need to collect a urine sample from Misty, dip the test strip into the urine and then read the result against the colours on the side of the bottle. You may actually have some at home if you haven’t been home testing her but checking the glucose in the urine at times.
I hope you are enjoying your coffee …..please let us know how things go with the vet. We’ll be watching for an update :)
Click to expand...

I’ve just realised I don’t think my phone will work with the libre because it’s too old. It’s an Apple 6s. I Can’t download the app. Do I need to rush out and get a new phone? I was planning on getting a refurbished one, but that wouldn’t come in time. Damn it.
 
Bron and Sheba (GA) said:
Can you get readings without the app.?I’ve never used a libre.
I’ll tag a few people who have used them to ask if you need the app or can use it another way.
@Kindagot
@JBat75
@Larry and Kitties
@Katherine&Ruby
Click to expand...
I've only used the app on my phone, which has been been helpful with a kitty that hides. Like yours, mine hides and sleeps under my bed. Its easier to just reach under and tap the device while she sleeps. Ill read the instructions real quick to see if you have to have the app.
Looks like you can get a reader. Ask your vet if they can order the libre with the reader....
 
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JBat75 said:
I've only used the app on my phone, which has been been helpful with a kitty that hides. Like yours, mine hides and sleeps under my bed. Its easier to just reach under and tap the device while she sleeps. Ill read the instructions real quick to see if you have to have the app.
Looks like you can get a reader. Ask your vet if they can order the libre with the reader....
Click to expand...
Thanks for that. I had to buy a new phone. No pharmacies near me had them and the vet wasn’t going to fit it unless I had the app. Now I have a new phone I didn’t want, don’t know how to use and at great expense. If I’d known I could have got a second hand phone last week. Another of life’s learning experiences.
 
rowena said:
Thanks for that. I had to buy a new phone. No pharmacies near me had them and the vet wasn’t going to fit it unless I had the app. Now I have a new phone I didn’t want, don’t know how to use and at great expense. If I’d known I could have got a second hand phone last week. Another of life’s learning experiences.
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I'm so sorry. Maybe you'll end up loving your new phone (fingers crossed)
 
rowena said:
Thanks for that. I had to buy a new phone. No pharmacies near me had them and the vet wasn’t going to fit it unless I had the app. Now I have a new phone I didn’t want, don’t know how to use and at great expense. If I’d known I could have got a second hand phone last week. Another of life’s learning experiences.
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How frustrating! did you end up getting the libre fitted?
 
I did, but I’m so upset about the whole thing. I didn’t get to talk to the vet. A vet called, but she knew very little. Misty had a senior blood test and that showed she is borderline anaemic. Her glucose was 22. That wouldn’t have been helped by stress, but she hasn’t eaten all day and she didn’t want to eat when she got home. I asked the vet I spoke to what dose I should give tonight and she had no clue. She said she’d have to talk to the other vet, but she’s not back til next Monday, so I guess she meant she’d call her at home. I’m just flabbergasted. I’ve been speaking with this vet clinic since last year about the libre and no one told me about the phone or app or need for a reader. I feel so alone.
 
I’m so upset with myself because I took back my ckd cat’s cerenia because I was told a few weeks ago I’d get a refund because they were still in the box. I didn’t get a refund and now Misty probably needs it. I didn’t get to ask the vet who treated her about the inappetence. I ended up hanging up on the vet that did ring because she couldn’t help me. There’s obviously no such thing as the hypocritical oath for vets. I know they’re busy. I have to stay back at work when I’m busy. I have to do a handover with someone if I have to leave. Sorry, I’m just whinging now. I will get my kids dinner and then sit down to try to do the spreadsheet and my signature.
 
I am sorry you have had such a rotten time with all this.
Has Misty eaten for you now?
I can’t believe they left her all day with no food and they didn’t contact you to try and get her to eat. That is terrible to do that to a diabetic cat.
Try and get Misty to eat something….anything at this stage. She needs to eat.
I think you have every right to be angry and annoyed with the vets. Being busy is no excuse for the way you were treated….we are all busy in our lives but you can’t leave someone hanging like that with a diabetic cat. What does she expect you to do between now and next Monday when the other vet comes back.
I would call in tomorrow if you can and ask for the cerenia back as you need it. Or get another lot.
I’m going to tag @Bandit's Mom for you again to see if she can help you get set up and then we can work out a dose.
Any readings you can get will be helpful.
 
Hi Rowena, I have set up the spreadsheet for you and sent you the link via PM. Let me know if you need my help with adding the spreadsheet link to your Signature.
Check your inbox :-)
 
I am happy with starting with 0.5u.

misty ate some more boiled chicken and I managed to prick her ear again 1.5 hours after the 19.7 reading. She was 19.1 this time, so a bit lower. I’m going to try to test her in the morning and then start the 0.5u. It’s 9.15pm here and I don’t have the energy to be up all night testing her to make sure she’s ok. I’ll be home all day tomorrow, so I’d rather start in the morning. Do you think that will be ok @Bron and Sheba (GA) ?

the libre doesn’t work. I spent $1000 on a new phone. I spent $400 at the vet. Why would the vet clinic say months ago they will do it for me, order one in —and not spend the $100 for a reader? It’s beyond belief.

I live outside a major metropolitan area and I’ve had 5 cats all with different maladies and chronic illnesses and all the vets around here have let me down.
 
rowena said:
I am happy with starting with 0.5u.

misty ate some more boiled chicken and I managed to prick her ear again 1.5 hours after the 19.7 reading. She was 19.1 this time, so a bit lower. I’m going to try to test her in the morning and then start the 0.5u. It’s 9.15pm here and I don’t have the energy to be up all night testing her to make sure she’s ok. I’ll be home all day tomorrow, so I’d rather start in the morning. Do you think that will be ok @Bron and Sheba (GA) ?

the libre doesn’t work. I spent $1000 on a new phone. I spent $400 at the vet. Why would the vet clinic say months ago they will do it for me, order one in —and not spend the $100 for a reader? It’s beyond belief.

I live outside a major metropolitan area and I’ve had 5 cats all with different maladies and chronic illnesses and all the vets around here have let me down.
Click to expand...
If you contact Abbot they will replace the Libre sensor
https://www.freestylelibre.com.au/contact

Also, have you got NFC enabled on your phone? That might be why it is not working.

Also if i is a Libre 2 then you need bluetooth enabled
 
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rowena said:
am happy with starting with 0.5u.

misty ate some more boiled chicken and I managed to prick her ear again 1.5 hours after the 19.7 reading. She was 19.1 this time, so a bit lower. I’m going to try to test her in the morning and then start the 0.5u. It’s 9.15pm here and I don’t have the energy to be up all night testing her to make sure she’s ok. I’ll be home all day tomorrow, so I’d rather start in the morning. Do you think that will be ok @Bron and Sheba (GA) ?
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I would rather you had started tonight but as long as she is eating well and she isn’t lethargic, you should be ok.
Make sure you don’t leave it too late in the morning to start.
I don’t suppose you have any Ketostix at home do you , where you could test the urine for ketones? If you do could you check the urine for ketones please?
 
Bron and Sheba (GA) said:
I would rather you had started tonight but as long as she is eating well and she isn’t lethargic, you should be ok.
Make sure you don’t leave it too late in the morning to start.
I don’t suppose you have any Ketostix at home do you , where you could test the urine for ketones? If you do could you check the urine for ketones please?
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I do have some ketodiastix, but she isn't going to the toilet. She is lethargic. She fell off my bed. I thought she was still experiencing the effects of the sedation she had this afternoon. Now I'm not so sure. I asked the vet if she had ketones and the vet said they didn't do a urine test. I asked them to do a senior blood test, so that's all they did. I didn't think to ask for a urine test and they didn't use their initiative at all. I would start at about 7 in the morning. I'll do it tonight if I have to. I will go check on her again now and see how she is going.
 
rowena said:
I do have some ketodiastix, but she isn't going to the toilet. She is lethargic. She fell off my bed. I thought she was still experiencing the effects of the sedation she had this afternoon. Now I'm not so sure. I asked the vet if she had ketones and the vet said they didn't do a urine test. I asked them to do a senior blood test, so that's all they did. I didn't think to ask for a urine test and they didn't use their initiative at all. I would start at about 7 in the morning. I'll do it tonight if I have to. I will go check on her again now and see how she is going.
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Try putting her in the litter box and se if she will pee for you.
 
@Bron and Sheba (GA) Misty did not want to urinate. I suspect she didn't drink today either. She doesn't drink much. I add a bit of water to her food.
She climbed the steps onto my bed again and ate some food. I gave her the 0.5u. I also tested her again. 19.7. She was upset by the testing and carrying her to litter tray, so she's laying on the cool tiles, which is probably better anyway because it's quite hot here.
I am fearful of testing her too much and she gets so upset about it that I can never do it. Shall I test at +3 or wait until +6 or leave it until I usually wake up at +8?
Thanks so much for walking me through this.
 
I would get a +3 and go from there. If it’s dropping a lot, test moe often. I would also give her snacks when you test. Hopefully she will eat.
You will be able to go back 1/2 hour a day with the doses to get back to 7 am. Will take a few days but I’m glad you gave the dose, especially if she’s lethargic.
I’m going to tag @Bandit's Mom to keep an eye out for you over the next few hours and when she goes offline I’m sure she will tag someone to look in on you to see how you are going.
See you tomorrow.. Hope you get some sleep.
 
@Bandit's Mom
I just tested Misty and at +3 her reading was 17.3. Her pre shot number was 19.7.
She is getting wary of me testing her. I will go back to sleep and try to retest at +6. At least she is not going low.
 
I can’t get another reading. She only ate a few pieces of chicken, I got the prick, but couldn’t get the blood into the strip before she got upset. She won’t have tinned food and actively moves away from it, making me think she’s feeling sick.
 
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