BG 68 and dropped to 52 20 min later, what should I do?

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Diana & Martin

Diana & Martin

Member Since 2022
Martin's BG was 68 20 minutes ago and now has dropped to 52. I gave him some high carb dry food and now he's sipping on a "Leonardo" Drink that I had on hand. I don't know what's the carb content. What should I do?
 
Diana & Martin said:
Martin's BG was 68 20 minutes ago and now has dropped to 52. I gave him some high carb dry food and now he's sipping on a "Leonardo" Drink that I had on hand. I don't know what's the carb content. What should I do?
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He's acting as usual and isn't showing any concerning symptoms atm
 
Looks like you stopped the drop. Never heard of the "Leonardo" drink before, quick search looks like mostly chicken/duck/beef or salmon broth.

Was that the only dry food he had so far today?

1.5units is your new dose going forward, while doing the mixed food transition, unless he goes low again and earns another reduction.

We base dose amounts on how low a particular dose takes kitty - even if the preshot BG is high, don't be tempted to go to a higher dose.
 
Shelley & Jess said:
Looks like you stopped the drop. Never heard of the "Leonardo" drink before, quick search looks like mostly chicken/duck/beef or salmon broth.

Was that the only dry food he had so far today?

1.5units is your new dose going forward, while doing the mixed food transition, unless he goes low again and earns another reduction.

We base dose amounts on how low a particular dose takes kitty - even if the preshot BG is high, don't be tempted to go to a higher dose.
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That's the only dry food he has had so far. I'm still very confused about this food transition because I feel like the big bounce from low to super high after eating dry food yesterday must be pretty harsh on his system?? So I'm not sure about how much or when to feed him dry food vs the new low carb one. And noted, I won't be going any higher than 1.5u even if preshot # is high.
 
Diana & Martin said:
I feel like the big bounce from low to super high after eating dry food yesterday must be pretty harsh on his system??
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If still giving dry I would feed it early in the cycle. For most kittys, feeding at or after nadir slows the action of the insulin down and the kitty loses duration.

HC food does not cause bouncing. What “can” happen is HC food can cause the brakes to be quickly applied on duration. When that happens, the BG shoots up quickly (many mistake this for a bounce when it is loss of duration). Subsequently, kitty may very well bounce on top of the loss of duration and so the bounce can look even worse.

Bouncing is an FDMB term used to describe the natural reaction to what the cat's system perceives as a BG value that is "too low".

A diabetic kittys body gets used to higher numbers and their body starts to think those higher numbers are normal and safe for him.

When you give insulin and his BG drops fast, too low or even what his body perceives as too low (even some of those low yellows or high blues could still 'seem' low to his body right now) his pancreas, then his liver is triggered and releases hormones and various sugars into the bloodstream to bring the BG back up to a level his body considers safe.

A bounce is the excess glucagon, glycogen and counter-regulatory hormones released by a 'panicky liver' and floating around in the bloodstream 'helping' keep the BG higher where his body feels safe.

It would really help if you could get some tests in the PM cycle. Most kittys tend to drop lower at night and right now you're missing half the picture. Most members try to get at the very least a before bed test - even a PM+2 can give an indication which way a cycle may be headed and give you a head's up he may go lower and you may need to set an alarm to test again later in the cycle to ensure he stays safe.

Some PM tests will also help tell us if he might be starting a bounce or if what you're seeing during the day is loss of duration. We will know when he onsets at night - if it’s just loss of duration he will come back down to those lower numbers where he is now.
 
I agree with Shelly you need to be getting sime tests un after the PM shot

Is that a human meter you are using or can pet meter

If you are following the SLGS dosing method you need to reduce the next dose
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unitimmediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Here is the link to read about the 2 dosing methods

https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/
 
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Shelley & Jess said:
If still giving dry I would feed it early in the cycle. For most kittys, feeding at or after nadir slows the action of the insulin down and the kitty loses duration.

HC food does not cause bouncing. What “can” happen is HC food can cause the brakes to be quickly applied on duration. When that happens, the BG shoots up quickly (many mistake this for a bounce when it is loss of duration). Subsequently, kitty may very well bounce on top of the loss of duration and so the bounce can look even worse.

Bouncing is an FDMB term used to describe the natural reaction to what the cat's system perceives as a BG value that is "too low".

A diabetic kittys body gets used to higher numbers and their body starts to think those higher numbers are normal and safe for him.

When you give insulin and his BG drops fast, too low or even what his body perceives as too low (even some of those low yellows or high blues could still 'seem' low to his body right now) his pancreas, then his liver is triggered and releases hormones and various sugars into the bloodstream to bring the BG back up to a level his body considers safe.

A bounce is the excess glucagon, glycogen and counter-regulatory hormones released by a 'panicky liver' and floating around in the bloodstream 'helping' keep the BG higher where his body feels safe.

It would really help if you could get some tests in the PM cycle. Most kittys tend to drop lower at night and right now you're missing half the picture. Most members try to get at the very least a before bed test - even a PM+2 can give an indication which way a cycle may be headed and give you a head's up he may go lower and you may need to set an alarm to test again later in the cycle to ensure he stays safe.

Some PM tests will also help tell us if he might be starting a bounce or if what you're seeing during the day is loss of duration. We will know when he onsets at night - if it’s just loss of duration he will come back down to those lower numbers where he is now.
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Thanks for explaining that, it makes a lot of sense! I did a test last PM at +2 and his BG was 367. I couldn't get any more test because we fell asleep – we give him his shots at 11:30 am and 11:30 pm, so it's hard to stay to stay up to test past +2 during the week but I'll try to get some more over the weekend. This morning's AMPS was 324, so I'm pretty sure he's going to drop below 90 today. Per what Diane said (and if he does drop below 90 like I'm guessing), does that mean that I need to decrease the 1.5units? And just to make sure, can you confirm that this is what 1.5 units looks like in the syringe??

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Diana & Martin said:
Thanks for explaining that, it makes a lot of sense! I did a test last PM at +2 and his BG was 367. I couldn't get any more test because we fell asleep – we give him his shots at 11:30 am and 11:30 pm, so it's hard to stay to stay up to test past +2 during the week but I'll try to get some more over the weekend. This morning's AMPS was 324, so I'm pretty sure he's going to drop below 90 today. Per what Diane said (and if he does drop below 90 like I'm guessing), does that mean that I need to decrease the 1.5units? And just to make sure, can you confirm that this is what 1.5 units looks like in the syringe??




View attachment 65237
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@FrostD

@Shelley & Jess

@Diana & Martin

Hi Ladies can you make this pic out , I can't is this 1.5 units on a U-40 syrings
By the way Diana is from Spain

Diana what is the brand of this syringe that you are using
 
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Diana & Martin said:
Thanks for explaining that, it makes a lot of sense! I did a test last PM at +2 and his BG was 367. I couldn't get any more test because we fell asleep – we give him his shots at 11:30 am and 11:30 pm, so it's hard to stay to stay up to test past +2 during the week but I'll try to get some more over the weekend.
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Diana is it possible to move the test times up earlier so you can get another test in after the +2 during the night cycle maybe 9 AM and 9 PM so you can get a test in @+5 or +6
If not ok just try and get more over the weekends like you said​
 
Just getting mobile for the day. I'll get on my desktop and will be back in a bit.

(Quick glance doesn't look like 1.5 units - more like 0.75 units)

Can you post a pic where you were drawing to for 2.0 units dose please.
 
Well, not a good start to my day....let's just say I had a run in with a big ol' orange tabby lookin' for lovin, a full mug of coffee and the need for a carpet cleaner first thing this morning. :oops:

Anyway, looks like a red cap we usually see on a U40 syringe. I can't read the writing on the left side of the syringe but it should say U40 on the syringe somewhere, if you could confirm please.

The lines on the right are the 'full' unit markers and the lines on the left the 'half' unit markers.

See where the 5 is? That's 5 units and the lines below on the right would be 4, 3, 2, 1.

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Shelley & Jess said:
Well, not a good start to my day....let's just say I had a run in with a big ol' orange tabby lookin' for lovin, a full mug of coffee and the need for a carpet cleaner first thing this morning. :oops:

Anyway, looks like a red cap we usually see on a U40 syringe. I can't read the writing on the left side of the syringe but it should say U40 on the syringe somewhere, if you could confirm please.

The lines on the right are the 'full' unit markers and the lines on the left the 'half' unit markers.

See where the 5 is? That's 5 units and the lines below on the right would be 4, 3, 2, 1.

View attachment 65240
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Oh no! Surely you were in a hurry, too. It's like they know when to be extra mischievous!!

Here's the brand of the syringes and several views of the syringe itself with what I was drawing for two units. Per my previous vet, 2 units was where I drew the black arrow

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Diana & Martin said:
Oh no! Surely you were in a hurry, too. It's like they know when to be extra mischievous!!

Here's the brand of the syringes and several views of the syringe itself with what I was drawing for two units. Per my previous vet, 2 units was where I drew the black arrow

View attachment 65241 View attachment 65242 View attachment 65243
Click to expand...
@Shelley & Jess

Hi Shelley it looks like she was giving 1 unit looking at her pic above thinking it was 2 units
Does it matter if she is using 0.5 ml syringes ?
What dose should she be shooting now looking at her SS
Instead of
U-40 Insulin Syringes 31G .3CC 5/16" 100/Box
She lives in Spain I don't no is she can get the ones I just posted above


@Diana & Martin Diana looking at the pic you posted above with the arrow you drew you were drawing up 1unit not 2 units. Look at the pic Shelley posted above in post #13
Look to the right and you will see the post numbers
 
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Diane Tyler's Mom said:
Does it matter if she is using 0.5 ml syringes ?
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Nope, just a bigger syringe that can measure more insulin at a time, they're fine.
0.5ml U40 syringe can hold/measure up to 20 units
0.3ml U40 syringe can hold/measure up to 12 units

Diana & Martin said:
Here's the brand of the syringes and several views of the syringe itself with what I was drawing for two units. Per my previous vet, 2 units was where I drew the black arrow
Click to expand...
Thanks for the pics - really helps!

Yeah, your vet had you giving 1.0 unit of insulin instead of 2.0 units - which is actually a good thing. 1.0 unit is the recommended starting dose.

And, you actually shot 0.75 units this morning. AM+6 today looks good at that dose. Stay with the 0.75 units unless he drops below 90 and we'll reduce the dose again.

Can you change your spreadsheet to reflect the actual amount of insulin given please so there's no confusion going forward.

How's the food transition going? Another thing you could do is make notes on your spreadsheet about when and how much dry you fed - will help us keep an eye on the transition and what it's doing to the numbers.

You are doing a FANTASTIC job :)
 
Shelley & Jess said:
Nope, just a bigger syringe that can measure more insulin at a time, they're fine.
0.5ml U40 syringe can hold/measure up to 20 units
0.3ml U40 syringe can hold/measure up to 12 units


Thanks for the pics - really helps!

Yeah, your vet had you giving 1.0 unit of insulin instead of 2.0 units - which is actually a good thing. 1.0 unit is the recommended starting dose.

And, you actually shot 0.75 units this morning. AM+6 today looks good at that dose. Stay with the 0.75 units unless he drops below 90 and we'll reduce the dose again.

Can you change your spreadsheet to reflect the actual amount of insulin given please so there's no confusion going forward.

How's the food transition going? Another thing you could do is make notes on your spreadsheet about when and how much dry you fed - will help us keep an eye on the transition and what it's doing to the numbers.

You are doing a FANTASTIC job :)
Click to expand...

That's crazy because now all I can think about is that if I'd given him the real 2 units yesterday that would've probably been really bad, since he dropped all the way down to 42 with 1 unit and this food transition. Our initial vet, the one that diagnosed him and prescribed Caninsulin, was the one that showed us how to shoot and about the markings – he explicitly said one line is one unit and which specific syringes to buy.

We started out giving him one "unit" of Caninsulin which was increased to 3 a couple of weeks later when we took him for his bi-weekly fructosamine test. This is before we learned about home testing. Then when I took him to the new vet last week they switched him to Prozinc and prescribed 2 units based on some calculation the vet did with his weight. They also asked if I wanted to see what 2 units looked like in the syringe just to make sure and stubborn me said no thanks because I thought I knew from the previous vet's explanation. But I guess this is a mistake I'm happy I made.
 
Diana & Martin said:
That's crazy because now all I can think about is that if I'd given him the real 2 units yesterday that would've probably been really bad, since he dropped all the way down to 42 with 1 unit and this food transition. Our initial vet, the one that diagnosed him and prescribed Caninsulin, was the one that showed us how to shoot and about the markings – he explicitly said one line is one unit and which specific syringes to buy.

We started out giving him one "unit" of Caninsulin which was increased to 3 a couple of weeks later when we took him for his bi-weekly fructosamine test. This is before we learned about home testing. Then when I took him to the new vet last week they switched him to Prozinc and prescribed 2 units based on some calculation the vet did with his weight. They also asked if I wanted to see what 2 units looked like in the syringe just to make sure and stubborn me said no thanks because I thought I knew from the previous vet's explanation. But I guess this is a mistake I'm happy I made.
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I'm glad everything turned out good :cat:
 
Shelley & Jess said:
Nope, just a bigger syringe that can measure more insulin at a time, they're fine.
0.5ml U40 syringe can hold/measure up to 20 units
0.3ml U40 syringe can hold/measure up to 12 units


Thanks for the pics - really helps!

Yeah, your vet had you giving 1.0 unit of insulin instead of 2.0 units - which is actually a good thing. 1.0 unit is the recommended starting dose.

And, you actually shot 0.75 units this morning. AM+6 today looks good at that dose. Stay with the 0.75 units unless he drops below 90 and we'll reduce the dose again.

Can you change your spreadsheet to reflect the actual amount of insulin given please so there's no confusion going forward.

How's the food transition going? Another thing you could do is make notes on your spreadsheet about when and how much dry you fed - will help us keep an eye on the transition and what it's doing to the numbers.

You are doing a FANTASTIC job :)
Click to expand...
Thank you Shelly :bighug::cat:
 
Can you add SLGS to to your signature and your spreadsheet so members won't have to keep asking you what method you are following
Add SLGS up top on your spreadsheet where it asks you
To add SLGS to your signature
:cat:
Tap on your name ,then tap on signature and add it then tap save
 
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Sounds good. It's early in the cycle for a number that low. Test in 20 minutes from when he just ate. If still dropping you might need a little honey or syrup to get a quick slow down.
 
Did another test - 74. The vet called me today to check in and said that his numbers are looking good. Told me to hold the dose for a week and then do another curve. Should we stay at 0.75 units?
 
Shelley & Jess said:
Oh goodness no!

He's earned a reduction down to at least 0.5u for sure, I'm thinking maybe more depending where you are with the food transition (still feeding a regular portion of dry?) and how much you can test this weekend, including the PM cycle.
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Ok we'll go down to 0,5u. I'm still feeding dry, 10g total throughout the day split between the afternoon and overnight. I can test this weekend as needed. How much should I test throughout the day and during the PM cycle? I just tested him for his PMPS and he's at 393.
 
The amount of daytime testing is great, the only thing I would change now that he's shown you limes, start keeping an eye out a little earlier for an active cycle, say around +4. If things are moving a little too fast, but he's still in safe numbers, gives you time to try a little LC food to see if it slows him down enough to surf through until nadir without going lime and having to pull out the HC food.

And, as far as the PM cycle, same idea. Would setting an alarm for a +4 or +5 work to collect some PM data? I know you shoot late, so whatever you can manage beyond a +2 would be great - believe me, we all know what it's like loosing sleep to get those middle of the night tests.:blackeye:
 
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