911 HYPO 29mg/dl

Vanlora Light

Vanlora Light

Member Since 2021
My cat just had a hypo, are these usually hypo symtoms?
So my cat has acute pancreatitis right now and eats very little, even tho I syringe feed him.

In the evening he started to look drunk, couldn't walk, was wobbly and confused, pupils dilated and weak.

Then I checked his BG and it was 29mg/dl on a human glucose meter, so I immediately gave him honey(all I had) and some normal cat wet food(high in carbs).

Should I even give him glucose tonight (it's 12am now), or should I recheck in 30 minutes and if it's high then I give him his regular 0.5 units of Lantus?
 
Keep testing every 20 minutes and give honey or high carb food until the BG is up over 50. And then keep testing and giving low carb food after the BG is up over 50.
Keep posting his BGs.
Don’t give any more insulin until we advise you.
I can’t see your SS you need to give us permission to see it
What dose are you giving. You will need to reduce the dose.
Can you put the 911 up on your subject line please. I can’t stay as I have an appointment
I’ll tag some others that may be around to help you.
@tiffmaxee, @Wendy&Neko
@frost @Suzanne & Darcy

You will need to take him to the ER if he is not responding to the honey.
If you have run out of honey can you send someone out for some more or do you have any Karo or corn syrup?
 
H
Bron and Sheba (GA) said:
Keep testing every 20 minutes and give honey or high carb food until the BG is up over 50. And then keep testing and giving low carb food after the BG is up over 50.
Keep posting his BGs.
Don’t give any more insulin until we advise you.
I can’t see your SS you need to give us permission to see it
What dose are you giving. You will need to reduce the dose.
Can you put the 911 up on your subject line please. I can’t stay as I have an appointment
I’ll tag some others that may be around to help you.
@tiffmaxee, @Wendy&Neko
@frost @Suzanne & Darcy

You will need to take him to the ER if he is not responding to the honey.
If you have run out of honey can you send someone out for some more or do you have any Karo or corn syrup?
Click to expand...
He was just at the emergency vet for few days and they gave him 0.50 units of Lantus there, they said they skipped the dose when it was less than 180mg/dl, I haven't updated the spreadsheet much right now since Missy has acute pancreatitis and doesn't want to eat, so I have to syringe feed him and it's so hard.
 
Wendy&Neko said:
It's been over half an hour since you posted. Could you test and post the new numbers please? And change that permission on the spreadsheet.

Here us a post with some information on hypo symptoms, which you are seeing: How to treat HYPOS - THEY CAN KILL! Print this Out!!
Click to expand...
He is 115mg/dl now. But now after I took the BG Im noticing he still looks "out" like he is drunk and trying to stand still but he is laying down with tongue out.
 
I would take him to the ER. If he has not been eating much and has pancreatitis, he may have ketones in he urine or DKA. Both need urgent vet attention.
 
Bron and Sheba (GA) said:
Is he still unable to get up and walk around?
Is his tongue still hanging out and he seems drunk?
Is he still eating via syringe ?
Click to expand...
He eats on his own alittle bit, the rest I have to give with syringe.
Now he is again just loafing on our bed, tongue in. Seems better.
I Now think that thr hypo situation was a coincidence with what really might have happened.
So my cat takes tramadol, mirtazapine and cerenia for his pancreatitis. But I just read that mirtazapine and tramadol if taken together can cause serotonin syndrome, so can cause tremors, muscle spasm, hallucinations.

And today he did get tramadol 50mg(1/4th of the pill) for the first time and mirtazapine almost at the same time(only 1-2 hours apart).
 
Vanlora Light said:
He eats on his own alittle bit, the rest I have to give with syringe.
Now he is again just loafing on our bed, tongue in. Seems better.
I Now think that thr hypo situation was a coincidence with what really might have happened.
So my cat takes tramadol for the first time, mirtazapine and cerenia for his pamcreatitis. But I just read that mirtazapine and tramadol if taken together can cause serotonin syndrome, so can cause tremors, muscle spasm, hallucinations.

And today he did get tramadol 50mg(1/4th of the pill) and mirtazapine almost at the same time(only 1-2 hours apart).
Click to expand...


Seratonin syndrome is unlikely imo. Looks like classic hypo. You need to continue testing to make sure he isn’t going to drop again, cause it can wear off all of a sudden over 10-20 minutes.
 
Vanlora Light said:
He eats on his own alittle bit, the rest I have to give with syringe.
Now he is again just loafing on our bed, tongue in. Seems better.
I Now think that thr hypo situation was a coincidence with what really might have happened.
So my cat takes tramadol, mirtazapine and cerenia for his pancreatitis. But I just read that mirtazapine and tramadol if taken together can cause serotonin syndrome, so can cause tremors, muscle spasm, hallucinations.

And today he did get tramadol 50mg(1/4th of the pill) for the first time and mirtazapine almost at the same time(only 1-2 hours apart).
Click to expand...
I would keep testing and monitoring symptoms. I notice you are not doing much testing during the cycles at all. I would strongly recommend you get at least one test in during every cycle so you can see what the dose is doing and how far the BG is dropping. Lantus dosing is based on the lowest point in the cycle.
With that 29 you need to drop the dose to 0.25 U. however cats that have had a symptomatic hypo can be very sensitive to insulin afterwards. So I would post and ask about whether to give the next dose or skip before doing anything.

Are you giving any antinausea medication such a ondansetron or cerenia for the pancreatitis?
 
Bron and Sheba (GA) said:
I would keep testing and monitoring symptoms. I notice you are not doing much testing during the cycles at all. I would strongly recommend you get at least one test in during every cycle so you can see what the dose is doing and how far the BG is dropping. Lantus dosing is based on the lowest point in the cycle.
With that 29 you need to drop the dose to 0.25 U. however cats that have had a symptomatic hypo can be very sensitive to insulin afterwards. So I would post and ask about whether to give the next dose or skip before doing anything.

Are you giving any antinausea medication such a ondansetron or cerenia for the pancreatitis?
Click to expand...
He is getting cerenia yes, along with mirtazapine and tramadol now.
 
Do you have Ketostix or Keto diastix to test for ketones in the urine? Which country do you live in?
They can be bought at Walmart or a pharmacy. All you need to do it collect a urine sample and then dip the strip into the urine and read the result exactly 15 seconds later.
If you could update the SS as much s possible that would be very helpful please. so looking at the SS the 29 was the preshot BG….is that correct?
Keep offering carb food during the cycle even though you didn’t give insulin.
 
Yeah honestly tramadol is a very bad opiate generally for the side effect profile. It’s more like an SSRI that also has a weak afinity for u opioid receptors. It gets metabolized by the liver into an opiate with more affinity for the u receptors (the ones that relieve pain/induce euphoria). So like codeine it can be very dependent on your liver enzymes to work properly.

Buprenorphine is not a prodrug like codeine or tramadol, has less side effects, and is safer due to it being a mixed agonist/antagonist, reducing risk of OD. Plus less interactions with other psychotropic medications. It also has a long half life, so it lasts a long time and provides constant pain relief.
 
Tramadol is also contraindicated in cases of impaired renal/liver function. It also makes anti nausea meds like ondansetron far less effective, and can cause nasuea due to excess seratonin (ondanestron is a seratonin antagonist; it blocks seratonin receptors from firing, tramadol inhibits the reuptake of seratonin reducing this effect).

Nerd rant over
 
Vanlora Light said:
He eats on his own alittle bit, the rest I have to give with syringe.
Now he is again just loafing on our bed, tongue in. Seems better.
I Now think that thr hypo situation was a coincidence with what really might have happened.
So my cat takes tramadol, mirtazapine and cerenia for his pancreatitis. But I just read that mirtazapine and tramadol if taken together can cause serotonin syndrome, so can cause tremors, muscle spasm, hallucinations.

And today he did get tramadol 50mg(1/4th of the pill) for the first time and mirtazapine almost at the same time(only 1-2 hours apart).
Click to expand...
With a BG of 29, it was a hypo. No doubt.
 
I really hope my vet can prescribe me
chuckstables said:
Yeah honestly tramadol is a very bad opiate generally for the side effect profile. It’s more like an SSRI that also has a weak afinity for u opioid receptors. It gets metabolized by the liver into an opiate with more affinity for the u receptors (the ones that relieve pain/induce euphoria). So like codeine it can be very dependent on your liver enzymes to work properly.

Buprenorphine is not a prodrug like codeine or tramadol, has less side effects, and is safer due to it being a mixed agonist/antagonist, reducing risk of OD. Plus less interactions with other psychotropic medications. It also has a long half life, so it lasts a long time and provides constant pain relief.
Click to expand...
I really hope my vet can prescribe buprenorphine because all I've gotten from the past from vets is basically a "‍♂️ that is all we can do". I cant even get subq fluids home from them, they are so strict.
 
Bron and Sheba (GA) said:
Do you have Ketostix or Keto diastix to test for ketones in the urine? Which country do you live in?
They can be bought at Walmart or a pharmacy. All you need to do it collect a urine sample and then dip the strip into the urine and read the result exactly 15 seconds later.
If you could update the SS as much s possible that would be very helpful please. so looking at the SS the 29 was the preshot BG….is that correct?
Keep offering carb food during the cycle even though you didn’t give insulin.
Click to expand...
I live in Finland, and yes the 29 was a preshot, I've taken ketone tests from him and it comes all normal.
 
Bron and Sheba (GA) said:
Keep testing every 20 minutes and give honey or high carb food until the BG is up over 50. And then keep testing and giving low carb food after the BG is up over 50.
Keep posting his BGs.
Don’t give any more insulin until we advise you.
I can’t see your SS you need to give us permission to see it
What dose are you giving. You will need to reduce the dose.
Can you put the 911 up on your subject line please. I can’t stay as I have an appointment
I’ll tag some others that may be around to help you.
@tiffmaxee, @Wendy&Neko
@frost @Suzanne & Darcy

You will need to take him to the ER if he is not responding to the honey.
If you have run out of honey can you send someone out for some more or do you have any Karo or corn syrup?
Click to expand...
This morning before dose time it's 84mg/dl, should I give 0.25units? Or not give?
 
Bron and Sheba (GA) said:
Just to add, as you are doing SLGS you do not shoot the dose if the Preshot is under 90.
Also I’m just checking you have a hypo kit set up. You said earlier you had run out of honey. I will give you a link to the hypo kit. Please make sure you get one set up as it can save your kittys life.
HYPO KIT LINK
Click to expand...
I gave him honey yesterday, and I have high carb wet food always to give if hypos happen.
 
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