Help! Bg so low with no shot

Monster's Mom

Monster's Mom

Member
I finally have my spreadsheet done!
Monster's bg is so low today and not getting very much higher. Her last shot was last night. Even with no insulin today, she's staying low... I don't understand. I was about to send the curve info to the vet, but it's so much different today I'm not sure what to do
 
What day did you start giving insulin? The answer to that an other questions are things we like to see in the signature. Details here: New? How You Can Help Us Help You!

I think what you are seeing are the effects of the Lantus depot. Basically Lantus is a depot style insulin and it can take 5-7 days for the depot to build and for you to see the impact of what the dose can do. Looks like you've given 5 shots? The depot also can impact the cycles for some time after you lower the dose. Meaning that you still saw some action this morning from the depot, but it is wearing off and the blood sugars are rising. More reading What is the Insulin Depot?

To me it looks like 2 units is too high a dose to start with. Typically we start with 0.5 or 1.0 units, depending on what type of food is being fed and dosing method being followed.

Are you still feeding the glycobalance food?
 
I am not feeding glycobalance. I started insulin shots on 11/5 when we got home from the vet. I went 11/6, Thursday with the food chart in hand, and got friskies and ff. I started feeding canned that same day. I didn't start testing until 11/8 because the vet said not to. I entered the info I had written down into the spreadsheet but I realize now I should have been more specific about some things
 
The switch to a appropriate food for diabetics can make a big difference in the amount of insulin needed. Update the spreadsheet Remarks column whenever you change something that can impact blood sugars, either up or down. That will help us help you too.

Sorry the vet said not to test, but definitely not the first time we've seen that. :banghead: I'm sure if they had a diabetic child they would be testing. Good on you for starting to test. What you saw today (thankfully no too low), is exactly why we test.

A suggestion about testing too, see if you can get some tests in the PM cycle too, Many cats go lower at night, and we determine how to change the dose based on how low it takes the cat. A test before bed, it it's at least 2-3 hours after the PM shot can be very helpful in figuring that out.
 
Ok, I can definitely try that. I have her on a 10am and 10pm due to my work hours. I need help with my spreadsheet now. I tried to go to it to change some things on there and every time i open it now, it says view only and won't let me change anything. Please tell me it gets easier.... and soon, lol
 
The first couple months are hard, like drinking from a fire hose! Soon enough you'll be a pro.:bighug:

Make sure you are logged into Google Sheets to make edits.
 
Bg is 184 one hour before she's due for a shot. Do I give her the pm dose? Or skip it as well for today? I was able to get back into the spreadsheet and it has all info now
 
Any signs of ketones for Monster? If yes, you definitely shoot. Her numbers could still go up before the shot. Typically we tell brand new folks not to shoot if under 200, unless there is DKA or ketones in the picture. But I've seen you have done so and have data on what happens when you shoot lower. You could shoot either 1.5 units, or if you want to be conservative 1.0 units.
 
The vet did not say anything about ketones or DKA. She said that Monster was not in diabetic crisis as she suspected she could be before the blood work was done. Unfortunately, the syringes I have don't have half markings. I even have trouble seeing the second line for 2 units lol
 
It is time for her shot so I just tested her again and she is 232. But I'm still not sure if I should shoot or not. Maybe 1.0.... I just dont want her to drop too low overnight
 
Hi 1U seems like a good choice for now. You can always work up to a dose, half of this is us humans getting used to the change too.

What area are you in? You are going to need syringes with half units marked and members will be able to advise better if they know where you are.

When you get a minute could you please add a signature to your posts. Here are the instructions. Stops you getting asked the same question over and over, I can see you've sorted your spreadsheet and added it already.

Make sure your signature is up-to-date.

  • In the top right, click on your username, and then Signature. This is where you will put information that helps us give you feedback.There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Thank you for your help. I think I have everything up to date now. I checked this morning and he numbers were higher so I gave her 1.0 again this morning. I sent the spreadsheet to her vet for info on her curve. I waiting to see if they have any problems with what I'm doing. I'm at work now for the next 8 hours. Please let me know any other info you all need. I did fill in info the "about you" section before I knew about putting it in the signature.
 
Monster's Mom said:
Thank you for your help. I think I have everything up to date now. I checked this morning and he numbers were higher so I gave her 1.0 again this morning. I sent the spreadsheet to her vet for info on her curve. I waiting to see if they have any problems with what I'm doing. I'm at work now for the next 8 hours. Please let me know any other info you all need. I did fill in info the "about you" section before I knew about putting it in the signature.
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All looks good you're doing great.

Now we just need someone more local to you (I'm in the UK) to give a heads up on the best U100 insulin syringes with half unit markings for you to get so you can measure the lantus better
 
Here is a list of some of the syringes available in the US that have half unit markings:
Click to expand...
High numbers are not unexpected right now. The skip yesterday depleted the Lantus depot, it can take a few days to see what the 1.0 unit dose can do by itself. Will you be able to get any mid day tests this weekend? We can tell how well the dose is doing by seeing how low it takes the cat, which means getting some tests mid way between the shots.
 
I work Fri through Tues noon to 8pm. My weekends are Wed and Thurs. I give her shots 10am and 10pm. I try to test her before I leave for work which is about an hour and a half after her shot. Then test her when i get home, about 815 to 830. She is usually triggered to eat when she see me wake up and when I come home so I try to get a test done before she eats. She doesn't eat all in one sitting. Both my babies have always grazed throughout the day. I will try to get more mid cycle test when I'm off.
I have a few questions about her dose and the depot. Will she continue to build and depot every week or so or will that stop if I lower her dose? I sent the spreadsheet for her curve to the vet and they replied it all looks good and she's controlled now. And said to do another curve in 2 months. They didn't say anything about changing her dose, so do I just continue to determine the dose on my own? Are her numbers good for where she is now? Should she be steadily up in the high 200s? I worry about giving her a shot and her getting hypo while I'm at work or sleeping. I've read alot of posts about people saying their baby passed away 6 months or so after being diagnosed and I am terrified. I'm sorry for all the new questions and such but I have been thinking alot, maybe too much.
 
Good to know on the schedule and that you do have a couple days you can get more data. It may be hard, but if there is anyway to change the schedule so you can get a +2 before leaving for work, instead of +1.5, it would be a more useful data point. Ditto for the PM test. If you see a drop to +2, it can tell you to leave a bit higher carb food out for her to graze on. Making sure she has food out at her lowest points in the cycle will be what keeps her safe while you are gone. Some people get autofeeders and have them open a bit before the nadir or low points in the cycle to make sure there is fresh food around then.

Sounds like your vet isn't going to be too involved in dosing. We do have a couple dosing methods we have here that can help you decide (initially with our help), how to change her dose. A cat's insulin needs can change a LOT in two months, a curve once a week is much better.

The depot takes 5-7 days to build when you start giving insulin. When you do increases, it is more like 3-5 days. When you lower the dose, the larger depot doesn't go away right away, it can take 4-6 cycles (2/3 days) to stop influencing the cycles.

She should not steadily be in the high 200's. It depends on what your goals are for her, but you'd definitely like to see her spending more time in lower numbers. Our Start Low Go Slow dosing method says that ideal is when their lowest points during the cycles is in the 90-149 range. Below 90 you reduce the dose, which is why I suggested a dose reduction with that 73. A full one unit reduction may have been too much of a reduction. Normally we reduce by 0.25 units at a time. Yes, we eyeball that with the 1/2 unit markings on the syringe.
 
Wendy&Neko said:
Good to know on the schedule and that you do have a couple days you can get more data. It may be hard, but if there is anyway to change the schedule so you can get a +2 before leaving for work, instead of +1.5, it would be a more useful data point. Ditto for the PM test. If you see a drop to +2, it can tell you to leave a bit higher carb food out for her to graze on. Making sure she has food out at her lowest points in the cycle will be what keeps her safe while you are gone. Some people get autofeeders and have them open a bit before the nadir or low points in the cycle to make sure there is fresh food around then.

Sounds like your vet isn't going to be too involved in dosing. We do have a couple dosing methods we have here that can help you decide (initially with our help), how to change her dose. A cat's insulin needs can change a LOT in two months, a curve once a week is much better.

The depot takes 5-7 days to build when you start giving insulin. When you do increases, it is more like 3-5 days. When you lower the dose, the larger depot doesn't go away right away, it can take 4-6 cycles (2/3 days) to stop influencing the cycles.

She should not steadily be in the high 200's. It depends on what your goals are for her, but you'd definitely like to see her spending more time in lower numbers. Our Start Low Go Slow dosing method says that ideal is when their lowest points during the cycles is in the 90-149 range. Below 90 you reduce the dose, which is why I suggested a dose reduction with that 73. A full one unit reduction may have been too much of a reduction. Normally we reduce by 0.25 units at a time. Yes, we eyeball that with the 1/2 unit markings on the syringe.
Click to expand...
I just ordered some of the half unit marking syringes, they should be delivered on Tues the 18th. Until then should I give her 2 units still? Her shot time is in a few minutes... I can stay up later tonight for a +2 test. She seems very tired today. She came to me to get up on my lap and she hasn't done that lately. She's 19 lbs so it takes some effort to get on my lap, lol. Now she's just laying at me feet. I get the feeling she's trying to tell me something.
 
I wouldn't give her 2 units if you know it can take her down to 73 while you are not able to monitor. Can you eyeball half way between 1 and 2 units?
 
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