Help! Concern about numbers!

Hi!

I just got a glucose meter today (ReliOn Prime). I tested Dexter at +10 and he was at 78. I just tested him again for his pre-shot and it was 44. This is a concerning number, right?! He is eating right now and hasn't shown any abnormal signs of concern.

He's been on tiki cat wet food since December 2020, when he was initially diagnosed. At that time, he was on novolin and his numbers were all over the place. In May, he had a hypoglycemic episode and was hospitalized (terrifying and close call). He was testing high again a couple weeks later at his follow-up vet appointment, so my vet switched him to lantus. We started at 1 unit and increased to 1.5 units 2 weeks later because his numbers were still high. So, he's been on 1.5 units since June 20th. I'm terrified about another hypoglycemic episode, so I told my vet I wanted to start testing at home. She advised against me adjusting insulin levels with the at home testing, but I'm seeing different recommendations on here and the message board.

Please advise on how to move forward! I'm also reaching out to his vet for recommendations. Thank you in advance for your help!

 

Hi Katie,
I am glad you gave Dexter some food.
Was it low carb or some higher carb food?
Normally at the end of a cycle the BG will start to come up with low carb food but in your case we don’t have any data at all to know how low it has been.
So I would suggest giving a teaspoon of some higher carb food now to bring him up over 50
Please test again in 20 minutes to see he is coming back up and post the result.

You will need to reduce the dose of insulin. More about that later. Let’s just get him into better numbers first.
Please hit the like button to indicate you have seen this post and let me know when you have giving the food.
Thanks Bron

 

Hi Bron,

I don't have any high carb cat food, but I do have some Karo syrup that I was advised to get for potential hypoglycemic events. Should I give him some of that?

Thank you!

Katie

 

Test now and see what it is if you can. If it is still under 50 give 1 drop of honey.
I will talk to you about a hypo kit later.

 

He just tested right at 50.

 

Excellent.
So you are going to skip this dose, but I would still keep testing to see he is still on the way up.
I would give him a teaspoon of his low carb food now and test again in 1 hour.
If you can keep the SS up to date that would be very helpful. I will watch for the test in 1 hour. I am helping someone else at the moment but will get back to you about the dose and a few other things
Bron

 

Hi Katie,
I would suggest going back to 1 unit of the Lantus twice a day and see how Dexter goes with that.
As you are going to be testing at home, you will get true readings and not artificially inflated BGs that can happen at the vet as the cars get stressed when there and that raises their BG.
To start with I would suggest if you get a BG under 200…..stall, dont feed, and test again I 20 minutes to see if the BG is rising. Also post and ask for help…..change the subject line to something like ..Stalling, BG xx, HELP. that will get attention.

Once you you have giving the dose, get a +2 (2 hours after the dose of insulin) and post the result. Then maybe a +5, depending if the +2 was higher or lower than the preshot number…….we can walk you through this.
Apart from the 2 main meals before the shots, I would suggest giving 2 snacks each cycle (am and pm cycles) at +2 and +5 to start with until we can see his BGs. Then we can adjust the times if needed.
Don’t feed for the 2 hours before the preshot BG as we don’t want the Preshot food influenced.

I will give you a couple of links
HELP US HELP YOU this has links to the spreadsheet, the signature ( if you could do that it will tell us all about Dexter), the hypo kit ( which I would recommend you get set up today) and other useful links.
Keep asking questions

 

Hi Bron,

Thank you for all of this information and for all of your help with this!

I just re-tested and he was at 57.

I will go down to 1 unit of lantus starting in the morning. I would be able to do the +2 and +5 readings and snacks on weekends, but with my job, I'm not able to do snacks/readings throughout the day during week days. Do you have recommendations on how to address that?

I have added Dexter's spreadsheet to my signature and will keep that updated.

Thank you!

Katie

 

If you were able to get a timed automatic feeder it could feed Dexter while you are at work. I had one for Sheba and it was so good to know that food was being dispensed while I wasn’t there.
As far as the testing goes……as you able to get a +2 before you leave for work?
Or maybe a +9 or 10 when you get home?
Then there is always the pm cycle to get some tests in as it is just as important. I would recommend you get into the habit of always getting a before bed test in every night. If that test is the same or lower than the preshot BG, that is telling you the cycle will most likely be active and drop lower. So I would suggest setting the alarm and getting up and testing later,
Think of the SS as a jigsaw puzzle and we need to try and fill all the spots….over time of course.

I can’t see the signature yet. Did you save it?

57 is good. I would get another test in 2 hours. And a small snack now.
Bron

 

I'll look into an automatic feeder. I work from home some days and can get some +2 and +5 readings on those days, but my schedule changes every day depending on visits and meetings that I have (I'm a social worker and it's just me and the furbabies here, so unfortunately there's no one else around to help out). I have more flexibility around the pm cycle and I can definitely get some of the other am cycle readings on the weekends. I'll plan to start testing before bed, as well.

I'll plan to test again in another 2 hours and just got him to eat a little more.

The spreadsheet is showing up as a hyperlink in my signature on my end. I'll go in and try to re-save it.

 

I meant to mention also…did the vet mention ketones at diagnosis?

Well done getting those two BG tests into the SS so well! you can use the remark column in the SS to write down food given, or results of tests such as ketone tests, or if Dexter is constipated, lethargic, happy etc. we look at the SS and the signature before we help every time so any information is helpful and you can look back and see what works.

 

Ketones weren't mentioned during the initial diagnoses, but I believe they were mentioned following the hospitalization when his numbers went back up (I moved in between those times, so there was a switch in vets). Should I be testing for ketones?

 

I just tested again and he was at 56. Should I be concerned that he went down by 1?

 

Yes. If you think there is a history of ketones please put that into the signature as it is important.
Yes I would test for ketones. You will need a bottle of Ketostix from Walmart or a pharmacy and follow directions on the bottle. I would test daily at first.
I would also make sure he is eating well as food helps ketones from reappearing as does insulin.

56 and 57 are really the same so no worries there. However he is certainly taking his time coming back up, so I would keep giving him small snacks and testing again in 2 hours. He is actually in normal numbers at the moment.
We will have to see what he is at PMPS. If you can get a +11 (that’s 1 hours before the insulin is due) , that will give us an idea what he has in mind. But in the meantime get that +5. Bad luck this is happening during the night…but that is cats for you

 

Ok, thank you! He did just eat a little more. I'll test again in 2 hours.

 

Just tested again and we're at 71

 

He should be fine to leave now. I would just leave some food out for him and go to bed. Sorry I didn’t see this earlier.
Try and pick the food up 2 hours before the next preshot if you can.
He’s surfing beautifully in green numbers at the moment. He may not he high enough to shoot next cycle.
I’m not sure if I will be online when you post the preshot number but if I’m not I will ask someone to look out for you.

 

Good morning - Dexter is at 93 at +11 this morning. I'll update with AMPS in an hour.

I left food out overnight and picked it up an hour ago.

Thank you!

 

Hi Katie, still in normal numbers.
Once you get the AMPS preshot number, if it’s under 200, stall, dont feed and test again in 20 mins. And post and ask for help….change the subject line.
I suspect it will be under 200.
The depot is still influencing the numbers as well.
As soon as you can get a test done for ketones, let us know please.

I am most likely not going to be online at AMPS as it is late here but I’ll tag @Sienne and Gabby (GA) and she will be able to help you.

 

Hi, Katie. How long until your AMPS?

 

Thank you for all your help, Bron! Goodnight!

Hi Sienne! AMPS is in 15 minutes.

 

@Sienne and Gabby (GA) he just read at 89 at AMPS. I will wait 20 minutes and test again. Should I start a new thread or continue on this one? Thank you!

 

On Health, it's fine to use the same thread. Since you're using Lantus, you may want to switch over to posting on the Lantus board. There are some different conventions for posting but the big advantage is that there are a lot of Lantus users and they are available pretty much 24/7 to lend a hand.

Dexter's numbers are great! Stalling sounds good. I was trying to re-read quickly. What did Bron suggest as a dose?

 

From my understanding, the suggestion was not to shoot if he was under 200.

 

I understood that. I thought she had suggested a dose if his numbers came up above 200.

 

He just tested at 77.

I don't recall a dose suggestion if he rose above 200.

 

Since Dexter seems convinced he wants to surf in low numbers, I'd suggest retelling in about 40 min.

Generally, we don't suggest stalling for more than 2 house since it plays havoc with your shot schedule. Unless you have a great deal of flexibility with your shot time, you may end up skipping the AM shot. (If you delay a shot, you move back to get on schedule either by shifting the time by 15 min at each shot time or by 30 min once a day.)

 

Do I still hold off on feeding, as well? Overall, I don't have a ton of flexibility with shot times (especially during the week).

He's starting to avoid me and his last reading was a struggle to get. He's not used to getting his ears pricked this much, but he's such a trooper.

 

I just tested again and he's at 87.

 

I honestly don't think Dexter's numbers are going to zoom up by +2. Maybe get a +2 and see where he's at and then feed your poor, starving kitty. If he hasn't risen about 200, skip the shot for this morning. You might want to get a test at +6 just to see what the effect of a skipped shot is but otherwise, if. you're skipping, you don't have to be concerned with low numbers.

We'll need to decide on a dose for this evening. I'mm thinking about 0.5u but I want to see where Dexter's numbers are. Do you happen to know any of Dexter's recent test data from the vet? I'm wondering how much stress may have been causing his numbers to be elevated at the vet.

 

Ok, sounds good! I'll let you know where he's at @ +2 and can plan to test again @ +6. He'll be very happy to eat

 

+2 is at 77 and he is happily eating! I'll test again at +6.

I don't have specifics from his most recent tests at the vet, but his numbers were in the 300s.

 

He tested at 125 @ +6.

 

@Sienne and Gabby (GA) - for figuring out Dex's dose for tonight, are +11 and PMPS #s good or would you like to see additional ones, as well? Thanks!

 

The +11 would be great. If you don't see me on the board, send me a PM. I'm guessing they'll also be other experienced members around by your shot time -- around 2 hours from now?

 

Ok, thanks! Yes, that will be 2 hours from now.

 

Dexter is at 97 @ +11. I'll update with PMPS in an hour.

 

He may not get another shot tonight with the way he's going!

 

This looks awesome, Katie!! Aren't you glad you started testing?

 

Absolutely!

 

He's at 83 @ PMPS

 

I think I'd plan on skipping again! Woo hoo! A night off!

 

Ok, yay! Thank you for your help! Should I plan to do any additional readings tonight?

 

Yeah, it's always good to get more data....just grab a "before bed" test tonight. It'll help in case you ever need to know what happens when you skip a dose (if he ever needs to be back on insulin again....we'll see!)

It's all information at this point and you can't have too much

 

Ok, great! I will plan to do a before bed reading. Thank you!

 

Just logging on and seeing Dexter has given you a beautiful PMPS! What a good boy! And handsome too! I love his photo!
His SS is a sea of green!

 

Thank you! He is such a good boy ❤ Can't thank you enough for your help with all of this!

 

It’s a pleasure to be able to help you and such a beautiful boy! And it’s so good to see those lovely BGs

 

Updates on Dexter's #s: before bed last night he was at 106 @ +4.5. This morning he's at 164 @ +11. Will update with AMPS.

 

146 @AMPS

 

I would

I would stall, don’t feed and test again in 20 mins

 

We're at 117 now

 

The BG could have dropped a bit because he was hungry but even so, I would skip the dose and see how he goes during the cycle.
After you feed him, test again in 3 hours. If the BG has dropped, it will mean that the pancreas has kicked in and is producing some insulin.

 

We're at 177 @ +4 (3 hours after eating).

 

Geez, maybe Dexter will want some insulin tonight!

Just as an experiment, could you give him a teaspoon or two of low carb food and test in an hour or two? I'm curious to see if the food brings his numbers down. If his pancreas is working, it may produce some insulin and bring numbers down a bit.

 

Sure, I'll update in an hour or 2. Thank you!

 

We're at 148 @ +6

 

Dex was at 126 @ +10, 102 @ +11 and 94 @ PMPS

 

You didn't give anything this morning, right? There's nothing in the U column. If you make a decision not to shoot, go ahead and put the N.S. in there so we know you skipped on purpose.

Let's plan on skipping tonight and seeing where we are in the AM. He may need a tiny bit like .25 or even .1 but I think it can wait until there's no chance you'd have to be up all night worrying about it. It's a lot less worrying during the day when you're awake.

 

Yes, no shot this morning. I'll make sure I add that NS on my spreadsheet. Thank you!

 

I'd like to invite you to start posting in the Lantus forum. You'll get lots of experienced eyes there.

This thread is getting pretty long so it's really time to start a new one....might as well move over there going forward (you don't have to...just an option)

We do post a little differently there but this "Make the most of your Lantus experience" guide should help