? 0710 Brody: PMPS 143, +3 78, +3.5 85, +4 83, +4.5 81, +5 92, +6 91, +7 91

drdrbrody

drdrbrody

Member Since 2019
Hi all,

We're new here! Brody is a 6yo, 22lb, neutered, domestic tabby. :)

Brody was diagnosed 2 weeks ago, and he's been on 1U Lantus BID for about a week and a half. His in office BG pre-diagnosis was 475, and fructosamine >400. The first week or so I had a hard time getting him to eat the new wet food and his BG was hovering in the 250-300 range, which I was honestly pretty happy with. The last few days, I think I've finally hit on the right food for him, and he's eating normally(ish) again, but his BG numbers have dropped into the 150-200 range. The vet said to give him his shot if it's <200 as long as he is still eating, but I don't think he expected it to be this low!

I'll be calling the vet this week, and hopefully doing a full curve on Saturday, but I was wondering if anyone else had experienced such a big drop in BG only one week in? Could it be due to his change in diet?

Thanks!!
 
Hello! Welcome to the Lantus Basaglar and Levemir board :)

I don’t personally have experience with numbers dropping low and fast but I do know that switching your cat to a wet food low carb diet can absolutely dramatically lower BG levels. A few experienced members on the board have even witnessed some cats go into remission from diet change alone :)
 
Hi there and welcome!

Yes, Amanda is correct. The low carb food will absolutely drop sugar quickly. It is important to keep an eye because you may need to adjust insulin now that the food is helping to lower his numbers. He is a big kitty, but the numbers are getting to where you want to get some more data, looks like if things continue as well as they have been, there may be a dose reduction coming in the future.

The good news is after a week of diet change and this dose you should be seeing the full effect of this dose now.

They tend to go lower at night, so since he is already in the mid 100’s would be really good if you can get a +2 after the pm shot to make sure he is not headed too low overnight. Also if any way to get a mid cycle during day, say +6 ish that is usually, but not always the time during cycle they are lowest.

I am tagging @Bron and Sheba and @Wendy&Neko to add any advice, they have more experience and may be able to offer more guidance than I can.

You are doing great!
 
Thank you for the warm welcome and the information!

I just did a +3 and it was 78. Should I give him some higher carb food? Or just take it again in 30 m? I'm using the Alpha Trak 2 which I think reads higher than the human glucometers.
 
Last edited:
drdrbrody said:
I just did a +3 and it was 78. Should I give him some higher carb food? Or just take it again in 30 m? I'm using the Alpha Trak 2 which I think reads higher than the human glucometers.
Click to expand...
Bron may respond, I hope, she is on now. You are getting very close to where you will need to be giving some high carb 68 on Alpha track is the low end. Also you are early in the cycle, you may be up for a few hours.

Do you have high carb like fancy feast gravy? Karo syrup in case?

I am checking something and will be back momentarily.
 
I have his old high carb dry food (Hill's Science Diet Perfect Weight) and I have Karo Syrup. He's a grazer, so he's still working on his dinner from ~4 hours ago as well (Wellness Turkey).
 
drdrbrody said:
I have his old high carb dry food (Hill's Science Diet Perfect Weight) and I have Karo Syrup. He's a grazer, so he's still working on his dinner from ~4 hours ago as well (Wellness Turkey).
Click to expand...
The dry take awhile to get into their blood, for future good to have a couple FF gravy in stock, the gravy itself has a lot or carbs. For now you can use a little bit of Karo say 1/8 tsp in some low carb, it doesn’t take a lot, the syrup acts quick. Don’t let him eat too much food though, you want him to be a little hungry if you need to feed him periodically over next couple hours. The other thing is the syrup will work, but will wear off, so you may be at this for a few hours. Also, he will get a dose reduction tomorrow morning to .75 units.

I would check him again first before the syrup, possible but not likely his liver may put out some sugar.

Still trying to find a helper here. Check his blood say 15-20 after last check and see which way he is going.
 
You could change the title from question mark to 911 if we see him going below 68, just so it gets more eyes on it. I have been through this twice with my cat, just want to find someone with a few years under their belt that can offer best advice. I’ll help as much as I can.
 
Julie and Honey said:
You could change the title from question mark to 911 if we see him going below 68, just so it gets more eyes on it. I have been through this twice with my cat, just want to find someone with a few years under their belt that can offer best advice. I’ll help as much as I can.
Click to expand...

I'll do that, thanks! Going to take his BG again at +3.5 and then give him a little Karo + LC wet food and measure again at +4. Thanks so much for your help! Now I'm worried he's been doing this for the last three days and I just haven't caught it. :confused:

He's not showing any clinical signs of hypoglycemia luckily.
 
drdrbrody said:
I'll do that, thanks! Going to take his BG again at +3.5 and then give him a little Karo + LC wet food and measure again at +4. Thanks so much for your help! Now I'm worried he's been doing this for the last three days and I just haven't caught it. :confused:

He's not showing any clinical signs of hypoglycemia luckily.
Click to expand...
My kitty hypo’d and no signs, which is actually scarier because you don’t know. I sent a private message to a couple more experienced people too.

Please post when you check 3.5 and let us know what it is. If he is hypo, change title to 911, want to make sure someone can help you.
 
Julie and Honey said:
My kitty hypo’d and no signs, which is actually scarier because you don’t know. I sent a private message to a couple more experienced people too.

Please post when you check 3.5 and let us know what it is. If he is hypo, change title to 911, want to make sure someone can help you.
Click to expand...
Oof that's scary.

He's at 85 right now, +3.5
I haven't given any karo, he just ate a few more bites of his regular LC food. Lmk if you think I should wait and check in 30 or give karo anyways.

Thanks so much!!! Never expected to deal with possible hypo one week in >.<
 
drdrbrody said:
Oof that's scary.

He's at 85 right now, +3.5
I haven't given any karo, he just ate a few more bites of his regular LC food. Will wait and check in 30m.
Click to expand...
Ok, you are on the edge, only reason I am concerned is the low point for Lantus is usually at +6 so he could still drop more
 
I would give him a good teaspoon of low carb food and test again in 1/2 hour. He could wobble up and down a bit because he hasn’t reached nadir yet.
Dry food is not good to give as it takes too long to get into the system.
You need to go out and buy some higher carb gravy foods tomorrow. Have a look on Lisa Pierson’s chart at the top of the main forum.
If he drops below 68 you need to give a drop of honey and test again 20 mins later to see if he is coming up.
Good catch!
 
The other thing you will likely see a little later is a bounce higher, when they go lower than normal often their liver will push out stored sugar in an effort to self regulate. That is normal if you see a really high number later or tomorrow.

Again, you will be reducing his dose in the morning to .75 BID, he earned a reduction!

This is a lot for your first week:facepalm:
 
Bron and Sheba said:
I would give him a good teaspoon of low carb food and test again in 1/2 hour. He could wobble up and down a bit because he hasn’t reached nadir yet.
Dry food is not good to give as it takes too long to get into the system.
You need to go out and buy some higher carb gravy foods tomorrow. Have a look on Lisa Pierson’s chart at the top of the main forum.
If he drops below 68 you need to give a drop of honey and test again 20 mins later to see if he is coming up.
Good catch!
Click to expand...
@Bron and Sheba So, just to clarify, you think hold off on any karo at this point?
 
Thank you both so much for your help!
He's hard to encourage to eat at the best of times, but I'll see if he will take some now. I've got some 10CC syringes around somewhere I think, but let's hope it doesn't come to that.

I'll post again at +4 (and probably +5, 6...looks like I'll be getting more work done tonight than expected)

In the words of my (wonderful) vet: "it's almost impossible to push him hypoglycemic on one unit of insulin". That was probably true when he was up at 400+!
 
drdrbrody said:
Thank you both so much for your help!
He's hard to encourage to eat at the best of times, but I'll see if he will take some now. I've got some 10CC syringes around somewhere I think, but let's hope it doesn't come to that.

I'll post again at +4 (and probably +5, 6...looks like I'll be getting more work done tonight than expected)

In the words of my (wonderful) vet: "it's almost impossible to push him hypoglycemic on one unit of insulin". That was probably true when he was up at 400+!
Click to expand...
So not true what the vet said. The diet change alone can knock off a couple hundred points.

Have to check my kitty, I forgot she was running lower than normal last I checked.
 
Julie and Honey said:
@Bron and Sheba So, just to clarify, you think hold off on any karo at this point?
Click to expand...
@Julie and Honey with the BGLevel going up to 85 I would hold off on the honey and see what the next test is. Brody could drop again as he hasn’t reached nadir yet. As Brodys mom hasn’t any higher carb food it might be necessary to add some honey or karo to low carb to get a high carb food. But let’s see what the next test is.
You’ve given good advice!
 
+4 83

He's just now starting to get annoyed with the repetitive ear sticks. I've been blessed with a super patient cat.
 
Bron and Sheba said:
@Julie and Honey with the BGLevel going up to 85 I would hold off on the honey and see what the next test is. Brody could drop again as he hasn’t reached nadir yet. As Brodys mom hasn’t any higher carb food it might be necessary to add some honey or karo to low carb to get a high carb food. But let’s see what the next test is.
You’ve given good advice!
Click to expand...
Thanks, I try:)
 
drdrbrody said:
+4 83

He's just now starting to get annoyed with the repetitive ear sticks. I've been blessed with a super patient cat.
Click to expand...
I would give another teaspoon of low carb food now and test again in 30 mins. Do you think you can manage that? We just want to get him safely through the nadir.
Do you give a treat when you test?
 
I can give him some more LC and test again at 4.5! Hopefully he will eat it. I'm good to stay up until +6, +7 if need be.

At the beginning I tried to give him a treat when testing, but he never wanted to eat it right afterwards. Now I just make sure to give him extra pets and ear rubs before and after and he purrs through the whole thing. Might try to butter him up with treats for tonight though!
 
+4.5 81
He ate a whole tbsp of FF classic (not gravy) about 5m before i stuck him, so it'll probably register on the next one.

Aw thank you! Thank you both so much for all your help!
 
Moving forward, are you able to get more tests in during the days and in the pm cycle a +2 or before bed test? During the cycle tests are really important as they tell us how the insulin is working in the body.
Always test before every shot to check it is safe to give the insulin but if you can fill in some of those blank squares in the spreadsheet during the cycles that would tell us so much more information
 
Bron and Sheba said:
So he’s surfing along nicely at the moment.
Are you ok to test again in 30 mins?
Click to expand...

I can do +5, but then I might give him a break until +6. Running out of places to stick.

@Julie and Honey you might be psychic! Thank goodness you suggested I check +3! Thank you so much for all of your help; hope things go well tonight with your own kitty, and I hope you sleep well. Thanks for staying up with me. :)

@Bron and Sheba It's hard for me to get during the day tests since I often work 9-10h a day. I can maybe get a +1 in the AM and a +2 or 3 in the PM before bed. I was planning to do a full curve this Saturday. Just a couple of days too late it seems.
 
drdrbrody said:
I can do +5, but then I might give him a break until +6. Running out of places to stick.

@Julie and Honey you might be psychic! Thank goodness you suggested I check +3! Thank you so much for all of your help; hope things go well tonight with your own kitty, and I hope you sleep well. Thanks for staying up with me. :)

@Bron and Sheba It's hard for me to get during the day tests since I often work 9-10h a day. I can maybe get a +1 in the AM and a +2 or 3 in the PM before bed. I was planning to do a full curve this Saturday. Just a couple of days too late it seems.
Click to expand...
Any you can get would be helpful.
 
drdrbrody said:
I can do +5, but then I might give him a break until +6. Running out of places to stick.

@Julie and Honey you might be psychic! Thank goodness you suggested I check +3! Thank you so much for all of your help; hope things go well tonight with your own kitty, and I hope you sleep well. Thanks for staying up with me. :)

@Bron and Sheba It's hard for me to get during the day tests since I often work 9-10h a day. I can maybe get a +1 in the AM and a +2 or 3 in the PM before bed. I was planning to do a full curve this Saturday. Just a couple of days too late it seems.
Click to expand...
Probably +1 in am will not show much, the after pm shot is better, don’t forget .75 tomorrow!
 
Also there are guidelines here for a curve if you need any help with that...off to bed with me I am unemployed and have a phone interview tomorrow and still need to go over stuff in the morning...

@Bron and Sheba do they say g’night, like they say g’day? Does Sheba meow with an Australian accent? Okay, I need to get some sleep.:p
 
+5 92!

Trending in the right direction! I gave him another tbsp of LC FF and I'm going to let his ears rest until +6. Hopefully nadir was early and this isn't a temporary bump.

@Julie and Honey Best of luck tomorrow!! If you're ever in NYC, I'll buy you a beer (or seven). Same to you @Bron and Sheba, although it might be a bit longer trip!
 
Well @Bron and Sheba I hate to do this to you, but @Penelope and Mačka may need some guidance if you are up for a double feature tonight. @Bobbie And Bubba was helping but I think she may be off for now. Penelopes post is on Lantus board. I will probably peek back in a couple hours when I get up to check my cat, setting my alarm. Her kitty will likely be in high enough numbers all night, but she has been very worried and getting different advice from vet, so she could use a little help to ease her mind.

Thanks all.
 
Julie and Honey said:
Well @Bron and Sheba I hate to do this to you, but @Penelope and Mačka may need some guidance if you are up for a double feature tonight. @Bobbie And Bubba was helping but I think she may be off for now. Penelopes post is on Lantus board. I will probably peek back in a couple hours when I get up to check my cat, setting my alarm. Her kitty will likely be in high enough numbers all night, but she has been very worried and getting different advice from vet, so she could use a little help to ease her mind.

Thanks all.
Click to expand...
Thanks. I’ll go over and look
 
+6 91

He didn't want to eat any of the FF this time around, so that's 91 w/ no food in the last hour. Hopefully that means he's starting to come up slowly, and he typically grazes throughout the night, so hopefully he'll keep eating a bit here and there.

I'm going to try and catch some sleep since it's 2am here, but I'll probably wake up in 2h to check on him just in case. He started eating again as I type this, so hopefully he keeps it up!

Just a quick technical question: Julie was saying he gets a reduction to 0.75 tomorrow which totally makes sense, but my vet said it's safe to skip doses if I'm not comfortable with his pre-shoot numbers as well. Is it much worse to skip a dose or give him only 0.5 instead of 0.75? I have a busy day tomorrow and probably won't be able to get away to check on him until it's time for his evening shot. I would hate to lose the great numbers he's had lately, but I'm also worried about a hypo episode when no one is home. Will one skipped shot knock him totally off track?

Thanks so much for all of your help tonight!! Fingers crossed that we're in the cruising zone.
 
drdrbrody said:
+6 91

He didn't want to eat any of the FF this time around, so that's 91 w/ no food in the last hour. Hopefully that means he's starting to come up slowly, and he typically grazes throughout the night, so hopefully he'll keep eating a bit here and there.

I'm going to try and catch some sleep since it's 2am here, but I'll probably wake up in 2h to check on him just in case. He started eating again as I type this, so hopefully he keeps it up!

Just a quick technical question: Julie was saying he gets a reduction to 0.75 tomorrow which totally makes sense, but my vet said it's safe to skip doses if I'm not comfortable with his pre-shoot numbers as well. Is it much worse to skip a dose or give him only 0.5 instead of 0.75? I have a busy day tomorrow and probably won't be able to get away to check on him until it's time for his evening shot. I would hate to lose the great numbers he's had lately, but I'm also worried about a hypo episode when no one is home. Will one skipped shot knock him totally off track?

Thanks so much for all of your help tonight!! Fingers crossed that we're in the cruising zone.
Click to expand...

I would definitely get another test in tonight to see he is safe. Hopefully he has reached nadir. He's surfing nicely at the moment.
Yes you need to reduce the dose at the next preshot as he has earned a reduction.
Skipping doses isn't great but the main priority is keeping kitty safe.
Why don't you see what he is in the morning, post and ask for assistance, and see what they say.
He may bounce from the lows tonight or he mightn't.
If he is still at a lower number they may suggest a reduced dose or skipping.
If you look at the SLGS method you will see suggestions there.
But I would get a +11.5 and then post and ask for assistance in dosing. Put '?HELP WITH DOSING' in the subject line.
How does that sound?
 
By tonight do you mean like, in the next hour or in a few hours? (+6.5 or +8-9?)

Sounds like a great plan! I can do that!
I read through the SLGS pages, and it all makes sense; I just feel nervous changing dosing w/o the vet's input. Carry over from human medicine probably! Would feel a lot more comfortable with input from the lovely people here, so I'll do that tomorrow morning.
 
drdrbrody said:
By tonight do you mean like, in the next hour or in a few hours? (+6.5 or +8-9?)

Sounds like a great plan! I can do that!
I read through the SLGS pages, and it all makes sense; I just feel nervous changing dosing w/o the vet's input. Carry over from human medicine probably! Would feel a lot more comfortable with input from the lovely people here, so I'll do that tomorrow morning.
Click to expand...
I would get a +7 I think just to see he's not dropping back and then reassess. Is that ok?
I used to be nervous too about changing the dose but honestly the people here who look after their kitties 24/7 are more up to date with FD treatments. Vets have so many animals and diseases to manage so it's understandable. My vet was absolutely fine in the end with me changing the dose. I know it feels strange to do it but your kitty's safety must come first.
 
+7 (well 6.75) is still 91!

I think that's probably a good sign that the trend is level/upwards right? I'll def still check on him in a few hours, but hopefully it's safe for both of us to get some sleep (he's more upset about being woken up than the ear sticks I think lol)

And that makes sense! I'll take his BG at +11-11.5 tomorrow and post here for advice. As long as it's safe to totally skip, I feel comfortable reducing the dose as long as you all think it's the right choice. I'd better get on that curve sooner rather than later though!

Thank you so much for all of your help today! I really, really appreciate it. Hopefully, this won't happen again, but if it does I feel much more prepared.
 
drdrbrody said:
+7 (well 6.75) is still 91!

I think that's probably a good sign that the trend is level/upwards right? I'll def still check on him in a few hours, but hopefully it's safe for both of us to get some sleep (he's more upset about being woken up than the ear sticks I think lol)

And that makes sense! I'll take his BG at +11-11.5 tomorrow and post here for advice. As long as it's safe to totally skip, I feel comfortable reducing the dose as long as you all think it's the right choice. I'd better get on that curve sooner rather than later though!

Thank you so much for all of your help today! I really, really appreciate it. Hopefully, this won't happen again, but if it does I feel much more prepared.
Click to expand...
Test again in 2 hours I think if you can. You are at +7 so hopefully at nadir by now but we don't know for sure.
Try and get him to eat some more before you go to sleep.
He's had an amazing cycle. He could well be too low to shoot in the morning. If you have to skip, he will soon catch back up so don't worry. But post and ask for help.
I'll watch for the 2 hour test.
 
You must log in or register to reply here.
Back
Top