08/05 Dixie AMPS 77 +4 40. Moderate Hypo Symptoms. UPDATE: She is doing good now

FarmKitty

FarmKitty

Member Since 2020
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Just tested her and she was 40.... and she is acting very disoriented just sniffing around and looking and walking around very oddly. We put her fav high carb food down and she doesn't even notice it. She ate a couple of dry chicken treats from my hands. BF is giving her corn syrup on her gums right now.

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She just ate 15g of it and I removed the bowl because she was eating it very fast and she has a tendency to vomit right after... Will give it back to her in a couple of mins
 
Just here for moral support as I’m too much of a newb to offer concrete advice and you seem to have things really well in hand! How far out after the initial reading was the 41?
 
Food takes 20-30 minutes to effect the bg. If the next test is under 50 feed a teaspoon of hc and add some honey. Keep her hungry so not a lot of food each time.
 
Sorry for the delayed reply, was on phone with my mum :D

She just tested at 85. I only gave the corn syrup after the initial test, but she has ate 50g of 21% carb wet food over the last hour.
 
I messed up initially and didn't read the sticky regarding the 1tsp food increments until after she was eating the food. I was just grateful that she was actually eating again. She seems quite hungry right now and is back to her normal self.
 
Perfect. Don’t feed again and test in 30 minutes. If the bg comes down but over 50 you can feed some lc. You need two hours without hc to know that she’s safe.
 
FarmKitty said:
I messed up initially and didn't read the sticky regarding the 1tsp food increments until after she was eating the food. I was just grateful that she was actually eating again. She seems quite hungry right now and is back to her normal self.
Click to expand...
They often get very hungry when low. I a,ways knew to test if Max was super hungry. Good job.
 
Ok, I just gave her another spoon of HC. I will set a 2 hr timer and will continue to test her in the meantime. Thank you for all of your guidance!
 
Thought I'd just expand a bit on what went down for anyone that is interested. I slept in today and when I woke up, BF said he had forgotten to do a midcycle test, so he went to do one. Dixie had seemed normal the whole day. She was chilling when we setup the testing stuff, and when she saw we wanted to test her, she came over to us on her own (like normal). She then tested at 40, which was pretty shocking considering we had already reduced her dose, so we retested and she was confirmed 41. She was laying on a big piece of cardboard during the test, and when we stood up, she did this really weird thing where she was basically slowly pulling herself in a circle without moving her hind legs, and her eyes/pupils were very wide. It looked like maybe she was smelling something, but something was definitely off and she wouldn't snap out of it. I thought maybe the cardboard was too slippery or something, so we picked her up and put her down, and she just kept the same stare and was wandering around as if she was hunting something, but her movements were very slow. She was basically gently sniffing and exploring, but there was definitely something off about her. She never meowed. I couldn't get her attention and I brought over a large bag of her favourite dried chicken treats and she didn't even seem to notice! She did take and eat a couple treats from my hand, but she dropped one and really just seemed out of it. We then dumped a can of HC food into a bowl and set her in front of it, but she was totally uninterested and continued with her disorientation. My BF rubbed corn syrup on her gums, although he said it mainly ended up on her tongue. I then posted here. We opened a can of a different flavour of HC food and she was interested in this one right away and ate from the can. We took it away after she had ate for a while because we didn't want her to throw up from eating too fast, or get too full.

It's been two years on insulin now and the only low BG symptoms she has ever expressed are hunger. Seeing her disoriented and walking in circles definitely gave me a pit in my stomach, so I am very glad that I was prepared with the kit all ready. Knew exactly where everything was and what to do.

Things I am glad I did:
* I knew the symptoms so that I knew what was going on immediately
* I had all of her stuff (syrup, instructions, HC food) in one big tub so it was easy to locate.
* I have a list of all the nearby vets along with their hours, the travel time etc. My mind was definitely racing trying to think of all the things all at once (where is the symptom sheet? what if I need to get her in the car? is she going to get worse? :nailbiting:), so any preparation helped.
* I am glad I made a post because it kinda helped ground everything and gave me a chance to re-read the info. I am lucky that my BF and I were both here. If you live alone then I think this process would be even trickier, and preparation will be even more key.
* Relieved that I had 4 different flavours of HC/MC food ready, so that when she didn't like the first one I had a backup.

Things that I wish I did differently:
* I wish I had a feeding syringe on hand. I do have one for feeding water, but I'm don't think that is the right type for food. She's always been interested in her food and especially the yummy HC stuff so I got complacent and assumed that she would be ready to eat if she had to. When she was disoriented and not interested in the food, that freaked me out and I was instantly regretting that assumption... The same thing goes for the bulb syringe. I have everything else in the hypo kit except those two things.
* I should have given her just a tsp of food and followed the low number guidelines sticky. I guess I forgot about how that part was supposed to work. Things could have gone bad if she decided to not eat anymore. I definitely got lucky this time!

I'm not 100% sure what I'm going to do regarding her shot tonight. Personally, I feel uncomfortable giving her insulin seeing as how she dropped so low on only 0.25u and was in her regular preshot BG range, and she was displaying moderate symptoms. Her values have been gradually trending downward over the last year so maybe it is time to try her off the insulin again (I tried back in Oct 23, 2021 on a whim)... but I am open to hear opinions on this (0.10u dose, etc.)
 
You handled this perfectly. It must have been very scary. She might be more sensitive to insulin now. She’s earned a decrease as you know. It looks to me like she might be going into remission. I would skip her dose tonight unless she bounces sky high. Her new dose will be 0.10. I’m going to attach a picture of what that looks like. What do you think?
 
Here’s 0.10.

upload_2022-8-5_16-34-30.jpeg
 

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FarmKitty said:
Thought I'd just expand a bit on what went down for anyone that is interested. I slept in today and when I woke up, BF said he had forgotten to do a midcycle test, so he went to do one. Dixie had seemed normal the whole day. She was chilling when we setup the testing stuff, and when she saw we wanted to test her, she came over to us on her own (like normal). She then tested at 40, which was pretty shocking considering we had already reduced her dose, so we retested and she was confirmed 41. She was laying on a big piece of cardboard during the test, and when we stood up, she did this really weird thing where she was basically slowly pulling herself in a circle without moving her hind legs, and her eyes/pupils were very wide. It looked like maybe she was smelling something, but something was definitely off and she wouldn't snap out of it. I thought maybe the cardboard was too slippery or something, so we picked her up and put her down, and she just kept the same stare and was wandering around as if she was hunting something, but her movements were very slow. She was basically gently sniffing and exploring, but there was definitely something off about her. She never meowed. I couldn't get her attention and I brought over a large bag of her favourite dried chicken treats and she didn't even seem to notice! She did take and eat a couple treats from my hand, but she dropped one and really just seemed out of it. We then dumped a can of HC food into a bowl and set her in front of it, but she was totally uninterested and continued with her disorientation. My BF rubbed corn syrup on her gums, although he said it mainly ended up on her tongue. I then posted here. We opened a can of a different flavour of HC food and she was interested in this one right away and ate from the can. We took it away after she had ate for a while because we didn't want her to throw up from eating too fast, or get too full.

It's been two years on insulin now and the only low BG symptoms she has ever expressed are hunger. Seeing her disoriented and walking in circles definitely gave me a pit in my stomach, so I am very glad that I was prepared with the kit all ready. Knew exactly where everything was and what to do.

Things I am glad I did:
* I knew the symptoms so that I knew what was going on immediately
* I had all of her stuff (syrup, instructions, HC food) in one big tub so it was easy to locate.
* I have a list of all the nearby vets along with their hours, the travel time etc. My mind was definitely racing trying to think of all the things all at once (where is the symptom sheet? what if I need to get her in the car? is she going to get worse? :nailbiting:), so any preparation helped.
* I am glad I made a post because it kinda helped ground everything and gave me a chance to re-read the info. I am lucky that my BF and I were both here. If you live alone then I think this process would be even trickier, and preparation will be even more key.
* Relieved that I had 4 different flavours of HC/MC food ready, so that when she didn't like the first one I had a backup.

Things that I wish I did differently:
* I wish I had a feeding syringe on hand. I do have one for feeding water, but I'm don't think that is the right type for food. She's always been interested in her food and especially the yummy HC stuff so I got complacent and assumed that she would be ready to eat if she had to. When she was disoriented and not interested in the food, that freaked me out and I was instantly regretting that assumption... The same thing goes for the bulb syringe. I have everything else in the hypo kit except those two things.
* I should have given her just a tsp of food and followed the low number guidelines sticky. I guess I forgot about how that part was supposed to work. Things could have gone bad if she decided to not eat anymore. I definitely got lucky this time!

I'm not 100% sure what I'm going to do regarding her shot tonight. Personally, I feel uncomfortable giving her insulin seeing as how she dropped so low on only 0.25u and was in her regular preshot BG range, and she was displaying moderate symptoms. Her values have been gradually trending downward over the last year so maybe it is time to try her off the insulin again (I tried back in Oct 23, 2021 on a whim)... but I am open to hear opinions on this (0.10u dose, etc.)
Click to expand...
Very well written and EXTREMELY informative and honest! I appreciate it more than words can express. I also will print this out and recheck my hypo kit, specifically for the bulb syringe. THANK YOU :bighug:
 
Angela & Cleo said:
Very well written and EXTREMELY informative and honest! I appreciate it more than words can express. I also will print this out and recheck my hypo kit, specifically for the bulb syringe. THANK YOU :bighug:
Click to expand...
I'm happy that you found it informative! This forum is such a great place to share info and experiences, and I think it definitely helps us create a safer place for our cats :cat:

tiffmaxee said:
You handled this perfectly. It must have been very scary. She might be more sensitive to insulin now. She’s earned a decrease as you know. It looks to me like she might be going into remission. I’d skip tonight unless she bounces sky high. Her new dose is 0.10. Here’s the sticky on fine dosing.
https://felinediabetes.com/FDMB/thr...info-proper-handling-drawing-fine-dosing.151/

What do you think?
Click to expand...

I agree about skipping her dose tonight. I showed my BF the 0.10u photo (he does all the shots) and he says he can do it, but I don't know... I feel conflicted about it because I know that it's impossible to get a consistent dose with these syringes anyways. So I feel like I need to weigh the risk of having this hypo happen again vs. the risk of not having a strong remission if I don't keep her on the 0.10u for a while. I guess I could up her testing regimine so that I get plenty of early-cycle tests to predict if she will go low on the 0.10u dose.

Would it be so bad to just stop shooting her and see what happens? Then start the 0.10u if she starts rising again?

Mini update: 30mins after feeding, she was 119, and 60 mins after feeding she was 115. She is begging for food right now, but I will hold out for the 2+ hours as directed.
 
FarmKitty said:
I'm happy that you found it informative! This forum is such a great place to share info and experiences, and I think it definitely helps us create a safer place for our cats :cat:



I agree about skipping her dose tonight. I showed my BF the 0.10u photo (he does all the shots) and he says he can do it, but I don't know... I feel conflicted about it because I know that it's impossible to get a consistent dose with these syringes anyways. So I feel like I need to weigh the risk of having this hypo happen again vs. the risk of not having a strong remission if I don't keep her on the 0.10u for a while. I guess I could up her testing regimine so that I get plenty of early-cycle tests to predict if she will go low on the 0.10u dose.

Would it be so bad to just stop shooting her and see what happens? Then start the 0.10u if she starts rising again?

Mini update: 30mins after feeding, she was 119, and 60 mins after feeding she was 115. She is begging for food right now, but I will hold out for the 2+ hours as directed.
Click to expand...
@tiffmaxee
 
FarmKitty said:
. I showed my BF the 0.10u photo (he does all the shots) and he says he can do it, but I don't know... I feel conflicted about it because I know that it's impossible to get a consistent dose with these syringes anyways
Click to expand...
If you do decide to ever shoot 0.10 and worried about being consistent I wouldn't worry about it, I did them and did the best I could , then did the drop dose after that
Tyler has been in remission since 1-24-2021 ( knock on wood)
 
You could try the drop dose and if not enough go back up. It’s easy to measure. You push the plunger in all the way and hold it as you insert it into the vial or pen. Then release the plunger. It will draw up a drop.

To do the 0.1 dose practice with a used syringe and colored water. Count the number of drops until you get a consistent number of drops.

Looking at your ss now that the excitement is over you should have been reduced after 7 days mostly normal which is 50-80. I’m glad you were home to catch the hypo as it could have happened many times before this. So you can try an official OTJ trial. If it works we can call it an otj trial. Get an Ambg and pmbg every cycle. If green go about your day or night. If blue, test 3-4 hours after eating breakfast or dinner. A working pancreas will bring down the bg. So if green no more tests until the next cycle would start. Post daily.

You have three choices but I think I would try a drop dose or a food trial? What do you think?
 
She is still 110 and it has been over 2 hours since her last HC meal, so I believe she is fine for the day. I think I will wait a day or two and then decide about the drop dose. If I was reducing her insulin dose like normal because of meeting the proper criteria, then I would be all for the 0.10u, but with her having a hypo with symptoms... I'm just going to go for OTJ. If it doesn't work them I am fine putting her back on insulin. Just a bit freaked out at the moment heh
 
I totally understand and after looking at your spreadsheet I actually agree. Sort of. I would call it a food trial like I mentioned above and test as I suggested. If you need help just holler or tag me. If the food trial goes well I will happily give you the OTJ directions. It’s up to you. It’s exciting to see likely remission after two years. I hope that’s what this is. Good luck with whatever you do and let us know how it’s going and if we can help.
 
tiffmaxee said:
I totally understand and after looking at your spreadsheet I actually agree. Sort of. I would call it a food trial like I mentioned above and test as I suggested. If you need help just holler or tag me. If the food trial goes well I will happily give you the OTJ directions. It’s up to you. It’s exciting to see likely remission after two years. I hope that’s what this is. Good luck with whatever you do and let us know how it’s going and if we can help.
Click to expand...
Oh I didn't realize food trial and OTJ trial were different! Yes, I will follow your test instructions and do the food trial.
 
It’s just a little different. Sort of but not official. If it proceeds like I think it will I will let you know at what point to make it official. Good luck. The worst that happens is if needed you move to a drop dose. The best is he’s had his last shot. Either way not too shabby.
 
Hi good luck with the Food Trial
I was looking at your signature and noticed Dixie has early stage 3 CKD and you ate feeding
Weruva Goody Stew Shoes (8.5%
Is that the only flavor she likes
Tyler's brother had kidney disease so I just thought you might like to see this, but I'm sure you know all this already

weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.
https://weruva.com


For diabetic cats and cats that have elevated kidney values
You want to feed low phosphorous wet food

When you go to the weruva site and click on one of the pics of the food , click on Detailed Nutrition information that is under guaranteed analysis to the left
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Go to this thread , there are a lot of weruva foods listed here in post #3 , post numbers are to the left
https://felinediabetes.com/FDMB/threads/kidney-disease.262271/#post-2940026

Also
https://www.soulisticpet.com/nutritional-information-pate
I think you look under the same two places like in the Weruva to get the carbs and phosphorus %

If Christy likes Pate here are the weruva pages
Take a look here https://weruva.com/nutrition-landing/pates-ni/

Try not to feed a lot of fish flavors , once a week is fine
By the way what a gorgeous kitty Dixie is :cat:
@FarmKitty
 
Thanks for sharing your thread and input by all our breadth and depth of experience by FDMB.
Dixie is indeed gorgeous and well loved!
Wish there were a way to use this entire condo/thread as a sticky or bump for an in-depth teaching thread sticky. It brings real life by the moment scenarios to append the well written sticky’s on FDMB.
I know it caused me pause to wake up at 2:30AM and test my sugar baby for action/assurance that it was safe for her.
WELL WRITTEN AND REQUEST TO BUMP/POST FOR ALL. :bighug::bighug::bighug:
 
For any lurkers the suggestion I made about a food trial on this condo were for Dixie and her situation. Many opportunities to reduce her dose prior to yesterday were not taken. If a cat is in normal numbers for 7 days a reduction is earned. She was on a small dose and cats can be extra sensitive to insulin after a symptomatic hypo. This was a unique situation. Please don’t decide on your own to try a food trial. We want our cats to have a strong remission. It’s a cat by cat decision.
 
tiffmaxee said:
For any lurkers the suggestion I made about a food trial on this condo were for Dixie and her situation. Many opportunities to reduce her dose prior to yesterday were not taken. If a cat is in normal numbers for 7 days a reduction is earned. She was on a small dose and cats can be extra sensitive to insulin after a symptomatic hypo. This was a unique situation. Please don’t decide on your own to try a food trial. We want our cats to have a strong remission. It’s a cat by cat decision.
Click to expand...


Excellent points Elise. Rule 1 remains ECID and that is exactly how Dixie’s situation was applied. I would say this is definitely more pertinent to long term diabetics whose cats/owners are under the very close guidance of experienced FDMB support like yourself. I am particularly excited to see a long term diabetic even with numerous other medical issues respond to small quantities of insulin. @FarmKitty spreadsheet is beautiful and envious. Demonstrates the protocol is proven. Thanks
 
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