11/23/11 Sid help AMPS 53 +.5 183 - still acting hypo

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Lydia & Sid & Jake(GA)

Lydia & Sid & Jake(GA)

Member Since 2010
I could tell as soon as I woke up and saw Sid that he was having a hypo episode. I checked him and he was 53. I gave him a little karo syrup along with a high carb meal, which he ate some of. I checked him 30 minutes later and he was at 183. However, he is still acting hypo - walking around disoriented: sniffing the floor and walking to each water dish and hanging his head over. Not sure what to do other than take him to the vet. Any advice is appreciated.

Lydia
 
Hi, Sid is at a high enough bg at 183, but that's a worry with his behavior. I'm hoping some others will also weigh in here. You're in Michigan, so your Vet's office should be opening (ours opens at 7:30 am). Could you call your Vet and report the symptoms. Sid may have gone lower in the night. How is he acting now, any better?
 
I would definitely call your vet when they open. Sid's BG is a good range now, but he may he may have gone too low overnight. Let us know how he is doing when you get a chance!
 
I hope Sid is fine. It may be that he's not used to being in lower numbers and he just doesn't feel "right."

I do want to encourage you to get a few more tests on a regular basis. I know you're familiar with the drill -- you need to get at least one spot check per cycle. You've already seen some blue pre-shots. Whenever you are shooting your lowest dose yet, you should be getting a +1 and a +2. It's entirely possible that Sid's numbers have been dropping during the cycle and bouncing up into pinks or reds at pre-shot times. Jill noted in the Tight Regulation Protocol sticky:
  • Kitty should be monitored closely the first three days when starting Lantus or Levemir.
    Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
    More monitoring may be needed
.
Click to expand...
 
I know you are right about more testing. Part of the reason I haven't been aggressive is that Sid and I are still getting acquainted. He is on the shy side and runs from me sometimes do twas trying to do the bare minimum. He cries when I poke him and it's pretty heartbreaking. I will definitely have to just plunge in and do it because his health depends on it. The vet wants to decrease his dose to 0.5.
 
Hi Lydia, thinking of you and Sid and so glad you got him in today and he's spending the day and in good hands.
Sid will get used to the pokes in time. Are you giving him a treat after the poke? I give Maggie a teeny treat of Beechnut chicken & broth baby food, stage 1 or 2. It's whatever Sid likes. Lots of hugs. Will the Vet be calling you to update on sid?
 
Thank you for your kind thoughts and vines for Sid. He is such an awesome little (6.5#) old man! I wish you could all meet him
:-D
The treats of dried chicken or fish worked at first but don't anymore. Maybe ill try baby food or he does like laxaire/ petrmalt alot.
 
It may not be a bad idea to reduce the dose until Sid gets acclimated to testing. One thought -- maybe you can bring him over to his testing spot, fiddle with his ear without poking, and give him a treat. It may help him to associate the process with treats and make it easier overall.
 
Good idea to rub his ear without a lancet poke and then give a treat. I did start doing all the testing in the same spot (bathroom) away from the other cats and that has bern working well.
 
thinking about the petramalt - doesn't that have sugar in it? i thought "malt" usually meant sugar.

we use neosporin ointment with pain relief on punkin's ear whenever he starts seeming like the pokes are bothering him. usually i put a lot on at night so it can sit overnight, but if it's during the day you can also put it on but wipe off the excess before you poke. otherwise it goos up the strip. i tried it on my foot where the cats had scratched me and it really does work.
 
another tip - if you're going to use the lancet pen, click it around his ears too. Just behind his head where he can't see it and let him get used to the sound so it won't startle him.

Hugs!!
 
Hi Lydia,
We hope that Sid will be fine and that the vet will have some answers for you. It does seem as if Sid is simply not used to those lower numbers. Thinking of you and sending a beautiful bouquet of healing vines.

Ella & Rusty
 
Re: *Update11/23/11 Sid help AMPS 53 +.5 183 - still acting

Thank you to everyone for your kind words and thoughts for Sid. He is back home and seems back to normal. The vet is convinced that he is trying to go into remission or may only need one dose of insulin per day. She thinks he was getting too much insulin at 1.25 and those high numbers are rebounds.

I updated his SS so if anyone can take a look at today's numbers, I would appreciate your thoughts. The glucometer at the vet (Alphtrak) reads about 30 less than mine (Relion) so if the vet had taken the PMPS check, it would probably be about 130. The vet told me not to give a pm dose if he was less than 180. I am to recheck him tomorrow and then try giving him 0.5 from now on.

Thank you for all of the hints and tips about the testing. I do not use a lancet pen, just poke him with the lancet. (I never had good luck getting the pen to work on my other cat.) Yes, I bet the petromalt does have sugar in it so that will have to be sparingly given.
 
Hi Lydia, so happy to hear Sid is back to normal. I'll bet he is so happy to be home, and you must be exhausted. Give Sid some hugs and scritches from Maggie and me.
 
Thank you, I will! He appreciates scritches!! Oh and I did buy a fantastic new bed for the cats and it came in the mail today (yay). I was thinking that it is mostly for Sid but he can share it with the other cats... Well, I think the stress of the vet has taken its toll and he won't lay in the bed. In fact he is spending some time under my bed but he is acting normal so that is good.
 
Hi Lydia, yes he is probably stressed and under the bed he feels safe. I hope he likes his new bed.
If you want some thoughts on your ss, can you go up to your very first post and hit Edit. Up at the very top you will see some emoticons. Click on the one for ? and it will show up on the left side and call attention for the dose advisors to take a look at your ss.
 
I don't have a problem with reducing the dose. However, I think going to once a day dosing is going to give you crazy numbers. What I would expect is that you will have reasonable numbers for roughly 12 hours and then by the time you shoot again, numbers will be high. I tend to think the way we taper down doses while shooting twice a day is a far better route. You won't get wide swings as the insulin is petering out. Remember, a cat's metabolism is twice as fast as a humans and all insulin for feline use is based on a twice a day dosing schedule. Further, you are giving a healing pancreas more support. The other downside of once a day dosing is that the shed will never be filled. So, based on the data you do have, I think this is a bad idea. I'd lower the dose to 0.5u and shoot twice a day and be sure to check for ketones.

I also think that vets err on the side of being very cautious about a "no shoot" number because the majority of their clients do no home test. If you vet doesn't want you to shoot below 180, basically he's not expecting Sid to be in a normal range. That said, this may be a temporary situation. A 180 on the AlphaTrack is a 150 on a human glucometer. If you look at the stickys, we tell newbies to not shoot below 150 until they have the data to shoot lower. So, this is reasonably consistent with what we suggest. Over time, you want to be able to shoot progressively lower numbers since if Sid is going into remission, he will be in the 50 - 120 range (on your Relion) most of the time. You also have choices other than to skip a shot -- you can stall or shoot a reduced dose. See the sticky on Shooting & Handling Low Numbers.

Right now, you are not data ready to shoot lower numbers. As I mentioned earlier, getting at least 4 tests -- your 2 pre-shot tests and at least one spot check per cycle -- will help you to become data ready so you can begin to shoot lower numbers.
 
I was thinking the same thing - that by skipping a dose he might have high numbers in the morning. I also agree that the 1x/day shooting is not very reasonable (based on my experience with Jake).

I guess my plan is to test him one more time tonight (in a couple hours) and see what he is at with no shot. Then in the AM, test of course and then give him 0.5 unless he is at a low to normal range number. If he is at a low to normal range number (which I realize he probably won't be), but if he is, then I will wait until PM and test again and repeat the scenario. I won't shoot him below 150 (180) until I have more data. Does this sound like a reasonable plan?
 
What I would suggest is that you post, if it's possible, at around +11.5. (What time do you shoot and what time zone are you in?) It may be that shooting a reduced dose (e.g, 0.25u) may make sense or stalling, if it won't destroy your schedule, may also be an option.
 
Hi Lydia, my Vet has said the same thing -- don't shoot unless the cat is over 180 (150) and only shoot once a day. Maybe they went to the same Vet school? lol

I am so grateful I found this forum and the knowledgeable people here.

I hope Sid adjusts well soon! Give him some skritches for me :-D
 
I'm in EST (Michigan). I typically shoot around 6:30 am and 6:30 pm. However today got off track because of the trip to the vet. It is now 12:00 am and I am getting ready to check his level. At this point I'm not going to shoot. I just hope he doesn't bounce too much tomorrow morning.

I am very glad I found this forum also! Not only was it a lifesafer for Jake and now Sid, I was also able to help a diabetic rescue cat find a new home.
 
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