1st insulin shot this morn, BG is 40 right now?!

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Sashi's Mama

Sashi's Mama

Member Since 2016
What the what. So here's my initial thread with background: http://www.felinediabetes.com/FDMB/threads/newbie-here-330-bg-amount-insulin-to-give.169449/

This morning his AM BG was 340. Last night was 284. He got fed immediately afterward. About an hour after he ate (he actually ate twice during that time period, he's a bit of a grazer, though he wolfs when he eats), I gave him his very first shot of NPH (Novalin N), which is what the vet gave me, 1U. Took me that long to do it since it was my first insulin injection and I checked out a few videos again to be sure I did it right. I also double-checked the syringes, yes, they are U-100s. Although he was diagnosed on Friday as being diabetic, I waited until today to do the first injection since I didn't want to do it over the weekend just in case (hard to get hold of vet on the weekend where I live), plus today I'd be home all day to monitor.

Just now checked his BG +2 and they show 40? Holy moly, that's a big drop. Am using Bayer Contour Next. As soon as I saw that reading I opened a new can for him (FF chicken classic, it's everyone's fave), which he happily set to. He's now curled up beside me, purring away. Does not seem to be in any lethargic state, is behaving perfectly normally. Might my meter be wrong?

Should I test him again right now? I planned on doing a curve today since I'll be home all day. I didn't expect such a drop right away, though. Good thing I didn't do the 2U the vet originally told me to do!
 
Mogs took the words out of my mouth-- I'm glad she's here to help guide you through this, and she's absolutely right. Karo/honey/syrup to get those numbers out of the danger zone, and a re-check to see where he's going.

It's great that he's feeling good so far, and fantastic that you chose to wait to start insulin until you could monitor closely. This is a potentially very dangerous situation for Sashi, but your being there for him could make all the difference.

Please do let us know how it is going.
 
I gave him karo too, he just licked it off my fingers. Should I also rub it on his gums even though he's licking it up? Also gave him some of the gravy from a chicken Abound pouch I have. Will test him again right now.
 
How about testing BG every 15 minutes and posting here for advice? Do you have higher carb food with sauce or gravy on hand. Give a teaspoon or so then test 10-15 minutes after. Don't feed too much at once because you need him to keep eating it as long as it takes to get him out of the woods.
 
Phew! Relieved to hear back from you and that you've given some karo.

Post the BG result as soon as you get it. If below 50 rub karo on gums and then post the test result here as quickly as possible (we need to see where he's going - it's very early in the cycle).

Don't give any more food at the moment.

Thank goodness you're home testing and that you held fire on the insulin till you could monitor the whole cycle.


Mogs
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You've given some gravy and some food. It will take a little time for the carbs to get into the bloodstream from these.

The insulin's kicking into the period of peak effect right now so you need to keep testing - and intervening till numbers are safe - and holding in safe levels.

Rubbing karo on the gums helps it get into the bloodstream faster. Not too much at a time.

NB:

How near is your vet and can you get there in a hurry should it be necessary?

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Critter Mom, our vet is over an hour away. We live in the boonies. He's a very nice country vet, but not a specialist in anything. My preference for a true emergency would be to go farther north, but it's at least two hours to a good vet hospital.
 
Sashi's Mama said:
Critter Mom, our vet is over an hour away. We live in the boonies. He's a very nice country vet, but not a specialist in anything. My preference for a true emergency would be to go farther north, but it's at least two hours to a good vet hospital.
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Your best bet, then, is to keep doing what you're doing and post updates here.
 
Yikes, that's some distance away ...

Good to see a little rise but it's still low for this early in the cycle. Rub a little karo into Sashi's gums again. (You don't want him to fill up or vomit.)

Give your vets a quick call to let them know about the low and ask for their advice.

We'll stay with you regardless.

TEST AGAIN NO LATER THAN 10 MINUTES AFTER APPLYING THE KARO.

Please post the result as soon as you have it.

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Of course the vet office closed for lunch from 12-1. I'm calling the emergency number, but he won't pick up. He checks the vm then calls back.
 
Rub more karo.

Give a teaspoon of gravy.

TEST AGAIN IN 10 MINS.



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How much gravy did he get earlier?

How much of the low carb food did he eat earlier?

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An hour's ride makes going to the vet a difficult option, but if he's only at 44 with all of the gravy and karo, that's worrying. Given that this is his first shot, there's really no way of knowing how he's going to react and how long he's going to stay low.

Is there anyone who could potentially drive with you to the vet if you were to go? If you do go, it's vital that you bring some karo with you to administer along the way.

Regarding dose, I just re-read your intro thread and was wondering if that might be part of the problem, given the confusion with insulin types. If I'm not mistaken, NPH is a U-100 insulin while Vetsulin is U-40, and they have different size syringes. If they gave you NPH insulin and Vetsulin syringes, the dose will be off.

This isn't important now, the first priority is managing Sashi's numbers after this first shot, but after things settle down and we get him into better numbers it's definitely something to double-check before giving any more insulin.
 
Critter Mom said:
@Kris & Teasel, @Red & Rover (GA) -

Can you keep an eye on Sashi for a short while? I have to pop away from the board for a short time.

(NB - to the best of my recall from seeing Shaak's progress Novolin is at peak effect from +2 onwards so close assist needed right now.)

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I'm checking fairly regularly. My work this afternoon is complexing piecemeal and has a "do this now" quality. I can check between bits (every 10 minutes or so).
 
Nan & Amber said:
Regarding dose, I just re-read your intro thread and was wondering if that might be part of the problem, given the confusion with insulin types. If I'm not mistaken, NPH is a U-100 insulin while Vetsulin is U-40, and they have different size syringes. If they gave you NPH insulin and Vetsulin syringes, the dose will be off.
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Good thought.

What size syringes did the vet give you?
 
Nan & Amber said:
An hour's ride makes going to the vet a difficult option, but if he's only at 44 with all of the gravy and karo, that's worrying. Given that this is his first shot, there's really no way of knowing how he's going to react and how long he's going to stay low.

Is there anyone who could potentially drive with you to the vet if you were to go? If you do go, it's vital that you bring some karo with you to administer along the way.

Regarding dose, I just re-read your intro thread and was wondering if that might be part of the problem, given the confusion with insulin types. If I'm not mistaken, NPH is a U-100 insulin while Vetsulin is U-40, and they have different size syringes. If they gave you NPH insulin and Vetsulin syringes, the dose will be off.

This isn't important now, the first priority is managing Sashi's numbers after this first shot, but after things settle down and we get him into better numbers it's definitely something to double-check before giving any more insulin.
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Yes, I checked and Novolin/NPH is a U100 insulin. I see in the post at the top of this page that the syringes are U100s so at least that's a positive.
 
Woodsywife said:
Honey if you have it might absorb faster.
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Hi Paula,

Current status:

The N is in peak period of effect, honey's wearing off quick. Asked Sashi's mom to tell us how much food already given so that we know how much high carb to feed so there's no risk of him vomiting.

He needs high carb food.

Glad to see you here.

.
 
Thank you, everyone. It helps somewhat too that he's acting normal, in that he's alert, interested in food, thrilled to be licking up the gravy as I offer it. Tested 8 minutes ago, still reads 44.

Okay, answers to questions:

9am: morning breakfast, FF classic chicken, given just after AM preshot test at 8:55am. He probably ate a 3.5 oz can over the course of an hour (grazer). Very good appetite, he adores food and always has. Not a picky eater.

When I was first told to give him gravy, he got just under a teaspoon--it was all I could get from the pouch at the moment--and rubbed karo into his gums, about 2 finger swipes of karo. Have given a teaspoon more of the gravy four more times since (one teaspoon each time), at 11:16, 11:53, 12:11, 12:38. He licked it off his paws when it dripped there. Was also given more FF classic chicken when I got the first 44 reading at 11:16am.

Yes, exactly 1 unit of insulin was injected, it's clearly marked on the syringe and that's what I gave. He also received 1ml of liquid amoxicillin late morning (I didn't want to give it at the same time he got his insulin so waited a bit).

Vet is confused why he'd drop so low after only 1U. He said he thinks this is as low as he'll go and it should be going up since the shot was administered at about 9am. He said no more insulin today and only .5U in the morning. Our other concern--the more pressing reason that I took him in to the vet in the first place last week--is the tooth that needs to be removed. Vet is definitely reluctant to put him under until the BGs are more stable, with which I agree! But he said he could do it with gas since it's just pulling the tooth.

I have quite a few high-carb kibble treats. Should I just give him some now?
 
Sasha's mom...u r doing great...keep taking deep breaths and listening to these ladies...Elmo had a hypo in the 30s back in October and due to this board's step by step help he recovered nicely...just a bit intense right now for you...U and Sasha r in thot and prayers. She and u will be great.
 
I think you'll be handling the rest of this at home. Do you have any high carb canned food at home - ie., with sauce or gravy? If you don't, can you send someone to get some? Keep doing what you're doing with the gravy. Does he get a meal mid-day? Maybe try a teaspoon of actual high carb food? Testing needs to be ongoing.

A small amount of karo can be mixed with a small amount of food.
 
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