5/28 Garbo AMPS 99, +12 54 No PM Shot

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Melissa&Garbo

Melissa&Garbo

Member Since 2011
Good morning Lantus Land!

We are relatively new here and still trying to get Garbo regulated. I'm not sure I have enough data to be helpful, but here's the scoop:

On 5/21 I was unable to get readings during the day but was not worried as she had been in the yellow. To my alarm her PM +1/+2/+3 were 39/43/60. On 5/22 she was back up to AMPS 237, so I was worried but not alarmed. Left message for vet as I was going out of town on business and hubby would only be shooting her, not testing. Vet called me back with instructions to maintain 3u 2x day and not worry so much. Hub shot 3u twice a day for the next week. I returned home last night to her PMPS of 173, so no worries then. AMPS today was 99, so shot 3u as usual. However, +2 was 32!! I gave her some treats but she seems unaffected by the low numbers. I'm getting ready to do a +3 reading.

Does this information mean that her dose is too high? Or do I need a little more data to know for sure? A week of no testing didn't help, but it couldn't be avoided. I'm stumped as to what to do next.

Thanks!
Melissa
 
Re: 5/28 Garbo AMPS 99, +2 32

please get another test now and post the number.

Do you have karo syrup on hand? And do you have high carb wet food (something with gravy?)
 
Re: 5/28 Garbo AMPS 99, +2 32

also, in case we need to know, how far away is the nearest emergency vet (or is your own vet open this morning?).

Test and give high carb food first, then come back and answer.
 
Re: 5/28 Garbo AMPS 99, +2 32

Trying not to freak out. BG at 26. Gave HC FF food with gravy. I have karo on hand. Vet is only 10 minutes away. How soon after the food should I retest?
 
Re: 5/28 Garbo AMPS 99, +2 32

is it now about +3? How is Garbo acting?

Please give some karo now and test in 15 minutes.

The indications are that Garbo's dose has been too high for too long. We don't know how far over dose he is. If he was mine, I would take him to the vet for a glucose drip. Better safe than sorry. This might be more than you can handle at home.
 
Re: 5/28 Garbo AMPS 99, +2 32

Melissa --

Garbo's been on too high of a dose. Your vet's should have recommended a dose reduction with that first number in the 30s. (Most vets get nervous if a cat has numbers below 100.) If the vet is that close, I'd be more comfortable having the vet intervene. I'm concerned that with this amount of insulin this early in the cycle, you are going to be in a battle to keep numbers up. The vet can start a dextrose drip and regulate Garbo's levels far more easily than you can at home. How is Garbo behaving? (Rubbing Karo on the gums will get a quicker response.)

Call and let them know you are coming in and that Garbo needs to be seen immediately. Bring your meter, strips, and Karo in case they make you wait.
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26

Ok, will rub in the karo and retest in 15-20 min. If no better we head to the doctor. I can't believe that it has been so low, and for how long? Geez. Just glad that she made it through the week. Will post the next reading. Thank you!!
 
Re: 5/28 Garbo AMPS 99, +2 32

Garbo acts as if nothing is wrong. She seems especially excited about having the extra food treat. Got the stuff ready to go in case no increase.
 
Re: 5/28 Garbo AMPS 99, +2 32

I agree with Sienne, I wouldn't try to do this yourself. Because Lantus is a long-lasting insulin, the low numbers could go on for 12+ hours, unless he bounces. The vet can handle it much more easily than you can.
 
Re: 5/28 Garbo AMPS 99, +2 32

I agree with Libby & Sienne, I would take Garbo to the vet. Cats can go from being fine to full blown hypo very quickly. If someone else can drive, that would be good so you can take care of Garbo on the way.
 
Re: 5/28 Garbo AMPS 99, +2 32

Also, should I test with a different meter? Is it possible that the battery might be low? Would that affect the reading? And how would I know if it was low? It's an Accuchek Aviva.
 
Re: 5/28 Garbo AMPS 99, +2 32

when my Aviva's battery went low, it quit working altogether. It flashed a low battery indicator for a few days before. I don't think it's the meter. She was in the 30s at +1 last week and the dose should have been reduced then. Just so you understand, +1 readings are usually higher than the preshot readings because usually you feed at shot time. Chances are you shot in the 20s on 5/21.
 
Re: 5/28 Garbo AMPS 99, +2 32

No, it's not the meter, these tests are consistent....she is very low, and it is very early in the cycle, I do not think you should try to handle this at home. I strongly urge you to take her to the vet.
 
Re: 5/28 Garbo AMPS 99, +2 32

That is better, but it is the food and karo talking, and it will only boost her temporarily. I would give a little more HC food with a good dollop of karo, gather your meter, karo, etc and head to the vet.

Remember that you will be fighting against the Lantus, onset is just starting so she will be trying to drop.
 
Re: 5/28 Garbo AMPS 99, +2 32

that's just the carbs and karo talking. When they wear off, the number will drop again. She could go up and down for hours.

I know it's a pain (and expensive) to go to the vet, but you would have to test/karo or gravy/test every 15 minutes for as long as it takes. We have seen it take up to 16 hours for Lantus overdoses to clear. If she gets full or vomits (pretty likely if you are giving karo every 15 minutes for hours) then you completely lose control. That's not a situation I would want to put myself or my cat into.

edited to add: Laurie is right, Lantus onset is probably just beginning. This is the time when she would normally start to drop. Please go to the vet.
 
Re: 5/28 Garbo AMPS 99, +2 32

It's better but you are nowhere near Lantus nadir. Numbers are still dropping and what you are seeing is the influence of the HC. As soon as it wears off, numbers will drop. I'm concerned that Garbo's numbers are going to be difficult to manage at home, especially if you've never had to do this before.
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43

Ok, we'll head to the vet to be on the safe side. Will check back in when we return. A million thank yous!!
 
Re: 5/28 Garbo AMPS 99, +2 32

just reading this made me sooo nervous....please update when you get back....

praying Garbo is fine...
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +4.5 84

Hey everybody, I'm back! First of all I can't thank you enough for being here for us during this scary time. We've used Lantus before and didn't have such difficulties.

Garbo was up to 84 in the clinic, but they were going to keep an eye on her and give her glucose if it started dropping. I'll be able to pick her up before they close barring any problems. Advice was to return to 2u 2x day and see how that does for a while. Does that seem like a reasonable plan? Or should we drop it down to 1 and then step up as needed? I don't want to disregard their advice, but their advice was also 3 back on 5/21 when we first had a number in the 30s. :-x
 
Re: 5/28 Garbo AMPS 99, +2 32

What time (your +time) will you be picking Garbo up? I think it will be better if you have a test closer to shot time for us to make a decision regarding dose and/or shooting. My hunch is that dropping the dose to no more than 1.5u is pretty reasonable.

Is there any way you can convince your DH to learn how to test? My guess is that Garbo was hitting some rather low numbers while you were traveling. When I'm gone, Gabby will not permit my petsitter to test. (It's truly ugly -- snarling, growling cat who has drawn blood when she's tried.) As a result, she has to shoot blind. I drop the dose so there's a very limited risk of low numbers.)
 
Re: 5/28 Garbo AMPS 99, +2 32

Melissa: thanks for updating us. I'm so glad she is ok....I'm sure all of LL breathed a collective sigh of relief!!!
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +4.5 84

Sienne, that is a great idea about dropping the dose to a safer level while away. I will try to see if DH will do it. Last time I went out of town he himself was not well, so I boarded her. She and Grace board all the time and seem to love the staff there.

He is as alarmed as I am thinking back over the week, shooting blind. So thankful that nothing terrible happened. Won't risk it again, that's for sure.

When I pick her up I'll retest, which will be probably be right before PM shot time. We'll see what the evening holds for us!

Thank you again for all the kind words of support today. For those in the U.S. I hope you all have a restful Memorial Day weekend. :cool:
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +4.5 84

Yes, we're EDT here. She's on an 8 and 8 schedule, so we'll be close to the 8 PM dose.
 
Re: 5/28 Garbo AMPS 99, +2 32

good for you for taking her in! btw, when you update the subject line you have to edit the first post's subject line for the edits to show in the main lantus forum listing.

re your husband . . . mine was not wanting to do any of it and now he can do it all. first he sat next to me for every test while he was home and he did the meter after i poked. after seeing it done 50 times and helping, and after punkin stopped being such a pain in the neck on the testing, he said he could try it. now he tests a lot. i think giving the shot is a lot more nerve-wracking than testing. if your husband has mastered the shot, he can surely do testing.

thinking of both of you . . . and so glad garbo is ok!
 
Re: 5/28 Garbo AMPS 99, +2 32

I'm so glad Garbo is ok, Melissa! Thanks for updating us.

My DH is not good with medical stuff, so when Tinkles was diagnosed, he didn't want any part of the testing and shooting. It took me a while to convince him to learn how to test, and what convinced him was that he worried about him being low when I wasn't around to test....I told him that he needed to learn how to test to help keep Tinkles safe. He did learn, and then he learned how to shoot after that. I hope you will be able to convince your DH to learn, it would be a big help to you. Remind him that you can't tell if Garbo is in safe numbers by looking at her....she looked fine this morning, right?

I know it can be tough, good luck!
 
Re: 5/28 Garbo AMPS 99, +2 32

Thanks for the tip on the subject line! I was wondering why it was reverting back.

I'm perplexed now because when I picked her up and now tested her and she is still kinda low...54. I know I'm not going to shoot her, but should she hold this line into the evening? How often should I test? I'm not sure why she is not higher, unless they didn't do anything at the vet other than watch her. I just fed her the normal dinner and rubbed in some karo just to be safe.

After this episode, I think he (DH) will be more interested in testing.
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +6 84, PMPS 5

hmmm, i don't know, melissa. here's a bump for more experienced eyes. so you're not planning on shooting tonight? i think it must be 15 minutes past your regular time.

hopefully someone will be by soon.
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +6 84, PMPS 5

With low numbers like today, the numbers can run low for quite some time. We've seen cats run low numbers for as long as 16 hours or more. You are wise to not shoot. Often with numbers as low as Garbo went today, she could easily be insulin sensitive.

I would grab a +1. It will likely reflect a food spike and the influence of the Karo. I'd also get a +2 to see what happens as the food and Karo wear off. (And maybe DH can begin his testing training by watching you!! Since it's a holiday weekend, he may be ready to test on his own by Monday!!!)
 
Re: 5/28 Garbo AMPS 99,+2 32,+3 26,+3.5 43,+6 84,PMPS 54

Yeah, I'm definitely not going to shoot, even if that means she is high in the morning. I'll test her once an hour for a while. We're night owls so should be able to pull a few readings. :smile:
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +6 84, PMPS 5

Melissa:

So glad your darling is home with you and safe. What a scary day you had. It will be interesting to see what she does tonight without any juice. My husband also does everything I do although he typically does not shoot. He's comfy with the shooting....he's just worried he won't pull up a consistent dose with the microdosing.

Could you do us a favor please? If you didn't shoot, then the subject line should just be +12 54 if it was 12 hours from when you shot this morning. Each time you test, the number should be the hours since you last shot. If you shot at 8 this morning, then 10 tonight would be +14; midnight would be +16 and so on. It gave me a start when I saw the subject line and thought you shot a 54 after the morning she had!!

I hope we see you in LL regularly. Have a good evening.
 
Re: 5/28 Garbo AMPS 99, +2 32, +3 26, +3.5 43, +6 84, PMPS 5

wow, it's amazing that Garbo is still low after today. Definitely no shot tonight. If you can get some tests this evening, that might help determine a good dose to reduce to. Seeing how long it takes before she starts heading up can give a clue as to how far over dose she might be.

Good job today! I know it's hard to take them to the vet, but it was absolutely the right thing to do.
 
Re: 5/28 Garbo +12 54

Thanks for the help on the subject line, too! I am a newbie and haven't quite got the hang of it yet, but want to learn. Garbo is certainly keeping me jumping today! I'll watch/test her over the next few hours and see when she finally heads back up with no juice.
 
Melissa:

Absolutely no worries.....we've all done the same thing and we're all here to help each other. Great job...thanks!!! I know we're all looking forward to seeing how Garbo is doing tonight. Thanks so much for letting us know.

And welcome to LL!!!
 
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