6/23 Henry's home from the hospital. AMPS +11 67

John & Henry

John & Henry

Member Since 2022
Henry's home (again)
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First, I know it isn't recommended for cats to ride in the car without a carrier, although I didn't learn that til fairly recently. He's been a "car kitty" since he's been a kitten. He's done 4 coast to coast treks. He'll only tolerate being in his carrier for about 15-30 minutes before he starts meowing non-stop.

Here's his previous thread. He's so much more energetic and bright than when he came home last time (3 days ago). His appetite is back in full force. He inhaled a whole can of fancy feast as soon as we got home. The vet wanted him to wear a libre, so she installed that and it doesn't seem to bother him one bit. The first scan showed a BG of only 67 @ AMPS +11. She told me on the phone that she had given him some R before I picked him up. I'm guessing it was .5U since that's what she wants me to give him. His next shot of Lantus is due in 15 minutes at 9pm, which obviously isn't going to happen with a BG of only 67. I gave him 2 "little soupers" (not sure what the carb count is on these) since he was still begging after the fancy feast in an effort to try and up his BG for the PM shot.

I understand the libre might not be totally accurate and I'll still need to do occasional manual BG readings. She sent him with subQ fluids (60ml/day) but she wasn't sure if the subQ fluids would effect the libre reading, so she put the libre closer to his hind end. She prescribed him the R insulin with the instructions "Give .5U SC 6 hours after Lantus ONLY if BG >300". I know that I need to start at .1U thanks to @Wendy&Neko. Just scanned the libre for the second time (@ almost 9pm) and we're still only up to 68. I'm guessing I should just hold on the Lantus till we're @ or near 200? She still has the Lantus @ 2U

I'm probably missing things, I'll add as I remember. Curious on how long I should wait to give the Lantus?
 

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So I just did a manual check of the libre (78) against the meter and the meter is reading 49 :( That's after all the eating he's done. Should I try and give some karo syrup?
 
Lovely photo of Henry. He looks better than in the last photo.
Oh, I am really very surprised she gave 0.5u of R and then discharged him. Did she say what the BG was when she gave the R and do you know what time that was?
No don’t give any Lantus at the moment. We need to figure what the R is doing. Keep a close eye on the BG. The sensor can be unreliable when the BG is under about 80 so I would be doing a manual check for any BG under that. Please wait u til Wendy says you can give the Lantus
I would follow @Wendy&Neko instructions for the R not the vets.
 
John & Henry said:
So I just did a manual check of the libre (78) against the meter and the meter is reading 49 :( That's after all the eating he's done. Should I try and give some karo syrup?
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I think the 78 on the manual check is the correct one. I would check again in 20 mins just to be sure. I would just feed some maybe higher low carb food. How many hours do you think it is since the R was given.?
 
Bron and Sheba (GA) said:
I think the 78 on the manual check is the correct one. I would check again in 20 mins just to be sure. I would just feed some maybe higher low carb food. How many hours do you think it is since the R was given.?
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No, you got the backwards. The manual is showing 49

edit: not sure when the R was given other than she mentioned that she had given him some when I talked to her around 5pm
 
If it is under 4 or 5 hours since the R was given, he could keep dropping so you may need to add honey or Karo to that is it drops lower.
 
Bron and Sheba (GA) said:
Sorry, Yes give some high carb food and test in 20
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So he wasn't interested in licking the syrup, so I just slowly put .5ml in this mouth. I then mixed 1.5ml into his friskies and he wouldn't touch it :( Gave another little souper and he ate most of it. He's acting a little weird. getting a bit worried.
 
I don’t know how many hours since the R was given but if it is under 4, then the BG could drop lower.
Is anyone else at home with you in case you need to drive back to the ER? You would need someone to drive while you looked after Henry.
Not saying this will happen but you need to be prepared that it could.
 
I'm guessing she gave that R not long before I picked him up and now he's getting the full effect of it. At what point should I head to the local ER for dextrose? The libre reading went from 79 to 53 just now, and the last meter reading was 44
 
John & Henry said:
I'm guessing she gave that R not long before I picked him up and now he's getting the full effect of it. At what point should I head to the local ER for dextrose? The libre reading went from 79 to 53 just now, and the last meter reading was 44
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Did you rub some honey on the gums. Test again in 15 from then and post, how many hours since you picked him up?
I have to leave but Bhooma is here and I’ll be back. She is great!
Keep testing and rubbing honey on gums if he won’t eat.
You have got this!
 
Bandit's Mom said:
Phew! 55 on the meter? This would be +13? Later?

Did the vet even test his BG before giving the R??!! :mad:
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I would assume so, but who knows? If I'd just straight up followed her instructs as written I would have just given him his Lantus shot when he was in the 40s!

edit: Yes, the 55 was on the nova and yeah +13
 
John & Henry said:
I would assume so, but who knows? If I'd just straight up followed her instructs as written I would have just given him his Lantus shot when he was in the 40s!
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:mad::mad::mad:


Don't feed any higher carbs or honey for now and keep scanning his BG every 15-20 mins.

What time do you shoot (Lantus)? Considering his low numbers thanks to the R and the fact that it's 10pm, I'm not sure about whether to give Lantus or how much. But there's also the multiple DKAs.

Let's wait for @Wendy&Neko and @Bron and Sheba (GA) advice.
 
John & Henry said:
Was supposed to be 9pm, but it's changed so frequently lately I'm not sure it really matters. I'm guessing he got his AM shot at 9am tho. So, yeah we're at +13 right now. Thank you for the help
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Let's keep an eye on his BG. If it starts rising sharply, it might me good to give his shot. He is going to bounce.

How is he doing? I guess he's not hungry after inhaling a whole can of food a couple of hours back?
 
Bandit's Mom said:
Let's keep an eye on his BG. If it starts rising sharply, it might me good to give his shot. He is going to bounce.

How is he doing? I guess he's not hungry after inhaling a whole can of food a couple of hours back?
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No, probably not after a whole can and almost 3 "lil supers", but I bet he'd still beg if I went out in the kitchen right now. He just looks kinda tired. Not sick tired. He usually lays his head down when he's sick tired. I think this is just normal cat tiredness. He seems alert. The nova just read 46 20 minutes after the 55 so we're not outta the woods yet I guess :(
 
Bandit's Mom said:
Did he eat anything when you got the 46 or is this just flat with meter variance?
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No, he hasn't eaten since the last lil souper about an hour ago. I tried to give him some friskies which is about 18%, but I mixed about 1.5ml of karo with it and he wouldn't touch it. Not sure if it was because of the karo or he's just full. Next reading in 4 minutes. fingers crossed
 
So just to reconfirm:
  • AM shot of Lantus (2U) was given at 9am?
  • 0.5U of R assumed to be given at 5pm?
  • Last meal / honey was 1 hour back?
  • It is 11pm now for you?
Don't feed unless he dips below 50. Let's get a clear number without the food influence of food when taking a decision to give Lantus.
 
Bandit's Mom said:
So just to reconfirm:
  • AM shot of Lantus (2U) was given at 9am?
  • 0.5U of R assumed to be given at 5pm?
  • Last meal / honey was 1 hour back?
  • It is 11pm now for you?
Don't feed unless he dips below 50. Let's get a clear number without the food influence of food when taking a decision to give Lantus.
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That's all correct. The R may have been given a bit before 5, I'm not exactly sure when, but she told me a little after 5 she had given it. Been about an hour and a half since food/syrup. Yes it's 11:09pm

edit: yes, lantus shot was supposed to be given at 9pm
 
John & Henry said:
That's all correct. The R may have been given a bit before 5, I'm not exactly sure when, but she told me a little after 5 she had given it. Been about an hour and a half since food/syrup. Yes it's 11:09pm
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One more question! Do you want to stay with the 9am/9pm shot time or move it up? Shooting at 9pm means staying up pretty late if it is an active cycle - unless you are a night bird and that's easier than waking up at 6am or 7am to give the shot.
 
Bandit's Mom said:
One more question! Do you want to stay with the 9am/9pm shot time or move it up? Shooting at 9pm means staying up pretty late if it is an active cycle - unless you are a night bird and that's easier than waking up at 6am or 7am to give the shot.
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Yep, total night bird. I was on 1am/pm for awhile
 
Looks like he is still wobbling up and down a bit but at least he hasn’t dropped below 44 again. So if the R was given around 5pm, it’s effects have lasted longer than 4 /5 hours.
Don’t suppose you have had a chance to test for ketones since you have been home?
 
Sorry, but can't stay on long. Morning alarm goes off in 5.5 hours so I have to sleep soon.

The R should be wearing off soon. Note I said "should". In most cats it lasts 4 hours. Neko was not "most cats", it both onset later and lasted longer with her. We know nothing about how Henry uses R, nor what his BG was when he got it, or even if he got R more than once today. Since Henry needs his Lantus, I think the best option is to see if you can wait a little longer until he's closer to 100 then shoot and feed higher carb food if need be. As Henry so recently proved, skipping the Lantus shot isn't a great idea.

Good to hear you are a night bird and Bron and Bhooma are on the case.
 
Wendy&Neko said:
Since Henry needs his Lantus, I think the best option is to see if you can wait a little longer until he's closer to 100 then shoot and feed higher carb food if need be. As Henry so recently proved, skipping the Lantus shot isn't a great idea.
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Wendy, if Henry doesn't hit the 100 mark soon - say after 2 hours of honey - is a token dose (1U) advisable? Or do we stall till he hits 100 and give the full dose - however late that is?
 
Hi John I know you are very busy trying to get Henry's numbers up, just wanted to say I'm glad he's home , he looks much better in that pic. I hope he keeps going up.
Jesus you and Henry need a dam brake :bighug::bighug::bighug::bighug::bighug:
Give him kisses for me ♥
 
Diane Tyler's Mom said:
You are right ,she could have kept him there to see how the R was going to effect him. Makes be so freaking mad !
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She said (and I quote) "Henry can't live at the hospital" ... Like, WHAT? passive aggressiveness. When I talked to the weekend ER doc I asked her if she has ever seen fast acting insulin given SC and she said she had not and only ever given it IV with those continuous infusion pumps before. No idea how much (if any) experience his IM attending has using R SC.
 
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