7/9 Huey AMPS 120, +13 76, PMPS 85, +0.5 96 +3.5 76

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Nancy & Huey

Member Since 2014
Still a little uneven after skipping a few shots over the holiday weekend, had to head to work a bit earlier and couldn't stall so I skipped this morning's shot.

I think he might have come close to hypoing last night, the two tests around 2am were right at ~60 but he seemed a little twitchy and out of it. It was hard to tell if it was because he was about to hypo or because it was 3AM but I gave him half a can of Fancy Feast and a bit of dry food and it seemed to help. Now I'm a little worried he's been mildly hypoing and I haven't noticed. It would probably show up as bounce on the spreadsheet though, right??

Previously: 7/4-7/5
 
Re: 7/9 Huey AMPS 120, maybe hypo last night?

Hi Nancy!

I've highlighted a couple of points from the Low Numbers sticky below that might apply to Huey:
Shooting & Handling Low Numbers
DON'T PANIC! or HOW TO HANDLE LOW NUMBERS

First, try to not panic. Post to the Lantus Insulin Support Group or on the Health Board. Make sure your subject line indicates you are concerned about a possible hypo and/or add the 911 icon to the first post in your condo. People who are experienced in dealing with low numbers will be there to help. After posting, remember to refresh your browser periodically to see if people have replied.

It’s important to recognize that just because your cat may be experiencing low BG numbers doesn’t mean that your kitty is critically hypoglycemic. Many cats will have low numbers and never have symptoms. It’s important, though, to bring those numbers up into a safe range. ALWAYS make sure you have a stock of test strips, high carb (HC) canned food that contains gravy and is over 15% carb such as Fancy Feast grilled, marinated, or Gravy Lovers varieties (see Dr. Lisa's Cat Food Nutritional Composition List for a full list of options), and/or a simple sugar solution such as Karo/corn syrup, honey, maple syrup, etc.

If your cat is experiencing symptoms, especially if those symptoms are severe, you need to rub Karo syrup, honey, or maple syrup on the gums or, if symptoms are very severe, administer rectally and get your cat to the nearest 24-hour emergency facility. Take the bottle of syrup with you to administer on the way if necessary. (Note that it is rare that we see episodes of symptomatic hypoglycemia with Lantus and even rarer to see severe symptoms. But, you need to know what to do should they occur.)

The symptoms to be concerned about include but are not limited to:
staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
disorientation (yowling, walking in circles, etc.)
twitching
stupor
convulsions or seizures
coma
If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.

Please post your numbers. Those people who are helping you will not abandon you. In fact, they are staying up with you. The experienced people will even work in shifts to make sure your cat is safe and you have the support you need. Remember to refresh your browser to see new posts and keep posting so we know all is well.

~ written by Sienne and Gabby

Typically the 50's are ok - and Huey should be well used to them because he's spent lots of time there. Most cats will even get into the 30's without symptoms, which is not to say that he wasn't having symptoms last night, but those are normal numbers so *ought* to have been ok. He doesn't appear to be bouncing any more.

I saw your questions from the last post:
Nancy & Huey said:
Chris and Julie, thanks for the advice and previous replies. I just got home and Huey came in at 139 so I gave him 0.25u. I'm figuring on probably skipping the AM shot and getting him back on schedule in the PM (unless he looks particularly high, in which case I will shoot at ~10am and gradually work back to 9am/pm).

I'd have tested after that 76 but it looked pretty similar to the previous few cycles and I had to run out the door to catch a train. You're saying I should see if that 78 was before or after the nadir? I left out food for Huey while I was gone though, took the advice on foodcicles, and it all got eaten. Now that his cycles are all screwy from me being gone, I'm gonna stick with 0.25u for a few days and try to get him back on track before making more adjustments.

I really appreciate all the feedback and support! I'm feeling optimistic for the first time since this all started!

I think you should feel really optimistic. He is on a very tiny dose and is nearly in normal numbers (50-120.) The path to OTJ is to keep their blood sugar in that normal range. As a cat spends increasing hours in normal numbers, their pancreas can heal and begin producing insulin again. I think if there is any way you could give him the same dose twice a day, you'd find he'd be getting a dose reduction and before long be worked off of insulin. Those skipped shots aren't helping him, but i understand when you've got to keep him safe. I would ditch the dry food though - just leave lots of canned low carb out if you're worried about him.

Yes, what i was saying about the 78 is that he could've still been going down after that. you're looking to catch him going under 50.

If you're off on the weekend, try giving the same shot twice a day to help him flatten out under 120. I think you'd find if you shoot the green amps (review the Low Numbers sticky about shooting low) his cycles would flatten out into close to a line. when you're home and able to monitor, go for it. that's the path to OTJ and it's the path to flattening out his cycle and reducing the overall BG range. as long as he's reliably eating and you're monitoring, you'll be able to steer his numbers and keep him safe.

If you look at the spreadsheets of all these cats that have gone OTJ in the past couple of months - the big change happens when the people start shooting the same dose into the green preshots. Here are some spreadsheets for you to look at - glance down the amps until you see green preshots, then look at what happens to the rest of the cycle when the full dose gets shot into that green number.
Davidson, Peyton, Dimitri

You're getting kinda wonky cycles because of the skipped shots. Lantus works best when given on a 12 hr schedule, so whenever you skip a shot, it wears off and his numbers rise, then you shoot and he drops down.

I'm not saying to shoot low and leave, though. Ya gotta do what you have to do when you can't monitor. BUT, if you can monitor, that's the time to shoot low. Most of the time everything over 50 is shootable if you can monitor.
 
Re: 7/9 Huey AMPS 120, maybe hypo last night?

Great job catching those lower numbers last night. Not all cats will have obvious bounces in reaction to low numbers, especially if they are at a lower dose. When you gave the Fancy Feast last night, was it one of the high carb gravy ones? It's better to give high carb wet food as it gets absorbed faster into the system to raise the blood sugar. I'd get rid of the dry food at this point. It's hard to say if Huey was feeling off at the low numbers, although we generally don't see hypo symptoms with numbers in the 50's. The first few times that Neko would get low numbers (or at least compared to what she was used to), she would get very nervous and hungry or hide under the bed.

I notice on your SS that you've had to skip quite a few times. I'm wondering if you should try lowering the dose just a little bit so you can successfully shoot two times a day. The more time you can maintain Huey in normal numbers with insulin, the better chances of healing the pancreas and going into remission. To lower the dose, you could try taking a drop off what you have been doing, or if you look at the New to the Group Sticky, most of the way down, there are some pictures of .1U. Alternatively, there is a Fine Dose Pictorial Guide that might give some ideas on how to reduce the insulin a little bit.

Do you have an autofeeder for Huey? If you are nervous about his numbers in the morning, you can always leave him wet food to graze on. If he is a hoover, then an autofeeder helps space it out. Or you can freeze "catsicles" of food that will thaw out over time. If you can get a +2 test or other test as you go out the door, that can help you decide if you should leave low carb, medium carb, or high carb food for him.
 
Re: 7/9 Huey AMPS 120, +13 76, PMPS 85, +0.5 96

Oy, tonight was tricky. First I was late, then he was low, then it took a bazililon tries to get a second test, and then he wouldn't eat his dinner (not usually a problem but naturally right after I bought a case of the big cans of Evo chicken he decides he doesn't want to eat it...) I gave him a tiny bit of insulin tonight though, at least, I think there was a drop still in the syringe. The syringes I have don't have half unit markings so I've been estimating, but I think I've managed to keep the dose consistant, if not exactly 0.25u. I've been trying to get a dose that's shootable twice a day, but between the holiday weekend and needing to decrease so soon, I haven't managed to get there quite yet... Can't believe a quarter unit is still having this much effect on his system!

Thanks for the reassurances re: hypoing. Last night I gave him the regular low carb beef pate, as well as the Last Greenie In The Apartment and a small spoonful of standard kibble from a pre-diabetes sample pack. I have a couple cans of high carb gravy food and maple syrup on hand but if he was hypoing last night, it didn't seem bad enough to warrant either. An autofeeder is on my wishlist, in the meanwhile, I will prepare some frozen food bits to have on hand to give him.
 
Hi. This is my first visit to your condo I think. Huey is doing really well on such a small dose. You have a lot to be encouraged about!!
 
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