9/4/25 * New Member Needing Advice Please! BG dropped to 72 :-(

Mo's Mom

Mo's Mom

New Member
Hi, I am new to this forum and am looking for advice about my fur baby Mo. He was diagnosed with diabetes in February when we noticed he was losing a lot of weight and just didn't seem like himself. The vet tested him and found him to be diabetic. He prescribed 3 units of Novolin N two times a day. We started doing that and he seemed to be getting better. He started gaining weight back and seemed more aware. In July we took him back again because he had started walking on his hind legs and not really his feet. The vet said he had diabetic neuropathy and prescribed him Potassium Gluconate two times a day with his meals. This has seemed to help a little bit, but he is still walking mostly on his hind legs. He would also drink SO much water, and then have accidents around the house. He also would act like he was starving when I fed him. After looking around this forum for a while I decided to get a blood sugar monitor to check it myself to see if I could notice anything I could show the vet. I only just started doing that on the first of September, so don't have that much data yet, but I would appreciate it if someone could look at it and tell me what they think of his numbers. I also only just recently (9/1/25) started him on only wet food. Before I was feeding him in the morning before his shot and then leaving dry food out during the day ( I have two other cats that graze throughout the day). He would eat some during the day as well. As of September 1st I no longer leave dry food out and he is only eating 2 times a day. He usually eats 1 Friskies can of pate each time (2 for the day)...once in the morning and then again in the afternoon. Sometimes he doesn't finish it, but he usually does. I have only been feeding him the pate kind and he seems ok with it. Since I started testing him, charting his numbers, and only feeding can food he seems to not be as thirsty or starving as he had been. Any thoughts would be greatly appreciated!! My spreadsheet is in my signature, and I hope it shows up with this thread.
***Edited to add I just took his glucose at 10pm and it is down to 72 from 104 @ 9pm. What should I do? When he went low last night I gave him Karo syrup and a small can of food. I'm thinking I shouldn't have given him his insulin tonight...should have skipped maybe?
*** I ended up giving him one small can (3oz) of pate @ 1025. I'll check his levels at 11 again. He seems to be doing ok...up using the scratching post, went potty..all normal.
***I checked his blood sugar at 11pm and it was 97. I'm hoping it stays going up...
 
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Hello and welcome. First of all, feeding and checking 1/2 hour later is a good idea when you see they are lower than you want. Sorry no one got back to you last night in time, but you did the right thing.

OK, the three important things in feline diabetes are home testing (good job on that), feeding an appropriate low carb diet under 10% carbs and Friskies pate works for that. The last part however, is a good insulin for cats, and that is not Novolin. The best choices for insulin are Lantus (glargine) or Prozinc. Novolin doesn't last nearly long enough in the cat. You see action like you did last night, a hard fast drop followed by the insulin wearing off. Any chance you can talk to your vet about a more appropriate insulin?

We don't want cats getting Novolin to get below 90. That means his dose is too high and should be lowered. Are you using U-100 syringe with half unit markings? Typically we change doses by 0.25 units at once - we eyeball that.

If you haven't seen them already, here are a couple Sticky Note posts for you to read:
INTRODUCTION TO CANNISULIN/VETSULIN & N/NPH
BEGINNER'S GUIDE TO HUMULIN N/NOVOLIN N/NPH

Lastly, did the vet do blood work before prescribing potassium? Potassium should only be given if the labs report says it is low. It can be dangerous otherwise. The solution for diabetic neuropathy is not potassium. Methyl B12 is a solution that can help. Feline Diabetic Neuropathy
 
Wendy&Neko said:
Hello and welcome. First of all, feeding and checking 1/2 hour later is a good idea when you see they are lower than you want. Sorry no one got back to you last night in time, but you did the right thing.

OK, the three important things in feline diabetes are home testing (good job on that), feeding an appropriate low carb diet under 10% carbs and Friskies pate works for that. The last part however, is a good insulin for cats, and that is not Novolin. The best choices for insulin are Lantus (glargine) or Prozinc. Novolin doesn't last nearly long enough in the cat. You see action like you did last night, a hard fast drop followed by the insulin wearing off. Any chance you can talk to your vet about a more appropriate insulin?

We don't want cats getting Novolin to get below 90. That means his dose is too high and should be lowered. Are you using U-100 syringe with half unit markings? Typically we change doses by 0.25 units at once - we eyeball that.

If you haven't seen them already, here are a couple Sticky Note posts for you to read:
INTRODUCTION TO CANNISULIN/VETSULIN & N/NPH
BEGINNER'S GUIDE TO HUMULIN N/NOVOLIN N/NPH

Lastly, did the vet do blood work before prescribing potassium? Potassium should only be given if the labs report says it is low. It can be dangerous otherwise. The solution for diabetic neuropathy is not potassium. Methyl B12 is a solution that can help. Feline Diabetic Neuropathy
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Thanks so much for responding. No the vet didn't do bloodwork before prescribing the Potassium 😕. Yes, I am using the U-100 syringes. So do you think I should reduce the dose tonight? His numbers are rising. It was 501 at 3pm today. What should I do? His insulin shot isn't until 7pm tonight, and he eats at 6pm.
 
Yes, reduce the insulin dose to 2.75 units if you can measure that. We eyeball between the 1/2 unit marks if you have those on your syringes.

The vet should have both checked blood work before and 2 weeks after the potassium was started. I've had a couple cats with low potassium that needed treating with potassium. Can you talk to the vet about this? Or consult a second vet? At it's worst, too much potassium can impact the heart or cardiac arrest.

Don't worry about the higher numbers. That is the result of his bodies reaction to the lower numbers. We call it a bounce, but basically they can dump sugars into their system whenever they see a lower number than they are used to, or a fast drop in numbers. This condition is temporary, but it can take 2-3 days to get over.
 
Wendy&Neko said:
Yes, reduce the insulin dose to 2.75 units if you can measure that. We eyeball between the 1/2 unit marks if you have those on your syringes.

The vet should have both checked blood work before and 2 weeks after the potassium was started. I've had a couple cats with low potassium that needed treating with potassium. Can you talk to the vet about this? Or consult a second vet? At it's worst, too much potassium can impact the heart or cardiac arrest.

Don't worry about the higher numbers. That is the result of his bodies reaction to the lower numbers. We call it a bounce, but basically they can dump sugars into their system whenever they see a lower number than they are used to, or a fast drop in numbers. This condition is temporary, but it can take 2-3 days to get over.
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Ok, I am attaching a picture of what the vet prescribed for Potassium. Should I stop using this? I will give him 2.75 of insulin at 7 tonight. Is there a preshot number I shouldn't give insulin at? It seemed like the last two nights after I gave it to him his blood sugar went low.
 

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Given where his numbers are trending today, I don't think you need to worry about too low a preshot number. As a general guidelines, we tell people not to shoot if under 200, until they have more data to do so. Provided that the cat is not recovering from recent DKA or showing ketones. Are you testing for ketones? You can get urine test strips for that. Tips to catch and test a urine sample

One option for you if you see a lower preshot number, is to not feed, and wait 1/2 hour to see if his numbers come up to a number you can shoot.
 
Wendy&Neko said:
Given where his numbers are trending today, I don't think you need to worry about too low a preshot number. As a general guidelines, we tell people not to shoot if under 200, until they have more data to do so. Provided that the cat is not recovering from recent DKA or showing ketones. Are you testing for ketones? You can get urine test strips for that. Tips to catch and test a urine sample

One option for you if you see a lower preshot number, is to not feed, and wait 1/2 hour to see if his numbers come up to a number you can shoot.
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Thank you so much for all this information! I have not been testing for ketones, but will look into that. Do I have to have feline ones...or can I use the kind they have at Walmart? For the low preshot number...I usually feed at 6pm and he gets his shot at 7pm...Do I use the number at 6 or 7 to decide about the shot? (I've been trying to test hourly till I get a hang of where his numbers are). Also, do you think I should stop the potassium? Sorry for so many questions!
 
You can use the Walmart (or where ever kind) used for humans. There are also blood ketone meters, but more expensive. Good if you do have a cat with ketones.

Regarding sequencing, this quote is from one of the documents I linked above, blue text:
  • The proper sequence for dosing insulin is: Test/Feed/Wait (an hour for N/NPH)/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle. NOTE: Because pet-specific meters (such as the AlphaTrak2) often read higher than human meters, you may want to adjust the NO-SHOOT/Ask for help number to 225 mg/dL {12.5 mmol/L} or even 250 mg/dL {14 mmol/L} This gives you an added margin of safety when using an AlphaTrak2 or other pet-specific meter.
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I can't help make the decision on the potassium, that should be done by a qualified vet. Perhaps not the one you saw who recommended it, as they don't seem to have much experience with feline diabetes.
 
Wendy&Neko said:
You can use the Walmart (or where ever kind) used for humans. There are also blood ketone meters, but more expensive. Good if you do have a cat with ketones.

Regarding sequencing, this quote is from one of the documents I linked above, blue text:

I can't help make the decision on the potassium, that should be done by a qualified vet. Perhaps not the one you saw who recommended it, as they don't seem to have much experience with feline diabetes.
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His reading is now 573 at 5pm. I'm pretty sure it will read HIGH by 6pm...his dinner time. Is it ok to feed him when his BG is so high? Sorry, I'm still trying to get a good grip on this!
 
Wendy&Neko said:
Feed him as you normally would. He'll be even hungrier in high numbers.
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I fed him at 6pm his usual food. BG was still high. It was still high at 7 when I gave 2.75 insulin dose. Numbers didn't start coming down till +3. Went from high to 390 @+3, then 202 @+4. He was acting hungry so i gave him a small 3oz can at about +4.2, then checked at +5 and it was down to 188. I am worried if I go to sleep he will go too low and I won't be there. Also his ears are pink, warm and tender. I think they are irritated from all the testing.
 
This is exactly what I went through with my Lantus. You're doing an amazing job, keep it up. It feels so daunting always chasing the lows doesn't it? Is there any way you can get a continuous glucose monitor and have it applied (or apply it yourself, it's actually easier than it looks!)? I am in British Columbia, Canada and I can get them without a prescription but I have no idea if it's the same in other countries. I can't recommend them enough - WAY less ear pokes, you can see in real time how the sugars are trending and you can send the data to the vet in a nice PDF. It calms YOUR nerves as well! My vet told me it's better to overfed than underfeed in these situations - it's less dangerous to be high than low and every low that mine had would result in me feeding him until he wouldn't eat anymore. And now I always have higher carb food (kitty junk food) on hand for those scary lows. We got off Lantus about 3 weeks ago and are now using Toujeo - it's been great for the curve levelling out but we can't get the numbers into normal range. We haven't had a scary crash since (some lower than expected but not as scary). Feel free to message me and I can show you the graphs and such if you would like more info! Just remember - you're doing the best you can for Mo!❤️
 
There are a few downsides to the Libres. Most important is that it tends to read lower in low numbers (under 100), and should be rechecked with a hand held blood glucose (BG) meter. From the side by side comparisons we have seen from people, there can be quite the difference. Our dosing methods have you change dose based on those hand held meter values, so it's important to double check.

Some cats can't tolerate it and rip it off fairly quickly. Their caregivers get really good at replacing themselves.

When you use your BG meter and learn how your cat uses the insulin and carbs, you can identify patterns in blood sugar numbers and learn when you can monitor less or need to monitor more. People with Libres see a lot more low numbers, which may not be that low when compared to a BG meter, but chasing low numbers can be stressful.

The Libre is great if you have a fractious hard to test cat, or are away on holidays leaving a petsitter in charge. And in the beginning when you are learning to test.

Fenster said:
every low that mine had would result in me feeding him until he wouldn't eat anymore.
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Don't overfeed. If you feed higher carbs, those carbs can wear off in a couple hours and the numbers start to drop again. Leave them a little bit hungry so they'll eat later if needed. Instead of overfeeding, learn how much of a numbers bump your cat gets from a certain quantity of food. Track the volume of higher carb food given, and when in the cycle so you can see it's impact. If you need it to be higher or lower, tweak the type of high carb food you are using to be higher or lower carb%. In addition, many diabetics cats are extra fluffy to start with. You don't want them to gain even more weight, which can make regulation harder to achieve.
 
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