9/5/10 Korbel post hypo

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jennifer & korbel (GA)

Member Since 2010
Hi everyone
So, Korbel had a hypo yesterday (viewtopic.php?f=28&t=24148)

So, now I need to figure out a new dose.
Unfortunately I don't have very much data for you. The last time I did any sort of “official” curve on her was in March. Here is that data:
amps 236 2units Lantus + wellness canned food (~3oz)
+3 219
+6 227
+9 220
pmps 232 2 units Lantus + wellness canned food (~3oz)
+4 217
+8 215
amps (+12) 225

I updated a spreadsheet (in my sig) with yesterdays and todays numbers. Todays numbers so far seem to be dipping down into the 100s.

Other than that, I've done the occasional preshot test (maybe once a week, more likely once every other week) those numbers were consistantly between 200 and 250.

Way back in 2000, when Korbel was first diagnosed, she was on humulin Lente. Early on when I was learing to hometest, I never saw numbers over 100 on her. I was new, not sure if I was doing it correctly or not, and her vet curves were up in the 300s so I was assuming that something was not working with the meter....then I went on vacation and came back and she was still only reading 100s-this after NO insulin for a long weekend (she will not let anyone but me get even close to her), then I knew that the 100's were real numbers. It turns out that Korbel was actually in what became a 3 year honeymoon and the 300s at the vet were due to vet stress. But what that also told me was that she can get some pretty low numbers for some time without crashing, so I have no way of knowing how low or for how long she'd been low before yesterdays episode.

While she was on her honeymoon, I also found that if she went high for some reason (often if she got into some “forbidden” food) she would need 1 or 2 days of 0.5units BID to bring her back to a point that she could maintain on her own. The basic pattern was that if she went over ~250, she would need a bit of help to get back down. Granted again, that was lente.

The other thing I have noticed is that she seems to be highest right before a meal. Even without insulin she would get a drop in numbers just by being fed instead of the typical food spike we see in most cats. We used to joke that she got stressed waiting for it to be dinnertime!


It is now almost 1:30pm MST. Any thoughts on what to do? I've still got plenty of time to decide, dinner/shot time is in about 4 hrs (5:30pm MST). I'm better during the week about the 12/12 timing...
I'll probably get 2 more checks yet today-3:00ish then the pmps around 5ish
 
My experience with hypo's on N insulin were it took at least 72 hours for their system to calm down. Meaning, getting the liver to stop dumping glucose. During that time I would reduce the dose by half and hold for at least 72 hours. I would actually mark my spreadsheet (xcel)with a highlight line to know.

I am not sure with Lantus if the protocol is the same or if it is a 0.25-0.50 reduced dose. I would suspect this is the case based on this protocal from the "stickey" http://felinediabetes.com/Roomp_Rand_20 ... otocol.pdf.

I am sure more experienced folks will be along soon though to help out!

Good job catching the hypo.
 
I hate to keep putting you off, but it looks like Korbel's bounce is already clearing. I think we need to see the next numbers before deciding on a dose. If she keeps going down, we might need to reduce even more than I was thinking yesterday. THis looks good!
 
Yeah, like I said I plan on getting at least 1 if not 2 more readings before the next shot is due. I just wanted to give people a heads up :lol:
 
2 1/2 hrs until shot time

recap of today's numbers
amps 221 ~3oz wellness canned, no insulin
+2 238
+4 179
+6 172
+8 198

she's starting to creep up, but like I said she is usually highest right before a eating, with or without a shot she usually has a drop after food.
 
nice. :smile:

I was hoping there would be some more eyes in here today, but there don't seem to be a lot of people around today. I'm leaning toward cutting her dose in half, to 1 unit, unless things change a lot before PMPS. It might not be enough, but we can always adjust upward in a few days if it looks like 1 unit isn't cutting it. What do you think? After all this time, you must know Korbel pretty well.
 
I knew her inside and out on Lente. I never did the monitoring on lantus the way I did on Lente. In those days I would skip the dose all together unless she got over 200.
I'm leaning towards a skinny 1unit or maybe a fat 0.5unit. I'll test again in 45min and then decide for sure. I really wish I knew where she was when I shot yesterday, that would tell me so much more.
Either way, I suspect I'll be in for another long night.....
 
If it's for your confidence and to get a feel for what's going on, get a +1. If it's not higher than your PMPS due to a food spike, definitely get a +2. The territory may be a bit uncharted since Korbel may be sensitive to insulin at this point.
 
+1 258
A little higher than I would have liked, probably because of no am shot. Usually, she goes down after food not up.
I think I'll check her in 2hrs
 
Welcome to the board, Jennifer! Glad that Korbel is doing okay today. I hope the dosing goes smoothly for you. Good job yesterday!
 
just wanted to stop by to say "hi, jennifer! long time no see!" :-D
you had quite a day yesterday. hope you get a good night's sleep tonight!
 
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