911 - Hypoglecemia episode

A

andreajay

New Member
Hi everyone,

My first time here.

I have a 12 year old cat Tibbs who was diagnosed with diabetes 2 years ago. Our vet was not thorough in giving us information regarding proper care. We have always taken him for regular checkups and blood work to adjust dose of his ProZinc.

2 years ago untreated he was at 22mmol/DL on the initial tests and given 2 units 2x a day
BG went down to 16 - vet increased dose to 3 units 2x per day to try
Retested curve and was brought up to 3.5 units 2x per day based on results
Last visit showed 13 and dose was reduced to 3 units 2x per day

After losing our other cat to cancer a month ago, I noticed him eating less and mentioned this to vet. She did not tell me to lower dose. He recieved his usual 3 units today around 12pm. Well, tonight around 10pm he showed signs up hypoglycemia and thank God I have some maple syrup, honey etc. I have a blood glucose test that I've never been shown how to use properly but YouTube helped immensely during this episode. His reading was around 1.26mmol (22 ML) which is dangerously low! I gave him the syrup and tested again about 45 minutes later and he went up to 3.4mmol. After some more food he came around and acted himself a bit more. Final test around 12:30am showed 5.8mmol.

This was my first experience seeing him so lethargic and acting strange. He was very shaky, uncoordinated and peed outside the Litter box. I am so angry at myself for not finding this site earlier and learning all I can about his disease - the vet mentioned only once in passing I could BG monitor at home and SHOULD especially with these increase in doses. Furthermore, I'm concerned about him eating less and need to adjust accordingly. I cannot afford anymore vet bills and feel so hopeless with managing his disease. I have spent over 5k on vet bills between my other cats illness and getting new kitten vaccinated, etc. This incident left me shaking especially so soon after losing my other cat. Any advice is helpful as my vet has been unhelpful during this time. Thank you.
 
Hello there. I’m really upset to be reading this about your kitty and the hypo episode. I am so sorry that this happened. This is why I try so hard to persuade people that it’s not safe to give insulin without testing at home. Oh, by the way, when you do get a number low enough to give karo syrup or other high carbs, you should test again in 20 minutes to see if you need to give more. Anyway, we can talk about that all later.

We are here to help you. Do not beat yourself up. We can only do the best that we can with the information we have at any given time. You are here now and we can move forward.

So this was just last night that this hypo happened? I would not give any insulin at all this morning. I would test BG at the normal shot time and see what it is. We need to make sure Tibbs is okay. Cats who have had a hypo can be extra sensitive to insulin.

Where do you live? What time zone? what is your usual shot time? In order to help you in the best and safest possible way, we will need more information on Tibbs’ numbers. We will need you to set up a spreadsheet or we can help you set one up. Would you be willing to do that? I have to run out the door for an hour or so and I will come back and check up on you and give more information and get more info from you .
 
So this was just last night that this hypo happened?

- Yes, his usual shot times are 12pm and 12am. He recieved his afternoon shot and began acting strangely about 8pm. I tested BG around 10pm at it was 1.26mmol/L or 22 mL/dl - I immediately administered simple syrup and honey. Once he perked up, I gave him soft food and some treats.

I live in Canada, EST time zone. I can definitely set up a spread sheet. Is there a sample or template? What type of info should be on there? Thank you for your help and kindness

Where do you live? What time zone? what is your usual shot time? In order to help you in the best and safest possible way, we will need more information on Tibbs’ numbers. We will need you to set up a
 
Let me send you some information to get started. How is Tibbs this morning?

I am also in the Eastern time zone. U.S. Georgia.
 
Hi, he is better this morning. More alert, etc. The vet said not to give him insulin until we do fructosamine test. I'm hoping to track his blood sugar doses etc. So any guidance or help is appreciated. Thanks.
 
Here's the information on how to create a spreadsheet.

GOOGLE SPREADSHEET: TRACKING KITTY’S PROGRESS

It is important to track your kitty’s progress over time. FDMB has a process for this, using a Google spreadsheet (SS). Other FDMB users can provide you better help if you keep your cat’s spreadsheet up to date. Once you type in the numbers, the SS will automatically update.

Make sure when setting up your spreadsheet that you choose the correct type: We have one sheet for human meters and another for AlphaTrak2 pet meters.

If you are not from the United States: Make sure you choose the World version so that your numbers will automatically convert to what most members are used to seeing.
  • Post the spreadsheet in your FMDB signature. Once you create the spreadsheet, put it in your FDMB signature block. See the link above, which includes easy instructions on how to update your signature block.
 
andreajay said:
Hi, he is better this morning. More alert, etc. The vet said not to give him insulin until we do fructosamine test. I'm hoping to track his blood sugar doses etc. So any guidance or help is appreciated. Thanks.
Click to expand...
So a fructosamine test is mostly useful for diagnosing diabetes and can be helpful in determining a starting dose of insulin. Many vets tend to overdose a cat from the very beginning and then send people on their way with no information about testing, hypos, etc. It's very dangerous. Fructosamine will give you an average of BG numbers for the period of a few weeks. I would not necessarily waste my money on one at this point. I would start home BG testing using a ReliOn Premier meter from Walmart. Test strips are cheap. You can get 100 of them for less than $20 ($17.88 last time I checked.) If you start tracking BG each day you can get your own "average" of BG numbers taken at home. You can do your own "glucose curve" (another thing vets like to charge for when they keep your cat all day) at home as well. It will be more accurate than readings taken at the vet since stress elevates BG. I definitely would not want to see you giving insulin again until you have collected some data.
 
Now, let's talk diet. What does Tibbs eat? Is he on a low carb wet food diet? Does he eat any dry food?

Also feeding times/snacks? It's important for diabetic cats to get multiple small meals especially early in the cycle, to help stabilize BG. On ProZinc, I like to see a snack at about +2 and maybe +4. This can vary depending on the cat and the way he responds to insulin, but that's kind of a general approach. We recommend not feeding after nadir (the typical lowest point in the cycle for your cat) because it can shorten the duration of the insulin. So nadir may be around +6 or so... again, depending on the cat.

OBTW, +2 means two hours after the insulin shot, +4 four hours after, etc. We use this since everybody is in different time zones and it doesn't work to use clock time in that case. This way we all know where in the cycle things are happening -- how long after the shot was given. Hope this is making sense.
 
In order to get an accurate reading of blood glucose at preshot time (we will still call it preshot time even though he's not getting insulin for the time being), you need to make sure that he's not eaten any food for two hours prior to that pre-shot test. This ensures that the BG test result is not influenced (elevated) by food. Only this way will you know if it is even safe to give insulin at all and/or if any dose adjustments need to be made or if a shot should be skipped entirely for that cycle.

There are two cycles in each day, the AM and PM. Each is 12 hours. AMPS is the morning preshot number and PMPS is the evening preshot number.

What is your work schedule like? I'm asking to find out if you will have difficulties getting mid-cycle tests done and snacks given, etc. A lot of people who are not home during certain parts of the cycle will use automated timers to dispense food at the desired times.

I'm sorry this is a data dump.
 
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
VIDEO: How to test your cat's blood sugarsugar

Here is a video that one of our members did
 
If you can fill out what we call our signature that will be helpful,it's at the end of everyone's post in gray

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Take a look at mine


We also use a spreadsheet to track our cats BG so we know how the insulin is working and how low they are dropping so we know when to either increase or decrease the dose
We adjust the dose by 0.25 units at a time . We don't adjust the dose by going by the Pre Shots

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers
 
Thank you so much for this information. I will review everything this weekend and reply. Thank you again for your insight and time - this is more education or tips than I ever recieved from my vet ☹️
 
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