Advice on insulin reduction?

A

Amber26

New Member
Hello, this is my first post here, although I've lurked some ever since my kitty Tom was diagnosed a few months ago. I was hoping someone could give me some quick advice.

Tom has been on 4u of ProZinc twice a day since February of this year (he was originally diagnosed in January). Today, he had his first ever hypoglycemic episode and I quickly brought him around with some corn syrup and then after he seemed more stable, a little bit of food and he's doing ok now. I called his vet, who wasn't in, to ask how much I should bring his insulin dose down by. Unfortunatley, he won't be back until tomorrow. So, what would be your advice? Should I go down by 1u, start over at 1u, or skip his dose altogether tonight? I really don't want to overdose him, if 3u may be too much, or not give him enough if 1u is still too little.

I don't have an accurate BG level, just "Low", because I ordered some PetSure strips that aren't working worth a crap (that price was nice though!), I'm ordering more of the painfully priced Alphatrack brand. I recently moved across the country and haven't been doing his tests as regularly as I should, in all the hubub. These PetSure strips don't seem very trustworthy anyway, when they work at all. I did not have these issues with Alpha and I'm absolutely kicking myself for not ordering more before I moved.

What should I do? I know this is my fault for not ordering new strips as soon as I felt these were off, but I really don't want my little kit to suffer anymore today. 1u, 3u, or none at all?

Thank you so much for your time.
 
Without any test data to review, there is not really anything to go on to advise you on a dose. 4u is a pretty high dose, and he has been on it for four months. When you were testing, what where his numbers like?

It sounds like the hypo episode was obvious by visible symptoms, correct? That along with the 'Low' reading indicates he was really, really low which can be very dangerous. Also, right after a hypo episode, a cat can be much more sensitive to insulin. So, a lot of caution should be taken. Do you at least have more PetSure strips that you could use to test him before administering any more insulin?
 
I rechecked my notes, he has been on 4u since March, not February. His highest levels were usually around 300, his lowest at 185. He bounced around a lot at first, but eventually started to even out to those numbers. The hypo was very obvious from his walking like the floor was sticky paper he could barely lift his feet from, wobbly gait as well, eyes super unfocused like he was confused by everything around him. I started to test him, and when I got the lancet to his ear he just lolled back and I said, "forget it, this has to be hypoglycemia" and gave him the syrup. He perked right up, I tested him and it read "Low", then gave him a tiny portion of his usual wet food, waited about an hour and tested again, still "Low". But, he's acting normal.

I have more strips and will test again before tonight for sure. Thing is, I don't trust these strips. When I first got them, all the readings were way too low, and deep reading the reviews for them (which I should have done before buying, that price was just a siren call) that seems to be a common issue for them. But since I had this huge move upcoming, I let it slide to the back burner and now I feel like an idiot.

Would it be best to just not give him any? I didn't know hypo can make a cat more sensitive to the insulin. Thank you so so much for replying, really. Thank you.
 
I don't feel comfortable telling you to give him any tonight. It sounds like this was a really bad hypo episode, and if you don't even have a way to monitor his glucose level accurately, there is just too much risk involved. Maybe others will chime in, but I think I would rather err on the side of caution and not give anything tonight. Is there any way you could pick up a human meter and strips this evening at Wal-Mart or a drug store or somewhere? You really need to be able to accurately test him before you resume insulin. Or, I have heard of people using FreeStyle Insulinix strips in their AlphaTrak2 meter.. I'm not sure if those can be bought locally or not.

If you have been 'lurking', you have probably seen that we use a spreadsheet to track our glucose test results and insulin doses given. I cannot stress enough how helpful it is. I cannot imagine managing this without it. Would you consider setting one up? Here is info on doing that: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ And on understanding it: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/ You can put a link to it in your signature so that if/when you ask for advice here, everyone can look at your spreadsheet data. Here is info on setting up a signature: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/ You can include basic info like your cats name, date diagnosed, type of insulin being given and whether you are using a pet or human meter, and that way you do not have to repeat that info every time you post.

Welcome! :)
 
Hello and welcome. All I can comment on is the meter situation. I too started with the AT2 and yes the strips were prohibitively expensive and not that accessible. The wonderful people here finally convinced me to get a human meter and it’s one of the best things I could have done. There are many out there and I’m sure others will chime in but i am using Diathrive... you sign up for 3 month deliveries based on how much you test.. it definitely allows close monitoring without worrying about running out or going broke. 400 strips is $66!! And they send a free meter with first order. Check them out on line or as I said I’m sure others will chime in with meter advice. The important thing to remember is to always have enough strips so that if you have an episode like you did today, you can closely Monitor BG levels and steer up as necessary. Again welcome and good luck!
 
Yes, I've been very impressed with the spreadsheets! I keep a notebook log for Tom, but the spreadsheet would be much easier for referencing. Now that I've joined up here, no reason not to use it! I'm looking into the human meters, I'm starting to be swayed toward them. I admit to being a bit set in my ways, a dislike of change, but I'd super appreciate those human prices. I think I shall err on the side of caution and not dose him tonight. He is doing fine, already meowing up a storm for his dinner, as per usual. It was pretty scary, I've never seen him like that and hope I never do again. I don't know what could have caused it, there is no way he had access to any food or secret snacks I don't know about. Child proofed cabinets, food is never ever left out on counters, he is solidly indoors, etc.

Thank you both so much. You gave me excellent advice and a calmer outlook. I appreciate you very much!
 
Hi Amber, would be great if you got your SS up and running. As for what caused the hypo... it would not be food related. If anything that would drive his numbers up. Hypo is too much insulin. Although you said he seemed fine on the dose he was on some cats will unexplainably dive on what was once considered a good dose .... just look at my various spreadsheets. As for the human meter I was very resistant as I too hate change of any kind... (who moved my toothbrush?!!! ...lol.). That said it turned out to be a change that gave me great peace of mind from an availability standpoint as well as financial.
 
Just in case either of you check back I wanted to let you know: Tom is doing ok! Yesterday, his morning BG was at 298 (since the neg reviews for the PetSure strips all say they are usually 10-20 points lower than Alpha readings, that would be 308-318), so I gave him 2u after his breakfast. His numbers started shooting way down too fast, even correcting by 10-20 points, so he got midday snacks 2 hours apart to keep him up, no insulin last night. This morning, his BG was 170 (180-190) so no insulin this morning. I'll of course be measuring him throughout the day.
My new Alphas arrive tomorrow, and I'm researching all I can on human meters to replace the Alpha. I just really wanted correct readings right away, so I ordered Alphas to give me cushion on finding the right human meter system. That Diathrive looks really good though!

Anyways, thank you so much for giving me advice in my time of panic. Doing frantic research on hypo, I think I got some info on hyper and that's how I got the idea it might be food related. Panic really short circuits my brain:facepalm:
 
Hi Amber. Deep breaths. We’ve all been there and if you continue to test and monitor mid days , hypo episodes can usually be managed with food. The idea is to test at +2 or +3 while you have hypo concerns. If you feel he is dropping too much or too fast at that time a little of his normal low carb food should be given and test again in 30 minutes to see if he came up. If he came up a bit and you are still nervous... repeat the food and 30 min test. With the hypo you just experienced I can understand the panic for sure. The key to avoiding an episode like that is the + 2 or +3 test. With that info you should be able to manage the hypo before visible symptoms appear. Please get your SS up and running so you can get accurate advice going forward with regard to dose changes. Again. Remember to take care of yourself, breathe and know you got this girl!! And PS I am really happy with the Diathrive... I did side by side testing with Alpha for a few days when I started the switch to calm my brain- and the numbers made me feel more confident. I now use that meter exclusively. Take a look at my PZI SS Tab starting April 4th to see comp numbers for yourself. :bighug:
 
You must log in or register to reply here.
Back
Top