BG goes too low after 0.25U injection.

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julycat

Member Since 2013
Hello, I'm new here,
I'm living in korea, there are not enough informations about feline diabetes here.

My cat is 11 years old, newly diagnosed diabetes about 2 weeks ago.

His natural glucose levels were 350~400mg/dl.
He had been so sick(sleeping all day, loosing appetite and activation) before regulation.
He had 0.5U of insulin per a day as a start.
During the home monitoring, his glucose went too low about 40mg/dl at peak times(about 6 hours later after injection).
There were no hypo symptoms, but I let him eat some honey.
After that his glucose level went up slowly then at 24 hours later after injection it came back up to 360mg.

So our vet reduced insulin to 0.25U per a day.
But after shooting of 0.25U, his glucose went down at a peak time by 43mg/dl again!
He looks fine, eats normally.

Though I'll meet our vet on Monday but I'm so confusing now.
Can we more reduce insulin under 0.25U?
 
Hello and welcome to FDMB! :smile:

Yes, it is possible to measure very small insulin doses. It is sometimes necessary because some cats are very sensitive to insulin. (I'll try to find some info on 'micro dosing' for you and post it here later - if someone else doesn't find it first!)

May I ask what insulin you are currently using?
And do you test your cat's glucose before you give the insulin shots?

Eliz
 
Yes, I tested my cat's glucose right before shot today, it was 361.

We can go with very small amount of insulin! :shock:
I'll discuss with my vet about that at the next meeting.

Unfortunately I don't know what kind of insulin is I'm using.
I'll ask to my vet too.

Thank you Elizabeth for helping me with useful info!
 
are you giving insulin once or twice a day?

there are three insulins that are recommended for use in cats - Prozinc, Lantus (glargine) and Levimer (detemir) and these should be dosed in 12 hour increments.

It is important to know what kind of insulin you are using, so you understand how it works. What type of container is the insulin in? The original container or did the vet put it into something else and therefore you don't have the information on the bottle?
 
Hillary & Maui said:
are you giving insulin once or twice a day?
Click to expand...
My vet planned to give my cat insulin twice a day at first.
But my cat's glucose became too low in 6 hours, we changed prior plan to ONCE a day.

Yes, I'll keep in mind that knowing what kind of insulin is I'm using is very important.
My vet gave insulin diluted with purified water in a syringe.
Because it was for one day testing. So I didn't see the bottle.

Now it is 24 hours after injection. I gave 0.25U of insulin once.

Before injection BG : 361mg/dl
after 6 hours : 43mg/dl - the lowest level today
after 24 hours : 336mg/dl.
 
Hmmmmm. It would be helpful to know what kind of insulin the vet diluted.

So the problem with once daily dosing is that insulin normally lasts only 12 hours in cats. Normally with once daily dosing, we see a cat who is at, say 300 at morning preshot, goes down for nadir and then climbs for the next 24 hours, usually over that 300 level. Your cat is not climbing but giving you a smile shaped curve. Preshot, lower nadir, back up to same preshot level, at same preshot level after 24 hours. One thing to try is to set your alarm and get some night numbers around that midcycle time. Does he stay at that 300 level for the whole 12 hours overnight? Does he go down at any point?

Once you get that info and what kind of insulin, we might be able to figure out some sort of strategy. It is clear the insulin takes him too low and he probably bounces back up. We might work around that with food given at stategic times to keep that nadir up higher. But I don't understand why you have the same nadir the next morning, after 24 hours without insulin - unless I am missing something. Which of course is always possible. :mrgreen:
 
Thank you for answer, Sue and Oliver.
361 - 43 - 336 points are glucose changing after a morning shot today.
(Sorry maybe I wrote hardly to understand.)

Yes I checked my cat's BG in mid cycle time, around 8~16 after shot.
They were between 90~150mg.

I think the problem is nadir is too low.
 
That is amazing that he is in the 300s at +12 and then goes down again in the next 4 hours or so. Does he eat at +12?

One thing you can try is to feed him about 3 hours after the shot and then again at 6 hours after. (It doesn't have to be extra - just divide what you are already feeding in more portions.) The idea is that the food should bring him up early in the cycle and then again at nadir. Maybe that will smooth out the curve and bring up the nadir.
 
My Bailey does that - he drops fast and rarely bounces much. I am thinking the dose is too high - this could be a microdose cat. Of course it would help to know what the insulin type was.

Wendy
 
Thank you all guys, you are all wonderful!

I met my vet today. Insulin was Novolin-N.
We decided to take 0.25 unit once per day.
Vet says I should feed my cat well after injection.
And should test BG around 5~8 hours after shooting to avoid hypoglycemia.

Sue and Oliver (GA) said:
One thing you can try is to feed him about 3 hours after the shot and then again at 6 hours after. (It doesn't have to be extra - just divide what you are already feeding in more portions.) The idea is that the food should bring him up early in the cycle and then again at nadir. Maybe that will smooth out the curve and bring up the nadir.
Click to expand...

Yes I did as you told today. My vet told the same. It worked! Glucose curve became smoother. Thank you! :-D
 
Where are.you located? N is a harsh insulin and does create the sharp drops early in the cycle. Any chance your vet would prescribe another type?

Glad the food helped smooth things out.
 
Feed first, wait 30 minutes, then give insulin. This ensures food is on board when the insulin starts working.
 
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