BG only 68 - delay/skip shot?

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Hi all,

My sugarcat has been on insulin for about a month now. I did a curve yesterday that was all over the map (details below). Now his BG is only 68 and he is due for his shot. (To be sure, I tested him twice and ran a control check on the meter- it's definitely 68.) I'm assuming I should delay and/or skip his shot, but for how long? He seems fine, not acting hypo at all, so I don't think I need to run to the emergency vet? My regular vet is closed. He's happily eating his dinner (1/2 can M/D, more if he finishes that) and I'll test him again shortly.

Curve:

4/11/10 (Yesterday)
AMPS - 358 (then 3u Lantus)
+2 - 240
+4 - 121
+6 - 141
+8 - 302
+10 - 557
PMPS - 598 (then 3u Lantus)
+2 - 502
+4 - 412
+8 - 388

4/12/10 (Today)
AMPS - 276 (then 3u Lantus)
PMPS - 68 (!)
 
Did you shoot this cat yet??--Looks like he? needs help, but 68 is not a number I would shoot with 3 units!
Those numbers are pretty all over the place! He had a very nice preshot number, but not knowing anything about you, we will definitely need more info to help you...
Who told you to start at 3 units?? Vet??
Here using the protoco; we use, we usually start a cat at 1 unit..then progress from there, or see if that's a good dose--
Please read the stickys at the top of the lantus main page--there is a wealth of info for you there..OK?
 
do you have any previous numbers you can share?

You don't have the data to shoot at 68 for sure. I would test again in 1/2 hour and see which way he's going, then post here and we'll figure something out.
 
No, I haven't given him his usual dose tonight. 68 seemed way too low for 3u, I agree, but not sure what to do now!

He started at 1u BID about a month ago, gradually working up to 3u BID. He's been at 3u BID since 3/25/10. I'm working on transferring my spreadsheet to Google so you can see everything.
 
Okay, it's now been an hour since the 68 reading, and he's up to 117. I've uploaded my whole spreadsheet and put a link in my signature so hopefully everyone can see that now.
 
Good job on getting your spreadsheet up. Libby is very good, so hopefully she'll come back soon.
 
Forgot to say Welcome to Lantus Land! What is your kitty's name? And your name?

Now a few questions to help us figure out what to do tonight:

If we stall the shot, the next shot will be due 12 hours after this one. Do you work tomorrow, so you would need to leave by a certain time? If so, how long can we stall tonight and still have you able to shoot 12 hours after that in the morning?

Are you home tonight and able to monitor?

Not saying we need these tonight because we're going to play things very conservative, but I have to ask: do you have plenty of test strips in the house? And do you have low carb and high carb canned food in the house? High carb food (most of us use something like Fancy Feast or Friskies varities with gravy) are GREAT if you ever need to bring up a number that is lower than you like. It works fast and doesn't stay in the system forever, plus most cats think it's a great treat to get the gravy food.

Also, does your kitty have any other health issues we should be aware of? Any medications?

Thanks, see you at the 1/2 hour test, which will give us an idea of which way he is going and how fast he is going there. Then we'll know what the next step should be.

just saw that you posted your next test, I'll be right back but please answer my questions in the meantime...
 
Thanks for the welcome! Sorry for not introducing myself! I'm Alison, (nickname Liadh) and my kitty is Pagan.

I do work tomorrow, but I can be late if need be. I usually shoot at 7 AM/PM ET, and leave for work at 7:50 AM ET. If I have to go in late, I can stay late to make up the hours.

Yes, I'm home tonight and able to monitor.

I have lots of test strips. I have low carb food, but no high carb food. I should get some! I was quite shocked to see his numbers so low, and was thus unprepared. I do have Karo syrup for a real emergency.

He's not on any other medications. I am going to start him on Methyl B12 for his peripheral neuropathy soon, but it hasn't arrived yet.
 
Just a couple quick notes.. I know there's a lot to take in right now.. we don't expect you to remember everything first time you see it..

When you are going to delay a shot because of a low number.. don't feed the normal meal.. the idea is to see if the cat is on their way up by themselves with delaying and testing.. feeding will elevate his numbers and you won't know if he was headed up or down. Once you do shoot, you can feed afterwords.

Also 2.5oz is a really big meal for a cat.. with our cats.. we usually try to feed in lots of small meals.. it creates less strain on the pancreas, more consistent BG numbers.. and allows more healing.. my diabetic cat gets two "big meals" twice a day.. which are about 1 oz.. and a series of smaller 0.5oz snacks..

If it's an option for you to feed smaller meals.. I recommend it.. many people who can't be home to split up the meals use timed feeders to help with that..
 
Glad we were able to get you over here--Yes, Welcome to lantus land, I was so concerned that you had a crisis, I forgot to say that!
Glad you have a ss, it is very necesssary, and that the others have found you, to help.
We have food lists with all the low carb foods you can use to help your kitty--Many vets want to feed FD cats that DM, but it has a lot of carbs, so maybe you can find something he'll like & will lower his BG!
Welcome Alison & Pagan--Liadh is a celtic name??
Moonie, gets methyl B12 for a long time & it really helps..
I free feed my cat because Moonie & my civvie do well on their own, and I am sometimes gone for a whole day-8-10 hours, but
I do use a timed feeder too..
Just do the basics for now- test, use low carb food, get data, & post on the board..Let's see where Pagan goes tonite!
 
Sorry, somehow I didn't see that you had answered.

Since you haven't caught Pagan in this range before, I would rather be conservative. Will 9pm be +14? Can you test again then? We might be able to shoot something then, or we'll make the decision to skip at that time. Ok?
 
Welcome Alison & Pagan--Liadh is a celtic name??

Haha, it's a made up Celtic name! Ali --> Lia --> Liadh =)

I'm so glad I have this community here! I was pretty sure I didn't need to truck him to the emergency vet and pay $200 to be told that he wasn't hypo, but I didn't know what to do!

I definitely want to move him to something non-prescription. I'm experimenting on my other (civie) cat, Ping. So far we like Weruva, since it actually looks like food instead of squishy mush. We're even thinking about going raw, but one thing at a time. I've transitioned them both off of dry food at least, so we're making progress. (And I thought I was being a good mommy, feeding them something crunchy that would keep their teeth nice! Oops...)

Will 9pm be +14?

Yes, it will be +14 in just a few minutes. I'll post again after I test.
 
Just to put your mind at ease on the "hypo" number...68 is a very nice number for a normal cat. In fact, some cats even test in the high 30s and low 40s, especially a couple of hours after eating, so you are nowhere near hypo territory. However, without more data, it would have been unsafe to shoot.

Do get some HC food when you get a chance. It brings them up nicer than karo or other sugars, and lasts longer.

And welcome! :mrgreen:
 
+14 - 162

I've never given him a shot at this low. My instinct is to either give him a much smaller dose (1u? 1/2u?) or skip it altogether. Thoughts?
 
if I were you, I wouldn't skip altogether because it looks like Pagan is starting to bounce, and he'll be way high in the morning. If you shoot a reduced dose now, most likely he'll be high enough to shoot again at 8 in the morning so you won't be too far off schedule. I'm thinking 1 unit, what do you think?

And please check back here later tonight or in the morning. A few of us are studying your spreadsheet to try to recommend a dose for you to use going forward. 3 units might be a big too much for where you are right now, but I want to talk with others about it. Sound good? Any questions?

Oh, our rule of thumb is that whenever you shoot your lowest every preshot, that you get a +1 and +2 afterward so we can see if he's going up or down.
 
Oh, our rule of thumb is that whenever you shoot your lowest every preshot, that you get a +1 and +2 afterward so we can see if he's going up or down.

I'm not sure what you mean by "shoot your lowest every preshot"?

Yes, I think 1u sounds reasonable. I'll give that to him now, plus some more food if he'll eat it. I'll check him tonight and tomorrow morning to make sure he's not dipping down too low, and call the vet in the morning.

Thanks again for all everyone's suggestions and support! I would have had a much more stressful evening without all your input!
 
that's just bad, fast typing. ;-) I meant your lowest EVER preshot. Since this is the lowest number you've given a shot on, you should test in 1 hour and again an hour after that, so we can see which direction he's heading. My guess is that he's going straight upward tonight, but I've been wrong before. :mrgreen:
 
Welcome Liadh!

Try to not get too overwhelmed by all of the information that's being thrown at you. There's a lot and we tend to dole it out in truckloads vs. spoonfuls.

People have mentioned food. I didn't see if you'd been given links.
  • Lisa Pierson's site on feline nutrition. It's a wealth of information about nutrition and feline diabetes, as well as other common feline illnesses and food. If you are interested in transitioning to raw at some point, there's great information on her site about this, as well.
  • Janet & Binky's Food Charts: This is information on protein, fat, and most importantly, the carbohydrate content of most of the popular cat foods.

You may also want to look at the sticky note at the top of this section that discusses the Tight Regulation Protocols that we use to guide dosing decisions.

You are absolutely correct when you observed that you found a community. This is an incredible resource with incredible people. Please continue to ask questions. Visit our condos (threads -- one per cat per day) and look at our spreadshesets. And again, welcome.
 
Welcome Lidah: Bless you for taking Kitty in. You are in good hands here. You will do fine. AlphaTrak reads higher than a human meter but the strips are expensive. I ditched mine in favor of ReliOn.
 
I would like to suggest to you that you consider lowering Pagan's dose a little bit. Based on the numbers from the past few days, I actually think that 3 units might be a pretty good dose for Pagan, or at least not very far off. However, we usually like to start at a lower dose and work our way UP to a good dose. The best thing to do is to find a dose that you can shoot every 2 hours, without having to stall like you did tonight. My suggestion would be to reduce the dose a little bit, to maybe 2 units. Then test at every preshot time, and whatever other spot checks you can. If you post here daily, we can help you interpret the numbers you find. It's possible that Pagan does need 3 units, but by reducing a little bit and working up, we can be sure he's safe. What do you think?
 
Libby and Lucy said:
The best thing to do is to find a dose that you can shoot every 2 hours

Libby most definitely means 12 hours.. I'm 99% sure you know this.. but the idea is so scary that I have to make absolute sure :).

Quick! Edit your post and I'll change this to a happy encouragement message and nobody will know! :)
 
Yes, I think a reduction in dose might be in order. I'll discuss with the vet and see what she thinks as well. I'm concerned that he's fluctuating over 500 points in a 24 hr period. He's back in the high range this morning, despite the 1u we gave him last night. Thanks again for all the input! I'll let you know what the vet says.
 
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