Caesar's Crashing Again Please Help? :(

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Justine & Caesar

Member Since 2012
Caesar's having another episode where he's crashing. Brief background: Was instructed by his vet to give him 3 units ONCE a day. This actually worked great until today.

BG: 368 (3 units given, ProZinc)
2 hours later: 168
4 hours later, 8:20pm: 57 (Gave Karo on gums/tongue)
8:35pm: 64
8:50pm: 99
9:30pm: 139
10pm: 189

Please help! Last time he fell low I took him into the vet and they gave him dextrose via IV, but I maxed out my credit card with that visit and they won't see him without upfront payment. I'm freaking out!


Edit: He has been on three units once a day for over a week now and hasn't crashed this hard from what I can tell, although this is the first glucose curve that I have been able to give him. He seems lethargic but is accepting a few bites of canned wet food, Friskies Patte. Also, if anyone is reading, could you please help me with how much Caro I should give? It says 2 tablespoons contains 10g of sugar.

Edit: (After 99) It seems like the Karo is really doing the trick. I'm not nearly as worried now, but I'm still concerned being that he's not reaching his peak yet.
 
Do you have any higher carb gravy food? It would be good to give him some of the gravy off it.( it won't fill him up but should help the bg levels go up). Test every 20 minutes or so until you start seeing a pattern headed up.

You can continue to give a small amount of syrup if you are worried. He has a couple hours before nadir so the syrup you gave could wear off and he could go lower again.

Definitely time to reduce the dose!
 
Thanks Sue -- I don't have any other canned food, but his appetite is pretty good all things considered. I haven't given him any more Karo just yet, but I understand he's not at his peak so I'm going to make sure and watch him. Do you happen to know 'about' how much syrup I should give him in each go? I gave him a couple of 'glops' from my finger on both sides of his gums, but I never know just how much is too little/too much.
 
I don't think you need to give him globs. Put a tiny bit of syrup - maybe like 1/8 teaspoon - on his gums. You don't want to overdo the syrup if he stays in the 50 range( which is safe)

The syrup will probably make his numbers high at the next preshot. You don't want to overreact to that. I would still reduce the dose by a unit or so. (it's always easier to increase the dose as needed than to try to guess how much to safely reduce)

Do you have another number?
 
I'm glad he is coming up .... I know we want to believe everything our vets tell us BUT I use PZI and this will keep happening until you split the dose in two shots 12 hours apart.

ProZinc is only meant to last 12 hrs. in a cats system. You give a shot once a day and he goes from having too much insulin .... to having none. And then he has too much ... and then he has none and at some point he will crash, again and again until you even his shots out.

You are already doing the hard part in the testing and keeping records, you need to read up on the insulin you are using and make educated decisions.

My cat is very complex and I kept listening to the vets and she kept crashing, well worse, going into DKA 4X until I decided I knew enough to make my own decisions. She is now coming up 2 yrs. since her Dx and is fat and sassy and running the house.

The people on this board know more about diabetic cats than most vets put together because we take care of them, day in and day out. Read the stickies in the PZI section, read the posts and you will figure it out and you can.

Nancy and Payne .....
PLEASE split his dose
 
I see you got 99. Much better but it may be the syrup and he could drop again. You want to monitor until you get 2 tests in a row with rising numbers and until he is past that midcycle - at least +6.
 
And put some higher carb food on your shopping list - the gravy Fancy Feasts are good. Mark them as hypo cans so you don't give them to him as a regular diet. They will give a better, longer lasting rise and won't have such an impact on this later cycle numbers if you get another cycle with the lower numbers.

I can't see your ss. but if you are only shooting once daily, I agree completely with Nancy. ProZinc needs to be given twice daily.
 
I see what you mean - he's at 139 now. I just know that when he dive bombed last time I gave him almost the same amount and he still crashed, so I figured I was giving him too little. It's nice to see him perking, but I'm going to have to keep testing throughout the entire night to actually feel safe to sleep.
 
Justine & Caesar said:
Now he's at 321. I just can't win.
Click to expand...

Justine - you ARE winning! You're gaining hugely valuable experience about how your cat is responding to insulin. There is no substitute for that kind of knowledge.

My cat is prone to steep drops too (he has a pancreas that wakes up when least expected...) And it took me quite a while to be able to 'catch' those drops and level them out a bit before he dropped too low. Sometimes I still overcompensate and his BG swings up higher than I'd like. This happened just last night! But he's dropping nicely again this morning, on his usual dose.

Remember the adage: "Better high for a day than low for a minute".

I hope you managed to get some sleep last night.

All good wishes to you,

Elizabeth
 
Justine, I hope you got some sleep last night! We would be glad to help you figure out what dose would work best for Caesar and hopefully avoid the crashes. Most likely the reason he is in the 300s is that the syrup does linger in the body and does bring up the glucose levels up. So the 320 isn't a "true" number - it's caused by the extra sugars he got last night. Regardless, you need to lower the dose as the 3 units took him too low.

I don't know why we can't see your spreadsheet. (The last date I see is August 28th) If you need help with it, send me a pm.

If he were mine, I would lower the dose and get a shot twice daily. Then I'd get a midcycle number whenever possible. That will let you know how low the dose is taking him. Once you have some data on a lower dose, you'll be able to see if he needs more or less insulin. You can post with your numbers and we will help you figure out how he is doing.

You did a great job last night, catching his low number early and intervening. After a low cycle and intervention with extra sugar, they always jump up in numbers.
 
Yeah. I have been keeping track of his numbers, but I had to switch back to 'hand writing' the doses because my spreadsheet suddenly stopped showing the times (they show ### instead of the time/doses) after that date I last posted. I *do* have them recorded, I just haven't been able to figure out what's wrong with the sheet. :(

I did get a little sleep. I have to go in for a 34 week glucose test (ironic, huh?) and had to fast for the last twelve hours. (I'm expecting a baby girl here.) - I'm hoping tonight I can start all over on my spreadsheet. I have numbers from well before what you can see too, ever since day one when I started insulin for him. I'll post it in the ProZinc boards when I get it figured out because I definitely think I'd like to talk to some people who have been there as far as figuring HIM out. I just don't trust my vet anymore, period. I'm going to call her on the way to my appointment and let her know what happened, make sure I can get more needles/insulin from her after my appointment, and then spend the weekend reading up on some new vets. I'm just in the awkward predicament where MY baby girl is measuring far ahead of her due date, and I've been fighting some contractions at home. I just hope I don't go into labor before I can figure out a good dose for him!
 
Hi Justine,
Sue PM'd me last night, but I had already crashed, but it looks like you got some great help and advice during the crisis.

I know that MS Excel will give you "###" sometimes on a spreadsheet due to the columns not being wide enough. Not sure if Google's will do the same thing.

(I'm expecting a baby girl here.)
Click to expand...
Congratulations! Hope your test came out good and you're no longer having to fast. :smile:

Everyone who said so already is exactly right - we all need to help you to figure out the dose on his shots. What you are after is a dose that will allow you to give insulin twice a day, about 12 hours apart. Start thinking about what times will work best for you given your schedule. What you want is time available for the tests before each shot, and at least once a day, getting a test in between shots, preferably catching the nadir or low point of his 12 hour cycle. That usually happens with Prozinc about 5 or 6 hours after the shot.

One of the big reasons you have been seeing high or odd numbers is because of the one-a-day shots. Insulin is only helping out his body for half the day, and the dose has probably been too high all along. Spending 12 hours a day with no "added" insulin to his system is probably undoing the good that 12 hours with insulin has been doing for him.

Now that you've found "us", I think that this adventure will be a little easier for you, so don't hesitate to ask lots of questions.

You did great dealing with last night's crisis.

Oh, definitely put some of the higher carb gravy style cat food on your shopping list. It will help should this happen again, and works a little better than karo or honey. Numbers in the 50s can be scary, especially the first time you see one. Given that they came early in the cycle, boosting his numbers up quickly was the right thing to do. 50s themselves are not dangerous, but can lead to lower numbers so the best thing, early on in the cycle, is to stop the drop before it gets to that point. If this had happened around +5 or later, then gravy would have done the job, and maybe not caused such a fast increase in BG numbers. High carb gravy is a good thing to have in the house, as long as you keep it separate from the normal low-carb food so you don't accidentally feed it to him when you're half asleep in the middle of the night. :-D

Carl
 
Wow, sounds like you have your hands full! I hope we can help you figure how to treat Caesar safely and effectively. We'd love to help!

If you are having troubles with the spreadsheet, just let me know. I'd be happy to get it set up for you.
 
Definitely sounds like the column isn't wide enough.
To check, put your cursor on the cell, then look at the lower right frame of the spreadsheet. If you see the value there, it is the column width.
 
Hi guys! I tried widening the column and it still didn't work. It's also not highlighting his BG colors like the rest. I think I might try to find an original sheet again and try from scratch. I have no idea how I broke it!

I missed Caesar's 'dose time' tonight, which was extremely late in the day anyways... (4pm)... and I think I'm going to just let him be tonight and start fresh with tomorrow. His vet *did* say that he sounds like he needs to be on it twice daily again, but I'm definitely going to start low again. He just can't handle 3 or 4 units when he's in the low 300's... I might just have to make a day out of re-recording his logs from day one in a new spreadsheet. I definitely need to get him steady! I think I may also try to post regularly here in the PZI forum to help keep track of small changes that I may overlook due to lack of knowledge.


Thank you everyone, once again, for all the help!
 
The colors get assigned to a cell through rules. If you can find a cell that works, you can copy the format to any other cells.
Maybe try changing the font size or the zoom/magnification of the sheet to make an entry visible.
 
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