? Can glucose drop from 380 to 60 11 hours after Prozinc?

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Amy C

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My cat is acting ok but I dont know what to do. He wears a Freestyle Libre...just replaced yesterday. The vet increased his dose from 1 to 2 units yesterday after his glucose was reading 380 and higher after 10 days on 1 unit.. This morning it was 380 and he had 2 units at 7 am. My alarm was blaring his glucose was 70 at 5 pm but it went back up slightly. Now it says it is 54. Ive tried poking his ear and he doesn't allow it.
 
@Amy C
Can you please set up your signature
Information we need about Bowie
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

  • 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)
    • Bexacat or Senvelgo (if applicable) and dates
    • 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.

Make sure you put your kitty had ketones and DKA and the date this happened
 
Amy C said:
My cat is acting ok but I dont know what to do. He wears a Freestyle Libre...just replaced yesterday. The vet increased his dose from 1 to 2 units yesterday after his glucose was reading 380 and higher after 10 days on 1 unit.. This morning it was 380 and he had 2 units at 7 am. My alarm was blaring his glucose was 70 at 5 pm but it went back up slightly. Now it says it is 54. Ive tried poking his ear and he doesn't allow it.
Click to expand...
@Suzanne & Darcy
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
 
Amy C said:
My cat is acting ok but I dont know what to do. He wears a Freestyle Libre...just replaced yesterday. The vet increased his dose from 1 to 2 units yesterday after his glucose was reading 380 and higher after 10 days on 1 unit.. This morning it was 380 and he had 2 units at 7 am. My alarm was blaring his glucose was 70 at 5 pm but it went back up slightly. Now it says it is 54. Ive tried poking his ear and he doesn't allow it.
Click to expand...
Ok you need to this, find honey or Karo Syrup or any syrup rub some on his gums,or if yoiu have a syringe with out the needle give 1ml of that if you have high carb between 15-18% give him 1 tsp of that or 2 tsp of medium carb food between 12-15 % test again in 1/2 hour and continue this process until his Numbers,BG gets higher, the syrup is for a quick fix once while you prepare the food, the food, are you feeding wet can food or kibbles, if you are giving kibbles, after the syrup on the gums, give a few kibbles every 15 minutes and retest continue this until the numbers are around 79ish, do not give too much carbs or the opposite will be the result, did his dose change? did you retest before shooting?? Also the Libre does not read low BGs accurately, is probably higher, I am tagging a ProZinc expert right now, in the mean time do the protocol I described, don't worry we are here
@Suzanne & Darcy
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
 
Med and High Carb food and have honey in your house



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs



Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods



https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.
 
He only had his morning dose, 2 units, at 7 a.m which is why I don't understand this hypoglycemia event this evening 12 hours laters. After 1 teaspoon of honey and nibbled on some wet food and is up to 76.
 
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Update: After second round of honey, up to 104. I won't be giving any insulin this evening and I'm definitely not giving 2 units ever again even with consistent high readings over 350 for 3 days (or until I get a second opinion). I'm terrified of him going back into DKA again because I will not be able to afford it a second time - so I took him in yesterday. That is when the vet increased him to 2 units (also, Ketone check was negative at the vet).
 
With DKA in the picture you need to be testing for ketones at the moment every day or second day, especially if you are going to skip a dose.
Have you been doing that?
You will need a bottle of ketostix from the pharmacy and collect a urine specimen from your kitty.
Do you have a spread sheet? If not it would be very helpful to us if you could set one up, other wise we can’t help you with dosing..
Information on how to set up SS HERE
The libre can be unreliable in low numbers. Do you have a manual meter to double check the BG when this happens?
Are you feeding lots of extra food since the DKA picture? 2 main meals and lots of snacks during every cycle.
We don’t recommend skipping doses with a post DKA kitty.
I will contact @Suzanne & Darcy re the dose. In the meantime, reduce the dose to 1.75 units until you hear from Suzanne.
 
Bron already tagged @Suzanne & Darcy so I’ll leave it to her to guide you. However, a couple of quick notes:

- I agree with @Bron and Sheba (GA) about the importance of checking ketones frequently given the recent history of DKA and not skipping doses if possible.

- The Libre can sometimes read artificially low so ideally the low numbers need to be checked with a handheld meter, especially before giving honey or syrup if possible. I know you said ears were a no-go… have you tried testing a paw pad?

- Prozinc tends to be more of an “in and out” insulin but sometimes has extended duration. I’ve seen too high of a dose cause numbers to trend lower later into the 12 hour cycle, amongst other things. Again, I’ll defer to Suzanne, but I understand your concern.

There’s a learning curve with Feline Diabetes and throwing DKA into the picture can be even more stressful. Make sure kitty is eating well (at least 1.5 times normal calories as a goal) and drinking well too. The folks around here have years of experience and will try to help you get through this. Please keep posting and let us know how things are going.

[edited to add: To answer your title question re: can glucose drop from 380 to 60 11 hours after Prozinc? Yes]
 
CORKY said:
Ok you need to this, find honey or Karo Syrup or any syrup rub some on his gums,or if yoiu have a syringe with out the needle give 1ml of that if you have high carb between 15-18% give him 1 tsp of that or 2 tsp of medium carb food between 12-15 % test again in 1/2 hour and continue this process until his Numbers,BG gets higher, the syrup is for a quick fix once while you prepare the food, the food, are you feeding wet can food or kibbles, if you are giving kibbles, after the syrup on the gums, give a few kibbles every 15 minutes and retest continue this until the numbers are around 79ish, do not give too much carbs or the opposite will be the result, did his dose change? did you retest before shooting?? Also the Libre does not read low BGs accurately, is probably higher, I am tagging a ProZinc expert right now, in the mean time do the protocol I described, don't worry we are here
@Suzanne & Darcy
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
Click to expand...
Do not use karo syrup or honey unless he has dropped below 50. You can use some medicine carb food and keep scanning the Libre every 30 minutes and move to high carb food if numbers are not stable or rising. All in small amounts like a teaspoon. Also do not panic because the Libre meters read too low in the lower numbers. But you need to gradually keep trying to train him to accept the ear testing because you will find s higher number when you test with a handheld glucometer.
 
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Amy C said:
Update: After second round of honey, up to 104. I won't be giving any insulin this evening and I'm definitely not giving 2 units ever again even with consistent high readings over 350 for 3 days (or until I get a second opinion). I'm terrified of him going back into DKA again because I will not be able to afford it a second time - so I took him in yesterday. That is when the vet increased him to 2 units (also, Ketone check was negative at the vet).
Click to expand...
You need to either be testing for ketones daily using the urine test strips or purchase a blood ketone meter. I used the Nova Max Plus blood ketone meter after my boy survived a DKA and emergency stay of one week.
 
So I would love to try to help you. I need to know what time your shot time is and what is your time zone. I am on Eastern time. I will need some data from your Libre to hopefully help us get started. You have the instructions from Bron about how to set up a spreadsheet. If you have difficulties then let is know because we have people who can set one up for you in a jiffy. We definitely need to know if ketones are present because that can alter our dosing decisions. I will wait to hear from you on some of these things. I will check back with you in the morning.
 
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