Can't get his BG raised

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mialia

mialia

Member Since 2018
I'm not really worried. He's eating, not showing symptoms, it's stable, but what the heck.

Quick history. DX about 5 months ago. Put on vetsulin. His BG was consistently High (read "HI" on meter quite often). No matter what we did, couldn't get it down. Took him to a new vet about 2 weeks ago. New vet did a full BG curve and ran multiple tests over 3 days. Found he only responded to Lantus and had something wrong with his kidney but not sure what.

We put him on a plethora of drugs (see his sheet) and I drove to Mexico and got Lantus. Saw an immediate improvement. Started getting good results, gaining weight, better energy. He was at 2.5 post vet, and with the vets guidance after two weeks he's at 1.5 IU twice a day.

I just came home from being gone two days (roomie (type 1) takes care of him when I'm gone) and his pre dinner BG was 43. So I gave him insulin, per doc and the Lantus ISG here, and fed him. He ate well but his legs were kinda shaking. I took his BG again in 30. Basically same. Gave him syrup - 1 ml and some Tempations. Repeated in 30. Still low but 60. Waited 30, back to 53. (I may have the exact details wrong, but to sum up, over 4 hours now he hasn't gone above 60. 7mL of syrup syringed down his wittle throat, temptations, and some chicken and shrimp (pure). I'll test again in 15. )

Why won't it go up?

There are a million variables here. He's been slowly finishing his various medications. Only on one now. (Besides insulin) He's new to Lantus still. The vet gave him dietetic food, and yes I know all about it, but we used it (he crashed the one day I didn't give it to him after he returned) so just to keep all things the same as much as possible, we used it til it ran out. It ran out yesterday so from yesterday to today we went from the higher carb dietetic to fancy feast again, stopped his Omeprezole, and all the other changes recently. It's a lot of variables. Frustrated that he's staying low. The amount of sugar / tempatations is nearly triple what I gave him when he crashed on Vetsulin, and that rose him to over 500...

I needed to be in bed 3 hours ago but am staying up until I get some good readings.

(Also anyone in palm springs looking for a roomie? My amazing cat nurse of a roomie is moving so I need a new one! Super cheap rent in exchange for help!)
 
Sadly, no. I THOUGHT the Sheba was that, but turns out, it's low carb! It's 1 am here, and just checked all the stores. I'll get him through this and resupply in the morning.
 
Looks like you will test in about 10 minutes right? I'm glad you are staying up. The syrup can wear off and Carbon could drop low again.
Just checking, Is the food you have on hand all low carb?
 
45. Four and a half hours later. I just did the ml to tbsp math and I haven't even given him a full tbsp of syrup yet, so there's that. I just gave him 3ml of honey.

The Sheba and Fancy feast is all 2-3 per the chart. he's eating some leftover pro plan dietetic dry food, which is 18% allegedly.

He's my best friend. I will stay up all night to see he's ok if I must. This is so weird though...

Come morning, do I reduce his insulin?

At each syrup feeding I'm giving him protein as well - sheba or chicken and shrimp dishes.
 
Go ahead and give him some of that 18% dry food with honey. We want to get him up above 50. Try not to fill him up too much though.
You'll have to test again in 20 or 30 minutes
 
He's a bit lethargic, but I've also kept him up for hours with this testing (I let him nap between of course but he's up with me every 30 minutes and I'm constantly checking on him). The only symptom I saw was the slight trembling earlier.
 
Ok, that's more like it! Could be the combo of 18% food & honey.
Can you tell me where we are in the cycle now/ how long ago was the PM shot?
 
Yep, I'm in Seattle watching the snow fall, I'm originally from LA so it's pretty magical to me! That's the only reason I was still up. I thought I'd check the board before I went to bed.

Okay, so the thing is after an event like this, we want to make sure Carbon's numbers will raise up on their own without the influence of the honey and/or the 18% dry food.
I would not feed him anything else right now (unless it's strictly low carb -if he's hungry) and test in an hour. We need to see two consecutive tests that show his BG is either holding or rising. Does that make sense?
 
It does. I'll test in an hour. He didn't eat anything else this round - I offered him his low carb food and he just blinked at me wondering if I'd lost my mind, feeding him AGAIN. I live in Palm Springs, based in Seattle, so I feel you!
 
Looking at Carbons SS I can see several places where you have not taken reductions when the BSL has dropped below 50..
It is really important if his BSL drops under 50 that you decrease the dose. Otherwise you are risking him dropping into hypo territory and having trouble getting him out of it.
This morning when he dropped to 43 at +11 it looks like you didn't test again beforehand giving him insulin. And you didn't reduce the dose down to 1.25 units.
Please, please ALWAYS test before EVERY preshot. And ALWAYS take a reduction in dose when he drops below 50.

Also when you get a low number such as numbers in the 40 s or 50s or 60s please ALWAYS test again to see the numbers are rising. If they are in the 40s you need to be giving some high carb food and/or honey to bring the numbers up over 50....then testing again in 30 minutes to see the numbers are rising.
 
I tested pre shot, but I might be filling out the SS wrong. He wasn't tested this morning. My roommate doesn't test and I travel for a living. In fact, she's moving out so I'm going to be looking for a new roommate who will be more comfortable with testing. Even considering moving to my base (seattle) or portland to do so, as finding roommates without these strings attached is tough in palm springs.

The vet asked we stay on the same dose because of all the other variables (meds, diet, etc) but sounds like that was wrong. I did only do 1.25 this last round, marked the SS wrong. (fixed now). I also retest when he's low. I need to be more diligent about the chart, that is becoming clear. So +11 is where I put preshot... Uh.. I just realized that PMPS means preshot huh? Outside of a cockpit, I'm pretty dumb. All the +11 are preshot...

So much to learn... at least this is easier to fix stuff.
 
Barbara & Uncle (GA) said:
Looks like the switch to Lantus is a good thing for Carbon.
You will get a lot of good feedback and info if you post over on the Lantus/ Blasagar & Levemir Forum in the future :bighug:
Click to expand...
That's a great suggestion Barbara.!
If I were you I would start posting over on the Lantus page tomorrow. They will help you get sorted. It is a lot to remember and learn in the beginning but we will help you to keep Carbon safe.
 
Barbara & Uncle (GA) said:
Looks like the switch to Lantus is a good thing for Carbon.
You will get a lot of good feedback and info if you post over on the Lantus/ Blasagar & Levemir Forum in the future :bighug:
Click to expand...

will do! The lantus has been night and day! I imagine the kidney treatment didn't hurt. It took 2-3 days to get the lantus and he was already seeming much better on the antibiotics etc. I was SO frustrated before that. Nothing made sense. Now it's making a bit more sense but it's still a steep learning curve. My type 1 roommate can regularly be heard chortling when I say things like, "Oh, well surely his BG will do this" or "This must be causing his BG to do that". She's had ten years to learn that there is no X therefore Y in diabetes.
 
Bron and Sheba said:
That's a great suggestion Barbara.!
If I were you I would start posting over on the Lantus page tomorrow. They will help you get sorted. It is a lot to remember and learn in the beginning but we will help you to keep Carbon safe.
Click to expand...
That's for sure!!! I kept sanity (mostly) and my cat alive with friends like Bron at that forum.
 
mialia said:
I tested pre shot, but I might be filling out the SS wrong. He wasn't tested this morning. My roommate doesn't test and I travel for a living. In fact, she's moving out so I'm going to be looking for a new roommate who will be more comfortable with testing. Even considering moving to my base (seattle) or portland to do so, as finding roommates without these strings attached is tough in palm springs.

The vet asked we stay on the same dose because of all the other variables (meds, diet, etc) but sounds like that was wrong. I did only do 1.25 this last round, marked the SS wrong. (fixed now). I also retest when he's low. I need to be more diligent about the chart, that is becoming clear. So +11 is where I put preshot... Uh.. I just realized that PMPS means preshot huh? Outside of a cockpit, I'm pretty dumb. All the +11 are preshot...

So much to learn... at least this is easier to fix stuff.
Click to expand...
You are not dumb at all. There is a lot to learn. And you have come to the best possible place to learn all about FD..
Your vet is wrong..if the BSL drops below 50 it is extremely important that the dose is dropped otherwise you risk a serious hypo....
Try and always keep the SS up to date and correct as we always look at it when we help you. I know it can be hard at times.
Also make sure you have some high carb food in the house always along with some honey or Karo.
 
Barbara & Uncle (GA) said:
That's for sure!!! I kept sanity (mostly) and my cat alive with friends like Bron at that forum.
Click to expand...
Since the day he was diagnosed, this board has helped me keep my sanity (mostly is generous in my case. I've had more than one breakdown). I'll head to Lantus forums tomorrow. I started reading the absolutely incredible Lantus doc the other day. I'm in training right now so time is very limited - prioritizing my cat in balance with lives in the back isn't simply.

Since it was 1.25 with this low, should I go 1.00?

I already have the grocery list ready. The syrup didn't work (it was maple... I must have read the instructions wrong and had that in my emergency kit) but I have tons of honey. I'll get karo and replenish the high carb food tomorrow. I got careless given that he was ALWAYS HIGH. Like super high, for so long.

I last fed him at 1.5 hours ago - high carb dry food. He didn't eat much. Plus the honey. And at about 2 hours ago he ate some syrup (maple) and low carb high protein food and some tempations.
 
mialia said:
The lantus has been night and day! I imagine the kidney treatment didn't hurt. It took 2-3 days to get the lantus and he was already seeming much better on the antibiotics etc.
Click to expand...
Yeah, sometimes when there is an underlying infection or other health issues (even constipation) it can keep the numbers higher.
 
253. Here's the bounce. Despite tonight, I feel hopeful. He's responding predictably to insulin, he's gained weight over the last two weeks. His personality is returning. He's obviously not feeling well tonight, but he survived to try again tomorrow.
 
mialia said:
Since the day he was diagnosed, this board has helped me keep my sanity (mostly is generous in my case. I've had more than one breakdown). I'll head to Lantus forums tomorrow. I started reading the absolutely incredible Lantus doc the other day. I'm in training right now so time is very limited - prioritizing my cat in balance with lives in the back isn't simply.

Since it was 1.25 with this low, should I go 1.00?

I already have the grocery list ready. The syrup didn't work (it was maple... I must have read the instructions wrong and had that in my emergency kit) but I have tons of honey. I'll get karo and replenish the high carb food tomorrow. I got careless given that he was ALWAYS HIGH. Like super high, for so long.

I last fed him at 1.5 hours ago - high carb dry food. He didn't eat much. Plus the honey. And at about 2 hours ago he ate some syrup (maple) and low carb high protein food and some tempations.
Click to expand...
Are you feeding low carb food or dry food?
Do you work during the day? Can you test during the day?
Normally I would say to stick with the 1.25 units because the depot from the 1.5 is still playing out with the numbers. But because you have not taken several reduction lately when they were due, the depot could be overfull so I think it might be a good idea to go down to 1 unit and see how he goes.
So give 1 unit each dose and see how he goes.
Test before all shots and try and get a test inbetween.
Take a deep breath. You are doing ok.. we will help you get sorted:)
253... so he is bouncing. That could last for up to 6 cycles....or as little as one. Stay with the 1 unit and see how he goes.
See you over on the Lantus forum tomorrow..
 
mialia said:
his pre dinner BG was 43
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ETA:
This is definitely not a scold, but I want you to know that even the most experienced don't give insulin with a reading under 50
50 is a great number to eventually shoot if you are following the TR Protocol to a T, but you have to have to enough data collected and the ability to test to know that it will be safe to do so:bighug::cat:
 
Are you feeding low carb food or dry food? Low carb wet food
Do you work during the day? Can you test during the day? I fly for a living, I'm gone for days in a row. I have a type 1 roommate but she doesn't like testing and she's moving. I'm currently searching for a new roommate to help me. (I was in a stable relationship with my cats but he decided that while I was gone, he didn't like our bed empty. So now I'm a cat mom with a tough cat mom schedule and little support)

Thank you for all the help! I can't tell you how much it means to not be alone in this.

ALso, didn't take it as a scold. With my first vet, he basically handed me some vetsulin and waved me off. The second vet has been better but not super great. I won't give it again if he gets that low.
 
Yes I can see it must be hard for you at times when you have to fly and there is no one to look after the cats.
As @Barbara & Uncle (GA) suggested, I think you should look at the 'START Low Go Slow' method for Carbon because of your circumstances at the moment. So when you have time, have a look at the yellow sticky at the top of the Lantus page that tells you about SLGS.
Carbon is responding very well to the Lantus....too well at times.....so you can be very hopeful it can all be sorted out.
See you tomorrow
 
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