? Cat was hypoglycemic last night but hyperglycemic this morning?

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SeiRuka

SeiRuka

Member Since 2022
my family cat Ringo is diabetic takes vetsulin insulin

11 units AM 11 units PM (vet kept increasing dose because he wouldn’t respond)

he’s been at that dose for some time but
My mom said the last few days she started giving him half prescription dry food half fancy feast instead of all dry food

last night blood glucose 57

He was alert but acting a bit more anxious then usual

we rubbed his gums with a bit of glucose and gave him some of his regular diet dry food. It took a couple hours but his values rose to 93 then I took it again an hour later it was 87

I ran out of lancets so I just stopped testing for the night. we bought more lancets this morning and My mom decided to not give him insulin in the morning and at 11am I checked his blood glucose and it’s showed “hi” aka higher than 600

we got scared and him his regular dose of insulin (11 units)

and sent an email to his vet but she’s out of office for the rest of the month :(

We are so stressed

He was given insulin 15 minutes ago when should I check his glucose again

what else should we do we can’t afford an emergency visit right now :(
 
I am new here but I would say it appears the switch to a lower carb diet had an fairly immediate impact and now 11U is way too much insulin for him

diabetic cats on a lower carb diet usually need less insulin so that would make sense. I do not know much about Vetsulin however, we are using glargine.

tagging some members who might be able to offer better guidance and support

@Wendy&Neko

@FrostD

@tiffmaxee

@Diane Tyler's Mom

@Bandit's Mom (might still be up)
 
Hendrick Cuddleclaw said:
you might want to edit your thread title to include 911 or at least a question mark, it helps get attention from the mods and admins and senior members
Click to expand...
Hi how do I edit the title? I press edit but it only lets me edit the post

UPDATE half an hour after insulin he is no longer lethargic he is playing with his favorite toy- crumpled up paper balls. He’s playing more aggressively than usual though could it be anxiety? I will check his glucose again in 30 min and report
 
UPDATE he is still reading as “hi” (above 600) an hour later

still alert a bit not very lethargic but drinking water a lot
 
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High numbers are not a 911, you can take that off now. He's high for two reasons. One was the 57, which unless you are using a pet meter, is a normal blood sugar number. But his body isn't used to it so he's bouncing. Definition of bouncing: Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Second reason for the high numbers is the skipped dose. At 11 units of Vetsulin - which is a huge dose of Vetsulin by the way! - he clearly needs insulin. However as Kyle commented, some of the reason for needing that much insulin was his previous dry food. If he continues to eat wet food, his insulin dose needs will come down quite a bit.

It looks like you are measuring his blood sugars at home, which is great. Would it be possible for you to record those in a spreadsheet (at least the last couple weeks), for us to look at and help you with dosing. Details on how to set up a spreadsheet and other things that help us help you in this post:
New? How You Can Help Us Help You!
 
Wendy&Neko said:
High numbers are not a 911, you can take that off now. He's high for two reasons. One was the 57, which unless you are using a pet meter, is a normal blood sugar number. But his body isn't used to it so he's bouncing. Definition of bouncing: Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Second reason for the high numbers is the skipped dose. At 11 units of Vetsulin - which is a huge dose of Vetsulin by the way! - he clearly needs insulin. However as Kyle commented, some of the reason for needing that much insulin was his previous dry food. If he continues to eat wet food, his insulin dose needs will come down quite a bit.

It looks like you are measuring his blood sugars at home, which is great. Would it be possible for you to record those in a spreadsheet (at least the last couple weeks), for us to look at and help you with dosing. Details on how to set up a spreadsheet and other things that help us help you in this post:
New? How You Can Help Us Help You!
Click to expand...

Hello thanks for the thorough reply, even at very high levels it’s not an emergency?

we use a pet meter

I don’t measure daily because the strips are expensive. I wasn’t aware of the diet change I would’ve measured daily if I knew, my mom doesn’t know how to measure

Even with the high insulin dosage he is usually around high 300s low 400s (pet meter)

he goes to the vet for checkups every 2-3 months for the A1C tests he’s usually high in those too


I suspect it’s that dang hills prescription diet m/d my mom my insists on using because of those vets

he’s also a large boy the vet says his large size might affect his insulin absorption rates

i told my mom to start trying to introduce fancy feast

So for today should we just stick to wet food and measure his blood every few hours and give him his night insulin ? His usual dose is at 7AM and 7 PM. We gave him insulin at 11 AM today so should we give the PM dose a bit later than usual

He indeed is a very good boy! We pinched him 6 times last night and he was still well behaved
 
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How long have you been home testing, and how often? Like Wendy said 11U is a huge dose, so I wonder if he's well past a good dose.

Weight affects dose a bit but I wouldn't expect it to be up to 11U. Has he ever been tested for acromegaly, IAA, or Cushing's? And recent thyroid labs?
 
FrostD said:
How long have you been home testing, and how often? Like Wendy said 11U is a huge dose, so I wonder if he's well past a good dose.

Weight affects dose a bit but I wouldn't expect it to be up to 11U. Has he ever been tested for acromegaly, IAA, or Cushing's? And recent thyroid labs?
Click to expand...

We’ve been checking blood for almost a year but we do it maybe once or twice a week because the pet strips for the pet meter are $50 a box, and is readings stay within the 300-450 range

The past couple weeks I didn’t check because I wasn’t home and my mom can’t do the blood test

He had thyroid labs and they’re normal

my mom brought up Cushings but the vet said he “didn’t fit the profile” of a cat with cushings

his walks on his heels awkwardly (the vet said it’s because of the diabetes)

Could his high dose requirement be because of his dry food diet? Would gradually switching to 100% fancy feast improve his symptoms and lower his dosage requirement ?
 
Ok most of us use regular human meters because they're much cheaper and still get the job done. A lot of us use WalMart's ReliOn brand.

Unfortunately once or twice a week doesn't tell us anything about dose or how low it has been taking him other than what you caught today. Are you able to get a human meter and start checking more regularly? I'm concerned he may be overdosed...though I suspect at this point if he was that overdosed for too long he'd be gone.

Given the 57 you do need to reduce to at least 10U, but I cannot say if even that dose is safe. (EDIT: after reading Wendy's post I realize this could be misinterpreted - I mean the new dose should not be more than 10U, but she is right you likely need a bigger reduction)

I would recommend a thyroid check, and also an acromegaly test. IAA as well if you're in the US or Canada.

We always recommend a low carb diet for our cats, but that is not safe to do at the moment until you can regularly test
 
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Since you did give insulin again today, what dose did you give? I'd test 4 hours after the shot time to start. You might need to skip again tonight to get back on schedule tomorrow.

I remember one cat here years ago. The member had adopted him when his previous owner could no longer care for him. He was huge and on all dry prescription food and 13 units of insulin. He was eating so much food cause that was the only way he could stay safe with that large dose. The new caregiver switched him to wet food, and he ended up on something like 1-2 units of insulin, and a lot smaller. That's the most extreme story I've seen, but yes, there have been others that have gone to way smaller doses or even off insulin when put on a species appropriate diet. So yes, food can make a huge difference. That also means you should not switch food all at once if you are only testing a few times a week. If if you were testing more frequently we'd only get you to change maybe 10% at once. That 57 on an AT means 11 units is too much insulin - we don't want them going below 68 on the AT. And if on dry food, not below 90. I would drop a lot more than 1 unit, depending on what the food percent is of wet and dry.

Next step, go out and buy a human meter than needs a small drop of blood and has much cheaper test strips. In the US a number of people use the Relion meters from Walmart, but there are others.

A bit of reading for you:
New? How You Can Help Us Help You!
 
FrostD said:
Ok most of us use regular human meters because they're much cheaper and still get the job done. A lot of us use WalMart's ReliOn brand.

Unfortunately once or twice a week doesn't tell us anything about dose or how low it has been taking him other than what you caught today. Are you able to get a human meter and start checking more regularly? I'm concerned he may be overdosed...though I suspect at this point if he was that overdosed for too long he'd be gone.

Given the 57 you do need to reduce to at least 10U, but I cannot say if even that dose is safe. (EDIT: after reading Wendy's post I realize this could be misinterpreted - I mean the new dose should not be more than 10U, but she is right you likely need a bigger reduction)

I would recommend a thyroid check, and also an acromegaly test. IAA as well if you're in the US or Canada.

We always recommend a low carb diet for our cats, but that is not safe to do at the moment until you can regularly test
Click to expand...

we didn’t use the human ones because we read they aren’t as accurate but if you recommend it I’ll buy one and compare readings, is the relion classic a good meter?

he had his thyroid checked and it’s normal he also had a test that my mom forgot the name of but I googled acromegaly and it sounds like what she described. He tested negative for that too.

what are the ideal times to check blood?

his current reading is 83 so it went down a few hours after his regular insulin. We are waiting on a call back from the vet but even if we don’t get the call we won’t give him insulin tonight just to be safe and I’ll check his blood every couple hours to make sure it doesn’t go to down to dangerous levels.
 
The majority of us here use human meters, and our dosing methods were written primarily around the human meters (we do have some provisions for the pet meters). ReliOn Classic is good, but I believe discontinued? You may have a hard time getting strips. I think the Premier is the latest one

I don't think you said when he was diagnosed, but the acromegaly test has an incidence rate of false negatives if done before 73 days on insulin. So we recommend waiting til they've been on insulin at least 73 days.

Yes, with limited data we only shoot if above 200...but right now we don't know just how overdosed he is so that's not necessarily a reliable cutoff. I will let @Wendy&Neko advise on dose because this is outside my comfort zone. I suspect she will want to know how much of each food he is currently getting, and at what times.
 
Do you have a spreadsheet set up…I can’t see one. Instructions can be found in the link about Wendy gave you in post 12.
If you need help with the SS @Bandit's Mom can help you.
To be really able to help with dosing we need to see the data on a spreadsheet.
Also the human meter is perfectly ok to use. Before the advent of the pet meter, all vets used the human meters. Now they push the pet meter which is very expensive to run. Our dosing methods are based on the human meters.
 
Wendy&Neko said:
Since you did give insulin again today, what dose did you give? I'd test 4 hours after the shot time to start. You might need to skip again tonight to get back on schedule tomorrow.

I remember one cat here years ago. The member had adopted him when his previous owner could no longer care for him. He was huge and on all dry prescription food and 13 units of insulin. He was eating so much food cause that was the only way he could stay safe with that large dose. The new caregiver switched him to wet food, and he ended up on something like 1-2 units of insulin, and a lot smaller. That's the most extreme story I've seen, but yes, there have been others that have gone to way smaller doses or even off insulin when put on a species appropriate diet. So yes, food can make a huge difference. That also means you should not switch food all at once if you are only testing a few times a week. If if you were testing more frequently we'd only get you to change maybe 10% at once. That 57 on an AT means 11 units is too much insulin - we don't want them going below 68 on the AT. And if on dry food, not below 90. I would drop a lot more than 1 unit, depending on what the food percent is of wet and dry.

Next step, go out and buy a human meter than needs a small drop of blood and has much cheaper test strips. In the US a number of people use the Relion meters from Walmart, but there are others.

A bit of reading for you:
New? How You Can Help Us Help You!
Click to expand...

We gave him his regular 11U dose

checked blood four hours later and he is at 83

we are waiting on a call back from the vet but even if we don’t get the call we will skip the insulin tonight

I’ll check his blood again in a few hours to make sure it’s not going down too much

what times would be optimal for me to check blood?

Do the human glucometer readings have to be converted or are they similar to the pet meter readings?

thanks for all the help so far
 
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SeiRuka said:
We gave him his regular 11U dose
Click to expand...
With the drop to 57 you needed to reduce the dose to at least 10 units, otherwise you are risking a hypo. When using a pet meter you must reduce the dose if it drops under 68

SeiRuka said:
what times would be optimal for me to check blood?
Click to expand...
With vetsulin I would test at +2 and +4 and +6

Are you testing then feeding and then waiting 30 minutes before giving the dose of insulin ?
 
SeiRuka said:
he also had a test that my mom forgot the name of but I googled acromegaly and it sounds like what she described. He tested negative for that too.
Click to expand...
Since you paid for blood test results, you should be able to get a paper or emailed copy of that. That will tell you the name of the test and the value. We've found some vets read the numbers wrong on that test.
 
Bron and Sheba (GA) said:
With the drop to 57 you needed to reduce the dose to at least 10 units, otherwise you are risking a hypo. When using a pet meter you must reduce the dose if it drops under 68


With vetsulin I would test at +2 and +4 and +6

Are you testing then feeding and then waiting 30 minutes before giving the dose of insulin ?
Click to expand...

Yes we wait the 30 min. do those numbers mean 2 hours after feeding, 4 hours after and 6 hours after?

Last night we didn't give him insulin, we fed him his portion of dry food (about 1/2 cup) tested him before bed and he was 198. In the morning we tested him before feeding and it was Hi (over 600), we fed him his dry food just in case then waited and gave him 10U. Tested him 4 hours later it was 207.

I'll try to figure out how to do a curve this week
 
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Wendy&Neko said:
Since you are using Vetsulin, you actually reduce the dose any time you see a number under 90. Tomorrow shoot no more than 10 units.
Click to expand...
Last night we didn't give him insulin, we fed him his portion of dry food (about 1/4 cup) tested him a few hours later before bed and he was 198. In the morning we tested him before feeding and it was Hi (over 600), we fed him his dry food just in case then waited 30 min and gave him 10U. Tested him 4 hours later it was 207.
 
We appreciate all your guy's help so far, thanks so much
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SeiRuka said:
Yes we wait the 30 min. do those numbers mean 2 hours after feeding, 4 hours after and 6 hours after?
Click to expand...
+2 means 2 hours after giving Ringo his insulin ,+4 and +6 the same
You only withhold feeding him 2 hours before AMPS ( the first test in the AM) Same goes for PMPS because you don't want the reading to be food influenced, then you can just feed him through the day
AMPS - means AM Pre Shot
PMPS - means PM Pre Shot
Ringo's a handsome dude :cat:
You can add Ringo's pic where you have SeiRuka,go to the top of your name and tap on it ,a drop down will appear ,tap on Avatar and add his pic

It would really be helpful if you can fill out your signature, it's at the end of everyone's post in gray, information about our kitties
Here is the link tap on your name above and a drop down comes up tap on signature, add info
Also if you can create your spreadsheet , it explains how to do it and how it works in the blue link helping us to help you
If you have trouble setting it up just ask, we have a member who will do it for you

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
  • 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)
    • 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.
 
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SeiRuka said:
we didn’t use the human ones because we read they aren’t as accurate but if you recommend it I’ll buy one and compare readings, is the relion classic a good meter?
Click to expand...
Nothing wrong using a human meter , almost all of us use one.
They read lower than the pet meters,
You said above
We’ve been checking blood for almost a year but we do it maybe once or twice a week because the pet strips for the pet meter are $50 a box, and is readings stay within the 300-450 range

You need to be testing Ringo much more during both 12 hour cycles
Yes $50 for the pet strips will kill you
If you live in the US go buy the Relion Premier Classic at Walmart it's 9 dollars
17.88 for 100 test strips
If you do switch to the Relion please post that you are going to and we can explain the numbers when using a human meter
 
SeiRuka said:
Last night we didn't give him insulin, we fed him his portion of dry food (about 1/4 cup) tested him a few hours later before bed and he was 198. In the morning we tested him before feeding and it was Hi (over 600), we fed him his dry food just in case then waited 30 min and gave him 10U. Tested him 4 hours later it was 207.
Click to expand...
That sounds ok for now, but he is likely bouncing from the low numbers (meaning his BG may stay high for a few cycles and then come back down). So please continue to keep a close eye on him and test
 
Diane Tyler's Mom said:
+2 means 2 hours after giving Ringo his insulin ,+4 and +6 the same
You only withhold feeding him 2 hours before AMPS ( the first test in the AM) Same goes for PMPS because you don't want the reading to be food influenced, then you can just feed him through the day
AMPS - means AM Pre Shot
PMPS - means PM Pre Shot
Ringo's a handsome dude :cat:
You can add Ringo's pic where you have SeiRuka,go to the top of your name and tap on it ,a drop down will appear ,tap on Avatar and add his pic

It would really be helpful if you can fill out your signature, it's at the end of everyone's post in gray, information about our kitties
Here is the link tap on your name above and a drop down comes up tap on signature, add info
Also if you can create your spreadsheet , it explains how to do it and how it works in the blue link helping us to help you
If you have trouble setting it up just ask, we have a member who will do it for you

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
  • 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)
    • 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.
Click to expand...
thanks, I added a signature! I also made a sheet and tested him as much as I could on Sunday. Saturday morning I wasn't able to get a reading AMPS because my mom said she would do it but wasn't able to and gave him insulin anyway...she only gave him a half dose though and I tested him a few hours after. The vet office didn't return any of our calls yet...so instead of his steady 11U twice a day we've been kind of flip flopping between 5U and 7U, his sugar levels are more stable now compared to thursday (but high). We are currently only giving him his dry food. My mom gives him 1/2 cup AM and 1/2 cup PM, he doesn't eat it all at once. I think it might be too much food but his weight has been stable and healthy according to the vet. After the hypo scare i'm worried about how I will transition to wet food. I don't know if we should wait until his vet is back in office (may 2) before switching up his diet, because the other vets don't care enough to return our calls.

spreadsheet- https://docs.google.com/spreadsheets/d/1Y2vxTRhaRcSYOt78Ml8ovMtE7KXpJgviDsDUCqk-oVw/edit?usp=sharing
 
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