Cat's dropped down to 40, please advise!

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Jennifer and Spot (GA)

Jennifer and Spot (GA)

Member Since 2012
he was 270 this morning, now my husband tested him and said he's at 40. (he tested that number twice, first time it was 44). I told him to give the cat food. Is that all we can do?

Jennifer
 
You are going what to keep testing about every 15-30 mins to make sure he isn't dropping any lower. How long after the shot did you get the 40?

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
we give the shot in the AM at 7:30 and he was high then, at like 277 (haven't entered in his chart yet, sorry). I am at work but my husband just tested him around 12:30. He says Spot's acting ok.
 
Just have him keep checking him, the food should bring him up but he needs to test to make sure. if he keeps falling or starts acting like he is going into hypo then your husband is going to want to give him a little bit of Karo syrup, just a tiny tiny bit, like just enough to rub on his tongue. The karo will take him up fast but it won't last the best thing is food to get the numbers up and stay up

Mel, Maxwell, Musette, Autumn and The Fur Gang
 
Well with that 40 Spot has definitely earned a dose reduction. :-D

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
Jennifer,
This is going to be okay. I know the hardest part is that you are at work and not there with Spot. Has your husband been able to test him again? Can you find out how much food Spot ate, and what kind?
Was the dose this morning .75?

Carl
 
Try not to panic. I know easy for me to say.

Do you have any high carb food, maybe the gravy type on hand. Because if you have to feed, you don't want to overstuff him, so giving him a couple spoons of gravy to lick with keep him going without overstuffing.
 
OK. Looking safe, now.

Did anything happen to reduce appetitite? Furrballs, vomiting, diarrhea, other?

If not, dose reduction looks like a good idea - a 0.25 decrease, down to 0.5 units.

You may wind up with a diet-controlled diabetic!
 
MommaOfMuse said:
Well with that 40 Spot has definitely earned a dose reduction. :-D

Mel, Maxwell, Musette, Autumn & The Fur Gang
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Jennifer,
As Mel said, this means he should get less insulin for tonight's shot. I think the standard reduction is ".25u", so that would mean tonight his new normal dose would be .5. At least as far as I understand this...

Carl
 
BJM - Spot's appetite did not decrease. He's always hungry and always eats.

He seems so skinny he does not seem well enough to be getting regular, plus his numbers are bouncing around. He was over 400 last night at 7:30, and now this. We have not been messing with his amt of insulin, giving him .75u 12 hrs apart. He gets food about 4 times a day, but main meals are morning and at 7:30 pm.

Any ideas why this is happening?
 
hi jennifer! got your pm - yes, you should decrease his dose by .25units.

the reason this is happening is because spot is responding to the insulin. it's a great thing. newly diagnosed cats are the easiest to work off of insulin - and every time he goes below 50, he gets a dose decrease of .25u.

from my perspective he's doing exactly what he should be doing and this is awesome.

your husband can stop carbing him now!

switching insulins isn't your solution. any insulin can take them low.
 
btw, just a reminder that it will help even out his curve if you get most of his calories (ie, carbs) into him in the time between getting his shot and 4 hours later. then the insulin is the strongest when the carbs are there.

spot eating at +6, +7 and +9 are likely contributing to the high numbers in the second half of the cycle.

so your new dose tonight is .5u. there are pictures on the "new to the group" sticky at the top of the Lantus TR support group if you don't have syringes that are marked.
 
Hi Jennifer-
Great catch today!

When you have a chance to look at your ss, you will see something like this:
4/27 am 95 no shot
Spot stays in higher numbers after that for 4 cycles

4/29 am 141 (likely on the rise from lower numbers over night)
Spot stays high for 3.5 cycles

4/30 pm midcycle test you find a 95
Spot stays high 2.5 cycles

5/2 Spot throws you a 40

Do you see the pattern? So if we try to fill in the blanks as to what we might see tonight, my guess is high numbers. The neat thing is it looks like bounces are getting shorter! :mrgreen: Eventually they will even out. But you have to give his body time to get used to lower numbers in order to do that. I know you wish it could happen quickly (we all do!). But it is Spot's body. We can help him along the best we know how. The rest is up to his make up/chemistry. We can't change that.

And yes, a 40 is a reduction of .25u

Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

This is all good stuff! Glad your husband was home to keep him safe. Make sure you give them both a hi five or hug when you get home. They did good!!!
 
My husband thinks it was low because he just opened a new can of ReliOn strips, said maybe it's the strips. I said I didn't think so.

We will give him .50 tonight.
 
it is true that sometimes you will get a wacky strip. one time i got a 30something on punkin, started to run for the high carbs, stopped and realized that i had expected a 200+ number so i'd better recheck. second strip was 200 something.

when you see something unexpected, it is good to recheck. i suspect in this case, though, because your husband caught rising numbers after that, that the strip was correct.
 
Plus, he did retest the 40 and got a 44, right? So it would have to be two bad strips in a row, and the odds on that are much lower seeing as how the test after that gave him a number that makes logical sense.
Carl
 
Those big dives are scary! Mikey did that when he was first on insulin, and he did it much earlier in his cycle than Spot. If you look at his spreadsheet, in the beginning he was dropping from the 200's to as low as the 40's within 2 hours (the only reason some cycles don't go lower is that he got lots of gravy or other carbs to stop the diving). He didn't stop until after several dose reductions. He didn't settle in until he was on just .1U (not saying spot will need this small an amount, it is kind of unusual for a dose to be THAT low from the get-go) and his curves flattened out. But even at that amount he'd still drop into normal range and then bounce. We increased a little in February, he did a bit better. As his body got used to the lower numbers, the bounces have gotten much better...he still bounces, but now only into the mid-upper 100's most times. He earned a reduction kind of by accident in March and now his numbers are getting better with every passing day. He can still dip low, and when he does, he still bounces a little, but he's looking more and more like a cat who wants (ANTI-JINX!!!!!!!)to be done with insulin altogether.

I've been in your shoes, and it IS scary and emptional. I wanted to switch to Levemir too, and I won't say that it isn't the right choice for you (ECID!!), and I was pretty sure I could never follow the tight regulation protocol, but with each passing day it gets easier and I'm glad we stayed the course. Even if Mikey never goes off the juice, he is a happy, healthy insulin-dependent diabetic. Spot can get there too, but it takes time. It's been almost six months for us; others go longer and don't go OTJ but have cats doing just fine on insulin with a dose that works for them. We've also had cats go OTJ after over a year of doing this crazy dance! Just remember, Spot is the one leading, and if you go with him, it will get easier each day!
 
You might invite your husband to come over here, do some reading, and get to know the board. He might develop some better understanding that way.
 
the other thing to keep in mind (and let your husband know) - lantus dosing is based upon the lowest numbers in a cycle. it's not that the highs don't matter, but the lows determine the dose.
 
My husband Bob got a call back from the vet, 3 hrs after he called him, and he said we shouldn't be giving insulin to Spot tonight, and he wanted us to take him in on Saturday at 8 AM and they will run a Fructosamine test every two hours. Ack, I can imagine how much that will cost. Guys/Gals, is this necessary? Bob is not pressuring me to go along with it, just told me what the vet said. He also said that the cat should only eat at breakfast and dinner, no eating in-between, 1/2 can of cat food (of course, Purina DM, which Spot won't eat) per meal. That is not very much food, he is skin and bones as it is!

So...is this more bad vet advice? I think it is, but being still new at this, would appreciate your input.

Bob does get on the board here but isn't as, um, nutty about it as I am. Some people really don't like being on computers that much. Remember though, he is the one testing Spot while I'm at work, and he gives Spotty the shots (while I help hold him).

Jennifer
 
No Spot doesn't need to go to the vet for a Fructosamine test, you are testing at home that is going to give you truer numbers than anything. Yes, you do what to give him insulin tonight as he is going to bounce off that 40 today and he will need the insulin to help pull down those numbers. Yes, he needs to eat, and he needs to eat more often than twice a day, especially right now while he is so thin and it also helps to smooth out his curves. There are lots of times that I see Musette heading down too fast and I will give her a snack to prevent her from going too low in the first place. Also I just adopted Lulu, who we renamed Autumn she was untreated for 10+ months, she is literally, skin, fur & bones. I'm free feeding her LC canned so that she can put weight back on.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
ammonzon said:
My husband Bob got a call back from the vet, 3 hrs after he called him, and he said we shouldn't be giving insulin to Spot tonight, and he wanted us to take him in on Saturday at 8 AM and they will run a Fructosamine test every two hours. Ack, I can imagine how much that will cost. Guys/Gals, is this necessary? Bob is not pressuring me to go along with it, just told me what the vet said. He also said that the cat should only eat at breakfast and dinner, no eating in-between, 1/2 can of cat food (of course, Purina DM, which Spot won't eat) per meal. That is not very much food, he is skin and bones as it is!

So...is this more bad vet advice? I think it is, but being still new at this, would appreciate your input.

Bob does get on the board here but isn't as, um, nutty about it as I am. Some people really don't like being on computers that much. Remember though, he is the one testing Spot while I'm at work, and he gives Spotty the shots (while I help hold him).

Jennifer
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Jennifer,
This is just more evidence that the vet just doesn't understand how Lantus works. Spot should be getting less insulin, but not no insulin tonight. About the "fruct" test.... The vet might want to run a curve checking BG every 2 hours, but he wouldn't run a fruct test every two hours. A fruct test will tell him what Spot's average BG has been over the course of the past couple of weeks. If he needs to know that, just email or link him to your spread sheet, and he can look at all the numbers and do the math himself. You already have all the BG data so paying for a needless test will just be money out of your pocket and into his.

As far as the food goes.....again, the vet doesn't understand how Lantus or any other insulin works, or how important food is to a diabetic (cat, dog or human). Ask any human diabetic how many times they eat each day. I think I would just use the vet for vaccines and yearly checkups, or to get a prescription when you need one for Spot. Other than that, you can learn more than he knows about feline diabetes by googling "feline diabetes".... Maybe share that with him too!
Actually, I'm pretty sure you already know more about FD than he does.

How much does Spot weigh? If he weighs more than 9 pounds (ideally, not right now), then one can of DM a day isn't enough food, period. Geez, all he has to do is go to the search box on the top of the screen and type in "How many calories does an adult cat need each day".....
http://www.ehow.com/facts_5219083_much-cat-need-per-day_.html
Answer:Calories Count
Adult cats need 20 to 30 calories per pound of body weight a day.
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And that is for a perfectly healthy cat, not one that needs more calories because he's diabetic.

I understand your husband wants to have faith in the guy you are paying to help you with Spot. And so do you. But sorry, I don't think you're getting your money's worth with that one. I would ask him one simple question - "what percentage of diabetic cats under your care have gone into remission?"

Carl
 
I agree, we will not be taking Spot in for that.

What a mess though. I still haven't entered his numbers, but ya know how he was 40 this morning? Now add a zero after that. Actually it's higher than that. We still just gave him .5 of insulin.
 
That really isn't surprising since he bounced off that low and the added carbs from feeding him to get his numbers up. Just hold the .5u and let him settle into that unless of course he decides to give you another super low number. Allow up to 3 days for that bounce to clear.

Mel, Maxwell, Musette, Autumn & The Fur Gang
 
ok, Mel, that's what we'll do.

I am going to make this a new post, but lately he's been so bad about getting a shot. He gets upset and we haven't even done it. Today and yesterday both he yowled like we were killing him and we were just finding where to give it. He seems to have very little fat to pull, he's kind of bony. :cry:
 
I shoot while my cat is eating, as soon as I see he's eaten enough to safely have insulin. He's so busy with his face in the bowl that he doesn't even notice the shot. I test him, feed everybody, then shoot while he's still eating.

Mikey was very underweight when he was diagnosed, and he eats about 4 cans of Fancy Feast (or the equivalent amount of another food) daily. He gets a whole can at shot time, another half at +1 and one more at +2 because he hits nadir early. You could spread it to shot time, +2 and +4. Mikey has steadily gained weight on that. If your cat will eat that much and is underweight, you could go to 6 cans (18 oz) split up into six to eight meals a day. Some cats here have eaten as much as 20 oz. or more of LC canned food a day while they were becoming regulated...remember, they can't get all the nutrients out of food when they're unregulated.

Good on you for shooting the .5U tonight...now the hard part is being patient enough to wait 3-5 days for it to settle! With a big bounce, it may take the full five days to see what the new dose is really doing for Spot, so try not to worry too much if he stays high the first couple of cycles from the bounce!
 
We were also trying to shoot when he was eating, but that also did not go well. Very unhappy. I'm wondering if we're giving the shot wrong. All the cats on the videos are so easy-going. Spot's not!
 
Make sure you are pulling up a tent of skin and shooting into the tent. It should slightly 'pop', then glide in easily. If you are hitting muscle, that will hurt more.

What size syringes are you using? The smallest u-100 syringes are 5/16" long needles, 30 gauge or higher (thinest I've seen is 33), 3/10 cc (or mL - same thing).
 
i completely agree with the advice you've been given in the past few posts, jennifer. the vet is probably planning on running a curve, meaning checking BGs every couple of hours for the day. you're already doing that.

i wouldn't feed a diabetic cat less than 4 times a day, i would just try to keepa majority of the carbs/food in the first few hours after the shot so that the carbs are there when the insulin is most potent. many cats graze and are ok with it, but many have better BGs if the carbs are there in the first half of the cycle. if spot is bony, he needs to gain weight, not be overly restricted. lean is good, bony is not.

a 400 isn't a surprise after hitting a 40. that's not a bad thing, just part of this Sugar Dance. spot will come down from the 400, although sometimes a cat will take as long as 3 days to come down. so if you see high numbers for that long, just know his liver is doing the right thing and working fine to keep spot alive. it will resolve and then we can help you re-evaluate the dose and decide if it needs adjusting.

a good answer to your vet is "i can't afford to come in this week, he seems to be doing ok now. i've reduced his dose so he's safe & i'm going to wait a little longer." he works for you and spot is your cat.

yes, make sure you pull up a tent of skin and the needle is aimed so that it stays in the tent. although if spot is giving you a hard time before you've even stuck him, you may be doing everything right and he just doesn't want it. if you hit muscle it will hurt and he will let you know.
 
Thanks Julie. And everyone. Gosh you guys have really helped me through some crazy feelings.

He's in the 300's today, we will keep him on .5 for a few days like you said. I just hope he gets regulated, because it's very stressful on ME. :lol:

I'm not going to deal with our vet right now. He called back 3 hours after we called, and meanwhile someone here on the board wrote back right away!

Jennifer
 
I have to check on our syringe size. Seems long for such a small amt of Lantus.

Any great giving a shot to your cat videos? Spot's freaking before we even do it. Yikes.
 
I always gave Bandit's shot to him while he was eating--he was so into his food he never even noticed most the time. Plus, switching to the short needle syringes helped A LOT. (5/16", 31g, .3cc with half unit markings). He would flinch and pull away every now and then when I was using the 29g, 1/2", .3cc syringes with half unit markings, but once I switched to the smaller ones he didn't notice a single shot.
 
ammonzon said:
I have to check on our syringe size. Seems long for such a small amt of Lantus.

Any great giving a shot to your cat videos? Spot's freaking before we even do it. Yikes.
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Jennifer,
There are TONS of how to shoot videos on youtube. Go there and search for "feline diabetes insulin".

Carl
 
And if your vet is insistent on wanting to do tests on Saturday... tell him you will be happy to bring him in only if the vet will cover all the costs associated with this. ;-)

That will shut him up quickly. I guarantee it!
 
WOOT~!

we struggled with shots too until someone told us to wait til his face was in his food. i can't say he's never reacted since then, but we've never not gotten the shot in ok.

glad that's helped! one obstacle overcome.
 
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