Dealing with HYPO for the 1st time

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The dose of insulin must have been too much for her. That's why she went so low. You got her to the hospital and that's what she needed. I'm glad she is there and is doing much better. Thank You God. Part of the higher number this morning is that her liver (finally) reacted to the low numbers and spilled glucogen sp? to save her in combination with all the honey and dextrose that you and the doctor's gave her. The doctors will continue to stabilize her. She will need a reduction in the insulin dose. My prayers and continued healing vines go out to Ducia. Thank you, and thank DCIN for helping to save her. :bighug:
Thank you so much! I wish I had clearer idea as to how long the stabilization takes. Her numbers were such roller coaster I am not sure what to think. She was on Lantus 1unit. Given that Ducia is eating how soon can they establish her proper dosage?
 
Cats that have had a symptomatic hypo are often very sensitive to insulin, so it may take a while to get her stabilized and to figure out what the right dose is. You will need to watch her carefully when she comes home and keep monitoring. We will help all we can. Thank goodness you learned to test and were watching over her! You are a wonderful mama bean!
 
Thank you so much! I wish I had clearer idea as to how long the stabilization takes. Her numbers were such roller coaster I am not sure what to think. She was on Lantus 1unit. Given that Ducia is eating how soon can they establish her proper dosage?
I'm so so relieved to hear she's alert and ok.

You are very sure you used the correct syringe and only drew it to the very first line, right?
This is a u40, I know lantus is u100, but you only drew it to the 1 line, right?
IMG_4302.JPG
 
Tanya, can you add DKA to your signature too, please?
The incident yesterday plus the DKA over the weekend was a stress on her body. Keep thinking positive thoughts. Imagine her healthy and eating and playing and purring and snuggling. I would think it would probably take a few days for her body to rest, heal, and normalize. Please keep posting and updating us, so we can hold your hand, and help you, and follow along. We all care about Ducia and you.
 
Cats that have had a symptomatic hypo are often very sensitive to insulin, so it may take a while to get her stabilized and to figure out what the right dose is. You will need to watch her carefully when she comes home and keep monitoring. We will help all we can. Thank goodness you learned to test and were watching over her! You are a wonderful mama bean!
I'm so so relieved to hear she's alert and ok.

You are very sure you used the correct syringe and only drew it to the very first line, right?
This is a u40, I know lantus is u100, but you only drew it to the 1 line, right?View attachment 26726
JanetNJ, Hi,
at this point I cannot be about anything. My husband administered the shot, it's unlikely that he gave her 10units instead of 1 but now he cannot remember either. Unlikely, but the chain of events yesterday looks to me as an overdose but I am not experienced at all and should not make any conclusions. My Ducia has so many other complications to muddy the picture I do not know what to think. I am so relieved she is in capable hands to monitor right now but her latest number was 409. How can they call it "stabilizing"?! It's more of a roller coaster to me. We use the same syringe as in your pic.
 
Tanya, can you add DKA to your signature too, please?
The incident yesterday plus the DKA over the weekend was a stress on her body. Keep thinking positive thoughts. Imagine her healthy and eating and playing and purring and snuggling. I would think it would probably take a few days for her body to rest, heal, and normalize. Please keep posting and updating us, so we can hold your hand, and help you, and follow along. We all care about Ducia and you.
I added post DKA if that's correct, the ketones were at trace amount at the discharge time from the clinic. I'd love nothing more for her tiny tortured body to rest but our clinic stay is extremely limited as we are using DCIN help and unable to pay ourselves.
 
her latest number was 409. How can they call it "stabilizing"?! It's more of a roller coaster to me.
Being high is much better than being low like last night. They have shorter/quicker acting insulin they can give to bring her numbers down to a more normal number. Really the only place I'd want it used is there. They can hook her back up to the dextrose drip if too low. It's a tricky dance and you will become a pro in no time.
My cat will go from 290 to over 600 in a matter of 3 hours some days! Their little bodies are part alien I swear!:p
Please get some rest. Have some comfort in knowing that once she's home you have the option to skip a shot or *edit to add: I'm not sure if the following is recommended for lantus please check with the lantus pros* feed then shoot if you are wary of giving insulin. There's always the option of a low token dose to give just a tiny bit and work your way up. I know she's post DKA and keeping good numbers is important.
You could also help ease your shot anxiety by drawing up the dose for your husband and you'll know exactly how much she gets. This is more practical for when she is on a dose for a few cycles, which I believe is even more so recommended for lantus because of the way it works.
Deep breaths. Sending peaceful and relaxing vines your way and healing vines for Ducia.:bighug:
 
JanetNJ, Hi,
at this point I cannot be about anything. My husband administered the shot, it's unlikely that he gave her 10units instead of 1 but now he cannot remember either. Unlikely, but the chain of events yesterday looks to me as an overdose but I am not experienced at all and should not make any conclusions. My Ducia has so many other complications to muddy the picture I do not know what to think. I am so relieved she is in capable hands to monitor right now but her latest number was 409. How can they call it "stabilizing"?! It's more of a roller coaster to me. We use the same syringe as in your pic.
The u40's in the picture are for vetsulin, not Lantus. Make sure you use the u100's for lantus. They are different amounts.
 
Oh, I wanted to say, don't freak about the 400 reading. She's ok. I was still getting preshot readings in the 300's and 400's two months after diagnosis. You can see at the top of my spreadsheet.... I didn't start home testing until 6 weeks after diagnosis so the top of my spreadsheet is after six weeks of insulin. I wasn't getting preshots in the 200's until 3 months in. She's high because she's bouncing from the hypo.
 
Thanks so much for the update Tanya! I'm so happy you got Ducia to the vet and she is doing ok!
I'm sure it's been mentioned previously but there is a forum here specifically for Lantus/Lev users and I would suggest posting there each day. If you could test maybe 15 minutes before you feed or shoot and post in the Lantus forum, we'll be able to help you decide on whether to shoot. Kitties who have had hypos can be very sensitive to insulin so I definitely would not shoot 1 unit.
I was wondering if you have recently changed Ducia's food? Sometimes a change in food from high carb to low carb is all a kitty needs to get their numbers down.
 
I'm so pleased that Ducia is getting the help she needs. It would be very helpful to us if you can tell us for sure which type of syringe you used to give the Lantus yesterday. If you accidentally used a U40 syringe and measured out to the 1 unit mark that would be far too much Lantus. On a U100 syringe, the 1 unit mark is less insulin liquid because the syringes are thinner in the barrel.
 
Oh, I wanted to say, don't freak about the 400 reading. She's ok. I was still getting preshot readings in the 300's and 400's two months after diagnosis. You can see at the top of my spreadsheet.... I didn't start home testing until 6 weeks after diagnosis so the top of my spreadsheet is after six weeks of insulin. I wasn't getting preshots in the 200's until 3 months in. She's high because she's bouncing from the hypo.
A-ha, JanetNJ, you lived thru Hypo? What was it like right after?We are planning on bringing Ducia home tonight and I am not sure the Hypo event changed anything in our original plan for home care. We will feed her thru the ETube, if needed but try making her herself and definitely be giving her meds thru the tubes. They can stay there for up to 2 weeks, and there is one med is 10 days.
 
Tanya, please get some sleep so your body can recover from yesterday too . :bighug: Ducia is in good hands right now and when she comes home tonight you need to be refreshed . You acted promptly yesterday which saved her life. Ducia was a very lucky litte cat yesterday. :cat:

If you start posting over in the Lantus and Lev forum, we can help you with dosing and other questions about Lantus.
 
Tanya, please get some sleep so your body can recover from yesterday too . :bighug: Ducia is in good hands right now and when she comes home tonight you need to be refreshed . You acted promptly yesterday which saved her life. Ducia was a very lucky litte cat yesterday. :cat:

If you start posting over in the Lantus and Lev forum, we can help you with dosing and other questions about Lantus.
Thank you Bobbie and Bubba for that. I think I got how to post now and will be on Lantus and Lev forum. I will try to rest after I spoken with Dr and hear that she is stable. Her Bg 115 last night around 8 pm pacific and BG 409 at 2 am this morning does not sound stable. There is so much to learn about her condition in general, that resting would be wasting of time. I only now beginning to get the big picture of what having complicated diabetes means. Ignorance is not bliss, being ignorant is hell. But thank you for saying that.
 
They probably meant stable as in she isn't critical condition anymore. Her blood glucose wasn't dropping to dangerous levels anymore. Kind of like humans can be on a ventilator and be considered stable because their vitals are OK.
 
she was interested in her food and ate herself

That's great news! So important to be eating, and it sounds like she's feeling better already. She's had a lot happen in the past few days, though-- a DKA alone takes weeks to recover from, and now she has had a hypo, too. Poor little girl.

See you in Lantus Land! And do try to get some rest for yourself as well as Ducia-- you both need it, I'm sure. :bighug::bighug::bighug:
 
A-ha, JanetNJ, you lived thru Hypo? What was it like right after?We are planning on bringing Ducia home tonight and I am not sure the Hypo event changed anything in our original plan for home care. We will feed her thru the ETube, if needed but try making her herself and definitely be giving her meds thru the tubes. They can stay there for up to 2 weeks, and there is one med is 10 days.
My cat never had a symptomatic hypo. The only really low number she ever had was 7/31 she was at 59 (on a pet meter under 68 is too low). I was able to fairly easily get her numbers up with some high carb treats. I never had to do the honey or anything like that. My cat's numbers just ran high for a while. It's not unusual. When you have time, take a look at other people's spreadsheets so you can see the variety of readings people get. You just seemed very concerned about that 400 reading, and I wanted to assure you that it's not unusual for a cat to get those readings before their numbers are regulated.
 
Tanya, thank you for the update on Ducia. I am so glad that she got to the vet's in time and that they were able to help her! You did a wonderful job of dealing with her hypo, you literally saved her life. Please do get some rest - when your system has a shock like that it needs time to recover! You'll need to be rested for Ducia when she comes home tonight. Again, great job!:bighug::bighug::bighug:
 
Thank you everybody so much. I've been helped with the spreadsheet (thank you Chris & China!) so I hope tomorrow I will start putting in GOOD numbers.
Ducia's BG at the clinic today was like:

6 AMPR 345
6 an Lantus 1U
meds via Etube
10 am 348
2pm 325

She is alert, moving in her cage and actively interested in her food both dry and wet, reacts to the nurse when she talked to her.:)
There are some not good changes with her body such as bilirubin is up again it means jaundice, right?;
She is anemic her red blood cell count is 20% but the Dr told me that her body shows signs that it tries to make up for it. The potassium level is down again , we were not successful in getting potassium gel into her orally and its present form is not for tube, the clinic may recommend something for the tubes I hope, her phosphorus is down too, so fishy meals are on the menu. Her ALT is up, but GGT is down.

Her demeanor, as the nurse put it this afternoon, is the day and night compared to yesterday when checked in. I think she is saying she is ready to fight for it. It is up to us now to provide the best care at home but I must admit that the Hypo event although taught me a lot was a bloody nightmare, and it made me lost my confidence somewhat as to my ability to test BG good when frequently needed. :blackeye: I WOULD NEVER BE ABLE TO HELP HER UNLESS I HAD YOU. THANK YOU ALL SO MUCH FOR BEING THERE FOR US!

I wanted to spread the word after I spoke with the doctor that honey isn't right to be given via tubes. It should be watered down but the proportion is not known. The cheaper the honey, the lower quality I mean, the MORE water should be used if etube is fit. It's easier 1 part sugar + 3 part water and start with 2 ml for tube feeding. Per someone advise on the board whose name I didn't get (thank you nameless) I administered 2ml watered honey rectally, that was really good.

I have tons of questions about her diet. The current advise from clinic is 5.5 ounces of canned (they proposed Critical Nutrition by ProPlan vetrx) for the DAY divided by 4 times. She is at 7lbs, I think it is not enough. Also I wanted to switch her to the Friskie Classic Pate - Ocean White Fish & Tune and Turkey & Giblet that already have at home. Both low carb high protein per Dr.Pierson chart but its from 2012. Any thought?

The plan is to her stable in BG numbers, restore her strength and stimulate her eating. The Hypo showed again that I misinterpret sighs that she gave me. I will be posting questions about them on the Lantus group forum as they come. Is it how posting works? I read all of the instruction but still figuring out if there is a section for me to post an intro.
 
I'm very glad that your kitty is improving. It will take her a while to get her strength back. We're here to help you get her diabetes treatment working.
 
to help her anemia, are the dr's giving a a shot of vitamin B? If not, ask them to. you can continue giving vitamin b12 at home either as an injectable, or as a supplement on the food, but it's really important as you want that HCT level up. I would think to start the injectable would be better. usually it's administered once a week. on food it would be daily sprinkled on. The b12 helps the body produce red blood cells. 20 is really low and could account for some of the lethargy you have been observing. normal range is over 30. my cat (not my diabetic, but one of my other cats that has kidney disease) was at 29% and the dr. was saying she would recommend b12 injections if it dropped any lower. Fortunately with daily supplements (I just opened a b 12 capsule and sprinkled it on his food) the anemia resolved itself, and in about a month he was at 42%.
 
Another thing about b12 is there's some evidence it helps pancreatitis and it tends to help appetite in kitties. It's probably worth trying and not expensive.
 
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