Dexter Hypo

[Jo_]

Hi everyone!

I resort to you again for help.
Dexter's values have been stabilizing and I just went to measure him at AMPS +9 and he's at 52 (on AccuChek. Confirmed with AT -> 63).

We have given him a tiny amount of honey and a bit of medium carb food. We're retesting after 30 minutes.

Should I at this point reduce his insulin dose to 2.5?
Not confident enough to make this decision on my own based on his results.

Any help, as usual, is highly appreciated

 

[CORKY]

Hi everyone!

I resort to you again for help.
Dexter's values have been stabilizing and I just went to measure him at AMPS +9 and he's at 52 (on AccuChek. Confirmed with AT -> 63).

We have given him a tiny amount of honey and a bit of medium carb food. We're retesting after 30 minutes.

Should I at this point reduce his insulin dose to 2.5?
Not confident enough to make this decision on my own based on his results.

Any help, as usual, is highly appreciated

I will tag several Lantus user that are qualified to help you with dosing, in the mean time, you did well, just remember that the honey is a quick fix, and you did great by testing, but that low BG is good to test every 15 minutes, feed teaspoon at a time after the quick fix and test again, food, a bit at a time after the honey is best than resourcing again to honey or Karo, even High Carbs continue this process until Bg has normalized, Good job!

@Bron and Sheba (GA)
@Sienne and Gabby (GA)
@Suzanne & Darcy

 

[Jo_]

Thanks for the help.
I gave both honey (way less than a teaspoon started with a tiny amount) and a just a little bit of food - medium carb - and measured. It was already at 72 just 25 minutes later.
Currently at 126


He ate normally and was ok all day. Hence an explanation could be too much insulin, but like I said... I'm too green to judge that.

 

[CORKY]

Thanks for the help.
I gave both honey (way less than a teaspoon started with a tiny amount) and a just a little bit of food - medium carb - and measured. It was already at 72 just 25 minutes later.
Currently at 126


He ate normally and was ok all day. Hence an explanation could be too much insulin, but like I said... I'm too green to judge that.

Good job!!
Ps: to give the honey if you have a small syringe without the needle you can give it easier by placing it on the side of the mouth and is less messy if you dont Have one you can ask any pharmacist for a non needle syringe

 

[CORKY]

Thanks for the help.
I gave both honey (way less than a teaspoon started with a tiny amount) and a just a little bit of food - medium carb - and measured. It was already at 72 just 25 minutes later.
Currently at 126

@Bron and Sheba (GA)
He ate normally and was ok all day. Hence an explanation could be too much insulin, but like I said... I'm too green to judge that.

 

[Jo_]

Good job!!
Ps: to give the honey if you have a small syringe without the needle you can give it easier by placing it on the side of the mouth and is less messy if you dont Have one you can ask any pharmacist for a non needle syringe

Great idea in the moment I went with the back of a soft spoon, but that sounds waay simpler. Luckily, Dexter lets us do everything to him.

 

[CORKY]

Great idea in the moment I went with the back of a soft spoon, but that sounds waay simpler. Luckily, Dexter lets us do everything to him.

Awesome, our furr babies know that everything we do for them is because we love them

 

[Bron and Sheba (GA)]

With honey or Karo a couple of drops is usually enough to bring the BGs up higher. If you give any more than that, your kitty is more likely to vomit and that will complicate things. You can also feed some higher carb food, just a teaspoon and test in 20 minutes.
I note you have SLGS on the SS but nothing on the signature. Are you feeding any dry food? With DKA in the recent past you would be better doing TR if possible. Can you put the 63 in the actual SS itself please with AT beside it to make it clearer what happened? I know you have it in the remarks column. Thx.

 

[Diane Tyler's Mom GA]

@Jo_
Are you using the Acu chek meter for good now?
If so you need to add that to your signature and the date you switched to it and to your spreadsheet

Also on your spreadsheet the last 2 color codes up top need to be charged to reflect a human meter
The dark green should be 50-99
The lime green should be BG<50
You can probably change it yourself


Where you have
52 @ 15:54
72 @ 16:20

We don't use times because we are all in different time zones
The 52 you will put in in the +9 cell where you did but put 52 @+ .5 if it was 30 minutes for example
Same thing for the 72
.25 means 15 minutes
.5 means 30 minutes
.75 means 45 minutes
Then you will need to color code it manually

 

[Jo_]

@Diane Tyler's Mom GA thank you for your message!
I've adjusted tge spreadsheet with your suggestions.

 

[Jo_]

I measured a 59. It was close to food time, so I fed him and waited just a bit to measure again.
I just measured again and dropped further to 35 (51 on AT)

Already gave honey and MC wet food. But I really think that currently, 3u is too much for him. But I don't know if I should reduce 0.25 or 0.5 units... My vet always switched entire units (from 2 to 3u or from 4 to 3u).

I would really appreciate your help on this

 

[Diane Tyler's Mom GA]

It looks like you switched to the Accu Check on 1-8
Can you please put that date on your signature after AccuChek
Also please put it on your spreadsheet up top
You can put it up top where it says

Meter in the salmon colored line put AccuChek and the date
I would also add ketones in your signature also
@Jo_

I tagged a few experienced members for you

 

[Diane Tyler's Mom GA]

I measured a 59. It was close to food time, so I fed him and waited just a bit to measure again.
I just measured again and dropped further to 35 (51 on AT)

Already gave honey and MC wet food. But I really think that currently, 3u is too much for him. But I don't know if I should reduce 0.25 or 0.5 units... My vet always switched entire units (from 2 to 3u or from 4 to 3u).

I would really appreciate your help on this

@Bandit's Mom
@Bron and Sheba (GA)
@Wendy&Neko
@Sienne and Gabby (GA)
@Angela & Cleo

 

[Jo_]

I would also add ketones in your signature also
@Jo_

Thanks
The ketone meter I am using or the current value?

 

[Diane Tyler's Mom GA]

Thanks
The ketone meter I am using or the current value?

I just want you to put the word ketones since I see on your spreadsheet that Dexter did have ketones
Just add it after you have DKA
You can just put how many ketones in the remarks section like you have been doing
@Jo_

 

[CORKY]

I measured a 59. It was close to food time, so I fed him and waited just a bit to measure again.
I just measured again and dropped further to 35 (51 on AT)

Already gave honey and MC wet food. But I really think that currently, 3u is too much for him. But I don't know if I should reduce 0.25 or 0.5 units... My vet always switched entire units (from 2 to 3u or from 4 to 3u).

I would really appreciate your help on this

Did you check the Bg 15 minutes after he food? if its still low if you have High carbs give 2 tsps. test again in 20 minutes and continue the procedure until safe numbers
@Diane Tyler's Mom GA

 

[CORKY]

Did you check the Bg 15 minutes after he food? if its still low if you have High carbs give 2 tsps. test again in 20 minutes and continue the procedure until safe numbers
@Diane Tyler's Mom GA

How's Dexter what is his BG right now? I saw the SS he's +9 / 90 that is good, no more MC or HC, now you can continue testing every hour for a few more times to make sure he does not plunger down. You did very well congratulations, always remember, you slowly hike up the BG slowly, 50 the honey quick fix, test in 15 minutes, then give 1-2 tsp of HC, check in 1/2 hour and so on do not give everything at once because his BG will go high very fast, then you'll get a bounce

 

[Jo_]

He was at 59. I fed immediately. It was his feeding time anyway -> he usually does not eat too much in the morning, so we give a larger portion in the morning and evening, but also feed smaller portions during the day.

I measured again 15 minutes after food. Was at 55. It is LC food and food does not spike immediately from my understandig.
But kept measuring every 15 minutes. Next one was 35 then I gave a bit of honey and MC food.

Next measurement was at 52. It kept going up and now, it is at 90.

The whole time he was in good spirit, even enticing our other cat to play... Which scares the cr** out of me, because even at 35 he was playing around... How are we to know from cues that our babies are in hypo territory?!

 

[CORKY]

He was at 59. I fed immediately. It was his feeding time anyway -> he usually does not eat too much in the morning, so we give a larger portion in the morning and evening, but also feed smaller portions during the day.

I measured again 15 minutes after food. Was at 55. It is LC food and food does not spike immediately from my understandig.
But kept measuring every 15 minutes. Next one was 35 then I gave a bit of honey and MC food.

Next measurement was at 52. It kept going up and now, it is at 90.

The whole time he was in good spirit, even enticing our other cat to play... Which scares the cr** out of me, because even at 35 he was playing around... How are we to know from cues that our babies are in hypo territory?!

I understand exactly how you are feeling right now, and no we do not know, they play the act like there's nothing wrong, while we are running around like a chicken without a head all over the place and stressing out , I was told here to take a step back, breath in and breath out that cats are very sensitive to feelings and they sense our stress quite easily, that can also give an incorrect BG reading. don't worry you did good, but as I explained on post #17, the best way to get Dexter where he needs to be is this procedure, you might begin to see a bit higher number and some lower numbers again from all the carbs, so keep testing for today every hour until you see a consistencyon BG pattern, One day Corky was in his 100's BG and when I tested 2 hour later he was 35.and it was when I was not even used to blue BG's, I bombarded this Forum with posts and I was blessed with a member that stayed with me until 4:30AM until he was stabilized, today I shoot hi in his 80's and I don't worry, of course he is on ProZinc, which is a different BG protocol than Lantus. So You did Amazing Dexter is proud of you!!

 

[Jo_]

With honey or Karo a couple of drops is usually enough to bring the BGs up higher. If you give any more than that, your kitty is more likely to vomit and that will complicate things. You can also feed some higher carb food, just a teaspoon and test in 20 minutes.
I note you have SLGS on the SS but nothing on the signature. Are you feeding any dry food? With DKA in the recent past you would be better doing TR if possible. Can you put the 63 in the actual SS itself please with AT beside it to make it clearer what happened? I know you have it in the remarks column. Thx.

Sorry, doing TR ever since you suggested on the previous post. I updated the spreadsheet and the signature to reflect it.

 

[Jo_]

I understand exactly how you are feeling right now, and no we do not know, they play the act like there's nothing wrong, while we are running around like a chicken without a head all over the place and stressing out , I was told here to take a step back, breath in and breath out that cats are very sensitive to feelings and they sense our stress quite easily, that can also give an incorrect BG reading. don't worry you did good, but as I explained on post #17, the best way to get Dexter where he needs to be is this procedure, you might begin to see a bit higher number and some lower numbers again from all the carbs, so keep testing for today every hour until you see a consistencyon BG pattern, One day Corky was in his 100's BG and when I tested 2 hour later he was 35.and it was when I was not even used to blue BG's, I bombarded this Forum with posts and I was blessed with a member that stayed with me until 4:30AM until he was stabilized, today I shoot hi in his 80's and I don't worry, of course he is on ProZinc, which is a different BG protocol than Lantus. So You did Amazing Dexter is proud of you!!

while we are on the verge of tears, they just mock us. I love my 2 kitties with all my heart, but they are such jerks sometimes

I'll be doing it all as suggested.
I didn't resort to honey when he was at 59, but maybe I should have. Just gave the normal food then to see if it would be enough.
Only fed a tablespoon of MC food with the honey because that 35 scared the living daylights out of me.
Monitored him frequently until I saw his values go up to less scary numbers.

Now I'm testing hourly, to give him a bit of peace.

 

[CORKY]

while we are on the verge of tears, they just mock us. I love my 2 kitties with all my heart, but they are such jerks sometimes

I'll be doing it all as suggested.
I didn't resort to honey when he was at 59, but maybe I should have. Just gave the normal food then to see if it would be enough.
Only fed a tablespoon of MC food with the honey because that 35 scared the living daylights out of me.
Monitored him frequently until I saw his values go up to less scary number
Now I'm testing hourly, to give him a bit of peace.

Don't worry, people that never owned a cat or do not bond with their pets do not understand the love we can have, when my cat was diagnosed, one neighbor told me to put him to sleep, I got very upset, this is a manageable illness, as long as you follow the protocol for FD, Dexter is going to flourish, but when you see a number below 50 TES you give honey or KARO syrup, I have a small syringe without the needle, I would put 1ml of the syrup and give him a very quick fix, then I would test feed test feed, but no more syrup though, you start with High carb a 1-2 tsp test if it went up a bit then 1-2 tsp at a time of Medium carb, I cannot remember when was the last time I used syrup or HC , You are doing AWESOME!! don't worry how others react. I spend sleepless nights cried till I was out of tears, stress to the point of breakdown, but it was all worth it, with the unconditional assistance of this Forum and members, mt Corky would not be here today. Something his Vet never did, he just brushed me off!!!, Stay tuned, let us know his progress, We are here for you!! If Dexter may reach such low BG title your post 911, or PM any of us again with 911, so we can assist you ASAP as soon as someone can assist you, if you need support

 

[Jo_]

Don't worry, people that never owned a cat or do not bond with their pets do not understand the love we can have, when my cat was diagnosed, one neighbor told me to put him to sleep, I got very upset, this is a manageable illness, as long as you follow the protocol for FD, Dexter is going to flourish, but when you see a number below 50 TES you give honey or KARO syrup, I have a small syringe without the needle, I would put 1ml of the syrup and give him a very quick fix, then I would test feed test feed, but no more syrup though, you start with High carb a 1-2 tsp test if it went up a bit then 1-2 tsp at a time of Medium carb, I cannot remember when was the last time I used syrup or HC , You are doing AWESOME!! don't worry how others react. I spend sleepless nights cried till I was out of tears, stress to the point of breakdown, but it was all worth it, with the unconditional assistance of this Forum and members, mt Corky would not be here today. Something his Vet never did, he just brushed me off!!!, Stay tuned, let us know his progress, We are here for you!! If Dexter may reach such low BG title your post 911, or PM any of us again with 911, so we can assist you ASAP as soon as someone can assist you, if you need support

Oh nooo! No one ever said that to me, but I guess we've all been looked at like we're crazy people for caring so much for our babies.
I don't really care what others think about all the love my kitties get! They deserve all of it and more.

The feeling of being brushed of by the vet I know very well. Dexter has spent a few months in very high values and with no real course of action, not even measuring him. Only now, with all the help from this group, all the info shared here, we are getting to know the disease better and knowing that there is help from people that know exactly what we are feeling is beyond incredible.

It is almost Dexter's shot time... I am scared now of giving 3 units after 50's yesterday and today, but not sure if 2.5 is too low. Any advice on that?

 

[CORKY]

Oh nooo! No one ever said that to me, but I guess we've all been looked at like we're crazy people for caring so much for our babies.
I don't really care what others think about all the love my kitties get! They deserve all of it and more.

The feeling of being brushed of by the vet I know very well. Dexter has spent a few months in very high values and with no real course of action, not even measuring him. Only now, with all the help from this group, all the info shared here, we are getting to know the disease better and knowing that there is help from people that know exactly what we are feeling is beyond incredible.

It is almost Dexter's shot time... I am scared now of giving 3 units after 50's yesterday and today, but not sure if 2.5 is too low. Any advice on that?

What’s his bBG right now ? if you think is too low wait 1/2 hours test again in the mean time make new post title with 911 with the same conversation about the dosing concern, from your last post to Sienne and Gabby (GA) and Bron and Sheba ((GA) I will tag them as well better to be safe then sorry hold off the dose for a bit I can’t guide you on dosing
911
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
@Suzanne & Darcy

 

[Diane Tyler's Mom GA]

With DKA in the recent past you would be better doing TR if possible. Can you put the 63 in the actual SS itself please with AT beside it to make it clearer what happened? I know you have it in the remarks column. Thx.

Bron she switched to TR yesterday and noted it on her signature
@Bron and Sheba (GA)

 

[Diane Tyler's Mom GA]

@Jo_
Where do you live , what are your shooting times
Please put the date you switched to TR on your signature and your spreadsheet so members don't think you were following TR the whole time and add ketones on your signature after the DKA

 

[Jo_]

What’s his bBG right now ? if you think is too low wait 1/2 hours test again in the mean time make new post title with 911 with the same conversation about the dosing concern, from your last post to Sienne and Gabby (GA) and Bron and Sheba ((GA) I will tag them as well better to be safe then sorry hold off the dose for a bit I can’t guide you on dosing
911
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
@Suzanne & Darcy

The notification for this message came just a couple of minutes late.
We chickened out and 2.75 (as best as we could measure with our syringes, which are in half units). He was at 135.

Reducing the dose is really new territory, but with 2 days where we saw 50's we didn't want to give the full 3 units.

But we'll be measuring more often tonight to see if he drops.

 

[Jo_]

@Jo_
Where do you live , what are your shooting times
Please put the date you switched to TR on your signature and your spreadsheet so members don't think you were following TR the whole time and add ketones on your signature after the DKA

We live in Switzerland. We usually shoot at 6:30 in the morning and in the evening.

 

[Diane Tyler's Mom GA]

The notification for this message came just a couple of minutes late.
We chickened out and 2.75 (as best as we could measure with our syringes, which are in half units). He was at 135.

Reducing the dose is really new territory, but with 2 days where we saw 50's we didn't want to give the full 3 units.




From the TR sticky

Reducing the dose:

The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Levemir, & Biosimilars ISG safe by taking reductions when appropriate.

• 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, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.
• Please do not let yourself become complacent or blasé about drops into the 20s or 30s. Please ask for advice immediately.

But we'll be measuring more often tonight to see if he drops.

That's fine since no one was around to give you advice. I see Dexter dropped to 35 during the day .
When following TR and Dexter is a long term diabetic (over a year) you would reduce by 0.25 units
Please update your spreadsheet with the dose you gave tonight on your spreadsheet. Please add Switzerland to your signature.
Bron will be on later tonight she lives in Australia.
@Jo_

Also
Please put the date you switched to TR on your signature and your spreadsheet so members don't think you were following TR the whole time and add ketones on your signature after the DKA

We have another member here from Switzerland


Here is your previous post intro post
https://felinediabetes.com/FDMB/threads/diabetes-management-advice.297065/#post-3233560

 

[Sienne and Gabby (GA)]

Jo -

For a longer term diabetic cat (a cat that is more than a year since diagnosis), with TR, if Dexter's numbers drop below 40, a dose reduction is warranted. It looks like you reduced the dose to 2.75u last night. That was exactly the right thing to do.

Dexter was in low numbers. Unless you saw symptoms of hypoglycemia, I would have called this "low numbers." You did a great job of managing the curve.

 

[CORKY]

Jo -

For a longer term diabetic cat (a cat that is more than a year since diagnosis), with TR, if Dexter's numbers drop below 40, a dose reduction is warranted. It looks like you reduced the dose to 2.75u last night. That was exactly the right thing to do.

Dexter was in low numbers. Unless you saw symptoms of hypoglycemia, I would have called this "low numbers." You did a great job of managing the curve.

Yes she did!! Great job Jo!!

 

[Jo_]

Jo -

For a longer term diabetic cat (a cat that is more than a year since diagnosis), with TR, if Dexter's numbers drop below 40, a dose reduction is warranted. It looks like you reduced the dose to 2.75u last night. That was exactly the right thing to do.

Dexter was in low numbers. Unless you saw symptoms of hypoglycemia, I would have called this "low numbers." You did a great job of managing the curve.

I'm so glad it was a good call. Perhaps next step for me is to find needles with .25 markings on them.

Yeah, no signs of hypo. He was energetic and playful the whole time.

 

[Jo_]

Yes she did!! Great job Jo!!

@CORKY

 

[CORKY]

I'm so glad it was a good call. Perhaps next step for me is to find needles with .25 markings on them.

Yeah, no signs of hypo. He was energetic and playful the whole time.

 

[CORKY]

 

[Diane Tyler's Mom GA]

I'm so glad it was a good call. Perhaps next step for me is to find needles with .25 markings on them.

They don't make the syringes with 0.25 markings just half unit markings you just have to eyeball it
@Jo_

Jo all the things I asked you to do on your signature and spreadsheet look good
EXECEPT the following

Jo about the ketones you put in your signature
Last ketone measurement: 09.01.25 = 0.3.
You don't need to put what the ketones were in your signature. I just wanted you to put the word ketones after DKA + Pancreatitis so members know Dexter has ketones.
You just have to put how many ketones there were in the remarks section on the spreadsheet like you were doing. So I would erase where you have
Last ketone measurement: 09.01.25 = 0.3. on your signature , it's not necessary
@Jo_

 

[CORKY]

@CORKY
Hi Maria her kitty is on Lantus so she uses the U-100 syringes with half units marking

You are right is Lantus, sorry, thought I was helping, when she said .25 markings all I though about were the 1/2 thank you for the correction

 

[Diane Tyler's Mom GA]

They don't make the syringes with 0.25 markings just half unit markings you just have to eyeball it
You did good giving the 2.75 units
The 2.75 units would be between the 2.5 and 3 unit markings on the syringes
@Jo_

 

[CORKY]

No problem at all Maria
Maybe just delete it your post about the care point
@CORKY

Done

 

[Diane Tyler's Mom GA]

Done

 

[Jo_]

Thanks @Diane Tyler's Mom GA and @CORKY!

 

[CORKY]

Thanks @Diane Tyler's Mom GA and @CORKY!

 

[Diane Tyler's Mom GA]

Everything looks good now on your signature and spreadsheet. Purr fect
@Jo_

 

[CORKY]

Everything looks good now on your signature and spreadsheet. Purr fect
@Jo_

Dexter's Looking good!!! Good boy! and you are doing great good SS and numbers

 

[Sienne and Gabby (GA)]

Jo -

Housekeeping reminder... We try to limit threads to no more than 50 posts.

 

[Jo_]

Jo -

Housekeeping reminder... We try to limit threads to no more than 50 posts.

Thank you! If needed, I'll create a new post in continuation to this one.

 

[CORKY]

Thank you! If needed, I'll create a new post in continuation to this one.

Your new Title can remain the same with the word Dexter's Continuation, one of the members will attach this one to the new one, as I explained on pm post, good yellows today, Dexter is getting there, and he will, you are doing Great!!