First hypoglycemia scare... Advice for tonight?

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nslade001

nslade001

Member Since 2018
Hi everyone,

I guess I made a rookie mistake, so I'm putting it out for (1) other newcomers to this to learn from and (2) to gather any more tips and information anyone wants to share.

Apologies my SS isn't up to date, I'll be able to get to a computer tomorrow to update.

Yesterday was a beautiful day, with ps numbers of 9.1 and 9.3, 0.4 units caninsulin, and a gentle curve to 5.9 at +4.

Last night gave 0.4, and
+2 was 10
+3 was 8.8
+5 was 7.5
+8.5 was 11.4

She was a bit restless last night, she vomited some undigested food at 5 am and a bit of foamy liquid at 7:30 am. I've been worried about constipation, but she had a BM between 5 and 7. So im pretty sure the vomiting is a hairball precursor as that isn't uncommon.

My mistake: I didn't take into account her new health issue. She has never gone off food or refused food because of hairball issues.
This amps was the highest home one ever at 13.6 so we upped her units to 1.0 which we had started her on when preshots were in the high 12s.

She only ate half her breakfast and maybe half her snack.

+2 was 7 and we realized this seemed too fast.
+2.5 was 5 (lowest ever)... She started eating the rest of her snack and I fed her some FF grilled in gravy and temptations treats
+3 was 3.9 so I mixed 2 ml corn syrup in more canned FF, and gave a small pile of temptations.
+3¼ was 4.4
+3½ was 6.4
+3¾ was 6.7
+4 was 6.8
+4¾ was 9.9

I know technically she never hit hypo that we tested ,and my glucometer freestyle lite may read a bit low on low readings as per others reviews, but I was scared, and I'd respond the same again.

So, could anyone please offer advice for tonight's dosing?

And next time she doesn't eat all her breakfast in a similar situation (stressed and inappetant) how should i dose? Should I have repeated the 0.4, lowered to 0.2, or skipped?

I'm petrified about our upcoming 12+ hour drive/move to Ontario this week, especially if she doesn't bring up this hairball! Again, would appreciate any tips.

Thanks so much, sorry for the novel.

With love,
Nikki
 
nslade001 said:
This amps was the highest home one ever at 13.6 so we upped her units to 1.0 which we had started her on when preshots were in the high 12s.
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There's so much to learn and it's hard to make judgments at the beginning when you don't have much data. If I understood you correctly, a couple of comments:
  • it's the lows near mid cycle that tell the story of the dose's effectiveness, not the PS. PS is only to tell you if BG is high enough for the planned dose.
  • going from 0.4 u to 1 u is a big jump
  • 0.4 u gave beautiful numbers yesterday and would have been a good dose to keep, AMPS notwithstanding. You need a few cycles at a dose to properly evaluate it
  • she got a significantly higher dose and ate less than usual this AM so the drop to 3.9 isn't surprising.
This is not criticism! There's so much to learn that these things often happen in the early days. :)
 
Thank you so much for your response. And especially for highlighting the first comment. I think the lack of uninterrupted sleep doesn't help my judgement either :)

I will post tonight around 8 pm with pmps, and an update with how she did until then.
Hopefully, you will be around to offer dosing advice?!

I hope you know how much we appreciate your help. With love,
Nikki
 
nslade001 said:
Thank you so much for your response. And especially for highlighting the first comment. I think the lack of uninterrupted sleep doesn't help my judgement either :)

I will post tonight around 8 pm with pmps, and an update with how she did until then.
Hopefully, you will be around to offer dosing advice?!

I hope you know how much we appreciate your help. With love,
Nikki
Click to expand...
Yes, I'll check in. You're an hour later than I am.

Nothing about this is easy ... I still struggle on many days. :confused::)
 
Hi again @Kris & Teasel ,

So the rest of the days readings are as follows: (I'll rewrite them all for ease):
Amps was 13.6
Gave 1 unit
+2 was 7.0
+2½ was 5.0
+3 was 3.9
+3¼ was 4.4
+3½ was 6.4
+3¾ was 6.7
+4 was 6.8
+4¾ was 9.9
+6 was 12.4
+8 was 11.8
And pmps was 13.6

We gave her one low carb snack thru the day, and she just ate 1/2 her supper (so she ate ¼ can FF just now); up until this morning she would clean up supper in one sitting, so her appetite is still off. She should be hungry, she's usually a grazer.

If I remember correctly, the body can respond to a hypoglycemic episode by becoming more sensitive to insulin, so you should decrease the dose a bit. Is that right, and for how long?

I had planned on giving 0.4 units which was yesterday's dose, (this morning's was 1.0 unit) but should it be even lower than that, since 0.4 was providing good results before the episode?

Will try to sweeten the supper with some chicken water (if she doesn't finish eating; she's eating it now)

Thanks so much, with love,

Nikki
 
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Try 0.4 u again even though PMPS is higher than yesterday. Give that dose tomorrow as well. After that it'll be easier to assess the dose and decide on whether to hold it or increase. Yes, they can be a little sensitive after dropping low. That 3.9 on a Freestyle Lite meter (same as I use) is a safe low number.
 
nslade001 said:
Ok, so even though her appetite is a bit off you think that dose should be ok? I'm borderline paranoid now, sigh
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She should be OK with 0.4 u on that PMPS. How "off" is her appetite? It's important to have food on board when you give Caninsulin because it can have a fairly fast onset. If 0.4 u worries you because she won't eat much try eyeballing 0.3 u or even go to 0.2 u.
 
Hey, decided to go with the 0.4 because she ended up eating maybe 3/8 out of 4/8 can. Hopefully she'll eat ok on her post supper snacks a bit later...Well do our best.
Thanks so much, with love,
Nikki
 
Hope you don't mind me tagging you @Kris & Teasel
Hi, so Willow is Still drinking and peeing a lot. It slowed down the first few days, then came back as bad as ever it seems.

Last night she wouldn't eat a thing at first. I thought it was nausea, because she'd seem interested but turn away. So I offered her a FF chicken grilled in gravy that I gave earlier for her fast BG drop nd she ate maybe 1/4 to 1/3 a can ... A fair bit (she finished the last tbsp overnight.

This morning no interest in the Pate mixed with water but she ate a bit from my hands...

So difficult getting her to eat anything. She pretty much just lies in her bed or on ours all day. She does not seem to be improving, if anything she's more lethargic although she appears interested...She sits sternal quite a bit, she's not always on her side.

What to do?

Levels were :
Last night pmps 13.6
+2 was 11.4
+ 4 was 10.2
Amps this morning 12.6

Ate a bit but don't know how much I'll be able to get into her.

She's lying looking at us like she's waiting to be fed but she doesn't really want to eat.

Do I still give caninsulin? How much?

Thanks, with love, nikki

PS edited to add I gave 0.4 units. Would love anyone's comments on her attitude. She seems like she just wants to be left alone. Is this normal ("normal" bwahahaha)
 
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nslade001 said:
looking at us like she's waiting to be fed but she doesn't really want to eat.
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That can be a classic sign of nausea.
Not eating is a problem. She might need some antinausea meds if it continues beyond today. Cerenia is one to try. Diabetics are fragile and prone to complications if anything goes off. Have you been testing her urine for ketones?

If those BG levels continue today she can be increased to 0.6 u tomorrow. I have to leave now for much of the day so post on the main forum if you need help ASAP.
 
Thanks so much yet again.

Eating better now later morning (she *loves * pumpkin apparently) and while definitely not great, at least her appetite seems to be intermittent rather than inappetant.
Ketones are still negative-trace.
Still drinking a lot.

Checked with vet records, she has had cerenia before...We've always called it her miracle injection. She had IBD from kittenhood and was frankly a horrible, pushy mean cat (bullied our others mercilessly, didn't tolerate human affection). She went off food and was interested but nauseous (licking), vet gave injection... And her personality changed! No more pain and she became a lover :) and her IBD was cured, has had solid poops with no recurrence of diarrhea since then (7 years!) And off IBD meds.

So going to see vet today to discuss options because I'm so worried about how Willow will handle this trip.

Will update tonight

With love,
Nikki
 
I'm in and out between appointments so I thought I'd check in. Cerenia injections tend to work better than the pills. I'm glad she's eating though. :)
 
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