First Hypoglycemic episode happening now

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arienette386

Member Since 2014
My cat had been eating less and less over the last couple of weeks when I decided to make the switch to low carb wet food. She was barely eating any dry food at all the last couple of days and I made the switch. The last three feedings she has not eaten on her own and I've had to feed her some with the syringe. This convinces her to eat a little on her own for about thirty seconds. Then she's back to snubbing the food. I have switched flavors each time hoping to find one she goes for. Also tried adding some warm water. So far the purina one turkey pate has had the best results-but i still have to sit with her and feed.

After giving her insulin(vestulin) tonight she dipped VERY low on BG-down to 50 and I have just given her a little smear of Karo on her mouth. I have been syringe feeding/coaxing her to eat a 3 oz can off and on since 7p (it's 1035). She finally finished it about forty minutes ago. Obviously 4 units is way too much insulin for a wet food diet. I am continuing to monitor BG until at least 11:15. It seems her peak low is about 4 hours post shot.

Her next feeding is supposed to be at 6:30 tomorrow morning. How much Insulin do you think I should give if I cannot be there to monitor her? I will have to leave for work at 7:40 and wont return until 1130 or noon.

arienette386

Update: I saw the post on how to handle low BG levels and am doing continual testing and feeding as needed. Any replies, support, advice, etc is much appreciated. This could be a long night...
 
Claudia's BG levels for 8-4-14

6:55a Pre-food 369
7:30a Post food and 4 units insulin 385
12:15p 94
7:15p pre food 174
7:20 Given food and 4 units
9:19 Post some food-syringe feeding 103
9:45 Syringe feeding slowly eaten almost 3oz 59
9:55 55 sent husband to get karo
10:18 post karo and some higher carb wet syringe feed 56
10:42 54 gave some more higher carb wet food
11:00p BG 55
11:18 BG 52 Fed 1 syringe HC food
11:41 BG 48 Fed 1 syringe and small karo dose
12a BG 50 Fed syringe
12:23 BG 53 She threw up a LOT of what I've fed her tonight. Skipped this feeding so her stomach can settle. Will be feeding less food and more Karo if she drops again

Post Vomit

12:43 BG 53 Plus 1/4 Tbl HC. No Karo
1:03 BG 48 Plus a little less than 1/2 Tbl.
1:28 BG 49 1/4 Tbs HC
1:50 a BG 45 little less than 1/2 Tbs HC-tested 2x to be sure
2:14a BG 45 Gave 1 Tbsp of milk/2 drops syrup mixture-still refusing to eat-sniffs then turns up nose. =(
2:34 BG 53 Gave 3/4 Tbsp milk/syrup mix Thank goodness she went up!!
2:54 BG 52 with 1/2 milk mix and 1/2 Tbsp 8% food-looking around the house for some longer lasting higher carb food
3:14 BG 52 Gave an undisclosed small amount of potatoes, milk, little cheese. Going to add more cheese to see if second try is more enticing for her. Probably got about 1/4 Tbsp of food altogether.
3:34 BG 62!!!!!! Given 1/2 Tbsp potato mixture...thank heavens another uptick. . .
3:52 BG 76!!! Given a little less than 1/2 Tbsp potato mixture
4:13 BG 88 No food given
4:33 BG 109
5:11 BG 157
 
You're doing perfect!!

Keep testing and every time you get a number under 50, give a little more HC ....Once you're into at least the 60's, stop the food but keep testing for at least until you get 2 climbing numbers without having to feed

Contacted one of the night people to come keep an eye on you but won't leave until I see her here
 
Setback listed in my other comment. She threw up big time... =( I listed my plan, hope it's right. I want to cry right now. Thank you SO much for the reply.

It would be so much easier if she just ate on her own.
 
You've been doing a great job. You want to be sure you don't get her too full or make her vomit from too much karo but she needs to be up a bit more. The karo usually wears off in a couple hours and the vetsulin should be waning, too.

The numbers she has been at are normal numbers and not hypoglycemic. They are scary but she's brrn at safe. Numbers and you've done a fine job. Being sure she has some low carb food on board now will help her if the karo wears off before the vetsulin.

I've never dosed vetsulin and it is done differently than Lantus or levemir which are depot insulins. If a kitty went below 50 on one if the L insulins, it would be cause for a dose reduction but I don't know if it's the same with vetsulin. You would be dosing on the preshot instead of the lower number, I believe.

Let me check around and I'll be right back.
 
Yes, that's fine...you only give a couple of drops of Karo at a time, but keep testing. It wears off quickly.

When you can get some real food into her, keep it to small amounts....like a teaspoon at a time. It sounds like maybe the high carb food was a little too rich for her...or too much too fast
 
Are you in the Central time zone? Trying to establish your timeline...

Did you lower her normal dose when you switched from dry to just canned?

As for reducing dose (regarding what Marje said) -

Anytime a kitty drops that far, that fast, it indicates a reduction is a good idea no matter which type of insulin, IMHO. With a non-depot insulin like vetsulin, or prozinc or any type that doesn't start with the letter "L", it is true that the preshot number matters. But the "low number" between shots is just as important. Dropping from 369 to 94 shows you what 4u can do. Her PM reading was only 174? And the dose was 4u?
 
Probably all of the above. I feel like I've been stuffing her all night and hadn't really seen her use the box. I had "just" made the comment to my sister that I was surprised she hadn't used the bathroom or anything.
 
I am Very new to this and trying to get her regulated on canned now. She was at 4u on dry and I naively left it the same for the switch. I had read that you should try to keep her on the same dose for at least a week between curves-but stupidly did not take into account my food switch. Learning hard this time.
 
Glad Carl popped in. He has more experience with the in/out insulins than I do but from what I understand, vetsulin duration can extend to 12 hours and I would think the more the dose might be too high, the longer the duration.
 
It usually takes about 30 mins to see the effects of the food and karo so keep that in mind when testing.

Do you have any fancy feast gravy lovers? It's higher carb and might help keep her BGs up a bit.
 
Have you tried crushing a few pieces of dry food and dusting it on top of the canned to see if she'll eat it on her own?
 
Also right now the highest carb I have is 8% as opposed to all of the 2 and 3% cans I bought preparing for her switch. Didn't even think to keep the higher stuff around. I am working my way through the 8% can. It's wellness salmon and trout-got carb info off of this link http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

I know fish is not reccomended but it's the highest carb content i have right now. She was fed a whole 3oz can of purina one turkey pate earlier and that's the majority of what she threw up.
 
So with all of this happening tonight what do you recommend I do for her Am feeding? Was going to be at 6:30a. Obvious less insulin-do I just have to wait and list her pre feed numbers? I'm hoping to leave for work around 7:40a...
 
One of our other experienced Lantus/levemir member's kitty was on Caninsulin (vetsulin) before Lantus. She said the info from the vet is if the kitty's BG goes below 54, reduce the dose by half. So I would only shoot a max of 2u tomorrow and check with the vet ASAP tomorrow.
 
I had read that you should try to keep her on the same dose for at least a week between curves-but stupidly did not take into account my food switch.
Click to expand...

You are correct that a reduction is a great idea when you go from dry to wet food.

But beyond that, as long as you are home-testing, the "keep the dose the same for a week" thinking is not a hard and fast rule. If you are getting preshot tests, you can use that number to make a dose decision.

While 4u might have been okay on a 369 preshot this morning, you can see that it dropped over 250 points this morning, right?
Tonight you had a 174 preshot number. So theoretically, if it had fallen 250 points again, her BG would have been less than zero. If you hadn't been testing tonight when you did and caught that number in the 50's, well you could have been making a trip to the ER with a kitty in the middle of a hypoglycemic seizure, or worse. Especially a kitty who is not a big fan of her new diet plan.

Because you are "new to this", you would most likely have been advised to hold off on giving a shot with a preshot reading of less than 200. And even on a 200, we would have suggested a much lower dose, like 1u or 2u at most.
Water under the bridge at this point, but just wanted to explain the "logic" a bit.
 
Makes sense. In hindsight there were better decisions that could have been made. I appreciate your explanation and have definitely learned from all of this. I was having some trust issues with my vet because he told me not to switch to wet food because it had too high of sugars in it-and everything I've been reading says wet is Waaay better than a dry diet. I think maybe I should have asked more questions of him and asked for more of an explanation. It is always so rushed in his office and I feel like a bother. This forum has been a godsend. I have been doing nothing but reading in my free time-trying to find the right canned food(s) to try and learning more about the disease in general.
 
So my next question would be if it's under 200 in the am and I hold off on the shot-she still gets breakfast right? I would only be able to check her within an hour of breakfast and then four hours after that(work). And if she's not eating on her own do I continue to syringe feed? I will def. try to call the vet but the office does not open until 7:30-just before I"m leaving for work
 
12:43 BG 53 Plus 1/4 Tbl HC. No Karo
1:03 BG 48 Plus a little less than 1/2 Tbl.

She's starting to get a little irritable with all of the ear pricking. That and I keep taking her out of her comfy bed.
 
Yes...you must fed her even if you don't shoot. I would try to get food in her in the morning even if you don't shoot.

Did you sprinkle some dry food on her food? Although dry food takes a while to bring up BG, you might give her a few crumbles.
 
Good Morning from the UK. ~O)
You're doing a great job there, and have had super duper advice and support.
I'll be around if you need some company.

Eliz
 
I think I'd raise the "bar" on not shooting to 150 myself. And no more than 1u on anything under 200. My 2¢.

Just curious, but what type of dry food was she eating? Many varieties of canned food are high in carbs (the goopy gravy styles for instance)- what your vet meant by "sugars" I assume. But there are only a couple types of dry food that come anywhere close to "low carb", and none are available at the grocery store. Even most of the prescription types are. in general, dry is way higher carb than canned.

One other thought... If she doesn't eat on her own in the morning, I think I'd skip the shot, or just give a token dose like 1u at most.
 
I was trying not to feed her in the bed because we do drip a little here and there-didn't think she'd appreciate a dirty comfy bed
 
She's flat which is good but ideal would be to see her coming up. I know she must be full.

Can you just test her in the bed so she's comfy for the test?
 
Her dry food was Purina Pro plan weight management...I think I chose the "savor" type. I am not 100% on it now because I bought the bag before her diagnosis and use a food container to keep it fresh. So naturally the bag got thrown out. What had lead up to her diagnosis was that I was trying to get her to lose weight by paying close attention to portion recommendations and feeding 3x daily instead of free feeding. Little did I know my room mate thought she was helping and was feeding Claudia whenever she asked for it-which was all the time. When that room mate left-Claudia was diagnosed not long after.
 
I will test her in her bed next time-She may not be full considering she threw up a pretty decent amount earlier...it was the biggest puke mess I've seen from a cat.. =( Once she gets above 50 should I stop the feeding? (I also left some dry kibble out for her pickings while I'm out of the room but I doubt she will touch it).
 
Usually when we have something like this occur, we have the caregiver feed a large amount of high carb food to "abort" the cycle and bring the BG up. I know you've been giving her small amounts of HC but it's not really bringing her up.

When you say HC...you mean the 8% which is really LC food. So we aren't really making any progress. Real HC food is about 15% + and usually gets them up there and is less likely to wear off then karo.
 
Elizabeth is in the UK so it's morning for her. Carl and I both have to get some sleep....he has to work tomorrow and my kitty is also running low so I'll be sleep/testing and need to grab a nap.

You will be in awesome hands with Elizabeth. You're doing a super job. Hang in there.

I'll pop by in the morning to see how it went. I know you are tired....it's very late your time. I hope you get some rest.

Good night to you and your sweet girl.

edited to add: if she goes any lower (30s), I'd consider getting her to the ER. They can give her dextrose and bring her BG up.
 
I suppose mine is still LC then at 8%. Any reccomendations? I can make a late night food run to Walmart or Dillons to grab something that might help speed this along. Anything to speed it up would be great.
 
Do you have any vanilla ice cream? Any high carb treats like Temptations? Maybe put some syrup in milk and let her drink it?
 
Vetsulin/Caninsulin actually has a 'double peak' (one earlier in the cycle and one later).
In cats this isn't usually apparent because in most cats the insulin duration is very short; but in cats who have longer duration with it the 'double peak' may become evident. This might be why your kitty's numbers aren't coming up yet.

I concur with giving a bit more higher carb food.
 
I can do the syrup and milk thing-I also have some old Pounce treats I could try-Might have to give those to her like a pill(cut in half first). Recommendations for amount of milk and syrup mixture? Which do you think would be best? Also have cookie dough ice cream-could use the vanilla around the dough....
 
Ok...my last post and I'm off :-D

If the ice cream is vanilla around the cookie dough, you could try that. If you are worried it's not just vanilla, give her a few drops of syrup in a couple tbsp of milk.
 
are there any high carb human foods she likes?
my alex is partial to Cheeze-It Crackers and Cheetos. Both snacks raise her numbers. :mrgreen:
 
2:14a BG 45 Gave 1 Tbsp of (2Tbst) milk/2 drops syrup mixture via syringe-still refusing to eat-sniffs then turns up nose. =(
 
Arienette,

Can I just check at this point:
How many hours since insulin?
Which glucose meter are you using? (ie Alphatrak or a 'human' meter)

It may be useful to get the number of an ER vet handy just in case you need it. (Chances are that you can manage this at home, but it is as well to be prepared.)

Eliz
 
arienette386 said:
2:34 BG 53 Gave 3/4 Tbsp milk/syrup mix Thank goodness she went up!!
Click to expand...
OK, a little rise there. That's good news.
But you may not be out of the woods yet.
As you know, the syrup acts fast but can then leave the system quite fast too.
Ideally, we'd like to see three rising numbers in succession before being sure that Claudia is on the way up.

Well done. I know you must be exhausted...

Eliz
 
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