Frodos' BG = 22 Lantus users please advise

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heidi

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I'm beginning to sound like a broken record but Frodo's hypo again. BG of 22 at 3 hours post shot. I got another test 20 minutes later and it had risen to 38 after a little high carb treat. He has no symptoms of hypoglycemia at this moment (is this unusual with such a low number?). I have arranged to be home the rest of the day and can keep a close eye on him.

If you look at his SS, you'll notice that I reduced his dose to 0.5 units on Saturday. We did two shot cycles successfully -- but I tried to shot low yesterday (probably is good that I didn't succeed) and believe I gave him a fur shot. His numbers seem to prove this out.

What now? I stayed home from school today so I could monitor him and I have tomorrow off and can monitor him, but Wednesday I need to go back to campus. Any thoughts?

Heidi
 
Personally I would take him off insulin for a few days, while testing for ketones, and see if he can maintain normal numbers on diet alone. Since it looks like the only time he is getting to shootable numbers for you on even that low of a dose is when he bounces from nearly going into hypo. If he remains high and doesn't start coming down on his own on diet alone, then maybe start him back on insulin at .25u.

But as fast as he goes down I think he just might be ready to try it without insulin and just diet.

Mel, Maxwell, Musette & The Fur Gang
 
Numbers are going up (just got a 67). . . Phew! I'll keep monitoring throughout the day.

I use a Reli-on micro.

I admit I haven't done any ketone testing yet. As an overwhelmed newbie, I decided one step at a time and was concentrating on getting BG testing in place. Following Frodo into the litter box is not going to happen. He's a former feral and is very private about his littler box habits. Some one suggested in another thread using aquarium gravel in a clean litter box and segregating the sugar kitty from his fur friends overnight to collect. Is this a decent plan? Actually, I have a feeling he'll reject the aquarium gravel and just pee on the floor, but that should also allow me to test and wouldn't be awful if I segregate him in the bathroom . . . Other ideas for ketone testing? I have to go to Wal-mart sometime later today or tomorrow for more glucose strips. Any type of ketone strips recommended?

I keep telling myself to breathe . . .

Heidi
 
Taking some time off the insulin may be an idea because after really low numbers, cats are more sensitive to the insulin.. Let everything drain, and continue with the proper diet and testing to see how it's going. You can try the food test later ... test, then feed, then test again after an hour and see how the numbers go; food can be used to juggle numbers pretty well.
 
I believe the Ketostix are what you are looking for. If you don't see them on the shelf, you may have to ask the pharmacist for them--no prescription needed but sometimes they keep them behind the counter.
 
just a note of encouragement...
Binks just got tired of the whole routine, and took himself off insulin at the .25u stage :-D

He did have a brief return from the Falls, but it was entirely due to access to HC canned & kibble :oops:

(noting here that Binks has no history of ketones)

best of luck to you & Frodo!

celi & binks
 
I agree with everyone one else--stop insulin for a few days and test to see if he's going down on his own. A few lucky cats do go into remission right away when the diet is changed. A good test to get to see if his pancreas is working is to test at meal time, then at 2 hrs after he eats and again at 4 hours after he eats. If his pancreas is producing insulin, you'll see that the +2 is higher than the pre-meal test, and the +4 will be lower than the +2, hopefully in a normal range.
 
Thanks for the advice, everyone.

So if I stop the insulin for a few days . . . I test for ketones (once a day?). I test with food as Julia suggested to see if his pancreas is producing insulin. Do I also randomly test to see if he's generally staying in acceptable ranges? What type of BG testing schedule would be ideal to check this?

I'm totally stoked at the idea he might be diet controlled!
Heidi
 
+6-8 is usually the low point of the day on Lantus. For some reason, he is experiencing his low in the morning 12 hours after getting a shot, when he should be high. It must take a really long time to fill his shelf at night. He may only need 1 shot per day of .25 or maybe 2, but I agree that if you shoot at all, it should depend on his count tonight and should not be higher than .25U and only if he is higher than 250 bg.

I also control Racci's numbers by feeding a lot. If too low before shooting I feed first and wait an hour and try again. I also agree that his diet may be enough and stress might be bringing his numbers up. Since his numbers are low in the daytime you can feed whenever you see that. Under 80, I would give a treat that would bring him up since you are new to this. Something higher in carbs or sweet but just a little of it and food, then test again in half an hour to an hour.

Melanie & Racci
 
I don't think it's necessary to test for ketones every day, especially if he's in lower numbers. Maybe every three days or so? Of course, if he's not acting normal for some reason (lethargic, doesn't want to eat( you'll want to test him for ketones immediately.

If it were me, I'd test before each meal (where the preshot tests have been), and then the +2 and +4 in one of the cycles, and then a random test in the other cycle (maybe around +6 ?)
 
Heidi, I forgot to ask--dose Frodo have any history of ketones? If he does, you may want to test more frequently for them than I suggested.
 
I've never tested for ketones. I'm not sure what the vet found at Frodo's diagnosis. If ketones were present they must have been at a low enough number that Frodo wasn't in danger. We started insulin right away, but he had no other treatment.

Heidi
 
Heidi, their is a mathematics to whether a cat gets Keto acidosis. I'll give you the simple maths from the ER vets on that, so you have something to check against.

Serum (blood) glucose 25-30 (450-540) (<14 (252) for some very very sensitive)
Blood pH all wrong < 7,3
Blood Sodium and Potassium all wrong <
Serum Osmos under < 300
B Blood Ketones > 3 mmol
I-STAT (a series of tests like blood gas etc.)


And the A urine ketones stix, if they are marked with +, ++, +++, corresponds to the B blood ketone machine like this

A-U-ketones ___-________ B Blood ketones
+ small 0.5 mmol -----------0.1-0.9 mmol
++ moderate 0.7 mmol-------0.2-1.8 mmol
+++ large 3 mmol-------------1.4-5.2 mmol


I have the B Blood Ketone meter, measuring the b-ketones in the blood direct, and if I get a 0.5-0.7 mmol, I am getting myself and Simba ready to hit the ER. That would be the ++ and +++ on your stixs if they show in +'s.


Hope it helped, and didn't scare you more. In the latter case, I am sorry then.
 
Heidi,
If you don't think the aquarium gravel will work, you can try hiding some saran wrap under the gravel to catch some pee. As long as you can get to it quick, the litter won't suck it up.

Carl
 
MelanieAndRacci said:
+6-8 is usually the low point of the day on Lantus. For some reason, he is experiencing his low in the morning 12 hours after getting a shot, when he should be high. It must take a really long time to fill his shelf at night. He may only need 1 shot per day of .25 or maybe 2, but I agree that if you shoot at all, it should depend on his count tonight and should not be higher than .25U and only if he is higher than 250 bg.

I also control Racci's numbers by feeding a lot. If too low before shooting I feed first and wait an hour and try again. I also agree that his diet may be enough and stress might be bringing his numbers up. Since his numbers are low in the daytime you can feed whenever you see that. Under 80, I would give a treat that would bring him up since you are new to this. Something higher in carbs or sweet but just a little of it and food, then test again in half an hour to an hour.

Melanie & Racci
Click to expand...

I just wanted to clarify that Melanie is only talking about giving something higher carb under 80 if Frodo is on insulin. Don't be doing that if he's not having any or, if he is diet controlled, giving him higher carb or sweet (ever again) could make him need the insulin again.

Also IMHO you have seen that Frodo can go very low without experiencing any symptoms so, even though you're new, I would think there's no need to give anything higher carb unless he's under 50 or even 40 - open to correction here people, maybe that's just a TR thing?
 
Thanks everyone for your thoughts.
After consulting with my vet and thinking things through, I have decided to take Frodo off insulin for a few days and see how he reacts. He rebounded pretty high this morning, but hopefully his pancreas will kick in and start bringing that down. We'll see. . . At least, I can relax for a few days knowing he's not going to hypo again.
Heidi
 
You're right, Vyctor's Mom, that is what I meant and I don't worry unless Racci is under about 60. She has never been below 59, but she has never had symptoms of a problem and has never had ketos when high either. I just didn't know how this new furbaby would react since Frodo is new to insulin and better safe than sorry. :smile:

I hope he can stay off insulin. It would be so wonderful if he could!!! Keeping my fingers crossed. Heidi, try and keep his food as low carb as you can.

Melanie

PS: Heidi, Please remove the 911 emergency icon until you need it again. Just open the original message & on the first one click Edit, then click one of the other icons and submit.

Thanks.
 
And look how pretty he is dropping even without insulin...it may take him a few days to work out all those counterregulatory hormones and stored sugars that his little body was releasing to help fight off the hypos. But just seeing the way he has already dropped over this first 12 hours without insulin he is looking great.

We will keep our fingers and toes crossed that he comes down into normal numbers and stay there for you, but if he doesn't it isn't the end of the world, for at the very least he will be a very low dose kitty. :-D

Mel, Maxwell, Musette & The Fur Gang
 
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