Help after hypo

Status
Not open for further replies.
B

Bebe Kaye

Member Since 2013
Miley just had another hypo, phew, scary stuff!



I had just gone to bed and lucky my youngest was still awake doing some cleaning, I don't know why, but before bed I went over hypo symptoms and how to treat it with her...psychic moment maybe? 15 minutes after I went to bed I heard her yell out for me, and sure enough, he was in the middle of a hypo. She did wonderfully, she saw him staggering, grabbed the honey and had already started giving it and checking his sugar. I'm so proud of her!! He was staggering really badly and then threw up a LOT of food, after he threw up he seemed to come good very quickly. I'm not sure how much honey my daughter gave him, I gather it's too much considering he was a very sticky kitty and his BG raised really quickly. I will be watching him the next few hours just to reassure myself he's okay, he's sitting next to me purry, bathed of his excess honey (bathing a cat is fun! ohmygod_smile ) and back to normal.


Anyhow, the '911' I really need to know where to go from here, this his second hypo in 2 weeks, he's been a diabetic a year and never had one...now 2 in 2 weeks, I'm scared! I've taken him to the vet, she's ruled out it being any of his other health issues, especially when he reacts so quickly and successfully to the hypo treatment. I just don't know when they will hit, they've been at 83 for the first and 79 tonight...so way too high considering if you look at his SS and see he's had a lot of numbers lower than that with no hypo. I know the tight regulation is not to drop him down in insulin, but it seems to be my only course right now...I need sleep! As you can see from his SS, i've been up every night for quite a while now, I don't expect my other family members to do this, they have other things like work and a baby to look after, so this is up to me majority of the time.

Any suggestions of where to go from here would be very greatly appreciated!

I'm heading over to Lantus Land to do my daily condo (yes i've been really slack with my own health and haven't done one today :oops: !)

Thanks!

A very shaky Bebe and a sticky Miley (what a pair! :lol: )


EDIT: removed the '911'


PS. Oh and I did my first Subq today...disaster central! I panicked too much and I think the needle was too big, it was so hard to push in and then I worried and took it out after about a minute, but he still got a decent size 'ball' of liquid in...though his body sucked it up reallllllly quickly! I will go back to watching the recommended you tube vid for it another 5 times and try again tomorrow with a small gauge needle.
 
No advice, just lots of sympathy. I trust you'll get the support you need in Lantus Land.
One thought - the subQ fluids may have had an effect as it improved his hydration. Therefore I would suggest you want him more closely particularly when you give more fluids.
 
Cats can be extra sensitive to the insulin after a hypo. Also, because Miley seems to get those symptoms at around 80, you want to drop the dose.

Maybe in half? for now to be safe? At least by 0.25U. I think you also might want to try for higher nadirs. Maybe try to keep the nadir above 100.

The sub-q fluids might have also had an effect on the absorption of the insulin. We had another member about 10 days ago that was giving sub-q fluids and insulin around the same spot. She gave the next sub-q far in the scruff area, and gave the insulin on the rear flank for her cat.

I do not know if the fluids were the cause of this hypo or the last one, but it is a possibility.

What is going on almost sounds like epilepsy instead of a hypo. Has your vet checked for that?

Here are some links to a couple of youtube videos. grand mal seizure http://www.youtube.com/watch?v=ZvvrP-2o8Bk
petite mal seizure http://www.youtube.com/watch?v=lnfCafjjCaQ&feature=endscreen

ETA: Please add in the remarks section on your SS when you have given fluids and how much. Times too please.
 
Deb & Wink said:
Cats can be extra sensitive to the insulin after a hypo. Also, because Miley seems to get those symptoms at around 80, you want to drop the dose.

Maybe in half? for now to be safe? At least by 0.25U. I think you also might want to try for higher nadirs. Maybe try to keep the nadir above 100.

The sub-q fluids might have also had an effect on the absorption of the insulin. We had another member about 10 days ago that was giving sub-q fluids and insulin around the same spot. She gave the next sub-q far in the scruff area, and gave the insulin on the rear flank for her cat.

I do not know if the fluids were the cause of this hypo or the last one, but it is a possibility.

What is going on almost sounds like epilepsy instead of a hypo. Has your vet checked for that?

Here are some links to a couple of youtube videos. grand mal seizure http://www.youtube.com/watch?v=ZvvrP-2o8Bk
petite mal seizure http://www.youtube.com/watch?v=lnfCafjjCaQ&feature=endscreen

ETA: Please add in the remarks section on your SS when you have given fluids and how much. Times too please.
Click to expand...

Thanks for those links Deb, no he looked nothing like those, he was staggering like a drunk, made one loud yeoww noise and then threw up, he came good after that. I gave his Subq fluids in the scruff of his neck, the insulin goes into his sides of tummy, quite a significant distance from the fluid area. I never even thought of it being from that so kudos to you for picking this one up!!! Problem is though, he has only had 2 lots of subq's, the first on Friday (5/31) at the vet and then my terrible try today.

I was thinking I may try dropping his insulin slowly, at his AM shot drop it to 0.75 and leave that for at least the 6 cycles and keep my fingers crossed there's no more of these. I've no idea why this is happening how it is...way higher than 'normal' cats would hypo. The only thing that I can think of is maybe he hypos when he has a rapid drop...though tonight wasn't all that rapid. He's also been a little finicky with his food today (tonight especially), though he did eat quite a bit judging from the amount he threw up! I had to open 4 different tins of food tonight as he's going through one of his 'fussy' periods, so he sampled them all before settling on one.

Thank you for taking the time to post and help, I really appreciate it!

Bebe and Miley
 
EllenandRover said:
No advice, just lots of sympathy. I trust you'll get the support you need in Lantus Land.
One thought - the subQ fluids may have had an effect as it improved his hydration. Therefore I would suggest you want him more closely particularly when you give more fluids.
Click to expand...

Thank you so much for taking the time to post and offer support (also a good stiff drink might help me more at the moment...pity I can't drink :lol:). The hydration that you and Deb mentioned are things that never crossed my mind, but it makes sense. I have to give him more fluids tomorrow *fingers crossed* it goes okay, he's not the one who needs a Valium to get through it, but I sure should be taking some! I have to keep reminding myself that I felt like this when I started BG testing and now that is second nature and something I could do with my eyes closed!
 
Were here to help. Sometimes brainstorming and throwing out ideas can make you go "That's it!" Sometimes, we have to keep brainstorming and suggest other possibilities.

We'll figure it out soon.
 
Goodness, this bean is going crazy...okay, okay I already was, so he's sending me a little more crazy!

I'll take the '911' off, he's doing well now, his numbers aren't yet stable but are at a less heart-failure-number.
 
Can I ask why you arent reducing the dose after these? To me, it sounds like he is dropping too low. Maybe you want to try 0.75 instead of 1? He is getting lots of good numbers so I think it would be worth a try.

Wendy
 
My first instinct was to DEFINITELY reduce the dose but on one of my condos over in LL someone posted that I HAD to follow the tight reg and I was NOT to reduce him until he had hit some 50's, which he has yet to do. I am so confused!

I decided after last night that I will just have to stop posting on the LL tight reg, as their policy doesn't seem to suit him, and it's giving me heart failure to shoot the full amount when he's so low and seems to hypo at different numbers to most kitty cats.

It's been a long night, I managed to get an hour and a half sleep (I think), I was so worried i'd come down this morning to something bad, but he was sitting on his chair happy and waiting.
 
Ok Bebe,

Here are a couple of changes I want you to do. Milo breaks all the rules so we want to make people aware of this however we can. That is why I am suggesting these changes.

1. Since Milo breaks all the rules and hypos at 80, I would like to see a note to that effect in your SS. Would you put something there please, insert a line where you plainly say "HYPOES AT 80". I'd like to see this running right across the range of cells where the test numbers go. In a nice large font. You may want to do this once a week so it continues to stand out from week to week and is not buried too far up on the spreadsheet for someone to miss this critical piece of information.

2. Next , update your user control panel, profile tab, edit signature. Add something similar here and the new protocol suggested for you so it stands out in nice large type. SLGS - HYPOES AT 80

3. Third , I see you did drop that dose to 0.75. Let's keep it there for a bit and maybe even reduce the dose again. That may mean keeping Milo more in the blues and some yellow numbers, but I think that is safer for him then those greens which are just too low for him.

4. Please tell me your normal shot times. Tell me these in your local time. I've looked it up and the time difference between where I live in the US and where you live in Australia looks like 14 hours. Now, with your shot times and taking the 14 hour difference into account, I'll see if I'm usually around at those times to help you out. I know I won't always be around at your shot times, because of work, but I'll try to keep my eyes out for your posts more.

How does that sound?
 
ok heres the thing. and I totally agree with Deb.

You hold the syringe not us and its up to you whether to follow the tight regulation protocol or not. But saying that your cat is acting very odd if having hypos at such a high number. Maybe its your meter. maybe its Milo... after all every cat is different.

In a normal situation 50 is the number below which we reduce since cats dont even show hypo symptoms until below 40.. But Milo is having hypos below 80. So I would make 80 your dose change number whether or not he shows hypo symptoms.

I am glad you dropped the dose to 0.75. Lets see how that does for a few days (at least 3) unless if he drops again below 80 or has another hypo .. in which case we try 0.5.

Edited to add - you are more than welcome to continue to post here and we wil help as much as we can.
Wendy
 
I'm wondering if the stage 4 renal disease is affecting the threshold for, or contributing to, the symproms you're seeing.
 
Wendy&Tiggy said:
In a normal situation 50 is the number below which we reduce since cats dont even show hypo symptoms until below 40.. But Milo is having hypos below 80. So I would make 80 your dose change number whether or not he shows hypo symptoms.
Click to expand...

I would make your dose change number 90 (5 mmol). That is the number in the SLGS protocol.

If Milo drops into the 90's (5 -5.5 mmol), manage more with food. Give a teaspoon of the low carb food whenever he drops below 100. Treat this the way we would a cat in the 40's (2.2-2.72). "feed the 40's" is a method for keeping the BG numbers from dropping lower into possible hypo territory.

Since Milo is unique, your mantra will be "Feed the 90's".

http://binkyspage.tripod.com/SLGS.html Some of this information in the SLGS protocol needs to be updated, but it give you a starting point.
 
Thanks for all the posts, you're all fantastic!

I have no idea if the CKD would affect his diabetes, the vet has told me that the FD takes precedence over the CKD, and that as long as we can keep the FD controlled, then we can look to see what we can do with the CKD.

I expected Milo to have higher numbers today after the high carb food and all that honey of last night, but apart from his morning 140's, he's been low again most of today. he's still dropping and he's sitting on 76 at +10 and he's had a bad habit lately of dropping instead of rising coming into his PMPS. I usually feel confidant shooting low as he eventually does go up or makes up with the amount of food he's eating, but with him being a little off the food, I don't want a repeat of last night. If his BG keeps dropping tonight, I will be skipping his PM insulin shot...I need sleep I-) !

I just don't know what's going on, my vet is away for the next few days...I have my fingers and toes crossed that his pancreas has just decided to wake up a little and not something worse like the CKD causing havoc. He's scaring me, I'm selfish and am not ready to lose my Ebony Prince yet. I can't see any discernible symptoms that his tummy is playing up with the CKD, but maybe that's putting him a little off his food...the rest of his behaviour is normal.



Deb & Wink said:
Wendy&Tiggy said:
In a normal situation 50 is the number below which we reduce since cats dont even show hypo symptoms until below 40.. But Milo is having hypos below 80. So I would make 80 your dose change number whether or not he shows hypo symptoms.
Click to expand...

I would make your dose change number 90 (5 mmol). That is the number in the SLGS protocol.

If Milo drops into the 90's (5 -5.5 mmol), manage more with food. Give a teaspoon of the low carb food whenever he drops below 100. Treat this the way we would a cat in the 40's (2.2-2.72). "feed the 40's" is a method for keeping the BG numbers from dropping lower into possible hypo territory.

Since Milo is unique, your mantra will be "Feed the 90's".

http://binkyspage.tripod.com/SLGS.html Some of this information in the SLGS protocol needs to be updated, but it give you a starting point.
Click to expand...

This sounds good, I'm so stuck because sometimes he hypos in the 70's and then other times he's fine...maybe i'm missing something. I'm already feeding him when he's under 5 (90) and all this is still happening :YMSIGH: .
 
Deb & Wink said:
Ok Bebe,

Here are a couple of changes I want you to do. Milo breaks all the rules so we want to make people aware of this however we can. That is why I am suggesting these changes.

1. Since Milo breaks all the rules and hypos at 80, I would like to see a note to that effect in your SS. Would you put something there please, insert a line where you plainly say "HYPOES AT 80". I'd like to see this running right across the range of cells where the test numbers go. In a nice large font. You may want to do this once a week so it continues to stand out from week to week and is not buried too far up on the spreadsheet for someone to miss this critical piece of information.

2. Next , update your user control panel, profile tab, edit signature. Add something similar here and the new protocol suggested for you so it stands out in nice large type. SLGS - HYPOES AT 80

3. Third , I see you did drop that dose to 0.75. Let's keep it there for a bit and maybe even reduce the dose again. That may mean keeping Milo more in the blues and some yellow numbers, but I think that is safer for him then those greens which are just too low for him.

4. Please tell me your normal shot times. Tell me these in your local time. I've looked it up and the time difference between where I live in the US and where you live in Australia looks like 14 hours. Now, with your shot times and taking the 14 hour difference into account, I'll see if I'm usually around at those times to help you out. I know I won't always be around at your shot times, because of work, but I'll try to keep my eyes out for your posts more.

How does that sound?
Click to expand...

1. I did my best, I couldn't work out how to put that writing across the columns.
2. Updated the signature.
3. Yes I reduced the dose this morning but he's still dropping down, but then his depot is probably still full up. I most likely won't be giving him his PM shot tonight, I really need sleep!
4. He gets his shots at 7:30am and 7:30pm...I used to do them at 6 but they've been pushed forward while holding off over the past few weeks and we never got back on schedule, but these times are working fine so will most likely leave as is.

Thanks so much for your help, sounds great!!!

Bebe and Milo
 
Bebe,

Would you do another test now to see where his number is. If it's dropping much below 90, we might want to put a single drop of karo syrup in his teaspoon of LC, to raise the number a bit and prevent him from dropping.

You did a good job on putting that warning across the SS. Good idea to put it in red also to make it very visible.

The remark for 6/4/13 on the SS is very good too. It tells us why you have skipped the PM shot. I do think you needed to skip because he is down to 5 (90 mg/L) and we have set that as your 'do not shoot ' threshold number.

It would be a good idea to feed him small amounts of food, to try to keep him above 90. His regular PM meal but then 1 teaspoon amounts every hour or so, mini-meals, to help keep those BG numbers up. Feeding these mini-meals is a way to manage Milo's curve and keep it more even, trying to keep him from dropping too far down.

Do you understand this food management tactic?

Signature change is good also. One tiny change there. Highlight the text with your mouse. go up to the editing toolbar for the posts, where you see the drop down list with the word Normal. click on that drop down arrow. click on that word Large in the drop down list. preview to see if you did the change correctly. your text should now look like this . submit to save the change.

I'm more likely to be able to be around at your morning shot time, that would be early evening the day before for me. I'm not usually up early enough for your evening shot time but I think Dyana might be. You might want to PM her and ask. She's on the east coast in the US also. Elizabeth and Bertie are in the UK. They may be on at your evening shot time.
 
I am very interested to see how his numbers were since you skipped that shot, his BG is looking good and I wonder if he can sustain it..
 
Deb & Wink said:
Bebe,

Would you do another test now to see where his number is. If it's dropping much below 90, we might want to put a single drop of karo syrup in his teaspoon of LC, to raise the number a bit and prevent him from dropping.

You did a good job on putting that warning across the SS. Good idea to put it in red also to make it very visible.

The remark for 6/4/13 on the SS is very good too. It tells us why you have skipped the PM shot. I do think you needed to skip because he is down to 5 (90 mg/L) and we have set that as your 'do not shoot ' threshold number.

It would be a good idea to feed him small amounts of food, to try to keep him above 90. His regular PM meal but then 1 teaspoon amounts every hour or so, mini-meals, to help keep those BG numbers up. Feeding these mini-meals is a way to manage Milo's curve and keep it more even, trying to keep him from dropping too far down.

Do you understand this food management tactic?

Signature change is good also. One tiny change there. Highlight the text with your mouse. go up to the editing toolbar for the posts, where you see the drop down list with the word Normal. click on that drop down arrow. click on that word Large in the drop down list. preview to see if you did the change correctly. your text should now look like this . submit to save the change.

I'm more likely to be able to be around at your morning shot time, that would be early evening the day before for me. I'm not usually up early enough for your evening shot time but I think Dyana might be. You might want to PM her and ask. She's on the east coast in the US also. Elizabeth and Bertie are in the UK. They may be on at your evening shot time.
Click to expand...

Thank you for the post Deb, yes I understand all you said, I am kicking myself this morning, I went to bed pretty much straight after Milo's PMPS test. My daughter was staying up for a little bit so she said she'd do some tests for me...her son was ill so she forgot all about it and then when she had to come downstairs to make a baby bottle, she did a quick test; that was at +4 and he was down to 70, so I'm not sure if he dropped any lower during the other 3 hours.

She fed him and he came up to 113 at +5 and then dropped a little before staying up enough for her to go to bed. When I got up this morning he was at 220 so no miracle remissions there :lol:, but I did have my fingers crossed. Looks like his depot kicked in over night with those numbers. Miley is also off his food, he's eating little bits, but i'm having to open a few tins to find what he feels like, I assume his CKD is kicking in and affecting his appetite :sad:. He's had 0.75 units of insulin this morning and i'll keep an eye on how he's doing today, i'll also feed the small amounts every hour and see how that goes.

Thank you so much for taking the time to help me with my boy, I really appreciate it.

Bebe and Milo
 
Wendy&Tiggy said:
I am very interested to see how his numbers were since you skipped that shot, his BG is looking good and I wonder if he can sustain it..
Click to expand...

Lowish numbers overnight but it shot back up sometime during the early hours, my youngest DD must have let the outside civie in during the night so I can't even say how much food Miley ate. I'm just glad my oldest DD had gotten up and thought to check Miley and make sure he ate, i'd hate to think of where that 70 reading at +4 would have gone! I really had hoped that he could have sustained no insulin, it would have been one less strain on his poor body. Oh well, maybe one day soon! :roll:
 
You daughter taking that +4 and knowing to feed him undoubtedly kept Milo from going lower.

Let's try managing the curve more with those mini-meals and keep his BG's a bit higher than we might for most cats.

Hope you got a good night's rest last night and are refreshed and ready to meet the new day.
 
Deb & Wink said:
You daughter taking that +4 and knowing to feed him undoubtedly kept Milo from going lower.

Let's try managing the curve more with those mini-meals and keep his BG's a bit higher than we might for most cats.

Hope you got a good night's rest last night and are refreshed and ready to meet the new day.
Click to expand...

Miley's numbers have been uppish all day, i've been giving him small meals all day and he's eaten more than he has over the past 2 or so days.

Sleep :YMSIGH: yes I had a good 6 hours, but a relapse of the head cold, :lol: screwed up immune systems aren't great...just glad I've had my flu needles for these colder months!

Hope you've had the most wonderful of days and it's not getting too warm on your side of the world.

Bebe and Miley
 
Ok, Milo was in the low yellow numbers at pre-shot and came down into some of the high to mid-blue numbers at mid-cycle. This is undoubtedly a bit of a bounce from the skipped shot on June 4 pm so not unexpected.

Let's watch him and see how soon he clears this bounce.

Because of the bounce, we can not really tell how the food management is doing to keep his numbers more level. We can see that smaller meals seem to be getting him to eat a bit more which is also a good thing and reassuring.

I'd rather be seeing some slightly higher numbers for Milo than having him hypo again.

Glad to hear you got a good 6 hours of sleep. Take good care of yourself with that relapse on the head cold. Hopefully, you can get in a nap during the day to help you catch up on your sleep. We care about you and how you are doing as much as we do about Milo.

Weather here in Massachusetts, east coast is very nice right now. Summer temps but not blistering hot like last week and low humidity. I enjoy being close to the ocean and getting those nice seabreezes to keep it cooler than a bit inland when the temperatures do get warmer. I live out on my screened in porch for most of the summer. And my 3 cats love it out there too! ;-)
 
:YMSIGH: Miley's numbers stayed up all day and then I'm not sure why, but with his weird numbers I checked him at PMPS+2 and got a shock. Way down to 65 :sad:, I'm double posting right now as i'm also writing up his LL condo for today, I never seem to get online until evening most days.

Head cold hit with vengeance today, i don't mind the whole head cold bit but the body aches...UGH!!!!!!! I greatly dislike doctors and this hasn't hit my chest yet so don't plan on seeing them until it does lol, *fingers crossed* the vicks and the hot lemon drinks kick in before hand!


It's cooling down here but most people around the world would kick me for saying this weather is cold, but to me it is! I have the warm blankets out and my ugh boots have become my stylish daily footwear. I have to say that I do prefer Winter to Summer, here it gets so hot with 100% humidity, it feels like you can almost drink the air...at least in Winter I can put more clothes on, in Summer there's only so much you can take off before they arrest you in public :lol: ! I grew up 20minutes from the beach and oh how I miss those days of youth spent on the beach watching the waves roll in and having the beach to ourselves! I'm still only about an hour or so (depending on traffic) from beaches, but the Gold Coast is soooo busy and touristy that I prefer just to skip it.

The screened porch sounds divine! I grew up in a huge 'queenslander' with a wrap around veranda with views over the cane fields...when the breeze blew, the sugar cane rippled like waves down into the valley, it was so beautiful, I could spend hours watching it! I miss that place...I really need to go up home to visit one day soon. Milo's not too happy being an inside cat, he always had free-run of whether he wanted to be in or out (mostly in) and his nose is really out of joint because since he's been a diabetic he's being restricted a lot more.

Hope everyone is having a fantabulous day, I lost a few days this week, most of today I thought it was Tuesday! Think the brain is going on me!

Bebe and Milo
 
Status
Not open for further replies.
Back
Top