? Help BG Level 60 several times a day no insulin

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cjenret64

cjenret64

Member Since 2022
Rasputin, DX'd: 01/19/2022 w/ initial levels in 500's. Started on Prozinc. Switched to Purinia DM wet. Posting levels from Freestyle Libre from Feb 01 to 07, last dose of Prozinc 1 c at night Feb 01 and crashed between 12am - 3 am and has not needed insulin since.

Has anyone ever experienced their cat going into the hypo states without insulin as seen in the graphs? Double checked with True Matrix glucometer and levels have been accurate with a 1 to 6 point variance from Libre.
 

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My experience is that the Libre tends to run artificially low at those lower numbers. Which values did you double check with glucometer?

Had he been on any steroids, infections, health issues, etc at time of diagnosis?

Do you mean 1U of ProZinc?

In my opinion he could still use some insulin, but at a dose of perhaps 0.1U...in some cases we do a drop dose, literally a drop of insulin. Reason being, most non-diabetic cats (or cats in a proper diabetic remission) test in the 50-120 range. Take a look at my spreadsheet - never a number above 95 except when he was ill. The 50-120 range allows the pancreas to heal, so if you can support him safely as long as possible on insulin to let it heal, you have an excellent chance of a very strong remission. That said, most vets would call what you're seeing now remission, but in my experience you'd be back here in a few weeks/months' time.
 
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Hi and welcome to the forum.
If Resputinis not receiving any insulin at all, he can’t have a hypo. Only cats receiving insulin can drop too low.
A cat not on insulin will generally have a BG of around 50 - 120. However many cats can drop lower than 50 and they are perfectly fine. This is their normal BG.
So there is nothing you need to do.
Now if he is in remission, I would check once a day for a month, then once a week for a month and then monthly forever.

You will need to feed a low carb diet always now because Resputin is a diet controlled diabetic.
Make sure any medications he gets are no added sugar and if he is u well, always check the BG and the ketones in the urine.
I would also make sure his teeth are looked after as teeth are often the cause of cats falling out of
remission.
I agree with Melissa, he could do with a bit more insulin so you get a strong remission.
I would post on here, set up a spreadsheet and get some help with that.
 
1mL of Prozinc 40 with correct 40 syringes at night February 1st. Last time he received any insulin.
Confused because the print out sheet for hypo says anything below 60 is hypo.
Also confused because I've seen that anything in 200 is a "no shoot" zone, in which case he hasn't been in the 200's, so that should also be a no shoot as well, correct?

For low numbers with the Libre, I double check with the monitor, and as stated previously it is normally a 1 to 6 point variance.
Trying my best to figure out how to help my buddy, but all this information difficult to find and even harder to tell when it's applicable or correct. (Such as 50 BG being okay, which is utterly new information to me...)

Thank you for responding, trying to figure this out.
 
cjenret64 said:
1mL of Prozinc 40 with correct 40 syringes at night February 1st. Last time he received any insulin.
Confused because the print out sheet for hypo says anything below 60 is hypo.
Also confused because I've seen that anything in 200 is a "no shoot" zone, in which case he hasn't been in the 200's, so that should also be a no shoot as well, correct?

For low numbers with the Libre, I double check with the monitor, and as stated previously it is normally a 1 to 6 point variance.
Trying my best to figure out how to help my buddy, but all this information difficult to find and even harder to tell when it's applicable or correct. (Such as 50 BG being okay, which is utterly new information to me...)

Thank you for responding, trying to figure this out.
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I do believe you mean 1 unit, 1mL is quite a lot (40 units).

The 200 threshold is when you're new and starting to gather data. The idea is over time you shoot lower and lower. I'll drop a few links here in a minute of some examples of cats very close to remission, shooting low numbers at low doses. Most newly diagnosed diabetic cats are in the 200s/300s and higher to start, so the caregivers have a lot of time to test and get comfortable.

60 is generally the threshold for a pet meter. We really don't want them going under 60 on a pet meter, in fact we don't really even like under 68. But both your meters are human meters, so we use 50 for those. The goal is to get nadirs in the 50s/60s but not below. If you're uncomfortable with that, you can raise that range a little and target say 60s/70s.

My two cents - make sure.you have a hypo kit with a variety of carb % (some 10-15%, some 16-20%, some around 23%, and some karo syrup or honey). On a day you can be home, try a drop dose. You push the plunger all the way down to expel any air, insert into vial, and release the pressure - the result is a drop of insulin in the needle, not even visible through the plastic barrel. When you give the shot, push it down all the way and do your best to hold it for 10 seconds. If the Libre is still on, just keep an eye on that and see how he does. If not, test hourly. If that brings him below 50, then nothing else to do but call it remission!

To be clear, I would not recommend this if I thought it would put him in danger. You just test, and if he creeps down around 50 you intervene with food so he doesn't crash. Absolute extreme case I see it taking him to 40s - that won't do any damage but we don't want them hanging out there - so again just give some higher carb food and problem solved.
 
We would never push you to do something you're uncomfortable with, which is why we gave you to the two options as we see them and their pros/cons
 
Link to Panzers latest thread: https://www.felinediabetes.com/FDMB/threads/02-07-panzer-pmps-109-93-4-116-5-123-6-119-7.259022/

Link to Red's latest post: https://www.felinediabetes.com/FDMB/threads/low-nadirs-decrease-dose.257780/

Link to Johnny's (he's in remission because nothing more she could have done with dose vs BG)
https://www.felinediabetes.com/FDMB/threads/johnny-update.256504/

Link to Tuna (he arrived in nearly your same situation and has been in remission for quite some time):
https://www.felinediabetes.com/FDMB/threads/otj-party-video-for-tuna.249313/#post-2812815
 
I did mean 1 unit of Pro Zinc. I do have a hypo kit and I was using it almost all day yesterday. I ended up rubbing his gums (both sides) with Karo syrup 5 times in total, and hardly ever saw a spike.
I have blue buffalo wet chicken & trout and kibble form, as well as his previous special diet enzyme laced kibble that's entirely soy for IBD [RoyalCanin Hydrolyzed Protein], and Purina DM kibble. I used all of that yesterday (he's a bit of a grazer, not really into eating a lot in one sitting) to try to get his levels consistently up from the lows and it felt like nothing was working. He has not had insulin since Feb 1st and his BG has not gone over 200 since that day.

So does that mean while he's on the Purnia DM wet food and he's 54-58 naturally on his own with no insulin, that's okay?

Thank you for all the information, I'm learning so much.
 
cjenret64 said:
So does that mean while he's on the Purnia DM wet food and he's 54-58 naturally on his own with no insulin, that's okay?
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Yes! If Resputin is not getting any insulin at the moment and you are seeing lower numbers there is no need at all to give any higher carb food or Karo. These are his normal numbers . Giving him higher carb food is only going to stress his pancreas.
 
cjenret64 said:
I did mean 1 unit of Pro Zinc. I do have a hypo kit and I was using it almost all day yesterday. I ended up rubbing his gums (both sides) with Karo syrup 5 times in total, and hardly ever saw a spike.
I have blue buffalo wet chicken & trout and kibble form, as well as his previous special diet enzyme laced kibble that's entirely soy for IBD [RoyalCanin Hydrolyzed Protein], and Purina DM kibble. I used all of that yesterday (he's a bit of a grazer, not really into eating a lot in one sitting) to try to get his levels consistently up from the lows and it felt like nothing was working. He has not had insulin since Feb 1st and his BG has not gone over 200 since that day.

So does that mean while he's on the Purnia DM wet food and he's 54-58 naturally on his own with no insulin, that's okay?

Thank you for all the information, I'm learning so much.
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Can you post Libre data?
 
Just verifying, no insulin yesterday or today correct?

If that's the case, congrats it's remission!! I "don't like" those higher numbers he's seeing but at this point you cannot safely give ProZinc. You could try a depot insulin like Lantus or semglee due to the flat nature of those, but at this point I'm inclined to say save your money. Just run the Libre til it dies, then do twice weekly spot checks for a bit - especially if you notice increased water intake or urine, or bad litterbox behavior.

If he does relapse, at that point I would request Lantus or semglee.
 
I've had non diabetic cats test at home in the 40's. We just don't want cats on insulin to go that low.

I wouldn't say remission just yet. Normally we have kitty go 14 days without insulin before making that call.
 
This is true. So typically twice a day tests for another 7 days. Most of the guidelines we use target all green numbers, but again you can't safely do that with ProZinc right now. In this case, the usual AMBG and PMBG wont tell us a whole lot because those are high, I would target those middle of the day lows (hopefully you get another 7 days out of the Libre).

If his lowest numbers start to hit mid 60s or higher then we might be able to try drop dose.
 
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