Help first time with low numbers

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nava075

Member Since 2014
My 14 year old cat Nava was diagnosed with diabetes 4 weeks ago. The vet started him out on 1 unit and had to stay on one unit for 2 weeks since we went out of town and i knew he wouldnt let anyone do a curve on him besides me. He then moved up to 2 units on 2/23 his numbers had gone down a little from the first curve we did on the first week. The vet suggested he go up to 3 units last Monday. i did a curve on him yesterday and starting out before food or insulin his number was the smallest it has ever been 288. As i tested him through the day his numbers were larger and i have noticed his back legs acting like his first week before and durring insulin, i was not happy with his numbers yesterday so i decided to do them again today. This morning I rotated the pen to mix it up since i read that sometimes insulin needs to be mixed around so i thought maybe it seperated. i didnt shake it just rolled it around. I tested him this morning at 730 before food and insulin he was 458 and yesterday before food he was 288. I checked him again at 930 he was 495. Yesterday 574 so a little improvement. I had to leave for a few hours and tested him at 1230 I got 89 and was shocked so I did it again and got 61. He hasn't been this low yet. He was acting fine but of course i was freaking out and we didnt have any corn syrup so we gave him sugar water( I now have Corn syrup). Now his numbers are going up but then he vomited and had a very loose stool. Before he got sick it was going up it was 128 and a little while after he got sick it was 168 i just tested him and it is now 86. What do i do?
 
How many hours since you shot this morning?

The sugar water and the syrup will wear off and numbers can come back down. Have you fed him any food and, if so, how much and when?

Because his increases were done in such large increments, it's possible his dose is too high.
 
730 eastern time so so 9 hours. i did try to give him food before his numbers went up and after sugar he ate a few bites and walked away. he then got sick his numbers were better and he ate a little more. i gave him 1/4 of a can and he ate half that. should i give him some corn starch? do you think me mixing his pen this morning made the insulin work better?
 
Lantus should NOT be rolled or "mixed". Some insulins require rolling, but Lantus does not.

Don't worry though...You didn't hurt it. Just treat it carefully and keep it in the refrigerator so it'll last as long as possible.
 
Are you using a human glucometer or an Alpha Trak? Did you get the 86 before or after you fed the 1/4 can?

If you are using an Alpha Trak, I'd like you to give him some more food, please, and retest in 30 minutes.

If you are using a human glucometer and he's at 86, he's at a safe number. I'd like you to just retest 30 minutes after you got the 86 because he's late in the cycle and might start coming up.

Let's hold off on the corn syrup or sugar water until we see where he is.

Lantus should not be rolled at all or mixed. It does not need to be. I don't think that has anything to do with his numbers today; his numbers are based on the dose.
 
Welcome to Lantus Land Nava's caretaker! (We'd love to know your name too!)

What's probably going on is your vet is increasing the dose too fast and too much. We hear this a lot here, many times when someone is in the middle of a hypoglycemic crisis. Vets just can't keep up with the latest treatments for every disease in every animal they see. The people here do nothing other than deal with diabetes and the diseases that tend to come with it.

We do increases in .25 unit increments, never whole units. The really high numbers you're seeing COULD be what we call "bouncing".

Bouncing happens when the blood glucose goes lower than the cat's body is used to, and the liver freaks out and sends hormones and sugars into the bloodstream to bring the numbers back up quickly. It's a survival mechanism from when our kitties were wild to protect them from hypoglycemia.

Unfortunately, the liver doesn't realize that "normal" numbers (50-120 on a human glucometer, 80-150 on the Alpha Trak) ARE normal anymore because it's gotten used to the higher diabetic numbers. It just takes time to re-learn what normal numbers are. Bounces are frustrating, but they're all part of this dance.

It's great you're home testing!! We have a great spreadsheet program you can use that you can share with your vet as well as us and we can help advise you on dosages. Here's instructions on How to set up your spreadsheet. Once set up, you just enter the numbers and they automatically color code which makes it easier to see the "patterns" we look for.

We can help you get Nava better controlled and look forward to helping you!
 
So i didn't make the insulin stronger. That makes me fill better.
I am using Rely On a human one. He ate between 310pm and 420pm the 86 is after he ate. i just got his numbers again and it is 66. it has been a 1/2 hour
 
Thank you. Great info.

Normally we would not give HC this late in the cycle, however, he's coming back down and we don't have any data on him. Do you have any high carb food there like Fancy Feast Gravy Lovers? If you do, could you please give him two big tsps and retest in 30?

If you don't, let's give him two big tsps of his regular food and a drop of syrup and retest in 30.

For right now, let's just focus on keeping his numbers in this safe zone and then we can deal with other issues :-D :-D Any questions and are you both doing ok?
 
Sorry my name is Becky. I will add that. I will try that spread sheet. Also i have the Lantus Pen.
 
i am about to cry but it is a good cry because i feel relieved. I dont think this fazes him he is just curled up on a chair and sleeping, Just me. Let me see.... I do have Friskes meaty bits with beef gravy i got him a few months back for a treat will this work?
 
Becky

I left you instructions above. Sometimes, we cross post and you might miss important suggestions. It's important to keep your browser refreshed and also to scroll back through the posts from time to time and make sure you got all the info, OK?

Again, let's focus on getting his numbers up a little bit right now. Did you feed him per the suggestions above?
 
Becky,

You are doing great!

Hang in there and glad to hear Nava is relaxed....now to get you relaxed! Dont forget to breathe as well!

That will happen with everyone here, promise...

I did send you a message, just dont know if you received it yet.
;-)
 
Great!!! That is 19% calories from carbs so a perfect choice. I'd give him two tsp of that, no syrup, and then retest in 30. Ok?

Thank you, Becky!!!
 
Nice to meet you Becky...and your sugardude Nava too!

He'll probably really love the Meaty bits with gravy! Most of our cats do! Personally, I think some of them go low every now and then just so they get their gravy fix in....LOL

What we usually do is just give them the "gravy" part because IF we need to keep getting them to eat, we don't want to fill them up by feeding too much (but don't worry about it right now!!) Hopefully since it's so late in the cycle, that'll be enough to get him going back up instead of dropping.

If you do need to give more, you can try putting the lid back on the food and press down hard to get just the gravy part to "ooze out" and into a bowl. Then you can just give a couple of teaspoons of the gravy part (that's where most of the carbs are) without actually feeding him too much.

Marje is right. Don't worry about the spreadsheet right now. Let's get him up a little and we can worry about it later.

I would like to ask a question, but it's not terribly important right now. Are you using the "dial a dose" on the pen?
 
What we usually do is just give them the "gravy" part because IF we need to keep getting them to eat, we don't want to fill them up by feeding too much (but don't worry about it right now!!) Hopefully since it's so late in the cycle, that'll be enough to get him going back up instead of dropping.

If you do need to give more, you can try putting the lid back on the food and press down hard to get just the gravy part to "ooze out" and into a bowl. Then you can just give a couple of teaspoons of the gravy part (that's where most of the carbs are) without actually feeding him too much.
Click to expand...

Thanks, Chris, but actually, I want him to have the food and the gravy now; not just the gravy. It's late in the cycle and I want a little food in there to help keep the numbers up.
 
okay it is now 55. 30 minutes since i put the bowl down. do you want me to try again in a few minutes?
 
Yes, please give him another tsp of the Friskies and let's add a drop of karo, ok? Retest in 30. I'll be waiting. I'm going to do a recap for you, ok?

Recap:
AMPS: 458 3u lantus
+2: 495
+5: 89 RT 61
??? 128 (vomit)
??? 168
+8.5 (approx): ate 1/4 can DM
+9: 86
+9.5: 66 ate 2 tsp Friskies (19%)
+10: 55

Becky....is the above correct and if you know the time you got the 128 and 168, please let me know and I'll revise. Thank you!
 
See above. And when you retest, if he's lower, don't panic, ok? :-D :-D We do this all the time and you are in control with food and syrup.

And I won't leave you :-D :-D :-D
 
Just wanted to say:
Momma - YOU ARE DOING GREAT!!!!!
AND SO IS MR. NAVA WITH ALL THE POKES!

There is a low carb food list that you will want to look at, print and take w/ you to the store....if you have not already
There is also a hypo kit instructions that I printed and it is still on my fridge!
I learned the hard way that I did not have much for hypo and that was changed the very next day, took off to the store and got me some stuff, let me tell ya!

AGAIN, GREAT JOB!!!
:dizcat
 
Well!!! That's good :-D

Just so you know, three things can cause that much of a jump:
1. the HC food; sometimes it takes a bit longer in some cats to kick in or it could have been the last helping had a drop of karo (depends on whether you put in a big drop or a little one)

2. end of cycle

3. bounce starting

Most kitties bounce at first and sometimes longer. Chris provided some good info for you on bouncing and other things way back earlier this afternoon so I'd take a peak at that now.

So....what next? I think the priority now is to get a spreadsheet up so we can help you with the evening dose. Chris left you with the SS link above. If you think it will take you very long to do, please send me a private message by clicking on the "PM" box under Gracie's photo to the right. I can do a SS for you in about two shakes of a kitty tail and you can fill in the numbers so we can help you with a dose for tonight. Are you in the US or outside of it?

A few other things that will help us determine that dose is to know how much Nava weighs and if he is underweight now. If he is not underweight, what do you think his ideal weight is? Has he been on any other insulin besides lantus?

As I figure it, his last food/karo was about +10; please don't feed him anymore because we want to see if the food will wear off and where we are at PMPS without food.

Questions? GREAT JOB!!!!!!
winking-thumbs-up-smiley-emoticon.gif
 
Much better number, so you can stop feeding and relax a little Becky! Great job!!

Are you using the special needles that come with the Pen and "dialing" the 3 unit dose? If you are, the "dial a dose" isn't accurate enough for our kitties. Since it's meant for humans who are on much higher doses, it's not so important if they're off a little, but our kitties can have big changes with just a .25 unit difference, so we don't use the "dial a dose" on the pens.

We use regular insulin syringes and pull the correct dose from the pen, just like you would a vial. The cap comes off and the little cartridge inside works a lot like a vial would, so you put the syringe into the little rubber stopper and pull out the correct dose. If you don't already have them, you'll need to get some U100 insulin syringes with 1/2 unit markings.

WalMart has them in their Relion brand. You'd want to buy U100 3/10mL, 31 gauge, 8mm length insulin syringes with half unit markings (the gauge and needle length are flexible depending on what's available)
 

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i just sent tech a question about the spread sheet because i dont know how to name it NavaSS, If you would like to help me that would be great. do you want all his numbers? We have only done 4 curves so i dont mind giving you everything.
i did squeeze out a larger drop than i meant to.
Nava use to weigh 13 pounds. Before he got sick they said his ideal weight would be 11 pounds. He now weighs 9 pounds. Lantus is the only insulin he has been on.
 
yes i only have the pen needles. Would i have to get a prescription from the vet for these syringes? I get what you are saying. Pull from where the regular needle twists on.
 
Different states have different laws and I don't know about Maine

Here in Missouri, we just have to ask the pharmacist for them. They're about $13 for a box of 100
 
It might take a while for tech to get back to you so I just PM'd you.

Here's the video Julie did to show you How to Draw Insulin out of a Pen or Vial.

You will need U100, 0.3cc, half unit marking insulin syringes. Many of us use 31g as it is tiny but gets the job done. You can get these syringes at WalMart (Relion) and can either get a short or long needle. Short or long is personal preference but many of us use short needle to minimize fur shots. You must insist on the 1/2-unit marking syringes; they do have them. You can also get some at Walgreens (not Relion brand) to carry you over until you can get some ordered. Many of us use these Terumo Syringes.
 
Looks like maybe Maine requires a signature or proof you're over 17. Any pharmacy would be able to tell you. Just ask if you need anything to buy insulin syringes.

Hopefully you won't need a prescription
 
Definitely get the syringes as soon as you can. The pen needles are designed for humans, who typically dose at 10u or higher. They are very inaccurate at the doses most people give for kitties, so it may be contributing to your issues.

I saw you said you were using a Relion meter from Walmart. They also make syringes that many of us use. Ask for these:

3/10cc, 5/16", 31 gauge (if they are out of 31 gauge, 30 gauge will work fine as well). These will have the 1/2u markings you need. As an FYI, they cost approximately $14/box, or they'll sell a packet of 10 for around $2.
 
That's an awfully big leap in one hour, although with the high carb food plus a bounce it's possible.

You may want to recheck just to make sure
 
I agree that I would retest. While you are doing that, I will look at his SS.

Becky: have you been giving him insulin twice a day?
 
It looks like you've also only been giving shots once per day Becky. Is that correct?

Lantus works best when it's given every 12 hours at the same dose, so we give shots twice a day. Of course after today, you're not going to want to give 3 units again unless and until he proves he needs it.

We usually start at .5 unit to 1 unit every 12 hours, and then test at least 4 times a day.

Always before shooting to make sure they're high enough to shoot. These are called Pre-Shot tests.

During the AM cycle, sometime between +5 and +7 (5 to 7 hours after the morning shot)
During the PM cycle, if you can't stay up late enough to get a mid-cycle test, you'd want to get a "before bed" test...and if it's much lower than the pre-shot, you might want to set an alarm to get up and get more later. Most cats go lower at night.

We understand there's a lot of information being thrown out right now, so don't become overwhelmed! We'll help you along the way!
 
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