Help! How long does "R" last??? 33 Now !!

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Gail & Houdini (GA)

Gail & Houdini (GA)

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Reagan got 1 U of R at 11 am and is now 33!!! Giving high carb stuff already but does it peak like other insulins or what ???? Vet is out to lunch and no one else is available at the vets office... Do I panic? He's still sleepy from the anesthsia so I can't tell if he's acting strange from low blood sugar or the drugs
 
fill me in....why did he get R? and why was he under anesthesia? i'll go in search of R experienced people k. brb

but yes, intervene a little ok
 
No idea hon, hopefully more experienced eyes will be here soon but with a 33 I would be treating just like hypo, but I think R hits hard and fast but short duration...but how short I don't know...Paws and fingers crossed here for you both.

Mel, Max & The Fur Gang
 
some of it may be the anesthesia lowering the BG's. i'm surprised kitty got R if he's under effects of anesthesia? often under anesthesia, fluids are also given, which can lower BG's so insulin dosing needs to be done carefully around any procedure involving either anesthesia or fluids is my understanding
 
He went in this am for dental - he was 440 at 6am with no food and no insulin. By the time they checked him he shot up to 520 so dr gave him 1 u of R at 11am its now almost 2 here so we are 3 hrs into it. Is he going to drop more or start to climb now?

He's curled up in his tent bed asleep
 
i'm thinking if i remember correctly that the R should have pooped or possibly will very soon. i'm thinking this is more the anesthesia/fluids causing this. i remember someone who had a very prolonged hypo due to regular dosing around the same time as a procedure involving anesthesia.

you're going to have to keep testing ok
 
From the pet diabetes wiki, peak is 2-3 hours, duration 4-5.

Kinda risky behaviour by your vet...would not be impressed if it were my cat!
 
No experience with R, but I would treat like a hypo.

Please retest now and post the results, ok?

If he's lower....rub karo on gums. Is there an ER vet near you?
 
Is he still groggy or out of it? Anesthesia should be wearing off...

I would be using karo to get his numbers up, up...

Test every 10-15 minutes.

Regular (R)


Short-Acting


30 minutes Onset


2-5 hours Peak


5-8 hours Duration
 
girlcat, (aka: lorna), agrees this is partly anesthesia and said you should karo him and if you can, go to ER & get glucose. she has all the details you posted here sooooo
 
hey Blue, is that info for humans or cats? i don't know enough about R to know

eta: nevermind. i just saw Jen's post about the duration too
 
What the others said.

I used to use R as a booster and 1u is a hefty dose for a cat, especially one undergoing anesthesia and/or getting fluids, IMHO.

I'd want to get the BG up higher than 33 if possible.. There's just no cushion there and you don't know whether fluids, anesthesia, etc. will have an impact on the "typical" action of R.
 
He's at 65 now and I know part of that rise is the Karo and Gerbers I gave him. So he's not going to go any lower??

I'm always bragging on my vet but I can't understand why he did this
 
i wouldn't say that just yet. if the anesthesia/fluids are involved in this, i want to say my memory of that one ages ago due to that stuff lasted way into the night. plus, the karo is temporary. i want to say though that the other cat i'm thinking of got their regular insulin and dose though so if all Reagan has gotten is the R, it would be different i would think.

at the very least you're looking at a few more tests but i think you can at least breathe for right now.

(editing to complete thoughts :-) )
 
3rd time trying this R lasts about 4 to 5 hrs. cat is about half way thru.keep the karo and test him every 10 15 minutes.he went to 65? good. keep karo and testing.im thinking that alsomthe anesthesia also plays a part in this.was any other insulin given to this cat?
 
Re: Help! How long does "R" last??? 33 Now 65 at 5:30

Gail & Houdini said:
He's at 65 now and I know part of that rise is the Karo and Gerbers I gave him. So he's not going to go any lower??

I'm always bragging on my vet but I can't understand why he did this
Click to expand...


There are other factors at work here including the anesthesia and fluids. Karo is short term, you may need to support for a while. I'd still be a bit nervous at 65 and might want to give the insulin something to "work on."

Have you called the vet back yet?
 
Poor baby.......wouldn't relax yet.......too many factors involved. Hope you have plenty of test strips. As for your vet....what was he thinking?


ththPenguin.gif
 
He's at 99 now and very annoyed that I keep waking him up to poke his ear.

Spoke to the vet finally and he said it was 1/2 unit of R and he was on a glucose drip during anesthesia.....he was surprised that he dropped so low. He also didn't get the message that he is only on .5 U anyway. Tech was supposed to test BG's before I picked him up just to make sure but 2 serious emergencies came in just as he was done with Reagan. He apologized that he didn't follow through (hope I didn't get any of the girls in trouble). He said to keep an eye on him and bring him in.

Do you think it's safe to let him sleep for an hour and then check again? What about giving insulin tonite? Maybe not ......
 
lorna is going to see if she can post again, if not, i'll relay for her. i'm thinking you're safe and no insulin tonight but let's get her here
 
he is going to be sensitive to any insulin since he went this low plus the anesthesia as well as the fluids. was half a unit of R? ok thats better than 1 unit.understand he is going to bounce off this low tonite i expect him to get very high which would be normal bounce from a low.u will have to be careful when u do resume his regular insulin now since he just went thru all of this.idk know what your usual dose is for him but wehn u do resume it you will have to shoot alot less because of all of this/check him in 30 minutes and tell me what his number is 99 is good.and if this had to happen with any insulin then R would of been the best as its an in and out no shed kind of insulin. tell me what his number is in 30 minutes
 
also know that since u had to karo him he may have some loose bowels diarrhea which would be normal due to the karo.it will pass.small price to pay
 
we don't use R, but we've seen low numbers post-anesthesia on lantus. see our spreadsheet, 2008-2009 tab: 5/29/08 on half dose. 8 hours later, she was still sub-100. and she was under for a very very short time, for staple removal, no fluids. we gave full dose that night and then had to watch her most of night.
 
He's on PZI 1/2 U BID.

So there is still a chance he could drop again? R should be wearing off soon and I know the Karo will wear off but I gave him some Gerbers BBF and Kitty Milk as well. So how long should I monitor this close?

If he's going to bounce high tonite then that's not good either....
 
he will bounce tomorrow for sure and its normal and its easier to bring down a high than bring up a low so id not worry about him being high right now.for now lets just deal with the situation in hand and check him in 30 min and see where he is.we will worry about tomorrow when tomorrow comes.lets get thru this part first

anytime a cat goes low they will bounce from it.its the liver seeing a low number and compensating as a safety mechanism by the liver putting out glucose to bring the number up. this is normal.not to worry.it clears out and passes on its own.not to worry about that for now is not a concern
 
give me a number at 7 o clock i want to see where he is going. 20 minutes ok? if he is lower then yu will have to sryinge him more karo.but test him in 20 min
 
so about an hour has gone by and he's held steady 99 to 100?

to be honest Gail, normally i would say yes but you have complicating factors today which i've seen happen on here but haven't experienced hands on so i have to defer to others for the answers. do you have somewhere to go tonight or is he just getting too pissed for more testing?
 
Cindy - he has very thin sensitive ears and is normally very tolerant of pokes but all he wants to do now is sleep. Pissed will be soon though......

No I'm not going anywhere tonite for sure
 
hes at 112.ok i think the worst is over for now. i think you are in the clear for now.i would see about getting a number in an hour. that should be the test for sure. 112 is good.but check him in an hour.let him sleep for now.u done good u done good...but check him in an hour...i know hes been thru alot today and then this and u feel bad for him and all of us do....but..i dont want to have yu have to go thru this again.....so...you will have to bother him and check his numbers again so as to make sure he is definately rising and not dropping.he shouldnt be by now but i want to make sure and i would do the same thing if it was my cat....and i have
 
Whew! Once again the wonderful people on this board saved my sanity and my sugarcat!!Thank you everyone especially Lorna and Cindy!!!

I can't begin to imagine what I would have done without this board in the past 5 or so years!

I'll keep watch on him and try to get him to eat......and to add insult to injury he will need pain meds and that nasty Clindamycin later....yuck He had 3 teeth pulled so he will need meds for sure. Checking him in an hour just to be sure .....
 
thats the combo of the hc and karo plus hes not had his nitetime shot tonite. i am not familair with your insulin which is pzi.let me see if i can get pzi people to help you here.as far as i would go.id let him sleep off his surgery and do your am shot at regular time.but u may have to go with a decreased dose due to his anesthesia.fluids situation.let me see if cindy knows of any pzi person who has had a similiar situ w a dental and low numbers. alot of this tho is the hc karo .
 
big jump yes but it means the R is gone. remember though, a night or two in higher numbers isn't going to kill a cat like low numbers can so i'd still consider skipping tonight and start fresh in the morning. i bet you and him wouldn't mind a nice quiet long night of sleep? :-)

does he have any ketone history by chance? that would be the only thing that could possibly change my mind i think in regards to shooting tonight. eta: the other option would be to shoot only a drop or two but i'd feel better about saying that if i could see numbers and see what kind of response he gets on the 1/2 unit regularly anddddd i'd tell you to do some late night testing. it's only 6pm here in so cal where we both are so in theory it would be possible to get like +4 or +5 pretty easily if you shot soon but i would still want some more input on this first. carolyn could probably help here with this since she has extensive pzi experience
 
general conscensus is to skip shot start tomorrow decreased dose.. youre ok so get some sleep and skritches for houdini
 
He is totally zonked now ...curled up in a ball. My last test got me a swat.....as if to say "go away and let me sleep"

Since I've only had him for two months I have no real history and because of that I am concerned with DKA. His numbers are all over the place but mostly low, sometimes getting 14 to 16 hrs out of 1/2 unit. Some days when he isn't feeling well (sinus and tooth problems) he gets some higher #s.

If I can't get him to eat he won't get any shot .... we'll see how high he gets later.
 
Gail, I wouldn't be too concerned about DKA since he wasn't even in the best shape when you got him and he didn't have ketones then or since, even with a bad mouth. Hope was still on PZI when she had her first dental soon after I adopted her. She was home by 4:00 that day, wide awake, showed absolutely no signs of pain, ate like a pig that night......this after 6 extractions and one filling. Mishka has had only one extraction so far from FORL but even with her dentals she is home early and wide awake and raring to go. I would ask your vet what he used for anesthesia. I have also over the years dealt with numbers in the 20's with both of them and used food, treats, ice cream, etc. to get them up and keep them up. In all those times both of them have slowly gone up, never shot up, never rebounded to high numbers. ECID so I would truly let him sleep it all off unless he wakes up and wants to eat, and I wouldn't give any insulin tonight. Let him get it all out of his system and see what the morning brings for numbers. Even if he wants to eat later, his tummy may bring it back up and you don't need that happening if you shoot him insulin.
 
home and the herd taken care of until their second feeding later soooo fwiw, i agree. especially hearing about that duration on such a small dose sometimes. really not worth the risk to give insulin tonight
 
I know this situation seems strange to me too because Houdini has had dentals with 8 teeth pulled at one time and in a few hours after being home he wanted to eat. He would be worn out after the trauma of the day but not like this guy who is still sleeping..... he raised his head just now, looked at me then went right back to sleep.
 
He woke up enough to eat a little and I tested him - 489. He just curled up and went back to sleep. I'm supposed to give him pain meds but I'm afraid it will just make him wonkier. Sigh
 
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