How to Treat Hypos document

[Buddy & Sue]

So I was reading the Sticky titled 'How to treat HYPOS - THEY CAN KILL! Print this Out!!' and everything made sense until I got to the last paragraph. This number 5.6 is confusing me because nowhere in the document does it speak of this number. Now I'm confused. I thought 5.6 was a good #.
It says
Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next.

 

[Sienne and Gabby (GA)]

The point of the last paragraph is that if you get a number like 100 mg/dL (which is the same as 5.6 mmol/L), you need to have a context for the number. If your nadir was 100 and numbers are heading up, that's fine. On the other hand, if you test at +3, BG = 100, and numbers are heading down you do not want to be cavalier and assume all is good. What the numbers mean depends on where you are in the cycle, what your cat's typical patter may be, and what you know about your cat.

 

[Christie & Maverick]

Good question. It is a good number; however it depends on *when* you get that number. The message really is that if your cat still has several hours before insulin peaks you need to continue to monitor and intervene if required. If you get that number after insulin has peaked and kitty is staying flat or rising, there are no worries.

That said, I see you are using AT2 so bear in mind that the numbers referenced in many places including the hypo toolbox are human meter.

 

[FrostD]

100 can be a good number, but the point it is making is WHERE that falls in the cycle. In your case (based on your spreadsheet data), your nadir appears to be +4 to +6. So if you see a number close to 100 before that (knowing the insulin hasn't reached peaked activity) you know Buddy will still drop and need to keep an eye on him. Now if your +8 is 100, that's less of a concern because based on your data.you know he's last nadir and his levels are heading up.

Using today as an example from your spreadsheet - let's say your AMPS had been 100 and you gave the full dose, Buddy likely would have been below 50 at the +4 test and potential hypo. This is why the ProZinc recommendation is usually to stall without feeding to see if numbers come up a bit first so it's safer to shoot.

 

[Buddy & Sue]

I'

Good question. It is a good number; however it depends on *when* you get that number. The message really is that if your cat still has several hours before insulin peaks you need to continue to monitor and intervene if required. If you get that number after insulin has peaked and kitty is staying flat or rising, there are no worries.

That said, I see you are using AT2 so bear in mind that the numbers referenced in many places including the hypo toolbox are human meter.

I've just switched today to One Touch Verio human meter. Can you explain 'peaks'. When does insulin 'peak'?

 

[Sienne and Gabby (GA)]

The peak and nadir are the same -- the lowest point in the cycle or equivalently, the "peak" of the insulin's action. The nadir varies depending upon which insulin you're using. With Prozinc and Lantus, it's around the middle of the 12-hour cycle. With Caninsulin/Vestsulin it's earlier;; with Levemir, it's later. However, you need to know when the nadir is for YOUR cat since some cats have early or late nadirs. In addition, nadirs can and do change. My cat's nadir on Lantus was at around +3 except for those cycles when it wasn't.

 

[Larry and Kitties]

Can you explain 'peaks'. When does insulin 'peak'?

That is where the BG is lowest between shots. That is also referred to as the nadir of BG.

 

[Buddy & Sue]

The peak and nadir are the same -- the lowest point in the cycle or equivalently, the "peak" of the insulin's action. The nadir varies depending upon which insulin you're using. With Prozinc and Lantus, it's around the middle of the 12-hour cycle. With Caninsulin/Vestsulin it's earlier;; with Levemir, it's later. However, you need to know when the nadir is for YOUR cat since some cats have early or late nadirs. In addition, nadirs can and do change. My cat's nadir on Lantus was at around +3 except for those cycles when it wasn't.

Thank you