Hypo help!

T

TooFar McGee

Member Since 2025
Norman got his regular 2.5 dose as 3.0 sent him into a dive... well he hasn't been interested in food today despite his mirtazipine and thank God for the Libre

I syringe fed him about 10 mL of a wet food with half a scoop of high cal supplement in it about 20 minutes ago and for the past hour he's wavered between 50 and 60. right now he's at 52, Libre numbers. AlphaTrak said 75 but I don't actually trust it. It's new to me and I haven't gotten the darn thing to work half as well as the WalMart One Touch.

I have honey on hand just in case, but right now he's just huddled up, thoroughly sick of me for today
 
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Depending on where you are at in the cycle, you may need to continue to monitor and test, and perhaps use some intervention with high carb food or syrup, Numbers appear to still be in the safe range, can you tell me more where you are at in terms of hours after shot time? Have you been able to test again?
 
Anyway, I explained about the problem with the Libres giving unreliable low readings in the lower end numbers (ask me to show you some spreadsheet examples of this tomorrow). Rely on your handheld meter when dealing with lower numbers. On the pha Trak, we don’t want him lower than 68 and with a human meter we don’t want him going below 50. Above those numbers, you can manage the numbers with regular low carb or medium carb food. Christie is excellent and can help of you are still experiencing low numbers. I will be signing off shortly.
 
I am back at work now... I saw the spreadsheet somewhere on here where the Libre measured 40 and a handheld read almost 100, so that's concerning. I'm just glad for the Libre because I'd just arrived at work and checked because the ProZinc hadn't 'hit' yet by the time I'd left, and all of a sudden he was in the 50s. Bless my boss, I said "I've gotta *go*." and he wished me good luck and forbade me get any speeding tickets on the way.

I'm having nothing but problems with the AlphaTrak 3 between theoretical BT connection and oddly, required sample size? The Alpha readings I got were 106, 79, 65 at the lowest. I ended up syringe feeding about 25mL of food with a little "under the weather" mixed in in two sittings. The first only sort of flattened the curve, the second with a little added honey (maybe 1/8 tsp, if that) started bringing it up again.

The dive started at about
+1 - where he started at 349.
+2, - he was at 209. That's when I leave for work.
+3 - 66 when I got to work, and showing no sign of tapering off.
+4 - 53 My first syringe feed more or less flattened things .
+5 - 54 and I wasn't sure, halfway through the curve here, if he would start to trend upward again
+6 - he was at 153.
+6.5 - a peak at 200
+7 - 183

I think contributing factors in this are that I couldn't get him to eat this morning beyond his probiotic "soup", and he wasn't terribly interested in food last night, either. My vet and I are weaning him off prednisolone and he usually got 8.5 mg/day for his IBD, in addition to 8mg Cerenia. Yesterday was his first 2.5mg prednisolone dose and I couldn't get it in him today. Figured he might tolerate it tonight better after his Mirazapine had some time to work...?

This is the same dose that he was at yesterday when he started around 300 and ended over 600 with a "nadir" of 280.

Then again, he was just diagnosed on the 4th and we're still figuring things out. Definitely didn't start with the "low and slow" protocol because starting numbers were so high. Any advice there is really appreciated.
 
If you are not at home frequently and will not be able to dispense the required snacks, you should look into getting an automated feeder. For new ProZinc users, I always recommend small meals of 1-2 tablespoons of wet food at +2 and +4 and possibly +6 (depending upon the cat.) ProZinc typically onsets at +2 for most cats. Some cats may onset earlier and should eat at about +1.5 for the first snack. These mid-cycle snacks are very important for helping to prevent steep drops and generally smoothing the cycle. I don’t recommend feeding much food after nadir as it may shorten the duration of the insulin.

I would recommend reducing the dose back down until you get everything sorted. I can’t be specific on the dose because I don’t have any spreadsheet data.

Do you test for ketones at home?
 
TooFar McGee said:
The dive started at about
+1 - where he started at 349.
+2, - he was at 209. That's when I leave for work.
+3 - 66 when I got to work, and showing no sign of tapering off.
+4 - 53 My first syringe feed more or less flattened things .
+5 - 54 and I wasn't sure, halfway through the curve here, if he would start to trend upward again
+6 - he was at 153.
+6.5 - a peak at 200
+7 - 183
Click to expand...
He definitely needed to eat that +2 snack for starters. I understand about cats that don’t want to eat though. I hope that’s going to settle out soon. He really should be on some kind of a low carb wet food diet if you can find one. The Dr. Elsey’s Clean Protein canned foods are not as expensive as some of the others. There are some single protein foods like duck and pork. I have used these.
 
How was his IBD diagnosed? Did he have any kind of a biopsy?

My current IBD cat (I currently have two— one easy to control on 2.5 mg. Pred every other day and some Visbiome probiotic — and one with super severe IBD that was refractory to Prednisolone after a year with absolutely no change in his intestinal thicknesses on ultrasound.) With my difficult boy, I recently switched him to Budesonide instead of Prednisolone because he has FIV and I was hoping to have less overall body-wide immunosuppressive effects. He’s been on that a little over a month and I have scheduled another ultrasound to see if anything has improved. That is scheduled for Friday. He also has pancreatitis now so it’s unbelievably hard to get him to eat most days.

But anyway, Budesonide is something you should look into for your cat if he can’t be controlled via diet alone. Budesonide is a steroid that doesn’t have a significant impact on blood glucose like the Pred does. Many cats do very well on it.
 
I free feed him from a sure-flap cat feeder so his greedy roommate doesn't scarf it all. The Mirataz is prn, and I was trying to do that, but now I'm thinking trusting him to have an appetite on his own isn't going to work right now. He LOVES the z/d. I mix it with a little water to make a liver-flavored soup, which he is VERY into. I wish it weren't so carby.

Tbh he was just diagnosed with diabetes last Thursday, on my partner's birthday (Friday was mine) after "not acting quite right" after I got back from a couple weeks in Japan. I wrote it and his sitters' reports of his not wanting to eat and being sluggish as having been stressed by having people over/me being gone, because he IS sensitive. The diabetes dx and everything since then has been a whirlwind and that, with the holiday and work, have me really overwhelmed and scrambling to catch up. I really thought I was doing the best for him with $$ Rx diet and being super consistent with his steroids, etc... so having to change *everything* has been a lot. My cats essentially know no suffering, so to have his ears poked by me multiple times a day and a sensor glued to his side, BID shots, food changes, it's all been a lot to him, too.

IBD diagnosis was blood tests and ultrasound that showed some intestinal wall thickening, but pancreatic enzymes and vitamin B levels were normal. Initial symptom was just a lot of regurgitation. A LOT of regurgitation, then weight loss. Steroids helped, so we just started those and I tapered off after some time to see if he did alright without, and he did... for a few months. then the vomiting started again, and diarrhea. Then we started Cerenia and resumed steroids. Vomiting stopped, diarrhea stopped for a while, then came back with a vengeance. Raised steroid dose, did US and found mild intestinal wall thickening, but lab work didn't seem to indicate cancer or pancreatitis (then or now)

He's been on Visbiome and I will be getting more. Thanks for the heads up on the Dr. Elsey's and Budesnoide. I ordered a ketone tester and will have that by Friday. Vet and I agreed to hold dose at 1.5U for now until things stabilize. I will try to put my spreadsheet together asap.
 
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