Hypo incident and resuming insulin

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Alden

Member Since 2022
So had first hypoglycemic incident last night - our other cat actually came and alerted us to our diabetic cats confused, drunk-acting behavior. I tested and found levels in the low 30s, so treated with honey on the gums and temptations treats until she was well enough to eat wet food again.
She recovered quickly and all is well. Normally I give her insulin morning and night, but I’ll be testing before doing so this morning. What number is too low for the usual insulin?
Thanks!
 
We need a bit more info to be able to help you. Can you please tell us what insulin your cat is on and what’s the current dose? You’ll need to reduce the dose starting today as it’s clearly too high.

Are you using a human or pet meter?

We tell beginners to not shoot anything under 200 on a human meter. If you get a number below 200, you can stall for 20 minutes without feeding and retest to see if the bg is going up on its own. You can also post for help but we would need you to have a spreadsheet set up so we can help you with dosing. The best way to keep your cat safe is to test daily before each insulin shot to make sure it’s safe to give the insulin. We advice testing a few more times a day too so you can start to see how low the dose is taking your cat in a 12-hour cycle.

for hypos, honey of Karo are good but you also want to have on hand a few cans of high carb food at hand since that works faster than dry treats/food. You can also mix some honey with low carb food.
 
Did you tested after the hypo? We also recommend with a hypo that you keep testing and feeding until their bg is back at a safe level. Anything under 50 on a human meter is a take action number.
 
My cat (Bella) is on Lantus, and has been getting 2 units in the morning and 1 at night. She started on 1/1 when she was diagnosed in November then we moved up to 2/1 maybe 4 months ago. I feed her prescription wet food but we have other cats and she winds up stealing from them, so I feed everyone low carb food (as per that epic spreadsheet). She loves the Friskies pate.
I'm using a human meter.

She tested 295 so I gave her 1.5 units this morning and am monitoring her behavior. I'll do another test later today.

Yeah, I need to get some high carb food. I'll grab some from the store today - fortunately her symptoms reversed within 10-15 minutes and she proceeded to go to town on her wet food.

Thank you for the help!
 
Alden said:
Yes after 20 minutes she was up to 55 and her behavior had normalized.
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Great. I would have tested her one more time after the 55 depending on when the hypo happened. Lantus typically starts to work 2 hours after the shot and it’s a gentle long-lasting insulin that tends to peak at about 6 hours after the shot. That’s when your cat will likely go the lowest too. Lantus also does better with the same dose twice a day so I’d recommend you stick to the same dose in the am and pm. Try to stay with the 1.5 twice a day unless she goes under 90. If she goes under 90, I’d recommend reducing the dose by 1/4 unit to 1.25. We do most dose adjustments here by 1/4 units. Are you using 1/2 unit market syringes?

Lantus is a great insulin for cats and if you’re willing to step up a spreadsheet, we’d be happy to help you with dose guidance as needed.

Here’s a link to the Lantus forum: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
The yellow sticky notes at the top have a ton of super useful info about the insulin, hypos and our dosing methods too.
 
Ale & Bobo & Minnie (GA) said:
Great. I would have tested her one more time after the 55 depending on when the hypo happened. Lantus typically starts to work 2 hours after the shot and it’s a gentle long-lasting insulin that tends to peak at about 6 hours after the shot. That’s when your cat will likely go the lowest too. Lantus also does better with the same dose twice a day so I’d recommend you stick to the same dose in the am and pm. Try to stay with the 1.5 twice a day unless she goes under 90. If she goes under 90, I’d recommend reducing the dose by 1/4 unit to 1.25. We do most dose adjustments here by 1/4 units. Are you using 1/2 unit market syringes?

Lantus is a great insulin for cats and if you’re willing to step up a spreadsheet, we’d be happy to help you with dose guidance as needed.

Here’s a link to the Lantus forum: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
The yellow sticky notes at the top have a ton of super useful info about the insulin, hypos and our dosing methods too.
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Good to know it should be same dose morning/night. The syringes are single unit but I can eyeball it pretty well. I'll try to do 1.25 am/pm and see how that plays out.

I'll try to test a little more regularly until things start to stabilize.

Thanks for all of the info and support - I really appreciate it!
 
If you could manage to test 4 times a day that would be ideal. But if not, definitely before each shot daily. Cats’ bgs fluctuate a lot some times for no reason at all and a dose that works today, may not work anymore next week or even tomorrow. A midday test at around +5 or +6 is what tells you how low that dose is taking her since that’s when the insulin peaks.

Also, just want to make sure you know this, for the preshot tests, you want to make sure the cat hasn’t eaten for at least 2 hours prior to the test so you’re getting the true bg not influenced or inflated by food. Any other times it doesn’t matter.
 
@Alden do you ahve a spreadsheet set up we can look at?
If not I would really recommend you set one up and start adding some data so we can help you.
Also if you could set up your signature as well, that would be helpful.
You will find the instructions here HELP US HELP YOU
Please also set up a hypo kit

Ale & Bobo & Minnie (GA) said:
Sorry, actually you were giving a total of 3 units a day, 2 in the am and 1 in the pm so if you give 1.5 x2 a day she’s still getting the same total amount. You may need to give 1.25 in the am and pm. Tagging a few others to get a consensus @Bron and Sheba (GA) @Sienne and Gabby (GA)
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Yes I would try 1.25 U twice a day and monitor closely as cats who have had a symptomatic hypo can be vert sensitive to insulin moving forward.

What type of meter are you using for the BG tests?
And what foods are you feeding?
Are you giving food during the cycles as well as the 2 main meals?
 
It sounds like you're on the right track with low carb food and a human meter. Just as an FYI, like others pointed out, Lantus is more effective if you're giving the same dose in the AM and PM. The insulin depot is what gives Lantus is gentle, long acting effect and if you make constant changes to the dose, the depot is always in flux and doesn't stabilize. The dosing methods we use with Lantus recommend holding the dose at least 3 days unless a dose reduction is indicated. If you decide to continue posting here, we can inundate you in explanations! We also change doses in 0.25u increments.

Please let us know how we can help.
 
I just caught that you’re feeding prescription wet food. It’s typically too high in carbs for diabetic cats. There’s nothing great or special about it other than the price tag. Most vets push it because unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Vets also get their information about nutrition from the big cat food manufacturers so they are biased in what they recommend. Most of us here feed fancy feast pate which is under 10% carbs.
a diabetic cat you need a low carb wet diet that is 10% carbs or under. Most of us use around 4-7%

FOOD CHART have a look on this chart and choose foods that are under 10%.
 
Hey everyone, thanks for all of the info. It's been a busy week but I've taken all of your advice and will try to get a spreadsheet and whatnot setup when I have a minute.

Yeah fancy feast pate is my go-to alternative food. One of my vets told me it's not very nutritious (that was one of their arguments for the prescription food - the quality). Any opinions on that?
 
Most prescription foods are actually less nutritious than fancy feast. They’re just expensive but not high quality. Minnie’s nutritionist actually told me she was fine with fancy feast and to quote her “they’ve been in the business forever so they know what they’re doing.”
 
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