Hypo last night, need advice

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Shelle Acello

Shelle Acello

Member Since 2020
Good afternoon....Berlioz's labs are now in his spreadsheet along with his first glucose readings that I did today. (I should have started doing his glucose myself when he started insulin on 12/21, but honestly, I was so scared. I was forced to do it last night.) Diagnosed on 12/12....I’m very new to this.


We had a major scare last night and the documents on this site helped me through it. I gave him 2 units at 8am yesterday and then another 2 units at 8pm last night. (Lantus) Around 11:30pm, he became very weak, couldn't even stand up and just glassed over. He was trying to get to his cat box, but couldn't make it and had an accident on the floor. He then just collasped. I brought him to the couch and he wouldn't even move his eyes. I knew something wasn't right. I rubbed honey on his gums and then gave him a can of Fancy Feast with gravy. I was so scared that I forgot to test him before I gave him the honey and high carb food. I did test him after and then kept testing every so often until his numbers came back up. Honestly.....please feel free to give your opinion. I had no idea what I was doing last night, but my gut was guiding me. His first reading after honey and FF was 27mg/dL at 11:42pm. (Relion Prime) His next reading was 34 at 12:06am. The last number I got was 121 at 1:59am. (It was a late night)


I did read about Keytones last night and I will buy some strips so that I can test him. I took in a lot of information last night since I was up until 2am. I was wondering if 2 units, twice a day was too much for him. I know that was mentioned in a previous post I sent (New Diabetic Cat Mom) so I thought I would try 1 unit at 8am this morning. Pre-shot was 317. 6+ hours later, after the 1 unit, it was 86. Again....I will not be offended by your opinions and directions. I love my boy so much and I want to make sure I am doing what is best for him.
 
I'm so glad you lowered to 1 unit... even on 1 unit was down in the greens. Some cats get very sensitive to insulin for a few days after a hypo. Good thing you were there to help him, that was scary low! Definitely don't give 2 units again. Good job helping him last night.
 
JanetNJ said:
I'm so glad you lowered to 1 unit... even on 1 unit was down in the greens. Some cats get very sensitive to insulin for a few days after a hypo. Good thing you were there to help him, that was scary low! Definitely don't give 2 units again. Good job helping him last night.
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Thank you so much. It feels good to know I did something right, even if not perfect. I was never so happy to hear his obnoxious meow for food this morning. He’s been more himself today.
 
His BUN is high... I don't see the creatinine listed, do you have that number? I'm just wondering if the BUN is high from dehydration or from kidney disease.... the creatinine would tell us.
 
JanetNJ said:
His BUN is high... I don't see the creatinine listed, do you have that number? I'm just wondering if the BUN is high from dehydration or from kidney disease.... the creatinine would tell us.
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When those labs were taken, they said he was very dehydrated. He goes back in on the 20th. I’m open to suggestions on what they should run. I’ll request it.
 
OH! and I just saw your cat is pretty anemic!! What is the vet doing to resolve that?? Is she taking B supplements? THat needs to be addressed before it becomes severe!
 
JanetNJ said:
OH! and I just saw your cat is pretty anemic!! What is the vet doing to resolve that?? Is she taking B supplements? THat needs to be addressed before it becomes severe!
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Vet said they’d check it again in a month after some treatment? I wasn’t so sure about that. I bought the Vitacost B12 5,000 mcg, but I’m unsure how to give it.
 
I'd have them run a complete CBC! Your cat is stage 2 kidney disease with a creatinine of 2.3. I would add that onto the lab tab. THat's probably causing the anemia. it's common to get anemia with CKD OK i'm glad you got the vitacost. With compromised kidneys I might only give half of that a day divided into two meals. just sprinkle on the food and mix in. You may also want to add in some B complex. Speaking of food you are going to need to switch to a food that is both low in phospherous and carbs. My cat is CKD also... so I'm right there with you.
 
Hi Shelle,

That's some scare you had last night. :bighug: I'm glad Berlioz is OK. (((Berlioz)))

PREVIOUS THREAD: https://www.felinediabetes.com/FDMB/threads/new-diabetic-cat-mom.240105/

To assist members replying to your thread, I've created the following summary in '+ time' format:

SYMPTOMATIC HYPO INFO and Details of last 3 cycles --------------------------------------------------------------------------

Previous doses (assumed): 2IU Lantus BID
Meter: Relion Prime

01.08.21-------------------------------

AMPS - ??? - Dose: 2IU Lantus (08:00)

<no mid-cycle readings>

PMPS - ??? - Dose: 2IU Lantus (20:00)
+3.50 - ??? - Severe symptomatic hypo (weak, unable to stand, eyes glazed over/unmoving, unable to climb into litter box, voided bladder.)
>>>>>>>>>>>>> Honey administered to gums, fed 1 can FF with gravy.
+3.75 - 27
+4.00 - 34
+?.?? - ??? - <other readings may have been taken btwn +4 and +6>
+6.00 - 121

01.09.21-------------------------------

AMPS - 317 - Dose: 1.0IU Lantus
+6.00 - 86

-------------------------------------------------------------------------------------------------------------------------------------------------

For future reference, Shelle, if ever you were to get a run of low numbers, in addition to using the hypo guide you can always post for help (Lantus board usually has more traffic). Use the 911 title prefix to let members know you are dealing with an emergency. If there are experienced members online they should respond and provide a bit of extra support to you. Needless to say, you'd start following the instructions in the hypo guide straight away while waiting for replies (sometimes the board can be quiet).

I'm going to tag some experienced Lantus users to ask them to give you some input on dosing and also some additional pointers on techniques for getting out of hypo numbers back up into the safe range and keeping them up (how often to test, what to feed and when, etc.).

@Christie & Maverick
@Wendy&Neko
@tiffmaxee


Mogs
.
 
Ok so the ff is too high in phosphorus for a ckd cat. You are going to want something less than 1% carb and under 10 carb. This is what I'm feeding my ckd cat. Lots of choices from weruva.


Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)

What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loves it.

Goody stew shoes 0.71 phosphorus, 8.5 carb. This one is a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)
Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p and
Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos

New favorite On the Cat Wok 3.8 carb 0.74 phos
 
JanetNJ said:
Ok so the ff is too high in phosphorus for a ckd cat. You are going to want something less than 1% carb and under 10 carb. This is what I'm feeding my ckd cat. Lots of choices from weruva.


Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)

What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loves it.

Goody stew shoes 0.71 phosphorus, 8.5 carb. This one is a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)
Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p and
Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos

New favorite On the Cat Wok 3.8 carb 0.74 phos
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So as long as the phosphorus is under1% and the cabs under 10...that will work? I want to be sure I am not giving too many carbs.
 
Hi. If the creatinine is high it would confirm kidney disease. It was something I mentioned when you first posted. Was last night the first time you tested at home or do you have more tests from December? If you have any tests from the last 2 weeks it would be really helpful. He is likely to be extra sensitive to insulin after last night. That must have been really scary. :bighug:
 
tiffmaxee said:
Hi. If the creatinine is high it would confirm kidney disease. It was something I mentioned when you first posted. Was last night the first time you tested at home or do you have more tests from December? If you have any tests from the last 2 weeks it would be really helpful. He is likely to be extra sensitive to insulin after last night. That must have been really scary. :bighug:
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Last night was the first time I tested. I feel horrible about it, but I was scared. Last night formed me to do it. Just a side note, I am suffering from a rare disease myself that has been hard to manage for the last couple of months. Not an excuse though. I have Addison's Disease and on't produce enough cortisol, especially in stressful situations. Last night was horrible for both of us. Now I know to post a 911 message for help.
 
Shelle Acello said:
So as long as the phosphorus is under1% and the cabs under 10...that will work? I want to be sure I am not giving too many carbs.
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Yes... unless your cat's phospherous levels are REALLY high, then you might need a binder. But at stage 2 changing to a low phospherous/low carb diet will help. and LOTS of extra water. My cat is late stage 2 and I just started doing sub q's at home a few times a week as well, but you aren't there yet.
 
Shelle Acello said:
Last night was the first time I tested. I feel horrible about it, but I was scared. Last night formed me to do it. Just a side note, I am suffering from a rare disease myself that has been hard to manage for the last couple of months. Not an excuse though. I have Addison's Disease and on't produce enough cortisol, especially in stressful situations. Last night was horrible for both of us. Now I know to post a 911 message for help.
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you did GREAT last night. :) Your cat is lucky to have you.
 
Shelle Acello said:
Last night was the first time I tested. I feel horrible about it, but I was scared. Last night formed me to do it. Just a side note, I am suffering from a rare disease myself that has been hard to manage for the last couple of months. Not an excuse though. I have Addison's Disease and on't produce enough cortisol, especially in stressful situations. Last night was horrible for both of us. Now I know to post a 911 message for help.
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Don’t feel bad. My neighbor, my sister, and another friend had two diabetic cats and never tested at home. They thought I was crazy! Thank goodness you caught it last night. I would like you to post on the Lantus board tonight. What time zone are you in and what time do your shoot? I’m on the west coast. I think you are two hours before me but checking.
 
tiffmaxee said:
Don’t feel bad. My neighbor, my sister, and another friend had two diabetic cats and never tested at home. They thought I was crazy! Thank goodness you caught it last night. I would like you to post on the Lantus board tonight. What time zone are you in and what time do your shoot? I’m on the west coast. I think you are two hours before me but checking.
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I definitely feel more impowered now that I've tested him on my own. I am in the central time zone....I believe I am two hours ahead of you. As for posting on the lantus board, anything patricular I should say? Or just kind of the same thing I posted here?
 
To help us help you with dosing, could you fill in a couple days in the spreadsheet before today. Even if you weren't home testing yet (no worries, you are not alone in this by far!), the data of what does you gave for a few days before hand will help us help you. Lantus is a depot insulin, and the depot of the larger dose can influence what happens for 4-6 cycles after you reduce the dose. It might be responsible for the 86 you saw today.
 
Wendy&Neko said:
To help us help you with dosing, could you fill in a couple days in the spreadsheet before today. Even if you weren't home testing yet (no worries, you are not alone in this by far!), the data of what does you gave for a few days before hand will help us help you. Lantus is a depot insulin, and the depot of the larger dose can influence what happens for 4-6 cycles after you reduce the dose. It might be responsible for the 86 you saw today.
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I was given some lantus in a glass container from the vet. Since 12/21....he has had 2units twice a day. 8am and 8pm. I use the syringe. I will fill in the spreadsheet.
 
Shelle Acello said:
I was given some lantus in a glass container from the vet.
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Can you post a picture of it? We've had more than a few people get Lantus from the vet that was repackaged and not up to full snuff. When you start a new vial/pen/cartridge, it's also good to note it in the spreadsheet Remarks.
 
See attached picture. I did get a prescription as well. I’m so new, I don’t know what’s best to order. Pen/cartridge/vial? Any recommendation?
 

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Yikes! That does look like repackaged Lantus. I would go for the pens as the most cost effective. You can use them to the last drop. Cartridges aren't available in the US.

Has anyone mentioned ordering Lantus through Marks for cost savings? Buying insulin from Canada.
 
I'd suggest getting a test at +2 hours after the dose was given. It will give you some idea of where the rest of the cycle might be heading, giving you warning of whether you need to test right through the peak. Remember that you can post for help when you need it. :bighug:


Mogs
.
 
Critter Mom said:
I'd suggest getting a test at +2 hours after the dose was given. It will give you some idea of where the rest of the cycle might be heading, giving you warning of whether you need to test right through the peak. Remember that you can post for help when you need it. :bighug:


Mogs
.
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Thank you. I'm still trying to understand all this. I'm reading though all the sticky's on this board right now.
 
I do have another question.....Berlioz has been on 2 units of Lantus twice a day since being diagnosed by our vet. I moved him down to 1 unti today after hypo scare last night. I was not aware of the TR or SLGS methods until recently. What do you recommend I do at this time to get him regulated?
 
I'd suggest spending a short time on SLGS (doesn't have to be very long) while you're learning the ropes. Then, as soon as you're confident about testing and have a better feel for how Lantus is working for Berlioz you could choose to switch over to TR as soon as you feel ready (as long as you can get a minimum number of tests each day and only feed wet, low carb foods).


Mogs
.
 
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