Hypo last night, steep drop today

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KaitlynandScamper

KaitlynandScamper

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Hey everyone!
Last night my 12 year old cat Scamper, 2.5 weeks into beginning PZI, suffered a scary dip from almost 500 to 40 over a few hours. We made it through with help from everyone on Health, but today has been another rollercoaster for him. Would you mind glancing over and letting me know if I should monitor him again tonight for hypo? I am in the process of setting up my official SS, but for now this is all the data I have collected since getting the BG meter:

7/30 at 10:30 pm 422 -- 1 hr 45 min after 2nd 2unit of insulin today, and after eating
7/31 9:10 am 475 -- pre-shot and ff
7/31 11:15 am 491
7/31 1:30 pm 466 (had some kibble)
7/31 4:00 pm 448
7/31 6:20 pm 489 (20 min after FF, 2.5 U in flank per emergency contact vet's instructions)
7/31 10:20 pm 68 and 75
7/31 11:45 pm 44 (gave ff, kibble, syrup)
7/31 1:35 am 158
8/1 9:00 am ps 402 (one can ff after, 1 U in scruff)
8/1 8:15 pm PS 594 (1 U in flank)
8/1 9:40 pm 579 (fed one can ff after test)
8/1 12:00 am 267

Thanks!
 
I should also note that he started at 1 U but continued peeing and drinking like crazy, so the vet told me to increase. Now, however, I am starting to think my scruff shots have been misfires, and giving the low dose in the flank has been much more effective -- but possibly still too much. New vet appt in a few days to straighten it all out.
 
How long has Scamper been on insulin again? How long was he on the 1 unit dose? Do you have any figures for that period? It would be interesting to compare with the more recent patterns.

I hope some of the more experienced users will chime in soon (some East Coasters are likely already in bed), but from what I've read, insulin injected into the scruff is less easily absorbed than insulin injected into the flank, so changing where you inject may account for some of the difference you see. Injections should be done under the skin. Make sure you are not going into a muscle because that will also increase injection power. A good picture of where you can inject and info on techniques can be found here: http://www.felinediabetes.com/injections.htm.

Yesterday you were dealing with a bit of a bounce from the hypo and likely this afternoon as well. When you test, do you feed before you give the shot? I assume that's the case but you tested again in an hour and mentioned feeding then so I am just checking.

Is it possible for you to get some midcycle tests in? You had info on the AM and PM pre-shots, but nothing in between. Knowing how low your cat is going and when during each cycle helps a lot in figuring out doses.
 
I see you also posted to your prior thread in Health. Good thinking! I answered there, but my feeling is that you had a pretty steep drop, similar to what Lori told you. I'd also cut dose back and continue to shoot in the same area (flank) vs. scruff so we can get comparable data. I'd suggest trying 0.6U or 0.8U and seeing how it goes. Cats are more sensitive to insulin after a hypo so cutting back a little helps.

PS: Expect to see some more responses tomorrow. It was past bedtime for many of our East Coasters and our West Coasters don't appear to be online just yet. Welcome to PZI!
 
Kaitlyn,
Looks like you've gotten great advice from Wendy and Lori.
All I'd like to echo is trying to continue shooting in the flank. If it's going to be absorbed at a different rate, then if you switch back and forth it'll be hard to tell when the insulin starts, peaks, and stops to work. The more numbers you can fill in between the AMPS and PMPS, the more sense this will make to you.
I'm for reducing the dose as well. Maybe it will smooth the drops and you can avoid problems like liver activity when his BG goes lower than his body is comfortable with.

Carl
 
He's been on insulin only about 2.5 weeks. He was on 1 U maybe 5 days to a week? No figures. I had been feeding just before the shot, but for the past couple of days I let him eat and wait 20-30 min. Tomorrow I hope to get some midcycle data via my roommate who will be home with the cat while I'm working.
 
Sounds like a plan! I know that frequent testing is a pain to do, but it is really, really helpful as you know how low your cat goes and when it happens. That data is so very helpful in deciding whether dose is too high or too low. When I first started, I didn't test enough and likely over and under shot insulin as a result. I'm lucky she didn't have big problems as a result. I even gave insulin once per day for a while because I didn't know better. That didn't work out too well, but thankfully no bad side effects like Kim's Kitty had (diabetic ketoacidosis or DKA).

Looking forward to seeing some of that data tomorrow. Hopefully the lower dose and more data will help us to nail down how Scamper is processing insulin throughout the day.
 
Just to be sure we are all on the same page:

1) What food is Scamper eating now? Is he on lower carb canned, or is he still eating dry food? That makes a difference in dose as dry food really ramps up numbers. If you are still feeding dry, as high as Scamper is right now I'd try to switch to canned if you haven't already as it will spike blood glucose less.

2) What dose did you give this AM and what was his level? Did you reduce dose and if so, to what?
 
He's been eating Fancy Feast Classic for the past couple of weeks, having kibble only accidentally when someone else feeds the other cat and doesn't put away the remainder. Should not be an issue anymore.

This morning he was up to 541. I gave him 0.8 U in the flank.

Meanwhile, my vet tech's friend's vet friend emailed me again this morning and said to increase to 3 units per day... but apparently he is not aware of the hypo episode that followed his instruction to give Scamper 2.5 units. Needless to say, I will not be taking his advice just yet!
 
Just wanted to say hello. My cat Max was diagnosed in January and I was right where you are now. I'm sure you're already figuring out that you've come to the best place for help with your diabetic cat. I knew next to nothing at first and was overwhelmed and stressed. This forum and following the great advice/protocol really helped me turn Max's health around. This first part is the hardest when you're learning about feline diabetes and how the insulin works are your super cute Scamper. Hang in there!
 
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