Hypo

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Charlyanne & Peanut

Member Since 2012
It's been a long time since I've been on. Peanut was diagnosed at age 6, he's now 14. I used to be a regular when he was first starting out. I guess I got used to things and stopped checking in. But this morning, we have a problem. This is the third time this behavior has occurred. He is unsteady on his feet, walking around and around in circles (always the same direction, counterclockwise) as though he doesn't realize his rearend is still there. Pupils are dilated fully. He purrs loudly when I pick him up, but he is confused. I don't have a working meter. I gave karo about 30 minutes ago with no improvement. Hypo or hyper? Any thoughts??? I tend to err on hypo and will be skipping his morning insulin, but thought the behaviors may be something you all have seen before.

Thanks,
Charlyanne
 
How long ago did you give insulin? How far into the cycle is he?

Sounds like hypo to me. Any improvement yet? If not give more syrup. Now. Do you have your vet's number ready to call if you need to take cat in? And if you do need to, is there someone who can go with you?
 
He gets Lantus 2 units BID. Last dose was around 8p last night (it's 5:45am here now). The big dilated eyes and the confusion are what really throw me off. My vet is open on Sat, so if he doesn't improve I will contact them. He's responding a little now to verbal cues like his name. He's stopped twirling too.....
 
Me again,

Is your cat able to eat? If so give a snack, preferably high carb (do have any cat treats or dry food?) The syrup will be fast acting but wears off quite fast. Other carbs are slower acting but last longer in the system. So ideally, both are good.

How is your cat now?
 
OK, Charlyanne, if cat's responses are better then it sounds like that syrup has kicked in. Good!

I don't use your insulin and so don't know when your cat's BG nadir (lowest number) is expected. How far is he from that point?
 
Lantus is a human insulin and when given to humans it is only given once a day. Alledgedly there is no peak and the insulin acts almost the same (very small curve) over 24 hours. However, vets claim cats require Lantus BID (not sure why, I have never read the actual research on this). He is responsive now as I said to his name, and is laying down, but still looking back over his left shoulder like he doesn't realize his back is there. I tried to give him something more substantial, but he wouldn't eat. I tried milk since he loves milk and there is some sugar in there, but no luck. Peanut is really finiky and won't eat anything at all other than his same dry kibble. I might try him again on some milk now. I wonder though - can cats have strokes?
 
I had to almost force his mouth into a small bowl of 1/2&1/2 but once he got licking, it didn't want to stop! He's looking a little better now, purring agin, head it straighter, and his pupils are constricting some. I will try to get him on food next!
 
Yes, cats can have strokes. But this confusion sounds very like moderate hypo. (I don't know stroke symptoms in cats!).

See this document http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

Have you given kibble as well as syrup? I'd keep trying to get something into him until you can see a significant improvement. The insulin may still be working in his system and his BG could continue to drop once that syrup you gave him wears off.
 
Charlyanne, have pasted hypo symptom info below:

- - - -

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness
 
Elizabeth - thanks for being here with us this morning. After reviewing the symptoms, it sounds like he was definitely hypo. Bumping into funiture, circles, "drunken" behavior. I will continue to encourage the food. No insulin this morning. Maybe I should look into Lantus once daily for cats. I should probably research it.

Thank you so much !!!! :)
 
Elizabeth - thanks for being here with us this morning. After reviewing the symptoms, it sounds like he was definitely hypo. Bumping into funiture, circles, "drunken" behavior. I will continue to encourage the food. No insulin this morning. Maybe I should look into Lantus once daily for cats. I should probably research it.

Thank you so much !!!! :)
 
OK, Charlyanne. I'm going to be around for a while so I'll keep checking the board to make sure you're OK. I expect others will be around soon too.

Do be aware that the hypo will probably have made Peanut more sensitive to insulin so you may be wise to reduce the dose. If this has happened 3 times then it may be that he needs a lower dose ongoingly...?

Do continue to be on the lookout for worsening hypo symptoms. In my cat the syrup only has an effect for about 15 - 20 minutes. You may need to give that again as well as trying to get some other food into Peanut. Don't assume that you're 'out of the woods' just yet.

Also, maybe it's time to get that meter of yours working again??? Then you'll really be able to know whats going on - without the guesswork. If my cat drops too low I give snacks until I get 4 rising meter readings in a row (and I know that he is past the insulin peak and not going to drop any more).

As I say, I'll be around for a while so will check back here a little later.
 
Charlyanne & Peanut said:
Lantus is a human insulin and when given to humans it is only given once a day. Alledgedly there is no peak and the insulin acts almost the same (very small curve) over 24 hours. However, vets claim cats require Lantus BID (not sure why, I have never read the actual research on this). He is responsive now as I said to his name, and is laying down, but still looking back over his left shoulder like he doesn't realize his back is there. I tried to give him something more substantial, but he wouldn't eat. I tried milk since he loves milk and there is some sugar in there, but no luck. Peanut is really finiky and won't eat anything at all other than his same dry kibble. I might try him again on some milk now. I wonder though - can cats have strokes?
Click to expand...

Good morning, I hope Peanut is doing better. I am not an expert by any means, but I do use Lantus for Zeus. From what I understand, cats metabolize the insulin much quicker than a human does, and that is why it should be dosed once every 12 hours. It doesn't last as long as it does for humans.

There is a peak with Lantus, and it can change from day to day and cycle to cycle. It usually peaks somewhere between +5 and +7, but it can be sooner or it could be later. Zeus' peak has ranged between +3 and +8. But then he has also had bounces where the lowest number I have caught was his pre-shot test.

I don't have any experience with hypos but it does sound like that is what you are experiencing. If it has happened three times, Peanut might be due for a dose reduction. The Lantus TR board is great for dosing advice, but they will want to see BG numbers. Typically Lantus is dosed based on the nadir (the peak), unless there are other reasons to change - such as a hypo.

Would you be able to get a meter today to test Peanut? I wouldn't give insulin today without checking him, and probably wouldn't even if I did check him. Cats that have been hypo can be more sensitive to the insulin going forward. If it was me, I would also try to see the vet today for a quick check, but I am a worrier. I once took my dog to the vet for a bump that turned out to be just a pimple, :oops:

Good luck. How is Peanut doing now?
 
Cats metabolize isulin twice as fast as Humans so twice a day insulin injections are needed. And yes, Lantus does have a peak, usually between 6 adn 8 hours for most cats but some cats may peak a little earlier or later. From the Lantus info sticky:

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Have you read the info on the Lantus board about how that insulin works, including the research paper that was done on using it for cats and the recommendations on dosing? http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139 This is a quick summary of the research by Dr. Rand: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

Do you test blood glucose levels daily before giving the insulin?

Charlyanne & Peanut said:
He gets Lantus 2 units BID. Last dose was around 8p last night (it's 5:45am here now).
Click to expand...

So 2 units was given last nigt and at +9.5 your cat is showing hypo symptoms? That's a bit late for hypo symptoms to show up burt ECID. It's past +12 now. How is your cat acting? Do you still plan on taking him to to the vet today?
 
You didn't mention if you are home testing. So, I need to ask are you home testing? And if not, are you willing to learn?

As you can see by these incidents, it's vital to the safety of your cat to test him. If you are home testing, that's great, do you have a spreadsheet?
 
In your first post you said you don't have "a working meter", so I take that to mean you used to, right? Can you pick one up asap? If this has happened more than once then it sounds like an immediate dose reduction is probably needed. You'll be able to see that pretty easily if you can run a curve or two.
Carl
 
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