Hypoglycemia help

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wombat88

wombat88

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Shaikha has been having a pancreatitis attack the past few days. Usually this makes her BG levels go wild, which they did initially. I had to increase her dose quite a bit to get her under control. Yesterday we had a long period of blues, which is very unusual for her because usually she goes through insulin like jet fuel, especially when sick. I skipped her mid-day dose and she was back up by the PM dose so I gave her a little less insulin. This AM she read a little low again so I waited and retested. About an hour after her usual dose she was rising again (or so I thought), so I gave a smaller dose of insulin with food. After I'd given it though, it seemed like it was a pretty sharp change in just a 1/2 hour so I decided to retest. She tested at 127, instead of the 174 I'd gotten just a few minutes previously. A retest at +1.5 gave her a level of 79. Alarmed, I gave her some dry food. At +2.75 she was down to 50, however, so I gave her more dry food. At +3.5 she was still at 50 so I gave her dry food mixed with karo syrup this time.

She is having no symptoms. She has never had a hypo episode before, actually, even when on heavy doses of R during a period where she was so high we could not get her regulated otherwise. She's on a TID schedule of PZI which usually has worked for her since we get so little duration usually. The only thing I can think is that her pancreas has suddenly decided to kick in because it was sure absent a few days ago if you look at her SS. She can be very unpredictable with her insulin needs given all the inflammation we usually are dealing with in addition to getting infections easily due to low white and platelet counts.

She has a complicated medical history and has triaditis. She does not eat low carb food, by the way. I've got her on hypoallergenic canned food, but it has about 20% carbs. I have to be very careful what I give her or we end up with tons of IBD problems. The dry food she just ate has about 38% carbs if I recall correctly. She takes 5mg. prednisolone daily to control chronic pancreatitis and IBD problems (budesonide was a non-starter for her -- not effective at all).

My vet is out for lunch but will call again when the clinic reopens. I plan to keep retesting at 1/2 hour intervals. Is there anything else I should be doing?
 
That is odd to have a drop like that. Any drop before +3 is from the previous dose really and not the dose you just gave. 50 isn't a hypo number, but one to watch closely. You are doing great and exactly what you should be doing - giving higher carb food in small increments and keep testing every 30 min to hour to make sure she doesn't nose dive. PZI is in and out of the system fairly quickly all considering, so I don't think there is a need to bring her to the vet for this right now. You should be able to take care of this at home. Good catch today!
 
It is odd, I agree. This is not typical behavior for her during flareups, so the only thing I can think is that her pancreas suddenly decided to wake up and help out. Usually she's off-the-charts-high in periods like this. She does tend to get very unpredictable during flareups though, so that much is typical for her. :shock: Off to test her again. Will report back.

PS: The reason I decided to retest was it was the last strip in my container, and the previous reading seemed off. I should have retested before shooting but given her past pattern she's actually risen 50 or more points in as little as 15 minutes, so I didn't second-guess. Will definitely not make that mistake again!
 
Update: At +4.5 she's up to 66, so we are headed in the right direction. Will continue to keep testing at 1/2 hour intervals until I'm sure she's above 100 and will stay there. I did give her some more of the dry food with karo, but will switch to plain canned food after this or dry if she won't eat the canned.

One possible trigger I guess is that she seemed to feel pretty badly yesterday afternoon. She did not eat all her normal food at mid-day and took a lot of coaxing to eat, not unusual for her when her belly hurts like it has been (it is painful to touch, something that happens with bad pancreatitis attacks on occasion). Last night though she didn't eat much at all. I tried to assist feed but she seemed so strongly nauseated I was afraid to push. I got enough food in to counter the insulin, I thought, but perhaps not enough. I did increase her anti-nausea medication and that seemed to help because she ate fairly well this AM. She's also got buprenorphine and fluids on board, which also help a lot when she's like this.
 
+5.5 at 83, so I think we are getting out of the woods at last. She's moving around the house normally, though sleeping off the load of dry food she ate this morning right now! I hope she doesn't go on a food strike after tasting the kitty crack (dry food). It took a lot to get her transitioned to canned food and I want to keep her eating it. She's a definite dry food addict!
 
Another update: At +7 she was back up to 125, so we'll be okay. Whew! She will not be getting her mid-day dose of insulin for sure, but will have to figure out what type of dose to give tonight. I'm sure her liver will kick in with a vengeance and we'll have a good bounce going, but we'll see. Her liver always panics when it sees a green. It's never had an extended green session like this one so I'm not sure how she'll react. Thanks again for your help today!
 
Maggies Mom Debby said:
Good catch today. I'm so glad she's out of the woods. Have you seen the How to Treat Hypos page? It gives you great information on how to spot and treat low bgs. viewtopic.php?f=28&t=15887
Click to expand...

Yep. Long ago I copied it and put it on my computer plus printed it and kept it with the supplies. Very easy to follow. She was not very enamored with the karo syrup, but thought the dry food feast was yummy! Hope I haven't created a monster....

She's up to 237 at +9, one hour past her usual second dose time (she gets insulin 3x per day). I fear we may be in for a zoom tonight, but she does that even without a hypo, which is why she's on TID anyway.
 
Now that the panic is passed.

If you purchase some canned foods with gravy - you can feed her the gravy from the food, to raise her numbers. You can also spoon the gravy onto the low carb wet food and this will raise her too, without resorting to karo or kibble.

Depending on the situation, you may want to only feed gravy - say a couple spoonfuls at a time, and save the food - in case she decides she is full when you really need to get food in.
 
Hillary & Maui said:
Now that the panic is passed. If you purchase some canned foods with gravy - you can feed her the gravy from the food, to raise her numbers. You can also spoon the gravy onto the low carb wet food and this will raise her too, without resorting to karo or kibble. Depending on the situation, you may want to only feed gravy - say a couple spoonfuls at a time, and save the food - in case she decides she is full when you really need to get food in.
Click to expand...

It's a good idea, but unfortunately gravy usually is made from wheat or corn flour, and she can't have either because of her IBD. I've become a huge label reader given her condition. I do keep a few cans of Fancy Feast in the cupboard for emergencies, but they are totally grain-free versions and I rarely give them because I know we'll end up with diarrhea or puddle poo later. I always have to bypass any flavor that has gravy at all because of the grain issue. The kibble she ate to raise her BG today is actually a hypoallergenic novel protein version with green pea flour, which seems to agree with the IBD at least, even if it isn't good for her diabetes.

I've managed to get her onto canned food only in the past few months. I'm hoping that continues. She nibbled only reluctantly at her usual canned food that I offered tonight. Pancreatitis is bad enough because her appetite goes way down, but she also develops food aversions if she has a bad flareup. I've had several foods that she used to adore that she's turned off completely after past attacks and will not touch even after months of not having it. Am hoping I do not have to go searching for another after this episode. I'm sure if I offered the dry food though she'd scarf it down. I'm hoping that tonight she'll be hungry enough to eat it or I'll have to assist feed again -- or offer foods I really don't want her to eat because of the impact on her diabetes.
 
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