Is this is an emergency?

T

TommyTheCat

Member Since 2026
Haven’t had a chance to do the spreadsheet. Cats numbers have been consistently in mid to low 300s, despite dosage. We have been slowly increasing as instructed by the vet. Now at 4 units lantus twice a day.
We’ve been frustrated by the lack of improvement in his numbers. But out of nowhere tonight we tested at 4 1/2 hours after insulin (no test prior- didn’t think it was necessary). His BG was 110 at +4.5. Never seen that low of a number before. We have been testing every 10 minutes since and the number keeps decreasing- 99, 76. Gave him food. And now 62. What do we do!?! Please help
 
tagging @Bandit's Mom to see if she's around to help tonight. I can't stay up longer. This Sticky Note has instructions on what to do. Don't Panic! or How to Handle Low Numbers

59 is still a safe number, you want him above 50 with that human meter. It's not a 911 situation yet. If you could take a moment to at least put today's blood sugar numbers in the spreadsheet, that'll let us help you.

For future reference, you need to have some high carb canned food around.
 
Adding, since you are following SLGS for dosing, his dose tomorrow morning is 0.25 less than whatever he's at now. I think that should be 3.75 units. Again, spreadsheet would help.

Don't fill him up, you want him to be hungry later, just in case it's needed. Instead of full cans of food, think teaspoons.
 
Wendy&Neko said:
tagging @Bandit's Mom to see if she's around to help tonight. I can't stay up longer. This Sticky Note has instructions on what to do. Don't Panic! or How to Handle Low Numbers

59 is still a safe number, you want him above 50 with that human meter. It's not a 911 situation yet. If you could take a moment to at least put today's blood sugar numbers in the spreadsheet, that'll let us help you.

For future reference, you need to have some high carb canned food around.
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Thank you! After karo syrup he is now at 96. I’m just panicking because we have had nothing but high numbers until now. This came out of nowhere. I have been writing everything on paper. Will update spreadsheet asap. For now, I’m not taking my eyes off him. Watching for any signs of emergency. Although the closest 24 hour ER is 35 minutes away. Reading your link now. Thank you for sharing
 
You likely don't need the ER visit. Karo can take a couple hours to wear off and numbers may wobble down again if that happens. So you will need to monitor for a bit yet. Since he's now at 96, you can wait an hour for that next test. If a lot higher (could be a bounce), then you are good for the night.

Please remove the 911.
 
Bandit's Mom said:
Sorry, just saw this. I am around. How long is it since the shot and what was the last test?
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That’s ok. The shot was at 7pm. The readings were between 11:30pm-12:30am. I haven’t slept. Just staying up watching him and he seems to be okay. He’s at 111.
Not sure how I handle insulin going forward. I’m going to do the spreadsheet. It might not be very helpful since the vet told us to not bother with it. But we’ve been doing at least 1 a day anyway. Just randomly.

Definitely going to be testing MUCH more frequently now. Not going to listen to the vet at this point. So scary
 
I've definitely found that sometimes you have disregard the vet (you'll figure out when over time!) in favor of the community's guidance. My vet wanted to start my cat on a super high dose, not test, and just bring him in for curves every two weeks. I was super firm that I'd be hometesting and tracking on my own.
 
Hi Lauren/Ryan, here is your previous post. We always include the previous post in our current post so that members will be able to see what has been happening with the cat to date: New member - help needed / questions

I think you probably already know this information since you've chosen SLGS as your dosing method, but here are basic instructions for increases/decreases: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

When you get a chance, please update your spreadsheet with as much data available, to include last night's numbers.

Remember that the goal is to get Tommy down into lower numbers similar to those you saw last night. That said, you were absolutely correct to check into the forum when those numbers started dropping. It can be scary when that happens, especially the first time (or tenth!--it's scary). The good news about last night is that you saw first hand that food is the tool that bumps up those numbers, along with frequent testing to ensure you know what his bg is.

Be sure to take your dose reduction, as Wendy advised, in the next cycle, and be sure to test before his shot and feed after (test, shoot, feed). If it were Jude, I would try to grab a +2/+3 shot to ensure he is not going too low. That +2/+3 test is right around the time the insulin is taking effect. If the bg is ~20% lower than the preshot test, you might expect an active cycle where you'll need to test more frequently. If it's ~20% higher, you might expect that it will be a quieter cycle. When Jude was first diagnosed, I would try to test at preshot and then at +2/+3 and then, if his numbers were fairly flat or moving upward, I would test about every 2-3 hours; I would test more frequently if his numbers were moving downward and stop testing when they began going back up again. As we say here on the forum, ECID (every cat is different), but as you gather more testing data, you'll soon understand Tommy's patterns.

When you post again tomorrow (or whenever you're on the forum again), please create a title that includes this information: date, cat's name, bg numbers. This helps the advisors to clearly see who needs help.

How is Tommy now?

How is the testing going?

If you have any questions, feel free to share them--we've all learned a lot from one another on the forum.
 
Sorry this is all a bit over our heads. Can you please help us now? We just tested before our evening shot and his number is 106. Wondering if we skip his insulin or shoot a smaller amount? Thanks so much for your help!
 
TommyTheCat said:
Sorry this is all a bit over our heads. Can you please help us now? We just tested before our evening shot and his number is 106. Wondering if we skip his insulin or shoot a smaller amount? Thanks so much for your help!
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I don’t give dosing advice but I think you’ll get a faster response if you use the dropdown menu by the title to “?” and include something like “Low PMPS Need Eyes.”

One thing I do when I get a lower than expected number is not feed and retest in 20 minutes. If that number is going up, I at least have confidence that I’m shooting into a number that should go up once Moonie is fed (since the effects of the prior dose have worn off).

I’d also consider whether you can stay to monitor in the dosing decision you decide to go with.

I hope someone more experienced weighs in soon!
 
Here are the SLGS instructions for shooting low to you numbers:

How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.
 
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