Jersey - +6 - 33; +7 - 140; +11 - 280

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Shelly & Jersey (GA)

Shelly & Jersey (GA)

Member Since 2014
AMPS 429 - .25 units Lantus
+2 - 352
+4 - 226
+6 - 33 (no signs, just hungry)
Fed high-carb FF; 20 minutes later - 57

Will test again in 20 minutes.
 
Re: Hypo Jersey +5 - 33

Hi Shelly, how you doing? Is this your first time faced with this low of a number? You need to get Jersey up as soon as possible. Have you rubbed a little karo or syrup on his gums?

Oh, ok, I see your update. Looks like he's fine. I just saw your subject line and wanted to make sure you were ok. Glad to see you have the situation under control. Would you mind taking down the 911? We only want it up if you have an emergency. Thanks.
 
Re: Hypo Jersey +6 - 33

It is the first time we've gone hypo. We just switched to Lantus a week ago and just switched to a quarter unit over the past couple of days. We've fed high-carb food, which brought her up some. Do we still need to do Karo?
 
Re: Hypo Jersey +6 - 33

Oh, I see. The last test was 57? You don't need the karo but keep testing to make sure Jersey stays above 50.
Liz
 
Re: Hypo Jersey +6 - 33

Latest test - 121

To recap:

+6 - 33; fed high-carb FF
20 minutes later - 57
20 minutes later - 121

Now what?

Thank you all so much! It's very, very stressful, and I feel better knowing you're all here!
Shelly
 
Re: Hypo Jersey +6 - 33

No karo, but retest every 20-30 minutes and post. The 57 is likely food induced numbers. You want to hold off on feeding and get two tests above 50 consecutively. If you do need to feed, try and just give the hc gravy portion. But post and we'll watch for you :smile:
 
Re: Hypo Jersey +6 - 33

With that 121, you don't need to feed HC either. Great job! Can you update the subject line of the very first post with the new readings?
Liz
 
Re: Hypo Jersey +6 - 33

Hi Shelley!

If you've gotten Jersey up to 120s, hold off giving carbs now and retest in about 30 minutes. Then repost your numbers - edit the subject line of your first post in this thread, so people will see it.

You're getting the ""baptism by fire!" start with your lantus. the good news is that Jersey responds to the insulin and you're doing a great job keeping her safe.

Here's the official scoop on how to deal with the low numbers:

DON'T PANIC! or HOW TO HANDLE LOW NUMBERS

First, try to not panic. Post to the Lantus Insulin Support Group or on the Health Board. Make sure your subject line indicates you are concerned about a possible hypo and/or add the 911 icon to the first post in your condo. People who are experienced in dealing with low numbers will be there to help. After posting, remember to refresh your browser periodically to see if people have replied.

It’s important to recognize that just because your cat may be experiencing low BG numbers doesn’t mean that your kitty is critically hypoglycemic. Many cats will have low numbers and never have symptoms. It’s important, though, to bring those numbers up into a safe range. ALWAYS make sure you have a stock of test strips, high carb (HC) canned food that contains gravy and is over 15% carb such as Fancy Feast grilled, marinated, or Gravy Lovers varieties (see Dr. Lisa's Cat Food Nutritional Composition List for a full list of options), and/or a simple sugar solution such as Karo/corn syrup, honey, maple syrup, etc.

If your cat is experiencing symptoms, especially if those symptoms are severe, you need to rub Karo syrup, honey, or maple syrup on the gums or, if symptoms are very severe, administer rectally and get your cat to the nearest 24-hour emergency facility. Take the bottle of syrup with you to administer on the way if necessary. (Note that it is rare that we see episodes of symptomatic hypoglycemia with Lantus and even rarer to see severe symptoms. But, you need to know what to do should they occur.)

The symptoms to be concerned about include but are not limited to:
staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
disorientation (yowling, walking in circles, etc.)
twitching
stupor
convulsions or seizures
coma
If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
(If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.

Please post your numbers. Those people who are helping you will not abandon you. In fact, they are staying up with you. The experienced people will even work in shifts to make sure your cat is safe and you have the support you need. Remember to refresh your browser to see new posts and keep posting so we know all is well.

~ written by Sienne and Gabby
Click to expand...

I'll let others keep helping you and stay out of it. but you're doing all the right things. and welcome to Lantus Land! julie
 
Re: Hypo Jersey +6 - 33; 57; 121

Hi all,

I've settled down now and will hopefully be able to provide information in a coherent form. Here are the latest numbers:

+6 - 33; fed high-carb FF
20 minutes later - 57
20 minutes later - 121
20 minutes later (now at +7) - 140

At this point, Jersey hasn't eaten since +6. It's now +7.

Thank you all again for your guidance and kind words. I can't tell you how very much I appreciate it.

My next question is about dosage. At .10 units, things were not going well (as can be seen by the high numbers on the spreadsheet). Either we were getting numerous fur shots, or we simply had bad draws (e.g., air bubbles). There were a couple of times when Jersey's AMPS was below the shot limit. By +5 or +6, her numbers were high. At those times, I tried to go ahead and give Lantus. I know that isn't the preferred bid dosing, but I figured that it would be better to "split" the time without insulin (e.g., instead of 12 hours without insulin, she would go 6 hours without it, get insulin, and then be without it for another 6 hours before moving back to a 12-12 schedule). I have no idea if that makes any sense.

After today's episode, I'm obviously worried that .25 might be too much insulin. Can someone help me try to interpret the data I have collected? Is there a certain time where additional data would be helpful? I'm lost with the numbers we've been getting.

Again - you have my sincerest appreciation!
Shelly
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

yes, i can see why you'd be worried about it.

i'd like to talk with some others before you shoot again, about whether you should try a 0.1u again or let this insulin clear out and see what kind of numbers are there without any insulin.

are you familiar with bounces? i'm wondering if those high numbers yesterday were a bounce from the 69 and whatever followed it night before last. if so, yesterday's numbers were high from the hormones that Jersey's body put out and it looks like they were clearing today when you gave the 0.25u. here's an explanation of bounces, if you're not familiar with it. look at the second post in this thread: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=46012
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

Thank you, Julie. I am familiar with bounces; I just don't know how to recognize them! :sad: (See, this is why I should be posting my numbers every day.) I promise I will keep re-reading the info you sent me until I get it right!

I would appreciate any feedback you or others have about dosing. I will hold off on shots until you all can guide me on this. (Should I make a new post for advice?) We're really struggling with Lantus, much more than we were with Humulin.

Thank you again!
Shelly
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

We usually do one posting per cat per day, so keep posting here. Could you update your subject line again? To something like
2/22 Jersey - Hypo +6 - 33; +7 - 140 need dosing advice

You can also use the ? icon to get more attention.
Liz
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

hi shelley!

here are your previous posts:
2/1, 2/4 Jersey & I need advice
2/8, 2/9 Berberine to lower BG?
2/4 Help with Numbers & Humulin
2/8 How do I switch to Lantus

ok - after reading through your previous posts and talking with Dyana, i think the consensus is for you to drop the dose to 0.1u and try to get an accurate dose given twice a day. Sienne had suggested that in your last post as well.

Sienne gave you the photos of the tiny tiny dose in the "How do i switch" post above. those pictures are also found on the "New to the Group" yellow starred sticky. I saw that someone earlier (maybe Deb/Wink?) told you about the technique for "screwing" the plunger to try to measure out a tiny dose.

Jersey is obviously very responsive to a small dose. The purpose of the TR protocol is to hold a cat's BG numbers between 50 and 120. Being able to do that allows the pancreas to heal. A newly diagnosed cat able to be held in those BG numbers has an excellent chance of going off of insulin. So that's our goal!

I'm so sorry about your loss of Bugsy. What a terrible experience - especially to have happen at your vet's! I'm so glad you're testing now, because that's going to keep Jersey safe. Not sure if you're testing on the paw still, or on the ear, but just so you know it takes a couple of weeks for capillaries to grow in the ear after you begin poking. the poking encourages the growth of the capillaries.

A couple of tips that I can add to help you get that tiny dose: you mentioned about you/your husband getting older and having more trouble measuring the insulin than when you were doing it 10 years ago with Bugsy. If the issue is being able to see the lines on the syringe, you can try either stacking reading glasses - yes, put on 2 of them at once. you'll be amazed at how clear the lines become! you'll look stupid, but hey! what we won't do for our kitties?!?

Another thing some people do is to buy a clip on magnifying glass at a craft store - some of them may have lights - and clip it on an open cupboard door so you can work with the syringe behind the magnifying glass. some people buy opticians magnifying glasses - i don't have a link for that, but Zener's people, Anne & Liz, use those. Find Zener's condo (thread) and you can ask them for a source if you're interested in that.

We do have a very small dose that isn't measurable. Not sure if that would be enough for Jersey at this stage. We generally have people go to it as their cats go off of insulin. One presses in the plunger very hard so absolutely no air is in the syringe, insert the needle into the lantus, then release the plunger. The syringe will pull in a "breath" of insulin. It's going to be less than 0.1u so it may not be enough. i would try the 0.1u dose first.

I'd try stacking the reading glasses, drawing up a half unit to a whole unit of lantus, then tinkering with it with the syringe to get a 0.1u. sometimes it helps to draw some air into the syringe AFTER you have the lantus in it, then do the flicking to try to get the lantus to drop to the plunger end and the air to rise to the needle end (pointed up) and then express the air.

another thought - some syringes are far worse at creating bubbles than others. some barrels of syringes are also thinner, making the markings spread out farther and therefore easier to measure than other syringes. there isn't a perfect needle/syringe, but i liked these: http://www.americandiabeteswholesale.com/product/terumo-thinpro-insulin-syringe_5891_112.htm. many people on here use them, but a couple of folks recently have said they didn't like that they have a longer needle. So . . . for what it's worth, i'm suggesting them if you can't get a dose drawn without bubbles that you can get out. if you decide to order from ADW, you might want to register first at http://www.mrrebates.com and they'll track your purchases and send you a rebate every so often.

Take a look at this page, and make sure you watch the video about 1/2way down the page: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151 Lantus is never rolled. You also test, feed and shoot all within a few minutes, unlike when you had the Humulin and fed first, then waited to shoot.

that's probably all a bit overwhelming. do you have any questions?
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

i'm just taking forever to post, liz! :lol:

thanks for pointing out about one thread per person, per day. it keeps everyone's posts on the front page and reduces confusion - also helps make sure no one gets lost and doesn't get help they need.

we also link our previous posts - that helps the people who are trying to help you by providing an easily navigated string of posts so we can see what the past advice or situation was.

it is great to use the ? icon when you have a question, it's also great to put it in the subject line of your first post. removing the ? when you've gotten enough of an answer to feel satisfied helps us too.

but that all takes people a little while to pick up so people will help you with it. no worries.

glad to have you here!
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

Thank you all for the wonderful replies. They are very much appreciated. I actually just posted some of my questions on the main discussion board (http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=114252). Sorry about that - I'm new to navigation. I will read through all of the information and links you have provided and will go back down to the .10 unit. I know I have more questions - I just don't know what they are right now.....deep breath.

Again, thank you. My current veterinarian told us to do .10 unit once a day since Lantus lasts 24 hours in cats. The first vet wouldn't work with us on food or insulin. Obviously, we're doing most of this on our own, and the support from this board is what's helping me get through it. If you could see the tears on my face right now, you would understand how very much your support means to me!
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

Hi, Shelley. It certainly seems like you had a busy day!

Just a point for clarification. If a kitty experiences low numbers like Jersey did today and there are no symptoms that would indicate a hypoglycemic event, we regard this as low numbers. It's only when a cat has symptoms that we look at this as a hypoglycemic event. Most of our kitties have wandered into numbers below 40 and don't have any negative symptoms. You have to take those numbers seriously and steer the numbers with food just like you did today.

I agree with what's been suggested and I'd encourage you to practice drawing a 0.1u dose. I think it's going to be important to stick with this dose and to do as best you can to shoot on time and to shoot every 12-hours providing it's safe to do so. If you're unsure of what to do, please post. There's usually someone around who can walk you through your options.
 
Re: Updated: Jersey - Hypo Episode +6 - 33; +7 - 140

cats have a faster metabolism - they almost always need one shot every 12 hours in order to get their blood sugar under control. that's what we'd like to see you be able to get to for Jersey - a small enough dose that you can give the same dose every 12 hrs consistently. skipping shots is necessary sometimes, but if we can get to 2x a day, that's ideal.

and we have ALL been where you are now. we get it. we know how hard it is to take care of a newly diabetic cat and many of us have had vets that didn't know much about treating FD. most vets don't have that much training or experience in FD and they often treat it like you would treat a dog, which isn't best for cats. fortunately, there are a lot of people here who stay to teach others.

we're not vets, but we understand FD after living it 24/7!

you can usually get a fairly quick answer to questions almost any time of the day, except maybe the early morning hours. even then there are people who will check in to see if anyone needs help.
 
Final update of the night and then I'll quite pestering you all!

I've ordered the Terumo syringes and have the magnifying glass and optivisors in my shopping cart - thank you all for the links. I've also been practicing micro-dosing again with colored water. I have no idea if it's actually .10 units, but I've been consistently getting 2 drops out each time - with one of them hanging on the needle point. I also sacrificed a dose of Lantus and got the same result. Since I could get 8 drops out of .50 units, I'm guessing I'm close to .10 with 2 drops. [Note to other newbies who might be reading this - please be aware that these are "my" drops. If you're trying to micro-dose, please don't go by the number of drops I've listed here. Your drop size might be different than my drop size.] I also re-read all of the stickies and links, as well as watched the videos again.

Because we were off schedule tonight, we didn't shoot. We'll start fresh in the morning.

Thank you all for helping Jersey and I get through a rough day. May you and your furry loved ones have a peaceful (and green) night!
 
you're definitely not pestering us! it's what we do for fun! :lol: everyone here is volunteering.

when you get new syringes you'll have to measure drops again - different size needles make different size drops. i had a high dose kitty (15.5u) so never did this microdosing, but i thought people usually get 10 drops in a unit, making 0.1u one drop. if you're getting 8 drops in 0.5u, that would be 16 drops per unit. so 2 drops would be close to 0.1u.

the important thing is that you get a dose you can replicate and that you are consistent in it.

just tell yourself that this is a great problem to have! Jersey doesn't need much insulin to get her into good numbers.

sleep tight! see you tomorrow.
 
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