Joplin's hypo (yesterday)

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Cherylockholmes

Cherylockholmes

Member Since 2013
Hi all...I've been getting support from the Facebook page, but wanted to put this out here too because I'm going to need to be getting some advice, and I understand that's really not the place for that.

Joplin tested at 298 yesterday morning. I gave him his normal 3.5 injection in the morning with breakfast, and went about my day. I came home to find him pretty much non-responsive in a pile of his own poop in my hallway. He had no control of anything-- his legs, bowels, mouth. I grabbed some syrup and in the process of trying to get some in his mouth, he bit down on my finger breaking the skin (that's another story...had to go to the ER myself last night). I raced to the ER vet at about 90mph, and by the time I got him there they said his heart rate was so low, he's lucky I brought him in when I did. Thankfully they were able to save him, and there doesn't appear to be any neurological consequences. He stayed the night, and after taking him off the dextrose IV's, his BG shot up. By this morning it was at 450 or so. The vet asked me to bring his insulin down, and gave him a smaller dose of 2u. I finally figured out how to make a new spreadsheet (my old one broke for some reason), and here are his numbers so far today. I have some Fancy Feast gravy lovers on hand, and am testing every hour at this point.

This was soooo scary. :cry:

I realize no one can give advice with such a small amount of information, but I have committed to keeping up with this spreadsheet, so ya'll will be seeing more of me. Thanks in advance.

https://docs.google.com/spreadsheets/d/ ... 1588549305
 
Hi there Cheryl and welcome :cool:

Glad you made it over to the FDMB. I saw your facebook post yesterday

I don't have personal experience with a symptomatic hypo or Lev but have put a shout out for assistance and am confident folks will be along to help.
I see the dose reduced to 2.0u, however that may be too much.

I'd feel better you can sit tight and await some input before shooting the PM cycle . Ho w many hours until shot time?

Better a day too high than an hour too low.

Hang in there and hang in here. the folks around FDMB will help you sort it all out :cool:
 
Hi Cheryl - sorry about yesterday's scary incident. :YMHUG: Good to hear that likely nothing neurological happened.

Is there any chance you could add data on your spreadsheet from the last couple of weeks? Of course we'd like more data than that, but 2 weeks should help give us a picture of where Joplin is now. I remember that you switched from Lantus to Levemir earlier this year. Do you have an idea where Joplin's onset and nadir are with Levemir? I see he's still coming down now. My Neko is on Levemir and often nadirs at PS time so this wouldn't phase me given what I know about my cat. However, more Lev cats nadir a bit earlier so like Sandy I'm worrying about tonight's dose. If 3.5U was way too high, then another skip might help drain that depot some more.

BTW: there are more people with cats on Lev posting on the TR forum. This one tends to be quite quiet.
 
She hasn't been keeping anything on paper since she went off Lantus, Wendy

She's now back on the spreadsheet bandwagon though and will be updating her spreadsheet as she gets new results. The lack of data is one of the biggest reasons I wanted her posting on the message board so she could get more experienced eyes helping her since she's basically starting from scratch in the data department
 
Thanks Wendy. Unfortunately, I do not have any more data to share at this time :( My spreadsheet had been broken and I had not been writing things down...maybe on notepads for my own accounts, but nothing that was saved (believe me, I now deeply regret that!) So I have nothing more to go on, unfortunately. His next shot time is 9pm (or around 9 is when the vet gave his AM shot). His last test shows him coming up. I'm going to put the new spreadsheet in the signature...
 
Looks like he's reached nadir and turned it around and you still have a couple hours to go until PS.

What is your availability to monitor tonight? Do you have lots of high carb food, plenty of strips?

Out of curiosity, how did you get to 3.5U? Just wondering if you've been doing curves, vet tests or what protocol you are following to change the dose. How much does Joplin weigh?
 
From LL (I told her to stay here for tonight and move to the LL forum tomorrow to keep from having 2 condo's going at the same time)

His SS has been updated with the most recent numbers. He is due for his shot at 9pm. Chris, I thought I picked up all the food, but I just caught him in the bathroom linen closet (where my Dexter sleeps) munching on his leftover breakfast :oops: It was only a few bites, and it is low carb (Wellness grain free canned), but nevertheless, I'm not sure how much effect it will have on his PMPS. We shall see. I will post in about an hour with his number, and would appreciate advice on what I should do from there. I bought a pound of coffee this morning, and good thing, because don't think I'll be able to sleep with all this going on. ~O) I could kill my husband for choosing this weekend to go away with his guy friends!! :evil: lol
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Wendy&Neko said:
Looks like he's reached nadir and turned it around and you still have a couple hours to go until PS.

What is your availability to monitor tonight? Do you have lots of high carb food, plenty of strips?

Out of curiosity, how did you get to 3.5U? Just wondering if you've been doing curves, vet tests or what protocol you are following to change the dose. How much does Joplin weigh?
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Joplin weighs 13 lbs. I'm available to monitor tonight...not going anywhere, and I'm off work tomorrow as well. I have plenty of strips, some Karo syrup, and cans of FF gravy lovers food that I picked up on Chris's recommendation. Joplin was on 4 units of Lantus when we made the switch to Levemir. We started him at 2.5, and every time I tested him it was high, so I raised it by 1/4u every week when I wasn't seeing a chance. Problem is I wasn't testing enough to detect what were probably low nadirs :/
 
ALSO....I keep a bowl of the Young Again Zero Carb food out, and the day BEFORE this happened I had ran out and was waiting on the shipment, so all he was eating was wet food. I'm wondering if that had an effect too, because even though the food claims to be "ZERO carb", I'm sure it has SOME.
 
I think I read somewhere on here that the "Zero Carb" is more like 5%. That's still well within the low carb range.

I forgot to ask if Joplin is at his ideal weight or if the 13 lbs is high or low. If it was his ideal weight, then the starting dose if you were starting Levemir from scratch would be 1.5U. I wonder if doing 1.5U might be a safer number to start with tonight. He did end up with a nice cycle today and a great nadir, but with yesterday's skip and the hypo, I think going conservative is best for now. I'd stick with 1.5 for at least 4 cycles and you could always bump him back up if the numbers aren't good.
 
Your other option if you are nervous, and I would be, is to skip tonight and start fresh again tomorrow. The two skips will help drain the depot.
 
hi cheryl! nice to see you again - i remember when you had Joplin on Lantus back when.

i don't have Lev experience, but we just went through a symptomatic hypo with a cat on Main Health, and at that time, for that cat, Libby & Jill recommended the shots be skipped. We know that cats that have had a symptomatic hypo can be far more sensitive to insulin after the event.

I think because of all that, i'd give one more skipped shot to let the depot drain and for you to get some data for us to see. i don't think 191 is high enough to feel safe to me, personally.
 
Wendy&Neko said:
I think I read somewhere on here that the "Zero Carb" is more like 5%. That's still well within the low carb range.

I forgot to ask if Joplin is at his ideal weight or if the 13 lbs is high or low. If it was his ideal weight, then the starting dose if you were starting Levemir from scratch would be 1.5U. I wonder if doing 1.5U might be a safer number to start with tonight. He did end up with a nice cycle today and a great nadir, but with yesterday's skip and the hypo, I think going conservative is best for now. I'd stick with 1.5 for at least 4 cycles and you could always bump him back up if the numbers aren't good.
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Thank you Wendy. I gave him the 1.5.
 
Sorry to be late but skipping would have been a good choice because cats who have had a symptomatic hypo are usually very sensitive to insulin. However, since you are there and have supplies, I'd just monitor him very closely.

In the past, we've seen symptomatic hypos shock the pancreas into remission. So be vigilant on the testing. As he comes down from all the dextrose, it is possible you will find his insulin needs really decreasing. We will all just have to wait and watch.
 
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