Just got back from the ER

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Kate & Toby

Kate & Toby

Member Since 2019
Oh what an evening, toby has been responding really well to the switchover from caninsulin to prozinc, hes been back to his old self. Anyway, I fed him his freshly cooked Cod for dinner at 7pm, he had his 2iu of prozinc at 740pm and then at 10pm I think he had a hypo episode. He was yowling and howling and walking around in a daze, very wobbly, and then just laid flat out with a very fast heart rate. I jumped into action and rubbed glucose powder in his gums followed by syringing glucose and water in, I rushed him to the vet who tested him and said he was fine and his levels were high. I'm now in a total panic, I don't know what to do about jabbing him in the morning, do I? dont I?, do i reduce it? I was told my my vet that his levels were still too high and so a hypo was very unlikely, so why did he have it? .... hes due back at the vets Tuesday to go up to 3iu, this sounds scary now.... the ER vet was very pleased with me and said i likely saved his life and what I did was brilliant (just followed the guide on here). I have a monitor on order so will be testing myself from next week, but right now I'm scared and feel vulnerable. Thanks in advance for any advice x
 
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Kate, I am so sorry you had a scare with Toby. You are brilliant!

What meter are you waiting for? I guess I would feel nervous not being able to test right now and see what the blood sugar is. Would you consider going to Walmart and picking up the ReliOn Prime meter and strips and testing today? The meter and strips are going to run you about $20 and a box of 28 gauge lancets is a few more dollars. Even if you are going to use another meter, it's nice to have a back up.

If you have been reading the information in the Prozinc forum, you will know that it's not recommended to raise the dose by one unit increments. The 2 Units may actually be too high right now. It's very possible that Toby experienced a "bounce" and you might have seen the results of a very low drop from the 2 Unit dose, then by the time you got to the vet it had bounced high again.

A bounce happens when numbers drop quickly, drop a lot (like from 454 to 91) or drop low. Your cat's liver and pancreas
react to the change in numbers by dumping a stored form of glucose along with counter regulatory hormones
into the bloodstream. These cause numbers to spike upward.
Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

Please consider getting the inexpensive meter and strips, and testing today.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

If you would also create your signature and set up the spreadsheet so you can record the insulin and testing data, that would be very helpful.

Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.
2. Another thing that will help us help you when you get started BG testing at home is to set up a spreadsheet like the one we use here. You will see how the trends and patterns emerge, and members can review his/her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
 
Idjit's mom said:
Kate, I am so sorry you had a scare with Toby. You are brilliant!

What meter are you waiting for? I guess I would feel nervous not being able to test right now and see what the blood sugar is. Would you consider going to Walmart and picking up the ReliOn Prime meter and strips and testing today? The meter and strips are going to run you about $20 and a box of 28 gauge lancets is a few more dollars. Even if you are going to use another meter, it's nice to have a back up.

If you have been reading the information in the Prozinc forum, you will know that it's not recommended to raise the dose by one unit increments. The 2 Units may actually be too high right now. It's very possible that Toby experienced a "bounce" and you might have seen the results of a very low drop from the 2 Unit dose, then by the time you got to the vet it had bounced high again.

A bounce happens when numbers drop quickly, drop a lot (like from 454 to 91) or drop low. Your cat's liver and pancreas
react to the change in numbers by dumping a stored form of glucose along with counter regulatory hormones
into the bloodstream. These cause numbers to spike upward.
Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

Please consider getting the inexpensive meter and strips, and testing today.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

If you would also create your signature and set up the spreadsheet so you can record the insulin and testing data, that would be very helpful.

Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.
2. Another thing that will help us help you when you get started BG testing at home is to set up a spreadsheet like the one we use here. You will see how the trends and patterns emerge, and members can review his/her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
Click to expand...
Thank you for your reply. yes very scary. I've done my signature :-). We are uk based and so sadly no Walmart, my Alpha Trak monitor should be here any day. With regards to a bounce, I'm a little confused, how is this handled? Reduce or maintain? I'm really looking forward to going able to do my own testing ASAP.
 
Well done on recognizing the symptoms, acting on them, and getting Toby to the vet.

Some cats can be insulin sensitive after a hypo.Since he was diagnosed after a "keto episode," I will leave it to people more experienced than myself to figure out a dose for the morning.
Introductory post here: http://www.felinediabetes.com/FDMB/threads/hi-from-kate-mum-to-toby-in-the-uk.218475/

You mentioned that you have cut out almost completely his biscuits. By this, I'm assuming dry food. That could account for the hypo you saw tonight.

From: UK Information: http://www.felinediabetes.com/FDMB/...-vit-b12-and-other-need-to-know-stuff.137376/

UK BLOOD GLUCOSE METERS
You can use a glucose meter made for pets or one made for humans. Both are fine. They do however 'read' the blood glucose slightly differently. It's important to be aware of this.
The most popular human meters in the UK currently (March 2019) are the Accuchek meters and the SD Codefree. (Other UK meters are just fine, they're just not generally used as much here). The most popular pet meter is the Alphatrak.

The main cost of testing is the test strips. The SD Codefree is currently the cheapest meter to use. The Alphatrak is probably the most expensive.

Pet meters, such as Alphatrak, usually give slightly higher readings than human meters, and may give readings closer to those that you would see at your vet's clinic. They are typically more expensive to use than human meters. The GlucoRx Vet meter, from Wellnostics, is a cheaper alternative to the Alphatrak.
If you use a PET meter please let people here know this if you are asking for advice. And add that you are using a pet meter to your 'signature'.

Human meters usually give slightly lower readings than pet meters. And they may give a reading slightly lower than your vet might get. They are usually cheaper to run (sometimes much cheaper) than pet meters such as Alphatrak. Most people here currently use human meters.

Note: All of the insulin dosing protocols used here were devised using data from human glucose meters. So an adjustment will need to be made if you are using a pet meter.
 
Since you haven't been testing and we have no data yet, if you think he had a hypo, then let's assume he did.

I think I'd go back to 1.5U of Prozinc and start over from there while you're getting some data

You mention a "keto-episode" in your introduction post, but that was back in June so I think at this point it's probably safer to reduce the insulin just a little while you're gathering data.

Just be sure to watch for signs like not eating, acting like he's feeling sick, etc.

Have you been testing for ketones?
 
Since you gave the high dose glucose, it's possible his sugars had already started climbing from it by the time he got to vet.

Others have mentioned the bouncing. Also, insulin is a hormone, and is therefore less predictable than a regular medication. There are a lot of biochemical pathways that affect how effective insulin is.

You will feel much more confident once you are able to test at home.
 
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