? Last night Glycemia was 21

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Francesca Fichera

Member Since 2021
Ok. I know I have already annoyed you but I'm under shock.
Last night he had only 21 mml, the vet was not answering the phone and we had to "save" the cat injecting glucose orally and via rectum, plus some honey on his gums. He got better, started reacting again (he normally meows and purrs consistently! and so he did). We measured again, it was 536. Now he reached 571.
He drinks a lot, he has diarrea, he is a little disorientated when walking, of course he wants to rest, but at least he acts himself.
I HAVE NO CLUE WHAT TO DUE and I'm about to panic. I don't think this is normal diabetes, and it looks like insulin is hyper toxic to him.
I don't know what to do, I don't want to torture him!!!
 
I'm sorry about not filling the spreadsheet, but, I swear to God, this situation is crazy.
He's taking Lantus, 1 unit for 2 days, previously 1/2. We're measuring glycemia by a human metre. Insulin was last given at 2.15 p.m. yesterday!!!
We managed to speak to the vet and we're going back tomorrow to repeat blood tests and also trying to get in touch with a veterinary ultra sound tech.
I'm going to try to write down his data but, believe me, they're so irregular we absolutely have no clue how to proceed also with his intake of insulin
 
Francesca Fichera said:
I'm sorry about not filling the spreadsheet, but, I swear to God, this situation is crazy.
He's taking Lantus, 1 unit for 2 days, previously 1/2. We're measuring glycemia by a human metre. Insulin was last given at 2.15 p.m. yesterday!!!
We managed to speak to the vet and we're going back tomorrow to repeat blood tests and also trying to get in touch with a veterinary ultra sound tech.
I'm going to try to write down his data but, believe me, they're so irregular we absolutely have no clue how to proceed also with his intake of insulin
Click to expand...
Hi I don't see a spreadsheet set up at all
Tagging
@Chris & China (GA)

@Bandit's Mom
To set one up for you, they will send you a private message ,look for it
In your previous post I see you listed the times , that does not help us because we are all in different time zones

Here is how you want to list it

EXAMPLE
If you give insulin at 7 AM you would say
AMPS and the number you get for his BG
If you test again 2 hours later you would put his BG number then @+2 (2 hours after giving insulin)

If you test 3 hours later it would be his BG then @+3 (3 hours after giving insulin
And so on
 
Last edited:
Is he eating and drinking normal amounts?

Are you using the correct syringes? I'm not sure how they are in Italy, but the syringe should say U-100 on the side of it somewhere.

You are currently giving two shots per day, correct?

What is his diet? Low carb canned food? Did you recently change food?

Has he been on any steroids lately?
 
FrostD said:
Is he eating and drinking normal amounts?

Are you using the correct syringes? I'm not sure how they are in Italy, but the syringe should say U-100 on the side of it somewhere.

You are currently giving two shots per day, correct?

What is his diet? Low carb canned food? Did you recently change food?

Has he been on any steroids lately?
Click to expand...
Thank you is Melissa I didn't know who else to tag :bighug::cat:
 
He was hospitalized for 2 days last week after a "crisis": my dad had found him blacked out in his pee and vomit. At the clinic the exam results showed nothing relevant (also the imaging), they gave it back to us after giving him 1 unit insulin with no feeding for two days and told us to monitor him.

SAT 22
7.00 am
BG 369 -> 1 u
meal : tunafish 80 g

3.30 pm
BG 38
honey + melted sugar

6.30 pm
BG 98
meal : baby food (forced feeding)

10.00 pm
BG 264

11.00 pm
BG 267

SUN 23
3.00 am
BG 394 --> 1/2 u insulin (the vets had told us to give it to him when the values exceed 250)

9.00 am
BG 113

12.20 pm
BG 104
sugar

3.00 pm
BG 306

6.00 pm
baby food

6.15 pm
BG 354

8.15 pm
BG 412

10.20 pm
BG 436

10.30 pm
meal: chicken, tuna (normal) and lamb (baby food)
1/4 u insulin
+ honey on his gums every two hours

MON 24
7.00 a.m.
BG 147

11.00 am
BG 161

3.00 pm
meal: half tuna fish can

5.45 pm
BG 476

8.00 pm
BG 506

meal : hills digestive
1/4 insulin

11.00 pm
BG 412

meal : canned wet food

1.00 am
BG 225

TUE 25
7.00 am
BG 267

8.44 am
meal : hills digestive

10.40 am
BG 395

1.00 pm
BG 496

3.00 pm
meal: canned wet food

3.45 pm
1 u insulin

5.30 pm
BG 514

8.00 pm
BG 422

11.00 pm
BG 261

WED 26
7.30 am
BG 77

meal : canned wet food

9.30 am
BG 91

1.30 pm
BG 172

meal : chicken + hills digestive

2.15 pm
1 u insulin (suggested by the vet)

4.25 pm
BG 105

snack : some honey + some chicken

6.00 pm
BG 78
honey and sugar

8.00 pm
meal: wet food + glucose

10.00 pm
BG 21
intensive care with glucose and honey

11.00 pm
BG 536

THU 27
8.00 am
BG 571

no meal

12.25 pm
BG 155

12.40
meal : hills digestive

2.00 pm
BG 187
 
FrostD said:
Is he eating and drinking normal amounts?

Are you using the correct syringes? I'm not sure how they are in Italy, but the syringe should say U-100 on the side of it somewhere.

You are currently giving two shots per day, correct?

What is his diet? Low carb canned food? Did you recently change food?

Has he been on any steroids lately?
Click to expand...

During the hospitalization and the first day back home he wasn't eating and the vets didn't tell us to force him. Since last Saturday, we're both forcing him and let him eat on his own when he shows appetite. But he tends to have nausea (we're also giving him an antiemetic) and he is experiencing diarrea.

The syringes are correct, I'm going to take a picture to show you. His diet was changed dramatically: he has always been used to kibbles. The vet told us to give him wet food and so we did.

She also told us to give him one shot per day since he has very unpredictable reactions to insulin.

No steroids at all. We suspect diabetes is secondary to another issue. I'm in pain, I'm doing him so much harm.
 
Francesca Fichera said:
He was hospitalized for 2 days last week after a "crisis": my dad had found him blacked out in his pee and vomit. At the clinic the exam results showed nothing relevant (also the imaging), they gave it back to us after giving him 1 unit insulin with no feeding for two days and told us to monitor him.

SAT 22
7.00 am
BG 369 -> 1 u
meal : tunafish 80 g

3.30 pm
BG 38
honey + melted sugar

6.30 pm
BG 98
meal : baby food (forced feeding)

10.00 pm
BG 264

11.00 pm
BG 267

SUN 23
3.00 am
BG 394 --> 1/2 u insulin (the vets had told us to give it to him when the values exceed 250)

9.00 am
BG 113

12.20 pm
BG 104
sugar

3.00 pm
BG 306

6.00 pm
baby food

6.15 pm
BG 354

8.15 pm
BG 412

10.20 pm
BG 436

10.30 pm
meal: chicken, tuna (normal) and lamb (baby food)
1/4 u insulin
+ honey on his gums every two hours

MON 24
7.00 a.m.
BG 147

11.00 am
BG 161

3.00 pm
meal: half tuna fish can

5.45 pm
BG 476

8.00 pm
BG 506

meal : hills digestive
1/4 insulin

11.00 pm
BG 412

meal : canned wet food

1.00 am
BG 225

TUE 25
7.00 am
BG 267

8.44 am
meal : hills digestive

10.40 am
BG 395

1.00 pm
BG 496

3.00 pm
meal: canned wet food

3.45 pm
1 u insulin

5.30 pm
BG 514

8.00 pm
BG 422

11.00 pm
BG 261

WED 26
7.30 am
BG 77

meal : canned wet food

9.30 am
BG 91

1.30 pm
BG 172

meal : chicken + hills digestive

2.15 pm
1 u insulin (suggested by the vet)

4.25 pm
BG 105

snack : some honey + some chicken

6.00 pm
BG 78
honey and sugar

8.00 pm
meal: wet food + glucose

10.00 pm
BG 21
intensive care with glucose and honey

11.00 pm
BG 536

THU 27
8.00 am
BG 571

no meal

12.25 pm
BG 155

12.40
meal : hills digestive

2.00 pm
BG 187
Click to expand...
Ok, for now let's do this - no more insulin until we get the spreadsheet set up. Tagging @tiffmaxee @Bandit's Mom and @Wendy&Neko because what I see here makes me nervous.

Lantus should be given twice a day, 12 hrs apart. For people new to this, we recommend only giving shots when the preshot test is above 200. Food should be withheld for 2 hours before a shot.

The high numbers you're seeing are bounces - when he drops so low like that his body panics and releases sugar into the blood.

Does he have any other health issues? Why the digestive food? Is that food wet or dry? Any history of ketones or diabetic ketoacidosis?
 
Francesca Fichera said:
During the hospitalization and the first day back home he wasn't eating and the vets didn't tell us to force him. Since last Saturday, we're both forcing him and let him eat on his own when he shows appetite. But he tends to have nausea (we're also giving him an antiemetic) and he is experiencing diarrea.

The syringes are correct, I'm going to take a picture to show you. His diet was changed dramatically: he has always been used to kibbles. The vet told us to give him wet food and so we did.

She also told us to give him one shot per day since he has very unpredictable reactions to insulin.

No steroids at all. We suspect diabetes is secondary to another issue. I'm in pain, I'm doing him so much harm.
Click to expand...
Gah!

Ok the food is the likely culprit here, your vet really should have known better. The transition from wet to dry should be done slowly and carefully monitored - because the insulin needs can change drastically with lower carb food.

His results are unpredictable because of the food change and bouncing.

When you set up the spreadsheet, please note the meals in the Remarks column. Rough amount fed helps as well (so a teaspoon or whatever unit of measure is easiest).

Side note, once you have a moment to breathe, I'd suggest looking for a new vet.
 
We don't know if he has other health issues, because the exams were said to be ok. The vet suggested the digestive food because of his diarrea.
All food is wet. Last week he was found negative to ketones. The vet told us to take him there to repeat the blood tests tomorrow
 
FrostD said:
Gah!

Ok the food is the likely culprit here, your vet really should have known better. The transition from wet to dry should be done slowly and carefully monitored - because the insulin needs can change drastically with lower carb food.

His results are unpredictable because of the food change and bouncing.

When you set up the spreadsheet, please note the meals in the Remarks column. Rough amount fed helps as well (so a teaspoon or whatever unit of measure is easiest).

Side note, once you have a moment to breathe, I'd suggest looking for a new vet.
Click to expand...

Yes, this is the second vet we have changed in one week...
The amount is 80 g circa each meal
 
Francesca Fichera said:
We don't know if he has other health issues, because the exams were said to be ok. The vet suggested the digestive food because of his diarrea.
All food is wet. Last week he was found negative to ketones. The vet told us to take him there to repeat the blood tests tomorrow
Click to expand...
Ok. The digestive wet food is still fairly high in carbs, but don't change anything with his diet yet. There's other things you can do for diabetic cats with diarrhea but I'll wait for the others to chime in.

Please ask for a fructosamine if they haven't done one (I believe I read somewhere in your threads they did not).
 
If you take a picture of your syringes, could you take the picture with it pulled up to your usual place when you dose 1U? The units and markings can be confusing, and sometimes the vets do not demonstrate the proper measurement.

I'm so glad you caught that 21, and were able to bring him back from that. Great job!
 
Francesca Fichera said:
What do you suggest I feed him? He's rarely eating on his own
Click to expand...
He probably feels like garbage with all these blood sugar swings, hopefully he starts to feel better once we get this figured out.

Here's a link to the food database, you want something less than 10% carbs, ideally 5% or less. When we say "medium carb" that's generally 13-17%, and "high carb" is 18-25% or so.
 
Francesca Fichera said:
And most of all, thank you... It's such a depressing situation, I cannot see him like this, this is a brother of mine, we grew up together
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Breathe! He's ok right now, we'll get it figured out. Unfortunately we see a lot of stories like yours, the only thing that saved me personally was the vet told me I didn't need to bother changing food ( it kept his BG high enough to not go hypo, I was giving insulin without testing for about 3-4 months).
 
I see you listed the times , that does not help us because we are all in different time zones

Here is how you want to list it

EXAMPLE
If you give insulin at 7 AM you would say
AMPS and the number you get for his BG
If you test again 2 hours later you would put his BG number then @+2 (2 hours after giving insulin)

If you test 3 hours later it would be his BG then @+3 (3 hours after giving insulin
And so on
 
Diane Tyler's Mom said:
I see you listed the times , that does not help us because we are all in different time zones

Here is how you want to list it

EXAMPLE
If you give insulin at 7 AM you would say
AMPS and the number you get for his BG
If you test again 2 hours later you would put his BG number then @+2 (2 hours after giving insulin)

If you test 3 hours later it would be his BG then @+3 (3 hours after giving insulin
And so on
Click to expand...
Diane I'm not even sure that would work right now because the insulin was given all over the place. Let's see what Bhooma thinks

Also Francesca - GA means Gone Ahead or Guardian Angel, meaning the cat has passed away. I think you want the question mark!
 
Ok, I need to get to work now, but I'm gonna try to figure the spreadsheet out as soon as I can.
What I meant was, what do I do for the transition, blend kibbles + water? Thank you and talk to you later!
 
FrostD said:
He probably feels like garbage with all these blood sugar swings, hopefully he starts to feel better once we get this figured out.

Here's a link to the food database, you want something less than 10% carbs, ideally 5% or less. When we say "medium carb" that's generally 13-17%, and "high carb" is 18-25% or so.
Click to expand...
Hi Melissa I wonder if she can get any of these in Italy
@FrostD
 
FrostD said:
Diane I'm not even sure that would work right now because the insulin was given all over the place. Let's see what Bhooma thinks

Also Francesca - GA means Gone Ahead or Guardian Angel, meaning the cat has passed away. I think you want the question mark!
Click to expand...
You're probably right :cat:
 
Francesca Fichera said:
Ok, I need to get to work now, but I'm gonna try to figure the spreadsheet out as soon as I can.
What I meant was, what do I do for the transition, blend kibbles + water? Thank you and talk to you later!
Click to expand...
Oh I see. No you just want to slowly feed smaller amounts of kibble and more low carb food over time.

@Diane Tyler's Mom I wasn't sure what food is available either but figured that's the best list we have!
 
FrostD said:
Diane I'm not even sure that would work right now because the insulin was given all over the place. Let's see what Bhooma thinks

Also Francesca - GA means Gone Ahead or Guardian Angel, meaning the cat has passed away. I think you want the question mark!
Click to expand...
I'm sorry maybe I'm getting this wrong but am I reading between the lines that I have no hope?
 
Francesca Fichera said:
I'm sorry maybe I'm getting this wrong but am I reading between the lines that I have no hope?
Click to expand...

Oh no there's plenty of hope!

I was replying to Diane and the spreadsheet formatting. I'm not sure what way is best for you to fill it out since the shots were all at different times, but Bhooma will be along later to help. She's in India so bit of a time difference
 
Francesca Fichera said:
Guys, just a quick question: what if at the next measurement the values go up? I'm terrified to go and check
Click to expand...

He will be fine. With no history of ketones or DKA there's not much harm in being high; it does do damage over time, but for now it is much better for him to be high than risk going too low. Another hypo episode could leave permanent damage, or worse.
 
I'll take a stab at summarizing the BG data so far [ETA: Francesca, let me know if you see any errors here, especially if I've missed any shots you gave!]:

Saturday
AMPS 369, 1U Lantus
+8.5 38, honey + melted sugar administered
+11.5 98 baby food meal (assist feeding), no shot given at this time
+15 264
+16 267

Sunday
AMPS (at +20) 394, 0.5U Lantus given
+6 113
+9.25 104, sugar administered
+12 306
+15 baby food
+15.25 354
+17.25 412
+19.25 436
+19.5, full meal, 0.25U lantus given, honey on gums every two hours

Monday
+8.5 147
+12.5 161
+16.5 meal (low carb)
+19.25 476
+21.5 (PMPS) 506, meal (kibble? Hills Digestive) 0.25U lantus given
+3 412 meal (low carb?)
+5 225

Tuesday
+11 267
+12.75 meal (kibble? Hills Digestive)
+14.75 395
+17 496
+19 meal (canned, low carb?)
+19.75 no pre-shot, 1U lantus given
+1.75 514
+4.25 422
+7.25 261

Wednesday
+15.75 77, meal (canned food, LC?)
+17.75 91
+21.75 172, meal (chicken and Hill's Digestive)
+22.25 (no pre-shot BG), 1U lantus given (vet advice)
+2.25 105 (honey and chicken snack)
+3.75 78 (honey and sugar administered)
+5.75 meal (wet food + glucose)
+7.75 21 (intensive honey+glucose administration)
+8.75 536

Thursday
+17.75 571, no meal
+22 155, meal (Hill's Digestive)
+24 187
 
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Impressions: he's diving a lot for relatively small doses, plus lots of glucose and honey along the way.

We really really need to double-check dosage. I'm especially concerned about what happened on Sunday night/Monday morning. If I'm reading things correctly, he got a tiny dose (0.25U), plus honey and sugar, and still went from high 400's down to 100's.

He's also diving extremely late in the cycles. That's somewhat more likely with an insulin like lantus (which "stores" some of each shot for future use), but he hasn't been getting enough regular doses to really build a depot. Two possibilities are first (again), he's getting a higher dose than we think, or second, his pancreas is working better than we think.

When you get a chance, please do take a picture of your syringe, drawn up to what you have been shooting as 1U. We want to be sure about this!
 
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This is the syringe... Sorry for not getting back fast but I had to work and then came the doctor for the imaging: nothing relevant was found but a mild gastro-intestinal suffering (which we could guess from the diarrhea). Tomorrow we're repeating the blood tests at 11.30 am.
Numbers are slowly increasing, I then found :
4 pm
BG 193

6.30 pm
BG 194

7 pm
meal: wet food (no more than 25 g, eaten on his own)

10 pm
BG 224
meal : hills digestive (no more than 20 g, eaten on his own)

11.10 pm
247

I'm sorry for not having figuring out the spreadsheet yet, it's been a devastating day between work and care giving. I hope you can forgive me and thanks thanks thanks for your precious help. I'm wondering whether I should wake up in the middle of the night for testing him again... He is still quite weak, that heart of mine. Again, thank you all!!!
 

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OK, those look like the correct syringes, so that's good. The first picture looks like the plunger is drawn up to 1.0U, right? But the second one is drawn up all the way to around 23U-- is that picture just to show all the numbers on the syringe barrel (not to demonstrate a dose)? Just double- and triple-checking here, sorry...

Francesca Fichera said:
I'm sorry for not having figuring out the spreadsheet yet, it's been a devastating day between work and care giving. I hope you can forgive me and thanks thanks thanks for your precious help. I'm wondering whether I should wake up in the middle of the night for testing him again... He is still quite weak, that heart of mine. Again, thank you all!!!
Click to expand...

You're doing great, don't worry. All of this is a lot, and unfortunately there's no way to ease into it slowly, suddenly it seems like you have to learn everything about FD, all at once! That's where we come in, we'll try to help you figure things out if we can :).
 
Please don't give 1.0 units again, it's too much insulin. Lantus doesn't work to shoot down high numbers by giving a one time higher dose. Lantus is a depot insulin, meaning it builds up over time (simplistic explanation). Once we can see the spreadsheet, we can give you a better idea what dose to give.

When transitioning cats from dry to wet food or to any new food, it's not uncommon for them to have digestive issue. That's why a gradual transition is easier on them. For food options, you have a different selection in Europe. These two links (the blue works are clickable) show may of the low carb options available in Europe:
 
After your reply to Nan & Amber let's start a new thread, this one is getting long. please put a link to this thread for reference, and tag us in it so we know where to find it (tag by typing the @ symbol followed by the username, a list should pop up for you to choose from).

Once we've got the spreadsheet up and running I think we can talk about diet change and the right dose to start back up on.
 
Nan & Amber (GA) said:
OK, those look like the correct syringes, so that's good. The first picture looks like the plunger is drawn up to 1.0U, right? But the second one is drawn up all the way to around 23U-- is that picture just to show all the numbers on the syringe barrel (not to demonstrate a dose)? Just double- and triple-checking here, sorry...



You're doing great, don't worry. All of this is a lot, and unfortunately there's no way to ease into it slowly, suddenly it seems like you have to learn everything about FD, all at once! That's where we come in, we'll try to help you figure things out if we can :).
Click to expand...

Yes, the first one is the dose, meanwhile the other is just to show you the syringe itself. Sorry for the late reply but we went to vet in order to repeat the tests, the results should be ready tonight. Meanwhile, numbers are going up, he was 500 a while ago, wanted to eat and we fed him 50 gr of wet digestive: the vet suggested to give him 0.5 (1/2 unit) Lantus, just one last try with this insulin (I already want to change it, but... ). I'm gonna set up my spreadsheet tonight, I promise. Dad is giving him his shot after 1h from the meal, if the glycemia is suitable with the injection. Let's see. I'm gonna open a new thread, I'm gonna do everything, I swear. For the record, he looks better. Fingers crossed and many hugs from Napoli <3
 
Francesca Fichera said:
Yes, the first one is the dose, meanwhile the other is just to show you the syringe itself. Sorry for the late reply but we went to vet in order to repeat the tests, the results should be ready tonight. Meanwhile, numbers are going up, he was 500 a while ago, wanted to eat and we fed him 50 gr of wet digestive: the vet suggested to give him 0.5 (1/2 unit) Lantus, just one last try with this insulin (I already want to change it, but... ). I'm gonna set up my spreadsheet tonight, I promise. Dad is giving him his shot after 1h from the meal, if the glycemia is suitable with the injection. Let's see. I'm gonna open a new thread, I'm gonna do everything, I swear. For the record, he looks better. Fingers crossed and many hugs from Napoli <3
Click to expand...
Lantus is one of the best insulins out there, don't discount it!

If it were me, I would start at 0.25U just to be safe. You can estimate it with the half unit markings
 
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