Lethargic, uncoordinated movements, 25mg/dL

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If you want to give her some food, that would be fine, I think.
 
i'd offer maybe 1oz of food since she ate a lot earlier. we want to keep her up, but you may need her hungry so she'll eat again later.

glad you've got enough strips.
 
Hi Sam

Julie had to run out and asked me to pop in and keep an eye out. Looks like your last test was 144 at +6. You fed. Any further tests?

You all have had a really long day but doing great.
 
I was gone for about an hour and a half, but I just tested now and it's at 96. Is there a specific goal I should be going for?
 
While 96 is perfectly safe, it's her trend of coming back down when she should be headed up at this point that I'm focusing on.

While the nadir (or lowest number in the cycle) is theoretically at +6, some cats nadir earlier, some later (even as late as the next preshot), and some change it up. We don't have any data on her to know what her nadir is but she's also overdose. This can cause the duration of this cycle to be very long (as was stated, it could be 16-17 hours).

So we need to keep in mind that we might need to feed later in the cycle. I'd like to see if she will eat a tsp or two of low carb food and see where it puts her BG. Do you think she would be ok with this? How is she feeling and doing with the tests? I'd feed her and test in an hour. Sound good?
 
Marje and Gracie said:
While 96 is perfectly safe, it's her trend of coming back down when she should be headed up at this point that I'm focusing on.

While the nadir (or lowest number in the cycle) is theoretically at +6, some cats nadir earlier, some later (even as late as the next preshot), and some change it up. We don't have any data on her to know what her nadir is but she's also overdose. This can cause the duration of this cycle to be very long (as was stated, it could be 16-17 hours).

So we need to keep in mind that we might need to feed later in the cycle. I'd like to see if she will eat a tsp or two of low carb food and see where it puts her BG. Do you think she would be ok with this? How is she feeling and doing with the tests? I'd feed her and test in an hour. Sound good?
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I'll give her some of the ground chicken food I've been making. She seems to be doing alright, wandering around the house and sitting in places like usual. She heavily dislikes getting pricked in the paw, but after I give the test it's fine.
 
Marje and Gracie said:
She won't allow ear tests? You typically have to poke harder to pierce the tougher toe pads.
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The last few times I tried the ear tests I couldn't hit the vein. I tried shining a light through the back but it was still extremely hard if not impossible to get it. I've found it much more reliable to prick the pads.
 
Ok. When she's through this, we can teach you how to poke the ear. You don't want to hit the vein. It will really hurt and bleed like the devil. We just poke the very edge of the ears. But again, stick with what she will let you do for now and we can address the other later.
 
sometimes with a hypo event, even though you didn't see low numbers since the 25 this morning, the overdose can influence the next few days. at this point, i don't think it necessarily means a vet visit, but it does mean extra monitoring.

Any chance you have time now to do a spreadsheet? It's going to be very helpful for us to help you as you move forward. Numbers alone don't mean as much as numbers in context, the way they are on a spreadsheet.

see you in another hour. i'm glad she's holding up there.
 
Sam, we're wondering about any BG tests you have from before today. It would be good to consider them when looking at her next dose. Especially the past 3 days, or more - whatever you have.

Have you been doing preshot testing every time? any mid-cycle tests?
 
julie & punkin (ga) said:
Sam, we're wondering about any BG tests you have from before today. It would be good to consider them when looking at her next dose. Especially the past 3 days, or more - whatever you have.

Have you been doing preshot testing every time? any mid-cycle tests?
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I have no data from beforehand because I couldn't get any blood from the ears, so it was pretty much blind.
 
I'm jumping in late here... it looks like it has been about 11 hours since her shot, correct? And the hypo was just before that? Last food was when?

My concern is that it has been at least 10-11 hours since a symptomatic hypo. When a cat goes too low, the body is *supposed* to release counterregulatory hormones that would bring the numbers up to a safe zone. Since that hasn't happened yet, hours later, it's possible that either she has been this low several times before and you haven't caught it (often enough that her body has been tricked into thinking super low numbers are ok), or that her insulin dose is WAY too high so it was able to counteract those hormones. It's a concern that the protective mechanism hasn't kicked in yet, so please be vigilant and conservative.

I would concentrate on getting through the next several hours until you see the numbers go up and stay up. In Lantus overdoses, we have seen that take up to 16-17 hours.

HOWEVER. I can't recall a time when we have had a 2u shot given right after a symtpomatic hypo, so we have no precedent to be able to predict what will happen here. I wouldn't even start to think about what dose to give next time. For sure I wouldn't give insulin tonight, and I would probably be inclined to skip tomorrow's shot too (maybe both shots tomorrow) to allow the insulin depot to deplete and the counterregulatory hormones to clear out. Then see where things settle out and decide where to go from there. Honestly I think it would be premature to try to guess what will happen next - just keep testing, feed to keep her propped up, and wait for a bounce to hopefully start soon.

Good job today, though! I know it was trial by fire, but you're doing a good job of keeping on top of things. Let's get through tonight, then worry about tomorrow.
 
we're thinking it'd be smart to skip tonight.

most people do shoot blindly until they arrive here and either learn more or have an experience like you had this morning. you've done a good job handling all of it.

i'm thinking it might be good for you to take the 911 off now - you can edit the first post of this thread to do that - so that if you need it again, you can put it up and it will get noticed.

for now, i'd keep testing every hour and repost the number here. we're still watching for you.

edited to add - i see Libby has weighed in as well. just keep doing what you're doing, sam.
 
Libby and Lucy said:
I'm jumping in late here... it looks like it has been about 11 hours since her shot, correct? And the hypo was just before that? Last food was when?

My concern is that it has been at least 10-11 hours since a symptomatic hypo. When a cat goes too low, the body is *supposed* to release counterregulatory hormones that would bring the numbers up to a safe zone. Since that hasn't happened yet, hours later, it's possible that either she has been this low several times before and you haven't caught it (often enough that her body has been tricked into thinking super low numbers are ok), or that her insulin dose is WAY too high so it was able to counteract those hormones. It's a concern that the protective mechanism hasn't kicked in yet, so please be vigilant and conservative.

I would concentrate on getting through the next several hours until you see the numbers go up and stay up. In Lantus overdoses, we have seen that take up to 16-17 hours.

HOWEVER. I can't recall a time when we have had a 2u shot given right after a symtpomatic hypo, so we have no precedent to be able to predict what will happen here. I wouldn't even start to think about what dose to give next time. For sure I wouldn't give insulin tonight, and I would probably be inclined to skip tomorrow's shot too (maybe both shots tomorrow) to allow the insulin depot to deplete and the counterregulatory hormones to clear out. Then see where things settle out and decide where to go from there. Honestly I think it would be premature to try to guess what will happen next - just keep testing, feed to keep her propped up, and wait for a bounce to hopefully start soon.

Good job today, though! I know it was trial by fire, but you're doing a good job of keeping on top of things. Let's get through tonight, then worry about tomorrow.
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Thank you so much for the thorough explanation. I would like to sleep today, but should I wake up every maybe 4 hours and test?
 
no, I don't think you're at a point at which waiting 4 hours is safe. She is still close to 100, right, and about 11 hours after the shot, if I'm calculating correctly. I would stay with every 1 hour unless you see a very significant rise. Set an alarm and catch cat-naps if you need to, but be sure you can wake up. If you're like me and you can't wake up from naps, then I would make coffee and stay awake. Sorry, but that's the tradeoff for not being able to take her to the vet for monitoring. She's not out of the woods yet. These numbers may look safe, but due to the way Lantus works, it can take a long time for the insulin's effects to wear off. Each cycle builds upon the next, it's not strictly a 12 hour cycle.
 
yes, if she hasn't eaten in a number of hours and is still surfing at around the same number, she might be getting past the "pull" of the high dose of insulin. We're just looking to be sure she's at a point where if the food wears off, she won't tank again. Try to feed, see where she is in an hour, then if she's around the same number you might be able to go 2-3 hours between tests. I'm sure she's not terribly hungry since she had so much food and sugar today, but getting something solid into her should help her maintain her numbers.
 
You're doing a great job, Sam. Well done.
(And you've had some phenomenal support here).

It's 6.20am in the UK, so I'm around now too. Just getting coffee and then I'll read through all the posts here.

Eliz
 
I've been watching along to see that everything was OK and just wanted to pop on and say "Congratulations" on keeping her safe!

You've had a true baptism by fire today...and now you're getting your very first PJ Party!

Hopefully by morning it'll be easier to know how to proceed, depending on how she does the rest of tonight.

I don't have any brownies to offer you for your party, but here's some ~O) ~O)

Great Job, Sam!
 
SpringHalo said:
She really hasn't eaten much, maybe 1oz or so.
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Aha, so it may be that she's starting to come up on her own now (not just due to the food).
It would be good to see another rising number though, just to be sure that she's definitely on the way up.

How does Shevee seem in herself? Any residual effects from the hypo?

Eliz
 
Elizabeth and Bertie said:
SpringHalo said:
She really hasn't eaten much, maybe 1oz or so.
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Aha, so it may be that she's starting to come up on her own now (not just due to the food).
It would be good to see another rising number though, just to be sure that she's definitely on the way up.

How does Shevee seem in herself? Any residual effects from the hypo?

Eliz
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She doesn't seem much different, though I don't really observe her much at night. I gave her a treat or two and she munched them down.
 
Great job today, Sam. Please keep us posted as to what the vet says. We will all be here to help you learn as much as you'd like to.

Hope she comes up so you can get some rest.
 
Latest is 148. Looks like it's stabilized fairly well. I'm getting awfully tired, so I might take a 2 or 3 hour nap.
 
Okey dokey,

So, she seems to be holding steady (rather than rising or falling) at this point.

Yes, do get some rest. But maybe set an alarm so you can check again in 2 -3 hours?
(I know you must be exhausted...)

Eliz
 
It was extremely difficult to get this reading, but she's at 140 right now with no food so far. I'll give her the normal breakfast with no insulin today.
 
nice job. :smile:

I think you're at a point where she is not at risk of dropping too low from last night's shot. I agree with no insulin today, though. I would give things a chance to settle down before deciding what to do. Test a few times today and keep an eye on her, and please let your vet know about the hypo.
 
Hey Sam!

I did not want to interrupt the flow of the awesome advice you were getting last night, but did want to chime in and say great job on testing and monitoring!!!

I was checking frequently to see how things were going and you did great. I am a newbie myself and I am not sure I would have been able to handle it as well as you did!

Looking forward to hearing what the vet has to say
 
'Morning, Sam. Great job managing Shivee's numbers! Kudos to the members who were free to help yesterday and through the night. I hope you get a chance to relax and get a nap or two in today.

Libby and Lucy said:
I think you're at a point where she is not at risk of dropping too low from last night's shot. I agree with no insulin today, though. I would give things a chance to settle down before deciding what to do. Test a few times today and keep an eye on her, and please let your vet know about the hypo.
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I'm another one who agrees with no insulin today. At this point, don't worry if you see Shivee's numbers rise... and if they don't... that'll tell us something, too. Today's a good day to let everything settle down. Then it'll be time to figure out where to go from here. She'll give us clues.

Like Libby said, get a few tests in today, let your vet know about the hypo, and get some well deserved rest.
 
Sam

I didn't want to stress you with this yesterday but if you need any help setting up a SS, it will take me about two minutes to do it for you. I'll even add in the numbers from yesterday and you can just edit if I have them in the wrong place.

I do need some info from you so they would best come via private message. If you'd like help, please send me a PM by clicking on the PM box to the right under my Gracies photo and just letting me know you'd like me to do it for you. Then I can tell you what info I need.

If you are comfortable doing it yourself, no worries. Here's how you Create a Spreadsheet.
 
Right. No insulin. This rise is natural. It's what we call a bounce, and it's his body's way of protecting itself.

Test again in like 3 hours or so, and let us know what you get.
 
Hi Sam,

I also didn't want to chime in while you were getting all the helpful advice. But you did a great job managing Shevee over the past two days! I'm very impressed - you kept your calm (at least online) and got through it!

I look forward to what the vet has to say about all this.

Good luck!

~Suzanne
 
Dyana said:
Right. No insulin. This rise is natural. It's what we call a bounce, and it's his body's way of protecting itself.

Test again in like 3 hours or so, and let us know what you get.
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Will do. Just gave her some food and adding data to the spreadsheet now.

EDIT: Added spreadsheet to my signature. I'm angry that I didn't start this right when she got diabetes.
 
don't worry about not starting earlier. Most of us don't (look at my Lucy's spreadsheet - I knew how to test, but it was still months before I started doing it regularly). I'm sorry you had to be introduced to it all this way, but you're not the first and I'm sure you won't be the last. Just move forward. :smile:

This could be the counterregulatory hormones I was expecting to see last night, or it might not be. If so, it's possible that she will come down from here on her own and I think it's smart to skip the insulin today. Plus, that will give both of you a break from the stress and testing of last night. We'll see where she goes from here!
 
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