low bg 56 at +5 Spicey
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Terri and Lucy
Active Member
Hi David,
Just read about last night's big drop on the 1.0 unit. You handled it great. The lows you got were not that low, but the drop from 400 to 46 is too steep. Generally what happens with a steep drop like that is the liver steps in to protect the body by releasing glucose in the form of a hormone called glucagon. Glucagon, on top of all the dry food she ate, will probably mean you see another 400 this morning. That's OK and this is all good information to have.
Like Gator and others have suggested, the way to get Spicy and yourself off this roller coaster is to adjust the dose in smaller increments. Dropping back to .5 isn't going to do anything except prolong the roller coaster IMHO--that would be a 50% reduction in dose. Until you can get the U-100 syringes with 1/2 unit markings, here's some guidance on giving fat/thin doses (substitute .5 with 1.0):
* 0.5U = on the 0.5U line
* 0.4U = thin 0.5U - (top of plunger) touching the edge of the line
* 0.3U = thin 0.5U - (top of plunger) no longer touching the edge - some daylight between
* 0.2U = fat 0.0U - (bottom of plunger) not touching the zero line
* 0.1U = fat 0.0U - (bottom of plunger) touching the edge of the line
* 0.0U = On the zero line
Also, when working with a cat that needs microdoses like Spicy does, you need to make your dosing adjustments in very small increments. I'd try to do a .8 unit dose this morning--that's a thin 1.0 or top of plunger no longer touching the edge - some daylight between.
Do you have a pet store in your town? They might have some food choices other than Friskies to help tempt Spicy to eat. Once you find a dose that won't drop her too far, getting the food situation worked out should be your job #1.
Just read about last night's big drop on the 1.0 unit. You handled it great. The lows you got were not that low, but the drop from 400 to 46 is too steep. Generally what happens with a steep drop like that is the liver steps in to protect the body by releasing glucose in the form of a hormone called glucagon. Glucagon, on top of all the dry food she ate, will probably mean you see another 400 this morning. That's OK and this is all good information to have.
Like Gator and others have suggested, the way to get Spicy and yourself off this roller coaster is to adjust the dose in smaller increments. Dropping back to .5 isn't going to do anything except prolong the roller coaster IMHO--that would be a 50% reduction in dose. Until you can get the U-100 syringes with 1/2 unit markings, here's some guidance on giving fat/thin doses (substitute .5 with 1.0):
* 0.5U = on the 0.5U line
* 0.4U = thin 0.5U - (top of plunger) touching the edge of the line
* 0.3U = thin 0.5U - (top of plunger) no longer touching the edge - some daylight between
* 0.2U = fat 0.0U - (bottom of plunger) not touching the zero line
* 0.1U = fat 0.0U - (bottom of plunger) touching the edge of the line
* 0.0U = On the zero line
Also, when working with a cat that needs microdoses like Spicy does, you need to make your dosing adjustments in very small increments. I'd try to do a .8 unit dose this morning--that's a thin 1.0 or top of plunger no longer touching the edge - some daylight between.
Do you have a pet store in your town? They might have some food choices other than Friskies to help tempt Spicy to eat. Once you find a dose that won't drop her too far, getting the food situation worked out should be your job #1.
Joanna & Bix (GA)
Very Active Member
Just to add to that advice, I found 0.75-ish manageable in the short term with U-40 syringes. Of course it's approximate, but looks like Spice needs some in-between doses!!!
Terri - with the prolonged hypo #s when David first arrived here, well after +12, someone had suggested that meant the liver was pooped-out and not able to produce glucagon that night. I wondered if you have thoughts on that? I have read about that, but never seen it in action, and given that PZI (at a dose of 4u I think that night) can have duration past +12 I wasn't sure how to distinguish liver poop-out from uber-duration from who-knows-what-else-is-going-on (pancreas action in the mix?). I think it may have been a Vetsulin peep who said that, so I'm not sure that their interpretation was PZI-focused. I ask because I've wondered since then if that means Spice is at more risk than many cats for additional hypos (i.e. we should anticipate a possible lack of the ability to have protective acute rebound), so wondered if you have thoughts/knowledge on the subject. Thanks!
Terri - with the prolonged hypo #s when David first arrived here, well after +12, someone had suggested that meant the liver was pooped-out and not able to produce glucagon that night. I wondered if you have thoughts on that? I have read about that, but never seen it in action, and given that PZI (at a dose of 4u I think that night) can have duration past +12 I wasn't sure how to distinguish liver poop-out from uber-duration from who-knows-what-else-is-going-on (pancreas action in the mix?). I think it may have been a Vetsulin peep who said that, so I'm not sure that their interpretation was PZI-focused. I ask because I've wondered since then if that means Spice is at more risk than many cats for additional hypos (i.e. we should anticipate a possible lack of the ability to have protective acute rebound), so wondered if you have thoughts/knowledge on the subject. Thanks!
Terri and Lucy
Active Member
Joanna & Bix said:
I've never heard that theory before Johanna. With the number of cats we've seen here over the years who have been in chronic rebound, I am skeptical of the theory in general and would want whoever claimed that to provide a reference.
Joanna & Bix (GA)
Very Active Member
Thanks Terri. Below is the sort of thing I've seen before (excerpt from Vetsulin website). No clue though where their info is coming from, and of course it is pretty vague. I have seen other similar mentions of it, but I've never looked around for studies, etc.
from page: http://www.vetsulin.com/vet/Cats_Monito ... mogyi.aspx
Half of which is Greek to me! But I was curious to see that idea mentioned the other night, although I'm very happy if that's not the explanation, and a simple overdose is all that was going on.
from page: http://www.vetsulin.com/vet/Cats_Monito ... mogyi.aspx
Half of which is Greek to me! But I was curious to see that idea mentioned the other night, although I'm very happy if that's not the explanation, and a simple overdose is all that was going on.
tajana340
Active Member
Joanna,
I read about the somogyi effect and i do believe that happend to spice after reading it last nite alon with the overdose. Spicey has been doing great since I lowered the dosage. And I have decide to keep her insulin at.5 for awhile and see what happens. She is eating the wet canned friskies special diet beef and chicken and no dry food exept on the bg test that i thought was going to cause hypo.
David
I read about the somogyi effect and i do believe that happend to spice after reading it last nite alon with the overdose. Spicey has been doing great since I lowered the dosage. And I have decide to keep her insulin at.5 for awhile and see what happens. She is eating the wet canned friskies special diet beef and chicken and no dry food exept on the bg test that i thought was going to cause hypo.
David
Gator & H (GA)
Very Active Member
David,
I just realized the syringe link the in sticky is wrong. I know you were going to be trying to pick some up shortly and wanted to let you know. The description of the link is correct - just the actual link was wrong.
Here is the correct link
http://hocks.com/hocks-healthcare/hocks ... 82316.html
The link in the old one went to 1/2cc and you want the 1/3cc ones.
EDIT - The link in the sticky has now been fixed.
I just realized the syringe link the in sticky is wrong. I know you were going to be trying to pick some up shortly and wanted to let you know. The description of the link is correct - just the actual link was wrong.
Here is the correct link
http://hocks.com/hocks-healthcare/hocks ... 82316.html
The link in the old one went to 1/2cc and you want the 1/3cc ones.
EDIT - The link in the sticky has now been fixed.
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