Low BG last night--See last 9/1 post, Q abt insulin today

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CheeseheadNicole

Member Since 2013
Lily was on 5 units ProZinc (reading last Friday was 352 on Alpha Trak 11 hours after 4 units of insulin so we increased to 5 units this week). Insulin given at 5:30am. Vet glucose test at 4pm was 73 on AlphaTrak, 51 on my ReliOn meter. Vet suggested reducing dose to 4.5 units. Gave that at 5pm, with new heart medicine. Just did ReliOn home test (yay!!! Worked the first time). Reading is 36!!! Lily seems fine but should I treat at hypoglycemic? What to do? Any suggestions for tomorrow morning's dose. Thanks!

P.S. Still feeding dry m/d food but added about 1 TBL of Friskies pâté for last night's feeding and tonight's (forgot to do that this morning).
 
Re: Low number...what to do

I'm not familiar with ProZinc dosing, but I'd give Lily a couple teaspoons of high carb wet food if you have it, and test again in 30 minutes. If you don't have high carb food (food with gravy such as fancy feast gravy lovers), add a couple drops of karo, syrup, or honey to Lily's wet food. You want Lily up above 50 on the Relion meter. Post your new number when you get it.
 
Re: Low number...what to do

Thanks Wendy. Wet food with maple syrup being eaten now. Suppose I should have clarified if "fake" syrup (Mrs. Butterworth) would be better. I'll retest in 30 min and post again.
 
Re: Low number...what to do

How many hours after insulin was given did you get that 36? Since we are all in different time zones here, we usually count number of hours after shot time. So, a +1 would be one hour after shot time, etc. Did you give this evening's shot one hour after getting that 51 on your Relion? We suggest always getting a test before shot time and for new people, say that you should only give insulin if BG is 200 or above.

You'll find when switching from dry food to wet, that insulin requirements will go down.
 
Re: Low number...what to do

As long as it's got sugar in it, it'll help bring up those numbers, but they'll come back down just as quickly, so you'll want to retest every 30 until Lily is into the 70's (on the Relion) and then for at least 2-3 hours after you haven't given anything other than a little regular LC food

And yes..Lily has earned a reduction....I'm not familiar with Pro Zinc, but any time they go below 50, they're telling you they're getting too much

Edited to add...On my first low number, I gave about 3 teaspoons of syrup...then I found out that it's only supposed to be a couple of drops :oops:
 
Re: Low number...what to do

CheeseheadNicole said:
Thanks Wendy. Wet food with maple syrup being eaten now. Suppose I should have clarified if "fake" syrup (Mrs. Butterworth) would be better. I'll retest in 30 min and post again.
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I can't access your spreadsheet, so I have a couple questions for you .
Are you on ET or on the West Coast or ?? You gave insulin at 5pm ( which time zone? )
Here's the thing. Even after her numbers come up after giving the wet food w/ some added carb
You need to keep monitoring until your kitty is past its nadir ( peak time of insulin action) and numbers are rising. ( 2 numbers in a row testing are going up into safe zone)
Sometimes when you give a carb like maple syrup it can be short acting and if your cat is not past nadir and rising, BG levels can go way down again.

I am not familiar w/ prozinc ,so I don't know the typical nadir for that insulin. And I can't see it on your spreadsheet. Can you post your time zone and that information ?
I am familiar w/ riding the low , but w/ a different insulin !
 
Re: Low number...what to do

I think I'd keep giving a couple drops every 30 minutes until she's up into the 70's and then keep testing to make sure she doesn't come back down too low. With the 20% variance in meters, 41 is still pretty much the same number

How much syrup did you give this last time?

I can't access the spreadsheet either, so if you can give us your time zone, the time you shot, and how long it's been since shooting each time you post, it'll help us
 
Re: Low number...what to do

I think I've got my spreadsheet working now. Let me know. I'm Central time zone. 51 was at +11. Gave 5 units. 36 was at +5, 41 was at +5.5. I gave just a few drops of syrup with ~2 tsp wet food at +5. The hypo link on this message board suggested dry food might help. Should I mix in additional syrup with her m/d.
 
Re: Low number...what to do

Yes! Spreadsheet works now!!

Always test before shooting! Lily was way too low to give any insulin tonight, so it may be a long night to keep her numbers up. Since she's a new diabetic, we don't suggest you shoot anything below 200 without advice. You're better to stall 30 minutes (don't feed) and use that time to ask for help. We want Lily to be safe first and foremost! The numbers will come down with time

Dry food takes too long to bring the numbers up and stays in the body too long...that's why we suggest having HC food in the house for these situations. I'd keep giving a couple drops until she's above 70


Edited to add....I guess your name should have been a good tip that maybe you were in Wisconsin....LOL
 
Re: Low number...what to do

CheeseheadNicole said:
I think I've got my spreadsheet working now. Let me know. I'm Central time zone. 51 was at +11. Gave 5 units. 36 was at +5, 41 was at +5.5. I gave just a few drops of syrup with ~2 tsp wet food at +5. The hypo link on this message board suggested dry food might help. Should I mix in additional syrup with her m/d.
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Yes, SS is working now for me too.
Rookie mistake, you shot too low. Learn for next time, for now focus on your kitty.
It will be a long night. I would right now plan on skipping the next shot.

It can sometimes take more than 30 min for a number to go up after feeding the carb.
Since you may be up a while, you don't want to over feed her. As mentioned, she could go up and come back down again before your cycle is through.
I would hold off on the dry. Dry food my fill her up. So I would also hold off for now. You want to keep her hungry.
Test again if it's been at least 15 min and see.
If no rise, give another tsp of wet w/ drop or two of syrup.
I hate to see too much short term carb go into a cat for her to go up and then down and then bounce next cycle.

Do you have another number yet ?
 
Re: Low number...what to do

While you are up w/ your kitty, a good time to read up on hypos. Maggies Mom Debby already gave you a great link.
Here is Jojo's hypo toolbox kit post.

You can put this together for next time. : ) Everyone goes low sooner or later. The important thing is to be prepared.

You are doing great, btw !
 
Re: Low number...what to do

Gave her another tsp of wet food with maple syrup about 10 mins ago. I will wait another 15 mins and then test again, right?

I am very surprised the vet didn't warn me about the PM insulin dose. The +11 number was taken by the vet's office today. The vet said to reduce the dose from 5 units to 4.5 units (since the week before, 4 units at the +11 time was 279 on the ReliOn meter...379 on their Alpha Trak).

What a way to be introduced to home testing. We're getting some practice tonight, huh?
 
Re: Low number...what to do

CheeseheadNicole said:
Gave her another tsp of wet food with maple syrup about 10 mins ago. I will wait another 15 mins and then test again, right?

I am very surprised the vet didn't warn me about the PM insulin dose. The +11 number was taken by the vet's office today. The vet said to reduce the dose from 5 units to 4.5 units (since the week before, 4 units at the +11 time was 279 on the ReliOn meter...379 on their Alpha Trak).

What a way to be introduced to home testing. We're getting some practice tonight, huh?
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Gee I can't believe the Vet said to shoot her. No, wait, sadly I can. :-x

Well I'm glad to read you are having a little sense of humor about your testing practice.
Good to keep from stressing.

Yep. keep the numbers coming.
 
Re: Low number...what to do

We're getting some practice tonight, huh?
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You sure are! It's a good thing Lily is evidently being a very good kitty for you!

Keep testing every 30 and posting...and you might want to put on a pot of coffee ~O) ~O)

IF she's above 200 tomorrow morning, I'd suggest you drop back to no more than 1 unit and start from there. If you're changing her diet over to low carb wet foods, her numbers will most likely continue to come down.

You can always give more insulin if the numbers show you're not giving enough...you can't take it out once it's in the cat...we've all had a cycle or two (or 10) where we've spent a good deal of time testing, feeding, testing, feeding, so you're not alone!

We have a saying here....Better too high for a day than too low for a minute
 
Re: Low number...what to do

Unsuccessful attempt to get any blood using the other ear. Rice sock wasn't as hot as before so that might have contributed. Gave Lily a treat and will give her a minute to sulk before trying again.
 
Re: Low number...what to do

Most cats have one ear that bleeds better than the other, and they also "learn" to bleed after you've done more testing.

What worked better for me than the rice sock was a small pill bottle with warm water in it. It gave me something hard to poke against.

I'm up at least for another couple hours too..China dropped below 50 today and although I reduced her dose, I'm watching her carefully too....Pass the coffee!!....LOL
 
Re: Low number...what to do

Hmm. My beginner's luck is wearing off and Lily is getting perturbed. Can't get a blood drop even from the first ear. Any suggestions?
 
Re: Low number...what to do

CheeseheadNicole said:
Hmm. My beginner's luck is wearing off and Lily is getting perturbed. Can't get a blood drop even from the first ear. Any suggestions?
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Can you give her a nice massage. Massaging the ears can do wonders. I never needed the rice sock w/ Winnie. I just massaged her ears. She liked that.
 
Re: Low number...what to do

And another question. For the lancet pen, are longer dashes a shallower or deeper poke? I've warmed with a rice sock and used lancet pen with a cotton ball on the other side. Should I use something harder to hold against the back?
 
Re: Low number...what to do

The poke should be at a 45 degree angle....with 90 degree's being what you'd do if you wanted to pierce her ears. That being said, for the first several weeks, I considered buying China some matching diamond studs.

I'd try a pill bottle if you have one. Fill it with warm water and put it against your wrist like you would test a baby bottle. Too hot and you'll upset Lily even more

If you can, if you don't get any blood on the first poke, go ahead and try again..really close to the first poke and then "milk" her ear a little. Lots of times the 2nd (or even 3rd) poke together with that first one will "pool" enough blood to get your test in

After 3 pokes, if you still don't get anything, give her a break, but we do want to see some more numbers on Lily to make sure she's headed in the right direction!

In case you haven't seen this:
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Re: Low number...what to do

Lily says "Tail thwap, tail thwap. Let me go to bed. Why aren't we all going to bed?" Failed attempt #3. Tried the several pokes in one spot and milking it. No luck. Will search for a pill bottle for warm water. Do you usually dial the lancet pen to the middle setting?

Edited: Thanks for the sweet spot diagram. I was poking lower than the sweet spot.
 
Re: Low number...what to do

I'm Pacific time and it's a three-day weekend, so I'll still be up for quite a few more hours for you, if need be. ;-)

When using a lancet device, make sure it's flush/flat against the ear with some backing (I use my finger as a backing because it lets me know if the lancet device is set to too high a depth and pokes through the ear to my finger).

Give her a break for about 15 minutes if she seems to be acting fine yet proving to be difficult for testing. If she's running about and acting fairly "normal," 15 minutes extra should be okay.
 
Re: Low number...what to do

Another tip would be if you're poking on the outside of the ear, try the inside. Sometimes it makes a difference.

It'll get easier..and the testing will become routine for both of you.

Come on up some for your momma Lily...THEN maybe you'll get some sleep....LOL
 
Re: Low number...what to do

When I first started out testing and Mikey's ears were "tougher," the middle setting (3) worked best. As his ears learned to bleed, I was able to lower the setting and now we're at 1. What device specifically are you using to poke? (I've tried out a few of the lancing devices, so I'm familiar with how many of them work "best.")
 
Re: Low number...what to do

Ugh! Not sure what else to try. Failed attempt with warm water bottle held up to ear that bled at the beginning of the night, poked 3 times with the lancet pen in the sweet spot, and 3 times with me just holding the lancet and poking 3 times. Not a drop of blood. Milking didn't help. :(
 
Re: Low number...what to do

I have poked on the outside so I can give the inside a try. The lancet pen is ReliOn (came with my ReliOn Confirm meter). I don't need much of a drop of blood for the Confirm. But I'm not getting anything. She seemed happier without the pen noise (the pen didn't seem to bother her at first, but the repeated pen clicks, especially when I had to reset it, got her mad).
 
Re: Low number...what to do

How is she doing currently? If she looks and acts "fine," wait a few minutes and try again later. Even try the other ear or the inside of the ear. If all else fails, aim for the vein.
 
Re: Low number...what to do

Also try it with the clear pen cap removed and simply the exposed lancet in the pen device and see if that works better.
 
Re: Low number...what to do

Is the 45 degree angle the advice for the lancet without the pen? And 90 degrees/flush with the skin if I'm using the pen?
 
Re: Low number...what to do

CheeseheadNicole said:
Ugh! Not sure what else to try. Failed attempt with warm water bottle held up to ear that bled at the beginning of the night, poked 3 times with the lancet pen in the sweet spot, and 3 times with me just holding the lancet and poking 3 times. Not a drop of blood. Milking didn't help. :(
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Some people have better luck w/o the lancet pen and poking free hand.

If she is acting ok. Give her a little break. Practice some freehand pokes on some fruit and/or yourself.
If you feel comfortable try that.
Or just plain practice on yourself w/ the lancing device

Are you using a new lancet every time ? Some folks reuse them a few times, but they will get dull.
Make sure you are using a new one, k?
 
Re: Low number...what to do

you can take the lancet out of the pen and try free-handing it..that way no click. It sounds a lot scarier than it is! (I just recently started it and am beating myself up over not doing it sooner...it's proving to be much easier for me)

The other thing is when you can get out to get some, get some 28 or 29 gauge lancets. The ones that come with the lancet pen are 31 and are very tiny. The lower the gauge, the bigger the needle. Until you get Lily's ears to "learn to bleed", this will make it much easier on you.

Look for "alternate site testing" lancets
 
Re: Low number...what to do

CheeseheadNicole said:
Is the 45 degree angle the advice for the lancet without the pen? And 90 degrees/flush with the skin if I'm using the pen?
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Yes, if you're doing it freehand, you want to go at a 45 degree angle. If you're using a device, most of them require it to be flat against the surface.
 
Re: Low number...what to do

By the way, Lily looks fine. Grooming herself and making her fur look pretty (no thanks to my massaging, holding and poking). I have extra lancets I bought per the recommended shopping list on FDMB. I'll go get those and give them a try. Cross your fingers. May try #4, free handed lancet at 45 degrees on inside of ear do the trick.
 
Re: Low number...what to do

Is the 45 degree angle the advice for the lancet without the pen? And 90 degrees/flush with the skin if I'm using the pen?
Click to expand...

It's pretty much the same either way. Picture yourself piercing your cats ears. That would be 90 degrees (straight through the ear) and although it won't cause any permanent damage, it's better to go in with a "slant" at about 45 degrees..but whatever works at this point! :-D

It'll just take some practice. You'll be a pro in no time!
 
Re: Low number...what to do

I did have 26G lancets. I tried that freehand, inside and outside of ear. Grr. No luck. I have got to be piercing the skin because Lily yelps. I even got a flashlight and see the big vein. No luck aiming for that either.

The 26G lancets seem shorter than the 30G I was using. Maybe I'm just imaging that. But it barely pierces my finger and doesn't draw any blood when I try it on me--with the clear plastic cap or on the deepest setting with the blue cap.
 
Re: Low number...what to do

Have you tried "damming" the blood by applying pressure directly underneath where you want to poke before you poke? Then, once you poke, proceed with "milking" it up as you have been doing?
 
Re: Low number...what to do

KPassa said:
Have you tried "damming" the blood by applying pressure directly underneath where you want to poke before you poke? Then, once you poke, proceed with "milking" it up as you have been doing?
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Thanks for all the great tips everyone. And for staying up with us. Haven't tried damming. I will with Try #5. Here goes.
 
Re: Low number...what to do

At this point, can I still use the meter strip that's been sitting in my meter for 2 hours? Or should I use a fresh one? Wanna get that right before I finally get blood. :)
 
Re: Low number...what to do

And for staying up with us.
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Someone has stayed up with us when we were going through it...we're just "paying it forward"! Once you get more experienced, you'll be helping some other newbie through their first low numbers...that's one of the great things about this board!!

Just curious...have you printed out the information on How to handle low test numbers ?? If not, it's best to have a hard copy somewhere just in case the message board goes down, or your computer has issues
 
Re: Low number...what to do

Use a fresh one "just in case" but you don't necessarily have to toss the one that has been exposed for a few hours. I'll usually set those "questionable" ones aside in a spare/empty container and use as "backups" when I get questionable numbers that I want to test twice. If they're wildly off, I'll toss them and disregard them as "broken," but if they're "close enough," then I won't feel so bad on wasting strips needlessly.
 
Re: Low number...what to do

I think I'd use a new strip....you want nothing to be wrong if you get blood this time

Save the one for sometime when it's not so important that you get it right the "first time"
 
Re: Low number...what to do

When was the last time she ate in relation to the last (successful) test number you got and what did you feed her?
 
Re: Low number...what to do

Kay...best I can tell, it was about 2 hours ago when she got the 41 and she gave a little more food with a drop of syrup after that..but I'm not 100% sure on the feeding.

Last note I can find was 2 tsp plus a couple drops of syrup at +5 when she got the 36 so it may have been 2 1/2 hours ago
 
Re: Low number...what to do

*$%*#$!* Grumble, grumble. Went back to my original rice sock, very warm ear, piercing with 26G lancet in lancet pen on deepest setting, damming blood before the poke. No luck and now Lily is super annoyed almost to the point of growling. And I was staying totally calm and positive.

KPassa--after a 41 test, she ate ~1-2 tsp of Friskies pate with a couple good size drops of maple syrup at 10:45ish central time.

Do you think she's out of the woods and we can retry this all in the (later) morning? Should I be trying anything else? How long should I give her before I try to poke her again? Yikes. I just realized she hasn't been getting any treats for most of these unsuccessful pokes.

She has been patiently laying on the bed despite the frequent pokings. She just picked herself up and moved to the closet, her "leave me alone" space. :(
 
Re: Low number...what to do

I just realized she hasn't been getting any treats for most of these unsuccessful pokes.
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Oops!! That's the important part....LOL

Personally, I'd still like to see at least one more test before you call it a night, just to make 100% sure Lily is climbing and within the "safe zone"

The good thing about having so much time pass since feeding or giving syrup is if you DO get a decent number, it's probably going to be safe to go on to bed..maybe then give her a little more LC food and turn out the lights


You can try poking her paw pad...that's an alternate site to test.
 
Re: Low number...what to do

Tempt her with some more LC food with a bit of syrup. We're not yet sure if she's out of the woods yet, so to speak, so we at least want one more successful test that show her numbers are higher (which at this point, they should hopefully be). Give her (and yourself) a break for now and chill out for about a half hour, yet keep an eye on her in case she starts acting "off." Go pour yourself a glass of wine or eat some chocolate or both. ;-) And try again in a little bit when you're both more relaxed.
 
Re: Low number...what to do

Okay. I'll give it another try. With treats this time. :)

While I'm doing that, I'll ask another question. Ok, multiple questions. We're almost at +9. Feeding time and +12 will be here before I know it. What do I do at 5am (+12)? I think I need to feed her and give her her new diarrhetic meds. What about her insulin? What if testing proves this challenging at 5am? Vet's office opens at 8am. Should I wait to give insulin until I can talk with the vet???

Here kitty, kitty. Momma's got treats this time...
 
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