Hi Everyone, this is reposted from my original question: https://felinediabetes.com/FDMB/threads/low-blood-glucose-this-morning.287423/#post-3159030 My kitty has had very high BG consistently since starting treatment. Her regular numbers are like 20-25mmols, and they don't tend to dip down much in the afternoon (maybe 18-19mmol/l on a "good" day so far). This morning when her number is usually highest, before food and insulin, has gone down to 12-10mmol/L????? She has increased her dosage of insulin by one unit yesterday as per her vet after a glucose curve. Why is her number so low? I know I'm not supposed to give insulin at 11mmol/L so I won't but I don't understand it. Should I give her vet a call and ask what's up? Should I monitor her BG today and see what it does? Thanks, Saia Should I give her food, see how her BG goes up and give the insulin? Update: I have not given her her insulin in the AM, I feed her 1/2 can Fancy feast chicken pate with 1/4cup dry and am checking her levels periodically today. I'm still confused by the weird drop in level, and it appears to be rising this afternoon. My kitty is a hungry girl and she likes to eat periodically throughout the day and night. So what I've begun to do since the diagnosis, is give her about 4 smaller meals during the day, and a little bit of dry food during the night. However, she usually wakes me up around 5am by grabbing my head with her claws (lol) because she is hungry. I usually give her a tiny amount of dry food when this happens. Is this bad to do before her 8:30am test and shot? I'm still feeling a bit lost at all of this. Thanks!!
@Saia ,one thing I see you don't have any tests after the PMPS, at least get a before bed test ( before you go to bed. You are missing half the picture by not getting any night tests
We really don't increase by whole units, we usually increase by 0.25 units at a time Have you read the 2 dosing methods yet? https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/ This is from the SLGS sticky method Hold the dose for at least a week: Unless your cat won’t eat or you suspect hypoglycemia Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately. After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments. If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Hi there. I would like to help you with managing things. First, I would not increase by a full unit to three units. I also would have suggested this morning to shoot a reduced dose of perhaps 1 unit as long as you were able to test her during the cycle. It’s great that you are testing her now — this will allow you to keep her safe. You do need to try, if possible, to get an evening test in during the cycle. Last night it looks like (based on your lower AMPS test this morning) she dropped a lot lower than her usual. I would not recommend increasing to 3 units- that is a big jump. I would recommend increasing only to 2.25 units and holding that dose for 7 days (per the SLGS protocol.)
@Saia Can you add SLGS to your signature and your spreadsheet please just so members won't keep asking you
Thank you both for your replies!!! Just wanted to let you know that I updated her spreadsheet with all the numbers I have from when I first got her meter (I have just been so busy between life and caring for her, I haven't had the chance to add them all) I feel so bad pricking her ear all the time, that's partially why I don't do a whole lot of testing during the night- to give her a break. I did do a couple overnight tests because I am nervous about her new dose. As for the dosing, I have just read the dosing method thread this morning and I have a basic understanding of it... but I will be honest, I am scared to take the dosing into my own hands. If I do so, and I get nervous and impatient, I really don't want to mess things up for her. My vet decided upon the 1 unit increase, though I can see why increasing it slower would show more about what the insulin is doing. I wonder why then, the vet would just drastically increase the insulin? Would a one unit increase just keep her BG with a flat curve like it seems to have been doing? She is overweight currently, so maybe that has something to do with it, I don't know... I guess then my question would be this: Would it be horrible if I just went with the 3 units for the two weeks, as my vet is looking for a glucose curve again in 2 weeks on the 3 units? (I mean, unless something drastic happens, as of now, her numbers are really high again but I did skip her dose yesterday). I was planning to do her curve again on the 17th of March unless something else happens. I am usually home with her, aside from errands and a few exams I need to take this month toward the middle of the month. But I will try to avoid giving her food in the early morning (5am) cause I believe it could have been inflating her numbers a bit. As for her food, I've been doing about half fancy feast and half dry s/o calm by royal canin. I had debated taking her off of it fully but my other cat needs it for her stress and urinary tract infections and as soon as I have lessened the amount of this food, Mia ended up getting a UTI. I am probably going to get the wet food version of this to help mitigate the amount of carbs she has going on a little... I am very soon going to switch to a human meter as the AT3 strips are too expensive for me right now and I need to conserve them for the vet's glucose curves. Are there some instructions on how to add that change to the current spreadsheet I have? Maybe I should start a new one? Here's a thought then... because it is supposed to take a few days for the insulin to see how it's doing, if she gets another strange low from consecutive doses of the 3 units in the next few cycles, I guess the best thing would be to reduce to 2.25? Or maybe 2.5 because my syringes don't have any lines between full units it might be easier to accurately get a half a unit at least? yeah I don't know. This is why I'm afraid LOL.
Hi when you do start using the human meter you don't need to start a new spreadsheet. All you have to do is on your signature after where you have Alpha Trak3 put a /Switched to human meter and the date. Then on your spreadsheet where you have Alpha Trak3 just put a /human meter as of then the date. Also put a blank line above the date you start it and put Switched to human meter and highlight the line If you don't know how to do it I can tag a member to do it for you. Plus the last 2 color coding up top will need to be changed to reflect a human meter . One thing you can do now Can you add SLGS to your signature and your spreadsheet please just so members won't keep asking you Just tap on your name up top then tap in the word signature ,add SLGS then tap done @Saia
About your questions about the dose I can't answer that question Let me tag Suzanne for you about that @Suzanne & Darcy
Thanks!!! I think I should be able to figure that out for the spreadsheet Added SLGS to my signature as well - sorry!!
The last 2 color coding up top will need to be changed the dark green would be 50-99 and the lime green would be BG<50 for a human meter . I don't know if you can change it yourself or Bhooma has to do it
Hello again. I’m glad you have been getting your signature and spreadsheet up and running with Diane’s help. If you have decided that you are sticking to 3 units based upon your vet’s advice, then please continue to test her regularly and frequently. One week at this dose (14 cycles) will be enough to tell us what is going on. However, you are feeding high carb dry food and that is driving her numbers up and can make things a bit more unpredictable. I would run a curve at home by testing every two hours after one week on this dose (unless we already have sufficient data to know how her cycles are going.) A lot of cats tend to drop lower at night. It is always a good idea to at least get a “before bed test” so that you know if she’s trending downward and if so by how much. And it os important to not feed her for two hours prior to the morning and evening preshot tests. It’s how you will know if it’s safe to give her insulin or if a temporary dose reduction should be considered. Next time she’s borderline at about 200 or a little less, I would try a half dose and monitor carefully. The goal os to gather enough data that you will be able to shoot lower numbers.
Thanks Suzanne, I really appreciate this advice. I will definitely test her after one week on the 3 units. I will probably seek your advice once I have the data for the curve. And, I will make sure to do a before bed test at night since this is a high dose, as well and not feed her two hours prior to her morning and evening preshot tests! That one I had completely no idea. I will also half her dose if she's at 200 and monitor her. Also, I will try to edit her spreadsheet for the human meter tonight (because I'm going to start with it tomorrow) with the last 2 color coding changes and see if it works, if not I will let you know Diane, thank you!!
Okay. Good. Be sure to post here. I will check in on her spreadsheet if you keep it updated. Yes, it’s important to keep them fasted (especially in the beginning of treatment) for two hours prior to those preshot tests so you know the number you are getting is not elevated by food (which can wear off and the BG goes down and you are shooting a number that’s been elevated by food — anyway it is just a safety issue.). Don’t hesitate to post here with any concerns or questions!
Thank you, I will keep her spreadsheet up to date! On that note, I think I have edited the sheet for the human meter as well, since if I input in a test BG for 50-99 or below 50, it turns the appropriate dark green and bright green colours. Really happy that I found this forum, I'd be even more incredibly lost without all the resources and everyone's help. Thanks again.
I'm thinking no shot at this point to be safe... and I'm half wondering if she should try going down to 2.5 units since this is her lowest preshot number yet
Since no one is around I see Suzanne said above I would recommend increasing only to 2.25 units and holding that dose for 7 days (per the SLGS protocol. I would skip the dose tonight, but I would keep testing her for awhile Do you have the syringes with the half unit markings? If she ever drops under 90 you need to decrease by 0.25 units @Saia
Yeah that might be best. I am going to skip to be safe. I only have the u40 syringe with full unit marking’s unfortunately. I will also be getting in contact with her vet tomorrow or monday if they are not around tomorrow
You can get the U-40 syringes half unit marking from Amazon https://www.amazon.com/UltiCare-Insulin-Syringes-12-7mm-Markings/dp/B08HX9BPH7 @Saia Just wanted to be sure you saw what Suzanne said about the new dose post #26 @Saia
Well, I did not like the full unit increase to begin with so I would be okay with that. You could try reducing to 2.5 units. It will be really helpful if you can somehow find syringes with half unit markings.
Now that is not a bad preshot number tonight - it is just that we don’t have a lot of data to know how to handle it yet — and I probably would have advised at least giving her a small amount of insulin- even 1 unit - to keep her from climbing too high by morning. But it is going to be okay and we will get her back on track.
Did you do anything different with her food today? What did she eat and when? Also, can you please tell me her shot time and your time zone?
I saw that she said in her post #17 I'm thinking no shot at this point to be safe... I told you I suck at giving dosing advice @Suzanne & Darcy
Thanks Diane - I will look into getting some syringes with the half unit marked on them. Yeah, I had thought about giving the one unit since you had mentioned it before, but it was a good bit below 200 and I really didn't want to risk it tonight... I'm happy to see that the insulin is becoming more effective, but just a little stressed about all her numbers going up and down to say the least lol. Either way, I guess with my current syringes, maybe the reduction to 2.5 units would be easier to eyeball right now. My time zone is Mountain time - her usual shot time is 8:30, but I was/am attempting to do the Spring time change where I do it half an hour earlier tonight and tomorrow morning at 8 o clock, and then tomorrow night at 7:30, so that 7:30 am on monday would be her old 8:30 time. I think. It still confuses me a bit. I don't think I did anything too different today, but I think she might be eating more fancy feast out of her bowl when I mix it in with the dry. I usually feed her 1/4 - 1/2 can ff with 1/4 cup dry and added water about 4-5 times a day. There might be a chance that she didn't eat as much of her dry food today now that I think about it. She eats in the AM with her insulin, and then a few times throughout the day. Oh, but today I did make sure that she didn't eat 2 hours before her shot times too. So the last she ate before 8pm was about 4:30pm today. She was hungry before her shot at 7pm but I waited til 8 to give anything.
This is what I am thinking. The 2.5 is going to be easier for you to eyeball for now. With ProZinc, it’s normal to have a curve in the BG during a cycle. I think it’s extremely encouraging to even see that blue number tonight. I’m kind of excited for the future— but believe me, I understand how nerve wracking it is at first to see the lower numbers. You are happy, but also scared.
You will know in 30 minutes if her BG has stabilized and with that 113 you have plenty of wiggle room before she’s anywhere near danger.
I freaked and gave her a little of both. I will test her again in 30 though anyways. I'm about as skittish as a cat lol. But I am encouraged to know that these numbers are safe and very thankful for your help here
Well that will probably bring her numbers up for sure, but now that you gave HC you will need to keep testing to make sure her numbers don’t drop back down too much (which I doubt because she didn’t have a shot tonight) but it’s important to test until you see her numbers are rising on their own without the influence of HC food.
I see she had a nice little run in blue numbers last night before she spiked up into pink. I would suggest beginning with the 2.5 unit dose this morning and hold it to see how things go.
Thank you, sounds like a plan. I have given her the reduced dose this morning though she was fighting me a little today about it. She normally doesn't mind if I'm quick enough about it, which I am not always lol
Yeah I typically do try to give it to her while she eats, she still sometimes will leave her food to get away from the needle
She sounds like she’s got a lot of spunk! You’re doing great! Today it looks like she’s bouncing perhaps from last night’s blues, but I hope she will come down from that soon.
Haha yeah she's a spunky girl and a sweetie too I didn't spend a lot of time testing her today, since I thought she needed a break from yesterday's ear pricking and wasn't at much risk of a hypo. Tonight her preshot test was 281 and I will monitor her every couple hours or so cause I'm a bit curious to see her low tonight if I can get it.
@Suzanne & Darcy Hey Suzanne, she's at 9.9 (178) preshot, I think I will give her 1 unit and monitor. Is it normal for cats to be lower on their evening preshot?
Nevermind, I think I'm going with no shot, cause I waited about 30 mins to check her BG again out of cautiousness and it's now 6.7
How’s everything going? Nice cycle yesterday! That is an improvement. It looks like she could have handled more insulin last night since she was above 200 and she stayed in the yellows. At least it’s good data to have for next time. I hope today’s cycle will be good again. What time zone are you in, by the way?
I was really happy to see her good cycle yesterday too!! She currently is doing really well with very little clinical symptoms right now, so I am happy if she's happy. Yes, I agree, I think she might have been able to her full dose last night. She seems to be staying in the yellow today too, but I haven't been able to test her as much today. I'm in Mountain Time zone I am thinking I will do a curve either this weekend or early next week some time, depending how my schedule goes, since it'll have been a week on the 2.5 dose.
It’s really good to hear that she’s feeling better. That’s what we want. I’m happy. Good idea about the curve. I hope you can swing it.
Hi there. I’m just checking your spreadsheet before I go to bed. I’m excited about the better numbers that you had yesterday! That’s so encouraging. Can you see about getting those tests tomorrow and if you add a message to your thread here, I will see it in my email box.
Yes she had a really nice cycle on the 14th!! She was doing really well! She had some high yesterday due to her missed dose - I'm still a little apprehensive about how much insulin to give her when she dips below 9 (162) or so. At 11-10 (200-180), I am comfortable with the fact she can handle 1.5-2 units. I don't have much time today for testing, but I am planning a curve tomorrow for her and hopefully that will shed a bit more insight on things. I am also searching for different canned food - something a little more high quality and with less fish (all fancy feast that she can eat has got fish in the ingredients which I don't like). By the end of this month I should be able to upgrade her wet food and maybe that will also help. She actually used to be on Nature's Variety Instinct LID canned food years ago. I wished I had just kept her on that food now. I haven't bought any new syringes yet with the half unit markings - I will either have to wait until the end of the month and/or use up what I have currently before getting more due to tight money... but I feel she will be okay - if I do have to eyeball .25 units, I think I will be able to with some reading glasses.
Hey Suzanne, just letting you know that I completed Mia's curve today and would like to know your thoughts on her data when you have a moment to spare. Thanks
