LOW READING??? - RESOLVED!!

We switched to wet food, and Baileys glucose has dropped to 80. It’s the lowest we’ve ever seen it. Ever. We gave her 2u of Lantus with her dinner.

I am panicking - how low is too low? What should we expect for a normal range? What do we do if it gets too low?

I promise I am working on updating my profile, signature, and chart. It’s on my list for tomorrow. This is all just so new and I am so worried right now!

 

Tagging some members that can hopefully help you.

@Wendy&Neko
@Bandit's Mom
@tiffmaxee
@Bron and Sheba (GA)
@FrostD

 

Thank you ❤️

 

Are you following TR or SLGS?
What kind of meter are you using?

 

I don’t know what TR or SLGS are
We have the libre freestyle on her right now.

 

Previous post
https://felinediabetes.com/FDMB/thr...and-confused-please-help.262653/#post-2944030

 

I screenshotted this from another post a couple of days ago. This is using an alpha track meter. I'm not sure what it would be for a liber freestyle.

 

What was she eating before you switched and what wet food is she on now? The normal range for blood sugar on a human meter (including the Libre) is 50-100. Below 50 is low. Lantus typically starts acting around 2 hours after the shot though for some cats it's a little earlier.

Can you get a scan an hour after the shot and post here?

I can help you set up your spreadsheet and signature. Will send you a PM with the details I need to do so.

 

Tagging them again
@tiffmaxee

@Wendy&Neko

@Bron and Sheba (GA)

@Bandit's Mom

 

Bandit's Mom just replied.

 

She was eating ProPlan Dietetic. We are trying a variety of wet foods to see what she liked. Tonight she got Nutro Pate, 2 containers.

She dropped about 1.5 hours after she got her dose. I’m trying to attach a screenshot but it says I don’t have permission.

 

This website will allow you to download pictures from your phone, then give you a thumbnail link where you can post it in a forum. Copy the link and paste it here. The picture will show right up. It's really easy but if you need help, let me know.

https://postimages.org/

 

Just read your previous thread.

1. When was she switched to wet food (how many days back)?
2. How long has she been on 2U?
3. What was her reading at the time of the shot?
4. So 80 was 1.5 hours after the shot? It's still a safe number. Please feed her a little wet food and scan at 2 hours after the shot?

The file upload facility does not work. You can copy paste an image or drag and drop.

 

She just switched to wet food tonight. The vet called us and was still not satisfied with how her numbers looked. She wanted us to switch to wet AND increase to 2.25 but we did not increase. She has been on 2u for about 10 days now.

We are now at 3 hours past the shot.

 

Thank you that worked like a charm!

 

Actually, a change to a low carb diet can significantly impact a kitty's BG numbers and greatly reduce the need for insulin. So any transition in diet when already on insulin, has to be made gradually and with careful monitoring of the BG (with home testing) and insulin requirements. We have had cats that have gone off insulin with just a change from high carb kibble to a low carb canned diet.

What is her reading now?

 

The vet never told us ANYTHING about a transition, and that we could just try the wet food to see if she liked it. Her current reading is 70

 

Well, when you make a food change, you want to make it slowly to avoid any tummy upsets and especially when the kitty is on insulin and you are switching from a high carb diet to a low carb, the sudden removal of carbs might cause the numbers to plummet like you are seeing now.

She is still in the normal range so it's good. Just keep feeding a spoon of the wet food every hour and keep scanning.

I can't tell from the pic you attached as to when you shot her. Can you tell me what her BG was at the time of the shot? So she was 80 1.5 hours after the shot and 70 3 hours after?

 

She was at 285 when we gave her the shot at 8pm. At 930pm she was at 86. It is 11pm now, and she just hit 60.

 

We just gave her a spoon of food.

 

Do you have any higher carb wet food at home to give her if needed? And any honey or karo if needed?

 

Yes, we do have both higher carb wet food and honey. We added Karo to the shopping list for tomorrow.

 

You don’t need karo if you have honey. Both do the same job.
If she drops further I would give her 1 teaspoon of some higher carb food as she is still early in the cycle.

 

Thank you so much. I will keep updating. I appreciate everyone’s help on this.

 

As long as you are monitoring you are in control. The meter and the food are what you need in this situation.

 

I just updated your SS with these numbers. So that you have a sense of how to do it

 

Thank you so much ❤️

 

@Bron and Sheba (GA) do you think a lower dose from tomorrow would be a good idea? 1.5 or 1.75U?

 

It makes total sense now. Thank you for doing that!!!

 

Yes I think that’s a very good idea, especially if she is going to continue with the lower carb food.
I think I’d go with the 1.5 units…what do you think?

 

Most welcome. If you can add even the last 3-4 days data that would be very useful for us to understand how she was doing on this dose. You don't have to enter all the data. Just one per hour is fine. What is important is the lowest point (or nadir).

You may also want to start posting on the Lantus forum from tomorrow. It has a lot of experienced Lantus users and is a busy forum so you might get faster responses.

https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

 

Sounds good. She can always go up if needed.

ETA @hmskelton do you use syringes to give the insulin? You will need U-100 syringes with half unit markings to dose in fractional units.

 

I agree. That was a fast drop. And I think without intervention it would have dropped further without a doubt.
Just goes to show what high carb food does to the pancreas. I think it is disgraceful cat food manufacturers are allowed to sell the high carb food at all.

 

True and vets are prescribing them! And Holly's vet asked her to up the dose after switching to wet food

 

Yes we use the u-100 syringes.

 

YES and I am so frustrated!!
She said to increase to 2.25 and try the wet food.
And she said the ProPlan Dietetic was one of the best foods for diabetic cats.

 

Holly, never do two things at once when you are changing things over. Always do one first and wait for the result, then do the other. That was not a responsible thing for your vet to suggest.

 

Vets get their nutritional information and lectures from pet food manufacturers so of course they will peddle their own products. It is the same all over the world. I just can’t believe vets can’t see it for what it is. Diabetic cats need a low carb diet….end of story. We give higher carb food to bring the BGs up when they have dropped too low. So why would you give/ recommend a high carb diet and a dry one at that for a diabetic cat to eat all the time.

 

Have you taken another reading yet?

 

Purina Pro Plan DM canned is low carb, but the Savory Selects and the dry are not. Also, not all wet food is low carb. You want to feed the ones with carbohydrates less than 10% (ideally less than 5%). There are low carb variants in most brands - Fancy Feast, Friskies, Tiki Cat, Weruva, 9 Lives etc.

This link will help you identify low carb food options. It's not an exhaustive list, but has a lot of the brands/variants.
https://catinfo.org/chart/index.php.

You can use this carb calculator to get a rough estimate of carb% based on the Guaranteed Analysis values on the label. Look at Dry Matter Carbohydrates % at the very end.
http://scheyderweb.com/cats/catfood.html

 

I fell asleep but my husband stayed up. We did have to rub some honey into her gums but we got her to stabilize! It is 430 AM here but I will update with more info throughout the day. Thank you everyone for your help through this crisis. I cannot thank you enough. Without you, we would have been running to the emergency vet at midnight. Thank you again.

 

Can you update the SS when you have a moment please? When we are helping with a kitty with low numbers we worry if we don’t hear or can’t see any BG updates on the SS
Would you mind removing the 911 now please that the problem has resolved. Thanks

 

These are the 2 dosing methods when you are using lantus
Here is the link so you can read about them and pick one that best suits you
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
I see you were advised to shoot 1.5 units tonight, the syringes you have are they the ones with half unit markings?


Please read the 2 dosing methods here is just a quick explanation
SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.

TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50 (Newly Diagnosed Under A Year). The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

 

I just want to throw this out there on the libre, we use it. We had a sensor malfunction on our cat and it started reading "low levels" for 24 hours when he was usually higher. I skipped a dose of insulin trusting it and come to find out the sensor malfunctioned and it wasn't reading correctly. I highly recommend getting a blood meter and doing a blood sugar test when you start getting funky looking numbers just to be safe.