Merlin went low (64) in the middle of the night

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Kelley and Merlin

Kelley and Merlin

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I woke up at 2:30ish AM (approx +6 from Merlin's PM dose). He was at 64 AT but acting fine and hungry. I decided to give him some Karo syrup. I read here that I should give 1 Tbsp. Stupid me thought he'd like it, no, he turned his nose up at it. So I got one small syringe (3ml) in his mouth with a massive fight. I read to follow it with food bc the syrup will work quick and end quick. I thought all I had was his sensitive stomach dry food and mixed a couple Tbsp with the syrup and made a nice rock that he nibbled at. I'm not my best when I wake up in the middle of the night. :) I threw that out and remembered I had his old FF wet in the cabinet (gravy lovers grilled which I think is 15% carbs), so I grabbed a can of that and mixed about a 1/2 Tbsp of Karo syrup in it and he gobbled it down. Now I'm sitting here wondering if his BG is going to be insanely high. We go to the vet at 8:30am (same time he is due for his insulin). I'm going to retest in about 15 minutes. Is there anything else I should do?
 
Hi Kelley
Yes retest in 20 minutes after giving the karo and food. A tablespoon is as lot of karo. I only ever have a couple of drops of honey to raise the BGs.

Let’s see what the next test is.
 
Bron and Sheba (GA) said:
Hi Kelley
Yes retest in 20 minutes after giving the karo and food. A tablespoon is as lot of karo. I only ever have a couple of drops of honey to raise the BGs.

Let’s see what the next test is.
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He's at 223 AT. Now that I'm more awake, I converted what he got and it was probably equivalent to 2 teaspoons. I see advice online for a teaspoon to a tablespoon. It seemed like a lot to me too.
 
The problem with giving a lot of karo or honey is you might make the cat vomit and a smaller amount usually dies the job anyway.
Kelley and Merlin said:
He's at 223 AT
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Ok don’t give any more high carb food or karo. But you will Need to test for the next 2 hours to make sure he can stay up on his own. He can have some low carb food if needed, and that won’t effect the 2 hour count.
 
If he drops under 68 again you can give some high carb food or a drop of karo.
As Merlin is a long term diabetic he does not earn a reduction in dose. He will need to drop under 68 three times to earn the reduction.
 
I'm going to try to plant an idea....

If you follow TR, a 68 is not dangerously low. For a cat that's within the first year of diagnosis, you don't reduce the dose unless numbers drop below 50 or 64 on an AT. If the cat is more than a year past diagnosis, you don't reduce unless numbers drop below 40. If it were me, I'd have given Merlin some of his usual, low carb food and re-tested in 20 - 30 min. The low carb may have bumped his numbers up a bit vs the jump from 68 to 223. I also encourage members to not wait more than 30 min in order to re-test. You want to be sure that your cat is in safe numbers. Waiting almost 90 min gives lots of time for numbers to drop.

This is a link from the Lantus board on handling low numbers.
 
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Hi everyone, ok, Mer was at 64 at 2:30am but it took me a while of scrambling around to get the karo in him. So the retest at 3:45 was probably more like a 45-minute wait after the karo and eating. At that point he was at 223 and I was feeling a little relieved. He was never symptomatic. It is good to know that wasn't a dangerously low number, which I guess I knew, but I was afraid it would keep dropping.

Good news, at the vet we learned his blood ketones are down to 0.3. :) She gave him 2.25 units (and said it was good that I had been more conservative than her suggested 3 units if over 300). He didn't eat until we got home, but she said it was ok because he was so high the AT couldn't read it. I just took a +6 reading and he's at 701 AT and I just fed him his usual low carb food. Just waiting it out like Bron said, the vet said he may run high for a couple of days until he gets back to where he was yesterday.

I will go by the lows in Sienne's post above on when to consider at what BG level to consider dropping below 2 units. In the meantime, the vet wants me to stay with 2.25 units if 300+ and drop to 2 units if 200-300. Once he gets into the less than 200 range, I'll reconsider. The vet said if it is upper 100s getting close to 200 continue 2 units. If it is lower 100s, then I'm not sure at this time. I know the thought is to hold the dosage, but it makes me nervous.
 
Kelley and Merlin said:
units. In the meantime, the vet wants me to stay with 2.25 units if 300+ and drop to 2 units if 200-300. Once he gets into the less than 200 range, I'll reconsider. The vet said if it is upper 100s getting close to 200 continue 2 units. If it is lower 100s, then I'm not sure at this time. I know the thought is to hold the dosage, but it makes me nervous.
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If I were you I would follow one of our dosing methods (TR is best for you with ketones in the picture) and not reduce the dose as the vet suggested. Lantus doesn’t like to be chopped and changed too much (unless there is a dose increase or decrease needed) as it messes with the depot. As long as you are monitoring the BGs well, he will be safe and the goal is to get him back into normal numbers. If you back away with the dose every time he starts to head towards good numbers this will take much longer to achieve.
If you are nervous, get a couple more tests in during that cycle until you feel more comfortable.
 
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