? Mild hypo 9 hours after eating?

Hi

Maddie is on 1 unit of ProZinc twice a day, and I've been transitioning her to low-carb wet food since her diagnosis. Usually she gets a pouch/tray of something around 6am, then her shot at 7am, then I feed her again mid-afternoon when she comes to demand food Usually I put down a little bit of dry in case she's hungry in the night, just to be safe.

Note: I have not started testing her yet as I was ill at the beginning of the month and have only just reached the stage of being able to look after both Maddie and myself without getting wiped out.

This afternoon she came to me looking rather out of it, with dilated pupils and a glassy stare, so I gave her a few treats and ran and got some dry food, which she tried to wolf like it was wet. So I ran to get a pouch of her favourite wet food, which she ate all of (and a couple more pieces of dry).

By now I was pretty sure she had a mild hypo, so I got out my AlphaTrak and tested her - the result was 36mg/dL, so I guess that means I was right? I'm going to skip her shot tonight, test her pre-shot in the morning and do a proper glucose curve as soon as my work schedule allows.

Any tips or advice? Is it possible she's in remission already, after only a few weeks on insulin? We think her diabetes might have been steroid-induced, as she's always been very healthy and only mildly overweight.

 

How long ago was the 36 on the AT????? That is very very low.

Please give her a couple drops of honey-- you can rub it straight onto her gums.

 

Tagging @Critter Mom, @Diane Tyler's Mom , and @jt and trouble (GA) , who I see recent posts from. I have to go out for an appointment very soon and won't be able to stay on this thread, but I don't want to leave you alone with this. We need to get Maddie UP.

 

Thats a distinct possibility. But let get through this first. lol Do you have any high carb food on hand? Something with gravy? Honey works well but it wears off fast.

 

Also, please re-test 30mins after that 36. Again, I may not be here for that test, but hopefully others will be here to help.

 

When was her last test?

 

Look at that face "I'M CUTE HUH?" lol what a charmer.

 

Hope everything is ok...

 

Sorry, had to pop out to the shops. Maddie is looking a lot better now, but I'll test her in a minute. The 36 was over an hour ago, maybe more.

ETA: she was 71 a moment ago (I deleted some near-duplicate posts, including the one that had this info).

 

UGH this site is having bouts of trouble In case it goes down you can always use PM's to communicate if needed. ok?

 

Good I would check her again in 30 mins just to make sure shes staying up!

 

Thanks, jt - I'll just be a bit more patient with posting!

 

I keep getting the "you must have permission to view this page" just to click LIKE!

 

@Maddie Mouse please get that BG test ASAP and post the results. Although it’s good that she’s looking better, a 36 on an AlphaTrack with hypo symptoms is not to be taken lightly and can be dangerous —as in life threatening.

 

I've been dipping in and out of the forum today so only saw this tag now.
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Anne,

That 36 was a ***really*** low number on an Alphatrak and based on your description of Maddie I would consider that to be a symptomatic hypo.

Please test her straight away and post the result. You need to make sure she's up high enough. You may also need to do further tests to make sure that she stays up.


Mogs
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@JL and Chip -

Would you be able to keep an eye on Anne and Maddie? I'm trying to do some stuff here for my own kitty at the moment but I can't leave Anne unless she has support.


Mogs
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I have to run down and help a neighbor bbiab
You are in excellent hands!

 

Yep, I’ll hang around for awhile.

 

Thanks again, guys. Maddie's BG is now 101 - obviously I'll skip the shot tonight!

I'm going to leave some of her Purina ProPlan dry food out, and will test her again in the morning.

ETA: she's currently snoozing on my bed, flicking her tail at the indignity of being dragged out of her cat bed for yet another test!

 

Thank you!

Anne, please can you let JL know what Maddie's BG is at now.

Also, the current dose of insulin is too high. You need to get advice from your vet urgently about how much to reduce the dose by.

Note that because Maddie has had a symptomatic hypo there is a chance she may now become much more sensitive to insulin as a consequence.


Mogs
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That's a pour karo down the throat and head to the nearest vet number on an AlphaTrak, especially since there were visible symptoms.

Questions.
1. Carbs wear off. Can you take another test right now please?
2. And tell us how long after the 36 it is?
3. What time did you give the shot? (I see no entries on your spreadsheets)

On the AlphaTrak, a cat has to be above 68 for two hours without feeding to be considered out of the woods.

It could be that Maddie will bounce sky high from the hypo.

Rover once had a symptomatic hypo. He was brain blind. I poured karo down his throat and headed for the ER. By the time we got there, he had recovered, thank goodness. There have been other cats on the forum that did not recover their eyesight for days.

It is very important to stay with a cat until the cat is above those numbers without the benefit of food.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

 

You need to test her again in 30 minutes to make sure she doesn't drop back.

I need to go but JL is keeping an eye out for the two of you. Please post the test result when you get it.


Mogs
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Tagging
@Panic
@Deb & Wink
for dosing advice.

 

Drop that dose in half, please! When transitioning from high to low carb like you're doing needs closely monitoring - as you can see! If Deb says to drop the dose more, do that. No insulin if under 200 for now.

If you are going to skip tonight I'd like to see you get a couple tests in - we want to see if it's going to bounce or see pancreatic activity. Would guess a bounce. Try to check a couple hours after feeding.

Please do start testing regularly, you were very lucky today. Withold food 2 hours prior to shot-time, test, then feed/shoot. You need to test right before shooting AND without food in the system to make a safe decision.

 

Ditto what Mogs said about potential sensitivity to insulin after a hypo.

Also, it will be critical that you begin testing BGs regularly now, especially before you consider giving more insulin. The combination of likely being a steroid-induced diabetic and changing to a low-carb diet is a double whammy that can significantly lower BG. I had a steroid-induced diabetic and he went into remission quickly after the steroids ceased. I had another diabetic who no longer needed insulin shots almost immediately after changing to low-carb food. It happens.

I hope you’re feeling better now and up to home testing because it really is important given the circumstances. Fortunately you “dodged a bullet” today but it could have turned out so, so worse. Trust me, I’ve seen it.

 

Hi Anne,
As others have said that was an extremely low number on Alphatrak and would be about 2mmol in UK numbers... And it is entirely possible that your kitty dropped lower than that earlier...
Was that your first ever blood glucose test? If so, well done!!!

Clearly a dose reduction is needed now...
And also as others have said hypo can make kitties much more sensitive to insulin for a while. So that needs to be borne in mind when deciding how much to reduce the dose.

I understand you're skipping tonight's shot. That sounds wise, and will give a chance for things to settle out a little.
Your kitty's blood glucose may 'bounce' up high after this low, but that number will just be temporary.

Do keep a close eye on your kitty over the next couple of weeks. Cats can sometimes seem to recover from hypo but then develop symptoms in the following days. If your kitty seems to be depressed or lethargic, or not wanting to eat, or just generally 'off' in any way, then DO take her to a vet to be checked over.

Sending you a huge (((HUG))) from Surrey.

Eliz

 

Thanks so much for all the advice! I'll check her in the morning - she's sleeping now (making her usual little dreaming grunts, so I know she's OK not just lethargic), and I don't want to stress her too much. I'll also email my vet first thing, and see what she says.

 

For future reference:

* Low blood sugar levels can sometimes trigger vomiting, one of the reasons for closely monitoring a cat throughout a hypoglycaemic episode.

A case in point from a couple of days ago:

https://felinediabetes.com/FDMB/threads/new-member-scared-and-overwhelmed.234834/#post-2634206

* It's best practice to manage a hypo by only feeding small amounts of food at a time, choosing the appropriate carb load at each point (low-, medium- or high-carb, possibly with additional support from honey/karo/glucose syrup), and then testing very frequently to make sure numbers come up and stay up. Sometimes a low run can last for hours and one needs to be sure that the cat will keep eating throughout that period, not fill it up straight away.


Mogs
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Phew!!! So glad she has come up, I was terrified to have to leave when I did. Thanks to everyone who stepped in today.

 

Do you have any numbers that you can fill in on your spreadsheet , there is nothing there, glad Maddie is OK

 

Sorry I didn't answer the tag, I have been in and out of the house dealing with my dad who has dementia, getting phone calls all day from my sister and brother, I am ready to have a nervous breakdown really

 

This must have been so scary to witness but thank goodness you saw her behavior changes. Not sure if you saw the post above where she waited and ended up at the ER and could have lost her kitty. If you happen to wake up during the night please grab a test. Things can change so quickly.

 

Sorry, I tried to update my spreadsheet but was having issues. Will try again in the morning when my head is clearer

 

Sounds good

 

You have to log into your Google Drive to edit the spreadsheet.
Google Drive may not work on some of the smaller devices.

 

Thanks! I don't use Google Docs much, so I thought I could just use the link

I need to create a new file anyway, as my AlphaTrak2 uses mg/dL, so the World spreadsheet won't work for me.

 

I'm tagging @Bhooma who can help you with your spreadsheet. She's a wonder.

 

How is Maddie?

 

She's fine this morning, thanks! Ate quite a bit of the dry food I put down at bedtime, and has had a mouthful or two of wet food. I haven't managed to get a blood sample yet, as her ears were a bit cold, but I've put last night's numbers into my new spreadsheet and updated the link in my signature.

 

Got a blood sample just now, which is her normal shot time, and it's 126, so I'm going to skip again. Unfortunately I wasn't up in time to withhold food for two hours, and she may have eaten recently since she hardly touched the food I put down for her.

I'll keep an eye on her and test a few more times this morning, and again before her evening shot.

 

Good decision.

 

Well done for getting that test! And that is top end of normal range.... I was expecting a 'bounce' so this is nice...

 

Thank you! It's actually pretty easy to get a blood sample from Maddie, at least when it's warm - Burmese ears are practically hairless except at the base, so it's easy to see the blood vessels, and the drop of blood just sits there on the skin.

(We do laugh when she shakes her head, because her leathery ears make a loud flapping sound )

 

Down to 102 now at +3, and bright as a button - we just went out for a short walk, and now she's running around playing with toys and yowling (she gets quite excited when she's been outside!).

 

Hahahaaaaa!!!

Is that more than 24 hours after insulin, Anne? If so that is extremely good news....
Have you ditched the dry food now...?

 

Yes, she hasn't had any insulin since yesterday morning (Tuesday)

I usually just put a small amount (15g) out at bedtime if she's eaten all her wet food - she still needs to put more weight on, so I'm sticking to the calorie guidelines my vet gave me. I left more out last night, to make sure her BG stayed up.

 

Just got the figures from my vet for Maddie's glucose curve at the surgery, and they couldn't be more different from now - she ranged from 14.6mmol/L to 30.8, which is 262-554 mg/dL. I assume that was with an AlphaTrak, since that's what they offered to lend me.

 

When was the surgery?

She's definitely not the same cat now! Fingers crossed that this holds...

 

19th August - exactly four weeks ago. By coincidence it was the day before we switched her from Lantus to ProZinc.

 

Right, definitely no insulin tonight! Last result was only 95, after a high of 168 - I skipped the 4pm test as she was getting stressed out, so maybe the high was a bit abnormal anyway.

I'll test again tomorrow morning and make a decision based on the numbers. Keeping fingers tightly crossed that this means she's in remission!

 

Surgery = "vet office" in Brit-speak.


Mogs
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Crossing fingers in the Shire...


Mogs
.

 

Oh, thank you! I thought I was missing a big part of the story and was extremely confused...

 

It's the ol' 'two nations divided by a common language' problem again, Nan.


Mogs
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Sorry, Nan - I realised when I re-read your message that you thought Maddie had had surgery. No, nothing worse than a shaved neck for her initial blood work!

 

Thanks, Mogs! She hasn't eaten much today (probably because the last 24 hours were very stressful), which has probably contributed to her low BG. I guess we'll see how things progress over the next day or so.

 

AMPS normal - 117

I'm going to withhold insulin for 24 hours and test her again tomorrow, but this is looking very promising!

 

Oooh, lovely....
If she can hold these numbers for 14 days then she'll 'most likely' be in remission.... Keeping fingers and paws crossed....