? Morning advice: Really low bg

[Tony’s person]

Hi. Out of the blue tonight when I went to do PMPS my boy was at 46. He is usually around 140-180. I retested and got 42. I immediately gave Karo syrup, high carb treats and his KD wet food...which is relatively high carb.
Now 30 mins later he is 131. Now what??
Two weeks ago I accidentally overdosed him...realized right away, did Karo and raced him into emergency vet. He spent about 30 hours there...on dextrose on and off as they monitored him. He never dropped below low-normal. But it was traumatic for me and him...and crazy expensive.
This time, however, was not an overdose. He hadn’t even had his insulin tonight. I gave him his morning shot today about an hour late because I was stuck leading a global conference call for work during his normal AM shot time.
What to do???? His regular vet told me yesterday that with Lantus I don’t need to panic so much if he goes low because it can be managed with food usually. But I don’t know about that??
He is alert and his appetite is strong. He has eaten a lot and seems “normal”. If I can avoid another traumatizing night in the vet clinic I’d like to, but I absolutely positively want to do whatever is best for him.
also, for some reason for the first time ever I’m having trouble getting blood from his ear. I’ve done the usual warm rice sock and I home rest every day and have never had this issue. Is that a sign of anything??.
Input?

 

[tiffmaxee]

Good he’s hungry. Try Testing again in 30 minutes. If you can’t get blood that will be a problem. Otherwise he should start to come up with food and without insulin. If you can’t get a test next time You could feed some mc and see how he behaves.

 

[Tony’s person]

Thanks. I just retested - super hard to get blood again I had to poke twice. That’s never happened. He’s up to 214. Are we out of danger or could that just be from the Karo I gave him 2 hours ago?
He’s eating again, which is good. I’m exhausted. Can I go to sleep and set an alarm for ...?? 2-3 hours from now?

 

[Wendy&Neko]

If it's been two hours since you last gave karo or anything else high carb, and you didn't shoot tonight, you should be fine for the night.

Your new dose tomorrow morning is 0.75 units.

I sometimes found it harder to get a big enough blood drop if Neko was in lower numbers.

 

[Tony’s person]

Ok. Thanks. He was eating less than 2 hours ago - he seems hungry and i was letting him eat whatever he would - so he ate some of the wet KD about an hour before the 214 number. He did just eat some more just now. So do you think we’re ok, even though he has been eating a lot (which is good...but he hasn’t had an empty stomach since the low low reading). No insulin either, obviously.

 

[tiffmaxee]

Since he came up and didn’t have insulin I think he’s fine.

 

[Tony’s person]

Thank you both so much. When I have had some sleep I’m going to have to read up more on what can cause a drop like that out of the blue. I’ll reduce to .75 tomorrow, at least. I was thinking .5 if he isn’t at least 175 or so. I was late with morning shot today. So what if I just happened to catch what was actually a nadir because I was preparing for PM shot about 10 hours later rather than 12 hrs?
Anyway - off to bed. I’m beyond knackered. Thank you again!!

 

[tiffmaxee]

Are you saying you were going to shoot two hours early? We never suggest shooting more than 15-30 minutes early. Get some sleep.

 

[Tony’s person]

Not necessarily. I was going to test, then feed him...then eat my own dinner and then (assuming his bg had been over 150 or so), shoot. It would have been about an hour early, which i thought would help get him back towards normal schedule. I didn’t realize the limit was 15-30 mins. Now I know! Thank you. Yes, to sleep! I need it. Can’t think straight any more.

 

[tiffmaxee]

Shooting an hour early might act like an increase. We suggest adjusting 30 minutes every 24 hours either all at once or 15 minutes each cycle.

 

[Tony’s person]

Ok thanks. So this morning he is over 300. Can I give him his shot back to his normal time, since I skipped last night’s shot all together? Or do I have to still move back time in increments since yesterday Morning I gave the AM shot late?

 

[tiffmaxee]

Sorry nobody answered. You can shoot the new reduced dose of .75 whenever you want.

 

[tiffmaxee]

Next time you have a question you need immediate help with like dosing change your subject and add the question mark prefix. I also suggest posting on the Lantus forum where there are more experienced people and many in your time zone. Some people to tag for help are @Bandit's Mom and @Bron and Sheba (GA) if early morning.

 

[Tony’s person]

So this morning I gave Tony .75u (down from 1u) per last night’s low reading and the subsequent discussion here. He was up at 340 this morning, which I’m guessing was a combo of no insulin last night with a potential bounce from the high carb food and Karo syrup I gave him last night when he came in with a wildly low (42) bg.
Tonight he is 90 for PMPS. I’m not going to give insulin (right??) but do I also reduce his dose again to .5 for tomorrow morning regardless of tomorrow’s AMPS reading, or do I stick with .75 for a while? What could be driving these
Low evening numbers??
Tagging @Bandit's Mom I’m sorry, I don’t know how to move thread to Lantus Forum!

 

[Wendy&Neko]

If you are following SLGS for dosing, you reduce if they go under 90. He was just at 90. Even though you skipped, make sure you test again tonight, to make sure he's on his way up.

I don’t know how to move thread to Lantus Forum!

You don't need to move the thread, you can start a brand new one over on the Lantus forum if you wish.

 

[Tony’s person]

Ok thanks. He didn’t eat a ton, but he did eat. Am I looking to see him going up without food, or with, or does it not matter so long as he goes up?

 

[Wendy&Neko]

Just as long as he's either flat or going up, and not still dropping.

 

[tiffmaxee]

Hi. He has not earned a reduction for you have had to skip both nights. Can you monitor all day if needed? Do you have enough test strips and high carb food? I know you have honey or syrup. We need a dose you can shoot consistently. If you can monitor I would try shooting .50
It would also be good to start a thread on the Lantus forum if you shoot so we can get more experienced Lantus users keeping an eye on you. Link this post to the one there. What do you think?

 

[Tony’s person]

Hi. I did start thread on Lantus forum...apologies about doing that out of order. I came back and deleted this one but you maybe replied in the interim. (thank you for quick reply!)
I do have high carb food and strips. I can be around for several hours but have to be in and out this afternoon and evening. I could probably test every few hours.
My concern is that he isn’t a huge eater - he will eat at mealtimes, but he never overeats. He was never overweight; his diabetes was not driven by that, so I can’t really “rely” on his eating his way out of low bg.