Murphys Low Glucose & Hospitalization

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MURPHYSMOM

MURPHYSMOM

Member Since 2014
I am very sad and concerned. Right now it is 3:15 am cst and I just left Murphy at the er hospital. If you have read my posts under other topics, he is a newbie, just over a month and is having a hard time getting regulated. Just yesterday at 7am I took his glucose and it was only 272, which is high, but for him was a low. he had a stay at the cat clinic where it jumped to 459 by 10am. I brought him home in the afternoon, fed him dinner and gave him his 4 units of pzi, which is what he has been on for a short time. Around 12:30 this morning I decided to check and the AlphaTrak 2 said his glucose was 92, which I thought must be a mistake as I had just opened up the new strips yesterday morning, but didn't use the solution to test, so I did and redid his glucose, which then read 82. This seemed nuts again as he had been and was acting perfectly normal all evening and was even eating his dry food whilst I tested him. I am at my wits end and had to leave him with the hospital in case his glucose drops again. I pray they wont call me in the next few hours which means he is ok, but I have to be back in 4 hours or so to bring his insulin. is this normal for a newbie? I am so sad for him!
 
If it was around +5 to +7 post shot, that would be the likely nadir, or lowest point post shot. While that is as low as you want to go measuring with an AlphaTrak, you could have cared for him by following the instructions for managing a HYPO, given in the link below, or for managing low numbers, which is explained in some of the forums. to steer his numbers. I'm sorry no one has explained that to you yet. Basically, when concerned about lows, you feed 1-2 teaspoons of HIGH carb gravy or food with a few drops of Karo or other syrup added, wait 20 minutes, and re-test, then repeat as needed, since gravy or syrup will wear off fast. You keep that up until you are past the nadir, have 3 rising numbers, and are above 130 mg/dl on an AlphaTrak.

[false assumption removed by moderator]

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
I'll just tell you a story about when I was fairly new with this.
It was the wee hours of the morning (like 2:00am) and J.D. tested in the 60s on a human glucometer. I called the ER vet and I told them that I may be bringing in a diabetic cat with low numbers. When he got into the 50s (this was before I joined FDMB), I put him in the car and drove with him, a bottle of Karo and a syringe for the Karo the 25 minutes to the vet. I pulled over and stopped three times on the way, to syringe more Karo into him. By the time we got to the vet I had Karo all over the cat, my clothes, my hair, and the steering wheel. When we entered the door, all I wanted to do was go into the bathroom and wash my hands and test J.D. Before I could reach the bathroom, they came out and took J.D. in his carrier from me and asked me if I wanted them to give him glucose or dextrose or whatever it's called. I said "yes" and proceeded to the bathroom to wash up, so I never got that test from J.D. after all that Karo he got on the way to the vet.

They are a busy hospital, and after waiting around anxiously for about an hour and a half in the waiting room, they came to me said he was up to 78 or something like that, and that I could go home and call back at 4:00pm (a zillion hours away!) and see how he was doing. When I called them at 4:00pm, they said they wanted to keep him over night. I remember all I wanted at the time that morning, was for him to get some glucose and go home. They said it was going to cost a ton of money for him to be left over night and I argued with them a little and I guess I convinced them that I could deal with him at home and they allowed me to pick him up that evening. I think they wanted to try to "regulate" him for me.

That's my story. Mostly, I just remember all the Karo all over me and laugh now (but I was really scared then).

I think Murphy is in the best place he can be right now with all the vets checking on him and giving him glucose or dextrose if he needs it.
They may suggest changing his dose a little. Remember that vets often think in 1 unit increments, so they tend to suggest changing doses a little more drastically than we suggest here on this site.

I am sending calming vines to Murphy (and to you) while he's in the hospital, and I hope that he is soon home and in your loving arms, purring and eating up a storm.
 
I am so sorry to hear Murphy is in the hospital, Donna. It looks like he definitely needs a dose reduction. (Remember that if he is high in the Vet's office or emergency room, he may be much lower at home.) You might suggest to your vet that you restart at one unit or 1.5 units, monitoring carefully with a small (.25) increase every 3 cycles if he is too high.

If he has to stay longer, consider taking in an unwashed tee shirt of yours or his blanket so he can sleep on something that smells of home.
 
(((Donna and Murphy)))

I had a similar experience, and knowing what I do now, I don't even think Angel was having a hypo. If you read my threads you may feel reassured, Angel's bloods were way down (on a human meter tho). Sounds like a similar thing, not exactly a hypo but needed to be brought back up. You absolutely did the right thing calling the vets, did they tell you to bring him straight in or did they talk you through trying to bring his numbers up? Now I would feel calm enough to try and bring his levels up at home, but it was just over 3 weeks since he was diagnosed. As it turns out I would have been better off doing that, but if the vets had done their job properly I would have done the right thing.
4 units does seem high, hope they canAngel is on one of Prozinc, been having an interesting 24 hours with that and just about to post.

Next time Murphy goes low, feed some high carb, test, feed, test, feed, test. Do you have the hypo instructions printed out and stuck to your fridge? if not, here they are along with another post about low numbers.
viewtopic.php?f=28&t=15887
viewtopic.php?f=28&t=61799
And here's Angel's little adventure!
viewtopic.php?f=28&t=120680
viewtopic.php?f=28&t=120699

Thinking of you, I kind of think of Murphy as Angel's American cousin since they're both kind of new and I seem to have been online when he's been having a tough time!
x
 
So sorry Murphy had to go to the ER! Please let us know how he is. I know you're scared now but with a all the vets there to keep an eye on him I'm sure he's fine. They'll care for him. Thinking of you!
 
I think it was the right thing to do, since you cannot look at him and test frequently at home. They will take care of him, but once he is around his normal numbers, he should go home.

My vet told me I should leave my cat with him for one week to make a curve (1 week for a curve?!!!) and he stayed 10 days, while they were trying to stabilize him. People with diabetes don't stay at the hospital until they stabilized, they go home, with diet and go back just for check ups.

I hope Murphy can go home soon!
 
He did not need any extra syrup at the er thank goodness. they checks his numbers at 130am, 330am & 8am his #'s were 82, 252 & 547
I took him the cat clinic and they advised to feed hm at 10am & give 3 1/2 uits of pzi
I left him for a couple hours. when I came back, he had thrown up just a tad.
I was to take his bg and call at 3pm
I got 3 readings...59, 70 & 72
they said to give him some maple syrup (lite is all I had) and test again in 45 min
he was acting fine and I even gave him a bit of canned food to eat as it was not easy to get the syrup on his gums.
I don't know what to do.
they will call back at 415...30 mins from now
 
Those numbers are good as long as he doesn't drop into the 40s. I'd give him a little snack of low carb food and test again in 30 minutes. If he drops in the 40s, I'd give him a little more food - maybe a teaspoon of the gravy and retest in 15 minutes
 
I bet they will want me to bring him back to the er if it is in the 50's,,,maybe even 60's
he is acting fine, which I know could change in a split second=d with diabetes
I will test in 5 minutes
why is he getting so many lows all of a sudden?
 
its 126! still lowish, but good. I changed the lancet, maybe that was an issue although the er vet got the same reading I did earlier this am. I had just changed it yesterday I believe but maybe it was a bad one.
waiting for the vet to call
 
Hi!

Wishing you and Murphy healthier times. So sorry about your difficulties.

I wonder if the fact that you use an Alphatrack is not being noticed by everyone. Perhaps, right smack by the BG put in "on Alphatrack" and in your signature make the meter's name in red and larger type. Lancet should be brand new for each poke as they go dull fast. Might help.
Best wishes,
Sophie
 
Thanks Sophie!
I hope the signature looks ok now. my neighbor helped as I am not a computer expert.
Murphys last Blood Glucose at 4:10pm was 126 on AlphaTrak 2.
The vet called and suggested I get new strips from AlphaTrak as the ones I ordered from a company called ADW might not be the best and there isn o customer service # to call. I am a diabetic and don't change my lancet for every poke. But in a cat, do I really need to do that, for each time? I will need to order more lancets too. They do look like the ones I use for my Verio IQ human meter..not sure.
The vet called and was pleased his BG went up. So my guidelines are to test him tonight prior to dinner and if BG is at or below 200, no insulin. If above, ok to drop to 2 units of PZI. Tomorrow I will do a curve at 0 hour, 6 hours and 12 hours again using same guidelines. If he starts acting weird or his BG is lowish - 70's, use maple syrup and food and retest. If not coming up, back to the ER, but I hope no more of that. She had not told me until this morning that there could be such dramatic swings in the BG with PZI. He had such almost consistently high #'s with Vetsulin, that this is a big change and still somewhat scary.
Its just after 5 cst and we are going to nap, hopefully for a couple hours. I have not had much sleep...1 hour today, 2 last night, maybe a few here and there during the week with all of the emergencies and my own physical ills...cold, flu or sinus..not sure. I am exhausted. so on with the ac and some snoozing.
Wish us luck for a quiet night.

I am so very glad you are all out there!
 
A good update.
Yu said "The vet called and suggested I get new strips from AlphaTrak as the ones I ordered from a company called ADW might not be the best". Are they genuine AlphaTrac strips? Is it genuine Abbot packaging?
 
Hi Donna,

I know the lancets from my friend's human glucometer and the one I used for Angel will fit the lancing device for an alphatrak. Try yours and see. I have some spare ones I know will fit as my friend who is a nurse gave me a load, if you like I can check on Monday if I'm allowed to post them from the UK and if so I can send you a load. I use an alphatrak too now, but if Angel is still diabetic in a year I'll be going back to the human one as the strips for the alphatrak are £40 for 50, and the Codefree are £8 for 50.

If the readings around the nadir are in the mid/high 70's and Murphy seems fine in himself, I would think that's ok, but check with someone more experienced than me.

Hope you both have a good night.

xx
 
Donna,

Something you might explore with your vet is to restart Murphy at a lower dose, maybe 1 unit. It seems like you are chasing lows and highs. Sometimes starting over, combined with home testing, can give you a much clearer picture of what is happening and allow for safe, small increases in insulin if/as needed. There need not be big swings with PZI if you start low and increase slowly.
 
Up from our short nap...

Hi Larry!
Yes, They are the genuine article in Abbott housing and all. I think the vet likes to say that if they didn't order it themselves it isn't good enough. They made...should I say made...sort of gave me no choice but to order the Alpha Trak 2, the insulin and the syringes from them. She was also sort of concerned that I might have gotten a bad batch of test strips even though the er clinic and I came up with the same lo last night of 82.

Hi Cassandra!
Yes, I will test mine as they look very much alike and let you know if I need some. That would be great, Thanks. Wow, what a price difference between the 2 types, huh? They are animals for petes sake. Why does it have to cost so much? I have not had too much difficulty with my own glucometer and like that it has a memory for when I go to the doctor.
What does nadir stand for. I know it is the lowest point between insulin, right, but what do the letters mean?

Hi Sue!
I was and still am a bit freaked about Murphy getting so many lows and then tonight's reading at 830pm cst, 45 minutes after dinner for Murphy was 482 on the AlphaTrak2. Just 4 hours prior I had to get him up to 126 from 72 with food & syrup.
Per the vet, the units have been dropped down to 2. He had been up to 4 since last Saturday afternoon and then only got 3 1/2 today at 10am She told me to give the evening dose a bit later tonight and get back on the 7am/7pm schedule tomorrow. I will do the curve starting tomorrow morning and report to her on Monday.
He seems fine, but zonked. Three doc visits in 2 days. Poor guy. I still will probably test him around 1230am or later if I am still up just to see where he is at before I start the curve at 7am.

Thanks to all! So very much appreciated! Your kittens are lucky to have you!!
 
I wanted to put in my two cents here and say I agree with Sue. I restarted my Gypsy at 1 unit and it helped me. I think Gypsy needed a lower dose. It's easy to skip over the right dose. Give it a try! It might help.
 
Rachel,
I didn't even think about starting over. Thank you for stating that.
I was just thinking well, this isn't working, now we have to switch to another insulin or he cant be controlled which of course freaked me out.
We have dropped the dose back from 4 to 2, so hopefully that will make things better.
I don't know how fast they should be increasing the units. I think the other vet was going up way too fast with the Vetsulin and didn't give it enough time.
I hope this vet does better with the PZI. Do I have the right to tell her hey, lets slow it down? I know they want to get him under control, but perhaps we have gone up a bit too fast here again.
I still need to get my spreadsheet up and running. The ones I had attached to a prior post of mine somewhere on the board in Excel format didn't download. They don't look like anyone elses.
 
Donna, did you get the spreadsheet I sent you via email?

Yes, you can certainly tell your vet that you'd like to slow down. Murphy is your baby and you are his very best advocate.
 
Hi Sue!
Yes, I just checked email, saw it and will review asap.
Thank you.
I keep thinking they are the experts and know it all, or lots more than me.
I was hoping that after last nights er episode that I could take Murphy back to his old vet.
The cat clinic is good, but really overpriced.
I had called and left a message when leaving the er, but no one called back so I felt obligated to bring him back to the cat clinic.
They have done enough diagnosing.
We are still waiting on a calcium test they ordered on Friday. The next thing they want is for murphy to have a dental cleaning,
but I am hoping the other vet will do that.
I just wish they would all work together and help the pet people and the pet. I know its about the $$ for them, but I wish they could
just all work together and for the good of your furry friends.
 
I left a message in your other post about the vet. You can manage the diabetes at home, if the vet will be your partner in that and then use them for his other issues. The dental can be an important piece of the puzzle as infections raise bg levels. But if he were mine, I would get him stablized first - getting preshot and midcycle tests in and get him in a range that is generally level and sort of predictable. Then look at a dental.

We can certainly help if you want. Get those numbers in the spreadsheet (let me know if you need help) so we can look back and see patterns in his numbers and dosing. At first, post with his preshot numbers and let us give you suggestions. Then you can your vet know what you are doing with dosing (you are keeping her involved, not asking permission). It is hard to get advice from people on the internet, but you have read posts and threads on this site. I think you think we have a lot of people with experience who are willing to help.
 
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