Need Help! blood sugar low

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Sandy96

Sandy96

Member Since 2012
When I checked Bugs bg at 2 this afternoon it was 29, i rechecked in her other ear and it was 30. She was acting like what she used to before the diabetes following me around. yelling at me, rubbing and generally acting like her formally normal self. We immediately fed her the leftover food from this am and another ounce from a new can ( low carb as we didnt have any othet) she ate all but about half an ounce of it then went and laid down. Brian went to get some hi carb food and some more lancets her bg 45 min later was 44. At that time shes sleepy, not interacting like she was earlier and immediately returns to her bed. Gravy food (fancy feast gravy lovers) 2 tsp given as soon as Brian returned from rhe store. At 3:15 pm her sugar was up to 61, she remains drowsy and not interactive as she normally is. 4pm: Bg 64 another 2 tsp ffgl given. She eats it very well if itsgivem tohee howevwr she still wont get up and walk to the bowl sitting within a foot of her.
 
What insulin? If Lantus or Levemir, you will want to continue monitoring past the nadir point as low numbers tend to last longer with shed insulin. You are doing great giving her small amounts of a little higher carb food and monitoring carefully. If she remains in the 60s, she should be okay. That 30/40 range is a definite sign to reduce the dose.
 
Is on 2u Lantus bid. Her sugar was up to 84 at 4:30 and am getting ready to check it again here in amin or so. What really bothers me is the fact that she was so active at 29 and is so lethargic now, why is that? I know every cat is different and this could be normal for hypo for her but being a former people nurse this just seems odd to me :? Thanks for your quick response! Will post her next bg as soon as i get it.
 
5pm: her bg is up to 93 gave another couple tsp of the ffgl and will leave her ears alone for an hr :-D
 
It sounds like she is doing well. I don't know why she would be more lethargic now, but you are right - every cat is different. (That's what makes this so much fun! :mrgreen: )

Please post before your next shot and ask for specific Lantus dosing advice. The low numbers should earn her a decrease in dose but you should see what people say about how much of a decrease.

BTW, congrats on surviving your first low number! Scary the first time, but you did a great job.
 
Thank you! I will her dose is at 7pm. I will post numbers and appetite before giving it :-D
 
Re: Need Help! need dosing instructions needed after low su

Her bg was 200 at 7pm check she didnt eat very well, about 3/4 of an ounce out of 1.5 ounces. Will hold off on insulin until someone here can help with adjusting amt needed
 
Hi Sandy
Couple of questions first.

IS this correct?

+10 BG was 93
At shot time it was 200?

This morning when you gave her a shot, and then saw that scary 29/30, what was her BG at shot time?
And was that low reading at +6 from her morning shot? (not too sure on the timing)

Carl

Edit to add -
How long has Bugs been on 2u, and how long since she was diagnosed with diabetes? What was her dose just before it was changed to 2u?
 
Thanks for answering Carl, i will try to get the answers for you.
2pm was the scary 29/30 reading which was 7+ from am shot.
5pm was the 93 which was the 10+ from am
7pm was the 200
Low reading was at +7 from 7am reading of 214
She was diagnosed on Oct25th and started on 2u Lantus bid on the 26th of Oct.
 
Thanks Sandy,

Well. First off, any time a cat goes below 50, that means an automatic reduction in insulin. Lost of folks here follow what is called the "Tight Regulation Protocol" when using Lantus or Levemir. There's also a protocol used by some called the "Start Low, Go Slow" approach.

The TR protocol would advise a decrease in dose of .25u.
The SLGS says that if you get a number below 90, the decrease should be .5u.

When Bugs was diagnosed, did the vet find any other conditions besides diabetes present? Any infection? Did they test for ketones? Trying to figure out the logic of the 2u starting dose, because most kitties are started on .5u or 1u, but 2u is "higher than normal".

Bugs went very low today. Some cats, when that happens, are more sensitive to insulin during the next cycle. The "typical" response to that low a number is that the BGs will then go pretty high (something we refer to as "bouncing"), and seeing Bugs only at 200 isn't bad at all. It could still go higher however.

Do you have a good supply of test strips? What's your evening look like? Working in the morning?

I'm thinking her dose needs to be lowered, but as to exactly what, if you can answer those questions, (and I'll ask someone else to take a look too), we can try to help you determine what to shoot. It's about an hour past shot time right now, right?

Carl
 
HI Carl
We are an hr+ past shot time and she is climbing at 317 right now.
Is being treated for a UTI, is almost finished with abt. Her liver enzymes were elevated so they will be retesting them on the 14th the possibility of liver problems were mentioned
The vet didnt mention anything aboit ketones however she was spilling 1000+ glucose in her urine at tje time of dx.
i have plenty of strips and dont work so will be able to monitor her as needed.
Thanks again
:mrgreen:
 
Sandy,
You definitely should reduce the dose. Do you feel okay with 1.75U? Can you eyeball that on the syringe? Do your syringes have 1/2 unit marks?

If you shoot, you'd want to get a test a +2 and +3 to see if the BG drops significantly by then. Feel free to post any updates, and someone will be here to help if needed. This place is open 24/7 :lol:

Carl
 
Ooops. Is your name Dani, and is Kitty "Sandy"? The "Bugs" in the first post confused me. ;-)

Carl
 
Welcome, Sandy. Carl asked that I stop by.

Unless you have more test data or there's a health issue, Bugs may have been started on too high of a dose. There is a formula to calculate the starting dose of Lantus:
initial dose = 0.25 x cat's ideal weight in kilograms​
This formula usually results in a starting dose in the neighborhood of 1.0u (give or take).

Like Carl suggested, a drop in BG below 50 (or 90 with SLGS) indicates that a dose reduction is warranted. With Lantus, regardless of whether you're planning on following the Tight Regulation Protocol or the Start Low Go Slow approach, you would reduce the dose by 0.25u. However, you may want to drop the dose so you're starting at a safer range.

I had the same question as Carl -- did Bugs have any medical issues going on at or prior to diagnosis. Diabetic ketoacidosis is particularly important for us to know about since this may be a consideration with regard to your current dose.

There is a great deal of information about Lantus and it's use in the starred, sticky notes at the top of the Lantus board. While you may not opt to follow the Tight Regulation Protocol, there is still a wealth of information on the board that you may find useful. The info in the sticky notes are as follows:
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

When you have a moment, you may want to compile Bugs' test data on a spreadsheet. This will allow you to keep track of your data and will make it easier for us to lend you a hand.

Please let us know if you have questions. We're more than willing to help.
 
I agree with Sienne. I was thinking that maybe you should start over at 1 unit, and if that isn't enough you can always go up. I would try 1 unit consistantly for 5 to 7 days and see how that works for her.
 
Im Dani, sugarkitty is Sandy or Bug. Shes always been a pillbug about all sorts of stuff :-D
I'll give her the 1.75u and watch her closely tonight.
I found her original ua from the 26th of Oct it shows she was spilling 15mg per dl ketones
 
Dani,

This board is based on "peer review", that's what makes it work. We all work together to give the best advice possible, and to make corrections or adjustments to what someone might say.

I sent messages to Sienne and Dyana and asked them to take a look (and thank you both for doing so quickly!!!).

You don't know any of us from Adam or Eve, but I wanted to let you know that both of these wonderful ladies have years of experience with this particular insulin. I have none. My cat was on PZI, not Lantus. I'm just a student of Lantus, not a user. If you have any doubts if we gave you conflicting advice on dose, go with their experience.

Carl
 
Good on finding the information on previous ketones!
Have you been testing for them at home or did you know that you can?

Carl
 
I gave her 1.5 units of the Lantus insulin just now, will check her sugar at 10pm and again at 2am.
I do thank all af you for your help today! I have only managed to observe her urinating once and was able to test for ketones it was neg at that time. I am really not sure if she is peeing like she should be at this time either.
 
Given the UTI, she may not be peeing as often as she would be otherwise. Glad you were aware of being able to test for ketones. That's a hurdle most new members haven't gone over yet! Most cats don't seem to be big fans of having the litter box space invaded either.

Good choice on the 1.5u I think. Having had ketones present before, that's something you definitely want to avoid going forward.

Are you two hours behind the east coast, or 3? I'll keep an eye out for her numbers.

Carl
 
Actually I am in Missouri so am only 1hr behind the east coast. And i will be sure to post her numbers throughout the nite. Right now she is sleeping, so here in a bit i will try to work on getting a spreadsheet done for her numbers.
 
Hah, I saw "NW AR" in your avatar, and dumb me thought "Arizona". I remember when state abbreviations were longer than just two capital letters!
Northwest Arkansas? Southwest MO? Fairly close to my daughter, who is near Fort Leonard Wood in MO.

OK, I'll watch out for your numbers!

Carl
 
Am in Rogers Ar. I too remember the 3-4 letter abreviations so def understand the confusion.
 
Sorry about the name confusion!

Thank you for that information on ketones. It is hugely important to know. Please, keep testing for ketones as often as you can stalk Sandy to the litter box. Up to a trace amount can be dealt with at home. More than trace requires a vet visit. With ketones being a potential issue, we don't want to reduce the insulin dose by too much. How is Sandy eating? If her food intake is good, that's fine. It will help to keep the ketones flushed out of her system if you can add water to her food.

You mentioned that she's urinating less. That's normal as numbers start falling into a better range. (One of the symptoms of diabetes is polyuria -- excessive urination. It's a good sign if you're seeing that urinating is closer to a pre-diabetes level.)

We use a different method of talking about time. Everyone here can be in a different time zone. I'm in CST with you. Carl is on Eastern time. In a few hours, a member from South Africa may stop by. Since 10:00 PM will be different for everyone, we view time in terms of the number of hours from when you gave a shot. So, if I'm understanding correctly,

  • AMPS - 214
  • +7 - 29/30
  • +10 - 93
  • PMPS - 200

And, you're planning on testing at +3 (10:00 PM) and +7 (2:00 AM).
 
I do believe so on the times.
You have the correct numbers and times. Actually her level of urinating isnt returning to pre diabetic state, she has always had what would be called Polyuria, but until recently it was "normal" for her as her (even stressed) numbers were well in normal range.
Actually she just used the litter box and I was able to test for Ketones which fortunately was neg
at +3 (10pm) her BG is 295 this time is also +1 1.5u insulin given

Her appetite this eve was understandably lower than normal and she ate only about half of what was offered (appx 1oz eaten) despite encouragement as I was giving her HC food to increase her bg. Her appetite is nowhere near normal for her right now as she is eating far less than she normally does and is requiring alot more encouragement and blending of her food than she ever has. I have alarms set and plan to be up as long as needed tonight to monitor her and make sure we come out smiling tomorrow morning.
Thanks for all the help!
 
One last question on the times. (going to revert to "clock" times for this)

You said the 200 was at 7PM
And this test was at 10PM.

So 3 hours since that test.

But what time did you give the shot of insulin?
Was it 9PM your time?

Carl
 
It seems like you're seeing a bounce. The low numbers today triggered Sandy's pancreas releasing a stored form of glucose along with counterregulatory hormones which is causing a rise in BG numbers.

It may be hard to make generalizations about what food intake and urination were "pre-diabetes." Most of our cats where probably in high BG numbers for some time before they were officially diagnosed. Most diabetic cats are ravenous since the lack of insulin prevents nutrients (i.e., glucose) from getting into their cells where it's needed. Once your cat is on insulin, food intake may begin to diminish.

With the potential of ketones, you want to do what you can to make sure that Sandy is eating.
 
Carl: Yes the time was 9pm cst
I expected to see a bounce, people tend to do that too and I have lots of experience on the human side of diabetes as I was in Nursing for about 12 yrs as a CNA and LPN, kitties seem to be a bit brittler tho from what I have seen on the boards so far.
I will watch her appetite carefully as well as continue to add water to her food to encourage adequate hydration.
Sorry it took me so long to get back to you was filling out the spreadsheet so you can look at her numbers since diagnosis. I am also keeping a journal so can show it to Dr Jackie as well as I will take a copy of the spreadsheet to show her. Will continue to post her numbers as I get them, she is pretty stable right now so my next bg will be around 2am or +5 from the insulin shot and +7 from PMPS
 
Dani,
Technically, the 200 number you got earlier would be called her "PMBG" because you didn't actually shoot at that time.
On the spreadsheet, you would indicate that you gave the shot at "+2", like maybe in the comments section. You didn't test again at 9 when you shot, right?

Just so anyone looking in later needs to understand tonight's excitment:

PMBG 200 Ate 3/4 oz
PMBG +1 317
Shot 1.5u two hours late

+1 295

Has she eaten besides that food when you got the 200?

Her next shot should be 12 hours after tonight's shot. So that will put you at 9am your time. Is that going to mess you up?

Carl
 
OK will mark that on my sheet. The +3 is at 10pm my time and is 1hr post shot, I didnt test her sugar at 9 when I gave the shot.
I will be testing at 3am (+6) which should be the low point in tonights curve. Do you think I should also test at +4 (1am) as well? I am gonna have to work her back to 7am and 7pm as while I dont work I am busy between 8 and 10 am most every morning.
 
Well, the +4 can give you some idea of what to expect by +6. If you're seeing a bounce so far, then you may not see much of a drop by +4. Typically, the insulin would onset about 3 hours after the shot, and then lower the BG until the nadir (+6ish).
"Typical" being the operative word.

If you're going to be up until +6, then sure, get a +4. All data is useful down the road. But if you were planning on a nap and a wake-up for +6, then it isn't crucial.

There's a good chance (pretty much a certainty) that I won't be awake for the +6. But I will send a message to one or two people who are usually on at that time and ask them to look here to see if you have any questions.


Carl
 
Thank You Carl. I will be up for the +4 and have an alarm for the +6. I know I am gonna be losing sleep but after this afternoons low readings I really feel I need to stay on top of her readings. Shes my 16.5yr old babygirl and I would hate it if I missed a reading and she crashed again. I would appreciate you sending the messages to your friends to look in and see if I need any help :-) Have a nice nite!
 
Dani,
You are very welcome! This place is an amazing network of people, literally around the world, who all share a love of our kitties, and a common bond of dealing with feline diabetes. Some of us (like me) were blessed with finding it, and with a fairly short "sugar dance" with our furries. Some people have dealt with this for years, with multiple cats. There are many here who have adopted a cat (or several) solely because they ARE diabetic. It's pretty incredible, and I'm glad you "found" us.

I gathered from your screen name that Sandy dated back to 1996. I've had a couple kitties over the years go that far and beyond. Bob is "only" 13, and my civvie, Mullet, is 15. I (and most everyone here) can certainly understand how special Sandy is to you having shared all those years together. Many have been found to have diabetes at that ripe old age, and have lived many more years as "diabetics". You and Sandy are in a good place :-D

Carl
 
My sister actually referred me to this website when she heard the news about Bug. I had another long living cat who passed away at 21 (17yrs ago) actually was about 6mo before I got Sandy. SNowy and I grew up together just like my son and Sandy have grown up together, he will be 19 this yr. I believe this is a good place. It is time to get the +4 reading so will brb in a min or so.
Back her reading this time is 130. I am off to get a couple of hrs sleep before i have to poke her ear again.
 
Recap
PMBG 200
PmBg +1 317
PMPS - (+14) BG not known
+1 295
+4 130

Dani,
Has she had any more food since the meal way back about 6 hours ago? It wouldn't hurt to give her a snack of low-carb food now. That's not a drastic drop at +4, but a snack now could slow it down so you don't get a surprise at +6.

I've asked Jane to take a look when she comes on (she's in South Africa). If you do see a lower number than you expect overnight, do what you did earlier today. Feed her some higher carb food and retest in 20-30 minutes. If you need assistance, go to the Lantus Tight Regulation forum, and post a "Need Help" message. That's the busiest forum on the board, and someone is there just about 24 hours a day.

Carl
 
I am a nuwbie myself but just as a comment-
My Bast is a sleepyhead all day. Last time he was below 50 his was chasing moths & catnip mice. He didn't want to eat because he was "playing"
So some cats just are not lethargic on low numbers
Misty & Bast
 
Her sugar hasnt gone below 130. At +6 it was 173 and in about half an hr i'll have the +8 number, since she cant have insulin till 9 am i plan to give her a snack then. The +8 number was 159, as it is 4 hrs till insulin time I gace her a 1/4 can of Natures Variety Instinct Venison to snack on watered down a bit for the fluids. She ate bout half of what was offered.
 
Hi sis, glad you came here! Hope buggy is better this mornin. Was wondering why you called me askin about meters. You sounded a little frantic, so I dodn't want to keep you.

Sounds like she's havin a good bounce.


Me
 
Am fine now. Needed the meter the other day as I ran out of strips and bug was not acting right (sugars were good tho). SHes in the cabinet now, has eaten a little and drank some too, which in and of itself is great since shes not been drinking that much. Next sugar check is about an hr from now, will let ya know when you get here how she did.
You :mrgreen:

She has def had a good bounce, LOL
 
Sandy96 said:
Am in Rogers Ar. I too remember the 3-4 letter abreviations so def understand the confusion.
Click to expand...

Hello Dani and Sandy aka Bug! From Rogers- I'm in north Little Rock, so at least in the state if not the vicinity.

I don't get on at all over the weekends but it seemed I missed a hum-dinger! Glad Bug is getting better.
 
She sure surprised me thats for sure!! She was acting like her old normal self when we got home that afternoon, and OOPS there was low reading on the meter :cry: She is better today
Thank You for the well wishes
 
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