need hypo infor

[yogakat]

Hello to all. It has been months since I last posted. Coleman has been getting along well. I test twice a day. He is getting a dose of 2.25 when readings are over 200. Less than 2.25 keeps him 400+, more than that keeps him too low. Eating wet food only off the approved list.

I was at work all day. Home about 6pm. He seemed fine, but I had to shower, cook, etc... When time for his test (which he loves), I could not get his attention and he was 'wandering the walls'...I was thinking he was looking for a place to pee (a bad habit, he is on Clomicalm). When I picked him up and put him on the counter (ODD...he always jumps up) he kept stepping in all the testing supplies and seemed unaware. His ears were really hot and bled out a lot. Reading was 29. It is not unusual for him to read 40-70 every few days, but this was too low and it all made sense. Disoriented, vision and hearing problems, clumsy.

I gave him 6mL of honey, his BFF dinner, some Natural Balance and a bit of Friskies. 15 min later down to 27. Called vet, they recommended bringing him in. (never happens on a weekday when regular vet is open!). Two more readings before I left for vet...+30 from initial was 54, +45 was 68. At the vets the read was 108 with their meter and 112 with ours. Said he seemed fine and doing better. Brought him home.

At +4 from initial reading, symptoms are less but still obvious. At +2.75 he was 223 and at +3.3 he was 300. I have continued to feed, Friskies with Pure Bites, and he has a good appetite. Soooooo....

HERE'S MY QUESTION: How long does it take for Moderate level symptoms to completely resolve? I will for sure take him to the Emergency Clinic again, but don't want to if he is improving but just at a slower rate. I am sure that they think I'm already crazy since I brought ALL of his equipment with us and insisted on BG tests with our meter as well as theirs!

 

[BJM]

How to treat Hypos - they can kill

Lantus is very long acting; you need to be past the nadir, rising, and above 50 mg/dL.
There are no recent tests in the linked spreadsheet. It is impossible to guess what is going on. Feeling very hot could be an infection. I'd go to the vet.

Your note about occasionally going too low every several days suggests the dose is to high.

 

[yogakat]

Yes, I have read the Hypos Can Kill...I even keep a copy that I leave out when we have a pet sitter.

We did try lowering the dose to 1.75mL and 2.0mL, but numbers stayed really high...in the 400s+

I know, I have not kept up with the online readings chart. I actually do have all of his numbers since his last post, they are all just hand written.

I am still curious as to how long this all could take to return to normal behavior...now at +4.5hrs from initial low read.

 

[BJM]

Which numbers - before giving insulin, or in the +5 to +7 hours post-shot? The nadir, often between +5 to +7 hours post-shot is how you adjust the dose, not the pre-shot tests.

 

[yogakat]

No, I've only been testing every 12hrs. Schedule and money had me cut back (most of my guys are special needs, and one had 3 knee surgeries this year and another Dx with IBD...wish I could spend lots more on test strips and other 'accessories'...)

Should I bite the bullet and lower the dose and test it for 1-2 weeks every ~6hrs?

Still my question...how long to recover from moderate level hypo symptoms?

 

[BJM]

It depends on whether the damage is permanent. Hypoglycemia can cause permanent neurological damage.

And Lantus takes a long time to wear off - over 12 hours.

Get a curve - test from pre-shot to pre-shot, every 2 hours for 1 day and chart the numbers. We can give better feedback if we see that, although having several days with pre-shot and nadir period tests would be better.

 

[Critter Mom]

I really understand the financial pressure. (Been there.)

Do you think you might be able to just about stretch to 3 tests a day? (AMPS, PMPS, and one mid-cycle to track how low the dose is taking Coleman).

From what I've read here, for safety I think you need to keep a very close eye on Coleman's BG for at least 16-18 hours after the low because of the Lantus depot.

I don't have sufficient experience to comment on symptom resolution.

 

[Dyana]

I would definitely reduce the dose as you don't want him going that low again, and I have heard they can be extra sensitive to insulin once they've had a symptomatic hypo, so you should probably test more for at least the next few days. Depending on his numbers tonight, you might also want to skip a dose, to help to drain the depot a little.
I hope he's all back to normal very soon.

 

[Critter Mom]

I'd suggest posting here for dosing advice before you next give any insulin. As @Dyana has advised above, a symptomatic hypo can result in a cat being much more sensitive to insulin so it's advisable to take extra care when deciding what dose to restart at.

 

[yogakat]

Coleman was finally himself this morning. I slept on the couch all night (well, hardly slept at all worrying about him). I am wondering if his advanced age could have made his recovery longer? Also, we had no high carb food in the house. Since he had not had a hypo episode in so long AND we have an IBD cat, we only have grain free low carb. I did buy some Gravy Lovers FF today to have just in case.

His AMPS was 370...but I didn't give insulin...+8 was 345.

I will probably not do insulin tonight either, and start tomorrow with a lower dose...ER doc recommended starting with 1mL.

I am going to try to do a week's worth of 4-5xday tests to see how his numbers run.

FYI to all...since we have diabetes and IBD and 7 cats (and I feed a feral colony) we were spending upwards of $400/month on food. We have gone to ordering from Chewy.com...all of the foods we use are much cheaper and our litter (World's Best) is 30% less than the store. And, free shipping over $49! We are (finally) saving money (and gas).

 

[Critter Mom]

I'm really glad to hear Coleman's recovered. You must be very, very relieved. The couch vigil is very familiar.

Skipping the doses may help the Lantus depot to drain? I've never been in the situation so can't help much. Might be an idea to post on the Lantus board and ask for someone to have a gander at Coleman's spreadsheet in light of the low.

Bless you for minding all those kitties! I'm glad you found some good deals. I hope you get a decent night's rest tonight. All that worry must have knocked the stuffing out of you somewhat, Kathy.


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[yogakat]

PMPS 348...still no insulin per ER doc....BUT +3.5 was 598...YIKES...his highest ever!!! Must...remember...to...breathe...

For sure starting insulin again tomorrow.

I hope you get a decent night's rest tonight. All that worry must have knocked the stuffing out of you somewhat, Kathy.

No such luck...our IBD cat Buttons is having a nasty (in all the worst ways) flare up...sleeping on the couch again so I can jump up (and clean) if needed.

 

[Critter Mom]

Must...remember...to...breathe...

Now you're getting the hang of this 'ere sugar dance!

Sorry to hear that Buttons is so poorly. Saoirse has suspected low-grade IBD and also pancreatitis. It can be very tough going when there's a flare. I hope he feels better very soon.


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