? New Member Mrs. Jones Dose Tonight and Bad Day Tuesday Night Hypo Hypervigilance

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MissyCat6

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Hello! We were doing so well! We had moved to a few consistent days with 1.5 in the AM and 1.5 in the PM. On the day she was getting her sensor changed, we were asked to give her gabapentin 2 hours prior. She went to our regular vet to get it changed and was quite dopey. While we were waiting for the sensor to start, she ate a 1 tbsp more of her food than usual and still seemed really dopey. My bad, and I did not wait for the sensor to start to get a reading. I was convinced with her usual intake, we could give her the usual dose. When the sensor started up 30 minutes after her shot, gluc dropped to 2.9. I went to my kit, gave her corn syrup and 2 sachets of Catit and took her to the vet. By the time she arrived, her gluc was high, and she was syrupy as well as ticked off. The vet suspected the gaba contributed to her lethargy and it was harder for her to clear it out due to her age. We took her home, monitored through the night, no problems but had to get another new sensor in the morning! She was high the next day, up and down the following day. Today was a good start but her gluc seemed to be dropping to the point I worried around late morning noon. The arrow showed a fast drop so we fed her, gave her 2 sachets of Catit, and a corn syrup taste. She is now back up 20. I am thinking 1.5 is now too much for her after she's regulated from the hypo event on Tuesday. What should we give her tonight and tomorrow morning? The spreadsheet is complete as it can be due to sensor change, the events, and time we can take her reading. Thanks so much!
 
Hello! We were doing so well! We had moved to a few consistent days with 1.5 in the AM and 1.5 in the PM. On the day she was getting her sensor changed, we were asked to give her gabapentin 2 hours prior. She went to our regular vet to get it changed and was quite dopey. While we were waiting for the sensor to start, she ate a 1 tbsp more of her food than usual and still seemed really dopey. My bad, and I did not wait for the sensor to start to get a reading. I was convinced with her usual intake, we could give her the usual dose. When the sensor started up 30 minutes after her shot, gluc dropped to 2.9. I went to my kit, gave her corn syrup and 2 sachets of Catit and took her to the vet. By the time she arrived, her gluc was high, and she was syrupy as well as ticked off. The vet suspected the gaba contributed to her lethargy and it was harder for her to clear it out due to her age. We took her home, monitored through the night, no problems but had to get another new sensor in the morning! She was high the next day, up and down the following day. Today was a good start but her gluc seemed to be dropping to the point I worried around late morning noon. The arrow showed a fast drop so we fed her, gave her 2 sachets of Catit, and a corn syrup taste. She is now back up 20. I am thinking 1.5 is now too much for her after she's regulated from the hypo event on Tuesday. What should we give her tonight and tomorrow morning? The spreadsheet is complete as it can be due to sensor change, the events, and time we can take her reading. Thanks so much!

Tagging members that have helped you on your previous post
@Wendy&Neko
@Bron and Sheba (GA)

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https://felinediabetes.com/FDMB/thr...jones-spreadsheet-review.288916/#post-3171284
 
Hi Natashya,
Gabapentin can make kitties drowsy. What dose was she given? Is she normally stressed at the vet? I would not use gabapentin unless I absolutely had to.
The freestyle libre is not very reliable with BGs under 100. That is why we suggest you buy a human meter and test manually when the BG drops under 100.You can buy a ReliOn meter from Walmart cheaply for this. You will also need lancets size 26 or 28, and test strips to go with the Relion meter and some cotton buds balls to hold behind the ear when testing.

With SLGS when the BG drops under 90, you take a dose reduction of 0.25 U.
As the libre measured 52, I think it is safe assume the BG most likely did drop under 90, so I would reduce the dose to 1.25 U and see how that goes.
Are you giving snacks during the cycles as well as the 2 main meals?
 
Unfortunately, we cannot buy the cheap Relion meters/strips in Canada - unless you cross border shop. It's a bit far from Calgary. ;) You might want to try Freestyle Lite, which is the meter/strip combination that takes one of the smallest blood drops. Which makes it easier for you.

Our members have also found the Libre isn't always reliable the first day/half day after installation: Freestyle Libre for Cats; Tips and Information So I'm not sure that 2.9 (52) was reliable. It seems totally out of keeping with the rest of the numbers you'd been getting on 1.5 units.

You don't need to give high carb food and corn syrup if they are dropping fast, but still in safe numbers. You can feed her a little of her normal low carb food. When following SLGS, you reduce the dose if they go under 90s. Mrs. Jones was in perfectly safe numbers today.

A favour to ask, could you put in the Remarks column when you replace the Libre sensor on that day. You will also find it helpful for yourself if you record when you gave her extra high carb food and syrup. As you found out the first time when you took her to the vet, too much carbs and syrup can send her sky high. Learning feline diabetes is both figuring out the right dose of insulin, but also how to feed her what and when.
 
Thanks Bron and Sheba. We will not be giving gabapentin ever again (1ml) 2 hours prior to the vet visit or ever; that was way too stressful. Noted 0.25 reduction. We were told no snacks during the day. She eats 2-3 tbsp dry in the morning 2 tbsp dry at night. She also eats 1 tbsp dry before we go to bed around 9:30pm. In the near future we will transition to a lower carb dry food. We fed her dry food when it started to drop late morning afternoon and the numbers were all over. Wendy and Neko, thanks for suggesting the Freestyle Lite. We have the reader so I guess we just need the strips. I will need to read the tutorial on blood droplets for the reader. Thanks for the link to Freestyle Libre for Cats-tips and info. Yes, I'll add to the remarks column regarding the sensor change. For today, we are going away for the day (although petcare will come in and refill her water and take readings) so I will only give her 1 iu but if she eats well tonight, we'll move the 1.25 iu. Any other suggestions. Thanks so very very much!
 
Hello again! Also, what are your thoughts on us offering food at 5:45am, she graze eats until 6:15-6:30am and we shoot at 6:45am? Are we missing the optimal 30 minute window? Sometimes she doesn't eat the 3 tbsps right away and goes back to it during this window. Thanks!
 
We recommend not giving any food in the 2 hours prior to when you give insulin. You don't want your pre-shot test value to be influenced by food. The only exception to that rule is if you test and numbers are low (e.g., below 90 with SLGS) and you need to intervene.
 
Thanks for the reply! Noted, and what about eating just that 1 hour window? If she eats all of from 5:45-6pm or 5:45-6:15-6:30pm. Is it always ok still to time the shot at 6;45pm (usual time)? Thanks!
 
I'm hoping I understand your question. If Natasha's shot time is at 6:45, you do not want to feed her between 4:45 - 6:45. Pick up any food at 4:45. Most Lantus users will test, feed, and shoot all within a very short time. I would typically give my cat her insulin when her head was in her food bowl. She barely noticed the shot but she was a very food motivated cat!

Also, I did a calculation for the carbohydrate content of the dry food you're feeding your cat. It's approximately 20.5% carbohydrate. This is a high carb food. The only dry foods that I'm aware that are low carb are Dr. Elsey's Clean Protein or Young Again Zero Carb.
 
Hello! Thanks for the reply. I put down the food at 5:45am/pm and let her eat until 6:30am/pm then shot 6:45am/pm. Are you able to provide guidance such as put the food down at 6:00am/pm let her eat until 6:30am/pm then shoot at 6:30pm? I think my grazing window is too long for Mrs. Jones. However, I don't understand the "give the shot 30 minutes after eating rule". Yes, I will be slowly integrating Dr. E's low carb dry over the next few weeks. It is hard to find where I live but I will try to get it this week. The SquarePet she is on in the lowest of the carbs for that brand. I also need to balance her early kidney disease with the right food. I look forward to your reply when convenient. Thanks so much!
 
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