Newbie- Help!!! Hypo support

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Amyitsallgood

Amyitsallgood

Member Since 2015
Hi my name is Amy and my kitty Delilah (aka Beast) was diagnosed with diabetes last Monday (30 Mar 2015) after I had the vet send in the CBC because I could smell Ketones on her breath. I had been smelling them for awhile but wasn’t sure what it was till now. On Wed I took her in for them to do the initial curve and give me a dose. They only took 3 BG because she is a feisty little thing! They told me to dose 2 units of Lantus every twelve hours. I’ve been doing a lot of research on my spare time (which isn’t a whole lot with two small children) and it wasn’t till yesterday that I broke down and bought a glucometer. I bought it because I knew I wanted to start her on an even lower carb diet as recommended by Lisa A Pierson, DVM. I should mention the first couple days the vet gave me royal canin diabetic food, than switched to hills m/d. I have been feeding her ¼ a can and giving her the 2 units at 7am and 7pm (or as close as I could manage). So yesterday I tested right after I bought the glucometer at about 2:30pm, her BG was 31!!! She was not and is still not today showing any signs of hypoglycemia. I take that back she is ravenously hungry! So after I tested her yesterday afternoon (I was freaking out a little), I gave her a 3oz can of canin hills. At her 7pm shot time I started to try to get a BG at 6:30. I wasn’t having any luck and getting pretty frustrated. By 7:15 I just decided to give her the lantus and a 3oz can of royal canin. Big Mistake… about 5 mins later I finally got a BD it was 37 . I knew I needed to continue to test her last night and I tried pretty much all night but couldn’t get another blood sample. I feed her extra food and kept a close eye on her till I went to bed. This morning a got a BG of 32, I did not give her the lantus and just feed her one of the Fancy Feast I bought yesterday (tender beef and chicken feast). I know I need to get her to the vet… I’ve just lost a lot of faith in them…and also I’m already in over my head $$$ wise already. My husband doesn’t support all the spending on her. I could really use some advice and support! I also know I should be getting BGs but it took me a half hour to get the one this morning and I hate torturing my Kitty!!!
 
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Do you have any higher carb food in the house -- such as Fancy Feast Gravy lovers?

You can feed her 1-2 tsp of the gravy portion only of the food
Test in 30 minutes
and repeat as necessary

If you don't have high carb food, you can use any simple sugar - karo, syrup, even take white table sugar and dissolve in water and syringe that into her

It will get her BG 's up, but may not keep them up.

The key is knowing how long since last insulin
 
alright - we will get through this -- you need to be testing her bg every 15-30 minutes and we need to get it up
the key is feeding the higher carb food (or gravy preferred) as you don't want to overstuff her and get her full that she won't eat.

You need to test
feed
test again

and we need to see three consecutive rising numbers to know that she is out of danger
 
I'm having trouble getting blood after I freehand stick her... I feel like her ears are all tore up... any advice on getting the ears to bleed better? I'm using a warmed up baby sock with rice already.
 
TREATMENT

During treatment for hypoglycemia, try to test every 15 - 20 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a teaspoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.
 
Alright.... my husband isn't gonna like it but I think I'm just gonna have to take her to the vet. There is no way I'm gonna be able to get a sample every 15 min. it took me a half hour to get the one this morning :(
 
Amyitsallgood said:
I'm having trouble getting blood after I freehand stick her... I feel like her ears are all tore up... any advice on getting the ears to bleed better? I'm using a warmed up baby sock with rice already.
Click to expand...


ok first calm down.

When freehanding, I found that it was easier to go in at an angle, not straight on like piercing. see this pic

You can massage or "milk" the ear to get blood flowing. You can even poke several times to get it flowing

Also you can use petroleum jelly on ear (massage it on) and it will bead up any blood and make it easier for testing.

What meter are you using? As some meters require large samples and others don't
 

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going back to a previous question... On hand i have the meow mix she eat before diagnosis, dry royal canin diabetic, and the low carb fancy feast mixes i bought yesterday. when i tried getting a sample about a half hour ago I let her munch on the dry canin (but she doesn't like it much)
 
Amyitsallgood said:
no i didn't give insulin this morning... so its been about 16 hrs now...
Click to expand...
Aha....
Then you should, hopefully, start to see the blood glucose come up now.
Amy, are you able to get another test?
Delilah's ears will recover, I promise. And she will forgive you. It may help if you tell her that you're testing her to try to keep her safe. ;)
 
Things that can help to get a blood sample are:
1. Warming the ear.
2. Putting a little pressure on the underside of the ear, opposite to where you're pricking. The lancet needs something to resist otherwise it can push the ear away rather than prick it. Some folks use a piece of folded tissue or some cotton wool, but I just use my finger (and sometimes get blood from myself that way...)
3. Massaging immediately below the ear prick can 'milk' out a little more blood.
4. Two ear pricks close together may get enough blood for a test where one ear prick might not.
5. A teesny weensy smear of vaseline on the outer edge of the ear can help the blood to 'bead up' rather than disappear into the fur.

Sending you 'good hometesting vibes'!
 
Sorry - the board crashed and just came back online.

OK - she is out of the danger zone. What you want to do is give her some wet food only - if you don't have any higher carb wet food - then take a tsp of the low carb and give her that. As long as her BG stays above 50, you are not in danger.

As for whether to give insulin later or not, well that is something we will need to see, as you test throughout the day. And if insulin is given, she gets a reduced dose.

Normally we recommend a starting dose of 1 unit or even 1/2 unit. Never do we start with 2 units at a time.
 
Dang vet! So as I tested I gave her about a 1/2 tbs of the FF beef and chicken feast. How often should I try to torture her and I?
 
Well done for getting that test. Yay! :cat:

It will be interesting to see what Delilah's blood glucose level is later on....

We recommend that, as a minimum, folks test the blood glucose before every insulin shot.
And the general recommendation for those new to dealing with diabetes (or who don't have much hometesting data) is that no shot is given if the pre-shot blood glucose is below 200.
Do post back here later on for advice on insulin dosage (when Delilah's next shot is due.)

Besides the pre-shot test, it is also helpful to get another test or two during the insulin cycle - if possible - to see how low the blood glucose is dropping.
Lantus dosing is worked out according to the lowest number of the cycle.

Hometesting should become easier for you with just a little practice.
Are you rewarding Delilah with treats after the tests?

Eliz
 
every 30 minutes
until you see either 3 consecutive rising numbers or staying steady numbers in the 60 range

then you can leave her be until getting closer to shot time, which you may be skipping

as a newbie, we also suggest a shoot/no shoot number of 200 - meaning if the bg is under that, you may want to skip the shot. As you get more comfortable and familiar with home testing and giving insulin, you can lower this number and eliminate altogether -- usually you only have it for the couple days, maybe a week.

given how low she went, a couple things may happen:

1) she may go very high as a result of the dry food you gave her and that can take a couple days to get out of her system -- in which case, you may want to give some insulin

2) she may stay within normal BG range in which you would then most likely skip the shot.

I suggest that when you do give insulin again, that you start over at a safe dose of 1/2 unit or 1 unit max.

AND given that she had ketones - you need to be doubly careful as you don't want her to have ketones again and it turning into DKA - which means a potentially lengthy vet stay.

OK - please answer some questions -

what insulin are you using?
what syringe are you using? does it have 1/2 unit markings?
 
I do not think this cat needs insulin. last shot last night and numbers are great. I would leave her alone and test again when next shot would have been due.. at 7PM tonight and we can take it from there.. IF any insulin is needed, I do not think more than 1/2u should be given but please post first with numbers.

you can put a little neosporin on her ears for healing. just a little and rub it around. and after testing, put a little pressure on the spot for a few seconds.

also, you can put the drop of blood on your finger and test it from there if you have a fidgety kitty
 
I would also think the vet would have kept kitty if ketones, whatchya think HIL. small or whatever would need flushed.

add some water to her lo carb food also. this will
help keep ketones flushed out
 
Thank you all so much for your support!!! I will definetly get a BG at 7 tonight and post the result here before i do anything. I might also try to get a couple BG before then too but we'll see how much I feel like torturing myself! What kind of treats do you reccomend giving her after tests?
 
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So we are using Lantus garline insulin. The syringes unfortunately do not have 1/2 unit markings. they are U-100 UltiCare for 30 units or less 29 Gauge
 
someone can post the treats as there are many but I use freeze dried chicken. I buy on line and it is the dog ones. more bang for the buck. can also give bonito flakes.

I have seen cats have ketones with lower BG but usually something else is causing it. some infection somewhere but usually it takes 3 things, high BG, not eating and not enough insulin, sometimes infection also
 
ts see where bg goes and it may be worth investing in 1/2u syringes. I have used relion from walmart. sometimes they do not know they carry the 1/2 unit ones
 
I am a newbie and cannot really offer advice, only encouragement. With the advice of the experienced members of this forum, getting blood does get easier, truly it does. I was in tears the first several days, but now I seem to be able to get some just about every time I try.
Take care, thinking of you guys.
 
Also I have some questions about how much and what I should be feeding her. Yesterday I bought several varieties of the low carb FF that are recommended on Dr. Lynne's wet food shopping list. Is it ok to feed her all the different varieties of FF or should i stick to just one, for example only feed her beef and chicken feast or is it ok to switch it up every meal? Also do I feed her the whole 3oz can at one meal? Before she was diagnosed she had lost some weight, I think she now weighs about 8.9 lbs
 
More Questions??? Is it worth it to buy the monitor that tests for both BG and Ketones. It looks like I need to at least buy the stripes to test the urine? If she still has ketones is the only way to get rid of them a lengthy and $$$ vet stay?
 
yes, you can mix and match all low carb FF. accordind to dr. lisa. 6 oz is a normal amount in a day. too fat, feed less, too skinny feed more

now, you can divide that 6oz up any way you like and feed several small feedings a day. this helps the pancreas by not having to work so hard eating a large meal. I was never home all day, so mine only got 2 meals a day.

unless your cat is really prone to ketones, I do not think I would get a meter like that. most here use the relion confirm or prime as the strips are the mot affordable.

as long as you have her numbers good and the right insulin and she is eating ok, ketones are low on the list.

remember to add water to her food. mine liked it really soupy and I make my own homemade food
 
on the ketones, $$$$ depends on how sick she gets with them. some may get a small on the strips and in a matter of hours go to large and needs emergency RX. but adding water to food and keeping everything else in balance should help.
if she is prone to ketones, then it is a possibility any infection could trigger them because that will raise BG and then not eating and not enough insulin. comes round to full circle
follow me?
 
OK - to answer your questions -

What kind of treats do you reccomend giving her after tests?

here is a link to a list of low carb healthy treats -- you can even use baked, boiled or rotisserie chicken (just no seasonings on the part you give her). Canned tuna works too.

http://www.felinediabetes.com/FDMB/threads/list-of-low-carb-healthy-treats.9172/

Is it possible to still have ketones and have such low BGs?

Anything is possible. It's probably unlikely, but it can happen. This is why you will want to test for ketones, if possible once a day is enough.


Is it worth it to buy the monitor that tests for both BG and Ketones. It looks like I need to at least buy the stripes to test the urine?

PErsonally, those meters are very expensive and you can just purchase ketostix or keto diastix at the pharmacy (usually in the diabetes section). Then you would need to stalk the litter box and catch her either while she is peeing, or set up the litterbox to capture the pee before it goes into the litter. Such as putting plastic wrap on to of the litter.

If she still has ketones is the only way to get rid of them a lengthy and $$$ vet stay?
Not necessarily, all the vet will do is flush them with IV fluids, you can do same at home by adding water to the food (I add anywhere from 1/2 can to 1 full can of water to food) and if necessary, getting the vet to write you a scrip for subQ fluids that you can administer at home to flush the ketones out.

Also I have some questions about how much and what I should be feeding her. Yesterday I bought several varieties of the low carb FF that are recommended on Dr. Lynne's wet food shopping list. Is it ok to feed her all the different varieties of FF or should i stick to just one, for example only feed her beef and chicken feast or is it ok to switch it up every meal? Also do I feed her the whole 3oz can at one meal?

Unregulated diabetes, will be very hungry and will require more than the normal amount of food. Once the bg's regulate that need for extra food will diminish.

For example, when Maui was diagnosed she could eat 2-3 cans of FF at one time, 3 times a day. As she got regulated she would eat 1/2 - 1 can at a time (all with full can of water added).

Many people find feeding several smaller meals works best to maintain steady bg levels. I put out food twice a day - as my cats are grazers and will eat it throughout the day, rather than eat a full meal.

There are all kinds of formulas and calculations for determine just how much food to give. Personally, I let Maui eat as much as she needed/wanted and then it slowed down to her eating up to 2 cans a day.
 
I like the thought of her being able to eat when and how much she wants. I feel like I've been starving her since this whole thing started. But then my question is won't the amount of insulin she needs very a lot from day to day? But I guess thats the whole point of home testing, right?
 
Regarding ketones, I would strongly suggest that you do get some Ketodiastix (or generic equivalent) and test Delilah's pee. Crumpling plastic food wrap in the litter tray is a good way to catch a sample, and you only need a tiny amount for testing.
Anything above a trace level is considered a reason for a vet visit ASAP.
Some ketones, as you've found out, Amy, have a strong smell like acetone/peardrops; so you can also remain vigilant for that smell returning.

One advantage of the ketone blood testing meter is that it will show up ketones sooner. Ketones may be detected in the blood a few days before they can be detected in the urine. So, for a cat who is prone to ketones, a meter that tests the blood could be a useful tool and a sound investment.

Ketones can develop into a condition called diabetic ketoacidosis ('DKA') which is extremely dangerous and is expensive to treat.
For an explanation of how that happens you may wish to have a look at this information sticky:
Diabetic Ketoacidosis (DKA)

Eliz
 
Amyitsallgood said:
I like the thought of her being able to eat when and how much she wants. I feel like I've been starving her since this whole thing started. But then my question is won't the amount of insulin she needs very a lot from day to day? But I guess thats the whole point of home testing, right?
Click to expand...

Exactly, you need to home test regularly to see just how she is doing and just like with people, when you eat, exercise, get excited, BG fluctuates, same with cats.

Feeding meals, lets you know for sure just how much she is eating or not eating. Yet, leaving food out, gives her the freedom to eat when she wants. And if her BG drops low, she will have access to food and can bring herself up with the food.
 
So I just poked my cat 4 times! She should have bled!!! How come I can't get a drop? Kitty is really angry now and I'm not sure what to do...
 
If you absolutely must get blood, aim directly for the ear vein near the edge. It may bleed profusely, so be prepared to get the droplet and blot firmly.

Also be sure to warm the ear to improve blood flow.
 
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