newbie needs help with hypoglycemia

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ellenjo

Member Since 2013
Hi all-
My cat (Sammie, female) was diagnosed with diabetes 6 weeks ago. Her bloodwork showed a BG of 547. Everything else was normal. (I brought her in due to excessive drinking & urination) I don't know how old she is - she's a rescue, but we've had her 8 years, so probably 10-12. The vet started her on 2.5 u humulin-N 2x/day & wanted to do a BG curve at the vet's but I had read on here that might not be the best thing. I switched vets because the first vet hadn't treated any diabetic cats in about 9 years & I didn't feel comfortable with answers to my questions. I found a vet who has several diabetic patients & had one of her own.
I got a meter but have a lot of trouble getting BG's - she doesn't like to be handled & it's just me now (my partner & her best buddy passed away last Nov). I got one about 3 wks ago & it was 200 about 2 hrs after eating & getting her insulin. The vet did a fructosamine a week ago & she said it was low & decreased her insulin to 2 units. (I don't know the # the fructosamine was).
I managed to get a BG yesterday morning about 4 1/2 hrs after eating & insulin & it was 47. she has no symptoms of hypoglycemia. I called the vet right away, & she said to give her carbs, which I did, & said not to give her any more insulin until sunday, and not to give her any if her BG was belwo 200. We decided to switch her over to the PZI for when she restarts. I just got another BG tonight prior to her eating (altho she nibbles some during the day) & it has only gone up to 56. I fed her her regular wet food, but she didn't eat too much. I just gave her a bunch of cat treats - either Pounce or Whiskas Temptations. I'm very concerned - I don't want to panic, but not sure what to do other than just watching her & make sure she's eating. What would cause her BG to stay so low for such a long time?
I have been reading all the info on this web site, and read posts recently to another newbie. I'm in a similar situation - very little money, and trying to do the best I can for her. Neither vet even recommended doing BG's at home - I just read about doing it here, and as you have read, have not been doing it except the 2 times. I'm going to try to get another 1 tonight to see if it's gone up. I feel neglectful that I haven't been able to get her BG's on a regular basis after reading everything on this site. When I have tried either I don't get any blood, or she gets upset with me handling her too long. I have to be very sneaky about everything with her & giving her her insulin took about 2 weeks until we got a pretty good routine, and it is working pretty well now. I was extremely anxious which probably didn't help.
If anyone is out there on a Sat night, please tell me what I should be doing here. I just got a new bottle on PZI after having spent a lot on the humulin-N, and don't want to haul her off to the emergency vet if I can avoid it, but will , or course, if it seems prudent. Everything I've had to get so far has gone on a credit card, and I will do whatever I need to do, but having a hard time making ends meet here.
Thanks for whatever advice you can offer.
Ellen
 
Then she should be fine. Insulin usually lasts only 12 hours so it should be out of her body. I would keep monitoring her. If she goes up in the 200s, you might give a little insulin, but not 2 units. That was clearly too high of a dose.

Sounds like she is doing well. Re testing. Do you sure give her a treat after each test? That's the secret - so she looks forward to the treat and is willing to let you poke her to get it.
 
Welcome to the board!

Make sure you always test before shooting because with pzi you don't want to shoot if she is under 150. Sue knows more about pzi than me and will be able to advise more..by the way 50-130 is normal cat numbers.

Wendy
 
I would up that number to 200 as you don't have many numbers. Once you have some data and can predict what she might do, you can lower your no shoot number.
 
Thanks everyone - I guess I was concerned that she had only gone up 9 points in 36 hours. Everything I had been reading said hypoglycemia was in the range below 60 - is that not correct?
 
Hypo is usually considered 50 and under - on insulin. A cat off insulin doesn't hypo. 50 is a normal number for a cat off insulin.

Wonder if she will continue to stay in normal numbers iwthout insulin? That would be wonderful!
 
oh, thanks for that info & YES, that would be wonderful! I had read that cats can go into remission - it would seem to good to be true! Thanks to everyone for responding so quickly. I was whipping myself into a good anxiety attack!
 
Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- lowest no shot limit for ProZinc, PZI, or other non-depot insulins, after you have been testing at least 5 weeks and reduced your limit gradually - maybe 10 mg/dL{.5 mmol/L} per week.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
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