Newbie with Hypo Kitty

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heidi

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Frodo had a BG reading of 40 about 15 minutes ago. He is acting normal. My chart is not filled in yet (sorry, still trying to figure it out.) Here's the important information.

He was fed at 7:30 (canned low carb) and got his shot at 7:45. 1.5 units of Lantus. I had to leave for a doctor's appt., so my mom was with him. I assume he finished his food. I did not get a successful blood test pre-shot.

I tested him 6 hours post shot and got the 40 reading. I went ahead and gave him another meal of his low-carb canned food. He ate it and is currently licking his paws. No, signs of stress.

I'm assuming I need to watch him like a hawk for the next how many hours? At least 4 right? Then it's probably imperative that I get a successful blood test before I give him a shot tonight.

Any other thoughts or suggestions? I'm a little freaked out.

Heidi
ps. I got a 52 reading 5.5 hours post shot on Sunday, so this looks like a pattern of dipping low.
 
You may want to feed him some high carb food, then test in about 15-20min.
Food does not last long so you may test and see his numbers come up but an hour later they could be low again.
I would think you may want to lower the dose from 1.5u to 1u as well.
 
Heidi, do you have another test yet? You'll need to test every 15-20 minutes until you have 2 rising numbers. The food will start to spike them shortly.

Did you feed hc food?

Yes he's definitely earned a reduction....

HUGS
 
Gidday Hypokittymum.

viewtopic.php?f=28&t=61799
Akbah has had a few sessions around those numbers lately so I perfected a honeygravy recipe that he really enjoys:
half a teaspoon honey
one and a half teaspoons gravy
warm water, like I guess, two teaspoons? enough to make a stinky sort of soupy/gravy consistency. Like a thin gravy.
administer to your cat, one teaspoon at a time, every 15 mins till the next reading.
Once numbers go over 50, stop with the gravy.

It was scary for the me the first time, after that I realised its a matter of watching his blood and giving gravy.
I dont' know Lantus but I should expect he will pass his nadir at some point soon.
 
And you can possibly expect Kitty to feel upset after all the sweet HC foods... kinda like eating everything in the candy store!
 
I just got another test. Frodo and I are still working out the whole blood testing thing . . . It's been 7 hours post shot now (1 hr. since the 40 reading) and I got a 42 reading this time. I gave him a high carb treat and now he's hiding from me. We really haven't gotten the blood testing down (sigh). Thanks for your responses. I'll try to get another test in a half hour or so.
Heidi
 
Please keep testing every 30min and feeding the high carb... feed the forties is the good rule.
It's looking like you're skipping the insulin this coming shot maybe; keep in mind that after a low number, many cats are more sensitive to insulin.

You want to bring numbers up from the forties and not drop down again.
 
Also, you don't want to feed your kitty too much at a time. This may take a couple or more hours, and you don't want your kitty to be so full he doesn't want to eat anymore. You can give him mostly gravy from the high carb food. The gravy is where most of the carbs are and isn't as filling as the meat.
 
It looks like having some high carb food on hand is a must . . .
I've tried a couple times and haven't gotten another successful test. I did get the ear to bleed but keep getting error messages for not enough blood. Frodo is looking good and acting normal. We're taking a break from pokes, so I can feed my sons. Then we'll try again.
Thanks for hanging in there with us.
Heidi
 
Just got another successful test. Frodo's back down to 40 at about 11 hours post shot. I fed him some of his regular food with honey mixed in. He loved it. He is acting very hungry despite the treats/food he's been getting all afternoon, so I also gave him some of the dry kibble I've kept for the other kitties to occasionally munch.

So, this means no shot tonight. Let's see -- I also have to keep trying to test every half hour (or hour if I'm lucky . . . Oy!) until I see a trend of it going back up.

What about tomorrow morning? No shot unless the numbers are how high? And then what do I do about dosing? He's been on 1.5 units Lantus 2 x day for ten days now (before that he was on Humulin N and didn't do well at all on it). My vet wasn't in the office this afternoon when I tried to call, but his vet tech said to drop down to 1.0 units tonight IF the pre-shot BG was over 300 (not going to happen . . . ) She also said to go to 1.0 units tomorrow morning unless I was able to talk to the vet before that and he said something else. This sounds like good advice to me. Does it sound right to you? I'm worried because I have to be in class tomorrow morning and won't be home to monitor him. I could probably get my dad to come by a couple times and check on him.

What do you guys do when you have to work or go to school? I'm a little freaked out about that!

Thanks,
Heidi
 
heidi said:
My chart is not filled in yet (sorry, still trying to figure it out.)
Click to expand...

I posted in your thread in Tech of how to use the spreadsheet: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=61889#p669340

Date - Self explanatory :smile:

AMPS - AM (morning) pre-insulin blood glucose test

PMPS - PM (evening) pre-insulin blood glucose test

U - units of insulin given

The + numbers - indicates the blood gluocse reading at X number of hours after the insulin injection. Example: +3 255 means that 3 hours after the insulin injection the blood glucose level was at 255. The boxes in the + columns will automatically fill in with color when you enter a number in. The color key is at the top of the SS (red for 400-400, blue for 100-199, etc).

Remarks - just notes like if your cat threw up, didn't eat, you started a new bottle of insulin, vet visit, etc.

Take a look at other members' spreadsheets to see how data is entered :smile:

Sometimes if the test strip doesn't completely fill with blood you'll get an unusually low number. Anytime you test and get a low number which doesn't seem right, test again and make sure that the test strip fills with blood.
 
Heidi:

Hi there...popping over from Lantus Land. Sounds like Frodo is done with this dose! His numbers are not all that different but I would have liked to see him come up more than that. The honey will help but will wear off. Dry food takes a bit of time to kick in but then you might see his BG shooting up like crazy from (a) the low numbers and (b) the dry food. Dry food tends to keep their numbers high for a longer time than just the HC gravy and/or honey/syrup/karo.

I think you should plan to skip the shot tonight unless you test him at +12 and he has come up above 200. If he comes up above 200 by shot time, you could shoot the reduced dose your vet tech recommended.

Without a spreadsheet or knowing what protocol you are following (Tight Regulation or Start Low Go Slow), my suggestion is that you follow your vet's advice on dosing. However, I would definitely plan to reduce his insulin.

Once you get past this, let us know and we can provide you with information about the protocols. Please keep testing every 30 minutes until you have a few rising numbers over a couple hours. It typically takes about two hours for HC food and/or karo to wear off.
 
As far as dosing and shots, nothing tonite for sure, and wait till the morning to see what number you get.
Be sure to test tonite as you want a much higher number than 40 before you go to sleep. Two rising numbers, and you can figure Kitty is rising.
 
I know about the two rising numbers rule, but without much data to go by, I think in this case, I'd kind of like to see the kitty in the 80s before she called it a night and went to sleep, tonight. The high carb can wear off and the kitty can drop again. Sorry Heidi, hope it happens soon.
 
Success! Just got a 113 BG level at about 13 hours post shot. I did not give a shot tonight . . . I'm playing with the spread sheet and hope to have numbers recorded soon.

Thanks everyone. What a relief!
 
I was just checking back to see if there was an update, Heidi.

I think Dyana's suggestion that the numbers be over 80 before you go to bed is a good one. I would say at least that because he could come up to 80, HC wear off, and come back down. So I like to see the rising numbers after no food has been given for a while. For example, if he was at 40 at +11 and you fed him HC and he came up to 50 at +11.5 (and you didn't feed) and 60 at +12 (and you didn't feed), I'd keep testing him until you get a couple of rising numbers above 80 after that two hour timeframe of no food. Then you will know that the number is not food/syrup influenced.

ETA: Just saw your post. Wonderful....so please read my info on the food. If you have not fed since +12, how about getting another test at +14 and make sure he is still coming up?

Thank you.
 
Heidi:

I wanted to provide you some information about the two lantus protocols available in FDMB.

The Tight Regulation protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range, ie, 50-120. caregivers following this protocol adjust insulin doses following the protocol guidelines, to aim for that range. in order to follow the TR protocol, caregivers need to test a minimum of preshot time (to determine if it's safe to give insulin) and during mid-cycle (to find the lowest point of the cycle in order to determine dosing). if the cat is likely to get into low numbers, then the caregiver needs to test enough to keep the cat safe. basic information on the TR is here: TR. if you want to follow the TR protocol, we strongly encourage you to post daily in the Lantus TR insulin support forum for a while to learn more about how it all works. There are specific requisites to following the TR protocol. These include monitoring BG levels at least at PS, +3, +6, +9, learning the signs of hypoglycemia and how to treat it, preparing a hypo toolbox, testing regularly for ketones with urine ketostix, using the correct insulin syringes, feeding several small meals a day of a high quality, low carb canned or raw food diet.

The Start Low Go Slow protocol has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. The low number in that curve determines any dose change for the following week. Basic information on the SLGS protocol is here SLGS. If you want to follow the SLGS protocol, you can post for advice on the TR ISG, the Relaxed Lantus or Main health for guidance and support.

Please let us know if you have questions and how we can help you.
 
Thanks, Marje, for the information and support. I'm hoping regular testing will become part of our management plan, but testing is not going well right now. I've been trying to get a second confirmation test that Frodo hasn't dipped again, but I think he's done tonight. He's biting, scratching and acting almost wild at this point (although calm and happy again as soon as I'm not restraining him and I put the nasty poker away). Anyway, it's counter productive at this point. He's fighting me with everything he's got and even the little blood I did get this last time was smeared into his cocooning blanket. I will have to just let go tonight and trust he's okay.
Heidi
 
You're welcome. Maybe just give him a little extra food before you go to bed. Better to have him up and safe.

Good job, Heidi. Hope we see you and Frodo again and can help you.
 
Checking back in to see how Frodo went, I thought of him today. Sounds like he had a bad time with the poker and the towel.
Hope you get better numbers tomorrow.
 
Frodo did fine through the night and had a pre-shot BG of 510 this morning. Thank you to everyone who stuck with me during the day and evening/night. I decided it was much better to be safe than sorry and left some high carb food out for him to nibble on when I went to bed (about 16 hours post shot and 3 hours after the 113 BG reading). I'm going to start a new post about today and how to go forward from here. Yes, testing is not going well for us, but I am glad I tested him yesterday and was able to see what was going on and intervene. We will keep trying to test until we learn. Hopefully those capillaries will start developing soon . . .

Thanks again. I am so grateful for this board.
Heidi
 
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