Newbie with low BG numbers

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angusc

Member Since 2012
Hello everyone.

New here, but have a pressing question.

We were diagnosed diabetic after a DKA episode about 4 weeks ago. We have been administering insulin twice a day since and our cat seems happy and healthy.

Today. I was finally sucessful getting blood samples from our cat and undertook a glucose curve as our vet requested. Data so far:

6:45am bg 40
6:50am breakfast and insulin
8:35am bg 36
10:30am 29
12:30pm 42
2:30pm 27
4:30pm 69

I am very concerned about the numbers being so low. My understanding is that anything under 65 is really bad. It will be Monday before I can talk to the vet. Should I cut back on insulin?

cat is acting fine, no hypo symptoms. Current insulin dose is 1 unit Glargine lantus 100u/ml

Thanks for any advice
 
40-70 is normal for a cat that is not on insulin. If you're giving insulin, that range can quickly dip into hypo range so that's why it's "dangerous". Readings in the 20s is dangerous even on a low dosage of insulin. If I were you, I would discontinue the insulin and continue to test until you can get ahold of your vet. Comtinue to post your readings here for advice. Could be that kitty no longer needs insulin or needs a much lower dose.

Just to be sure, can you check your blood with the same meter? Human BG should be 70-100 fasting, and below 140 if you have not eaten in >2 hours. If yours is way off from that range, could be a meter problem. Also, if you don't get enough blood or don't get it all in one go the meter can read low - but you have many tests in a row in the same range, so I'd be inclined to say those are real readings.

Did you change his/her diet since the DKA? Going from dry food to wet or from higher carb to lower carb food can have a big impact. Also, does kitty have other health problems or recently get a steroid injection or other meds before the DKA incident?

Thanks for reaching out. I hope we can help.

Lori
 
If you got those numbers today, then yes, you should definitely cut back on the dose.
How long until you are supposed to shoot the next dose of insulin?

I'm going to cross link this post over in the Lantus TR forum, for some more eyes.
 
Next dose is in an hour. Cut in half
or skip entirely? I plan to monitor hYogier closely until Monday.
 
I'm thinking to cut the dose in half, but you will need to be able to test throughout the night time too.

I'm so glad you are testing. Do you have any other numbers besides these, for us to reference?
Being that your cat was DKA, it's a little tricky. I have asked for help from others on the Lantus board.

Edited: to cross out the recommendation to shoot.
 
Because of your cat's very low numbers, today, it might be better to just skip the shot tonight.


Let's see what her +12 number is. Can you post the number you get and ask for advise before shooting any insulin?
I will be watching for it. We usually don't have a newbie shoot if their cat is below a certain number, like 200 or 150.
 
6:30pm 51
The only other numbers I have are from when she was hospitalized. 155 when released.

That was four Weeks ago.

Diet wise zhe eats only hills w/d low fat diabetic gastrointestinal.
 
Okay, please don't shoot any insulin tonight. That is too low of a number.

My computer is acting funny, so I'm going to log off and back on again.
 
May I ask what is your name?

I would continue to test your kitty, tonight, as 51 is still a very low number. After she eats, if her pancreas is working somewhat, she could continue to go down. Do you have any karo or any wet food with gravy in it, to give her if she should go down too low?
 
Lantus is a long acting insulin, and what you gave her previously, could still affect her tonight.
 
My name is Angus, kitty is Cashew.

We have Karo on hand.

We really appreciate your concern and advice.
 
Hi Angus and Cashew. And Welcome :-D

I will be looking for your morning BG number, so please post it, before you give any insulin okay?
Is that at about 6:30am EDT?

Also, if you can set an alarm or two, and get some more tests tonight, that would be great.

We will want you to set up a Google Docs spreadsheet, so we can help you with the dose.'
Here are the instructions on how to set it up and to link it to your signature:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Are you giving the wet or the dry food of w/d?

Once again, I am so glad you are testing Cashew, and that you found this site :-D .
 
Hi Angus,
Can you tell us which meter you are using?

I agree with Dyana that skipping tonight is the right thing to do. Like she said, you should continue to test tonight because the way Lantus works, she can still have some in her system that could affect her numbers tonight.

Are you in the Eastern time zone?

Carl
 
Yes, it will be around 6:30edt tomorrow. I will post.
Feeding wet w/d.

Using Walmart relion meter.

I'm new to all this, but could we possibly be in remision. Probably to soon to say.

Just want to safely get through the weekend to confer with our vet on Monday.
 
I would say that Cashew is looking good. :-D I'll see you in the morning. Don't forget to test tonight ;-)
 
You may be well on the way to "diet controlled diabetic" cat! Nobody has mentioned this yet, but that w/d food, even though it is canned (much, much better than any dry food), it is still pretty high in carbohydrates. Once you get past this low number situation tonight, tomorrow you might consider a switch to a lower carb canned food, which will help the numbers considerably (even without insulin).
A low carb wet food diet is one of the most important factors when dealing with feline diabetes. Low carb is anything that contains less than 10% of its calories from carbohydrates. W/D has 26%, so we'd refer to that as "high-carbs".

The concern with Cashew is that you've had to deal with DKA on top of just diabetes. So insulin is still important since it will help avoid the reappearance of ketones. But, let's take this one thing at a time, one day at a time. Right now, just keep monitoring to make sure the numbers don't fall. In the AM, before you give a shot, post here for any advice needed. Someone should be online at that time to help if needed.

Oh, thanks for the info on your meter. The Relion meter is just fine, and lots of us use one. Just wanted to make sure that you weren't using any meter that had been discovered to give bad readings by others here. You're "good to go" with the Relion.

Carl
 
Hi Angus and "welcome" :cool:

Plenty of good advice has been given, on what must feel like a really scary day. You can breathe a bit easier - you came to the right place :cool:

A few questions, to round out the picture a bit more.

How are Cashews weight and appetite?
What can you tell us about the DKA episode? Any symptoms in the days leading up to it ?
Do you know what Cashews BG was at diagnosis?
 
Hi Angus

Dyana asked me to check in and see how Cashew is doing. Have you gotten another test just to make sure she is coming up?
 
Can you answer some of Sandy's questions, Angus? Just to help us to help you.


That BG number this morning, is really good news :-D
 
With regard to Sandy's questions, appetite is good. On the weight grading scale of 1-10 with 5 being ideal, she rated a 6, so slightly overweight.

The DKA episodewas precipitated by a steroid shot. We took her to our regular vet because she was picking at her fur in certain spots. The vet said it was allergies and recommended the shot. Our first question was "is there any risk?" Vet said no. Three days later she was like a ragdoll, completely lethergic and not loooking well.

Our vet referred us to the Internal Medicine unit at the NC State vet school. She spent three days in ICU. initial BG was 579.

Since bringing her home, she has been looking health and happy. I have had a hard time learning to get blood from her. Hence the four week delay from release from the hosipital to now to get a daylong test.

Saw your other post, no shot this morning.

Thanks
 
Vet schools are good places, I think, to take your cat. My cat had DKA and was hospitalized for 8 1/2 days at the UPenn Vet School in Philadelphia.

I'm glad her appetite is good. How long has she been eating this special food, and does she seem to like it? I'm just asking because my cats like lots of variety.

Cashew sounds like she is doing really well. I think you may be a very lucky care giver, and have her diet controlled.
That means no high carb food. No regular cat treats (you can give her all meat treats, like chicken, or steak, or shrimp, or the freeze dried 100% meat treats that are normally found in the dog isle of pet stores).
 
angusc said:
appetite is good. On the weight grading scale of 1-10 with 5 being ideal, she rated a 6, so slightly overweight.
Click to expand...
Beautiful
Lori&Scout said:
Also, does kitty have other health problems or recently get a steroid injection or other meds before the DKA incident?
Click to expand...
I believe high BGs can indeed be a side effect of steroid use. Which vet will you be consulting with on Monday ?

So glad you are testing Cashews BGs - keep at it, it will get easier for both you and Cashew.
And although it may sound kooky in light of the currently low BG numbers, please continue to check for ketones.
A kitty does not need to have crazy high BGs for ketones to develop. ECID (every cat is different).
It's all about energy, in the form of glucose, being able to reach the cellular level. That can get out of whack regardless of BG.

Random thought - I wonder if a switch to one of the many available quality low carb canned foods would also improve the skin problems she may have. . .

Keep us posted :cool:
 
Definitely going back to the vet school. They wouldn't come rivht out and say it, but they implied that the steroid shot was probably the culprit.

I will discuss the low carb food also.

Bg numbers today holding steady in the 70-85 range.

Thanks toeveryone for helping us through the weekend.
 
Glad you and Cashew are doing well. Fingers crossed his numbers stay so low!

I first noticed Scout was sick when she was limping and having trouble going up stairs. But when the vet mistook diabetic neuropathy for arthritis and gave her cortisone, she got 100x worse in very short order and then I put two and two together with the increased thirst and hunger and constantly full litter box. Once my regular vet saw her, she said there was a good chance she would not need insulin long term if the steroid had made her diabetes worse - once it was out of her system her sugar levels might go down to a level that did not need to be treated with insulin. In some respects, the fact that the cortisone made her so sick was the reason I found out about the diabetes and was able to change her diet and help her get better. Blessings in disguise and all that. :)

Anyway, please keep us posted. Fingers crossed over here for little Cashew!

Lori
 
The vet school vet said Cashew was probably borderline diabetic prior to the shot. The shot inhibited the pancreas and then the DKA occured. Its a blessing to know, but an expensive one with the hospitalization.

Waiting for a callback from the vet at the moment.
 
Glad we were stable. Vet got back to me yesterday.

Her recommendation is to cut the insulin dose in half, monitor clasely and do another glucose curve in a week and a half. At that point we would re-evaluate dosage and diet.

While I am anxious to know "the answer," I understand that small changes have to be made while monitoring results.

Cashew has been much more energetic since the numbers have come up. She and our other cat have been playing chase for the first time since she came home from the hospital.

Thanks again everyone.
 
angusc said:
Glad we were stable. Vet got back to me yesterday.

Her recommendation is to cut the insulin dose in half, monitor clasely and do another glucose curve in a week and a half. At that point we would re-evaluate dosage and diet.
Click to expand...
Did the vet give you a number when you should not shoot? Are you still getting non-diabetic numbers?

If this were my cat, I would not give insulin if I got numbers under 200, let alone under 100. If you do give .5 unit with low numbers, be sure to keep a close eye on Cashew's numbers.
 
I agree. I would test before every shot, and skip the shot if she is less than 200. If you do give her insulin, you'll want to get some tests in, at least the preshot test and a test at her lowest point, usually around +5 or +6 with Lantus.
 
My regular vet was the one that recommended cutting in half.

Finally got hold of the vet school vet today. She was alarmed by the numbers and said to discontinue all insulin, monitor bg before every meal, and do a curve in the next few days. Since she thinks this whole episode was brought on by the steroid shot, we may be able to go off of insulin completely.

Have been keeping a close eye on Cashew and she seems fine, normal appetite and liter box habits.
 
angusc said:
My regular vet was the one that recommended cutting in half.

Finally got hold of the vet school vet today. She was alarmed by the numbers and said to discontinue all insulin, monitor bg before every meal, and do a curve in the next few days. Since she thinks this whole episode was brought on by the steroid shot, we may be able to go off of insulin completely.

Have been keeping a close eye on Cashew and she seems fine, normal appetite and liter box habits.
Click to expand...

This vet seems to have more up to date information of FD than your other one :lol:

Good to hear that Cashew could be diet controlled and that she is getting back to normal in all other ways.
 
Steroids - ex prednisone & prednisolone - have increased blood glucose as a known side effect.
Its an issue for human diabetics too.
 
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