Oliver -Post Hypo

I hope GA means general advice
Hi all. I realize I did not report Oliver’s readings from last night so:
January 30
5:30 PM PT 249
7:30 PM PT 281

He had no issues in the night, I pulled their food dishes about 10 PM PT.
This morning, 24 hours after last shot, and with an empty tummy is reading is
1/31 7:45 am - 24 hours since last shot:
BG is 579
He was slow on the stairs, but food motivated. He fought his ear prick. That means he is back to his ornery self. “Don’t touch my ears!”
Advice? what next? I have not given any insulin today.
I do appreciate all the help you have given us
Shelley
https://www.felinediabetes.com/FDMB/threads/oliver-was-seizing-now-up-to-232.242335/#post-2730585

 

I'm glad Oliver is ok, The GA means Gone Ahead , a kitty that has passed. You can remove it .
I'm sure some of the experts will come in and give you advice on what to do next

 

No it doesn't! It means 'gone ahead' or 'guardian angel' - for kitties that aren't with us any more.

When I saw it, it put the heart crossways in me! I feared something bad might have happened. I was so relieved to read the rest of your post, Shelley! (((Oliver)))

Tip: If you look to the right hand side of your first post on this thread, you'll see Thread Tools. If you click on that it will give you the option to edit the thread title. To draw less panicky attention to the thread (and to keep everyone's blood pressure normal!) you can change the prefix icon from GA to the question mark.

Oliver's little body went through a lot yesterday. It's not uncommon for kitties to be a bit tired and lethargic for a little while after a hypo but it should wear off. Just keep an eye on him in the meantime. You can post for help any time if you're worried about any of his behaviours [ETA] or clinical signs.

Glad to hear that Oliver's cattitude is working well!

I'm going to leave it to @Marje and Gracie and @Wendy&Neko to give you some input on the insulin side of things.

Again, well done last night for getting Oliver safely through a very scary situation. (((Shelley)))


Mogs
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Gah! Thank you Mogs I will try and change change that title!!

 

Geez. Thanks!! I fixed the title!!

 

That's gonna do wonders for the collective cardiac health of the FDMB community!




Mogs
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PS: You're far from alone in the GA mishaps department. When I first joined the forum I thought, very mistakenly, that there were an unusually high number of FDMB members hailing from Georgia.


Mogs
.

 

haha! Well, I hope I didn’t scare anyone before coffee! Now I know. Thank you!

 

I agree with Mogs.....my heart stopped when I saw that GA even though I’ve seen it used accidentally many times before. I almost spewed my first cup of

I know that BG this morning was a shocker but it’s to be expected because of his hypo yesterday and not receiving insulin. I’m not sure how much sense Tucker’s SS will mean to you yet so I’ll explain it.

Tucker was overdosed by his vet with 6u of Humulin which is a fast-acting insulin. We had him drop the dose back to 1u as that is the usual starting dose but he still dropped to 24 on 7/26. Normally bounces from low BGs like that 24 take six cycles to clear but it took Tucker 8 cycles. When he started him on Lantus at a low dose, it quickly became apparent that he didn’t need insulin.

You can see the same thing happened with Teronto albeit a little differently.

If you can please grab a couple of tests today at maybe what would normally be +3, +6, and +10 if he had gotten a shot this morning, then Wendy, Sienne, and I will discuss and figure out what the best step is next for him. Testing his urine ketones is really important if you can get out.

Thanks, Shelley.

 

Shelley wrote:

To save you a bit of digging around the site, here are some helpful links for you, Shelley:

How to use the spreadsheet

Ketones, diabetic ketoacidosis and ketone meters

Tips for collecting urine samples

Give a shout with any questions you have.


Mogs
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P.S. Tucker, don’t be mean to your sister!

 

Love the picture of Oliver, Shelley. He's an absolutely beautiful cat!

(((Oliver)))


Mogs
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I added his tests just to help out. If you look at the PM I sent you yesterday, I also included instructions on how to use the SS. I need to know, please, when he was diagnosed and how far back you have any BG tests...even from the vet...so I can set up the correct dates. You can send those to me in a private message response to mine yesterday.

 

What a gorgeous kitty Oliver is

 

Sent private message response with the only reads I had and a question about the ss

 

Got it. And he’s gorgeous!

 

Good morning Shelley and Oliver, so happy to see his sweet little face here. And am happy to hear he's eating again.

How's the snow situation? Are you still locked in? One of the tradeoffs for dosing is the number of test strips you have and how long until you could get more. Could you count what's left after yesterday's ordeal?

 

Glad to hear there weren't any more shenanigans with Oliver last night! Sure was one heck of a day!

Hope you'll do a quick update for the Facebook group when you get a chance. Lots of people were concerned and not everybody followed over here to see what happened. You'll have to start a new post since I shut down the one from yesterday so you could concentrate on the advice you were getting here instead. The FB group has it's place, but here is where you needed to be!

Give Oliver a head scritch or tummy rub from all his new aunties!

 

In comment #10 above she says she has to wait for the plow to come in so she can get out to get urine ketone test strips.

 

25 strips left. Chewy will not deliver to my PO Box last I tried and, we have no mailbox and none of the delivery people will drive up here. They put deliveries in a plastic bag and put them in a snowbank way down on the main road. I kid you not. It’s never above freezing here, so I know that is not good for test strips. I’m going to start working on a source. The nearest town is 45 miles and you have to go over a pass. It really is a beautiful place to live except when something like this happens! I’m going to try calling chewy.

 

I will do that. I thought I did, but I don’t think it was since yesterday afternoon. Thanks for the reminder

 

One of the reasons many of us use human blood glucose meters is that they are easier to source. Sounds like you have a way to go to town, but if that town has a pharmacy (or even Walmart), you could get a human meter/strip solution as a backup.

I have a friend who lives up a mountain near here (I'm in British Columbia) - gorgeous place. He snow shoes down to his car to get out this time of year. It's the winter trade off.

 

The Relion Prime meter is $9...a box of 100 strips is $17.88. If you need lancets, a box of 100 is anywhere between about $2 and $12 depending on brand. Most of us freehand the lancet instead of using the lancet device, but if you want one, they're about $5 (or if you find a "combo pack" they usually include the meter, 10 strips, 10 lancets and a lancet device)

If you look in the Facebook group's Files, there's a document titled "Getting Started Shopping List" that has links to products at WalMart so you get the right ones. I don't know why you couldn't order them online but with the problems you have with delivery, I'm not sure if they'd deliver to a PO Box....or a snowbank!

 

Let me check around here because I had a ton of human meters including a Contour and also an extra ReliOn Micro. Although they are no longer making the Micro, they are still making the strips. If I have one, I can fedex it to you tomorrow. You can order the strips through Amazon prime and have them by Tues. There are also meters and strips on Amazon prime of different types.

I’m working on something for another member but when I’m done, I’ll check on my meters for you.

 

thanks Chris! I called chewy and they weren’t budging so I ordered some at a place called ADW. I freehand the lancets too, and found a box for $6.50 on Amazon. Will ch ck out that shopping list!

 

Shelley... if you see my post #26 above, strike-out, so I’m glad you ordered from ADW. They are great and I got alot of supplies from them as do many members.

I think in my grief-stricken haze after Gracie crossed, I donated all her meters because I’ve been through everything, and I’m very organized, and I don’t have them.

 

I am having a hard time figuring out what I’ve read and what I haven’t on my iPhone. I’m glad to hear ADW is a good supplier. No worries about the meter, really. I will get one mid month I think. I thank you for checking.

 

Oliver - afternoon 1/31. Advice?
I have put Oliver’s numbers in his spreadsheet. His evening shot time is 8pm. Can you give advice on whether or not to give him any insulin tonight??

 

I've contacted the people who were helping yesterday. Give us some time.

Would be great to get a +11 if you can. (7pm if your shot time is 8pm)

 

Sienne, Wendy, and I are discussing it and will give you our thoughts here shortly. Pros and cons and one is the paucity of test strips and your isolation. Symptomatic hypos have put a few cats into remission and, until he clears this bounce, we don’t know if he will be one of them. Conversely, if he needs insulin, not giving it isn’t helping him much. We will go with what is safest.

How much would you be willing to monitor him tonight especially if we give him a small dose and his BG comes down but not dangerously?

Also....are you absolutely going into town tomorrow or where you can get more test strips and ketone strips? Will the weather forecast allow that?

 

Thank you! I was planning to get one at 7:30, (11.5) then feed him, then give him a shot at 8:00 if we think we can get going again with a lesser amount. Oliver says Thank you! His Aunties are the best.

 

Shelley...can you please answer the questions in my post 32 above as that will help us give you some options. Thank you.

 

We will leave on Tuesday for the “big city” where we have many options (though not a Walmart) I was going to go to the small town vet tomorrow if they can take him and make sure he is ok, and there is not anything that is apparent to us. He is very much himself today!

I’ll talk to my husband, but my first thought is, if we were to give him a shot, to put him in his crate (which he loves) in our bedroom so we can keep an eye on him, but he can’t go anywhere in case he has a problem. He really let us know on Saturday! When you say “how much are you willing to monitor him” what do you have in mind?

 

It really depends on his numbers. If you give a shot at 8, we'd say to start with a test at +2. That is usually a good hint of what is going to happen in a Lantus cycle. If you see a big drop at +2, it could be a late nighter.

 

Will you be able to get more strips for the AlphaTrak there? Or a new human meter and strips? Walgreen's, Target and CVS are other stores that usually have affordable supplies if there's no WalMart nearby. Your ability to get more testing supplies as well as the other things we listed yesterday has a lot to do with the decision we make tonight.

Also, did the plow come through? If you had to get out, could you?

Some people absolutely have to get a certain amount of sleep....or have jobs they have to get up for....so I think she's just asking "if we give insulin at all tonight, are you able and willing to test as much and as often as might be necessary"?

 

Ok, I see what you mean. We talked it over and feel like we would be more comfortable doing it in the morning in case we have another bad reaction.

I don’t know that we will be able to get more supplies tomorrow. The plow came once during this snowstorm and we haven’t seen them since. We are hopeful to get out tomorrow to the vet and they could check his ketones?

If I can’t find alpha trak strips on Tuesday I will buy a people monitor. There are many pharmacies nearby the town we are going to.

 

It is definitely a concern if you shoot and only have 20-something strips. Even shooting tomorrow, if you don’t have enough strips to get you through when you could get them on Tuesday, it’s a concern. Does your vet sell the strips?

IMHO, it is wiser and safer to skip tonight again. That also gives us another cycle with some monitoring to see if he starts to clear this bounce a bit or stays high and flat. I’d say just a before bed test tonight is fine after the 8 pm-ish test (PMBG).

And we will put a suggestion for tomorrow out to you in just a bit. I’d like to see what his PMBG is.

thanks, Shelley.

 

Just FYI....the only place you're going to find AT strips are from a vet or ordered online. They won't be at any human pharmacy (which is one of the reasons most of us use human meters....just being able to get strips when we're running low....and cats have an annoying habit of running too low at 2am on a Saturday morning when you're down to your last 10 strips)

If you take him to the vet tomorrow, yes, they should be able to check for ketones...either blood or urine. Is this the vet you've been seeing? Was this the vet that sold you the AT? (just wondering if this vet would have the strips for sale)

 

I don’t know if the vet sells strips, but I sure will ask!

I think it is a good plan to hold off tonight. It was stressful enough when I was wide awake and full of energy. I can’t imagine doing it in the middle of the night (if I have my choice.)

 

Oliver’s spreadsheet is up to date now with PMBG. Thanks for all your help.

 

Thank you. Can you please get a before bed test?

We are thinking about a 0.5u dose in the morning provided he’s 400 at AMBG or more with a test at +2 to see if he’s up, flat, or dropping. You’ll need to be able to get more strips tomorrow. What do you think about that?

 

My test helper is already asleep, we go to bed early. I won’t know if I can get strips tomorrow until I can call the vet. They open at 8. I like the idea of starting him really low like that.
In the morning, I will test him, put his number in the spreadsheet (which I love) and call the vet the minute they open. Is that ok? I so appreciate you all hanging in there with me as it is all so new to us and very worrisome. You guys make me relax and just do it.
Shelley

 

Yes, that’s fine. Will you shoot, if he’s 400 or above, regardless of whether you get the vet?

 

Shelley,
When you have a chance, can you post details about the insulin syringes you’re using? (the wording on the package, such as “u-100 3/10cc insulin syringes” would be great.)

I ask out of an abundance of caution. Everything you said during the hypo “adds up” to the hypo being caused by an increase in insulin combined with a food change to a low-carb option ... but it’s always good to confirm that there isn’t a second variable at play — such as incorrect syringes. It happens occasionally, so it never hurts to verify. That hypo was dramatic and dangerous, one experience which I’m sure you never want to experience again.

I, too, was on the sidelines watching. I’m glad all turned out okay. Good job with all you did.

 

I am waffling. I only have 20 strips and I now understand how fast you can go through them. I have not shot. Vet open in 15 minutes

 

2/1 7:30 a.m. Oliver is at 608 this morning. (No shot since Saturday morning) I only have 20 strips left. I am calling the vet to see if I can buy them there.

 

I see you have just tested oliver and he's 608.
Are you waiting to see if vet is open and if he can give you strips??
Can you get a human meter and strips from a pharmacy at town? maybe ring them first, I read you are quite isolated.

I have to nip out now to walk my dogs, if you decide to shoot, shoot just the 0.5u.

 

Thank you. The vet does NOT have Alpha Trak strips. we are taking Oliver down there at 11:00 to have a general look see after all the trauma he went through on Saturday. Thank you for the info on the shot dose.

PS Anybody? How do I start a new thread on this thing? Would like to start on for today’s date.

 

If the vet says you can get strips, I’d definitely shoot the 0.5u as soon as you can and then you can go get the strips. It’s easy to get you back on an 8/8 shooting schedule when we get to that point.

I’m going to be gone all day but I’ve asked others to watch out for you all. It takes a village. Good luck today!!

 

T

Thank you so much
!!!

 

Shelley, you can go back to the main page of the Welcome forum and then go to the upper right corner of the page and click on Post New Thread:

 

Thank you!

 

Hi

, update. I started a new thread for 2/1. No vet in the next two towns has those test strips. But I went ahead and gave him a 0.5u shot at 8:39. I will track down a human meter. Hopefully, this one and only pharmacy in town will have one. anyway. I started a new thread and crossed reference this one. Thanks for your help!!