Please help - LOW BG last night, offered kibble/wet food/honey, is now vomiting all next morning

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Ryn & Grayson

Ryn & Grayson

Member Since 2015
Hi everyone,

Yesterday was my birthday so we went out last night after Grayson's PM dose. We came back during his +4 and he measured at 65 mg/dL (3.6 mmol/L) - this scared me and I wasn't too sure what to do. I had some spare kibble that I have stored that he has not had, so I mixed a bit of his wet food with a bit of kibble to raise his BG to blue levels. It didn't seem to work since his +6 was exactly the same so I mixed in a 1/4 teaspoon of honey with it. He cleaned the bowl and back in blue for +7, but this morning I woke up to some vomit that he had overnight and red BG levels.

He's not feeling well this morning, off his wet food but thirsty. He won't drink out of his bowl so I gave him some water mixed with wet food. He lapped up all the water. He then proceeded to walk to the corner of the room and vomit everything up again, three more times.

He just drank some more wet food/water mix and is now laying on the floor ignoring me and doesn't seem too happy. He will probably vomit again within the next hour. I'm not sure what's going on and I feel terrible for leaving him yesterday. Was it a mistake to offer him the kibble? I don't think his body liked it at all. Or was it a mistake to mix in the honey? Please help.

Thanks,
Ryn & Jim & Grayson

EDIT: He just hopped up onto the window sill and seems a bit more comfortable but I wouldn't be surprised if he had another bout of vomiting again soon.
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Can you please confirm that you gave Ryn 1.25 units of Caninsulin this morning.

If yes, can you please confirm how long ago Grayson got the insulin. (Need hours and minutes, not time of day.)
 
Critter Mom said:
Can you please confirm that you gave Ryn 1.25 units of Caninsulin this morning.

If yes, can you please confirm how long ago Grayson got the insulin. (Need hours and minutes, not time of day.)
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Grayson got Caninsulin at 6:00 am EST, it's currently 6:27 am. I gave him 1.25 units.
 
Ryn, when you post the BG result please say how long after insulin in '+' format, e.g. XXX mg/dL at +0.75 hrs (that would be 45 mins).


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Hi Ryn,

You're doing just fine.

Regarding the vomiting: It may be the dry food (especially if he's not used to it); or it may be that he was intolerant to something in the food; or it may be that swinging from a low number to a high number has upset his system; or it may be any of a whole host of other reasons. At the moment, we just don't know....
(Two of my five kitties were throwing up all over the place this morning. All five had the same food for breakfast. Sometimes life is puzzling; and more so if it happens before you've had coffee....:rolleyes: )

Please try not to worry. :bighug:

Eliz
 
He's so fed up with me, I got a good scratch and now swishing his tail angrily at me. I'm scared his gonna put me on his hitlist. He's back at his bowl now, I'll try again for blood in a few minutes.

And as for ketones, I'm not aware.
 
Oh lord, finally. We're at 376 mg/dL (20.9 mmol/L) at +1 and 10 minutes. His AMPS was 437 mg/dL (24.3 mmol/L) at 6:00 am.

We've had no more vomiting yet. He's back and forth to his bowl for more water.
 
Keep it topped up.

Have you any high carb foods with gravy in them at home, Ryn?


ETA: Well done getting the BG test. It was needed - looks like you've already got onset.

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I'm starting to suspect the kibble was the culprit for the vomiting. His last bout of vomit contained the last of the kibbles. I think wet food with gravy will be a better option next time he is low. He really enjoys his Fancy Feast so I will pick some up today for the next scare!

EDIT: He's really annoyed with me right now, so I'm going to leave him alone with plenty of water. I'll likely be back with his +5 and any reports. Thank you everyone for helping us! :bighug:
 
Check the ingredients on the kibble for future reference. Also check the batch number and sell-by/use by dates. Make a written record of them.

When you're shopping this evening try to pick up some ketone test strips (e.g. Keto-Diastix) - should be available anywhere that does diabetes supplies. You can check Grayson's pee for ketones at home (should be a regular part of diabetes management).

You still have the problem of getting Ryn through this cycle. He hasn't got much food in his tummy and you've already had a 4mmol/L drop in the first hour. The Caninsulin hasn't reached peak effect yet. I'm worried about him going low again.

I don't think it's safe to leave him unattended at the moment.

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The red number this morning was probably due to a bounce and possibly some of the carbs from the kibble. Ryn, I think it would be wise to reduce the dose: because Caninsulin is so harsh it is safer to aim for a higher target nadir. Also, Grayson's appetite may still be off. Please can you post for help before giving any insulin this evening?

If it's at all possible for you, I'd recommend you take Grayson to see the vet today to make sure there's nothing else going on and also to get advice on proper rehydration and restoring electrolyte balance. The vet might even be able to give you advice over the phone about what to do if you're not able to make a physical visit.

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Ryn, is there any chance that Grayson was off his food yesterday evening also? (Just wondering if that might account for the lower numbers last night). Or is it only today that he's been off his food?
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He hasn't had an issue with not eating before this morning. I'm just on my way to work (on mobile), I'll post before his evening shot.
 
Ryn, has Grayson eaten anything this morning! THIS IS VITAL!!


ETA: Did he eat since he threw up the last of the kibble? If so, how much did he eat???


ETA2: Is Jim at home with Grayson?


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Ryn & Grayson said:
He hasn't had an issue with not eating before this morning.
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OK. Then it may well be that the 1.25 units was simply too much at that preshot of 16.8 last night, given that he dropped to 3.6 four hours later.

We have a saying here that 'it's not just what the number is, but where it's headed".
3.6 (on a human glucose meter) might be a very nice number to see at the peak of an insulin cycle (ie. the lowest number/nadir of the cycle). But if it happens before the peak of the cycle then there is the possibility for it to drop lower, and, for safety's sake, it's not good to let it drop much lower than that. So you did the right thing in trying to get the blood glucose level up again. That kind of thing can be very stressful, so well done for keeping a cool head. :)

Also, extra care needs to be taken when using faster-acting insulins like Caninsulin. We've found that it can often drop the blood glucose pretty fast.
When the blood glucose is dropping fast it can be harder to pull the kitty out of that dive. For that reason some Caninsulin users aim not to let their kitties drop lower than about 5 at the peak of the cycle. That's just to allow some buffer of safety in case they drop lower than that on occasion.

Although Grayson's insulin dose has gone up and down a wee bit, it looks to me as though he is responding to it better as time goes on. This is a good thing, and very encouraging to see. But it is also another reason to be cautious about the dose. If Grayson continues to improve then it is likely that his insulin dose will continue to need to be reduced accordingly.
I would suggest a small dose decrease after that 3.6 last night, possibly back to one unit, to see how he does. But let's see what his preshot level is later today...

It is not at all surprising that you got a high preshot this morning. As Mogs said, it may be due to the higher carb food, or to rebound/bouncing from that low number, or to both of these things. But a high number in these circumstances is a temporary phenomena. It will come down again. So just try to ignore that number if you can, and give it time to settle out.
When the high numbers settle down, it is quite likely that the 1.25 unit may continue to be too much. This is not always the case, but it is prudent to exercise caution. (We don't 'know' why his blood glucose dropped lower than expected. Maybe it's because the dose is now too high. Maybe it was a one-off occurrence. Time will tell.)

It will be interesting to see what his blood glucose is later today.

If Grayson still seems to have tummy problems later then you may want to have a chat with your vet before giving more insulin.

Keeping fingers and paws crossed that Grayson is back to his normal self soon.
Do update us when you can.

Eliz
 
1. He has eating now, he had about half a can of Fancy Feast pate with a little bit of tuna. He seems to have his appetite back and acting more normal.
2. Jim is at home.
3. His +4 is 12.9 mmol (232 mg/dL).

I'll likely reduce his dose back to 1.00 units this PM.
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Thanks for updating us, Ryn. Just back from the vets here. I was worrying about you all. Thank goodness Grayson is eating again.
 
It was a productive visit, Ryn. Saoirse has a pancreatitis flare and unfortunately she's in pain. I've got a new Rx to try for her.

Very, very glad Grayson's OK and that Jim is minding him. :)


Mogs
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Ryn & Grayson said:
Thanks for thinking about us! I hope all went well at the vets. He seems to be doing just fine :)
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Hi, Ryn - Sorry to hear that Grayson had such a tough time, am really glad he's feeling better today!:)

Found this link; an article by a holistic vet & it was an interesting read: http://www.littlebigcat.com/nutrition/why-dry-food-is-bad-for-cats-and-dogs/

You had written in your first post: I had some spare kibble that I have stored that he has not had, so I mixed a bit of his wet food with a bit of kibble to raise his BG to blue levels.

As both Elizabeth & Mogs said earlier, it is possible that he reacted to something in the dry kibble.
Would you believe, for example, that there is a actually a toxin called "vomitoxin" that can occur with microscopic mold growth?
Check this out: http://www.rma.usda.gov/fields/ks_rso/2015/vomitoxintesting.pdf

Keep in mind that dry kibble can be contaminated with mold growth, even when it's not visible to the naked eye ... What's most disturbing to me is that some random lab tests of various dry-kibble pet foods done in recent years have determined that some of those foods came from the manufacturer already contaminated with mold toxins! (Whoa, that's scary.)

Just thought you might be interested in knowing this, as knowledge is power! (Unfortunately, I've had to learn way more about mold-related toxins than I ever wanted to know in this lifetime ...:rolleyes:) - Robin
 
He's doing fine for himself! He still isn't happy with me though, bit of a wrestling match to get his PMPS measurement. He's been sitting in Jim's lap lately instead of mine. :rolleyes: I'm a bit worried that I might have bruised his ear this morning with the pricks.

I picked up some turkey + gravy Fancy Feast for the next time he is in low greens.

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Ryn & Grayson said:
He's been sitting in Jim's lap lately instead of mine. :rolleyes:
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Grayson? Traitor! :p

Belated good wishes for your birthday, Ryn. Many happy returns of the day and all the best for the coming year. :)

Well done on securing the gravy food. Try not to worry about Grayson's ears. With that dose and tummy problems it was really important to know what the insulin was doing.

That's your lowest PMPS to date. If he were mine my preference would be to only give 0.5 units tonight. I certainly would give less than 1.0 unit. He has a slight tendency to run lower at night, and he had quite a late nadir on this morning's dose. The lower dose would also reduce any risk from any potential further digestive upsets just in case his tum might not have quite settled yet. Other members may have a different view. You're the one with the syringe, Ryn. You've got to be comfortable with the decision. Let me know what you decide.



Mogs
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Thanks for letting me know, Ryn. I'm delighted to hear that Grayson's eating better. It's always a worry when kitties don't eat, but it's a much bigger worry when they're receiving insulin. :nailbiting:

Grayson may run a little higher but he will have had some insulin and he'll be safer. You can always edge the dose up again if necessary. Be sure to do a 'before bed' check on him to be on the safe side.

Just looking at his spreadsheet I think he's progressing nicely. You're doing a fantastic job with monitoring his BG. :)



Mogs
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@granadilla - Thank you for the encouragement: spent most of today shaking even more than usual - before, during, and after the vetty bean appointment. Saoirse's very sore. I'll be posting an update on her 'Euthyroid ... ' thread at some stage in the next day or so. Absolutely shattered now. :(
 
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For you, Ryn ...

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@Critter Mom - Mogs, I'm so sorry to hear the appointment was so rough. Please keep me posted on how poor Saoirse is doing. And please please try to take care of yourself too. Hugs from me and Marshmallow.
 
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