please help. very low numbers 30's then up to 170

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Deb14

Member Since 2015
hello,

my cat was a diabetic for about a year went into remission 6 months ago with numbers around 120-125. I take her blood sugar once a week to monitor her well last week it was 280.
Back to vet for more insulin prescription.

So all went good she has been on a low dose 1/2 unit twice a day lantus for a week. Her numbers have been consistently between 79, (6hrs nadir 50-55) for 5 days. Recently the nadir dropped to 41) so we reduced it to 1/4 unit. Been holding that dose for 3 full days.

Her 3rd day of holding a 1/4 unit we gave her insulin last night at 9:15 on time. Her blood sugar was 79 and at 10:15 ( 1 hr from injection) she was extremely hunger, we checked her blood sugar it was 38. Very concerned we fed her and it went up to 44. We got concerned knowing that at the 4 hrs pre-shot and 6 hrs pre-shot she would go very, very low. So we fed her a tsp of sweet potatoe.
Her numbers went up to 45 at 3 hrs and at 4 hrs pre-shot went up to 67. She would not eat again after the sweet potatoe. Then at 6 hrs up to 85. got a little sleep.
Her next meal fed canned low carb food at 6am took her blood sugar (9 hrs pre-shot) her number is now 170!!! Took again at 7:26 (roughly 2hrs pre-shot her number went down to 159 wheh! so its coming down.

What do i do ?????? Her last insulin shot was 9:15 pm last night

1. do i wait and not give her anything at all.
2. give her a reduced dose at 1/8 (literally a few drops at 9:15 am)
3. watch her numbers to see how low they go. If they are below 75- 80 wait till they rise above 75-80 then shoot a 1/8 unit.


I think number 3.? because you cant just stop the insulin correct.
look forward to hearing from you all.

thanks so much.
Debbie
 
Hi Debbie--

Experienced Lantus folks will be on soon to help out, but I just wanted to say, well done for catching that low and getting your cat's numbers up again! It's hard to say, but it looks like her pancreas may be waking up/sputtering a bit, so from here on in you're going to have to be extremely cautious on insulin administration (microdoses, etc.). I'll let the pros guide you in that, but in the meantime, just wanted to answer your question:

Yes, #3-- watch and wait, and (at least for now) don't feed (if you haven't already) so that the numbers won't be influenced by food. Especially with her going down (170->159) after the breakfast meal (indicating a pancreas doing its job and pulsing some insulin), you don't want to interpret a later temporarily high "food spike" number as being safe to shoot-- if you do, you'll possibly be adding extra insulin on top of the insulin her pancreas is producing, and that's how you can get to those dangerously low numbers.

Again, well done on managing the low!
 
Here is a picture of what we call a .1 dose. A drop to the 30's certainly warrants a reduction. Do you think you can measure this accurately? It would be more helpful if you had a spreadsheet with all the numbers but hope this helps for now.

01unit-1.jpg
 
thank you :-) yes i can do that . I have a mark on a piece of paper from the 1/4 unit and just cut it down 25-30 percent less a bit tricky. Reason i use a paper with pen mark on it the syringes are all different the first black line i never the same some are higher and lower. i figured this out last time she went in remission cause her numbers where all over the place even at 1/8 units. cause it could be and 1/8 or a 1/4 the next time. it seems like the can be off by an 1/4 unitwhich isa big deal when ur giving such a small amt. well thanks again. im just gonna watch her numbers, just concerned that most likely she will not be ready for dosing at her normal 915am dosing and sometimes if given later it could bounce again.. hopefully if it does not as much and its prob from the sweet potatoe ugg h. take care and thanks again
 
thank u. appreciate answering so quickly you all are awesome. its been crazy like i mentioned she has been off insulin for 6 mths and her last blood sugar test at home showed 280. so to vet. they did blood work and found out she is in 2nd stage renal failure go figure and borderline hyperthyroid too. tricky think is vet says u cant treat the hyperthyroidism cause it actually helps the kidneys and if u did treat the kidneys would get worse very quickly. Hyperthyroidism ends up causing other issues heart, hypertension etc etc. so worried wish more testing and research was done on kittys so sad. on top of that she had IBD which is how she got diabetes in the first place with the steroids. Shes off the steroids and the raw diet has helped so far . goodness sorry to rave just a worried momma.. any input on these issues would be greatly appreciated. I see your baby kitty has alot of issues as well. Hoping she is doing well. take care and thanksso much
 
Stage 2 is not that far advanced from what I understand. There are quite a few beans here that have experience with CKD. You might add CKD/ HyperT? to your title to capture some eyes. Sorry about the hyperthyroidism and I don't know much about it. My Doodles is in the advanced stage of HCM & CHF and heart usually trumps all.

Here are a few lists of low phosphorus foods that can help with the CKD. You want to keep the phosphorus level under 1% if possible and kitty also needs carbs under 10%.
https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/edit#gid=0
http://www.felinecrf.org/canned_food_usa.htm

ETA: let me tag a few @Amy&TrixieCat and @tiffmaxee have quite a bit of experience in CKD as well as @Wendy&Neko
 
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Hi Deb....like u I am dealing with hyperthyroid and slight kidney involvement as well. Elmo has been hyperthyroid for 3 years , controlled by food. Since diabetes Dx we have gone on thyroid meds , low dose, to lower the thyroid a bit but high enough to help the kidneys(per regular vet and holistic vet advise). Don't know if that might be something your vet would consider but thot I'd throw that out there :). And yes, finding food that is low phos(kidneys), no fish ( thyroid) low carb ( pancreas) is entertaining but doable. Then once found they need to be willing to eat it :eek:. Will be watching and cheering you on :bighug:
 
Beth 73 said:
Hi Deb....like u I am dealing with hyperthyroid and slight kidney involvement as well. Elmo has been hyperthyroid for 3 years , controlled by food. Since diabetes Dx we have gone on thyroid meds , low dose, to lower the thyroid a bit but high enough to help the kidneys(per regular vet and holistic vet advise). Don't know if that might be something your vet would consider but thot I'd throw that out there :). And yes, finding food that is low phos(kidneys), no fish ( thyroid) low carb ( pancreas) is entertaining but doable. Then once found they need to be willing to eat it :eek:. Will be watching and cheering you on :bighug:
Click to expand...

I use special food to control Bamboo's (one of my 15 cats) hyperthyroid. The food is very expensive, and since I have other cats, I isolate Bamboo from the others, until they finish their food. I don't know the carb values for this food, and haven't needed to know because Bamboo is not diabetic. It works quite well, but as Beth said, you must continue to monitor kidneys to keep the tricky balance
 
Hello and welcome. What is kitty's name?
Deb14 said:
they did blood work and found out she is in 2nd stage renal failure go figure and borderline hyperthyroid too. tricky think is vet says u cant treat the hyperthyroidism cause it actually helps the kidneys and if u did treat the kidneys would get worse very quickly.
Click to expand...
Sorry to say this, but your vet is a little out of date. Hyperthyroidism can mask kidney disease, but treating it does not hurt the kidneys. You might want to take a look at this paper by Dr. Mark Petersen, the endochronoligy vet who discovered hyperthyroidism in cats. Treating hyperthyroidism does not make kidneys worse, and in fact, not treating can make the kidneys worse. The article has some ideas on managing the dual conditions. Here is a second article from him on diet to feed the hyperT cat. He's not a fan of y/d, and it's really high in carbs. For a CKD and diabetic kitty, chose a low carb, low phosphorus diet and add plenty of water.

You are right that you can get other conditions, such as higher blood pressure. CKD does that too. If you haven't already, you might want to get her blood pressure taken. And you might want to consider a review by an internal medicine vet. They are good at managing multiple conditions.
 
Wendy&Neko said:
Hello and welcome. What is kitty's name?

Sorry to say this, but your vet is a little out of date. Hyperthyroidism can mask kidney disease, but treating it does not hurt the kidneys. You might want to take a look at this paper by Dr. Mark Petersen, the endochronoligy vet who discovered hyperthyroidism in cats. Treating hyperthyroidism does not make kidneys worse, and in fact, not treating can make the kidneys worse.

My understanding is that a hyperthyroid condition does not precisely "mask" the kidney's malfunction, but rather it helps the kidneys function more eficiently. As the thyroid is treated, and returns to more normal functioning, those same kidneys will start to function more poorly, since they no longer have the help they had been receiving from the hyperthyroid condition. I do not understand the interactions between the accelerated thyroid and the damaged kidneys, but I do understand that within that interaction there occur some processes that actually help the kidneys function better, even though they are damaged.
Thus a cat who tests as hyperthyroid, and upon testing shows no signs of kidney disease, might begin to show signs of CKD, as the cat's thyroid functions improve.

I have a sister who chose radiotherapy for her hyperthyroid kitty. Her vet did not know that after first testing for kidney deterioration, even though no CKD is found, you must then start the cat on thyroid medicine to slowly lower the hyperthyroid condition, and as you lower it, check kidney function. Sometimes as the hyperthyroidism is alleviated, the kidney panel will begin to show signs of CKD. No CKD appeared on her cat's initial kidney panel, so her vet declared the cat free of kidney disease. My sister then put her cat through radiotherapy. A week or so after the irradiation treatments, her cat went into renal failure and died 3 weeks later. The under-educated vet did not even know how to treat acute renal failure. :mad:

Well, I've gone a bit astray here, but my point was that "masked" is not a very good term, since the kidneys actually perform better because of some processes that the hyperthyroidism puts into action. I'm a writer, so I sometimes get a bit exercised over imprecise use of terms, even when they are medically approved.:rolleyes:
Click to expand...
 
Hi Deb, just want to give you some kudos for catching things so quickly when your kitter's blood sugar went up. The sooner it's caught, the greater the chance for a second remission, although it is more difficult to get cats into remission more than one time. Some cats can do it, though.

You're absolutely right about the inaccuracies of the syringe markings. Probably doesn't matter for large people sized doses, but it definitely matters when the dose is 0.25u! Many people here use calipers to measure because of that issue - enough that we have a link explaining how to use them.

There is tons of information in this group. If we can answer questions or help you move ahead, just ask!
 
thanks so much. got her regulated. the bounce came down highest was 170. insulin given 1/8 unit if that her numbers look good. 116 pre-shot , nadir at 6hrs was 70. we shall see what happens. i will keep this dose for 3 days unless she dips low again. im not using a caliper but using a marked index card since i started her back on lantus last thurs. next reduction will have literally 6 drops or so . I used this same way last time i got her in remission. ;-) hoping i caught it in time before her beta cells lessened. i usually take her bs once a week religously but i fell and broke my shoulder so i was late by 3 days go figure. so not sure when she spiked but it wasnt more than 10 days and the frucosamine test at the vets said the same thing under 2 wks.. take care and thank u
 
Wendy&Neko said:
Hello and welcome. What is kitty's name?

Sorry to say this, but your vet is a little out of date. Hyperthyroidism can mask kidney disease, but treating it does not hurt the kidneys. You might want to take a look at this paper by Dr. Mark Petersen, the endochronoligy vet who discovered hyperthyroidism in cats. Treating hyperthyroidism does not make kidneys worse, and in fact, not treating can make the kidneys worse. The article has some ideas on managing the dual conditions. Here is a second article from him on diet to feed the hyperT cat. He's not a fan of y/d, and it's really high in carbs. For a CKD and diabetic kitty, chose a low carb, low phosphorus diet and add plenty of water.

You are right that you can get other conditions, such as higher blood pressure. CKD does that too. If you haven't already, you might want to get her blood pressure taken. And you might want to consider a review by an internal medicine vet. They are good at managing multiple conditions.
Click to expand...


thank u. i try reading it kind of confusing, need to read again. i am also seeing a small animal specialist next week. lets see what he says. I add extra water to her food and she eats raw rad cat and weruva chicken both low in phosophorous. which helps. i may have to take kitty to see dr. pederson in ny if i dont get the help here in ma. my daughter lives there and is a trauma er nurse in nyc, so i have a place to stay. we shall see. u all are awesome thanks again so very much :-)
 
thanks much for replying. a bit confused. i am getting two different opinions online and from different vets. his ., i need to read it again havent slept in a few days with my kitty. i had her blood pressure check it was great 125/90 which is one less thing to worry about. im am seeing a feline specialist next week will see what he says. i was reading the the t4 numbers should be even lower with cats with ibd and or kidney issues. so eve if she is in the high to normal she could still clearly have it. one test isnt enough to rule it in plus hope he can re-check her neck area tosee if any lump. u are all awesome thanks so much. ill keep u all updated. goodnite.
 
Deb14 said:
thank u. i try reading it kind of confusing, need to read again. i am also seeing a small animal specialist next week. lets see what he says. I add extra water to her food and she eats raw rad cat and weruva chicken both low in phosophorous. which helps. i may have to take kitty to see dr. pederson in ny if i dont get the help here in ma. my daughter lives there and is a trauma er nurse in nyc, so i have a place to stay. we shall see. u all are awesome thanks again so very much :)
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im sorry the kittys name is patchy and she is a calico. sweet baby 13 yrs in may. take care
 
Kathy and TiTi said:
I use special food to control Bamboo's (one of my 15 cats) hyperthyroid. The food is very expensive, and since I have other cats, I isolate Bamboo from the others, until they finish their food. I don't know the carb values for this food, and haven't needed to know because Bamboo is not diabetic. It works quite well, but as Beth said, you must continue to monitor kidneys to keep the tricky balance
Click to expand...
hello thanks for replying. an u tell me what u feed ur kitty.? i feed mine weruva chicken and rad at raw lamb. thank u talk soon :)
 
Deb14 said:
im sorry the kittys name is patchy and she is a calico. sweet baby 13 yrs in may. take care
Click to expand...
Deb14 said:
thank u. i try reading it kind of confusing, need to read again. i am also seeing a small animal specialist next week. lets see what he says. I add extra water to her food and she eats raw rad cat and weruva chicken both low in phosophorous. which helps. i may have to take kitty to see dr. pederson in ny if i dont get the help here in ma. my daughter lives there and is a trauma er nurse in nyc, so i have a place to stay. we shall see. u all are awesome thanks again so very much :)
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...one more thing im sorry didnt get much sleep monitoring her last night. any ideas for constipation thats natural. not sure if its the kidneys or just changed her to a new raw food, but poor thing is constipated. she went yesterday , but yelped . today nothing and she had sweet potatoe last night due to her super low blood sugar. i also put krill in her food which helps the kidneys but still constipated. thank u
 
Deb14 said:
...one more thing im sorry didnt get much sleep monitoring her last night. any ideas for constipation thats natural. not sure if its the kidneys or just changed her to a new raw food, but poor thing is constipated. she went yesterday , but yelped . today nothing and she had sweet potatoe last night due to her super low blood sugar. i also put krill in her food which helps the kidneys but still constipated. thank u
Click to expand...
Folk here use pumpkin either fresh or canned, and add a teaspoon to their food, if it's canned make sure it is just pumpkin as opposed to pumkin pie filling which has a ton of added sugar.
 
Gill & George said:
Folk here use pumpkin either fresh or canned, and add a teaspoon to their food, if it's canned make sure it is just pumpkin as opposed to pumkin pie filling which has a ton of added sugar.
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thank you will try today hoping it doesnt do a spike in blood sugar. thinking giving it to her after she has her insulin? sug
gestions...not sure how long it takes to raise blood sugar maybe and hr or so?
 
If you are in the Boston area or close by, Angell Memorial is a great veterinary clinic as is the clinic at Tufts. My sister used a vet at Angell who was recommended by a former member here -- Dr. Brum. He's an internal medicine specialist.
 
Sienne and Gabby (GA) said:
If you are in the Boston area or close by, Angell Memorial is a great veterinary clinic as is the clinic at Tufts. My sister used a vet at Angell who was recommended by a former member here -- Dr. Brum. He's an internal medicine specialist.
Click to expand...
yes i am about an hr. i am working with a small animal internist in hanover. if things arent working i will def look this doc up. thank you
 
Deb14 said:
...one more thing im sorry didnt get much sleep monitoring her last night. any ideas for constipation thats natural. not sure if its the kidneys or just changed her to a new raw food, but poor thing is constipated. she went yesterday , but yelped . today nothing and she had sweet potatoe last night due to her super low blood sugar. i also put krill in her food which helps the kidneys but still constipated. thank u
Click to expand...
Sometimes switching to raw can cause constipation, as there is no fiber in it. As Gill said using plain pumpkin (not pumpkin pie filling) usually helps. It shouldn't raise the BG and most people just add it in when feeding. My cats have always been crazy about squash and love it.
Hope it helps and that issue can resolve quickly.
 
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