Possible Hypoglycemia, not sure

Status
Not open for further replies.
seagullcanfly

seagullcanfly

Member Since 2013
On Thursday I switched from Purina DM dry food to Halo Spots Pate for lower carbs. I went to the vet Friday morning, and her reading had changed from the previous week of 445 to a 222. I asked the vet if her dose should be changed from 2 units twice a day to 1, and she interpreted the question as me not responding to a lower measurement but as me trying to get out of shots, explaining how I'll be giving shots the rest of my life to the cat. That wasn't the point of my question.

I ordered home testing kits on Friday (yesterday) from ADW. I haven't tested before, but I'm not impressed by my vet since they recommended the Purina DM dry food and when I asked she had no response to my questions about nutrition. I seriously said, should she be eating canned/wet food, and she just looked back at me. I was insecure even questioning the vet, so I also moved on.

As I've been writing this post my cat seems to have improved. My wife and I put some honey around her gums and under her tongue, but she seemed very lethargic, and we thought we saw evidence of drooling. She was meowing loudly, seemed disoriented, and could barely move. When we gave her honey, she did not try to get away at all while we opened her mouth. She's not the kind to bite or scratch, but she definitely would not put up with that normally.

I think she's better now. She got out of my wife's lap on her own, and is now eating some food, and we're going to give her some food high in carbs for the moment to get her back to safety. I'm going to go pick up a meter in a little bit to at least see what's going on, but I wanted to know what to do from here on out.

Tonight, do I do a reading and give her the same insulin dose? If I'm unsuccessful getting a reading from a test kit, do I still give her insulin? Should I give her less?

I don't trust my vet, and I'll be looking into going to another, but from the small amount of reading I've been doing so far I don't understand how to handle her insulin doses based on home test readings. My vet doesn't want to see the cat for another two weeks to do the other test (I think it's one that measures her over time), but I'm concerned that even if I do see lower readings I won't know what to do about them.

I can provide more details I just don't want to overwhelm people with info right away. Thank you so much for any help/guidance you can give me.
 
Welcome to the forum! There are many awesome members here that will help guide you along.

222 does not seem to be a bad number.

I can provide more details I just don't want to overwhelm people with info right away.
Click to expand...

Please overwhelm us with info asap so someone can chime in before you are ready for tonight's shot. It would help us help you and your sugarcat. :smile:
Type of insulin/dosing info/type of meter/etc/etc.

Home testing is very important. Kitties numbers might be higher at the vet due to the stress of being there.
Most of us here feed Fancy Feast pate and/or Friskies pate. None with gravy.

BTW...there is a good chance that you will NOT have to give your kitty insulin for the rest of his/her life. With proper low-carb wet food and correct insulin type/dose, many cats have gone into remission.

We are all here to help. :smile:
 
My diabetic Maggie has been gone for quite a while, so I don't give much advice anymore. BUT people will want to know some more information before they can help.

1. Which insulin you are using?

2. What time did you give the shot?

3. How soon after that did the symptoms start?

4. How is your cat? (and what is her name?)
 
First Welcome! Sorry it's such a critical issue with your first post. Our first advice - BREATHE! ...and BREATHE!

I'm not sure where you're located but you gave readings in US numbers so am 'assuming' you're in USA. I humbly suggest you make a trip to Walmart and buy a ReliOn Confirm or Micro meter and a box of 25 or 50 test strips for that meter as soon as you know the cat's stable and out of danger. We can teach you to test so you'll KNOW if you're in a hypo situation and if your efforts are working. You'll need a box of lancets too but there are 10 that come with the meter to get you started. Your vet may not support home testing but we can deal with that issue later, right now let's get extra sweet kitty on good ground.

BIG HUGS! There'll be more people popping in! Never worry about overwhelming US with info, I apologize in advance if we overwhelm YOU for a bit.... :-D
 
that does sound like your cat's glucose level dropped too low. keep a close eye on her for the next bit of time because the honey will wear off and she can crash again. a bit more unlikely by giving her the higher carb food too but to be honest, i'd rather her be high than be symptomatic again so you are doing the right things. if one of you can do that while the other one goes and gets a meter that would be ideal. or if you would feel better with her in the hands of a vet you could go ahead and take her.

as far as going forward, if you get a meter today, you will most likely see high readings tonight simply because of the honey and the higher carb food. we have to keep that in mind when we suggest what, if any, amount of insulin to give tonight sooooo if you can answer some of the other's questions before it's time for the evening shot that would be great. first, make sure kitty is safe, then tell us more :-)
 
Thank you so much for all the replies. Just responding quickly now and getting all the information that was asked for.
 
Cat: Fluffy is a Persian, 9 or 10 years old, and about 9.5 lbs. We've only had her for the last 3 1/2 years. We took her in as a quasi-stray since our former landlord didn't want her anymore. She's always had litter issues, pees inside the litter, but poops next to it. We have two jumbo litters, no other cats. She's an inside cat 24/7 for the last year.

0Lyk1Sf.jpg


Location: Long Island, NY. Forgot about the international difference in measurement readings.

Insulin: ProZinc

Dosage: First week 1 unit twice a day. Second week 2 units twice a day. Currently on the second day of the third week, vet said to continue the dose at 2 units twice a day.

Measurements: Initial bloodwork somewhere around 450, second measurement after 1 week at 450 still, 2nd week at 222. (Just tonight did a measurement at home and it was 81.)

Current food:Halo Spot's Pate for Cats Grain Free Ground Chicken

Diet Changes: The first week, I was given Purina DM dry food and a few cans of Purina DM savory something. I at first mixed her old food half and half for the first three days with the new Purina DM dry food. Unfortunately, I forgot to fast the cat for her first reading at the end of the first week, so they did a reading which was still in the 400s and said to come back a week later and remember to fast. The second week I introduced the Savory Purina canned food for a couple of meals. On Thursday night, before my Friday morning reading, I started feeding her the Halo Spot's Pate listed above and this is currently the food I plan on continuing to give her, bar any more hypoglycemic events.

Shot schedule: Usually around 7am and 7pm.

Home test: Just did my first home test. Seemed easier than I thought it would. I have the benefit of a cat that never scratches or bites. I used the Contour but I've already ordered Arkray Glucocard from ADW based on recommendations from a sticky on this forum.

Miscellaneous: My sister is a vet, but does not live near me. She works on exotic animals but did not like what I was telling her about my vet the moment I started explaining the situation. The vet said it didn't matter if my cat had Type I or Type II diabetes, that the treatment would be the same. I don't think my cat has ever been overweight, as we don't feed her treats, but the vet never spoke to me about nutrition, just gave me some Purina DM dry food, and gave me some wet food because she thought I gave wet food as a treat. I had inquired about it because I had read about wet food being healthier for cats.

Current situation: I think my cat is back in safe territory. As I wrote before, her reading is 81 at the moment. I think she was having a hypoglycemic reaction. We did give her the honey, some food that was a little higher in carbs, and that reading of 81 was an hour after we gave her the honey and the food. She ate all of it. She's currently sleeping to my left, but before she had been meowing as if in distress, very lethargic, staggering when walking, and trying to hide in a closet.

Current plan (would still appreciate advice): Based on the 81 reading an hour after giving her a tablespoon of honey and some leftover Purina DM dry food, my sister advised not to give an insulin shot tonight. My plan would be to do another glucose reading tomorrow morning before giving her another insulin shot Not sure if that glucose reading should be taken before she's fed or after. I'm also not planning on returning to that vet.

Thank you again. I didn't respond to each of you individually but I really appreciate the advice. I would hate to make a decision or not make a decision that could harm my cat.
 
Welcome to FDMB.

You stumbled upon the basic tactics for handling a hypoglycemic episode. High carb and recheck until OK. You might appreciate the specific instructions in case it happens again - here

A nice thing about ProZinc in this situation is that it doesn't carry over between shots, so that once the glucose is at a safe level and you're past about the halfway point between shots, you may relax a bit.

There are some Vet Interview Topics in my signature link. If you bring up Google Maps, you can do a search on 'veterinarian near address' and put your full address in. This will display markers for all the practices near you.
 
Great job on managing the low numbers and on getting your first successful test in! :thumbup

As BJM mentioned, ProZinc is an "in-and-out" insulin so I would suggest you test her at shot time tonight and if she's over 200, give her 1u. If she's under, then skip till tomorrow morning, but make sure you also test before tomorrow's shot. I would also ignore your previous vet's non-advice and drop her back to 1u (if she even needs that much) till we can get some more data from home testing. :mrgreen:

The only reason I say to give a shot tonight is because if she did go low, she might bounce into higher numbers (over ~240 is renal threshold) and we don't want her in too high of numbers for too long if we can help it. "Bouncing" is when the pancreas feels like the cat is dropping too low and triggers the release of stored sugar (glycogen) from the liver. More sugar = higher BGs.
 
BJM said:
A nice thing about ProZinc in this situation is that it doesn't carry over between shots, so that once the glucose is at a safe level and you're past about the halfway point between shots, you may relax a bit.
Click to expand...

Thank you for the interview questions and the hypoglycemia information. I don't understand the part I quoted here. Hypoglycemia doesn't carry over after the next shot is administered? Is that it?
 
KPassa said:
if she's over 200, give her 1u. If she's under, then skip till tomorrow morning, but make sure you also test before tomorrow's shot.
Click to expand...

I tested again at 8:30 and it was 101, so it seems the consensus advice is to test her again tomorrow morning but skip tonight's shot, and drop down to 1 unit tomorrow?

If I test her tomorrow and she's still under 200, do I still give her 1 unit and just watch for signs of hypoglycemia? It's a little unnerving because it just happens to be the weekend. I would hate to think she could have to go through this alone when we're at work, or that she could go into some severe reaction and die.

Thank you, again.
 
Yep, skip the shot tonight. Test her tomorrow and if she's under 200, don't feed or give a shot but post here for advice (usually, wait a half hour without feeding and test again and see if the number is going up or down).

For any on-going shots, with ProZinc, dosage amount is based on pre-shots more so than nadir (lowest point) and there is a sliding scale often used. I use Lantus so I'm not as familiar with dosing, but at this point, I definitely think 2u is waaaay too much and 1u might even be too much. I'll let someone with ProZinc knowledge answer more specifically for you. ;-)
 
I like your sister :-)

great job with the testing too! those numbers are actually lower than i would expect given kitty was given honey and higher carb food so it's critical that you test her before ever giving an insulin shot in my opinion.

and yes, no shot if kitty tests under 200 and i'd say go to half a unit or 1 unit if over 200 for the time being. it is better to be safe than have another incident. via testing you will quickly see if a dose is too much or too little and you can then adjust the dose again if need be. that glucose meter as i tell people is your best friend when dealing with this disease because you can see where kitty is whenever you want and keep kitty safest.

as far as testing before or after eating, test before eating.
 
seagullcanfly said:
BJM said:
A nice thing about ProZinc in this situation is that it doesn't carry over between shots, so that once the glucose is at a safe level and you're past about the halfway point between shots, you may relax a bit.
Click to expand...

Thank you for the interview questions and the hypoglycemia information. I don't understand the part I quoted here. Hypoglycemia doesn't carry over after the next shot is administered? Is that it?
Click to expand...

I hope I can explain this ok. Some insulins (Lantus and Levemir) are "depot" insulins. They use a kind of a carryover effect, building up an insulin "depot" in the body to keep the glucose levels flatter, or with less highs or lows. ProZinc doesn't do that, so once the insulin is used up in the body it is really gone from the body. This can be a benefit when facing a hypo situation.
 
Alright, you guys are really going to impress me if you woke up to give me advice.

She tested 153 this morning, haven't fed her yet or gave her a shot. My sister (who is a vet) advised against giving insulin. Your thoughts?
 
I know that Carl (who knows a lot about Prozinc) had a late night as he was up with some members on the Lantus board helping out, but I believe with Prozinc that you wouldn't want to give insulin around a 150 number.

Edited to add: What you can do if you haven't fed is stall the shot for 30 minutes and retest. If the number has gone up, you could probably shoot. I don't know a lot about that insulin though, so I can't advise a dose, sorry!
 
Nikki's Mom said:
I know that Carl (who knows a lot about Prozinc) had a late night as he was up with some members on the Lantus board helping out, but I believe with Prozinc that you wouldn't want to give insulin around a 150 number.

Edited to add: What you can do if you haven't fed is stall the shot for 30 minutes and retest. If the number has gone up, you could probably shoot. I don't know a lot about that insulin though, so I can't advise a dose, sorry!
Click to expand...

Thanks. I decided to forego giving her an insulin shot this morning. I won't be able to monitor her today for any hypo reactions, so I'll test again tonight before I feed her when I return.
 
Great job! :thumbup "Better high for a day than low for a minute," as we say around here.

With the 151, it does look like she might need a tiny bit of insulin still (with a cat not getting insulin, we want to see her in double digits for as much as possible), but I'll leave the dosing suggestions up to others who are more familiar with ProZinc. ;-)
 
She went up to 179 last night, still gave no insulin, but she was at 219 this morning so I gave her 1 unit. I'll be measuring her again tonight pre-shot and I'm in the process of researching new vets.

Thanks again to all that posted, helped calm me down quite a bit when dealing with this.
 
seagullcanfly said:
BJM said:
A nice thing about ProZinc in this situation is that it doesn't carry over between shots, so that once the glucose is at a safe level and you're past about the halfway point between shots, you may relax a bit.
Click to expand...
...I don't understand the part I quoted here. Hypoglycemia doesn't carry over after the next shot is administered? Is that it?
Click to expand...

Depot insulins - Lantus and Levemir - have a cummulative effect that builds up over 3 or more days. If you had used one of those and given too high of a dose, you'd likely have been up most of the night fighting a hypo as it may take that many days to get the build up out of the system.
 
We can read your SS just fine. Thanks for doing that, because it will really help us to see what is going on with Fluffy.
 
Wendy&Tiggy said:
Thats great we can tell a lot from this. and nag you too ie did you get any mid cycle tests today nag nag? ;)
Click to expand...

I was wondering about that. I see some people testing quite a bit. I only tested her just now, about an hour before her shot. I thought it was going to take longer based on the other tests, but this new arkray seemed to do it much quicker and she was very excited about the shredded chicken breast I used to coax her into it (less than half an ounce). I tend to feed her at 7:00am/pm, and then give her her shot at 7:30.

I don't get home from work until 5pm, so I could test her closer to then tomorrow, and maybe a couple of hours after her shot, but otherwise the weekend is really going to be the only time I can get some mid cycle readings, unfortunately. I'm data obsessed so it's not something I'm avoiding, I want to compete with these other spreadsheets I'm seeing :)

Waiting on my sistervet to suggest a dose, but if anyone wants to chime in based on the spreadsheet, I'd really appreciate it. Currently still looking for a new vet.
 
I don't think there is enough data for anyone to want to comment on dose yet but we will see.. I am not a prozinc user . 1 unit seems like a safe starting dose.

A test before every shot is mandatory. Before bed (2-3hours after bed time shot) is also useful as it tells you what might happen overnight. The weekends extra tests would give enough data to suggest a dose change.

So weekdays 7am test shoot
7pm test shoot
9pm/ 10pm/11pm before bed test (Vary the time if you can)

Occasional spot checks at 5pm when you get in the door would be useful and if the 10pm before bed test is a bit lower than the 7pm test you might want to set the alarm for a test around 3am as it can mean an active cycle.

Wendy
 
I tried searching the forums, but I had noticed that a lot of people are eventually giving doses in different increments. I have the u-40, but I've seen that with the conversion chart others are using the u-100 and the 5/16" length. I'm still doing a lot of testing so I'm not jumping any gun as far as changing dose, but I'd like to be prepared with syringes that give me more control.

Isthis the kind of syringe that would be appropriate for Fluffy? It's the BD Ultra-Fine U-100 Insulin Syringes 31G 3/10cc 5/16" 90/bx for 20.99.

Thanks!
 
30-31 gauge needles are thin (good)

needle length is personal preference - I used the shorter needle as I was less likely to poke through the tent I made and stick myself!

Most of us use 3/10 cc (aka 3/10 mL) capacity syringes, as our doses are so small, plus you can get ones with half unit increments.
 
Status
Not open for further replies.
Back
Top