? Sammy low BG after PM shot 10/17 & 10/18 - 10/19 low tonight: 52@+1.5PM; 69@+2

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Jessica & Sammy

Jessica & Sammy

Member Since 2022
Hi all, just looking for more information. The last couple nights, Sammy has been going low after this PM shot. I have a vet appointment tomorrow about possibly lowering his dose and gave him 0.5u this morning. I am not home during the day so do not know if he is experiencing any issues or for how long it has been going on. Last night, he went his lowest at 52 at +2.5 and that was after I gave him HC crunchy snacks and HC wet food. An hour later, he only went up 7 points, to 57. I gave him more HC wet food and at +4, he was at 69.
I feel this is still too low and wonder why? Before I gave him his PM insulin (maybe 40 minutes prior), I fed him some of the HC crunchies as a precaution. He also had some kibble and a little wet food. When I gave him his insulin, I gave him his LC pate and he ate about half. He has never eaten an entire can/portion of food, even when he was a hungry outdoor cat. He always leaves some for the other kitties even though none of them have gone hungry under my care.
Am I not feeding him enough? Is his dose too high? He was reduced on Saturday from 2u to 1u, but since his numbers have been low, I have been giving him less. Yesterday, he got 0.75u and today he is getting 0.5u. Has anyone else encountered this? Please share any recommendations =). Thank you!
 
Some cats race down the dosing scale. It can be a wild ride.

Do not give any more than 0.5u tonight and do get some tests in to make sure that even 0.5u is not too much. Reductions are taken below 90.

I was not a Novolin user so am tagging a couple of members for their input.
@Suzanne & Darcy
@FrostD
 
Hmm.

I would drop to 0.25U for each shot and give that a few days. We don't want them below 90 on Novolin so he may not give.you much choice. Unfortunately I can't begin to give you a shoot/no shoot number...my best guess is shoot above 140, skip below that - but I am not sure how low he may still go so be careful.

Going to dig through post history in a minute and come back with other thoughts
 
Cant quite find info I'm looking for - was he on steroids at all? Did he have any other infection/inflammation/issues at diagnosis other than the ones in your signature?

Update - I see the labs, looks like no infection at least.

I believe you did a diet change, when was the last day he received high carb food as a regular meal? (Ignoring trying to avert hypos)
 
Hi @FrostD. Thank you for your assistance. I believe the last day he received a normal/typical high carb meal was maybe the 9th? On the 10th, his BG was high at the vet so we changed his diet and he’s been doing well, except for dipping too low in the evening.
He occasionally gets cortisone shots during allergy season. I think his last one was in July/August. His allergies get so bad, he rubs the hair and skin off from around his eyes.
In July, he had a bout of pancreatitis. This was found when I took him in due to constipation. He’s normally very regular. When the vet sent his blood work for the diabetes diagnosis, he said the neutrophils were high and may indicate an infection. We were prescribed an antibiotic, 2 a day for 7 days.
 
So I gave Sammy 0.5u 40 minutes after he had kibble and about half a can of FF turkey pate. I tested him at +1.5 and he was 52. Gave him some HC FF chicken and rice with gravy along with some HC crunchy snacks. At +2, he was at 69. I will test again at +4, but feel he will be fine. He seems to be feeling better. He had a bad day today since one of the other kitties he lives was mean to him. She usually is but I guess today it affected him more. After his pate and shot, he hid and I got concerned. But now he is milling about and seems to feel fine. I think I will aim for 0.25u in the AM so he doesn’t have any issues tomorrow
 
Ok I suspect you have a few things going on - if there was an infection, that resolving brought BG down. The diet change will also have brought things down, and we say you usually see full results from that within about 2 weeks. Could have also been steroid induced.

All this to say - he may be diving straight into remission. I see the 105 this morning, can you get one or two midcycles just to see what happens?
 
Good Morning @FrostD. That is my hope as well - that he is speedrunning into remission. He is truly an amazing cat and I wouldn't put it past him to make his body get over this as soon as possible. He tolerates the shots and the testing since he knows I want it. He gets a lot of attention and a snack right after so he knows he is being cared for.
Unfortunately due to my work schedule, I cannot get any tests in between the AMPS and the PMPS Monday through Friday. I give him his AM shot about 30 minutes before I leave in the morning and get back about 45 minutes before his PM shot. I have been attempting to get more test results on the weekends just to see how he is doing.
 
Hi Diane, sorry, I thought I had filled it in. Yes, I gave Sammy 0.25u this morning since he was 105. We had our vet appointment today and the vet recommended taking Sammy off insulin! We will continue with the BG testing and if he goes over 250, the vet said to give him 1u until he is regulated again. He will definitely be thankful not to be stuck twice a day with the syringe :)
@Diane Tyler's Mom
 
Jessica & Sammy said:
Hi Diane, sorry, I thought I had filled it in. Yes, I gave Sammy 0.25u this morning since he was 105. We had our vet appointment today and the vet recommended taking Sammy off insulin! We will continue with the BG testing and if he goes over 250, the vet said to give him 1u until he is regulated again. He will definitely be thankful not to be stuck twice a day with the syringe :)
@Diane Tyler's Mom
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Hi Jessica I'm going to tag Melissa
@FrostD
I don't think what your vet said is such a good idea
She might not see this until tomorrow
 
I had debated the idea of trying an OTJ (off the juice) trial, but his numbers are still a smidge high so in my opinion it's better to continue the smaller dose as long as safely possible.

I'm not sure I'd wait for him to creep back above 250 though, and also not sure if give 1U at that number...but can cross that bridge if/when we get there.
 
Good Morning Melissa, I will resume giving Sammy low doses as long as he doesn't drop too low. I am thinking continue the 0.25u maybe once a day?
I will continue to test him throughout the day to ensure his numbers stay low and continue him on his high protein, low carb diet. It seems to be agreeing with him the best.
Thank you both for all your help!
@FrostD @Diane Tyler's Mom
 
That will be fantastic once he is off the insulin. He tolerates the shots since he knows I want them, but he hates them. Understandably. I am glad it is resolving so soon. Yesterday was 3 weeks to the day from his diagnosis. Are there any low dose syringes available anywhere? I am eyeballing the 0.25u but wondered if there is a more accurate means of measurement? I couldn't find any via Google. I saw the thread about where the best assumption is on the 0.5 measurements for 0.25u, but would like consistent dosages. Thank you again for your help @FrostD =)
 
Jessica & Sammy said:
That will be fantastic once he is off the insulin. He tolerates the shots since he knows I want them, but he hates them. Understandably. I am glad it is resolving so soon. Yesterday was 3 weeks to the day from his diagnosis. Are there any low dose syringes available anywhere? I am eyeballing the 0.25u but wondered if there is a more accurate means of measurement? I couldn't find any via Google. I saw the thread about where the best assumption is on the 0.5 measurements for 0.25u, but would like consistent dosages. Thank you again for your help @FrostD =)
Click to expand...
You are using U-100 syringes with half unit marking correct? 0.5 units is easy to do with half unit markings , so is 0.25. After that is 0.1 ,then a drop dose if needed
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Then
49822973598_359300d752_o.jpg
 
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If you don't have the U-100 syringes with half unit markings you can get them
You can also get the syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like: either box
They won't say it half unit on the box but the are . open then and look before you leave the store, can't be ordered on line , need to go into the store
:
upload_2021-9-5_23-18-9-jpeg.62508
 
Hi @Diane Tyler's Mom , yes, those are the exact syringes I have with the half unit measurements =).
I found this thread for general dosing suggestions for 0.25u:
https://felinediabetes.com/FDMB/threads/source-to-measure-0-25u-accurately.166485/
Part of the posting lists:
Fine dose gradations:
  • 0.5U = exactly half a unit
  • 0.4U = skinny 0.5 touching the line
  • 0.3U = skinny 0.5 with daylight under the line
  • 0.2U = fat zero with daylight over the line
  • 0.1U = fat zero barely touching the line
LOL, a little confusing but makes more sense in practice. I figure some doses, Sammy will get 0.3u and other times he will get 0.2u. Should still be enough to keep him regulated =)
 
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