Seizure and Low Blood Sugar - Pls help!

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Princethecat

Princethecat

Member Since 2022
Early this morning I woke up to my cat Prince having a terrible seizure. He has never had one before and he was screaming out in pain. It passed quickly and he was good for about ten minutes and started rapidly deteriorating. I rushed him to the emergency vet and his blood glucose levels were deathly low (23mg/dl). They gave him some glucose and monitored his levels closely for the next five hours.

I realized in my panic of this morning that I had glucose in my home that I could have given him however just coming out of that seizure I was afraid to even move him hence the mad dash to the emergency vet.

When he let the vet this morning his blood glucose levels were around normal for him (123 mg/dl).

I've been testing him in intervals since we've gotten back from the wet. His levels dipped slightly but then came back up after eating. Now he's hovering around 168 mg/dl.

I know...I apologize in advance bc I know this is where a spreadsheet of past levels would have come in handy and I so regret not keeping an organized and up-to-date spreadsheet. His levels when tested I wrote down on paper and follow kind of my own timeline and he had had frequent blood glucose levels done by the vet which made me feel a little more secure in not testing him frequently. I regret so deeply being pretty relaxed on testing his levels etc. he was actually doing quite well before this episode.

Tomorrow I am taking him back to his primary vet and they are going to once again monitor closely and fry and figure out if the seizure is related (most likely given his levels) or something unrelated.

My question is about insulin Since his shot last night he has not received insulin today and the emergency vet advised against it. He is on 5 units of Prozinc 2/day (yes I know insane - but prior to this his levels have been considered normal and his primary vet has insisted on keeping it on 5).

I will be testing him throughout the rest of the day and early next morning - but should I be giving him insulin tonight? The primary vet said it best not to give him the whole 5 units maybe 1-2u depending on where is bg/dl count is after his nighttime meal.

Please help!

Here's a reference to my original post which gives his general background: https://felinediabetes.com/FDMB/threads/new-here-need-advice.267700/#post-2995454background: https://felinediabetes.com/FDMB/threads/new-here-need-advice.267700/#post-2995454
 
Princethecat said:
Early this morning I woke up to my cat Prince having a terrible seizure. He has never had one before and he was screaming out in pain. It passed quickly and he was good for about ten minutes and started rapidly deteriorating. I rushed him to the emergency vet and his blood glucose levels were deathly low (23mg/dl). They gave him some glucose and monitored his levels closely for the next five hours.

I realized in my panic of this morning that I had glucose in my home that I could have given him however just coming out of that seizure I was afraid to even move him hence the mad dash to the emergency vet.

When he let the vet this morning his blood glucose levels were around normal for him (123 mg/dl).

I've been testing him in intervals since we've gotten back from the wet. His levels dipped slightly but then came back up after eating. Now he's hovering around 168 mg/dl.

I know...I apologize in advance bc I know this is where a spreadsheet of past levels would have come in handy and I so regret not keeping an organized and up-to-date spreadsheet. His levels when tested I wrote down on paper and follow kind of my own timeline and he had had frequent blood glucose levels done by the vet which made me feel a little more secure in not testing him frequently. I regret so deeply being pretty relaxed on testing his levels etc. he was actually doing quite well before this episode.

Tomorrow I am taking him back to his primary vet and they are going to once again monitor closely and fry and figure out if the seizure is related (most likely given his levels) or something unrelated.

My question is about insulin Since his shot last night he has not received insulin today and the emergency vet advised against it. He is on 5 units of Prozinc 2/day (yes I know insane - but prior to this his levels have been considered normal and his primary vet has insisted on keeping it on 5).

I will be testing him throughout the rest of the day and early next morning - but should I be giving him insulin tonight? The primary vet said it best not to give him the whole 5 units maybe 1-2u depending on where is bg/dl count is after his nighttime meal.

Please help!

Here's a reference to my original post which gives his general background: https://felinediabetes.com/FDMB/threads/new-here-need-advice.267700/#post-2995454background: https://felinediabetes.com/FDMB/threads/new-here-need-advice.267700/#post-2995454
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I'm so sorry this happened I'm going to tag Melissa for you a prozinc user
@FrostD

Melissa please go back and read her last and only post , She is still giving 5 units

Here is her post
Here's a reference to my original post which gives his general background:https://felinediabetes.com/FDMB/threads/new-here-need-advice.267700/#post-2995454background: https://felinediabetes.com/FDMB/threads/new-here-need-advice.267700/#post-2995454
 
I am going to tag @FrostD as she is a Prozinc user.
Do you normally test the BG levels regularly? If not I would highly recommend you start testing before every dose to see it is safe to give the dose and then test during every cycle to see how low the dose is taking Prince.
5 units is a lot of insulin to be giving without regular testing. Testing every so often at the vet will not keep Prince safe.
insisting on keeping him on 5 units without daily testing is very risky in my opinion.

I would certainly not give 5 units of insuli. I would test regularly and see what the BGs are doing.
As you are going to be reducing the dose I would strongly recommend you test the urine for ketones each day at the moment. If you don’t have any Ketostix at home you can buy them at Walmart or a pharmacy. Follow the directions on the bottle.
Ketones can start appearing if there is not enough insulin, not enough food. make sure he is eating plenty of food.
Are you feeding snacks during all the cycles as well as the main meal.

let’s see what Melissa says about the dose tonight. How long before the dose is due?
 
Cats that have had a symptomatic hypo, like yours just did, can be sensitive to insulin right after. That means a reduced dose next time you give it. And monitoring closely will be essential.
 
@Bron and Sheba (GA) thanks for the response. Yes I am feeding him treats and such in between meals usually at the intervals I check at. The next dose is due now about 8.5hrs from when I post this (930am PST).


Update from last night: I have yet to give Prince insulin today, especially with going blind on what dose to give his bs levels did not need to drop more then they already have. But I’ve been monitoring Princes levels. From their initial 168 they dropped slightly to 122 and then to 107 all within a sort of okay range. I gave him some treats to bring it up a little right before midnight. I knew I wasn’t going to be able to test that frequently during the night because, by this point Prince was fed up of me constantly poking him and put up quite a fight causing him (and me) quite a lot of distress.


And this is what I’m worried about. This could partially be because of traumatic morning w/ the low bg level emergency vet trip but Prince was especially difficult these past couple of times when I try and draw blood. I feel so bad his poor ears are a little bruised and as well as you can clean up a car that’s actively fighting you there’s always a little dried blood stuck to the fur. and I’m terribly worried that it’s too much for him. I know that the benefits obviously of getting a read at this moment is probably more important than note and letting his levels crash. But is it normal for his ears to look so bruised up?

Right now I have been feeding him treats and a little bit of corn syrup to keep his levels in a good place. I don’t know any other types of foods I can be giving him to help increase whenever need be. Are their specific wet foods that are higher in carbs but still safe to give?


Taking him into the vet tomorrow morning and I feel a little more secure having them monitor him so I can get a good idea of where he’s at.
 
Are you able to enter in all the data you have taken so far please into the spreadsheet?
I’m not sure where you live but I’m taking a guess it might be the UK? Is that correct?
If you are from the UK, have a look at this thread and look at post 43. A UK member has lost some higher carb foods that are available in the UK.

if you are from the US have a look at this FOOD CHART
Look for food 11-15% carbs for medium carbs and for high carbs look for 26% and above carbs.
Are you saying you still need to feed him corn syrup to keep the BG up high enough?

With testing the BG in the ear…if you hold the pricked ear for 29 seconds after you get the blood, that should stop the bruising.
you will get better at it as time goes by
Here is a link to HOMETESTING HINTS AND LINKS
Make sure you give him a treat every time you test him.

Take special note of what Wendy said…..that after a symptomatic hypo, a cat can be very sensitive to insulin right after.
 
If you are using the Relion, he's fine as long as he's above 50 when not in insulin. You don't need to feed him high carbs to stay above 100, if you haven't been giving him insulin. How many hours since he last had insulin?
 
Unfortunately without more BG data I can't really say what dose to be giving. Do you keep paper notes? Daily testing?

He definitely needs a reduction of at least a full unit (so down to 4U, but even that may be too much). But as Wendy said he may be extra sensitive right now, so something lower than that.
 
you say your vet insisted on the 5 units. It is good to remember that you hold the syringe

it is super-common among folks who come to this forum to have this same story -- their vet says a certain dose is right and they dare not question it. But many, many of us eventually come around to using the resources here at the FDMB, the dosing methods and guidelines, and ultimately end up with a dose different than the vet recommends. Sometimes the vet is aware, sometimes they aren't.
 
Hi all thanks for the responses.

An update on Prince after is a visit to the vet yesterday. Prince is looking better and determined that the seizure was due to low bs (as I had thought). He ran blood work which came back as normal. At the vet Prince was holding at around 126 mg/dl. He recommends to continue on 3u. I still think this is too high, given that he's gone quite a while (1 day) without insulin and his levels are a little normal. I want to monitor closely and then make a decision for his night shot tonight.

Thanks @Bron and Sheba (GA) for the list ill be looking to get a few of those higher calorie cans just in case. Also im from the US :) I've been staying up very late monitoring Prince and half in stress, hence my middle of the night posting.

@Wendy&Neko Yes I do use Relion (added this to my signature), good to know about the levels. He dipped right after coming back from the vet on 11/9 (from 122 to 64) despite having eaten so that is when I gave a higher-calorie treat as well as I was scared it would drop lower. Last night I gave him .5u of insulin as his level was 137 mg/dl. He has gone at this point ovr 24hrs without a shot, but I defintely think 3u was too much. The vet said, that it is better to keep him a little higher then low and I did not want this to dip in the night.

@FrostD Yes I have been keeping paper notes unfortunately and I went just the times I tested throughout the day, knowing he gets insulin at 930am/930pm my time. I tracked yesterday as well but Prince was at the vet for half the day where they tracked his levels there. I have started to track today as well. I have added this to my spreadsheet. Hoping I did this right. As of the last time I tested he is at 151 mg/dl (after food).

Not sure if i should put yesterdays levels in the sheet as it doesn't really follow the right times since he was at the vet but this was his levels from yesterday:

AMPS - (before vet) 121 mg/dl , At vet (not sure of exact time that they tested, and he was fed there but again not sure of exact times) 126 mg/dl right before he left the vet 122 mg/dl. PMPS ( +12 after AMPS) 137 mg/dl. He ate quite a bit at the vet so didnt want the food I gave before this test so this reading I don't think is too affected my food? Not sure though.

So now I'm trying to figure out what insulin amount would be appropriate - would like some advice. I will keep updating my sheet through the day when I test.
 
Yes, add yesterday's values to the SS. Annotate under Remarks on the right the the values that were taken@vet and he was fed some @#vet.
Also add a new row for the dose you gave previously and what dose you gave yester morning and evening. If no insulin enter 0.
 
Princethecat said:
Not sure if i should put yesterdays levels in the sheet as it doesn't really follow the right times since he was at the vet but this was his levels from yesterday:
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Yes, please put in the levels from the vet. They will be helpful. If you could put in the remarks column that he was at the vet and if he had any insulin that day please.
 
Are the BGs you have put into the SS for 11/11 without any insulin?
I am going to tag @FrostD about the dose of Prozinc as I don’t use Prozinc but I’m not sure she is around for the next week….let’s see.
While you are not giving any insulin (and I would not with the BG 122 and 151) I would definitely test the urine for ketones. I mentioned in post 3 why they are so important and where to get the Ketostix..
Keep monitoring the BGs and feed lots of food.
 
I am around and keeping an eye - today is/was my due date so I will do my best to pop in until baby comes.

I don't have access to the spreadsheet, probably needs changed to Anyone with the Link Can View.

If today's numbers were without insulin, you're probably looking at a dose of 0.25U if above 130 - but even that might be a little much so I'd only recommend that if you have hypo kit and can monitor.
 
Hi all. Updated the spreadsheet with yesterday's tests (added comments) as well as today

How often should I be testing today? I was going to do one a before I feed (that would be around AMPS +11) and one before I give a "insulin shot" Still unsure how much to dose. Per @FrostD (congrats btw!) rec maybe .25u?

Prince's energy has been overall pretty low today, not sure if this is because of the lower than usual levels and the stress of the last couple of days or what.
 
I can see it - sticking with my prior recommendation.

The important tests right now are the +4 to +7 window, we want to pinpoint nadir to make sure the dose isn't too high. The later tests only tell us duration, which doesn't appear to be an issue. Testing earlier at +2 to +3 may help you stay ahead of a drop - they're good tests to have, but if you have to pick and choose I prefer +4.
 
@Bron and Sheba (GA) I did not test after the insulin was given, unfortunately. I will test tonight.

Confused by his most recent reading. (on SS) right now it is at 278 mg/dl. This is at +10 and two hours after his last meal. I am going to test twice today once before his nighttime meal and then again after his shot. But this is the highest I've seen his level since the seizure. Not sure what dose to give. Would .25u be enough?

I think I need to figure out what times are best to test, since I have to coordinate them around my work. I will test the AMPS then +4 and +7 as you suggested @FrostD and then PMPS and then after the insulin? So four times a day?

Thanks, everyone again for the help I really do appreciate it, I feel I will be little less stressed once I get a grasp off what insulin dose to give
 
Princethecat said:
@Bron and Sheba (GA) I did not test after the insulin was given, unfortunately. I will test tonight.

Confused by his most recent reading. (on SS) right now it is at 278 mg/dl. This is at +10 and two hours after his last meal. I am going to test twice today once before his nighttime meal and then again after his shot. But this is the highest I've seen his level since the seizure. Not sure what dose to give. Would .25u be enough?

I think I need to figure out what times are best to test, since I have to coordinate them around my work. I will test the AMPS then +4 and +7 as you suggested @FrostD and then PMPS and then after the insulin? So four times a day?

Thanks, everyone again for the help I really do appreciate it, I feel I will be little less stressed once I get a grasp off what insulin dose to give
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The 278 is because he has not had any insulin this cycle and he is possibly bouncing from the low BG he has had over the last day or two.
Hopefully @FrostD will get back to you about the dose but if she doesn't I would stick with the dose she suggests for now and see how that goes.
I will also tag @Suzanne & Darcy in case Melissa is unavailable. She can help with prozinc as well.
Did you get the ketostix and test the urine for ketones?
After the PM dose I would test 3 or 4 hours later and if that test is a lot lower than the preshot I would test again a bit later.
 
Princethecat said:
@Bron and Sheba (GA) I did not test after the insulin was given, unfortunately. I will test tonight.

Confused by his most recent reading. (on SS) right now it is at 278 mg/dl. This is at +10 and two hours after his last meal. I am going to test twice today once before his nighttime meal and then again after his shot. But this is the highest I've seen his level since the seizure. Not sure what dose to give. Would .25u be enough?

I think I need to figure out what times are best to test, since I have to coordinate them around my work. I will test the AMPS then +4 and +7 as you suggested @FrostD and then PMPS and then after the insulin? So four times a day?

Thanks, everyone again for the help I really do appreciate it, I feel I will be little less stressed once I get a grasp off what insulin dose to give
Click to expand...
Ideally yes, 4 times a day.

I would stick with the 0.25U for at least 3 days to see, even if preshots are high. As Bron mentioned about ketones - if those show up we'd be a little more aggressive. I suspect he may have gone low after last night's dose and then bounced during the day today, "aided" by no insulin. Also possible he's getting slightly longer duration from ProZinc.

Either way, the next 3 days will tell us a lot about dose!
 
Thanks @Bron and Sheba (GA) and @FrostD. After his night time meal I will test before and after the shot (will be trying .25u)

I havent had the chance to go to the store over the weekdays. So i'll be picking up the ketostix tomorrow and will be at home all day to test at better times since is the weekend. I've been reading up on how to test for ketones. Not sure if Prince will be the most helpful and comply with the methods but I'm going to try.
 
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Hello all an update with Prince. Still a little unsure about dosing. Updated my spreadsheet with todays numbers. Still tested high in the morning before insulin (231). I gave .75u as I feel like last nights .25u was a little low maybe. Texted again at +2 and he’s at 238. Wondering if I should go higher for night times shot.

Will be picking up the ketostix today and testing throughout the day. Will try to test ketones as well.

Prince has been sneezing a little this morning I think he has a little cold. :(
 
I would not increase the dose tonight, as it looks like he's bouncing (the yellows) from those blue numbers. If you increase and he decides to break that bounce, you could have too much downward momentum from both the bounce break (where his numbers will come down naturally) and the increased insulin. Please try to dose consistently and hold the dose (unless a low preshot or a really low nadir tell you otherwise.)
 
Also, please know that a lot of cats tend to drop lower at night. Without night time tests, which you don't have yet, we can't know what Prince's pattern is. If he's bouncing, of course, you may not see it in a particular cycle, but it is a phenomenon we observe here a lot -- dropping lower at night. We must keep Prince safe. It's going to require some patience and consistency. By the way, I really think you are doing great with the testing. I'll check in later to see how he does for the remainder of the day. What's your time zone?
 
Oh, they have blood ketone meters. I have a NovaMax Plus blood ketone meter (bought from ADW Diabetes Supply.) The strips are kind of expensive, but it's way easier than trying to catch them in the act in the litter box.
 
Thanks @FrostD and @Suzanne & Darcy for the dosing info - you were right he is dropping a little lower at night just tested PMPS at 173. So im sticking with the .25u dosage. Now starting to understand the patience ith figuring out levels/dosage. Getting better at not panicking at each low or high reading as well :/ . I will test in about +2 to see how his levels react to the shot.

@Suzanne & Darcy I am in PST.

Bought the ketostix today but was not at all successful. Tried putting plastic to catch the urine but Prince ended up hating that and practically digging it out. Since he's been a little more low energy its hard to track his bathroom times as there not really as consistent as in the past. I will try again tomorrow also might purchase nonclumping litter and see how that works with the sticks.
 
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