Should I give a kitty with a reading below 100 his insulin shot?

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AndreaJ

AndreaJ

Member Since 2020
Hello,

If my kitty's blood sugar levels are below 100 on a pet blood test meter, should I skip his insulin shot? My vet wants me to give him his insulin, I am just terrified of overdosing my kitty!

Back story: About a three or four weeks ago my Halo was diagnosed with diabetes. I was testing him today, and his blood sugar was down to 71 and then a couple of hours later, 90. He has been getting three units of insulin every 12 hours in a U-40 pet syringe.

Attached is his blood testing chart.

Thank you for your feedback!

Best,
Andrea
 

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AndreaJ said:
If my kitty's blood sugar levels are below 100 on a pet blood test meter, should I skip his insulin shot?
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Please don't give any insulin at the moment.

More in a moment. Please keep watching this thread for my next post.

(Sorry for brevity of first reply. Need to ask some urgent questions and wanted to make sure you don't give insulin before I have time to type them out.)


Mogs
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Critter Mom said:
Please don't give any insulin at the moment.

More in a moment. Please keep watching this thread for my next post.

(Sorry for brevity of first reply. Need to ask some urgent questions and wanted to make sure you don't give insulin before I have time to type them out.)


Mogs
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This is what my gut was telling me; probably from poring over these boards :)

Thank you! He isn't scheduled for his insulin for another hour. I will test him right before I give it to him. Thank you!
 
Okay, I just retested - it is now 53!!!! I haven't given him any insulin in 12 hours! I tested my meter to make sure it was working correctly and it came out okay. This is very strange and I am calling the U of M veterinary center - it's a few miles from where I live.
 
Hi Andrea,

AndreaJ said:
Okay, I just retested - it is now 53!!!! I haven't given him any insulin in 12 hours! I tested my meter to make sure it was working correctly and it came out okay. This is very strange and I am calling the U of M veterinary center - it's a few miles from where I live.
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Good that you're calling them ... BUT... BEFORE you call, please can you give Halo a small amount of food - preferably a FF Gravy Lovers medium or high carb variety (or similar med/high carb food) - because at 53 on Alphatrak he is below the hypo threshold. You need to get his numbers up above 68 ASAP. If you don't have med or high carb give some low carb with a small amount of honey mixed into it to give a quick boost to his BG levels.

Test again 20 minutes after feeding and post the result here. If he's at the same level or lower, give more honey and a tsp of the highest carb food you have.

DO NOT GIVE ANY INSULIN!!!

More to follow. Please keep checking this thread for updates.


Mogs
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Thank you! I have been trying to get him to eat his highest carb cat food - I gave him a bunch of Temptations treats, which he loves. He is HATING me poking his ear right now. Extremely unhappy and he has been such a good sport. I am keeping a very close eye on him with the exception of checking this board. Outwardly, he seems just fine. But I am going to continue to ply him with his favorite treats.

Thank you!!!
 
@Panic

Elizabeth - if you're available at all, Halo is on Prozinc, is at the end of the cycle and is currently at 53 on Alphatrak. I know your schedule is tight this week but if you had a few minutes to give me some pointers on the Prozinc side of things I'll do my best with general stuff.


Mogs
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AndreaJ said:
Thank you! I have been trying to get him to eat his highest carb cat food - I gave him a bunch of Temptations treats, which he loves. He is HATING me poking his ear right now. Extremely unhappy and he has been such a good sport. I am keeping a very close eye on him with the exception of checking this board. Outwardly, he seems just fine. But I am going to continue to ply him with his favorite treats.

Thank you!!!
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He'll forgive you for the ear pokes, Andrea. :)

Can you rub a little honey on his gums now, please. It will take a little while for the carbs from the Temptations to get into the bloodstream. The honey will boost numbers faster.

Again, test 20 minutes from when you gave the first batch of treats. Don't give him too many at once because you may want him to eat every 20 minutes until his numbers recover.

I'm parked on this thread watching for updates.


Mogs
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Will do! Thank you!!! The U of M won't take phone consultations for someone who isn't a patient - (my dog has went there who passed but I haven't taken Halo. Taking him to the vet is extremely stressful for him that is why I pay for a vet to visit him at home. )

Thank you,
Andrea
 
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Thank you for your help! This is very alarming! I cannot figure out why his blood sugar is going up and down and hypoglycemic 11 hours after his last shot!
 
I'm sorry that you couldn't get support from them, Andrea. We'll do all we can to help. :bighug:

Please post your test result here as soon as you get it so that I can help you with next steps.

Good call going with your data and posting for help tonight, BTW. :)


Mogs
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While we're waiting for the test time to come up, here are a couple of questions I need answers to:

1. Has Halo ever tested positive for ketones, or has he ever had any episodes of diabetic ketoacidosis (DKA)?

2. Do you have a Google Drive account?


Mogs
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Hello,

I will call my vet that did all the testing (the one that wanted me to put him down). I just tested his blood glucose again - he's at 112. Whew!!!! Thank you for your help! I do have google drive.

Best,
Andrea
 
AndreaJ said:
I just tested his blood glucose again - he's at 112. Whew!!!!
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Great that Halo's back up above 68 but you're not out of the woods quite yet, Andrea. The first step was to get Halo up into safe numbers. Now we need to make sure he STAYS UP in safe numbers.

The honey is likely boosting that 112 reading but it wears off quickly.

Next step:

* Don't give any more Temptations or any other food for now.

* Test again in 30 minutes.

In the meantime can you let me know how many Alphatrak test strips you have in the house, and also whether you have a backup meter and strips for that (human meter is fine here).


Mogs
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AndreaJ said:
Halo hasn't had any episodes of diabetic ketoacidosis that I know of.
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If Halo had had DKA it's definitely something you'd be very much aware of.

I asked about this because it helps us to assess the safety of skipping a dose. (Extra caution in this respect is needed in cats with history of ketosis/DKA.)


Mogs
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Critter Mom said:
@Panic

Elizabeth - if you're available at all, Halo is on Prozinc, is at the end of the cycle and is currently at 53 on Alphatrak. I know your schedule is tight this week but if you had a few minutes to give me some pointers on the Prozinc side of things I'll do my best with general stuff.


Mogs
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Still flaky today unfortunately but yes, get him over 90 ideally, on his own for 2 hours. Prozinc does have a history to last 14 hours on occasion, I ended up with a 48 at AMPS on it once. The nice thing about Prozinc is you aren't fighting a depot. Looks like he needs a reduction!
 
Nan & Amber (GA) said:
Unfortunately I don't have any personal experience with it either. I mostly only pipe up with (what I think are) conservative thoughts and observations until one of the Prozinc folks come by, and then defer to them for the knowledgeable advice.
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Do you have a rough idea of what good or exceptional dose duration might look like in hours? Also, I know that there can be some carryover from one dose to the next but I've no idea how long that carryover effect can potentially last. Have you come across any info, however basic, in this regard?


Mogs
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Panic said:
Still flaky today unfortunately but yes, get him over 90 ideally, on his own for 2 hours. Prozinc does have a history to last 14 hours on occasion, I ended up with a 48 at AMPS on it once. The nice thing about Prozinc is you aren't fighting a depot. Looks like he needs a reduction!
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Elizabeth to the rescue! I know things are a bit tricksy for you this week so thank you very much for answering the tag. That's just the info I was after re duration/carryover.

At the moment, Halo's spreadsheet is in Excel format but I'm hoping to work with Andrea to make it visible in Google Sheets. If we can get it sorted would it be OK to tag you and ask you to have a look at Halo's data for Andrea (at a time convenient to yourself, of course!)? Other than saying 'reduce!!!' I can't offer anything insightful for Prozinc on the dosing side of things.


Mogs
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AndreaJ said:
Thank you so much you guys. Halo started on the 3 units on September 29. Here's his chart in google sheets: https://drive.google.com/file/d/1VrCDIzYZeQg7ytqISc21-bp8tQJ588w0/view?usp=sharing
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Yay! I can see data!! Thank you.

Andrea, if you haven't already done so please test Halo's BG again and post the result so that we can see how he's doing. As you can see from recent posts above, it is possible for Prozinc doses to last more than 12 hours so vigilance is very much necessary.


Mogs
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Nice job getting that into our spreadsheet format so fast!

I will be interested to see what the Prozinc folks like Elizabeth have to say about his numbers. My (very general) view is that there's been a clear downward trend in the last week (starting to hit blues on 9/30, and now we're clearly off to the races!).

The reason I asked about food changes is that one thing we've seen over and over again is that changing from high carb to low carb food can have a dramatic effect on a diabetic cat's insulin needs. In some cases, the food change alone can send them into remission! So I was wondering whether there might have been something like that going on to explain his rapid progress...
 
Hello!

He is now 161 - this has been about 45 minutes after the honey; he also got his favorite gravy-like Fancy Feast.

I did switch his diet to mostly pate cat food/fresh tuna/sardines. I used to spoil them with the gravy/creamy canned cat food from Purina. I also cut back big time on the treats.

But, I haven't totally deprived him.

I am so grateful to you all for your help.

I did give him his shot at 7 a.m. this morning.

Best,
Andrea
 
Thanks for posting the latest test result, Andrea.

As noted above you need to make sure that Halo now stays in safe numbers for 2 hours WITHOUT *ANY* FOOD.

Next steps:

1. Do not feed.
2. Test again in 30 minutes.
3. If BG is less than 68, feed a few tsps of FF with gravy or other higher carb food (preferably a wet HC food, but dry is OK if nothing else available). Go back to step 2.
4. If BG is below 90, feed a couple of tsps of LOW CARB food. Go back to step 2.
5. If BG is above 90, go back to step 1.

Keep following the above steps until Halo has stayed above 90 for two hours WITHOUT any feeding between tests.

I'm tagging Elizabeth again (@Panic) to ask her to look at your spreadsheet data. I hope she will be able to give you some pointers on Prozinc dosing. There's only one that I can give you with confidence and that is:

** Do not give 3 units of Prozinc again. The dose is too high. **

I also recommend that you consult with your vet urgently in the morning about the low numbers you've recorded today and discuss dosing with them. You can seek advice here any time, including feedback on any dosing recommendations from your vet that you feel uncomfortable about. Whichever way, you need to seek advice on how much to lower the dose by. Because I've only limited knowledge of this insulin it's not something I can help with.


Mogs
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AndreaJ said:
I also cut back big time on the treats. But, I haven't totally deprived him.
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You can actually have the best of both worlds: most cats really love freeze-dried protein treats (e.g. Purebites) - and they're diabetic-friendly. :)

Wishing yourself and Halo a safe night. Post again if you need more help. (I'm in the UK so will be signing off but other members should be around.)


Mogs
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Thank you so much for your help!!! My vet is the one who told me to give Halo MORE INSULIN even after the low readings! So I don't trust her judgment. That's why I came to this board. I will retest Halo in a half hour. I will check out pure bites right now. Thank you! Thank you so much Mogs!!!
 
AndreaJ said:
My vet is the one who told me to give Halo MORE INSULIN even after the low readings!
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If you look under the forum FAQs there's a sticky about vet interview topics, in case you choose to seek a new one who's more knowledgeable about feline diabetes.

I'm glad we were able to help you both, and we'll be only too happy to do so again any time you need us. :)

Some helpful resources for you (which you no doubt have already seen but which are always worth re-reading):

Prozinc Dosing Methods

How to Treat Hypos

Hypo Toolkit


Mogs
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I think you can probably ease off on the testing now (unless you want to collect more info).

We call what he's doing right now "bouncing". When BG goes lower than the cat's body is used to, there's a protective counter-reaction in which the liver basically dumps all the sugars it can into the blood to raise BG. Bounces can be long (up to six shot cycles!), so he may be high again tomorrow morning. As Mogs pointed out, there's some indication of bouncing on the spreadsheet, but I don't think we have enough data to have an idea of how long he usually bounces.

Bounces are a pain, but one good thing about them is that you'll probably be able to get a good night's sleep, even after the scare today!
 
I want to tag a couple other Prozinc people for dose recommendations but the SS isn't updated and we really need to switch you over to the google sheet ... some people here won't offer advice without the spreadsheet set up. @Bandit's Mom or @Chris & China (GA) what can we do to get that ball rolling please? :)

SPREADSHEET LINK

I am thinking maybe backing up to 2u ... We know Halo needs a reduction but with such scattered data (lots of missing pre-shots) I can't give solid advice. I would prefer @Deb & Wink or @JanetNJ input here but again, they probably won't be comfortable offering dosing advice until the SS is updated. I wish I could give concrete advice but I'm just not 100% sure so I will have to leave that up to you. I DEFINITELY think you need to reduce by 0.25 units, but past that I can't say for certain. Bigger reductions are more Janet and Deb's forte.

EDIT: Spreadsheet was made, updated, and added to signature.
 
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Thanks for taking the time to respond and your advice. I am not good as I should be at recording things, especially when I am panicked. Here's what his day looked like today:

11 a.m. (he got his shot at 7 a.m.) he was 71
2:12 p.m. he was 90
2:25 p.m. he was 125
4:20 p.m. he was 53
5:00 p.m. he was 112
5:56 p.m. he was 161
6:51 p.m. he was 248
7:31 p.m. he was 347
7:52 p.m. he was 385
8:16 p.m. he was 410

And I am not going to bother him anymore tonight because he was pretty upset on that last draw.

Thanks again.
 
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