Subject Change: What is Going on With Todd's BG Numbers?

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ToddyTiger

ToddyTiger

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Todd's BG is 64 right now. I just double checked. The vet said it's not OMG freak out low, but she said to give him some Karo syrup and skip his insulin tonight. I have two kinds of Karo. Karo Corn Syrup with brown sugar (it's dark) and Karo Light Corn Syrup with vanilla (it's light)

Which one do I give, how much and do I just put it in his mouth??

I should point out, he is not acting odd AT ALL. He is purring, bright eyed, chatting with me and eating his k/d right now.

Thank you!
 
Re: Which Kind of Karo Syrup.. Help!

Either will work. Honey will also work.

Rub the corn syrup or honey onto the gums. Watch out for your fingers. A hypoing cat may bite. Use a needless oral syringe if you have one. I think pharmacies sell some. Start with a teaspoonful or 1 ml and increase if needed. Keep a very close eye on bg levels. Do you have any gravy canned food? Those will also rais bg levels and stay in your cat's system longer than corn syrup or honey.

64 isn't very low. How many hours after the insulin injection is this number? What insulin is your cat on and what dose? If it's early in the cycle you do need to watch out for dropping numbers.

Hypo reference sheet: http://felinediabetes.com/hypogly.htm

What to keep at home to use for a hypo: viewtopic.php?f=14&t=2354
 
Re: Which Kind of Karo Syrup.. Help!

Thank you!

he received 2.0 units of Lantus at 9:30am this morning. His BG was 466 this morning, before insulin.

It was 4:30pm when I checked his BG again, which was the 64. It's been about 6 hours since he got his Lantus.
 
Re: Which Kind of Karo Syrup.. Help!

I put some of the Karo on my finger and gave it to him. I did that twice, I also gave him a treat and a teaspoon of tuna water.

I'll recheck in 10 to 15 minutes
 
Re: Which Kind of Karo Syrup.. Help!

like was mentioned, 64 isn't a crisis number just yet so not sure if i would have used the syrup already but if this is the first time you're seeing a number like that i totally understand :-)

my math has you at actually 7 hours since the shot? if so you should be fine but yeah, test again in a few just to make sure. data is never a bad thing :-)
 
Re: Which Kind of Karo Syrup.. Help!

This is only the 2nd time I have seen his numbers drop into 60's. The last time this happened, he was in the 60's, shivering, not moving, glassy eyed and not acting normal at all. This time, he is acting normal and looks normal, just has a low number. I probably shouldn't have given the syrup.. but I suppose better safe than sorry. I put out some Friskies in gravy as well.

I have to leave shortly and will be gone about an hour. I hope his numbers go up..
 
Re: Which Kind of Karo Syrup.. Help!

ToddyTiger said:
Thank you!

he received 2.0ml of Lantus at 9:30am this morning. His BG was 466 this morning, before insulin.

It was 4:30pm when I checked his BG again, which was the 64. It's been about 6 hours since he got his Lantus.
Click to expand...


Insulin doses are measured in units, not ml. 2 ml would be two completely full 100 unit/1 cc/1 ml insulin syringes :shock:

Lantus peaks for some cats around +6. Your cat's bgs may be on their way up now. Hold off on the syrup/honey for now. Do a few more tests if you can.
 
Re: Which Kind of Karo Syrup.. Help!

definitely better to be safe, especially if you've had symptoms in the 60's before. YIKES!
 
Re: Which Kind of Karo Syrup.. Help!

If the kitty is able and willing to eat -- food is pretty much always better than syrup or honey.

If the kitty is having a seizure or cannot eat -- THAT is when you need to wipe syrup on their mouth/gums where it can be quickly absorbed
 
Re: Which Kind of Karo Syrup.. Help!

haha sorry squeem3, I wrote ml when I meant to write units. Fixed that. ;)
 
Re: Which Kind of Karo Syrup.. Help!

466 to 64 is over a four hundred point drop in less than six hours. Sixty four isn't very low but couldn''t such a drastic rapid drop also cause rebounding?
 
Re: Which Kind of Karo Syrup.. Help!

Well, now, at 11:20pm, he is at 325. He is still acting fine.. well, as fine as he has been for a while.

Does anyone know what these numbers are telling us? If you take a look at Todd's SS, you can see what has been going on the last few days. The numbers really are all over the place.
 
I would lower the dose to 1. And a half units for a few days. It would be better to have the numbers a little too high than too low. The drastic rise and fall like that is also not good for your kitty's metabolic system. It takes a while to get the right dose. My cat is on lantus too and it was almost six months before he was off the BG roller coaster!
 
Please pardon me for asking.. but what do you mean by "rebounding?"


The vet at our clinic today said to give him 1.5 units, rather than the 2 units. So I'll do that and see how he does today. He's back up into the 400'd this morning.
 
meh, so he threw up a bit before breakfast and his insulin. It was some white foam. He looks just fine though. I gave him a Bonito and that made him happy. I called the vet again and he said to hold off on insulin until tonight and give it a couple of hours before I give him his other pills (tumil-K and such). I gave him some Pepcid (after he threw up), I'm going to give him some Sub-Q in a minute and just watch him for the day. He looks ok though...
 
Hi, I see you've been here for a little while. Did you recently start Lantus?

You may want to stop over and check-in on the Lantus board, there is lots of great information regarding Lantus and how to deal with some of the low number issues. An example would be we would not be telling you to reduce your dose tonight based on a normal BG number. If you do reduce you dose for tonight do so by only a 0.25u. Lantus has a "shed" that needs to stay filled and dropping dose to quickly will only leave you with high numbers.

Link to the Lantus Support Board
viewforum.php?f=9

Don’t Panic! or How to Handle Low Numbers for Lantus
viewtopic.php?f=9&t=28888

STICKY: LANTUS & LEVEMIR - INSULIN DEPOT -AKA- STORAGE SHED
viewtopic.php?f=9&t=150

Actually, I see you skipped a shot/shots entirely. This means you have to start over. But...that's ok we can get you back up and running in a few days. Please visit the Lantus Board and post there. We can help you a great deal.

Lantus likes consistency in dosing time and amount. It looks like the 2.0u was a good dose for you guys. If you are worried giving 2.0u tonight give 1.75u.

But I think your biggest tool and opportunity available is visiting the stickies at the top of the Lantus Support Group Board.
 
Hi Blue,

Todd has been on Lantus for a couple of years. But we just recently started doing home testing, due to him getting sick in July and not fully recovering. He's been getting higher numbers for months now, but the vet just decided on Tuesday this week, to up his dose from 1.5 to 2 units. It did bring his number down and like magic, his neuropathy was gone by the next day! So I know he needs a higher dose. I agree and had already planned on doing 1.75u, rather than jumping back down to 1.5u. Thankfully I am home 90% of the time, so watching him is easy.
 
Great job on starting home testing! ;-)

You have taken an important step forward for Todd. And ...definately c'mon on over to the Lantus Board. Even though you've been using it for years, it sounds like there is a lot you may not have known about it.

Lantus is a unique long acting insulin, which I'm sure you realize.
 
Thank you! I will hop over there shortly.

Since it seems to be a community all it's own, should I just do an introduction post with some background on what is going on with Todd?
 
Re: Which Kind of Karo Syrup.. Help!

Based on the last few days of your spreadsheet, (glad you are testing) - it seems like his dose is too high and his numbers are all over the place. The next time you shoot, why don't you cut it down to one unit - test several times during that cycle - and see if the numbers become more stable throughout the curve...

ToddyTiger said:
he received 2.0 units of Lantus at 9:30am this morning. His BG was 466 this morning, before insulin.

It was 4:30pm when I checked his BG again, which was the 64. It's been about 6 hours since he got his Lantus.
Click to expand...
 
Re: Which Kind of Karo Syrup.. Help!

SaraJaye said:
Based on the last few days of your spreadsheet, (glad you are testing) - it seems like his dose is too high and his numbers are all over the place. The next time you shoot, why don't you cut it down to one unit - test several times during that cycle - and see if the numbers become more stable throughout the curve...

ToddyTiger said:
he received 2.0 units of Lantus at 9:30am this morning. His BG was 466 this morning, before insulin.

It was 4:30pm when I checked his BG again, which was the 64. It's been about 6 hours since he got his Lantus.
Click to expand...
Click to expand...


Generally speaking when using Lantus insulin, one doesn't reduce dose unless the cat falls below 50 on three separate days or below 40 once. The reduction is done very slowly in a step-by-step manner (0.25 or 0.5 IU increments). At each newly reduced dose, try to make sure the cat is still stable in the normal range before reducing the dose further.

Bouncing or rebound is normal and signals a "panicky liver," not too much insulin unless the previous criteria occur. So technically based on Todds SS, he should actually remain at 2.0u. Lantus doesn't function like typical insulins and reading & becoming familiar with the stickies on the Lantus Support Forum will help explain this, much faster and better than I can in a few posts.

The suggestion to drop back to 1.75u is for safety's sake at the present time until Todd and his Bean get fully up to speed on testing and how Lantus functions. Skipped shots and drastic dose changes of 0.5u or more are not recommended when using Lantus.
 
when blood glucose drops rapidly, conterregulatory hormones are released to increase BG and prevent hypoglycemia. This is in effect the body's "panic" system. but often excessive glucose is produced. The medical term for this is the Somogyi effect. This causes large variation in BG and. also destabilizes other metabolic processes in the body. Rebound hyperglycemia. Is not desirable in either cats or human diabetics. I do disagree with blue's opinion that rebounding is normal and is just a panicky liver. I base this on my experience as a licensed health care professional and medical reference sources. Toby Tiger's. Person also said that this cat had developed hypo symptoms before when in the 60s. Some cats may be able to go down that low safely but each cat is different and going that low may be dangerious for some cats like T. Tiger.
 
Jan, I respectfully encourage you to visit the stickies at the top of the Lantus board. There is a Queensland Review Protocol we use for diabetic cats. Part of poor Todd's problem is stemming from an improper use of the Lantus insulin in determining dose and regulation. The starting and stopping of the insulin Lantus, the constant depleting of the insulin depot of Lantus, etc. is not helping Todd and is what is causing the radical swings in Todd's blood glucose. Normal ranges for feline BG is between 50-80, and when using Lantus or Levemir insulin these are the ranges we work to achieve, they are not hypoglycemic ranges when using these two types of insulin.*

This protocol was developed by lay people, including myself (not me), who are members of the German Diabetes-Katzen Forum. It has since been published in the Journal of Feline Medicine and Surgery. http://www.tillydiabetes.net/en_6_protocol2.htm
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*Do not attempt to achieve these ranges using other insulin or not fully understanding the Queensland Protocol.
 
Jan -

I don't want to hijack this thread however, there is truly a dearth of research literature on Somogyi in humans, let alone with felines. I've done two extensive searches and I have access to medical and veterinary databases within a university medical/veterinary school library system and come up with surprisingly little. The term was coined in the 1930s based on an n = 5 observational study of urine glucose levels in humans. Even in the 1980s, researchers were calling the concept of chronic rebound/Somogyi into question. At best, the the phenomenon is controversial. None of the little research that exists has been conducted with long-acting insulin, such as Lantus or Levemir, making the extension of Somogyi to cats on long-acting insulin dubious. I would also underscore that a cat bouncing in the way that Todd's numbers describe is normal. This is not a chronic rebound hyperglycemia situation, which is what Somogyi ostensibly references.
 
The text and reference books used in human medicine treat the somogyi effect as an established medical phenomenon.Yes I am part of the medical establishment and advocate a more conventional approach. There is clearly some different models in the medical community for treating both human and felines.Readers can research and then decide what is best for their cat.
 
Guess 100's of cats going into remission, in this forum alone, using the Queensland Protocol for Lantus is meaningless to you then. Thousands of cats worldwide.

Your medical background should not obscure the success of a proven methodology, reviewed and published in the Journal of Feline Medicine and Surgery.
 
I did read the link to Tilly's page about the treatment mode and insulin recommendations. Can anyone provide me with a link or citation to the journal article? I will read that article if I can get that link or the month and year it was published in that journal.

I do not want to take up any more of the space on this tread since poor Toby Tiger's person (aka bean) was just wanting to get info. For his cat.
I. Will start a new post on this topic later. To be fair will people also read any references or sources I find?
 
Sorry Toddy Tiger I. realize I called you Toby Tiger by mistake. Whatever your person (aka beanie) decides to do about your insulin I hope you get better and are roaring again soon!
 
jan ellery said:
I did read the link to Tilly's page about the treatment mode and insulin recommendations. Can anyone provide me with a link or citation to the journal article? I will read that article if I can get that link or the month and year it was published in that journal.
Click to expand...

Link is available in both the Lantus Support Forum and at the Tilly link on this thread. The link is available by clicking the highlight Journal of Feline Medicine and Surgery in the Read this first section.
 
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