sudden BG drop

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jaybeth

jaybeth

Member Since 2021
Hi there, my Nick has been on 4 units of Lantus for a few weeks now. We started at 1 unit over a month ago and moved up slowly. I was finally able to start home testing last night and he tested at 309 preshot. I fed him FF and friskies pate (removed a small amount of C/D from his diet with this meal) and this morning his preshot was 166. I gave him 3.5 units and FF & friskies. At +1, he was at 229. He dropped to 62 and I immediately gave him FF gravy lovers and put honey on his gums. I am waiting to test again in about 5 mins. He is not symptomatic & he is active, strong, and eating. He is not dehydrated or shaky. How should I adjust his dose as needed? Clearly it needs to be reduced, is 2 units too high or low for tonight’s dose? His dose tonight is in 6 hours.
 
Hello and welcome. Congrats on getting going on the home testing. Looks like it was a good thing you did! How many hours after the shot did you get that 62? Keep testing every 30 minutes at this point and reporting back here.

First some questions. 1) what insulin are you using? 2) what type of blood glucose meter are you using? To better help us help you, we need to see some information in your signature, and ideally get you started today on setting up a spreadsheet we use to track blood sugar numbers and doses. We can do that after we've got him safe. Details in this post:
New? How You Can Help Us Help You!

C/D is very high carb, moving to a low carb diet can make a big difference, as you are finding out!
 
110 is safe. How long after the 62 is that? Depending on what type of blood glucose meter you are using, 62 might be a safe number, or not.
 
I’m using a relion meter — the one recommended on the FB page. I’m so relieved that he is down to a safe number now. We are using Lantus and he got 3.5 units 6 hours ago, his pre shot was 166. I should’ve dropped his dose more and I feel awful
 
Wendy&Neko said:
110 is safe. How long after the 62 is that? Depending on what type of blood glucose meter you are using, 62 might be a safe number, or not.
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I’m using a relion meter — the one recommended on the FB page. I’m so relieved that he is down to a safe number now. We are using Lantus and he got 3.5 units 6 hours ago, his pre shot was 166. I should’ve dropped his dose more and I feel awful. He tested 110 30 mins after the 62
 
Relion is a human meter, so the 62 was safe but getting down there. It would be too low if you were using a pet meter. You can wait for an hour now to make sure he's still up. HIgher carb foods can wear off in a couple hours and you want to make sure he's not going to come down again.

OK, how much C/D was he eating before today? And for how long have you been shooting 4 units of Lantus? Lantus is a depot style insulin, meaning what you shoot one cycle can impact subsequent cycle, for 4-6 cycles after that. So unless you had really dropped his dose a lot this morning you might still have seen the impact from the 4 units you've been shooting the last while.

If you can put together a spreadsheet, I might be able to better give a suggestion for tonight's dose. We have some time. Let us know if you need help doing that, we have some folks who can help out.
 
Wendy&Neko said:
Relion is a human meter, so the 62 was safe but getting down there. It would be too low if you were using a pet meter. You can wait for an hour now to make sure he's still up. HIgher carb foods can wear off in a couple hours and you want to make sure he's not going to come down again.

OK, how much C/D was he eating before today? And for how long have you been shooting 4 units of Lantus? Lantus is a depot style insulin, meaning what you shoot one cycle can impact subsequent cycle, for 4-6 cycles after that. So unless you had really dropped his dose a lot this morning you might still have seen the impact from the 4 units you've been shooting the last while.

If you can put together a spreadsheet, I might be able to better give a suggestion for tonight's dose. We have some time. Let us know if you need help doing that, we have some folks who can help out.
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I would love some help with a spreadsheet. He has been on 4U of Lantus for about two weeks now. He was eating 1/2 a 5.5oz can of Friskies and a 1/2 of a 5.5oz can of C/D 2x a day — so one can of each per day. I guess I didn’t expect such a huge (wonderful) difference now that he’s on 100% low carb food. This morning was his first meal with just FF and Friskies
 
OK, let me tag a few people. One of them is in India and might still be asleep but will be on later. I love that we have members world wide. :) @Bandit's Mom @Chris & China (GA) We have a member looking for help in setting up a spreadsheet.

Do you might telling me what your first name is? So I can refer to that.

Can you tell me a bit more about how the diabetes diagnosis was done? What triggered you going to the vet? Any other conditions diagnosed at the same time? I am specifically wondering about DKA or ketones which would change what we suggest for a new dose. Also, how much does Nick weigh?
 
Wendy&Neko said:
OK, let me tag a few people. One of them is in India and might still be asleep but will be on later. I love that we have members world wide. :) @Bandit's Mom @Chris & China (GA) We have a member looking for help in setting up a spreadsheet.

Do you might telling me what your first name is? So I can refer to that.

Can you tell me a bit more about how the diabetes diagnosis was done? What triggered you going to the vet? Any other conditions diagnosed at the same time? I am specifically wondering about DKA or ketones which would change what we suggest for a new dose. Also, how much does Nick weigh?
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Honestly, he is not my cat — his owner and I are working together with him. She’s out of town so I’m in charge of him! I love him as my own. My name is Jadon, Nick is 12 and he’s around 8.5lbs. He was very underweight so that’s why he’s eating so much, he’s in the process of getting to a healthy weight. He’s been dx for at least a year to my knowledge and was on Vetsulin until October of this year. He was inappropriately urinating and was generally just unhappy. Now that his sugars are better regulated he’s no longer having those issues and he’s the happiest I have ever seen him. He recently went to an IM specialist and that is who prescribed the Lantus. He has a B12 shot 1x a week and has had a full senior blood panel & urinalysis in the last month. Unfortunately I do not have ketone testing strips, his most recent BG (10 mins ago) read 194
 
Jadon, I think you can stop testing for now. How long after the shot was that 194?

Good to hear he's getting to a better weight now. Lantus is also a much better insulin than Vetsulin. The dose was just too high.
 
Wendy&Neko said:
Jadon, I think you can stop testing for now. How long after the shot was that 194?

Good to hear he's getting to a better weight now. Lantus is also a much better insulin than Vetsulin. The dose was just too high.
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Yes - just wanted to make sure he is staying stable. The 194 was +7, so I’m not unhappy about that! Lantus has been great so far.. my only complaint is that I miss the length of the U40 needles, I have so many more fur shots with the U100!
 
One thing I noticed is that you said he went from 1 to 4 units in a month. That is a significant increase. Generally you only increase the dose by .25 - .5 units at a time with at least a week before adjusting the dose again. You may have missed the optimal dose.

I am glad you are home testing. You may want to consider starting over at 1 unit and if an increase is needed after a week, increase the dose by .25 - .5 unit at the most. The increases need to be done slowly to find the best dose that will work for Nick
 
A reset to 1 unit may not be the right thing to do. That could just leave him in high numbers, plus without ketones testing ability it's not wise to drop them back so much. 4 units got him to 62, but that still was a safe number. How high a dose did he get to on Vetsulin? I agree he needs a dose reduction, the question is how much of one.
 
Wendy&Neko said:
A reset to 1 unit may not be the right thing to do. That could just leave him in high numbers, plus without ketones testing ability it's not wise to drop them back so much. 4 units got him to 62, but that still was a safe number. How high a dose did he get to on Vetsulin? I agree he needs a dose reduction, the question is how much of one.
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Thanks. I did not realize he was on Vetsulin prior to starting Lantus. Wendy is right, he does need a reduction but not to 1 unit.
 
Wendy&Neko said:
A reset to 1 unit may not be the right thing to do. That could just leave him in high numbers, plus without ketones testing ability it's not wise to drop them back so much. 4 units got him to 62, but that still was a safe number. How high a dose did he get to on Vetsulin? I agree he needs a dose reduction, the question is how much of one.
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Should I just reduce him to 3, or even 2.5 for this evening? I’m just super worried about him getting too low — he was on 4 units of vetsulin and it just didn’t work at all for him. I would like to find a good dose, it was just pretty scary how low he got today, even if it wasn’t dangerously low
 
In an unfortunate turn of events, he broke into his sister’s automatic feeder and his sugars are now super high. so… three it is, I guess
 
jaybeth said:
He got his insulin and his OWN food… such a stinker. I’ll check in an hour and make sure he’s not tooo high. he’s in good spirits just soo stubborn when it comes to food hehe
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Well the temptation is always there if there is high carb food around…….just like us with chocolates!
 
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