Tigger just went hypo!!! I'm still shaking

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CarolandTigger

CarolandTigger

Member Since 2015
I can't believe what just happened! I'm literally still shaking. My husband got up with him this morning and went downstairs to test, feed, and shoot. I was still asleep. So then I came downstairs and asked what he tested. He said 37!!!!!!!! So I asked him, did he give him Karo syrup? Or the high carb FF with gravy that I bought?? NO HE DIDNT..HE DID NOTHING. He thought he went low because the cat had just used his box and had a huge poop!!! He was withholding EVERYTHING and waiting 20 min to test again!!!! I just about had a heart attack when he told me this, I'm seriously still trying to calm down. He said Tigger appeared perfectly fine. (He does..he's acting totally himself). He just wanted to be fed. I went into a rage. My husband just sat there. Right now I'm so upset at my husband I could literally leave. His new vet said that we don't have to test as much, that we would see "clinical symptoms" if he went really low. I was just on here last night reading others telling me that sometimes you DONT see clinical symptoms! Now I know it's true. Wow. I'll be heading to the vet next week for a curve,and I can't wait to present this info to her!!! So after husband says he was 37, I immediately tested again to make sure it wasn't a wonky test. Nope..now he's 34!! I gave him the food. The he tested at 40, so he's rising. Then I immediately gave him another 1/2 can and pancake syrup (I couldn't unscrew the darn Karo syrup top!) He seems fine..he's sitting by the window wanting desperately to go out. I'll test again shortly.
My husband has fled to his cave (office)...won't listen to me, says nothing. So this is how I'm starting my day today? My husband nearly killed my cat. He wouldn't even give him food because he was waiting to test again!! Unbelievable!! PLEASE someone tell me they also have a clueless spouse??
 
I don't know which is worse either. So now my next question is: do I skip Tiggers insulin entirely this morning? This scares me because of his recent DKA episode. He was low that morning (59), I skipped his shot, and everything went downhill after that. I'm afraid that whole cycle will start again!
 
PS ... maybe your hubby panicked. Most people are familiar with the 'fight or flight' response in the face of fear. They sometimes forget that fear can cause a being to freeze into inaction. The brain can just stop processing information rationally and shut down normal thought processes.


EDITED TO ADD:

This is why it is good when things are calm and normal to practice what to do in an emergency so you don't have to rely on being able to think clearly should an actual emergency situation arise: the practice makes the emergency response automatic.

:bighug:
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I don't know about skipping entirely with recent DKA. Can you get back on track if you shoot late? How long since the last test, what kind of food did he have, and will you be able to monitor?
 
What dose has he been on? The U column is empty for the last week :(

I would highly recommend more mid-cycle testing, as well. At least a +2 and a before bed test every night if you're not able to test during the daytime

Are the three tests today at AMBG, +1, and +2?
 
I don't think he froze in panic. He's just totally clueless,doesn't listen, and refuses to read. What if I was diabetic? That thought scares me!! And he's a POLICE OFFICER! Maybe it's the training to remain calm in an emergency and not panic??
Ok...Tigger is on a 8-8 schedule. Tested at 7:15, 7:30, 7:45. Then I gave him a can of FF gravy and some syrup (oops..I think I did that totally wrong after reading more!!). now he's sleeping and I can watch him. He seems just fine and ate everything...1 1/2 cans of food, as usual..
 
I'm thinking at least 1/2 of the newly reduced dose, but need to know the actual timing on those last 3 tests.

ETA: Okay so they were all within 30 minutes, and the last one was 15 minutes ago?
 
CarolandTigger said:
I don't know which is worse either. So now my next question is: do I skip Tiggers insulin entirely this morning? This scares me because of his recent DKA episode. He was low that morning (59), I skipped his shot, and everything went downhill after that. I'm afraid that whole cycle will start again!
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Is Tigger eating OK? That will help some bit re the ketone situation until you can get some advice on what to do.
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Oh darn..I didn't finish filling out his spreadsheet. He's on 2.5u Lantus. And the 3 shots today were within 10- 15 min of each other, now hourly as it looks on the spreadsheet. I made a note of that in the Notes column.
 
Just tested him at 9am..he's up to 179. That's after 1 1/2 cans of FF high carb food, and a little syrup. I think I panicked on that...should I have given him JUST The syrup or just the food?? No insulin..yet.
So he went from 37-34-40 between 7:15-8am, and now 179 at 9am. Please advise!
 
@Critter Mom - Aine, go to bed... :) It's daytime here, many of us are nearby.

Carol, as long as you can monitor, these are your options:

Give a full dose since he's now starting WAY up and monitor thru the day when food/syrup starts wearing off
Give a reduced shot when he's rising to help with the bounce that's likely going to happen
Skip

If he were mine, I'd likely do the full dose and test more frequently but that's ME - you know what you can do.

And yes, others have 'hubby' issues - my DH doesn't do ANYTHING associated with anything medical for any of our fuzzy feetz. At least yours tests! And yes - he was just as scared as you, he just didn't show it....
 
Can't help with the dosing but you need to keep testing to make sure that Tigger doesn't drop too low again as the carbs wear off. The syrup carbs tend to wear off fairly quickly.

If you post for help on the L&L board you might get a faster answer on the dosing. You can add a link to this thread so people can catch up with events thus far.


Mogs
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CarolandTigger said:
You've all been great..thanks! I will probably give him his full dose and monitor throughout the day. I'm done talking to hubby about it. He's tuned out at this point, and I look and sound like a raving idiot I'll keep you posted.
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I like that choice Carol but DO remember to take the reduction.

HUGS! Don't give him too hard of a time, he was scared - all he could remember at the time was the manta - don't feed, retest. Yes that's when Tigger's above low end but when in that situation he was faced with, everything else went out the window. Those first few low numbers are TERRIFYING. Being a man AND a police officer, he doesn't let it show. His insides are still torn up over it...go give him a BIG HUG and thank him for what he does do...
 
Squeaky and KT said:
HUGS! Don't give him too hard of a time, he was scared - all he could remember at the time was the manta - don't feed, retest. Yes that's when Tigger's above low end but when in that situation he was faced with, everything else went out the window. Those first few low numbers are TERRIFYING. Being a man AND a police officer, he doesn't let it show. His insides are still torn up over it...go give him a BIG HUG and thank him for what he does do...
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I second that recommendation.

CarolandTigger said:
I look and sound like a raving idiot
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My kinda kitty momma! ;) :bighug:


Mogs
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Just tested him, about +2 after his lowest reading this morning, and he was at 292. I just gave him a slightly reduced dose of 2.25u...well, since these syringes don't have 1/2 u markings, it was a little bit of a guess, but I measured a hair's breath over the 2u line.
 
Glad Tigger's BG is coming up, hypos are scary, I know! As for hubby, he probably froze and just did the first thing he thought of when confronted with a wonky number. Once things are calmer maybe you can patiently go over with him when low numbers require stalling (waiting) and at what point they require action to keep kitty safe. My husband was a police officer, too, and that's exactly as he would have reacted, I'm sure! :)

CarolandTigger said:
I look and sound like a raving idiot
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Lol, I think all of us in this sugar dance have a bit of raving madness in us! :bighug:

ETA: Squallie has had several hypos and he is ALWAYS asymptomatic, I would never know it without testing him.
 
Suggestion for the future - make a "cheat sheet" for your DH with instructions for different readings. My DH always needed specific instructions for taking care of Maggie. For example (but with your numbers):

1. BG over 120: give 2.5 units insulin, feed normal food.
2. BG between 80-120: give 2.5 units insulin, feed normal food, test 2-hours later.
3. BG between 50-80: wait 30 minutes and test again.
4. BG under 50: wait 15 minutes and test again. Prepare to treat for hypo if BG continues to drop!
 
Maggies Mom Debby said:
4. BG under 50: wait 15 minutes and test again. Prepare to treat for hypo if BG continues to drop!
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In the interest of taking every last bit of guesswork out of the equation in a crisis situation (especially if Carol were not to be around), I'd suggest refining this step to show a band where it might be OK to wait for those 15 minutes (e.g. 45-50) and also a MUST INTERVENE NOW number (e.g. <45) where honey/karo should be given immediately. (And possibly a warning for when a trip to ER is necessary together with instructions to keep rubbing honey/karo onto the gums while travelling to the vets.)

I'd also suggest that there are instructions for hubby to follow to get help on FDMB if Carol's not able to get online for some reason.

My two penn'orth.


Mogs
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Just had a talk with hubby about this, In a calm voice. When he got the first reading of 37 his thinking was to wait a bit and then retest and then if it was low he said he would've given him the high carb food and/or the Caro syrup. I don't know if he's just saying that now because he heard me rant for an hour about it or if he actually knew that. At any rate, I feel a little better about things and I'm going to make a chart and put it on the inside of the pantry door where Tiggers food is for future use. Now when he got such a low reading of 37, what would be the point of waiting 15 minutes for another test? Without any food it would have gone even lower, right?
 
Mogs, I like your suggestions! I just wanted to throw out the idea of chart with written instructions. I know my hubby didn't test or treat enough to keep it all in his brain.

(Husbands can be a real problem. I was across country with my sick mom, my vet was on vacation and Maggie was not doing well. DH decided to wait a couple of days, because he didn't want to take Maggie to the substitute vet. I actually called the vet on her cell and pleaded with her to call DH to tell him to take Maggie in! I caught the vet on the ski lift, but she did call DH!)
 
He probably froze up and didn't want to cause any more harm. Some people get nervous and don't know what to do in bad situations, so instead of doing anything, they do nothing. Other people are designed to jump into a bad situation without attached emotions and fix the problem. He may have been nervous and embarrassed to admit it, and in his mind he thought if he waited it out it would resolve itself. I don't trust anyone with Diego and its because I'm afraid something like that will happen!
 
I know how you feel! Now I'm afraid to leave the cat...
Another question: In case of a hypo situation like I had..is it better to give Karo syrup first (I had to give pancake syrup..couldn't get the lid open on the Karo!) OR the high carb/gravy food? I did both in a panic. Probably stupid, I know;)
 
Karo syrup is liquid sugar. I'd give that first. High carb food needs to be broken down and metabolized into its different components before the sugar can be used. It takes a little longer.
 
CarolandTigger said:
I know how you feel! Now I'm afraid to leave the cat...
Another question: In case of a hypo situation like I had..is it better to give Karo syrup first (I had to give pancake syrup..couldn't get the lid open on the Karo!) OR the high carb/gravy food? I did both in a panic. Probably stupid, I know;)
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Carol - first, I don't think you'll have to worry about him not reacting correctly next time. He learned from this one and will probably be extra diligent.

HC/gravy will bring him up to stay longer but it has to begin the digestive process before it has an effect. Karo will boost him quicker but wears off a lot quicker. I think both was likely a good choice today...
 
It's actually a little more tricky than that.....from the sticky "Shooting and handling low numbers"

Some general rules when stalling (ECID): (red highlights added by me)
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** 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off. (usually but not always)
** 40s or lower – you have a couple of choices.
  • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
  • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
    • --- Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he? This is where "Know Thy Cat" really becomes essential!
** Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.

Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading.

Using the overlap by shooting low is a great way to take advantage of Lantus/Levemir’s long, flat cycles, once you have learned to do so safely.
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All that being said, dealing with a PS in the 30's is a whole other thing. I don't think there are any of us that would shoot a 30'something!

Looks like Tiggers liver has truly kicked in though....and he's going to do a little bouncing!

Sorry to hear you had to go through such a scary time to learn how important more testing is! ...but the important thing now is that Tigger is OK and daddybean has learned what I hope is a valuable lesson!!

Save your best "raving lunatic" act for your vet who didn't tell you how important home testing was!;)
 
Carol, now that things have calmed down some, you should make some changes on your spreadsheet. The AMPS and PMPS are always the number you actually shoot.....so his AMPS today will be 292 since that was his BG when you actually shot....then all your other numbers fall into the same usual places....1 hour after the shot is +1, 3 hours after is +3, etc.....

Here I'm a little confused....Does your husband test an hour early in the morning? Because you said your shooting schedule is 8am/8pm but you say he was tested at 7:15, 7:30 and 7:45.....that would be +11.25,+11.5 and +11.75
 
Thanks Chris! for pointing this out to me. I was unclear how to post it on the spreadsheet, so I appreciate it! I'll make some changes. It was confusing to me as well;) He's down to 267 at this point, so coming down nicely from the post-high carb meal and insulin.
 
I'd do the reduction, but I'm a little concerned that there aren't any tests overnight so it's hard to say what is happening at night. Moving the shot time a little later and getting some +9-+10 shots would be a really good thing to do at this point. Also, consider you may be pulling back on the food situation too quickly.

For any reductions you do now and in the future, make sure you get a ketone check 24-48 hours into the reduction and again a week into the reduction - at a minimum. Your cat will always be prone to ketones. If numbers are normal or low, and ketones start coming back, then maintain insulin dose and increase food/carbs.

For food, EVO makes a cat and kitten food that is low carb/ high cal. IAMs kitten is also a very good high cal food and pretty easy to find.
 
I'm holding off his shot tonight to 9:30, which would be 12 hours after this morning's dose. Then I can test at +9, etc tomorrow morning and see where he is. I don't understand what you mean by "you may be pulling back on the food situation too quickly"??
 
You have been transitioning the food since his DKA, but he seems to have times dropping very low and times still in the pink numbers. Sometimes taking the reduction in insulin can lead to even higher numbers at the high times and not better overall control. You can use food to "steer" the numbers so they are more flat if you catch the green number early and feed as soon as he touches green. This requires more testing. This will help you avoid reductions in insulin before he's ready and help give you a flat blue/green curve which should be the goal at this point.
 
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