Too Low to Shoot?

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Emily

Emily

Member Since 2014
Good Morning,

I tested Prince before he ate this morning (7:15am) and he was the lowest he has ever been-137. He is scheduled to get his shot at 8am. I will test him after he eats, but is this normal?? I thought he was supposed to be higher-at least 200-when I get up to feed him. Will the 2.5 u be too much?
 
Hello,

I've not been able to see your cats SS (my computer is playing up...) but the general 'rule' around here for newcomers to feline diabetes is NOT to give the shot if the blood glucose is below 200.

An alternative is to give a reduced shot/token amount of insulin.

If ever I am in doubt I skip the shot. Sometimes that means the blood glucose level is much higher when it's time for the following shot, but, as the FDMB saying goes, "Better too high for a day, than too low for a minute."

(Oh, that 137 is at the higher end of the normal blood glucose range, and is a lovely number to see!)

Eliz
 
Me again,

It may be worth you're posting your question on the Lantus Forum also. Sometimes people pop into that forum that don't visit the main Health Forum.
 
Thank you, Eliz. But won't his BG rise after eating? What if I test right before shooting and it is around 200-can I shoot then?

Thank you!
 
Emily said:
..But won't his BG rise after eating? What if I test right before shooting and it is around 200-can I shoot then?
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Have I understood you correctly that you're asking if it's OK to shoot if the blood glucose level is elevated by food?

If so, it's not necessarily that straighforward...unfortunately... The increased BG number you see from giving the snack may or may not give you reliable information...

A case in point is my Bertie. He's a complicated chap...
His BG may be too low to warrant a shot. If I then give him a snack, well, that may raise his blood glucose level, and it may continue to rise meaning that it is OK to give him a shot after all. Or, his blood glucose may actually drop following the snack because his pancreas decides to wake up suddenly and drop his blood glucose level. Or, most infuriatingly of all, his blood glucose may rise sharply, I give the shot because I think it's OK, and then his blood glucose drops suddenly because his pancreas decided to join the party a little later on, and now he has injected insulin in his system as well as his own. Yikes!

It's unlikely your cat is as complicated as my Bert. But you should know that this kind of thing can happen...

If you're in any doubt at all, skip the shot. Better safe than sorry....

Eliz
 
Update: I tested him after eating and right before his shot-he was at 175. I gave only 2.0u (usually 2.5). Will be monitoring him closely. Is testing every hour ok or should it be more?
 
OK Emily,

I think testing hourly should be fine unless you see a drop in blood glucose that causes concern and seems to warrant closer monitoring.

If Bert goes into a steep blood glucose drop I sometimes test every 15 minutes until I'm satisfied that the drop has slowed sufficiently, and/or he is past the peak of his insulin cycle.

Do you know how long after the insulin shot Prince's blood glucose is at it's lowest? (6 hours? More? Less?)

Remember too that you can use food (small snacks) to slow a blood glucose drop if necessary.
Do you have any higher carb food available just in case you need that too? (You may well not need it, but I always find it easier to think these things through in advance.)

Eliz
 
Hi Eliz,

Thank you so much for your help. I have a variety of high carb food available-both wet and dry (we only recently made the switch to a low-carb, all-wet diet). His nadir is supposed to be around 6+ (he is on lantus). Once he hits his nadir I don't have to test as often?
 
Hi Emily,

I just got the following from a sticky in the Lantus forum. It shows what I think is deemed to be a 'typical' Lantus curve (but not all cats are 'typical')

"Example of an active Lantus cycle:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number."

(From - viewtopic.php?f=9&t=18139 )

If you know from experience that your cat tends not to continue dropping after say, +6 (6 hours post shot) then no, you shouldn't need to test after that - unless you want to!

Eliz
 
Definately get a +2 as the food will start to wear off then and you will see where you are. Let us know.

Next time you are under 200 you can skip, or stall or give a half dose and test a lot. Stall means you don't shoot, don't feed and wait 30minutes to see if her BG has gone up more than 20%. If it has, then you can shoot and feed but best to also get a +2. This also assumes you don't feed two hours prior to shot time which is something we always recommend.

Wendy
 
Hi there ~O) :cool:

Well Prince gave you a real eye opener this morning - glad to hear you are available to monitor today.
Emily said:
I have a variety of high carb food available-both wet and dry (we only recently made the switch to a low-carb, all-wet diet)
Click to expand...
Good job on converting to all wet! It's the best foundation on which to build your FD treatment for Prince.
Can you tell me when that happened?
Converting to all wet low carb can have a profound effect on BGs - there is a kitty over on the Lantus board right now who recently made the conversion and went from 5u Lantus to zero within a few days. He is now on his way to remission.

Regarding using food to guide the numbers , should that be required, it's best to use high carb wet rather than dry. Dry will take longer to work and longer to clear the system as well.
Emily said:
His nadir is supposed to be around 6+ (he is on lantus)
Click to expand...
It's important to try and determine nadir, however it can be a moving target. Looking at his ss I think his nadir may be later than +6 and he may be visiting lower numbers during the later half of the PM cycles .

Come on over to Lantus Land. Lot's of information on using Lantus and lot's of experienced folks available to guide you.
 
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