***URGENT*** LOW BG and Vomiting

Leigh B

Leigh B

Member
I am updating Murphy's chart. This morning his AMPS was 160, so I gave him a leaner dose of 2.75, vs his usual 3.
He'd been throwing up all night. I thought it was from eating a plant, which I moved out of the room.
I made sure he was eating before giving his AM dose.
He threw up again.
I tested him 2 hours later and he was at 46. I gave him some food with gravy, so that he'd eat something quick.
I had to go to work for a little while.
I just got home, and he'd thrown up the gravy food.
His BG is at 56 now, and he's parked at the water bowl
I don't know what to do because he can't hold down any food.

Can someone tell me what to do for a fast fix?
 
It might be good to also post this on the main health forum to get more eyes on it.

If it were me, I would give him some karo syrup or honey since he cannot keep food down
 
Sarah&Soph said:
It might be good to also post this on the main health forum to get more eyes on it.

If it were me, I would give him some karo syrup or honey since he cannot keep food down
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THANK YOU!! I have no karo syrup, but I do have honey.
I also have a call in to my vet.
 
Good that you have a call into the vet, here is some info from my files:
'
If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)
Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
 
THANK YOU!! He's thrown up the food I've given him today.
Just got some honey in his mouth.
Will keep trying, and let you know
THANKS!
 
Vet said to bring him in.
I have to go to work, so I am going to take him there and then to the emergency vet when I am off work.
 
I got some honey in his mouth, and he's already to 78.
His demeanor is not lethargic, but I am super scared of this low number
 
78 is better, but it might just be the honey. Those low numbers can be a bit frightening. I hope they determine cause of vomiting.
 
Idjit's mom said:
78 is better, but it might just be the honey. Those low numbers can be a bit frightening. I hope they determine cause of vomiting.
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Yes. I am watching him for a bit longer at home. He's had a little more honey and gravy from a higher-carb canned food.
I told them I'd be late getting to work. Taking him on my way
 
He ate the gravy out of the food I gave him. So, I strained the gravy out of another can, added some honey, and watched him for vomiting.
He's kept it down. He's still drinking water, but is up to 89 now:nailbiting:
 
Can you try a little soupy LC food Leigh? You don't want to high carb him up too much and you want to see if he will drop back down w/o the higher carb boost. You don't want to have him up in the trees later either.
 
Hopefully his BG stays up! I would make make another post tonight asking for dosing advice, as I think his dose probably needs to be re-evaluated
 
Sometimes the gravy food can cause them to vomit since they aren't used to those ingredients. I'll keep fingers and paws crossed that that's all it is. Please give us an update after the vet has a chance to see him. :bighug:
 
Thanks, All~
I ended up staying home and monitoring him myself. He's kept all of his food down, has even nibbled on some solid food just fine. His last check was 162!
I appreciate all of the support you have given. This is such a wonderful place to go when you need to find people who understand!

I'll take another bit of advice from you if you have it...about dosing. Should I just keep monitoring him tonight and lay off of the juice?
His tummy seems to be ok right now, but I am afraid to give him any insulin, in case he ends up sick again tonight. (I would certainly only consider a much lower dose, if any)

THANK YOU!!
I'll keep you in the loop~
Murphy's lounging on his favorite scratcher/toy/thingy...seeming pretty happy :D
 
Then I would skip the shot tonight and then see where he is pre-shot tomorrow. He dropped off really quickly today and stayed low for ages. I'm sure he will bounce up higher tonight but how much he'll bounce and for how long is the big question. Let's see where he's at in the morning because those lows today could make him a bit more sensitive to insulin and night cycles is not the time one wants to be chasing BG.
 
That high is a bounce from the low numbers. I would still skip tonight just to be on the safe side. It looks like the dose should have been reduced to 2.75u back on the 24th when Murphy went down to 45. Looks to me like a lot of those numbers you've been seeing since may be bounce influenced because the dose was too high. Makes it hard to know what his actual readings would look like without the bouncing. Today you may have had a view of his "real" levels. Let's see where he's at in the morning.
 
MrWorfMen's Mom said:
That high is a bounce from the low numbers. I would still skip tonight just to be on the safe side. It looks like the dose should have been reduced to 2.75u back on the 24th when Murphy went down to 45. Looks to me like a lot of those numbers you've been seeing since may be bounce influenced because the dose was too high. Makes it hard to know what his actual readings would look like without the bouncing. Today you may have had a view of his "real" levels. Let's see where he's at in the morning.
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:bighug::bighug: THANK YOU!!
I have been so confused by the super low, then super high numbers. I appreciate your insight.
I'll skip tonight, keep an eye/ear on him, and check him in the am.
 
MrWorfMen's Mom said:
That high is a bounce from the low numbers. I would still skip tonight just to be on the safe side. It looks like the dose should have been reduced to 2.75u back on the 24th when Murphy went down to 45. Looks to me like a lot of those numbers you've been seeing since may be bounce influenced because the dose was too high. Makes it hard to know what his actual readings would look like without the bouncing. Today you may have had a view of his "real" levels. Let's see where he's at in the morning.
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He's at 436 this morning. Would you advise the 2.75 with his food this morning? I don't see signs that he threw up during the night last night.

He HAS been parked at the water bowl all morning, which he has not been doing until yesterday.
I'll try to get a ketone test this am, too.
 
What is your availability to monitor Murphy today? That higher AMPS is partly skipped shot and partly bounce which can clear at any time so you definitely need to reduce the dose to at least 2.5u if you can monitor. If you can't monitor, then I'd drop him down to 2u for safety sake as he may still be a little insulin sensitive after yesterday.
 
MrWorfMen's Mom said:
What is your availability to monitor Murphy today? That higher AMPS is partly skipped shot and partly bounce which can clear at any time so you definitely need to reduce the dose to at least 2.5u if you can monitor. If you can't monitor, then I'd drop him down to 2u for safety sake as he may still be a little insulin sensitive after yesterday.
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I have a flexible work schedule. I'll be able to come home throughout the day.
I'll go with 2 to be safe, and still check on him throughout the day.
I appreciate your advice so much. The bounces confuse me so much!
 
Bounces confuse everyone. It's a defence system that works to prevent the BG from dropping too low. Our diabetics get so use to high BG that they start to consider it normal causing the defence system to react too quickly and causing the BG to go way up when the BG drops to more normal or lower than the cat has become accustomed to. It's frustrating but totally normal and something we can't control and we don't know when it will clear and BG will drop back to the cat's current "normal".
 
MrWorfMen's Mom said:
Bounces confuse everyone. It's a defence system that works to prevent the BG from dropping too low. Our diabetics get so use to high BG that they start to consider it normal causing the defence system to react too quickly and causing the BG to go way up when the BG drops to more normal or lower than the cat has become accustomed to. It's frustrating but totally normal and something we can't control and we don't know when it will clear and BG will drop back to the cat's current "normal".
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Do you mind taking a look at Murphy's chart when you get a chance? I've slowly moved his number up a bit.
Should I stick with 2.75 twice a day? How long should I give it for him to "balance" before moving up on the dose?
Wondering if 3u in the morning and 2.75 in the pm might be the magic dose for now, but easing into that.
Would love your advice.
Thank you!
 
I think you are getting yourself wound into a vicious circle increasing the dose back up to 2.75u yesterday and then 3u today. There have been numerous occurrences that have warranted dose reductions you did not take. At most right now as I mentioned on Thursday morning, I'd try a dose of 2.5u and even that may be a little too high. It looks to me that the higher doses you have been giving are just perpetuating the high numbers you are seeing. Too much insulin can look identical to too little and some of the high numbers you have seen the last couple of days are from bouncing as a result of the too low BG on the 31st. Dosing based on pre-shot numbers alone doesn't work and is dangerous. This is a marathon not a sprint and throwing more insulin at those high numbers isn't always the right answer. Murphy has dropped too low several times on both 3u and 2.75u recently so for safety reasons as well as to get out of the vicious circle this sets off, I'd back the dose down to 2.5u and hold it for at least 2 and possibly 3 days to see if his numbers start to drop.
 
MrWorfMen's Mom said:
I think you are getting yourself wound into a vicious circle increasing the dose back up to 2.75u yesterday and then 3u today. There have been numerous occurrences that have warranted dose reductions you did not take. At most right now as I mentioned on Thursday morning, I'd try a dose of 2.5u and even that may be a little too high. It looks to me that the higher doses you have been giving are just perpetuating the high numbers you are seeing. Too much insulin can look identical to too little and some of the high numbers you have seen the last couple of days are from bouncing as a result of the too low BG on the 31st. Dosing based on pre-shot numbers alone doesn't work and is dangerous. This is a marathon not a sprint and throwing more insulin at those high numbers isn't always the right answer. Murphy has dropped too low several times on both 3u and 2.75u recently so for safety reasons as well as to get out of the vicious circle this sets off, I'd back the dose down to 2.5u and hold it for at least 2 and possibly 3 days to see if his numbers start to drop.
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THANK YOU...
I have lowered him to 2.5 for the last several days.
I have noticed that he seems to be feeling really well- his energy levels are pretty good-

***I posted this message about his bowel habits, but literally, as I was typing it, he had a HUGE bad accident outside of the litter box....:banghead:****but, here's what I said, for reference: Also, for MONTHS, he's been pooping outside of the box. I know that this usually indicates that he doesn't feel well, and I felt like the higher doses were to blame. Since I've lowered his doses, he's only pooped outside the box once. I hope this means his tummy is better. (I'd tried probiotics in his food, too, but that didn't seem to do anything. I really felt like it was related to higher dosing issues, but wasn't sure)*****

NOW- I am still confused about his numbers.
They still look high? Do I need to stay the course for a few more days at 2.5? My vet told me that they are at "renal risk" if they are over 300. That is part of the reason I freak out when I see a number around there. Although, he sometimes seems to be doing great at those readings.

I appreciate your input so much. I have been so confused and chasing numbers. As you said, this is a marathon...hard to be patient.

Thoughts about the poop issues? :(
 
GI issues can play havoc with BG numbers. Constipation/diarrhea can elevate BG. I think constipation can be an issue with diabetics simply because they pee a lot and can be a bit dehydrated as a result. I'd definitely try adding water to Murphy's wet food to get more fluids into him. Has Salem been having regular BMs? Have his readings changed at all in relation to his bowel movements?
If Murphy is having issues with BMs, you could also try adding some pumpkin (plain pumpkin not pie filling) to his food for more fibre.

Loving that yellow start today!:)
 
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MrWorfMen's Mom said:
GI issues can play havoc with BG numbers. Constipation/diarrhea can elevate BG. I think constipation can be an issue with diabetics simply because they pee a lot and can be a bit dehydrated as a result. I'd definitely try adding water to Murphy's wet food to get more fluids into him. Has Salem been having regular BMs? Have his readings changed at all in relation to his bowel movements?
If Salem is having issues with BMs, you could also try adding some pumpkin (plain pumpkin not pie filling) to his food for more fibre.

Loving that yellow start today!:)
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I know it does not seem so, but I am not going to message you every day. Just want to get your thoughts on the high numbers over the last day or so?
Staying the course at 2.5, but fighting the urge when I see 400's.

Thanks
 
As I mentioned previously, there were a couple of reductions you didn't take when low BGs occurred. Looks like Murphy may have had an active cycle during the night of the 6th and he had a nice lower AMPS and PMPS on the 7th but there were no mid cycle tests either cycle to see what the cycles actually looked like. Strictly guessing, BG may have come down enough to set off some bouncing which you are now seeing with the higher readings. Without any mid cycle tests it's impossible to figure out what is going on. If getting day time mid cycle tests is not possible every day, get them on your days off. Also make it a habit to grab a minimum of a test before bed every night. All data is helpful and the more you have the better.
My best guess right now, and it is simply a guess, is that the dose may still be a tad too high.
 
MrWorfMen's Mom said:
As I mentioned previously, there were a couple of reductions you didn't take when low BGs occurred. Looks like Murphy may have had an active cycle during the night of the 6th and he had a nice lower AMPS and PMPS on the 7th but there were no mid cycle tests either cycle to see what the cycles actually looked like. Strictly guessing, BG may have come down enough to set off some bouncing which you are now seeing with the higher readings. Without any mid cycle tests it's impossible to figure out what is going on. If getting day time mid cycle tests is not possible every day, get them on your days off. Also make it a habit to grab a minimum of a test before bed every night. All data is helpful and the more you have the better.
My best guess right now, and it is simply a guess, is that the dose may still be a tad too high.
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Wow! Thanks so much!! I'll get mid day tests over the weekend for sure, and make sure to do tests before bed.
Appreciate your help more than you know!!!:bighug::)
 
MrWorfMen's Mom said:
As I mentioned previously, there were a couple of reductions you didn't take when low BGs occurred. Looks like Murphy may have had an active cycle during the night of the 6th and he had a nice lower AMPS and PMPS on the 7th but there were no mid cycle tests either cycle to see what the cycles actually looked like. Strictly guessing, BG may have come down enough to set off some bouncing which you are now seeing with the higher readings. Without any mid cycle tests it's impossible to figure out what is going on. If getting day time mid cycle tests is not possible every day, get them on your days off. Also make it a habit to grab a minimum of a test before bed every night. All data is helpful and the more you have the better.
My best guess right now, and it is simply a guess, is that the dose may still be a tad too high.
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Do you mind giving me your thoughts on the last few days? Numbers are high. He's had some runny poops, but that is not out of the ordinary. Not sure if that could contribute to high numbers? The litter box seems to have more urine lately, too. Although, I have not noticed him parked at the water bowl or anything like that.
We are going out of town this weekend, and have a sitter. I would like to have a decent grasp on his dosage before we go.
Thoughts?
Thanks, again!
 
Quite honestly I don't know what to think right now. If Murphy is having runny poops and peeing more, along with his numbers, it makes me wonder if there isn't something else going on but then you said the runny poops aren't anything new. Has this been a recent development or something he's always had? Any diet change lately that might have precipitated the poo issues?
Also wonder if a UTI could be at play with the increase output of urine but lack of increased drinking. Are the pees large/sticky puddles or more frequent than normal small deposits? Any sign of trying to pee without success?
Any other medical issues could definitely raise Murphy's BG levels so if you suspect something else going on, best to see the vet to get it treated ASAP.

On the 10th of Aug in the +6 day cycle cell, you've written 2.5 hrs. From the other like entries I thought this was notations about how long post shot the test beside it was done but this one seems out of synch. Is that perhaps a typo or am I misinterpreting? Usually when we do test at a half hour interval we type it as "352 @ +7.5" in the proper +7 cell. You will have to manually colour the cell but it keeps everything neat and tidy.
 
MrWorfMen's Mom said:
On the 10th of Aug in the +6 day cycle cell, you've written 2.5 hrs. From the other like entries I thought this was notations about how long post shot the test beside it was done but this one seems out of synch. Is that perhaps a typo or am I misinterpreting? Usually when we do test at a half hour interval we type it as "352 @ +7.5" in the proper +7 cell. You will have to manually colour the cell but it keeps everything neat and tidy.
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ARG!! Yes, this was a typ-o. Should have been 6.5 hours.

Murphy has had poo issues on and off for a while. Part of the issue is that he's stubborn with his food. He gets "tired" of a specific flavor, and just stops eating. Obviously, I have to feed him when he gets his insulin. So, I rotate flavors of food. Nothing crazy...all Fancy Feast or Friskies Classic Pate (approved foods). But, I do change them out when he gets fickle, so that he'll keep eating. I've wondered if that doesn't keep his tummy a little out of whack.

He really seems in good spirits, etc. I've been surprised by the high readings.
He's always had "large" pees, and that is no different. I will see if I can "catch" him going and get a ketone test. Although, the larger quantity of urine is not too much. I may be overthinking everything, trying to make sense of it all??
 
As I mentioned before.... just a guess...., there are a couple of things on the SS that make me wonder if the dose is still a tad too high but the gaps in testing are still not making it clear it could be Murphy needs a dose increase. Too much and too little insulin can look very similar and mid cycle testing is key to sorting out what is going on. You've held the 2.5u dose for 8 days and there isn't much if any movement in Murphy's numbers and those black readings are concerning. Definitely check for ketones and if they are negative, when you can monitor through the cycle, you could try dropping the dose to 2.25u for a day or 2 to see if numbers come down at all. If they don't start coming down the dose can be raised back up again. If there is any sign of ketones, don't lower the dose and post.

ProZinc is usually at peak action between +4 and +7 post shot so any testing you can do in that time frame will help. Also, please try to get a test before bed EVERY night even if that happens to be at +2 or +3. Those earlier tests are helpful in that they can often tell you if the cycle is going to be active or not.
 
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