We're back and Simmie is 42

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LydetteSimmie (Iceman)

LydetteSimmie (Iceman)

Member Since 2014
Help. Simmie's glucose is at 42 at +5 His nadir is usually between +6 or +7. I just gave him a little Karo and some higher carb food.

For any of you that have been following us you know I have had a number of long weekends where Simmie has had to stay at the vet. The first time 3 weeks ago they did a terrible job at testing. Last week I decided not to have them bother with their testing as I am interviewing new vets. I haven't changed Simmie's insulin dose (it was recommended to move him from 3 units to 3.5 by the vet) because I would have too many boardings for him at the vet over the course of 6 weeks and I thought that might really screw-up his numbers.

Anyway, rather than poke him insanely once I got him back from his second long weekend visit at the vet I waited until today to get more than the standard readings (amps and pmps) and he is dropping badly. He has not reached his nadir and I'm scared to death. I've updated my spreadsheet.

What should I do and when should I test again?

Love you guys

ps he seems just fine.....
 
Test 1/2 hour after he last ate and post the new number. You want him up over 50, so if he's not over 50 in 1/2 hour, feed some more high carbs, then test again in 1/2 hour after that. How is Simmie acting?

Just so you have it in front of you, here is the part from the Handling Low Numbers Sticky:
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.
Click to expand...
 
YOu want to test him about 20 minutes after you gave the karo....

Keep in mind the karo is going to eventually wear off as it quick jump starts....once you get him above 50, you can stop giving the karo and HC food, but still need to test probably every 20 to 30 minutes.....

Again, once above 50 and you stop with the karo and HC food, you want to get TWO rising numbers not influenced by food...so once over 50, don't feed because you wont know if those rising numbers are due to the food or not....once you get TWO rising numbers not influenced by food, I would get another test around 60 minutes after that, to ensure he is still rising....

I do believe you have also earned yourself a reduction....I am in the Midwest, so it is 137 am here, so I will not be able to stay up, but wanted to at least get you started.....I would maybe edit your original post to use the 911 icon, so you can draw attention to your post, once you have a couple ppl who can stay up with you, you can remove that 911....I just happen to get up to test Skooter....
 
BTW - good catch, this is why night time spot checks are a good idea. Simmie has earned a decrease down to 2.75U. :-D
 
Oh Wendy, I am so glad you are there.

Simmie seems just fine and dandy. Licking his ice and acting normal. I have a blinding headache but will stay with him all night to monitor. He has been through so much with me going away. I had going away again next week but I have to see my best friend who has terminal breast cancer. Sometimes life is just too much, but then, what's the alternative? (I actually hate that stupid joke).

Ok. I'm getting ready to test him again.
 
Simmie now at 60 and acting grumpy. But he might just be irritated by all the testing again.

I love that you are all here with me.

Do you think we might have a natural sense when our 'kids' might go low? Since I was feeling so lousy all day I was going to go to bed early but I knew I needed to start up Simmie's more regimented schedule. So weird.

Another test in 1/2 hour, right? Should I try to fee him again?
 
Now that he's in the 60's, I'd try doing without food to see if he's rising. You want two tests without influence of food where he is rising. If he's the same or up in 1/2 hour then that's the first one. So test in 1/2 hour and we'll see how he is.

I've seen a number of people comment about getting an intuition they should test, but personally I've guessed wrong before and had a bounce that told me so. That's why getting at least one other test per cycle is so important.

ETA: Could you update your first post with the new test numbers?
 
Since you guys have helped me and Simmie and I are seemingly ok right now I guess I should remove the 911? Or should I wait until the next test? That would be the second test after his BG at 42.

Thank you Wendy and Molly. You are wonderful.
 
You can remove the 911 as soon as someone has responded to you. We like to reserve if for medical emergencies. It's just as effective to put something like "HELP" in the first subject line.
 
Ok, I'm going to test him again in about 10 minutes. I hate keeping you up. Simmie is sleeping next to me, listening to the rain and seeming to be happy as a clam. Not knowing what he is doing to ma! Why don't you go to bed Wendy. With all the info you sent to me I should be ok. Or, maybe if you could wait another 10 minutes...when I do my next test???? :-)

:oops:
 
Simmie is at 55. So, he went from 42 to 60 with Karo and higher carb food. A 1/2 hour or a bit longer, he went from 60 to 55. No additional food or syrup provided.

He seems to be ok, doing what he normally does. I guess I should test again in about a 1/2 hour.

Love to all,
Lydette and Simmie
 
If anyone is listening/reading, he should be getting his shot in about +5.5 hours...I'll of course check his BG before then but given his drastic drop tonight should I reduce his normal dose like either Wendy or Molly suggested?
 
If you have a question, change your first post to the ? icon and put something like "Dose ?" on the subject line. Newly diagnosed diabetics (less than one year since diagnosis), earn a reduction if they go below 50, which Simmie did tonight. If Simmie should bounce by the morning, say over 300, then you have an option to do what we call shooting through the bounce. You'd give Simmie 3.0U once (the old dose) in the morning to help him get over the bounce, then go down to 2.75U in the evening.

Since Simmie isn't going up, I'd keep testing every half hour. The karo can wear off a couple hours after he's eaten it. So make sure you test until two hours after he go the 42. If he goes down below 50, you'll have to give him high carb food again. If he's staying flat or increasing after two hours, you can give him a little LC and go to bed. The other option if you are getting really tired now, and he'll eat, is to give him a lot of high carb food and try to get him over 100.
 
Hi Tricia,

Sorry, I actually passed out with a glass of juice in my hand last night (and woke up by it spilling all over me a few hours later) :lol: and thank god Simmie is ok. But he tested at 325 this morning so he did bounce. I gave him his usual dose and will test during the day. Thanks for checking in. I'll send an update to the board once I get some data on his today. He's a real trooper.

Hugs
L

ps - thanks to everyone who stayed with me last night. Simmie is doing fine, had his ice, and is sleeping comfortably next to mom.
 
Hi Lydette,

Your comment above:
Anyway, rather than poke him insanely once I got him back from his second long weekend visit at the vet I waited until today to get more than the standard readings (amps and pmps) and he is dropping badly.
Click to expand...

sure caught my eye. i'm so glad Wendy, Molly & Tricia were on last night to help you, but i hope I can change your mind about what is a "standard reading" on Lantus. It is definitely NOT just getting the preshot tests.

From the TR Protocol yellow starred sticky:
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
Click to expand...

I know how much you love Simmie. The truth is that with Lantus, unless you are going to be happy with his blood sugar running high enough that it never gets under 100 or so, you can't keep him safe if you aren't checking him at least once mid-cycle in both the day and night cycles. You can't know how low he's going without those checks. When I see that 406 on 9/8, I'm suspecting he went low in the night in the hours before that amps. I don't mean to nag you, but it would be devastating to have him hypo because his dose was too high. The hassle of checking is worth it for this little ice-licker that you love so much! cat_pet_icon

i'm so sorry about your friend. Life is precious, isn't it?
 
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