? Woody HYPO events last three days in row

Mimik

Mimik

Member
Hi there,
I am a little stuck in not understanding ( refer to SS) what's going on with Woody --- the last three days I started to " glucose" test him ( ear prick) and I seem to be getting numbers I have not seen before when he wore the sensor -- I don't know if that has anything to do with his situation ( low numbers and hypo) last three days or it's simply a need for dose decrease?

9,10, hypo event's would prob. be catagorized as "serious" -- he is outside in the HOT sun and when we go to find him he's in the throws of a total low blood sugar drop - it's not the first time he's been baking in the sun, it's jus the last three days these events have happened.

It was SO bad yesterday I thought he was not going to make it -- I kept on top with the karo, RC recovery wet( syringing) applying cold wash cloths to his body and laying on the floor with him. After about two hours he started coming around.

Day before was "almost" as horrendous, again followed up with high fat food( wet) lickey sticks, karo and wet cold washcloths.

Tonight we grabbed him around 5 and he was "just" starting Blood sugar drop. I loaded him up with wet food, lickey sticks and karo -- he's okay now. I did give him 2.5 U's ( just in case ) as his glucose read was 144 -

I've been following "hypo" protocol from the board and some of my own common sense.

Maybe a stupid Q - but is it possible I need to cut back his U's from 5.25 and 5.50 to 4.5 from here on in and just evaluate as I go along? Of course, if his sugars drop below 50 or 60 I would not give him any insulin, is that correct? I'm almost afraid to give any amt. after a serious hypo even in the same day?

my notes are not as articulate as I would typically send out, I am bloody exhausted with all of these events for the last three days. I also have TOO many other pets that go into my daily mix of work for hire mother ( me) -- I'm usually not this messy.
 
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Hello. I am not sure I can answer all your questions, but yes, you should definitely decrease., as he was very low and he’s been diabetic for less than a year. Can you keep testing him for a while tonight? At least until +4 or later if he seems to be going low again.
It is good you gave a smaller dose tonight, and you did a great job feeding him higher carb food and giving syrup, too. You probably saved his life testing him and reacting like that.
I will tag people who can help you better than me.
@Bandit's Mom
@tiffmaxee
@Wendy&Neko
Can you help Mimi with Woody’s dose?
 
Mimik said:
Hi there,
I am a little stuck in not understanding ( refer to SS) what's going on with Woody --- the last three days I started to " glucose" test him ( ear prick) and I seem to be getting numbers I have not seen before when he wore the sensor -- I don't know if that has anything to do with his situation ( low numbers and hypo) last three days or it's simply a need for dose decrease?

9,10, hypo event's would prob. be catagorized as "serious" -- he is outside in the HOT sun and when we go to find him he's in the throws of a total low blood sugar drop - it's not the first time he's been baking in the sun, it's jus the last three days these events have happened.

It was SO bad yesterday I thought he was not going to make it -- I kept on top with the karo, RC recovery wet( syringing) applying cold wash cloths to his body and laying on the floor with him. After about two hours he started coming around.

Day before was "almost" as horrendous, again followed up with high fat food( wet) lickey sticks, karo and wet cold washcloths.

Tonight we grabbed him around 5 and he was "just" starting Blood sugar drop. I loaded him up with wet food, lickey sticks and karo -- he's okay now. I did give him 2.5 U's ( just in case ) as his glucose read was 144 -

I've been following "hypo" protocol from the board and some of my own common sense.

Maybe a stupid Q - but is it possible I need to cut back his U's from 5.25 and 5.50 to 4.5 from here on in and just evaluate as I go along? Of course, if his sugars drop below 50 or 60 I would not give him any insulin, is that correct? I'm almost afraid to give any amt. after a serious hypo even in the same day?

my notes are not as articulate as I would typically send out, I am bloody exhausted with all of these events for the last three days. I also have TOO many other pets that go into my daily mix of work for hire mother ( me) -- I'm usually not this messy.
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@Bron and Sheba (GA)
 
Hi there -- Cecile, yes I did an ear prick +1 pm shot and + 2 ( 9pm pst) also -- he's now hunting on the property with the rest of the crew -- I also just loaded him up with more FAT food (wet) he's gotta be bloody tough. I honestly thought he was going to die yesterday. I've never seen such a horrific event take place in a special needs cat -- and I've Seen a LOT in the years of owning special needs this was so bloody horrific. I am very good at handling stress situations, so that helped. I relax and divert. The little guy was talking so loudly ( he talks really well when he wants to) crying " oh no, no mom help" over and over very loudly. I guess it's scary for them jees.
 
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Cecile, yes, his nadirs are getting lower, yes. Ha, do I have rescues. I had ( up until 2022 ) a special needs cat that was. literally had " operating" instructions --- we had to express his bladder twice a week for poop removal at his doctors -- and a constant battle with kidney, bladder infections so horrendous that most would end up septic. And there was way more with him --- 14 years we kept him alive. he should have been dead year one. His doctor always worked with me. His by line was " what do YOU want to do" prob. spent $$$$$$ enough to buy a few luxury super cars -- and I never once complained. I just got in there and figured it out and got him back on his feet. LOVE of my life he was. And we have some rescue Macaws ( abused, neglected) horrible condition. I rescue those that no one wants ( toss out's) I guess -- I toss them into our family and they end up living past their " expiry" dates -- makes me happy to help these poor souls.
 
Well done handling the hypo events. After a symptomatic hypo a cat can be very sensitive insulin so you need to go forward carefully. Even with 2 reductions and 2 skips he dropped to 36. The depot must have been very full. I am glad to see you have given a much lower dose this evening.
moving forward with the dose I think you you should see how he goes this cycle… maybe get a +11 and then post and ask advice about the am dose. Make sure you change the subject line to day you need help with dosing

When you say you are giving FAT food do you mean high carb food? When the BG is low you need high carb not fat food to bring that BG up again
 
Hi Bron - ahh right - post hypo event kitty is super sensitive to insulin - I remember now reading one of the threads on the board - I was not even going to give him the 2.5 this evening ( a bit skeptical ) and pondering “should I?” Okay, so what does depot full mean ) I understand the terminology but not the science behind the comment ? Does it mean his body is not properly using/utilizing it, and it’s sitting ? High carb food ( somewhat ) more fat it is - it’s RC recovery wet - he gets this stuff all the time ( and fancy feast ) the problem is this - Woody was raised syringe fed - he has a bit of an eating disorder - all he would eat ( on his own ) was cat crack and greenies - no type of dry cat food - he’d starve himself when I took the junk off the menu - and would end up refusing to eat anything - so I had to start to syringe feeding him at a young age - he likes to be pencil thin and - it’s just a tick with him - I can’t syringe feed the gravy stuff or he’d aspirate on it - so I just push in as much wet RC as I can - and the karo - I’ll keep u posted on his #s tomorrow for sure - thanks very much -
 
Oh I forgot to add - these events all started to happen when I stopped using the sensor and took off his little onesie - which I find a little odd - he’s had a sensor and onesie on for months - I am wondering if it’s caused him stress in his little mind ( the change )?
 
INSULIN DEPOT
Here is information on Lantus depot.
No it doesn’t mean he is not using the depot. Sometimes when the dose is too high the depot also gets too full and the way to drain the depot is to either skip a dose or reduce a dose.
If you are giving karo with the RC recovery food that is high carb. Or you could add karo to the FF you feed. That would also be high carb.

I don’t think that the removal of the libre and onsie has anything to do with the lower numbers. It is more likely you have hit or gone past the best dose.
 
Okay - I’ve been following TR protocol and kept to .25 dose increases - I did go up to 5.5 for a bit as at 5.25 was seeing HI too many times in a day - that’s why this is a bit confusing - I’ll keep evaluating this as we go along - he may need a dose decrease when this settles as his body could be getting used to utilizing the insulin properly - would this be a correct assumption ? I just tested him 66
 
And lastly ( promise ) if his BG is higher tomorrow am - would I still be dosing 5.25 ) I suppose I’m concerned he will drop to hypo during the day -
 
Mimik said:
Okay - I’ve been following TR protocol and kept to .25 dose increases - I did go up to 5.5 for a bit as at 5.25 was seeing HI too many times in a day - that’s why this is a bit confusing - I’ll keep evaluating this as we go along - he may need a dose decrease when this settles as his body could be getting used to utilizing the insulin properly - would this be a correct assumption ? I just tested him 66
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With TR, a reduction is earned below 50 with a human meter/Libre for cats within a year of diagnosis. He dropped to LO on 7/5 which earned him a reduction to 4.75U. For doses between 5U and 10U dose increases/decreases are in multiples of 0.5U and not 0.25U.

Maybe 5.5U was a breakthrough dose for him and he has decided he wants to get regulated and race down the dosing ladder!

66 was how long after the shot?


Mimik said:
And lastly ( promise ) if his BG is higher tomorrow am - would I still be dosing 5.25 ) I suppose I’m concerned he will drop to hypo during the day -
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Let's see where he is tomorrow morning at AMPS and take a call? Cats with symptomatic hypos can be extra sensitive to insulin.
 
Mimik said:
I did go up to 5.5 for a bit as at 5.25 was seeing HI too many times in a day -
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Dosing is based on the lowest numbers in the cycle, ignore the high numbers. There are a lot of reasons higher numbers happen (including bouncing), so focusing on them can be deceiving and lead to bad dosing decisions.
 
Sending you hugs and prayers, Mimi. You did an amazing job with Woody! I hope he stabilizes quickly for you.
So glad Bron and Bhooma were around to help guide you :bighug::bighug::bighug:
 
Good Morning Ladies --- I want to add a few more details ( to the script from last night)
When Woody goes out on the property ( acres of ) we cannot find him at times -- "typically" when he had the silly sensor and onsie on he'd ( for some weird reason ) be under one of the cars in the driveway or on one of the ( close) walk way areas -- Since I started the ear poking for his BG he seems to be " hiding like a pro" and it's not because he's afraid, in fact, he doesn't seem bothered by it now - and I have gotten really good at it -- the reason for this little story is this -- he usually gets fed every 3 hours like a religion --- adding to 3 cans of FF during the daytime and wet snacks in between -- what is prob. happening is his sugars are bombing because he's gone hours since his AM meals --- his am meals are a full can of FF half can of RC wet recovery, two to three lickey stix, and sometimes more -- which is both syringe fed into him and he eating out of his bowl - perhaps, he is one of those cats that need to be fed consistently many times in a day?
Second -- I am starting to " wonder" just how accurate the libre sensors are? and he's been on the wrong dose based on the sensor #'s I don't know?
Thirdly -- Since I have been injecting into his scruff is when I noticed his #'s starting to go down ( green) and then hypo -- when I was injecting his hind leg area his #'s seemed to be higher? I really noticed a difference, immediately -- I know this shouldn't make sense, but them's the facts --

lastly - his #'s were low AMPS -- so I just dosed 2.5 ( fearful) of him going hypo again -- okay, ALL Ladies here thanks so very much for helping me last night --

I just took his BG it's 1.9 ) after the 2.5 U's this am. I will keep him inside and monitor.
 
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Good luck getting Woody up again. That depot can be an ugly thing! I hope the two reduced doses help.

For what it's worth, Royal Canin Recovey is 3% carbs or LC. It's a great food for syringing, but not for bring up the BG. Might want to get a higher carb option around for lows. A/D is also good for syringing and 12%, but still only considered medium carb.

No rush, but when you have time, could you put your current meter type in your signature.
 
Hi Wendy, Woody is at 2 BG reading right now -- after the 2.5 U's this am. I have on his SS -- he as the verio flex glucose meter and I use the 30 G lancets -- I ordered a huge box from LD here and the delivery system ( plastic unit) is hard to work with -- I can't get hold of 28 G lancets unless my vet can get some for me, which I'll call now. It's super hard to use the 30 G -- but I am managing -- yes the RC is not high in carbs -- I'll get some pate with higher carb content today for sure -- he won't eat the hills AD wet NO way --- I've tried all the variables ( high carb) at the vet he will only gobble the RC recovery -- It just seems very weird once I started shooting in his scruff his numbers have gone to green ( mostly) OR hypo -- it's all a bit of a learn curve for me 2b sure. Thanks for popping in.
 
I'm surprised your local pharmacy doesn't carry 28G lancets. I didn't use the plastic unit but rather freehand poked. That meant I could use any brand of lancet.

Interesting that you are getting these lower numbers with a change in shot placement. The other possibility, mentioned above, is that you finally hit a fitting dose, and you are now breaking through glucose toxicity. Which can be a wild ride down dose. Take a look at Dyson's spreadsheet, he's doing similar now.
 
Hi again Wendy --- no where for 28 gauge. I called my vet tech at the clinic. They use 25 G lancets at the clinic to glucose test and are going to give me a bunch -- so, that's better. Being said I am getting little drops of blood each time I poke in with the 30 -- I don't use any backing when I use the lancet -- I just feel for the very outer rim with my fingers and give a poke and so far awfully good. I cannot believe how easy this is -- I've tried many times ( past) but I was using the lancet device, backing the ear on the other side for resistance -- doing it the total natural way works for me -- I have been poking at Woody every few hours today ( will upload his #'s in a bit) he's gone HI again --his am dose of 2.5 prob. did not get in. I had the used needle on the bathroom counter and did not fully screw the lid on - I took the lid off and saw the needle was bent. I did NOT smell anything on him post shot so? but maybe he did not get the juice this am. I'll forge forward 2night for his pm shot at 5 and see what happens. I will closely monitor his sugars for next few days and see what that tells me pre dose t-- and YES. I agree with the comments about he's at a good dose 5.25 is getting him out of the sugar toxic tumble --- I get that -- took me all day to figure out what it all meant. But, yes, I believe so. as always thank you,
 
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Wendy&Neko said:
I'm surprised your local pharmacy doesn't carry 28G lancets. I didn't use the plastic unit but rather freehand poked. That meant I could use any brand of lancet.

Interesting that you are getting these lower numbers with a change in shot placement. The other possibility, mentioned above, is that you finally hit a fitting dose, and you are now breaking through glucose toxicity. Which can be a wild ride down dose. Take a look at Dyson's spreadsheet, he's doing similar now.
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I am going to start to study Dyson's SS you included link for -- I can see ( blink second) seems a lot like Woody's down and up and back down again theatre production.
 
I used 25 gauge terumo needles to test and bought them online. I don’t know if they are sold in Canada though.
 
Tiff, my cats clinic is going to give me a bunch of the 25 G lancets and ordered me a box -- it's terribly strange that I manage ( without any practice) to start to get the prick by feel with my finger and not seeing the 30 G lancet -- but somehow the kitty Gods are on our side -

You'd be awfully surprised what we CAN'T get in Canada -- not like the US where, pretty much, everything is a tap away.
 
Lots of 28G lancets available in Canada, just google "lancets 28g canada". Made by Freestyle, AccuCheck, Onetouch, Bayer/Mircrolet and more. If you have a Safeway near you, check out their pharmacy. Back in the day for me, they had the best prices on lancets. I liked the Onetouch Ultrasoft. Lots of the above brands also available online in 28G.
 
Hi Wendy, I have an order ( and some to last ) me at my vets of 25 G -- my vet tech, Denise uses the 25 -- say's she finds the 28 G still too thin. So, happy with that -- thanks,

the guy I know at LD over here ordered me a box of these https://www.amazon.com/McKesson-16-PBSL28G-Case-Safety-Lancet-Needle/dp/B01MYHD7NX -- I don't like them -- did not realize they were going to be push button.

I just want the lancet with twist tops --- now, I will have to see if my vet tech is talking about twist top lancets OR these ones -- these ones are great for humans NOT for tapping down on a cats ear.
 
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I've never seen the push button ones before. I just poked with the plain lancets by themselves. I started with the Freestyle 28, but ended up with the Onetouch 33 once her ears learned to bleed better.
 
Yeah, nor have I ( push button) till I got them in my hands - I am supposing the 25's I'm getting will be like a darning needle -- one tip poke my vet tech said? I guess the 33 G would be like a sliver, yikes --- Woody's ears bleed real good. I remember my vet ( one of two) said there is no way I would be able to get a prick because his capillaries were barely there. Me, being stupid back then thought, " Gee, thanks for the heads up" I got a poke and drop the first time I tried using the method I am now ) natural with no backing behind the ear - he puts up with it, but it's a poke I am sure it hurts -- he winces -- when he is really well he has tried to take me down -- and I am very gentle.
 
@Mimik I see on your SS you have for the date 7-8 you said


No sensor using verio flex 30 G lancet ear prick testing
If you are not using the sensor any longer please add that to your signature so members are aware of it. Just put Vero Flex as of 7-8
Also on your spreadsheet put a blank line above the date you started using the Veri Flex and the date and highlight that line
@Mimik
You should have given 2.25 units last night not 5 units

Here is the TR instructions
Reducing the dose:

The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Levemir, & Biosimilars ISG safe by taking reductions when appropriate.
  • If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit
Woody is still considered newly diagnosed. Over a year of diagnosis is considered a long term diabetic. We do not change the dose based on the AMPS or the PMPS numbers. We adjust the dose on how low their BG is dropping
 
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Hi Ladies, I was not sure what to dose Woody last night. That was a huge error on my part -- He was at 5.50 ( last few days) before the hypo events --- I scaled back to 5 U's -- I guess, the way I read ( or my mind interpreted) TR was 0.25 reduction from the 5 U's I was at ( not smart) I should have used, yesterdays #'s and dosed for pm 2.25 ( as you say) this week was so terrifically a bomb that I was really not thinking clearly -- I guess I saw the Higher # again and thought he needed 5U's -- I believe that I am fully understanding "now" what this science is telling me --- I was stuck in the am/pm dose calculation. Loud and clear I am out of of it -- I might put his sensor back on ( and take some ear pricks) because of the hypo events this week, his ears are getting poked and prodded every hour and he's not happy about it -- I am sure "by now" they are tender -- I'll make notes Diane and thanks EVERYONE for all this input and slap to get it right --
 
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Wendy&Neko said:
I've never seen the push button ones before. I just poked with the plain lancets by themselves. I started with the Freestyle 28, but ended up with the Onetouch 33 once her ears learned to bleed better.
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Wendy, since you are CDN --- the verio flex I am using is not a great device. I have gone through 30 strips ( this week) half reading error when I am for sure getting enough of a droplet of blood -- the test strips are terrible. half the time they read error -- it seems to be a common complaint with the strips for these -- even when I tilt the meter ( as required) and doing everything right, it can be hit/miss- 80 strips are 90 bucks here -- what about any on this page from LD https://www.londondrugs.com/health-...th-care/diabetes-care/blood-glucose-monitors/ you mentioned you used the free style glucose meter I can certainly go get one of those, if you think it's better. And as I read the reviews on the free style meter it aint too much better?
 
We sometimes do what’s called shoot through the bounce and shoot the higher dose one time. So it’s not so bad what you did. With all those limes and a skip I would reduce tonight to 4.75 but if under 100 then either skip to drain the depot or possibly s one time reduced dose. Post for guidance.
 
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The Freestyle Lite needs a smaller blood drop - so that might make it easier to get a reading. Plus I've often seen sales on strip prices for it. Do some searching online - sometimes you can get deals where you get a free meter if you buy 100 strips. Alternatively, look on eBay for strips for more savings.
 
Hi Wendy, It's probably, in reality, being new to the ear prick testing -- I got "two" strip reads after I complained about the strips --- but, there is a lot of humans using one touch who grumble about the error reads -- I'll keep at it. I was going to put on a fresh sensor. And decided not to tonight -- I want his bald target spots to fur grow for a while --- his ears ( with all the poking I've done this week) are not damaged at all. I use (either) polysporin antibiotic OR the polysporin antibiotic with pain relief a few times a day. It prob. does wonders --
 
Mimik said:
I use (either) polysporin antibiotic OR the polysporin antibiotic with pain relief a few times a day. It prob. does wonders --
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Neosporin or Polysporin ointment with pain relief is NO LONGER RECOMMENDED due to the ingredient, polymixin which, if ingested in great enough quantities, can cause problems.

@Mimik

I have read that many members use pure coconut oil, I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears)
It seemed to help with the healing
You might be able to get it at a health food store or just Google pure coconut oil
 
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Diane Tyler's Mom said:
Neosporin or Polysporin ointment with pain relief is NO LONGER RECOMMENDED due to the ingredient, polymixin which, if ingested in great enough quantities, can cause problems.

@Mimik

I have read that many members use pure coconut oil, I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears)
It seemed to help with the healing
You might be able to get it at a health food store or just Google pure coconut oil
Click to expand...
Thanks Diane - I will just use the one w/out the pain relief and we use coconut oil all the time around here - it’s what we use to remove the Libre sensors also - it’s an endless use the coconut oil stuff - use costcos organic -
 
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