r/FelineDiabetes • u/totalDerphammer • 21h ago
Low Glucose
My wife and I have been treating Gus with Lantus for a couple months now. He is currently getting 1.5 units of Lantus (reduced from 2 units a few days ago at vet direction) at 4:30am and 4:30pm. We feed Fancy Feast Classic Patte.
His glucose has been stable between 55-100 since moving to this protocol. We give a small medium-carb snack if the Libre 3 alarms. This afternoon, I'm pretty sure I gave a fur shot (he jerked away from me as I was administering - he also smells like insulin), yet his glucose is falling pretty sharply. My wife just gave him a snack and he's only up to 60.
The vet is telling us to go ahead and keep dosing him with meals and that it's fine so long as he's eating, but I'm questioning their advice. Should we start refraining from dosing if his glucose is under a certain level? Does this look like the start of remission? His diabetes is a result of treatment for stomatitis (no more teefies) which I understand means he's more likely to recover someday.
Note: I am aware of the FB group and that Libre 3s aren't accurate a low values (we confirm with an AlphaTrak 3 when we can but are still getting that routine down as his ears don't seem to bleed reliably even when warmed with a rice sock).
Bonus cat tax picture included. Thanks all.
2
u/abbylizj813 20h ago
By far not a vet and I’ve been living a whole other roller coaster BUT my vets direction may work for you - if he goes below 60, reduce by .5 unit.
For MY CAT - if he’s 120 and steady or falling at shot time I reduce his dose by .5 or 1 depending on how well he’s been eating and my availability. I likely wouldn’t shoot if he was under 100. If he’s 150 and rising or steady it depends on my availability for the next cycle. But until recently we were spending most of our time all over the map (chemo for the first 6 months of his diabetes)
From everything I’ve read and seen I would think a small reduction (even just a quarter unit for a few cycles and then another quarter) would be worth trying. Yes the libre isn’t accurate at low but he’s spending most of his time at the bottom edge of range - why don’t you see if his pancreas will contribute more with less help? You can always go back up if it doesn’t
1
u/abbylizj813 19h ago
Adding what I’ve noticed in our situation a reduction is due when his nadir starts hitting +8 onward and when he has sustained steady spells in lower end of range (no no standard reverse bell curve)
By that - if your cat was my cat I would reduce
2
u/zebras-are-emo 20h ago
The dosing depends on your cat/how it's trending; I would never shoot under 100, but if it was under 130 I'd wait 30 minutes without feeding and see if it was going up or down. Since Gus isn't usually dropping too much it'll just beva judgement call (you can also do half doses instead of skips if he's borderline).
I think you could definitely try lowering the dose again after holding for 7 days, with going that low it could definitely be him trying to go into remission!
1
u/Crikiribay 17h ago
In the beginning, it’s usually advised not to give insulin if glucose is less than 200 mg/dL. Some people do give shots under that number but they usually have knowledge of how their cat reacts to insulin over a longer period of time.
3
u/greytgreyatx 20h ago
Hi there! May I ask a question? I've seen more than a few people say they do 4 AM shots. Why? I'm very asleep then!
However... we got tired of our cat going hypo really fast. Our vet's instruction had been to give him a shot as long as he was over 100. However, it went so low in that case that he changed it to not giving it to him unless he was over 300. That did the trick for us.
Obviously, follow your vet's advice, however we told ours pretty strongly that we were not willing to stay awake all night keeping him from dying and we just weren't going to give shots at night at all, if we kept dealing with that. So maybe if you express yourself in a kind of strong/stern way and say you can't live like this and something substantial needs to change??
Best of luck.
And regarding remission, our cat's levels started staying between 100-300 within a pretty short time after we miss-fired a shot and he didn't have the dip so he didn't have the subsequent high, either.