What to do if you cannot give shot @ regular time & DKA is a concern?

Calicos are Best (GA)

Calicos are Best (GA)

Member Since 2019
Today is Sunday and I have a concern coming up on this Friday the 26th? My cat Lily has a history of ketoacidosis. I will have to leave my house 3 hours before Lily's evening shot on Friday.

Lily is on a schedule of:
AM = between 7am - 8am,
PM = 7pm - 8pm.

I don't have anyone else to give her the shot. Skipping her shot is not an option w/ her DKA history. Should I give Lily the shot when I get home at 12am - 1am on Friday? OR do I need to change her scheduled times all week to work up to when I am leaving?

Does anyone have any advice for shot times changing? Thank you for any advice anyone can offer. :cat:
 
Obviously, the best option is if you can find someone to give a shot. Any chance one of the vet techs from your vet's office could help out?

Either option you noted is feasible.If you opt to move the shot times, you can move the times 15 min early at each shot time or 30 min early once a day until your back to your preferred shot time.

A third option would be to shoot 18 hrs after your AM shot on Friday and give the next shot 18 hrs later. That will put you back on schedule. This option is pretty close to your shooting as soon as you get home. If you opt to shoot once your home, just remember that you need to adjust your shot time as noted above in order to get back on schedule.
 
ohhh, very smart!!!! 18 hrs, I didn't ever hear of that option. That might be the best choice for my situation. If I do this method to stay on track Friday and shoot 18 hrs after the AM shot = between 12am - 1am that seems like it should work. However the 2nd 18 hr shot will be skipping the AM shot Saturday morning.

The 2nd 18th hour dose would be Saturday's pm shot... Will this be bad to do? To skip the AM Saturday morning?
 
If I'm understanding correctly, you're looking at the next day's shot as your usual Saturday AM shot. It's not. The timing is off.

It sounds like your normal shot time is around 7:30. I'm splitting the difference between the 7 - 8 shot time for the sake of convenience. So, on Friday, you would shoot at 7:30 AM. You can't shoot at the usual PM time and would have to shoot around 12:30 AM -- 5 hours late -- when you return home. This means that in order to stay on a 12 hour shot schedule, your new AM time would be 12:30 PM. (Or, if you're walking the shot time back, either at 12:00 or 12:15.) This isn't "skipping" the Saturday dose -- you have to move your usual shot time to stay on a 12-hour shot schedule. If you shot at 7:30 AM, you'd be shooting roughly 5 hrs early and and shooting that early isn't recommended. (An early shot acts like a dose increase.) Does this help to make sense out of the shot schedule?

Even if you adjust your shot time over the course of this week to accommodate your being out on Friday, you would have to go through the same process in the opposite direction next week.

If you skip the Friday PM shot, you can stay on schedule. You mentioned that Lily was diagnosed with DKA. When was that? Have you been checking for ketones? I can't really tell from your SS when the DKA occurred and how Lily has been doing since. If she's been healthy and there hasn't been any evidence of ketones, you could conceivably skip the shot.
 
I did do the 18 hour shot schedule once, when no one could be there for shot time. It worked fine for Neko, but I have seen differing results between cats. You do want to keep shots at least 12 hours apart, so unless you can shoot your second 18 hour shot earlier and gradually work your way back on schedule, it may be your best choice.

Elsewhere you asked me a couple questions about the idea of switching to TR for dosing. TR requires testing before each preshot, then at least one additional test per cycle. The comment on testing at +3, 6, and 9 is for when you start out. At that point you are looking for two things. First, testing more frequently in case the starting dose is too high, and second, trying to figure out when Lily’s onset and nadir are, and what type of duration she is getting. Once you have those figured out, you can be more strategic about when you test. And also about feeding. Cats that dive early may need more meals before onset. The other major differences with SLGS is that you can increase more quickly and the reduction points. Testing more means it is safer to increase sooner.

One suggestion for you tho think about, if possible, is to get an earlier test in the PM cycle. It’s possible Lily is nadiring earlier than +6. As a bonus, if you see she is safe earlier, you can go to bed earlier. I was always trying to figure out how to maximize my sleep.

Good luck in your dosing method decision. We do have more cats on TR get better regulation and potentially remission, because TR allows the cat to spent more time in the healing blood sugar range.
 
Thanks @Sienne and Gabby (GA)! Yes I see what you mean now. The 18 hr shot is just delayed 5 hrs...and I should match it Saturday by doing the +12 like usual, only at 12:30 PM for the AM shot...or around that time. I seeeeee! Thank you for explaining that to me.

Sienne and Gabby (GA) said:
You mentioned that Lily was diagnosed with DKA. When was that? Have you been checking for ketones?
Click to expand...

It would be very easy to skip, but I worry that Lily is so sensitive that skipping the shot could make me regret it. She could get sick and I don't want to risk it. In October of 2018 Lily was hospitalized and in January of 2019. Both times she had ketones in her pee and was diagnosed w/ the DKA. I do try to check her for keytones w/ those color coded strips you use in the kitty box. I don't check everyday.


Thank you for writing back @Wendy&Neko!

Wendy&Neko said:
First, testing more frequently in case the starting dose is too high, and second, trying to figure out when Lily’s onset and nadir are, and what type of duration she is getting.
Click to expand...

I know that nadir is the lowest point of the cycle...what is the onset? Is the onset when her numbers first begin to drop? Or just the opposite, when her numbers begin to rise?

I noticed that TR also mentioned to give your cat .25 units of insulin / kg of the cat's ideal weight. Lily's weight at the vet last week was 10.13 lbs. In kg that = 4.5948907. So if I take (this number) 4.5948907 times .25 = 1.148722675. Would this mean I should actually to measure out just a little bit more than 1 unit. OR just round it down to 1 unit?

On some nights I can check Lily before + 6 and other nights I am not able to. Most nights I go to bed late so it is ok. I want to try the TR method soon. Maybe in a week or so I will try to do TR.
 
That formula for TR is only if they are brand new to insulin. You would stay on the same dose as you are before changing dosing methods.

Onset is when the insulin begins to take effect and the numbers drop. You should know those times for Lily, regardless of dosing method used.
 
Thank you! I just checked Lily at +2 and I already see a drop tonight. I will try to check her numbers more often if I am able to. I think that will give me a better sense of her pattern because I still have not been able to see one.
 
You must log in or register to reply here.
Back
Top