2/17 Gadget amps 293 2U +6 378 +10 369

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Deborah & Gadget

Deborah & Gadget

Member Since 2015
Gadget has really bad numbers and it is my fault. Feb. 13 his AM shot went in one side and out the other. Sunday Feb. 15 I gave his PM insulin 2 hours late. I just read about the "depot" so understand that better. And I will try never to miss a time again but I have to work and I have no back up person.
My question is: Why is it better to skip a late shot than give it? Is 1 hour late ok? How late can you be and still give insulin?
Also: I gave his late shot at 10:30pm 2 hours after his normal time. So in the morning I gave his shot at 9:30 thinking 11 hours between AM and PM shots better than 10 hours if I had done the usual 8:30AM.
Maybe I should have done 10:30 so there was a 12 hour diff?
So Monday and Tuesday I have done 9:30/ 9:30 just to keep it the same while he builds his reserves back up. Is that the correct protocol? And eventually I'd like to get him back to 8:30/8:30. And if that goes well I might like to try 6:30/6:30 one day in the future. Someone on the boards pointed out that Lantus change should be 15 min decreases per shot per day or possibly 30 minute decrease once per day.
When my ignorant vet put me on insulin she did not even mention that the doses needed to be 12 hours apart. I don't even know how I ended up with 8:30/8:30 but it has worked OK I just think earlier would be better.
I do not plan to be late on a shot again but s**t happens. And I'd like to know if there is a set protocol. Thanks!!
 
Hello Deborah, and welcome to you and sweet Gadget to the Lantus/Levemir forum. There's a lot to learn but we can help. Keep reading and keep asking questions.

Lantus likes to be given 12 hours apart, however, you can move it around up to 1/2 hour a day. You can do that 1/2 in one cycle, or 15 minutes at each shot time. We have a post on Getting Back on Schedule, that may help explain how to do that. You can give a shot an hour late, but then the shot after that should be at least 11.5 hours later.

Things happen in life where we have to be early or late. Sometimes we have to skip. That's OK, the cat will get back on track. I have a couple of monthly meetings I have to go to that are earlier than shot time, so I just start adjusting shot time part of a week before hand, then move things back after the meeting. If you shoot late, it's a bit like a decrease. Shooting more than 1/2 hour early is like an increase, and not something you should be doing with Gadget getting the kind of nadirs he is.

You commented about fur shots - those happen too. :oops: Don't give another shot, as you never know for sure how much insulin got it. To help us when we look at your spreadsheet, could you put a comment in the units column when you do a fur shot? Something like 2.0FS will let us know, rather than having to check out the remarks. I also noticed you have skinny 2s in some of the remarks. If that was a dose, could you put that in the units column so we know which one it was (AM or PM). Lantus also likes consistent dosing.

We have two dosing protocols here, Tight Regulation and Start Low Go Slow Method. If you could let us know which one you are interested in following by putting it in your signature, it'll help us help you and Gadget. One final comment, many kitties like to go lower at night. You might want to try getting some more spot tests at night, maybe just before you go to bed.
 
Gadget is quite the cutie pie :) I also include the time I shot in the cell with the units shot, eg 2 @ 8.30 to help keep track. Don't beat yourself up about the fur shots, they happen to everyone. You might find it useful to use a magnifier to help keep your dosing consistent. Another option is to make up a sample syringe using coloured water of the dose you want to give. You take your time getting that just right and then you can compare each dose to your sample syringe before you give it to make sure that they match.
 
There's really not an issue with giving a late shot other than it functions like a dose reduction since you lose at least some of the overlap between shots. The headache is getting back on schedule. If you shoot early, you increase the overlap and the early shot acts like a dose increase. If you can't be there to monitor, Gadget's numbers could drop lower than you expect. That said, 30 minutes one way or the other isn't an issue for most cats. If you have to shoot an hour or more late there can be an effect on your cat's BG numbers.

Skipping a shot has the most impact both on the numbers for that cycle and probably the next 12-hour cycle. It also depletes the depot -- hence the effect on at least the next cycle.That's the reason why at least in my opinion, it's better to shoot a bit late. However, if you shoot too late, it may be quiet difficult to get back to a workable schedule. In this case, skipping is preferable especially if you want to readjust your shot time.
 
I've worked on my spreadsheet to make it easier to understand. Dr Pierson has said we are on Tight Regime.

In retrospect I made MANY mistakes regarding the late shot and I thank FDMB for helping me to understand!
1. I should have reached out for advice not just given his shot 2 hours late.
2. The 2 hours late may not have been as big of a mistake as the hour early the next morning.
3. I should have given his AM dose at +12 not tried to adjust it an hour and shooting at +11
4. I should have checked Gadgets history. Dr Lisa had me give a lower dose last time I was late and that worked good.
5. Lastly I think the main thing is don't panic! Don't just shoot and then try to figure it out.
 
There have been times when I've shot rather early in order to get back on schedule. The difference is that I've been doing this for 5+ years, have a ton of data, and I'm pretty confident in my ability to manage Gabby's numbers if they drop. The issue, which I think you're catching on to from your post above, is the cardinal rule of this board -- "know your cat."

We always encourage people that if you don't know what to do, post and ask for help. There's usually someone around almost 24/7. Even if they aren't comfortable giving dose recommendations, they can help you puzzle through your options. You really don't have to fly solo unless you want to!
 
Sounds like you're a quick learner Deborah but there is a lot to learn and we'll be more than happy to help you with that, everyone here was a beginner at one stage :)

That 46 today has earned Gadget a 0.25 unit dose reduction :D make sure you take it.
 
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