Boo Radley; going to miss 630PM Shoot - need advice?

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Jessica & Boo Radley

Jessica & Boo Radley

Member Since 2011
Good afternoon,

I'm hoping to get some advice on shooting off schedule. I am typically shooting at 6:30AM and 6:30 PM (1.25 units each) and feeding the same. As info, we're 4 days into our first dosage increase of 0.25 units. Today, we are going to be away from the house from about 3:45PM until 8PMish - which means we'll miss our 6:30PM shot and feed.

We have been running high (200's - 300's) consistently and are obviously still in the phase of searching for his perfect dose and adjusting to being diabetic @-) . Yesterday for example: AMPS 231, +4/257, +7/302, PMPS 292, +2/246, +4/253.

My gut says I should test him before we leave and give him maybe half of his regular dose (barring no critical numbers), feed him, test him again when we get home, shoot the other half and feed again.

Any thoughts or different suggestions would be appreciated!
 
ummm, no - i don't think you want to do that. when you shoot early it acts like a dose increase. when you shoot late it acts like a shot decrease. lantus works on about a 12 hour curve and as you shoot you have to imagine the rest of the last shot's curve overlapping with the new shot's curve. does that make sense? and i wouldn't think (but i've only been doing this since february, so perhaps someone with more experience will advise you differently) that you would ever split your shot.

as far as tonight goes, i think i'd continue to test, including one right before you go, and right after you get back. if you want to shoot late, then that is the time you have to shoot tomorrow morning. so it becomes your new shot time and you have to work backwards to your 6:30 schedule by 30 minutes a day - either all at once or 15 minutes early at each shot. that's your choice.

there are also times when we just screw up the shot and call it a "fur shot." sometimes the kitty jerks during the shot and you know some didn't get it, but you never re-shoot. or you poke the needle in and it goes out the other side of the "tent." in either case you just let it go and try to get back on track with the subsequent shots.

i would see your choices tonight as either shooting late and having a new shot time, or skipping the shot entirely.
 
I totally agree with Julie. Never split shots. It probably would be preferable to shoot at 8 PM when you get home tonight and then at 8 A.M. tomorrow. But if because of your work schedule you can't shoot at 8 A.M., or make up the time easily (30 minutes a day, either all at once, or 15 min. at AMPS and 15 at PMPS), then I would skip the shot tonight. You will see a rise in bg numbers, but Boo Radley will come down again. Since you started insulin so recently, I don't think skipping the shot will hurt your kitty at all.

Enjoy your evening out, and do make sure that you test. The data that you gather will help in future situations.

Ella & Rusty

p.s. give him a snack before you leave.
 
julie1220 said:
ummm, no - i don't think you want to do that. when you shoot early it acts like a dose increase. when you shoot late it acts like a shot decrease. lantus works on about a 12 hour curve and as you shoot you have to imagine the rest of the last shot's curve overlapping with the new shot's curve. does that make sense? and i wouldn't think (but i've only been doing this since February, so perhaps someone with more experience will advise you differently) that you would ever split your shot.
Click to expand...

Thanks for the reply Julie. If I look at Boo's numbers, at this point, I'm not "worried" about hypoglycemia if I shoot early - we're not dancing anywhere close to low and haven't been. I'm not 100% convinced that 12 hours is the magic number - for some it appears to be longer, shorter, etc., and depending on what study you read, you could see up to 24-28 hours. There is actually one study I read that compared qid, bid, and qd and showed similar control results for all 3, but the best at qid.

I also anticipate another dose increase tomorrow after I run my day 5 curve (but won't know for sure until the end of the day). Boo's a FIV kitty, so for us hyperglycemia is just as bad as hypo, so I'm really working to control the highs and keep the sugars out of his bladder. An infection for him can be a death sentence.

It sounded like your thoughts stemmed from a concern of too much insulin on board....let me know if I'm missing something or interpreted it incorrectly, because I certainly want to make sure I'm thinking this through.
 
i'm not an expert on this, jessica. i have shot punkin early when he was quite high with the same reasoning that you're expressing. but i have seen it here with a lot of cats that the more consistent you are with your shot times the better your kitty will do. it's not hypo that i'm thinking of, although a cat with lower numbers, yes, that's a concern. it's that the more consistent you are with dosing, timing and food, the quicker your cat will begin to thrive.

most people seem to arrive here with the idea that the preshot number determines the safety of a dose and we know that the nadir is the critical piece of info that determines dose.

many vets (including mine) say that you have a window of a couple of hours to shoot - that's flat out wrong. i've seen many folks arrive with cats that are bouncing, and as they follow the protocol here, including 12 hr shots, the cat's numbers flatten out, people gush that "their" cat has returned and has begun to play, groom, eat normally, and the excessive urination and drinking has disappeared.

if you stay here and read new people's posts for even a month, i suspect you will become convinced of the "magic" of the 12 hour dose and the success of following the Rand/Roomp/tilly protocols. i think FDMB has been around since 1998 or so and they have thousands of kitties that have gotten controlled with it. If you scan down the Lantus forum a couple of days past, you'll see the last "OTJ (off the juice) Party" - look at the video with it and you'll see the list of cats that have gone off of insulin. in the 6 months we've been here i suspect there's been an average of one cat going off of insulin every week. and some of our cats (like mine) have conditions that mean they will never go off. Given that, a cat a week isn't too bad of an average!
 
Julie- thanks again. I am certainly on board with following the protocol, just trying to find the balance between my knowledge with diabetes and humans and what is happening with cats as well as tying in Boo's kitty FIV. So please know, I appreciate your input, very much and will use that as part of my guiding process.
 
Can your schedule accommodate your shooting late and then working back the time to your usual shot time? I think this is a safer strategy. Also, it may be possible to shoot early tomorrow in order to make up an hour depending on where Boo Radley's numbers are.

We generally don't split the dose (half sooner and then half later). What can end up happening is that you have 2 nadirs and they can end up overlapping and creating problems. Remember, Lantus dosing has a cumulative effect. There's no way to know if this will happen but there's no way to know that it won't.
 
Hi Jessica!
I'm new myself and I'm the queen of the complicated schedule! Just ask Julie and Sienne! ;-)
Too new to offer advice; your thread caught my eye because I just love the name Boo Radley!! :-D
Just wanted to say hi! I'll be watching your condos; sounds like we have some of the same hurdles.
Nice to meet you and Boo!
Ashley
 
I have nothing to add, being new and all, except I, too, love the name Boo Radley! That's fantastic. Good luck with the dosing and schedule - it is quite a challenge keeping it every 12 hours, with our busy lives.
 
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