Double shot.. Advice needed

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lbeerman

lbeerman

Member Since 2012
Riley has been on Lantus for 4 years. 5 units am/pm. Shot time is 5am. I gave him shot and then DH woke up 45 minutes later saw an empty food bowl and fed and gave him shot again. I have caro syrup, will grab some fancy feast w/ gravy, and chicken flavor pounce cat treats. Should I just keep giving him treats and the high carb food starting now and then keep testing every hour or so? How long do I have to worry about hypo? Can't believe we did this.

Background: Riley was on Prozinc for 2 years prior to Lantus before building up a resistance to it which led to a DKA incident where we nearly lost him. New vet at that time took him off fancy fast classic and Prozinc and put him on Purina DM wet and dry with the Lantus. I know 5 units is a high dose and that the Purina DM is considered unnecessary and higher carb but I have been scared to change anything since it seems to work for him. Pre shot numbers low to mid 200's on micro relion and +6 normally low to mid 100's.

Any advice would be appreciated. Thanks!
 
Go back and edit your thread title straight away and put up a 911 icon to attract attention to this thread.

TEST IMMEDIATELY and intervene with honey/karo..

(Removed rest of original post text - not relevant to severity of situation and didn't want to interrupt focus on kitty).


Mogs
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An extra 5 units of Lantus is a LOT of extra insulin. With preshots of low to mid 200's and +6 normally low to mid 100's. I would suggest taking him to the ER. You have no updated data so it is impossible to say how the cycle goes.

This is not something I personally would want to deal with at home.
 
So, your kitty has accidentally been given 10 units Lantus instead of 5?

You will need to watch him and take any remedial action (to keep blood glucose up) for many hours to come.
And please be aware that this may NOT be something that you can handle at home, so please DO find the number of an emergency vet as you may need to take your kitty in and get him put onto a glucose drip.
If/when you take your kitty to the vet do phone ahead, give syrup/glucose before setting off, and take it with you also in case you need it en route.
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Take a reading right away....how long since the first and second shot...give Karo or other syrup and contact the ER vet to bring your kitty in.
 
Elizabeth and Bertie said:
@lbeerman - Your SS doesn't have any recent data, so we are working completely 'blind' here.
The safest option is to give syrup/glucose and get your kitty to an ER vet.
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TOTALLY AGREE. Once the insulin kicks in the numbers could drop like a rock and the usual home treatment for hypos most likely will not be enough to keep the numbers from tanking out. This is not a situation to wait and see.
 
Thanks

AMPS was 260 when I gave shot
DH did not check before shot
+ 1 213
+1.5. 244

I gave him a bunch of pounce cat treats which he gobbled up, not sure how high in carbs they are but figured couldn't hurt. I rubbed some caro on his gums As well. Have the number for ER vet and my vet is open so Sunday although not til noon.

Thanks for any and all help!!!!!
 
Relion Micro Glucometer

AMPS 260mg/dL - DOSE 5IU LANTUS
AM+0.75 - SECOND DOSE 5IU LANTUS
AM+1.00 - 213
AM+1.50 - 244

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Lantus usually starts acting around +2 or +3 so the crunch of the 10 units will be starting to take effect very shortly. Once it hits it could be a total nose dive which quite likely may not be able to be controlled with the usual low number home treatments. If Riley starts to drop like a rock you may not be able to get the numbers up. Also with that large a dose the effects of a hypo could last 16-24 hours.
 
I hate suggesting an ER vet because of the financial costs. I have dealt with a number of very low hypos at home with my two and feel very confident about being able to handle them. I actually have one of my kitties on a dose of 5.0 units of Levemir, which acts almost identical to Lantus except for a later onset and nadir. HOWEVER in this situation I would be contacting ER and getting my kitty there ASAP.

ETA I WOULD NOT attempt to deal with this at home,
 
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oh my... good call getting snacks in him early... I agree, be ready to leave as this could be very dangerous for him.
 
JanetNJ said:
oh my... good call getting snacks in him early... I agree, be ready to leave as this could be very dangerous for him.
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As well as the overdose look at this morning's BG numbers. There's no 'could be' in this situation, Janet; he needs to be on his way to the vet immediately.

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Hi, thanks so much for both the advice and the prayers. We just got back from the vet. Turns out our regular vet changed their Sunday hours to 8-4 so we were able to go there which is 5 minutes away versus ER vet which is 45 minutes away.

She checked his BG, it was 276 on their pet meter. last read was at 10:00am which would be +5 for 1st shot . She said she was comfortable sending him home with us to home test every hour. She actually said she had suggested we come in when I called because she didn't know we were able to home test. I am nervous but she said she would do no different if we left him there. She said to check his blood every hour and call her back about 3:30 to let her know how he was doing, she advised to test hourly until midnight.

I picked up some of his old high carb food (fancy feast w. Gravy and Purina cat chow dry) he ignore the wet but has eaten some ofmthe dry. I have been rubbing a bit of caro on his gums here and there figuring better too high then low. The vet agreed so will continue that.

Again, just wanted to say Thank You! I will keep,you updated.
 
Thank you for the update..we all tend to worry about all the kitties on here. :bighug:

That is good news that the numbers did not drop into dangerous levels. I wonder if one of the shots ended up being a fur shot? With 10 units of Lantus on board Riley's numbers should logically have dropped very low. I would still do some more testing as was suggested.

It would be most helpful if you could update the spreadsheet with some of the more recent numbers.

ETA Also now that Riley is safe could you remove the "911" tag on your title, so that others don't panic when they see it :)
 
Just removed the 911 tag and checked his BG it's 204 at +6 on the first shot.
I will be watching him very closely. We shut all bedroom doors as he tends to nap under the bed during the day and I don't want to have to deal with trying to lure hm out.

Re: the possible fur shot, it's possible. With a 5 am shot time we r definitley not at our best!!
 
Great news that Riley is holding in good numbers. It sound like one of those shots must have been a fur shot. Keep us posted!
 
lbeerman said:
she advised to test hourly until midnight.
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Relieved to hear the update. Great that you could get him to your local vet so quickly.

I recommend keeping a brief written record of food alongside BG levels while you're intensively monitoring today because you need to keep track of both his BG levels and an idea of how much food he's eaten, how high in carbs, whether syrup given, and how long ago. You need the full picture to get a better grasp on how safe Riley is - and with all the stress and worry it is more than likely you'll lose track if you don't keep a little note of what he gets when. You will eventually need to check that his numbers are stable between feeds and having this record will help you to better judge that.

e.g.

AMPS 260 - fed (food??) - FIRST DOSE OF 5.0 IU LANTUS
AM+0.75 - SECOND DOSE OF 5.0 IU LANTUS (food??)
AM+??? - BG ??? - fed ??? amt high carb / low carb / gave karo / other food (i.e. whatever combo he got at whatever time).

(Note: One can only speculate about whether one of those doses might have been a fur shot; for Riley's safety you need to work on the premise that both doses were correctly administered.)

What did the vet say about when to give insulin again?


Mogs
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So glad to hear Riley is safe, thank heavens for a possible fur shot!!!
I agree whole-heartedly with Mogs' advice about keeping a written record of foods, bg #s, times, etc, it's all really important data to have at your fingertips. Yes, what did your vet say about Riley's PM shot?
 
For once a fur shot that does good. Keep checking and keep us updated. We will be checking to make sure Riley remains safe.

Start posting immediately if he starts to drop.
 
lbeerman said:
She checked his BG, it was 276 on their pet meter. last read was at 10:00am which would be +5 for 1st shot . She said she was comfortable sending him home with us to home test every hour. She actually said she had suggested we come in when I called because she didn't know we were able to home test. I am nervous but she said she would do no different if we left him there. She said to check his blood every hour and call her back about 3:30 to let her know how he was doing, she advised to test hourly until midnight.
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Good advice!

Just a word of caution...

We've seen cats react to Lantus over doses in several different ways. Most of us expect numbers to careen downwards in the first few hours, but often that's not the case. Sometimes the whole incident becomes a non-event and numbers will remain high. However, sometimes the blood glucose numbers will actually rise and then drop towards the end of the cycle and continue low for several hours (through what would be about 15 - 17 hours after the shot(s).

One cannot assume a fur shot was given or that kitty will not drop at some point. I love your vet's advice to test hourly through midnight! It's great advice!

Talk to your vet about whether Riley should be dosed tonight. I'm not a vet, but if he were my cat I would skip the PM shot in an effort to drain the insulin depot since Lantus is a depot insulin.

One more thing... try not to fill Riley up too much in case there becomes a point where you need him to eat to pull his numbers up.

Just my opinion and observations based on years of working with a depot insulin and my involvement with the FDMB's Lantus and Levemir Insulin Support group.


Good luck! Post if you need help.
 
Relieved to hear you are skipping tonight's shot! Definitely good advice on your vet's part! I hope Riley continues to stay in safe numbers. :bighug:
 
Hope everything's going OK with Riley.

Should the need arise that you need more help and you don't get an answer quickly on Feline Health, try posting for assistance on the Lantus and Levemir ISG board (sometimes there can be more footfall there). If you're in any doubt about anything don't hesitate to call your vets for advice straight away.

Fingers and paws crossed here for a straightforward, uneventful night.

:bighug:


Mogs
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