Extra shot by mistake-need advice

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Sue and Ruben

Member Since 2010
hi--i just gave my cat an extra insulin dose totally by accident. he is on a unit and a half. i took his reading he was at 255. gave the shot. i don't know what happened but i gave him another shot about 10 minutes later. totally got confused. question now is what to do. i can monitor him for the next several hours and continue to feed him and give him karo or take him to the hospital where he can be put on a sugar drip and be monitored. this happened once before when a pet sitter gave him the wrong dose. When i came home, his BG around 30. the karo wouldn't bring it up fast enough and he wouldn't eat so i took him to the ER where he was for 2 days. it was the best call. wondering now if i should do the same to be safe. this all happened about 8:30EST. Pls advise asap. thanks.
 
Please put a 911 on you condo to get lots of expert eyes.

You are going to need to monitor very closely, probably all night. Once a cat has had a sever hypo the can be extra sensitive to insulin. Do you have plenty of high carb food on hand? Others may correct me but I would feed HC as soon as you see the slightest movement down. If you can keep him up w/ food to counteract the insulin, he may never get to the danger zone. They can get filled up easily though so I would not feed LC at all and small amounts of MC or HC frequently. For this it is better too many carbs and bouncing than not enough!
 
Sue and Ruben said:
question now is what to do. i can monitor him for the next several hours and continue to feed him and give him karo or take him to the hospital where he can be put on a sugar drip and be monitored.
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in addition to the answer to Sienne's question about the ER...

What do you want to do?

Are you prepared to monitor him (possibly every 30 minutes) all night long if necessary?

Do you have an ample supply of test strips, karo, and hc with gravy foods?

Even if you start out monitoring at home, you may have to end up taking him to an ER.

How comfortable are you managing the curve?


If there's any doubt in your mind, I'd opt for the ER. Its the safest place for him. They'll monitor all night.
 
Lots of testing all night I'm afraid esp around his usual nadir... everyone elses advice is great. Be ready with syrup and HC as soon as you see a drop. Keep us updated and get ready in case you need a trip to the vet.
 
thanks for the replies. yes, i have plenty of high carb food. i just took a reading and his level is at 276 up from 255 one hour ago. i don't know if i can stay up all night, but i can stay up at least another 4 hours. i am about 25 min to the ER. the last time this happened he did have a seizure at the ER but his numbers were way lower then and it unclear how much extra a dose the pet sitter gave. he is on 1.5 units now and i gave him an extra 1.5.
 
If you decide to try to stay up all night and monitor him, I would call the ER just to let them know what happened and give them a heads up that you may be coming in tonight. They'll probably grab him from you as soon as you walk through the door, and they'll be prepared. I'm not trying to scare you. He may be just fine at home. I would start the coffee now and make sure you have all your supplys now, though.
 
ps: i have the karo too. i feel somewhat comforted that his BG is at 275 ....my hope is with monitoring it wont get to hypo stage.
 
Hopefully by +4 you'll know where he is going and then maybe you get some cat naps in if he is still yellow or high blue . If you cant stay up any longer after that, and he is still yellow or high blue, I would give him a decent amount of HC, bring him into the bedroom with you where you can keep an eye on him and set the alarm for a snooze. Then get up and test again. Or do you have DH that can help?
 
Sue and Ruben said:
thanks for the replies. yes, i have plenty of high carb food. i just took a reading and his level is at 276 up from 255 one hour ago. i don't know if i can stay up all night, but i can stay up at least another 4 hours. i am about 25 min to the ER. the last time this happened he did have a seizure at the ER but his numbers were way lower then and it unclear how much extra a dose the pet sitter gave. he is on 1.5 units now and i gave him an extra 1.5.
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Sue, I just looked at your ss. Am I missing something or does the data stop in March?

Do you have any current data recorded somewhere else???

When is his *usual* onset?

At what +hour does he peak?

How much duration is he currently getting out of 1.5 units?
 
FYI to those helping on this thread...

Just want everyone to be aware an over dose on one of the long-acting insulins can produce a prolonged hypoglycemic event.

Sometimes situations like this become a non-event. However, we've also seen them last as long as 16 -17 hours.
 
i have been bad about updating the SS. he had been on 1 unit and his numbers are mostly in the upper 200's because after the hypo incident the ER doctor wanted me to keep him in that upper 200-low 300 range. Nadir typically for him is about 6 hours and has stayed in the low 200's. I admit, however i used to do a lot more mid-day testing and have not done so since his dose has been low and his numbers high, as per the doctor. only recently have i even increased his insulin to 1.5. (in late october) and now the Pre and post shot numbers are in the mid-200's.
 
Sue and Ruben said:
i have been bad about updating the SS. he had been on 1 unit and his numbers are mostly in the upper 200's because after the hypo incident the ER doctor wanted me to keep him in that upper 200-low 300 range. Nadir typically for him is about 6 hours and has stayed in the low 200's. I admit, however i used to do a lot more mid-day testing and have not done so since his dose has been low and his numbers high, as per the doctor. only recently have i even increased his insulin to 1.5. (in late october) and now the Pre and post shot numbers are in the mid-200's.
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Sue, I'll be honest. Given the unknowns, if you don't think you can stay up with him all night if you had to... you're best off taking him to an ER.
He'll be safe there.
 
i agree, the last time, he did have an event at the vet even though he was on drip. it can last a long time. again, i don't know how much insulin he had but the better of me is not thinking i should err on the side of caution and go to the ER and have him monitored overnight.
 
I think it's a wise decision to take him in.
Please update when you can. We'll be worried about him.
With any luck it'll turn into a non-event...
 
quick update and a big thanks to everyone who provided better advice than the ER folks who answered the phone. I did bring Ruben in because i felt he would be better monitored. It was the right choice. He is staying overnight where they will check his BG levels and hopefully this will pass with no hypo event. Thanks again to everyone who weighted in with sage advice.
 
Thanks for updating, Sue.
Having him there will give you some peace of mind tonight.
Stop by with an update tomorrow if you can...
 
ruben is back home. all ok overnight. his levels never got below 206. it is now about 15 hours since last injection so i think we are out of the danger zone. i will continue to monitor at home, have high carbs on hand. thanks again for the support.
 
I'm very glad this was a non-event!

Just a comment. You mentioned that after the petsitter incident, the ER vet told you to keep Ruben in the 200 - 300 range. That may have been OK for a couple of days. I wouldn't want you to keep Ruben in that range. Numbers above the low 200s are above renal threshold and you risk compromising your cat's kidneys. If you're wanting to keep his numbers in a safer zone, I'd suggest below 200.
 
Great news!

I'd agree with Sienne. Lots of vets seem to like to keep kitties over 200, because I guess most owners don't test and monitor closely like we do. Since you're a home tester, I'd also aim for lower numbers, too.

Keep us posted on Ruben!!
 
i couldnt agree more. when i told her that, she was insistent that anything in the 100's was too low. he did fine for a long time in that range and that is what i am going to aim for again.
 
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