furshot - new to this

[Newpowers]

Hi I am a bit panicky right now!

My 7 year old male cat was diagnosed with diabetes about 11 days ago now. It has been a struggle to learn about all of this and hope I am doing right by him. He has has high blood glucose readings, anywhere from 20mmol/L - 38mmol/L and I know it can take a while to see improvements. It has been a very stressful time, trying to get him to eat wet food (he's a carb junky), while managing his very restrictive diet (only thing he's not allergic to seems to be duck, he plucks/licks himself completely bald on other foods or starts vomiting, etc). But tonight I am worried about what just happened.

I have been communicating with his vet quite a bit to make sure I'm doing everything I can for him. When I went to inject him tonight, I did the usual, I tented his skin, parted his fur, inserted, and as I pushed the plunger, he jerked and I believe I squirted basically all of his 2.0U Lantus all over his neck and my hands. I saw a full droplet of liquid, as well as at least 3 fingers coated in it; I was pretty wet. I chose to inject 1.5, which I definitely got in him. I chose the 1.5 dose because perhaps a small amount was injected. I would also like to add I could strongly smell it all over my hands.

Of course I am worried and read I should DEFINITELY have not redosed according to other posts on this forum, but it is too late for that. Pre-injection his blood glucose was 32mmol/L. His readings have barely improved during the time since I first started monitoring 11 days ago. A few days ago vet recommended I up the dose from 1.5 to 2.0, and have been dosing 2.0 since.

How worried should I be? I am pretty sure basically none of the first dose got in him. I am tired and wore out, very stressed about his situation, so mistakes happen. I feel awful and like I am doing everything wrong. His appetite is good, he ate a good amount of canned food just prior to his injection.

 

[Bron and Sheba (GA)]

Hi and welcome to FDMB.
First of all take some slow deep breaths. The first couple of weeks of this journey can be pretty stressful but the good news is it gets MUCH easier. Don't beat yourself up. When you are tired and stressed it does feel like everything is going wrong. We have all been there and understand.
We have all done a fur shot at one time or another so don't worry about that. But in future definitely no not give a second dose. The main reason being that one really doesn't know how much of the furshot actually got in, and repeating the dose can potentially double the dose.
Are you testing the BSL yourself? It sounds like you are.
If you are I would test him every few hours this cycle to see he is not dropping too much, and I would make sure you have some honey available in case you need it. Also some higher carb food in case he drops as well.
Here is a link to hypos
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

We can help you a lot here.
Could I suggest you set up a spreadsheet and post in all the blood sugar levels you have done so far with any comments in the remarks column.
Here is the link. If you run into trouble setting it up, yell and someone will help you
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

We recommend you always test the blood sugar before every shot to make sure it is safe to give the insulin and then at least once at 4 to 6 hours later to see how low the insulin is taking him (the nadir).
We base our dose increases or decreases on the nadir not the preshot and recommend holding the dose for at least 6 cycles (3 days) before changing the dose. We also go up and down the dosing scale in 1/4 (0.25)unit increments to make sure we don't go past the correct dose. Our first priority is always to keep kitty safe.


Bron

 

[Newpowers]

Thank you so much for your reply. I have definitely learned my lesson, as well as a few others. I just wish I didn't have to make the mistakes first. I know I am still very much in the early days of his treatment and learning. He has been such a good boy taking all his poking and prodding and I hope I can do the same for him.

I just checked on him, he was sleeping soundly but woke up, alert to my presence, purring etc. These things always seem to happen in the dead of night unfortunately for me

I will be testing his BSL in a few hours which will be approximately half way through to his next dose. I have done so much reading about feline diabetes this week and learned many things and hopefully I can take this just as a learning experience and not a nightmare!

I know Lantus is long acting; regarding his depot and this potential mild overdose, will this potentially effect his BSL for a few days? Thank you so much for telling me about the nadir in a simple way, as I've seen it all over this board and been wondering exactly what it is. The vets have also made no mention of this aspect either, perhaps to not overwhelm people of newly diagnosed cats, but I find more information much more helpful. His care sheet really only stated the dangers of hypoglycemia and nothing else about diabetes.

I have been so paranoid over him hovering around 30.0mmol/L BSL and worried about the longterm effects it might have for him - though he has likely been diabetic for a few months now, fluctuating up and down without my knowledge, but now that I know I find myself over-analyzing absolutely everything.

Also I will definitely work on the spreadsheet later today, hopefully once this has blown over

Update: just tested him roughly five hours after my mistake he was 25.0mmol/L so not a drastic change from usual ranges he's been in. He was a happy boy as usual. I am going to try to get some sleep and check on him in a few.

 

[Bron and Sheba (GA)]

If indeed kitty got extra Lantus insulin from the repeated shot after the fur shot, it could possibly add to the depot so just keep that in mind for the next few days.
Everyone who starts on this FD journey has a very steep learning curve in the beginning. Try and get sleep when you can. Sleep is one of the things that the caregiver is often deprived of.
When we increase or decrease insulin doses we recommend that they go up and down in quarter unit increments, not a half or full unit increments. And keep the same dose for three days ....six cycles. Unless kitty drops low and earns a reduction.
Looks like he is not going to do too much with this cycle with that plus five reading.......sorry my iPad is playing up and it won't let me switch to typing numbers

ETA try not to worry unduly about the high numbers. Cats can cope quite well with high numbers and once you get the dose right, they will come down. Just make sure there is plenty of water for kitty to drink and you test each day or two for ketones while the BSLs are high.

 

[Phoebes (GA)]

Omgosh can I tell you stories about furshots and repeated furshots. Just a month ago. It happens to us all. We do what we can when we can. Don't beat yourself up. Your furbaby sounds like he has a caring compassinate sugar momma. Just what he needs. It does get easier, it's a marathon not a sprint. Patience pants required.

 

[Newpowers]

Thank you both so much, while he was fine throughout the night and today, it was very helpful to hear from people who've done this longer than I and know more about it. Vets can only help so much, and I find first hand experience invaluable.

He was perfectly normal throughout all of this, his numbers have stayed pretty much the same as they have the last week. I tested him before his morning dose and decided it was fine to inject and continue on as normal. He's been his usual happy self, but yes he continues to drink lots and lots of water, etc. Glad to have made it out the other side of this furshot and definitely learned a lot for the future Going to try to be a little more careful in the future.

Good to hear that it is okay he still has pretty high BSL 12 days in and hope to see some improvement with him in the coming weeks. I definitely know to watch for ketones and have been using a combination of blood ketone tests as well as the regular urine strips.

Thank you thank you thank you!