? High dose accidental

I am brand new here today. Milo was switched from Caninsulin to Lantus. It was recommended to give him 3 units. But I didn’t know about u-40 (I used for Caninsulin) vs u-100 needles. I gave him 2.5 units in a u-40 needle at 8:30pm. Doing the math, I think that’s more than double what I should have given him! I had no idea..
His BG was 351 (human meter 19.5) before the insulin. At +3 he had dropped to 225 and now +4 1/2 he's at 194. He’s acting ok; I don’t know how low he can safely go or when this could happen. I have given more of the raw food. I’m afraid to go to sleep. It’s 1am here. What should I do??

 

I'll tag a few more experienced members, hang on
@Wendy&Neko

 

Same time for me. I'll respond more fully in a bit but what I really need to know is: do you have lots of strips? Honey or maple syrup? High carb wet food?

 

PMPS 351 (accidentally gave aprox 6 units instead of 2.5 units of Lantus)
+3 225
+4.5 194

194 is not a huge drop from 351.

Lantus is a depot insulin. It has not had time to build up a depot. That is in your favour.
Sometimes, events like this turn out to be non-events, however …

you will need to stay up and keep testing.

In general, cats on Lantus have their nadir around +6 but we don't know when Milo's nadir is yet.

 

I have lots of strips. I also have both honey and maple syrup. I have a renal diet dry food. I don’t know how high carb that might be. I thought I’d test again in 15 mins at +5 1/2

 

Thank

Thank you. I will stay up and keep testing.

 

What is the ideal range?

 

If you don't have any high carb food like Fancy Feast Gravy Lovers, you can add a few drops of Karo/honey/syrup to a small amount of his regular food or apply it directly to his gums IF it becomes necessary.

You're going to need to keep checking though until his numbers start to rise on their own without you having to intervene with anything high carb. Lantus is a long acting insulin that can last up to 16 hours (but luckily, if this was your first shot, the depot hasn't had a chance to fill yet so you're probably going to be fine!)

He's got a ways to fall yet before he's in any danger though. If he drops below 68 (on the AlphaTrak) it's your "time to act" but you can always intervene before then with just a little higher carb food just to slow down how fast he drops.

There's no reason to panic as long as you can keep an eye on him and test as long as necessary

 

Chris always beats me in a typing test.

68 on a Canadian meter is 3.8

 

Thank to

 

For reference, here is Sam's first posting thread from earlier today.
https://www.felinediabetes.com/FDMB/threads/new-member-in-need-of-advice.232596/#post-2601105

 

You want to keep Milo a bit on the hungry side. It is easier to get a hungry cat to eat than a full cat to eat.

 

Goo

Good point. He’s only dropped to 171 +5 1/2. Should I wait about another hour or more?

 

PMPS 351 (accidentally gave aprox 6 units instead of 2.5 units of Lantus)
+3 225
+4.5 194
+5.5 171

I think you are safe to wait an hour.
Did you feed at +4.5?

 

Sorry, another question for you.
Are you using the AlphaTrak or the new human glocumetre?

And yes, @Wendy&Neko – we should all be asleep.

 

I did

feed a small amount each test time. It’s the only way I can get him to cooperate. I am using the new human meter now for these numbers

 

Thank you everyone. You should all be asleep! I think I’m ok to stay up on my own now. I appreciate all of your advice.

 

It's the Contour, so she has a bit more room than the AT.

 

As slowly as he's dropping, I would set an alarm and get maybe a +8....I have a feeling this is going to be a non-event (thank goodness!)

When things have calmed down, you should change your signature and update which meter you're using.

 

Good night all. I’m going to try and catch a few winks now and try for a +8. Much appreciation.

 

Good luck. I'd suggest waiting until you have U-100 syringes before shooting Lantus again. BD Ultrafine II, purple and yellow box, at any pharmacy.

 

Can you go ahead and take the 911 down? Once you have someone helping you, it's best to edit your subject line and change it to "no prefix"

That way if you do have another emergency, you can put it back up and people won't think it's the same one

 

@Bron and Sheba (GA) lives in Australia and may be online later.
Holler if you need help.
Read and print off for future reference: How to treat HYPOS - THEY CAN KILL! Print this Out!!

U40 insulin syringes have red caps. U100 syringes have oranges caps.

The BD Ultrafine II box looks like this:

 

I’m online now if you need any help. Tag me by typing @ then bron and Sheba which will come up on a little box which will give you options of names, which you click. Like this @Bron and Sheba (GA)

 

Update:
+8 203 sigh of relief. He’s heading back up.

 

That’s good news. Was the last test 171 at+5.5?

 

That‘s correct

 

When was the last time he ate?

 

Good morning. Milo is doing well this morning. At +12 he was 205. Yesterday, by comparison, he was 643 even with an increase in Caninsulin the night before to 4 units.) I have heeded the advice and not tried to give anymore Lantus until I can get to the pharmacy today for the correct needles. Unusual that my pharmacist didn’t mention the I-100 needles when I got the insulin and meter.
Anyways, I am grateful that Milo is ok despite my error. He is happily eating all of his raw food, as he did at +8. I am wondering when I should give insulin again. I’m assuming probably his evening dose around 8 again? Or perhaps a bit earlier if his numbers get high? I’m hoping someone can give suggestions later when I take his BG (afternoon?)
Thanks again for all of your support. What a godsend.

 

Some one will be here for guidance later. No worries there. I am blown away by the level of caring here. BRAVO everyone that helped!

Mistakes happen its when we learn from them, that makes us more vigilant. You are part of this community, this family. We are all related by one thing diabetes. Welcome to our family.
jeanne

 

I couldn’t agree more. Having people through the night committed to helping blows me away. I knew there were people from across the world so I was hoping I could tap into someone during more reasonable hours (for them)!
Thanks again. I’m going to get going on the proper chart to share Milo’s US numbers. The learning curve is STEEP.

 

Believe me I KNOW! LOL I remember the overwhelming feeling because I am tech challenged. My very first "forum" was this one back in 2006-7-? Obviously I am no better with dates
Suffice to say I was a complete MESS.

 

Whew! So glad Milo (and you) handled this so smoothly!

Tonight, you'll want to shoot at whatever your preferred dosing time is. Lantus does best dosed at consistent times, if you shot early tonight you'd be commited to shooting early tomorrow morning too...

 

I second what Nan said!!!

Im also glad you switched to Lantus. As you can see even from just yesterday, it’s a much gentler insulin and I’m convinced you’ll get better results with it!

all is well that ends well

And thank God you noticed the syringe issue right away, otherwise you might have kept using it and giving the wrong doses. I’d give that pharmacist a little piece of my mind

 

Good morning, Sam. You were great last night.
I'm sorry you got caught in a shoulda situation. The vet shoulda said something. The pharmacy shoulda mentioned it. One of us shoulda double-checked that the vet said something. It was a busy morning on the forum. My apologies.
Put the U40s (red cap) since Singha is resolved (I'm not quite sure because of the "resolved?" in your signature) in a different cupboard or part of the house. If you are still giving Singha insulin, never fill Singha's and Milo's syringes at the same time. Do one cat and then the other. And start a mantra to yourself – Singha red, Milo orange. Put the insulins in separate containers and put a big orange dot on one and a big red dot on the other. This will also help if at some point someone else is giving the insulin.
If you can't find the specific syringes that Wendy mentioned (there are great because they have half unit markings), ask the pharmacy to order some for you and ask the pharmacy to sell you a couple of bags (sometimes they split the box) of something similar – but they must be 3/10 cc syringes with a small gauge (the larger the number, the smaller the gauge).
And you should probably pick up some more strips as well. As you saw last night, during a hypo or risky event, you can blow through an incredible amount of strips.

And I third what Nan said.
With Lantus, the shots need to be given at the same time. It is an insulin that craves consistency.

The learning curve is indeed steep but it will become second nature very quickly. And there is an encylopedia worth of knowledge and experience on this forum willing to share and help.

Today will be easier. Enjoy the day before we get hit on the weekend with the next heat wave.

 

You have been terrifically supportive, along with the rest of the community. Ultimately, it was a mistake because of my own lack of knowledge but it's all ended well. At least I read about it last night and didn't repeat the same mistake this morning.

I am questioning if Singha is in remission because I have stopped giving insulin a day ago, in consultation with my vet. Because I just got a meter just 2 days ago, I didn't know that he was going down as low as 63 after his 1 unit of Caninsulin. More than 24 hours after his last shot, he's now at 74. So, I'm just keeping an eye on him and testing a couple times a day to see if we're still in the clear. Hopefully he's in remission??? He's also been switched to mainly raw food. I am open to suggestions with how to proceed with him.

Unfortunately, I live in a very small, rural setting with 1 vet, part-time. He is so incredibly busy, it can be very hard to get ahold of him. Yesterday he wasn't able to call back before he went home at the end of the day because they are just so overwhelmed with clients/emergencies etc. His son was consulting with him as he was busy with other clients so it was just an unfortunate miscommunication. They are generally very supportive and open to my questions.

I bought 100 strips yesterday with the new meter so I'm set for a while. My vet has some small needles so I'm picking them up shortly. I feel better today as I see both cats seeming to be ok. I will feel better when I can give Milo a shot, though.

 

I'm so confused. My vet took back my u-40 box of syringes and sent two syringes that still say only use with u-40 insulin. They are SOL-M .3 ml u-40 needles with 12 units marked in 1/2 unit increments. This is all he has in the office. They are willing to get me u-100's but they come either in .3ml, .5ml or 1ml. They don't know which ones I want. Unfortunately, neither do I! Can anyone help!! I can't get them until Tuesday minimum.

 

Because U-100 is a "human" insulin, you should be able to get the syringes in any human pharmacy. I don't know, though, whether you need a prescription for syringes where you are. If you do, the vet should be able to write a prescription that lets you get syringes today.

Get the 0.3ml ones-- they have a narrower barrel, which makes it easier to measure small doses-- and definitely the half-unit markings (same reason).

 

A prescription is not needed in Canada. And you can get them at any pharmacy.
Since you are in a very rural area, the pharmacy may not have half unit syringes. For now, ask the pharmacist for a couple of bags of full insulin syringes. Each box contains 10 bags or 10 syringes. They may sell you a couple of bags of full unit syringes to get you through until they can order some half unit ones for you.

 

So I should order u-100 .3ml from the vet for next week? He's now +6 403 so I'm getting alarmed. What to do?

 

Don't worry about Milo being high. He won't be high for long.

How far is the nearest human pharmacy from you?

 

Before you order from the vet, I'd also check out the prices at human pharmacies or online merchants to make sure there isn't a big markup. Since they don't use those syringes themselves, I'd bet they're probably just going to order from some of the same places you would.

 

I will respond again on the other thread, as suggested, as it's confusing to go back and forth. I started the new thread due to the possible emergency last night. Could we all jump over to New Member In Need Of Advice?