JUNE 7 2023 Sir thomas PMPS 22.5- was given 1.75 units over dose

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Charlene0718

Charlene0718

Member Since 2021
June 7th 11:09pm
Hi there,

Sir Thomas is currently on 5.25units of glargine.

He had a babsitter tonight that mistakenly gave him 7 units instead of his dose of 5.25units. What to do now? Take BG every hour nightly??? encourage food? At what point can I expect to be out of the woods?

His diabetes is not regulated yet. We have been working with an internal medicine specialist for dosage, and plan to so the SLGS protocol soon as it has not been regulating on vet's advice. Due to liver conditions etc the vet thinks he needs higher doses than most.

History:
Kidney disease
Liver disease
herpes
IBD

Medications:
Budesonide
Zentonil

Spreadsheet:
https://docs.google.com/spreadsheet...ouid=111352137329808214665&rtpof=true&sd=true
 
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I would continue to test hourly at the moment so you can catch any drop quickly. At the moment the BGs are looking like they might have stopped dropping, but I would keep testing hours for the next few hours as it could bounce up and down

Have you given any food since the PMPS meal?

You will need to wait and see how the cycle plays out before deciding on the AM dose
I would post each hour with the BG so we can see and advise.
 
Bron and Sheba (GA) said:
I would continue to test hourly at the moment so you can catch any drop quickly. At the moment the BGs are looking like they might have stopped dropping, but I would keep testing hours for the next few hours as it could bounce up and down

Have you given any food since the PMPS meal?

You will need to wait and see how the cycle plays out before deciding on the AM dose
I would post each hour with the BG so we can see and advise.
Click to expand...

Thanks so much, super helpful! just wondering if you mean make a new post on the hour? Or update on this thread? He seems to be going up again this last reading. At every reading, I offer a handful of food
 
Charlene0718 said:
Thanks so much, super helpful! just wondering if you mean make a new post on the hour? Or update on this thread? He seems to be going up again this last reading. At every reading, I offer a handful of food
Click to expand...
Keep posting on this thread.
That is good to give a little snack each time. Don't give too much in case you need to feed him later.
 
It looks like it was a sleepless but uneventful night!

I suspect I know what Bron is concerned about. With Lantus, dosing decisions are made based on how low the insulin takes your cat's blood glucose numbers and not on the pre-shot. What that translates to is that you need to get a minimum of 4 tests daily -- your two pre-shot tests and at least one test during both the AM and PM cycles. Without having data from somewhere during the cycle, you have no idea whether Sir Thomas is in safe numbers.

With SLGS, you need to evaluate the dose every 7 days. If numbers aren't in an acceptable range, you increase the dose. The general guidelines from the dosing methods sticky state:
The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Click to expand...
You've been holding doses longer than is really necessary especially given how high your cat's numbers are -- or at least what's visible on your spreadsheet. I would suggest a dose increase to 5.5u if not today (so you can be sure you know what the effect of the 7.0u dose was) then tomorrow.
 
Sienne and Gabby (GA) said:
It looks like it was a sleepless but uneventful night!

I suspect I know what Bron is concerned about. With Lantus, dosing decisions are made based on how low the insulin takes your cat's blood glucose numbers and not on the pre-shot. What that translates to is that you need to get a minimum of 4 tests daily -- your two pre-shot tests and at least one test during both the AM and PM cycles. Without having data from somewhere during the cycle, you have no idea whether Sir Thomas is in safe numbers.

With SLGS, you need to evaluate the dose every 7 days. If numbers aren't in an acceptable range, you increase the dose. The general guidelines from the dosing methods sticky state:

You've been holding doses longer than is really necessary especially given how high your cat's numbers are -- or at least what's visible on your spreadsheet. I would suggest a dose increase to 5.5u if not today (so you can be sure you know what the effect of the 7.0u dose was) then tomorrow.
Click to expand...
Thanks so much. That is super helpful. Generally I am gone 10 hours a day. I can have a friend come over and do some daytime checks today and then I can curve this weekend. I think it seems scary to me that he is so high, but clinically he is doing well so I will change to 5.5 this morning
 
Thanks so so much everyone for the advice and support. Super helpful, the 5.5 went well today and we will keep doing checks and curve and read up on SLGS and hope the vet gets on board :)
 
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