Missed Cat's Insulin Dose

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gishstar

Member Since 2012
Our cat was diagnosed with Type 1 diabetes. my husband and I haven't been very good lately with giving her her shot. Normally, we're really good, but there's been a night where he forgot, and then I forgot two mornings in a row.

Today, our little Zoey is lying next to the toilet in the bathroom (not normal for her), not drinking, she's dehydrated, and she looks super sick.
Is she experiencing hypoglycemia??
We gave her her normal shot at 6PM tonight,we missed her 6 AM shot.
If I give her some syrup, will she be OK? She's diabetic because she's producing too much sugar in her system and her pancreas can't handle it. I don't want to give her sugar and find out that I shouldn't have.

thanks.
Ari.
 
without being able to get a glucose number via testing, it's hard to say if it's hypo or not. the symptoms don't sound too much like hypo but i am not there and able to actually see kitty.

you are not testing right? any chance you could take a crash course in it tonight? in other words, is there a store closeby that you could go to and get a glucose meter?

also, fwiw, it could be something like ketones too. can you smell her breath? does it smell at all like acetone? fingernail polish remover?

and one last thing, when you say her normal dose, what is her dose? and what kind of insulin?
 
She's really dehydrated, whereas normally she drinks like water is going out of style. When I hold the scruff of her neck it takes a few seconds for her skin to return to normal.

We are not doing any testing. Vet said it wasn't necessary. However, my husband and I are pharmacy technicians, and work a lot with human diabetics (mostly type 2), so we are considering purchasing a glucometer and strips, but strips can be very pricey.

Her breath does not smell like acetone at all. She kind of stinks though, not a normal cat stink. Not urine, but maybe more like poop... But her acetone breath was very obvious when we first diagnosed her with diabetes though.

Her normal dose is 4 units BID. She gets 4 units at 6am and 4 units at 6pm, fairly standard from all the reading I've done.
Her insulin is ProZinc (protamine zinc recombinant human insulin) in an aqueous suspension. 40 units per mL.

Thanks!
 
could you maybe try to give her a little water via needleless syringe? if so, do it very slowly so as not to choke her. dehydration can make them feel like crap. in all honesty, you may even need to take her to the ER at the very least for some fluids

i would definitely get your hands on a meter. it really is invaluable. you will never have another situation like this with a meter. you can test anytime you want, any time things are off, whenever kitty seems odd, and know what your next step is

the acetone smell means ketones. was she diagnosed with ketones too initially? and if so, was she treated for them? i believe the ER can do a ketone test pretty easily and quickly too for that matter.

4 units sounds a bit hefty to me so yeah, that could bring hypo back into the equation but the symptoms don't really sound like it. fwiw, i'm not real familiar with prozinc doses anymore as i haven't been following it's progress for some time now so take that with a grain of salt.

i'll try to see if i can get a bit more input for you
 
I would urge you to take Zoey to a vet - ER tonight if you have one nearby.

That dose of 4u is hefty without knowing her glucose levels. If her numbers are high she will need insulin no matter the amount of food - but you really need to know where she stands and how she will react.

I hope all is better soon.

Best,
Pam
 
Thanks all! I'll get some water into her, we have plenty of no needle syringes around here. We have another cat with health issues.
I never thought that she might have ketones too because even with her on an insulin schedule she still drank water like it was going out of style.

Honestly though, she's a super good kitty. She waits patiently for her shot, and lays down for us to give it to her.
There aren't any ER's in the area for pets, so I'm hoping her next AM dose will set her back to normal.
 
IMHO it doesn't sound like your kitty is regulated at all. Being that thirsty, even on insulin makes it sound like she's still running high. I'm pre-diabetic & know that voracious thirst..it's not fun. :sad: It means the body is trying to flush the extra sugars out of the body. Please consider hometesting, so you know how your kitty is responding to the insulin. It doesn't sound like what you're doing now is working..

I hope this doesn't sound to blunt or harsh..I'm just on my phone, so takes awhile to type everything out. Please keep us posted!
 
You can get cheaper diabetic supplies either online (I shop American Diabetes Wholesale) or Walmart. I use the Maxima AST meter, and the Walmart Relion is similar in price for the test strips.
 
Hi and welcome,

4 units is whopping high dose for Prozinc. While you're at the pharmacy getting a meter, test strips & lancets also pick up some Ketostix to test the urine for ketones.

Walmart has the cheapest supplies around, the Relion Confirm, Micro or Prime. The Prime has the cheapest strips for sure.

Come over to the PZI Insulin Support Group for dosing advise when ever you are ready but always post here in Health in an emergency, there is a lot more traffic here.

Robin
 
Hi Ari,
Are they sure it's Type 1 and not Type 2? I only ask because type 2 is much more common.
Is there any other vet you can see? Because having a cat on a dose of 4u BID, and telling you that home testing is not necessary.... well that's a recipe for disaster, and leads me to believe your vet isn't very knowledgeable about feline diabetes. Using the AAHA guidelines for cat dosing, your cat would have to weigh thirty-something pounds for that starting dose to make sense. Most cats start at one unit or less. How long has she been on insulin?

Carl
 
Carl & Bob said:
Hi Ari,
Are they sure it's Type 1 and not Type 2? I only ask because type 2 is much more common.
Is there any other vet you can see? Because having a cat on a dose of 4u BID, and telling you that home testing is not necessary.... well that's a recipe for disaster, and leads me to believe your vet isn't very knowledgeable about feline diabetes. Using the AAHA guidelines for cat dosing, your cat would have to weigh thirty-something pounds for that starting dose to make sense. Most cats start at one unit or less. How long has she been on insulin?

Carl
Click to expand...
I didn't think cats were dosed by weight? (Dogs maybe, but not cats?) Did something change recently? I haven't kept up on things since Cuddles passed, so just wondering.
 
Steph & Cuddles (GA) said:
Carl & Bob said:
Hi Ari,
Are they sure it's Type 1 and not Type 2? I only ask because type 2 is much more common.
Is there any other vet you can see? Because having a cat on a dose of 4u BID, and telling you that home testing is not necessary.... well that's a recipe for disaster, and leads me to believe your vet isn't very knowledgeable about feline diabetes. Using the AAHA guidelines for cat dosing, your cat would have to weigh thirty-something pounds for that starting dose to make sense. Most cats start at one unit or less. How long has she been on insulin?

Carl
Click to expand...
I didn't think cats were dosed by weight? (Dogs maybe, but not cats?) Did something change recently? I haven't kept up on things since Cuddles passed, so just wondering.
Click to expand...

Hi Steph,
These are the AAHA guidelines I was referring to:
Most cats are well regulated on insulin at 0.5 U/kg q 12 hours, with a range of 0.2 to 0.8 U/kg.
The panel recommends a starting dose of 0.25 U/kg q 12 hours, based on an estimate of the cat’s lean body weight. This equates to 1 U q
12 hours in an average cat. Even in a very large cat, the starting dose of insulin should not exceed 2 U per cat q 12 hours.
Click to expand...
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

And the Prozinc info on the FDA site says this:
The initial recommended PROZINC dose is 0.1 - 0.3 IU insulin/pound of body weight (0.2 - 0.7 IU/kg) every 12 hours. The dose should be
given concurrently with or right after a meal.
Click to expand...
http://www.fda.gov/downloads/animal...ldrugproducts/foiadrugsummaries/ucm198121.pdf

And this from the Tight Regulation sticky:
Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight.
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight.
Click to expand...
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

So the "dose by weight" thing seems to be pretty universal, at least as far as establishing an initial dose goes. I think the main reason why it doesn't get mentioned too much is that many/most cats fit into the 1u starting dose range probably because that range covers the average weight of the majority of kitties? And almost universally, when a new member joins, what's mentioned as a good "logical" starting dose (absent any extenuating circumstances) is 1u BID?

Carl
 
I just wanted to add is one way to help kitties to stay hydrated is to add some water to the canned food. Cats are designed to get water from their prey. I have learned to add water to Buster's food and I don't think I've seen him at the water bowl in a very long time. He is nicely hydrated and put on all the weight he had lost at diagnosis.

I do hope Zoey gets to feeling better soon! :YMHUG:
 
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