Out of town care

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RPM123

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I need some advice on a schedule change as I need to leave town.
I have been treating my cat Squeaker with diabetes for 16 months. She is on a schedule of 4 feedings a day of canned food (bigger feeding at shot time, and smaller feeding other times), and 2 insulin shots per day, of 2 units of Lantus each. I haven't left town in the time I have been treating her. She is well maintained on her schedule, but I need to see how much variance I can have when I am out of town.
It will be short trips (leaving on Saturday after her first feeding and shot, and returning Sunday before her last two feedings and shot.) Since it took me a few months to acquire the skill to give shots easily, I don't see one of my friends able to get the skills in a short period of time, and she may not cooperate, even though she is very friendly. She has hypoglycemic episodes about once a month, not able to walk well, some twitching, but extra food and a bit of corn syrup brings her back quite quickly.

My questions are:
1. Can she skip two shots (late Saturday and early Sunday) and still be OK?
2. Can I increase the amount of food and only feed her twice a day, and be OK? I am experimenting with this before I need to leave town, but don't have a lot of time.

I would appreciate any advice you can give. Thank you.
 
The food may be easy to take care of. Have you looked into a timed feeder? http://www.drsfostersmith.com/product/p ... atid=10283

The shot problem will be harder. As I understand Lantus, it builds up a "shed" of insulin to keep the BG fairly even during the day. If you skip two shots you will have to start that over and you will see higher bg numbers. On the other hand, once a month hypos are a problem and really shouldn't be happening if your cat is well controlled. If you are seeing once a month hypos, it may be dangerous to have a stranger give a shot and then leave, especially if the pet sitter isn't testing the blood glucose. I'll wait for someone who uses Lantus to reply and help you decide which is the lesser of two evils.

PS: Do you home test? You might be able to avoid the hypos in the future if you got a better idea of your cat's glucose levels. Then you could figure out if you need to reduce the dose.
 
Thanks for the info. I forgot to mention that I have 3 other cats too. Although Squeaker is agressive about getting her food, she may not get enough with the timed feeder.
I do occasionally test her BG, but not on a regular basis. She doesn't appreciate the ear prick, so I didn't want to do a few tests in a day as they say should be done. To test for my situation, wouldn't I need to skip a shot to simulate the out of town situation? I was testing occasionally to avoid a Vet's visit just to get her insulin renewed, as they insist on a BG test before renewing. If I have a few tests logged, I thought I may be able to avoid taking her into the vet for a BG test.
I thought she may be getting better and possibly was making her own insulin, but wasn't sure. If she has more frequent hypoglycemic times, would that possibly indicate the shots were becoming unnecessary?
Thanks.
 
Hi there,

I'm very concerned about the hypo episodes. One hypo a month is one too many.
Unfortunately, without regular BG testing, it's hard to see what's happening to her numbers.
A couple of links to help you out. Good idea to print them out too.
Jojo's Hypo Tool Kit
How To Treat Hypo

If she is seeing more and more hypo, BG testing will show you what's happening, and will indicate the need for less insulin based on the numbers.

With Lantus, skipping shots will drain the shed. And you have to begin all over again. Lantus requires consistency and
patience with 12/12 shooting schedule and time allowed for a dose to settle.

Insulin Depot ---> (aka "storage shed" in Lantus Land) "spare tank" of insulin, which has yet to be used by the body
More on the Shed ---> Lantus & Levemir Insulin Depot AKA Storage Shed

Does your kitty have a history of ketones?
IF you have to skip the shots, you will want to be careful with this. You should also consult with your vet.
If kitty needs insulin and is not getting it, ketones can easily and quickly creep in.
Ketones is very serious. Ketones

If it helps you, regular BG testing does get easier, usually within a week of regular testing, cats get use to it.
Home Testing Links

If you would like more info on Lantus and how it works, please visit the Lantus forum. These are a couple of our information stickies that may help you.
If you scroll down, you will come across a typical curve chart.
Don't worry you don't have to test on the hour, but preshots and a couple of mid cycle tests are highly recommended.
New To The Group

This is the protocol we use as a guideline for dosing:
Tilly's Protocol: Modified Version


Good luck to you and please consider regular BG testing.
Safety first.
 
Without any data, I'd suggest contacting your vet. Perhaps your vet can board or one of the vet techs can cat sit while you're gone. In either of these options, you'd have a veterinary professional available to monitor your cat.
 
Thanks to both of you - Ronnie & Luna and Sienne and Gabby...

Squeaker has no history of Ketones, and each Hypo episode was mild. I suspect a hairball for most cases, I sometimes find one spit up around the time of these issues. I may have overestimated the frequency of hypo events, it was 4 weeks at the minimum. It has been 4-8 weeks (or more) between them, there have been about 6 of them in 16 months.

I'll review all of the information and will start testing regularly. I'll check with my Vet. I have the impression that the boarding facility doesn't have 24/7 attention, so I didn't know if this would be a good situation. I'll see what I can figure out.
 
I did contact my Vet and they do have continuous care. She was boarded for only $17 a day, in the special care area, due to her diabetes. I'll be testing her BG regularly and will continue to follow up on the information provided in this forum.

Thanks to everyone for the advice.
:-D
 
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