Preventing overdose

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nkace

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I have on a few occasions run into giving my Azrielle too much insulin because I didn't shake the vial properly or some other weird reason. She then wakes me up in the middle of the night acting drunk & such. If I see these signs happening before it gets too bad, what shall I do before her blood glucose gets too low? :?
 
What insulin are you using? How much?

Lantus should not be shaken. Humulin N & PZI should be rolled gently to mix it up.

Hypoglycemia (low blood sugar) can occur when either too much insulin is given or when unusual exercise / activity occurs or when kitty has not been eating the "normal" amount or same food. (changing to a high protein, low carbohydrate food will require a reduction in insulin dose)

My kitty went a bit too low last week when we fed a LOT of chicken breast -- which is basically ALL protein and different from his normal cat food which has 4% carbohydrates.
 
Yes I have done molasses & maple syrup when this has happened previously. Good to know I am on track to help her. Thankfully it is not a regular thing, tends to happen when at the end of the bottle for some reason.
 
what insulin are you using?

are you familiar with the necessity of home testing? are you open to learning how to do this?

This is truly the only way to keep your cat safe - home testing and adjusting the insulin based on safe recommendations from this group and the BG levels.
 
Hi nkace, and, of course, you too, precous Azrielle,

nkace said:
Yes I have done molasses & maple syrup when this has happened previously. Good to know I am on track to help her. Thankfully it is not a regular thing, tends to happen when at the end of the bottle for some reason.
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Molasses and maple syrup only give a short BG/sugar spike for 15-20 minutes or so (give or take, depending on the cat). It's buys you a little time. Real food is lasts longer in terms of bringing up the BGs (canned with gravy, or a bit of dry food in an emergency); but, can take 15-20 minutes or so to kick in (again, give or take, depending on the cat and the food).

But, the real deal, nkace, is that you do not want Azrielle to go so low she hypos. Period.

As other kind souls responding have asked: What insulin and dose is she getting? What is her normal food and feeding schedule? Are you willing to home test on a regular basis (only takes a couple of extra minutes twice a day) to keep her safe?

Encouraging, albeit worried, hugs for you both,
Deb and Nikki -- and, Giz, forever dancing in my heart...
 
I think she is using ProZinc: http://felinediabetes.com/FDMB/viewtopic.php?t=33582 Was Previously using Humulin N http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=32551

Testing the bg before giving the insulin will help prevent hypos. It doesn't matter if you are giving the same dose twice a day. Sometiems a diabetic cat's bg will be in the normal healthy range and blindly giving insulin on that may result in a hypo.

Are you using U40 insulin syringes or U100 insulin syringes with the ProZinc?
 
The best way to treat a hypo is to prevent it by testing her bg before every shot. While this isn't a guarantee, it will certainly prevent many problems. If you test her bg when you see early symptoms, depending on the number, you may be able to stop or slow the bg drop with either med or hi carb food. This intervention, however, relies on having adequate data from regular testing to know what point she is in her response to the insulin and how she responds to higher carb food. Home testing is so easy to learn, and gives you so much information. There are several expert teachers on this board - just ask.
 
Hi Nkase,
the first thing that struck me was you said 'don't know if i shake the bottle right' and i don't think there is any insulin here that you shake. with pzi you gently roll.
that actually is the least of the problem tho'.
a test before every shot is simply a must do.
there was a woman who'd been shooting for a few years and no longer posting until one day.....and no longer testing every day..
here she came with a cat in dire hypo.
she did'nt even think hypo at first....she thought 'is he having a stroke?'
she had shot the same dose every morning and every nite for some time'
this time it was not the right dose to shoot.
when she tested her cat at like 31 she realized. it had only been about an hour after the shot too.
we stayed with her for like 10 hours as she could not keep the numbers up. they would go up with the karo and food but then fall back down.
in the end the kitty lived to be fine...but that day the kitty was HIGHLY overdosed and mama did'nt even realize it at first.

one day, one evening...or perhaps several consecutive days you kitty may be running low and showing no symptoms until...BAM and it can come on quick.

so please dear mama of a sugar kitty, please, test before every shot...ok?
 
I disagree - you must know the nadir (lowest point of the curve) to determine whether or not to adjust doses.If you're getting pre-shot numbers only, that is only one piece of the puzzle. By the continual hypo episodes this cat is suffering, though, it seems obvious that 2 units is too much for this cat. PLEASE start hometesting your cat - it's very simple to present these episodes which could easily get more severe.

Just-As-Appy said:
The best way to treat a hypo is to prevent it by testing her bg before every shot. While this isn't a guarantee, it will certainly prevent many problems. If you test her bg when you see early symptoms, depending on the number, you may be able to stop or slow the bg drop with either med or hi carb food. This intervention, however, relies on having adequate data from regular testing to know what point she is in her response to the insulin and how she responds to higher carb food. Home testing is so easy to learn, and gives you so much information. There are several expert teachers on this board - just ask.
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I do home testing but not regularly. I know just found out that the testing strips have an expiration date on them which I didn't realize & can now be skewing results. I can actually tell when she is hypo or hyper glycemic by the way she acts but I know that isn't a certainty but at least is a beginning measure to know something is off though. I never thought that having to check her BCG was necessary before every dose. I mean doesn't the vet also have some input when something like this is needed? Apparently doing a 12 or even 24 hr curve is the only way to see what is going on.
 
nkace said:
I do home testing but not regularly. I know just found out that the testing strips have an expiration date on them which I didn't realize & can now be skewing results. I can actually tell when she is hypo or hyper glycemic by the way she acts but I know that isn't a certainty but at least is a beginning measure to know something is off though. I never thought that having to check her BCG was necessary before every dose. I mean doesn't the vet also have some input when something like this is needed? Apparently doing a 12 or even 24 hr curve is the only way to see what is going on.
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The trouble is that by the time you are seeing hypoglycemic symptoms, the blood glucose is already dangerously low and they can become unconscious and seizing quickly. You are playing with fire if that hasn't happened yet.

Have you ever tested her BG when she has symptoms?

Just as people do, to properly control feline diabetes it takes home management - one simply can't be running to the vet every day for blood glucose tests. In addition, I would say that the most successful of us here (success as in no diabetic symptoms and that includes no hypos) manage our own dosing. That takes some study of the insulin you're using and we give help on sections of the board called Insulin Support Groups for each insulin to figure out what the best dose is. I rarely discuss diabetes treatment with our vet, as she can see he is doing well there. That is by my choice because I have learned how to manage our insulin. Knowledge is power and I have empowered myself to not need my vet's help on the diabetes.

Yes, checking BG's every 2 hours over 12 hours will give you a good idea how the insulin is working. You can also check it at different times over several days to get somewhat of an idea how a dose is working.

This may seem fanatical, but no one would give a child insulin without knowing how low his or her BG was. It needs to be the same for cats to properly manage feline diabetes.
 
It's like saying sometimes I drive down the highway with my seatbelt on, and sometimes I drive after drinking 6 tequila shots. The goal is to prevent hypo episodes. Your cat is not regulated. Your dose needs to be lowered. YOU need to do the curve across the 12-hour cycle and I highly recommend you go through this website and read up on how do do so. You'll find dozens and dozens of threads just like this one which explains how to do this. If I had listened to my vet, I most certainly would have injured and hurt my cat (if not worse) with a dose that was too high. If your cat's hypo episodes aren't enough evidence that you do not have this under control, I don't know what will convince you. If your son or daughter was going through this, what would you do? Sorry to be harsh, but your cat deserves to be as healthy as possible and only YOU can control that.

nkace said:
I do home testing but not regularly. I know just found out that the testing strips have an expiration date on them which I didn't realize & can now be skewing results. I can actually tell when she is hypo or hyper glycemic by the way she acts but I know that isn't a certainty but at least is a beginning measure to know something is off though. I never thought that having to check her BCG was necessary before every dose. I mean doesn't the vet also have some input when something like this is needed? Apparently doing a 12 or even 24 hr curve is the only way to see what is going on.
Click to expand...
 
nkace said:
I can actually tell when she is hypo or hyper glycemic by the way she acts but I know that isn't a certainty but at least is a beginning measure to know something is off though.
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Some cats never show symptoms of hypo until it's too late.

nkace said:
I never thought that having to check her BCG was necessary before every dose. I mean doesn't the vet also have some input when something like this is needed? Apparently doing a 12 or even 24 hr curve is the only way to see what is going on.
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Unfortunately, some vets don't tell their clients about the importance of hometesting. Some vets even discourage it. Are you comfortable with your vet and how your cat's diabetes is being treated? I see you live in the same general area as I do. If you ever need a new vet, I highly recommend mine :smile: Just send me a PM for the info.
 
nkace said:
not regularly, don't think that will help when I am giving her the same dosage 2x/day.
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As others have said, testing regularly is imperative in managing your cat's diabetes. You need to test before shots, and in between shots, to know exactly how your cat responds to insulin...every cat is different.

Another thing to keep in mind is that a cat's insulin needs can, and frequently do, change. Giving a certain dose today may very well be way too much (or too little) two weeks down the road. So testing definitely WILL help.

The only way to prevent "overdosing" and hypos is to test regularly and consistently. Remember, hypos are much more than just symptoms of appearing drunk. Hypos can kill.

There are lots of very informative Stickies on this website...definitely take a look at all of them.
 
there was a dear kitty 'bean' who owns 'ohbell' his mommie who came in at his very first test with a reading of 27 at +2. absolutly symptomless. ohbell is new, i got her on the phone for expediancy and she carbed and sugared sweet bean up real good but by +3 he was onlyby 28. more carbs, more sweet honey, and finally by +7 he was in the 40's.
one 1 unit of pzi
this kitty never showed a single symptom.
however i can tell you with very little hesitancy that bean would be in the hospital today, maybe dead or comatose, had ohbean not gotten this very first test in at +2 and loaded up the carbs.
you see, even with honey, dry food, bread etc...you see how long it took this kitty to respond to the carbs. that only means without the help, kitties numbers would have dropped below the level of survival. it was midnight, there was no emergency vet close by. and frankly...unless you have a person in the car with you rubbing karo on the gums...by the time you are symptomaic you don't have time to drive to the er while leaving your kitty unattended on the seat next to you.

this is what can happen. well, this is what did happen just 2 days ago.
with no symptoms.
lori
 
Keep in mind that when your kitty is "acting drunk", this is because her brain is not getting enough glucose and is not functioning properly. Unlike when people are actually drunk, a being in a hypoglycemic episode is acting that way because the brain is not getting the fuel it needs to function, at which point there is the potential for brain damage. It would be safer for your kitty if you found a way to avoid getting to this risky point.
 
lori and tom said:
there was a dear kitty 'bean' who owns 'ohbell' his mommie who came in at his very first test with a reading of 27 at +2. absolutly symptomless. ohbell is new, i got her on the phone for expediancy and she carbed and sugared sweet bean up real good but by +3 he was onlyby 28. more carbs, more sweet honey, and finally by +7 he was in the 40's.
one 1 unit of pzi
this kitty never showed a single symptom.
however i can tell you with very little hesitancy that bean would be in the hospital today, maybe dead or comatose, had ohbean not gotten this very first test in at +2 and loaded up the carbs.
you see, even with honey, dry food, bread etc...you see how long it took this kitty to respond to the carbs. that only means without the help, kitties numbers would have dropped below the level of survival. it was midnight, there was no emergency vet close by. and frankly...unless you have a person in the car with you rubbing karo on the gums...by the time you are symptomaic you don't have time to drive to the er while leaving your kitty unattended on the seat next to you.

this is what can happen. well, this is what did happen just 2 days ago.
with no symptoms.
lori
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Not sure I understand all of this though.
 
Well if not enough insulin is given, that is no better since her eating & peeing go through the roof.
So are test strips actually supposed to be used before the expiration date?
 
Is it confusing becuase the kitties name is 'bean' and we call people here 'beans'
or because of my writting
or because I used +2 and +3 as descriptive words.

+ any number is the number of hours gone by since you shot insulin.
this kitty was hypo, without symptoms by +2 (2 hours after his shot)
his mama is ohbell.
she is new and this was her first test.

does any of that help?
 
nkace said:
Well if not enough insulin is given, that is no better since her eating & peeing go through the roof.
So are test strips actually supposed to be used before the expiration date?
Click to expand...

It actually is better to have too low a dose than too high. It's more likely a cat will die from hypoglycemia from too much insulin than develop fatal ketoacidosis from not enough insulin, especially if *some* insulin is being given.

If you're not testing and guessing at what the dose should be, then you're playing a very deadly game either way, but it's even deadlier if your cat is going hypo on a regular basis. I urge you to reduce the dose immediately, and start home testing daily. You need at least three tests in order to dose your cat safely and regulate him. One before each insulin shot, and one about half way through one of the cycles. What insulin are you using?

As for the strips, it depends on the meter. What meter are you using? How long have the strips been expired? Is there a problem getting new strips for some reason?
 
Ok, I actually found some info from a previous post:

nkace said:
I failed to mention she was on Science Diet W/D & then switched to M/D.
It is prozinc that they changed her to. She is being started at 2 & they checked her BG 3x today & they were all high.
She ended up losing a pound when we found out what was wrong which she has thankfully gained back though. She around 8lbs right now.
The heart murmur seems to be at a level 2 & I can't afford an ultra sound right now.
I have spent $500 in the past two days & am unemployed so am having financial difficulty w/ this. All the syringes I had from the humilin is now useless & I can't really do anything w/ it.
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nkace said:
Well if not enough insulin is given, that is no better since her eating & peeing go through the roof.
So are test strips actually supposed to be used before the expiration date?
Click to expand...

Again, this is where testing comes in. By monitoring where your kitty's BGs are, you know for sure that you are giving the appropriate amount of insulin...the amount that will keep her safe. The hypo symptoms your cat has been displaying indicate that she's been in a very dangerous place, and by testing her, you can prevent that from happening again.

What's even scarier is your cat can go hypo without displaying any symptoms at all, and that was what Lori was talking about when she was telling you the story of Bean and Ohbell. Bean had dangerously low blood sugar, but was acting completely normal. Hypoglycemia is extremely dangerous...just because a cat isn't displaying symptoms, it doesn't mean the cat is safe.

If the strips for the meter you are using are too costly, take a look around at other meters. I don't have as much experience as others, but I know there are some meters out there with reasonably priced strips.
 
nkace said:
Well if not enough insulin is given, that is no better since her eating & peeing go through the roof.
So are test strips actually supposed to be used before the expiration date?
Click to expand...

Neither too much nor too little insulin is "good enough." The only thing that is "good enough" is the CORRECT dose for YOUR cat - and the only way to find that dose if by YOU doing the proper testing. If you are curious to learn how, please ask. Most, if not all, people who come through here and learn the right way to test end up regulating their cat. They have been successful. Your cat is not regulated and you need to drop your dose or else you continue to put your cat in jeopardy. You've been lucky so far - but you are playing with fire and I don't think you realize how dangerous this is.

And yes, if your test strips are expired then throw them away. Go buy new ones asap and start testing your cat. Ask for help - people here will help you.
 
if you have a walmart near you - they sell the least expensive meter and strips - called Relion. It only takes a small drop of blood and they have meters that do not require coding the strips to the meter. so for about $30 or so you can get yourself set up with a cheap/new meter and unexpired strips.

Something else to think about, aside from the expiration date on the strips - every time the strips are exposed to air, it can potentially ruin the strips. It's why they are kept in sealed plastic containers to keep exposure at a minimum.

And better to pay $30 for meter and strips than hundreds possibly thousands for an ER visit.

There are many people here who are unemployed, underemployed and low on funds. We have lots of cost saving ways to help you manage the diabetes.

Not taking your cat to the vet every week or however often you do for BG testing is the first major cost savings.

I hope what everyone has told you is finally sinking in and you are willing to do and learn how to home test. Remember we can help you.

My last point, if it were you that were diabetic, would you inject yourself with insulin without knowing your BG's? Would any human doctor recommend that to their patient? The answer is no, then why is it different because the patient is a cat? I just don't understand. Nor do I understand your resistance to test your cat. You want to prevent an overdose, the only way to do that is by testing your cat.
 
I would send you a reli-on meter but I only have one and the strips for it are'nt here yet.
Newbie Kits

But if they come pronto, (expecting them) and if you PROMISE to test kitty I can send it to you with I think 50 strips.
Deal?
And if you have never had a newbie kit, are you set up with a rice sockie to warm the ear, lancets, toys for your kitty.
Lori
 
Dear Ms. Azrielle and your mommy!
Since Ms. Azrielle cannot read, I will direct this to her mommy... I have a story that I want to share! But first, please know that I am very new at this, I ask questions, some good and some silly... I take alot of the advice given and I LISTEN! BUT most importantly, I LEARNED THE HARD WAY...Thank gosh my Bean Girl is doing great after I did a shot and DID NOT TEST BEFORE! She went down to 26... was very hard to raise her back to just 43... SHE NEVER NEVER ACTED DRUNK (HYPO)~ I think the help with the folks here is what got me through that! Yes, test strips expire... If it were me, I WOULD NOT use them.... I would think that your Ms. Azrielle is JUST as IMPORTANT as my BEAN is.......
I was STUPID STUPID STUPID and very very scared to test that wonderful little ear area... I thought my vet knew what he was talking about and that it wasnt that important to test BEFORE YOU SHOOT!
If you poor kitty is hypo all the time, HELLO! YOU HAVE TO TEST! That is just not fair to that poor baby to have to go thru that and THANK THE LORD that she has made it so far! It will KILL HER!
Go to the Walmart kind of store, spend 9.00 on the machine and 11 on 20 strips! that is at least 10 days! AGAIN, ALWAYS TEST BEFORE YOU SHOOT!
Hope I helped you understand how important it is!
Hugs to you! and Ms. Azrielle!!!
 
strips have arrived in the mail today.
where are you mama of azreille
 
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