Skipped AM shot AGAIN

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supervix56

Member Since 2012
Hi everyone,

Is it bad to skip shots? This is the second time I've skipped a shot and LeeLee's only been diagnosed for a week (wow...has it ever been a long week!) Her BG was 190 this morning and she would only eat a few bites of food, so I skipped the shot (I'll be away for 11 1/2 hours today). Last night, 4 hours after her PM shot, her BG was down at 43, which kind of freaked me out. I spoke to my vet yesterday and he said with 1 unit twice a day, he wouldn't worry about her becoming hypoglycemic. He said he would only worry if she went below 36 (which seems frighteningly close to 43).

I just can't get her to eat enough. I think I'm going to switch them all to FF. She likes Wellness OK, but I think she finds FF even more tempting. She used to eat SO much dry food. There's still a bit of dry food out, but she's not eating it. I think all these ear pricks and shots are confusing her.

Erin & LeeLee
 
I don't know what's proper... I went thru a very short time of having to give the insulin... but when it was my cat, I wouldn't give him a shot if he was (generally speaking) below 210... but I would have kept a close eye on him if I could. That was just a number I was comfortable with him having. You know your cat best & hopefully your gut is telling you right, trust it. You'll be near at her next normal shot time to check her again... imagine how long she was slightly high before you noticed any signs & had the diagnosis. It's just my personal opinion & comfort level... but I would much rather my cat be slightly high while I'm away all day at work than risk a hypo!

Good luck...

PS - and maybe take the dry food away for the day, if you're concerned about her going too high (just an afterthought)
 
Thanks for the advice!

I keep planning to take away the dry food, but I'm starting to worry that she's not getting enough food in general. She had fatty liver disease when she was younger (she's about 13 now) and I'm not sure either of us could go through that again (well, we would if it happened...but I'd really rather it didn't).

Hopefully my husband will be working from home tomorrow - they she can have her AM shot and he can keep an eye on her. Then it's the weekend and I can watch her. I plan to test every two hours on Sunday.

I hope LeeLee doesn't think the ear pricks are punishment for something. Poor cat.
 
Erin, are you reducing the dose at your PM shot? That 43 last night means that she should be down to .75u.

Have you tried fortiflora for the food issues? Dry food is attractive to cats because it's coated with animal digest--the pet food companies are not playing fair. Fortiflora is a probiotic that comes in powdered form, and is really good for gastrointestinal issues. However, it also has the added bonus of containing the same flavoring as dry food, so it's great for getting picky cats to eat and to transition them to canned food.

You can get it from your vet, but I found it's cheaper on Amazon: http://www.amazon.com/Purina-Fortif...ment/dp/B001650OE0/?tag=felinediabetesfdmb-20. I'm in the US, though.

Here are some other tricks to try with her: http://catinfo.org/#Transitioning_Dry_Food_Addicts_to_Canned_Food_

But if she loves the Fancy Feast and doesn't like the Wellness too much, I would just feed the Fancy Feast! I'm fortunate that Bandit is a gobbler and eats everything I give him, but Gabby was more refined in her tastes, and there were certain foods she wouldn't touch so I just avoided them. It took a bit of trial and error (fortunately I could feed all the low carb errors to Bandit) to find foods she would eat all the time.
 
I've been going with what the vet says (or skipping a shot altogether). Her evening BG numbers do seem to be quite low. I'm not quite sure how to give a .75 unit does, but I think I saw some pics here.

What if her BG is quite high just before her PM shot? I'm assuming it will be since I didn't give her an AM shot. Should I still do 0.75u?

I had tried fortiflora on one of my other cats and she didn't like it (of course). Never thought to try it with LeeLee. I did try crushing some Temptations (LeeLee LOVES Temptations) and sprinkling them on the canned Wellness, but she wouldn't go for it.
 
What insulin are you using? Some can be dosed on a sliding scale- IF you have the numbers for it- but you don't really as she is newly diagnosed.

Levemir and lantus are NOT based on PS #'s but on nadir #'s and the ones you have are low.

PZI- I wasn't on it long enough, correction, Sneakers didn't have the best numbers on it while she was on it, to have to worry about it- all her PS were high. But I would think that the PS #'s are just the edges- especially if you are using a short acting insulin- and you need to focus on the nadirs.

I will be corrected if I am wrong and be nice, please :oops: .

Her higher numbers look like bounces because she's gone so low- I would reduce the dose regardless for this PMPS. That way you can consistently give insulin and keep her on a level keel all day rather than the dropping, bouncing, skipping, raising she has now.

What syringes do you have? You are dosing 1u, go a little short than that but not down to half the unit. Others will send you pictures and links.
 
supervix56 said:
I spoke to my vet yesterday and he said with 1 unit twice a day, he wouldn't worry about her becoming hypoglycemic. He said he would only worry if she went below 36 (which seems frighteningly close to 43).
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I'm sorry, but I don't agree with what your vet said. YES a cat can go hypo on 1 unit. A cat can even go hypo on less than 1 unit. For him to say this is dangerous and plain wrong.

Also there really isn't much difference between a BG of 43 and 36. In my opinion, those are really the same numbers and the way we look at BG's - anything below 50, if a cat has insulin in their system, needs to be monitored closely as the cat can hypo. Plus this also means a dose reduction is needed.

Just my two cents.
 
LeeLee is on Lantus.

So, should I try to give her 0.75u for both the AM and PM shot? I'm going out at lunch to stock up on FF. She seems more interested in that than in Wellness.

This is so stressful! (As I'm sure you all know.) And, while my vet has been wonderful in the past, his attitude/directions towards LeeLee's diabetes have not been making me comfortable. Someone with a diabetic cat goes to another vet at the same practice and really likes her (and I've seen her before with another cat). Should I give her a call? See if she's more helpful and then I can switch LeeLee to her? I hate the thought of offending my regular vet, but hey, this is LeeLee's life.
 
supervix56 said:
LeeLee is on Lantus.

So, should I try to give her 0.75u for both the AM and PM shot? I'm going out at lunch to stock up on FF. She seems more interested in that than in Wellness.

This is so stressful! (As I'm sure you all know.) And, while my vet has been wonderful in the past, his attitude/directions towards LeeLee's diabetes have not been making me comfortable. Someone with a diabetic cat goes to another vet at the same practice and really likes her (and I've seen her before with another cat). Should I give her a call? See if she's more helpful and then I can switch LeeLee to her? I hate the thought of offending my regular vet, but hey, this is LeeLee's life.
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Check out the dosing guidelines in the Lantus forum: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581. Ditto what Hillary said--a cat can certainly hypo on 1u. 1u is the average dose for cat on a low carb, canned diet, not a low dose. Many cats need less than 1u, especially when they are about to go into remission. You should shoot .75 at your next shot and hold that dose for at least 3 days, unless you see a number below 50 again and then you will reduce the dose again.

It's very rare that vets get every detail for treating feline diabetes correct. Vets are general practitioners, and it's not likely they will know every detail for treating every disease for every animal. My vet was wonderful in that she had me put Bandit on a low carb, commerical canned food, told me I HAD to home test because vet testing was unreliable, and prescribed Lantus. But her dosing advice was completely wrong! She was having me dose Bandit like a dog (she had diabetic dogs herself), when cats need a different dosing protocol. So I printed out a copy of the protocol and Rand article, brought it to her, and told her that's what I was going to use to dose Bandit. I got dosing advice from the Lantus forum after that until I was experienced enough to make my own decisions based on the protocol. I switched vets to one that specialized in cats that was closer to my house, and Bandit's new vet was not familiar with Lantus (she was prescribing Prozinc at the time), but she read everything I brought her and understood that I knew what I was doing in the dosing department and so she gave me more general advice and observations based off his spreadsheet. After observing Bandit's treatment and another diabetic problem cat that I was helping out at their practice (both went into remission), the vets at the practice all changed their treatment guidelines to what's recommended here.

If your vet is open to you bringing him information and working with you, then he is a good vet and I would keep him. If he tries to scare you into doing what he says and ignores information you bring him, find a new vet who will work with you.
 
Oh, and here is how to measure .25u of insulin:

025unit-1-2.jpg


.75 would be halfway between the .5u and 1u lines, just like .25u is halfway between the 0 and .5u lines.
 
Unfortunately my syringes don't have half unit lines. I had bought some syringes at Walmart that do have the half unit line, but I was worried they were somehow different and I would wind up giving LeeLee an incorrect dose (even though I took my syringes to the pharmacy and the girl there said the ones I was buying were the same.)

I left a message for the other vet to call me (the one that was recommended) and see what she has to say.
 
supervix56 said:
Unfortunately my syringes don't have half unit lines. I had bought some syringes at Walmart that do have the half unit line, but I was worried they were somehow different and I would wind up giving LeeLee an incorrect dose (even though I took my syringes to the pharmacy and the girl there said the ones I was buying were the same.)

I left a message for the other vet to call me (the one that was recommended) and see what she has to say.
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Go back to Walmart and get the U100 syringes with the 1/2 unit markings on them.
Then just go with the dose of 1/2 unit, measure the insulin to the first line on the syringe and let your cat level off.

Then after a few days, you can decide if the .5u is a good dose or if you need more.

Get rid of those temptations treats and all of the dry foods. You can get some freeze dried chicken to use as treats, and the fancy feast or friskies are just fine but make sure it's only the pate flavors and none of the grilled or gravy ones as they are full of carbs.
 
I do still have the Walmart syringes. I don't know much about syringes sizes. Is 1 unit in my vet-approved syringe the same as 1 unit in my Walmart syringes? They look the same to me, but I would certainly hate to be out by any amount.
 
supervix56 said:
I do still have the Walmart syringes. I don't know much about syringes sizes. Is 1 unit in my vet-approved syringe the same as 1 unit in my Walmart syringes? They look the same to me, but I would certainly hate to be out by any amount.
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There are no veterinary U-100 syringes. All U-100 syringes are human syringes. If your vet is selling you U-100 syringes, then they are purchasing them from a human pharmacy or medical supply company and then reselling them to you.

1u of insulin is 1u of insulin in any U-100 syringe. A "unit" is a standard unit of measurement, like a milliliter or a centimeter. It is going to be the same regardless of the size of the U-100 syringe.

Veterinary insulins like Prozinc are U-40 insulins, and those syringes are different, but you don't need to worry about that because you're already using a U-100 insulin.
 
I just want to add in that mocha was on lantus, and on .25u she went down to 37 .. thankfully, she did not hypo because we were diligent about home testing and brought her back up, but that just proves right there that your vet misspoke to you ..
 
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