What happens when insulin is not given strictly on time?

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Bebe Kaye

Member Since 2013
hi all,
My health isn't the best and sleeping is a battle each day...sometimes I need to take medications at night to help and this causes issues when it comes to my sugar baby. This morning after a horrific night, I was 3 hours late giving him is AM shot. My daughters are both amazing and have both learnt how to do home testing, to administer insulin and know the signs to keep an eye out for...this helps so much for those days I can't leave the bed! But they too have lives...work, child etc. So there's always that day every so often where Miley is 1-3 hours late getting him AM testing and insulin. How bad is this for him? And how do I continue on for the rest of the day? I usually give Am at 06:00 and PM at 18:00...if the AM is running late, is it still okay to give the PM on schedule at 18:00 or should I be waiting or cutting the shot down?

Thank you for your help! Miley is still drinking a lot today and while he seems fine, he is still sleeping more than usual...not sure if this is from the CKD diagnosis and just symptoms of that or if the Ipakitine is binding too much potassium. Because I was too stupid to find out more about kitty health before this past week and always took what the vet said at face value, never asking questions; I find that i'm now in limbo with a lot of questions regarding his CKD and his diabetes! *slaps head* Wish I had found you guys a year ago!!

Bebe
 
Up... Epakatin binds phosphorus, not potassium.

If you are using a depot insulin such as Lantus or Levemir, you want to adjust times a maximum of 30 minutes in 1 day. Try to pick shot times that are least likely to be impacted for you (if you can) or most likely to be aidedby your family for giving the shots. Maybe an hour or two later would work better?
 
You asked "what happens". Your signature shows you are using Lantus. If you give it late, it's like you are decreasing the dose, plus by then the chances are that your cat's blood sugar will have risen quite a bit while waiting for the shot. So that cycle the cat's blood sugar may stay higher than usual. If there are often change in the shot times, it might make your cat's blood sugar hard to regulate . . . but realistically, occasional late shots sometimes happen for reasons beyond our control (stuck in traffic or whatever). Occasional blips in the schedule are not going to be disastrous.

If you do have to give the shot quite a bit later than usual once in a while, try to keep the next shot close to 12 hours later, just adjust 15 minutes earlier until you're back on schedule. So if your usual shot time is 6:00 AM, but one time you couldn't give it until 9:00 AM, then make the next one at 8:45 PM, the next morning at 8:30, then PM at 8:15, etc. until you are shooting again where you want to.

As BJM mentioned, though, maybe it would be easier to just make the usual shot time a bit later? When I started giving my cat insulin I thought around 6:00 would be good timing for me, but various things made me reexamine that plan and I've changed it to a time that works better for everything else in my life I have to do. Just do the best you can; it's great you have family members that can help! I'm jealous!
 
BJM said:
Up... Epakatin binds phosphorus, not potassium.

If you are using a depot insulin such as Lantus or Levemir, you want to adjust times a maximum of 30 minutes in 1 day. Try to pick shot times that are least likely to be impacted for you (if you can) or most likely to be aidedby your family for giving the shots. Maybe an hour or two later would work better?
Click to expand...

Hmm...you're right, seems my vet slipped up on that one...he told me it binds potassium...silly man!

Usually the 6am-6pm works for us, but there are those times where something does inevitably come up and the furry baby suffers for it. I'm just stuck, if I wait until later to do his insulin, I likely won't be able to do many PM spot checks to keep an eye on him.
Amy & Papaya said:
You asked "what happens". Your signature shows you are using Lantus. If you give it late, it's like you are decreasing the dose, plus by then the chances are that your cat's blood sugar will have risen quite a bit while waiting for the shot. So that cycle the cat's blood sugar may stay higher than usual. If there are often change in the shot times, it might make your cat's blood sugar hard to regulate . . . but realistically, occasional late shots sometimes happen for reasons beyond our control (stuck in traffic or whatever). Occasional blips in the schedule are not going to be disastrous.

If you do have to give the shot quite a bit later than usual once in a while, try to keep the next shot close to 12 hours later, just adjust 15 minutes earlier until you're back on schedule. So if your usual shot time is 6:00 AM, but one time you couldn't give it until 9:00 AM, then make the next one at 8:45 PM, the next morning at 8:30, then PM at 8:15, etc. until you are shooting again where you want to.

As BJM mentioned, though, maybe it would be easier to just make the usual shot time a bit later? When I started giving my cat insulin I thought around 6:00 would be good timing for me, but various things made me reexamine that plan and I've changed it to a time that works better for everything else in my life I have to do. Just do the best you can; it's great you have family members that can help! I'm jealous!
Click to expand...

Thanks! This is what I wondered. So far the readings today have been really good, so luckily it doesn't seem to have affected him, but I can see the potential for it to affect him badly over the coming 48 hours or so (i've just started learning about how Lantus works, my vet didn't mention home tests, he just gave me insulin, needles and said 'good luck', so everything i've learnt here over the past week has been a huge revelation!). The adjustments you mentioned are great, when this has happened in the past I usually do 30 minute jumps, but will reduce that to the 15. What worries me about moving his insulin times, is that i won't be able to do as many PM spot checks and that seems to be the time that he's most likely to have an issue. In the past, any extra high readings we've had for him, have all appeared at the PMPS or even at the +1 to +4. I struggle at times to stay up for +4 readings at night, so any later would be a no go lol.

I'm very very lucky to have my girls, they both take great care for me and are always so willing to help out where and when they can...it also helps that they love Miley so much and are not squeamish so the needle thing doesn't worry them at all. Plus my mind is a little screwy on pain meds etc at times, so it helps to have 2 extra heads who remind me and can help with with Milo's day to day treatments!




Thank you both for your time and help. I guess for now I just have to worry about Milo's lethargy (vet appointment not until Tuesday), it may just be something to do with the kidney issue.

EDIT: spelling
 
Hello Bebe,

Gosh, you have a lot to cope with at the moment (big reassuring hug to you). But in spite of everything you have going on you are still doing a great job with Milo. What a trooper you are! But please be kind to yourself, too...

I don't use the same insulin as you, but I hear a lot on this forum about Lantus shots needing to be given as close as possible to 12 hours apart for the best effect. There is another insulin, 'PZI', which tends to be much more forgiving about shots given late (or indeed early...). Is PZI available in OZ? Just wondering if that might be an option for you to think about...?

Regarding the kidney disease, here is the link to 'Tanya's CRF' website which has a lot of info and a support group also. I'm guessing someone might have already given you this link but just in case they haven't, it's here:
http://www.felinecrf.org/

Eliz
 
For about over a year three years ago I gave my kitties shots on an 16/8 hour schedule on the weekends. They did fine. Five were on Lantus and on one Levemir and N
 
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