A shot two hours early?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Sarah97, Feb 10, 2020.

  1. Sarah97

    Sarah97 New Member

    Joined:
    Jan 26, 2020
    Can I give an SID Shot two hours early?
    Or should I just skip it? He’s not regulated yet.
    Please know that I’m only asking because I won’t be with him at the time of his insulin shot and it’s a long car ride for him. His BG will rise.
    It’s a mix of fast acting insulin and NPH
     
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I would skip. There's not enough data on your spreadsheet to know how this insulin will work.

    I would also discuss changing insulin with your vet. Mixtard is not recommended for cats. In fact, NPH, which has been around for a long time, is not recommended for cats. Frankly, Mixtard is way too dangerous (IMHO) to be used in cats. In discussing it's use with a vet, her read on the use of Mixtard was that it might be of benefit in a cat that is hospitalized for diabetic ketoacidosis where you need to lower blood glucose levels very quickly, the cat is being monitored 24/7, and is on a continuous glucose or dextrose drip. I doubt this is the case for Tiggo. The vet actually put a note out on a professional listserv and it is not being used in the US with animals.

    The American Animal Hospital Assn recommends either Lantus or Prozinc and has been making this recommendation for years. This is a link to their 2018 recommendation paper.
     
  3. Sarah97

    Sarah97 New Member

    Joined:
    Jan 26, 2020
    he
    He was hospitalized for a week for being ketoacidic and when asked if he still has ketones the vet said yes he still has some traces in his urine
     
  4. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Why are you giving SID (once daily)? Both components of the Mixtard 30 should wear off in 8-10 hours and BID (twice daily) dosing would ne a lot better than SID.
    I have no problem based on your SS data of giving a SID dose at +22 hours vice 24 hours after last dose.
     
  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Trace levels are manageable. You want to make sure Tiggo is eating -- calories are important. You also want to add water to his food.

    The general recipe for ketones to develop is an infection/inflammation + not enough insulin + not enough calories.

    Given that Tiggo has had an episode of DKA, I would not skip his insulin. The issue with Mixtard is it has very limited duration and slams numbers down. Is your vet having you dose insulin only once a day? This is also not acceptable in a kitty that's post DKA. Please talk to your vet about switching your cat over to an insulin that's appropriate for felines. I'm just not comfortable with your giving your cat 2.0u. The drop from the 300s to 80 warrants a dose reduction. We usually reduce doses by 0.25u.

    None of us have experience with Mixtard. If DKA were not a factor, I'd suggest you reduce the dose to 1.0u at both AM and 12 hours later so you're dosing twice a day. Is there a vet who's a cat specialist in your area?

    @Larry and Kitties - I actually think the onset and duration are shorter, although it may depend on the ratio of R to NPH. See this post - there's info in the 3rd paragraph. I wasn't able to find any compelling research on the use of Mixtard in cats.
     
  6. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I would have no problems with going to the same 2U Mixtard BID since you are using a human meter and have history of ketones. I would have not objection to droping it to 1 1/2 units BID but would not drop further to 1 units BID
     
  7. Sarah97

    Sarah97 New Member

    Joined:
    Jan 26, 2020
    I know it was not the right choice, but he just finished his first week of insulin at home and he was very recently diagnosed. I'm still new to all of this and still learning. I was scared to not follow the vets advice and he would not listen to me.
     
  8. Sarah97

    Sarah97 New Member

    Joined:
    Jan 26, 2020
     

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