emergency!Update: Doing great!! Thanks for all your help!

OMG!! I accidentally gave to much insulin! (Lantus) Garland is currently taking 1.0 unites 2x a day. Her before shot was 276 (which is about where it always is in the morning).

I always fill the syringe with more insulin than needed, so I can get all the bubbles out and then adjust it to the right dose. (does that make sense?) After I filled the syringe, I got distracted with my 2 year old screaming and then my 1 year old threw his cereal across the room, so I ran in real quick to give her the shot so I could take care of my kids. As soon as I did it, I realized I forgot to adjust it !!!!!!!!! I have no idea how much was even in the syringe. If I had to guess, I would say about 3 units. I know for sure it was less than 5. WHAT DO I DO???

So far, I went ahead and have her a lick of honey and put out some carby dry food. But I dont even know if that is what I should have done? HELP! THANKS!

 

Re: EMERGENCY!

I don't use Lantus but will ask some Lantus users to come over.

I would plan on some testing today to be sure she stays in safe numbers. Maybe wait until you get some numbers and guidance before you do any more honey or dry carb.

Sounds like you have a very busy life and it is easy to make mistakes. But Lantus is a forgiving insulin and we will get you some help.

 

Re: EMERGENCY!

how long ago was the shot? What # is he at now? And not to cause panic but we need to know this, how far away is the nearest emergency vet?

 

Re: EMERGENCY!

At what hour are you after testing now? I would suggest you monitor her very closely (every 30 mins); when the numbers start to drop, feed HC gravy/karo and monitor every 20 mins and so the drop in her BG does not get ahead of you. It's good you gave her sugar but the dry food takes a long time to kick in so don't rely on it to bring her numbers up right away. If she were my kitty, as soon as the numbers start to do down, I'd give her karo, syrup, honey, etc even if you bounce her up. You can give her some HC food but try not to overfeed her as you don't want her to get too full...the gravy is the best. Even if her numbers start to go up, you must stay on top of the testing until she is way up (and I don't mean just to 100) because as the karo/HC wear off, her numbers will probably come back down. The other thing I would do if it was my kitty.....be ready to go to the ER. You might not need to but I'd just be prepared.

Once the dry food does kick in, it might really shoot her numbers up (I don't know how your kitty responds to dry but most of them, dry skyrockets their numbers) and it takes a while to bring the numbers back down...by a while I mean anywhere from the rest of the day to 2-3 days for some cats.

Please keep us posted.

 

Re: EMERGENCY!

Just a couple questions:

Are you able to be home all day today and this evening and potentially tomorrow?

Do you have lots of test strips on hand? You are going to need to do a lot of testing and monitoring.

We have the preshot number great, do you have a SS or do you know the nadir number?


My concern is we're dealing with a potentially unknown amount of long duration insulin. My gut is telling me to advise you, if you cannot monitor for the next 24-36 hours...get to a vet ER. They can continuously monitor and provide glucose as needed to keep kitty safe.

 

Re: EMERGENCY!

I am home today and can test whenever. The nearest emergency vet is down the street. So I should test every 30 minutes? I gave her the shot 30 minutes late today (hectic crazy morning) So its only been 45 minutes so far. She is usually only fed classic fancy feast. She is otherwise very healthy and spunky.

I did a curve on 4/28

AMPS 240
+2 308
+4 320
+6 330
+8 324
+10 355
PMPS 402

Thank you for all the quick responses, Im a bit panicky.

EDIT: Just tested at 45 minutes after the shot : 314

 

Re: EMERGENCY!

How long has she been on lantus? Remember onset is typically at +2 but I would still monitor her more frequently to catch the beginning of the drop. The main thing is staying on top of the testing and reacting appropriately to offset drops. Some cats can drop quickly from AMPS to +2.

Looks like you have a few of us checking in ....I'm around all day and hopefully with careful monitoring and responding, you wont have to go to the ER.

 

Re: EMERGENCY!

So if I understand correctly you do not have any high carb food in the house for Garland?

Just the FF classics and some dry kibble? What brand or type of kibble? Can someone run out and pick-up some gravy style FF?

Again, check your test strip supply. This is going to be a potentially long event.

I see folks checking in on you already and they have some awesome experience and advice to guide you. I can't be here with you all day...I have at least one client I must go see. But, there is lots of folks checking up.

 

Re: EMERGENCY!

do you have high carb wet food on hand (like fancy feast or Friskies with gravy)? If you are going to do this at home, please be sure to have a lot of gravy food, some syrup, and lots of test strips on hand.

The thing about Lantus overdoses is that sometimes they are a non-event, but other times you can be fighting low numbers for 16+ hours. It's good that the ER vet is nearby. It wouldn't hurt to call them and give them a heads-up that you might have to head in later.

 

Re: EMERGENCY!

I dont have any gravy wet food, but I will go to the store and get some. Shes been on Lantus since March 9. The lowest test number I have ever gotten from her was at +3 198 March 12. Ive never seen it lower than that, and her typical numbers usually hover around 300-350 after her morning shot

 

Re: EMERGENCY!

Great info. Yes....you absolutely need to have someone get some 18% food WITH GRAVY. The Fancy Feast gravy lovers grilled chicken feast is HC (15-17%) I think the regular grilled turkey in gravy and grilled chicken in gravy are the highest FF % carbs I know of at 18%.

 

Re: EMERGENCY!

Glad to see so many people around. Would human canned gravy work? I'm asking all? I have never been able to make gravy fresh, I either use canned or drippings saved from the time before (frozen). Just in case I would fall into this situation. The two times Maisey went hypo, I use tupelo honey and canned ff with gravy. But it would be good info. I also had the hypo page printed out and posted on the ice box.

 

Re: EMERGENCY!

Can you send someone for you? A friend, neighbor, family member...

 

Re: EMERGENCY!

I would be concerned there would be onions and or garlic in human grade gravy.

They are bad for kitties.

 

Re: EMERGENCY!

Hi elizhope, and, of course, you too, sweet Garland,

It makes perfect sense. I do the same thing. Load a little too much to shoot out the air bubbles... I try to only load maybe an extra half unit in case of distraction. Then again, I don't have nearly the distraction potential you do...

I humbly think you can step away from the honey and pull up the dry food. You may need it later, so you don't want Garland's tummy too full if you need her to eat. Just keep an eye on her and test maybe once an hour unless you see her going low. Low would be 40 or less, so then you'll need to test more frequently.

I'm home today too. So, please keep us posted, okay?

Life happens, dear elizhope. Just breathe...

Love and lots of hugs because I have a feeling you could use extras now,
Deb and Nikki -- and, Giz, who totally taught me life happens dancing with a sugar cat...

 

Re: EMERGENCY!

We also had a hypo in LL a few weeks ago....kitty in the 20s all night....all they had was ice cream (VANILLA ONLY) and it really helped bring her numbers up but then they would fall back down. Something to consider although the cat gravy and HC food is the best....that helps bring up the numbers and keep them up. Since you don't know how carb sensitive she is, it might really work for her.

Also, I respectfully beg to differ on allowing her to go into the 40s. This is a cat who has never been low and we do not know how she reacts to carbs/karo, etc. I would absolutely not let her go that low not knowing how she responds to carbs. LIke Libby said, this may be a non event or it could be a very long day. Let's hope it is a non event....but 40 is too low for this kitty today. I do agree that I would not give her anymore honey, etc. until we see where she is headed.

Do you feed her on a schedule to manage her numbers? If so, what kind of schedule and have you been doing it today?

 

Re: EMERGENCY!

Hi Marjorie, and, of course, you too, sweet Gracie,

I also respectfully beg to differ. Sometimes the best thing we can do for both the sugar cat and their parent is to not induce panic.

Love and respectful hugs,
Deb and Nikki -- and, Giz, forever dancing in my heart...

 

Re: EMERGENCY!

Totally agree Deb.....preparation yes. Panic no Breathing is an excellent suggestion and a great thing to do in this situation. And Deb is so right, Elizhope (what is your name?). Life happens and we just deal with it. That's why we are all here.

 

Re: EMERGENCY!

Nothing more I can really add, the peeps already here are giving you great advice. I just wanted to say that I am also here, we have all fingers and paws over here crossed for you, and we are sending our very best thoughts that this will wind up being a non-event, Garland does fantastic, day.

 

Re: EMERGENCY!

Did she go shopping? Haven't heard an update in a bit.

 

Re: EMERGENCY!

Thank you all for all the responses and reassuring words. Im feeling much better. Still worried, but not freaking out I was in major panic mode when I first realized what I had done... I still cant believe this happened! I feel like such a bad kitty mommy

My name is Beth

I only gave her one lick of honey right after and I already pulled up the dry food. I am going to test her +2 shot in 15 minutes. Cross your fingers it looks good

I dont have her on a feeding schedule. I say I open a small can for her every 2-3 hours. And she eats it freely. But once its gone she likes to be very loud about her bowl being empty LOL

I also have gravy food on hand now

 

Re: EMERGENCY!

Dear Marjorie, and, yes, you too, sweet, pretty Gracie,

It is most interesting and rewarding dancing with a sugar cat. I firmly believe it makes us better people. (Okay, so having the sugar toe shoes steel-tipped helps...)

It would be good to hear from Elizhope regarding how her sweet Garland is doing...

How great is it that it's Sunday during the day? Elizhope has volumes of support, should she and Garland need it.

Love and continued respectful hugs,
Deb and Nikki -- and, Giz, who taught me to have the sugar toe shoes steel-tipped...

 

Re: EMERGENCY!

Big hugs, dear Beth,

It'll be okay. You have many time zones with you right now. I'll hang in forever imagining the projectile cereal...

Nikki's a grazer too...

Much love and fingers and paws crossed kind of hugs,
Deb and Nikki -- and, Giz, who taught me there is no such thing as a bad kitty mommy...

PS: Don't give the gravy food yet. Just put it wherever you keep the secret treats for yourself. You do have secret treats for yourself, right?

 

Re: EMERGENCY!

+2 307

 

Re: EMERGENCY!

Beth: glad you got the food. Please don't panic.....you are absolutely NOT a bad mommy. You have two small children and a sugarbaby...I'm in awe of what you must handle every day. We are all here to walk you through this...just let us know her numbers and we'll take one at a time. You're doing great!!! Thanks for the info on Garland...so she's eaten a bit this morning..great. We'll wait for her +2.

Deb:

:lol: :lol: I'm working on my umpteenth pair of patience pants....maybe I need a pair of those shoes! Thanks for the humor....always helps

 

Re: EMERGENCY!

AAhh....there's a food spike!! Cool!! Doing great!! Are you having a big sigh of relief? Go ahead and reward yourself with the secret treats Deb mentioned. Since we can't see a spreadsheet, do you know when she typically has her big onset....is it +2 or +3? Does she usually get a food spike at +2?

 

Re: EMERGENCY!

Color us happy, dear Beth!

And, thank you for the update. It means a lot... Truly. Now, just tell me you have a treats for you... You are important! (Chocolate works...)

Please keep us posted with say a +3 (if you feel like it) or +4, okay?

Much love and we're hanging in with you, great mommy! kind of hugs,
Deb and Nikki -- and, Giz, forever dancing in my heart...

 

Re: EMERGENCY!

Dear Marjorie, and, of course, you too, sweet Gracie,

I honestly forgot about those steel-tipped sugar toe shoes stored in the back of my closet until Nikki decided to rescue me. They come in handy whilst pirouetting and head-banging. Now, I just need to find that friggin football helmet...

Ahhhh, dancing with a sugar cat... Sigh...

Love and continued respectful hugs,
Deb and Nikki -- and, Giz, who taught me everything there is to know about patience and pirouettes...

PS: My mantra is: without a sense of humor, we are lost...

 

Re: EMERGENCY!

Hi Beth

Just to let you know we are still here when you need us. Hope you are nom noming the chocolate.

 

Re: EMERGENCY!

+3 369

Shouldnt it be lower with the overdose? I know I gave her honey 3 hours ago, but it was only 1 little lick.... Im not even sure she had a single bite of the dry food bc I had the wet already down

 

Re: EMERGENCY!

Beth:

As Libby said, this might be a non event...it's early to tell. It's good she isn't dropping. In some cats, a little honey/karo goes a long way and a few bites of dry food can, too. You know how sneaky cats can be about getting the good stuff (dry)!

You are doing super...a +4 would be awesome. Thanks, Beth!!

eta: I think it's ok to remove the 911 from your original post. Deb and I are keeping an eye out for you.

 

Re: EMERGENCY!

Hi Beth: just checking in to see if you have a +4? I know she may seem high, but it's important to continue monitoring hourly. Thanks and looking forward to seeing Garland's number

 

Re: EMERGENCY!

Well if it all went into the shed, instead? That is why I was asking if you had a SS. Your curve looks like you caught a bounce, but if it is Garland's normal...then the extra insulin isn't as worrisome. Most of it would have gone into the shed.

Which means you may see some action tonight in the second cycle, instead of this afternoon.


And as Libby pointed out...it may end up being a non-event.

 

Re: EMERGENCY!

Beth's (Blue) point is very important. We can't see what she's been doing so don't know where you caught her with the extra insulin. That is why we ask you to continue monitoring hourly; you could see effects later today, tonight, tomorrow.

 

Re: EMERGENCY!

+4 411

I have a not filled out all the way spreadsheet. I know, I know...

Thanks again for everyone helping me today!!! You have really made me feel sooo much better. I will be testing again at +5

 

Re: EMERGENCY! EDIT: Looking okay so far

Beth

Thank you very much. We'll keep checking in.

 

Re: EMERGENCY! EDIT: Looking okay so far

Just sending love and hugs for you and Garland, dear Beth,

You are a champion!

Looking forward to your +5.

Even more love and hugs,
Deb and Nikki -- and, Giz...

 

Re: EMERGENCY! EDIT: Looking okay so far

Beth you're doing great! Just keep breathing...

 

Re: EMERGENCY! EDIT: Looking okay so far

what is her normal dose supposed to be? I don't see that it was listed in the thread.

 

Re: EMERGENCY! EDIT: Looking okay so far

Hillary: it's 1u bid. First line, first post Numbers are easy to miss on a busy condo.

 

Re: EMERGENCY! EDIT: Looking okay so far

Beth you are doing great!

Monitoring is the most important thing to do right now. With the extra insulin on board...we're not sure if or when it may show itself.

But...you have something many onwners would never imagine...

You home-test and you have knowledge and if you didn't realize it...you have a network of people to help you.

The SS would be nice for the future, for today...we have what's in front of us. And we'll all do our best to help you pull through.

Beth & Atlas

 

Re: EMERGENCY! EDIT: Looking okay so far

well that's what I get when I don't wear my glasses!

 

Re: EMERGENCY! EDIT: Looking okay so far

:lol: :lol: :lol: I've done it a million times...even on my own condo!!

 

Re: EMERGENCY! EDIT: Looking okay so far

+5 367

 

Re: EMERGENCY! EDIT: Looking okay so far

Looks like the insulin is starting to show itself...

Breathe....you and Garland are still fine.

 

Re: EMERGENCY! EDIT: Looking okay so far

How weird....I posted before Beth (Blue) and said the same thing and my post is nowhere to be seen!

Beth: great job. Thanks for being so vigilant...it's paying off. We'll see you in an hour with a +6.

 

Re: EMERGENCY! EDIT: Looking okay so far

Okay, I went ahead and re-posted my SS link. And please dont yell at me. I know it is incomplete. When I had stopped regularly testing last month everyone (very sternly) told me how I needed to get back to doing it. Now I always test, but I dont always record it. I have no good excuse. So please dont yell at me. nailbite_smile But this way you can see what I have recorded since so many of you have asked about my spreadsheet.....

EDIT : +6 342

 

Re: EMERGENCY! EDIT: Looking okay so far

Oh Beth sweetie!!!! We don't yell...ever!!! We know you have a life and you are doing the BEST for Garland!!! I admire you so much for having two small kids and hometesting....so many don't.

Just a quick thought: LATER when we are done, you might want to hop over to Lantus Insulin Support Group, introduce Garland, and get eyes there on her SS.

Will wait for your +6. Thank you!!!!! HUGS!

 

Re: EMERGENCY! EDIT: Looking okay so far

Thanks for being understanding about my spreadsheet.. LOL I got in big trouble last month when I wasnt testing before every shot. But I always do that now. I know Im not as diligent as I should be about recording the numbers. Shes so happy and spunky, that sometimes (other than her 2x a day shot) I forget she even has anything wrong with her. And in all these months of testing, her numbers are never lower than 200. But I promise to start writing it down better. I do pay attention to how low it gets though. Thats how I know that 198 I got March 12 was as low as its ever gotten.

So I should test again at +7 or wait for +8?

 

Re: EMERGENCY! EDIT: Looking okay so far

Thanks, Beth! Glad you are doing PS testing now.

I don't think there's any harm in being conservative and testing hourly as long as she is doing ok with the pokes. You know her best. It *might* be a long night of poking if the insulin kicks in.

 

Re: EMERGENCY! EDIT: Looking okay so far

The SS issue is something we can ALL deal with tomorrow. It does help to see it though. Even the little bit of information I am seeing indicates you are most likely at a too low dose. Which...might make today a whole non-event. Paws crossed on that actually.

But, I too would encourage you to visit the Lantus Support Group.

I would also direct you to this protocol to read: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL This is the protocol we use to determine dosing for our sugar babies. If you take a look at it, you've been at the starting dose of 1.0u BID a long time and you are still getting long term unhealthy numbers for Garland. A lot of this can be corrected. And Garland can truly get healthy.

But...all this is for another day. We need to get you and Garland through the next 24 hours safely. And so far it looks to be going OK and look at all the data you are getting today!

 

Re: EMERGENCY! EDIT: Looking okay so far

How old is your insulin?

Your curve from 4/28 looks like it goes in one direction after AMPS - just UP - like the insulin may have lost strength.

That could be why even with the overdose today, her BG is not dropping like a rock.

 

Re: EMERGENCY! EDIT: Looking okay so far

Great question Phoebe. Very valid point. We are seeing some movement but no...she's not dropping like a rock right now.

 

Re: EMERGENCY! EDIT: Looking okay so far

Beth: how ya doing? Did you decide to wait and do a +8? Just asking....thought if you did, I'd jump in the shower while waiting :lol: :lol:

 

Re: EMERGENCY! EDIT: Looking okay so far

Okay, sorry I went MIA .. Had to cook dinner for the family, bath time and do some dishes. I did test though +7 351 +8 359

So weird, her numbers seem to be 100% normal.....

Maybe her dose is kinda low.. But the 3 she had this morning is way more than she usually has

 

Re: EMERGENCY! EDIT: Looking okay so far

I started a new pen on 4/28 when I did my last curve

 

Re: EMERGENCY! EDIT: Looking okay so far

Great info on the pen. That would somewhat minimize that being the culprit here.

No worries about being "MIA". Kids gotta eat :lol: :lol:

I have to agree with Blue....my first thought is she is not getting enough insulin but even if that is true, neither of us can predict how this will continue to play out.

Her number looks pretty stable right now....good. Do you feel comfortable waiting to get a +10? If she were still dropping, I'd suggest a +9 but she is the same. Your call on your comfort level and based on how she's doing.

 

Re: EMERGENCY! EDIT: Looking okay so far

+10 371

Do I go ahead and give her her usual shot in 2 hours?

 

Re: EMERGENCY! EDIT: Looking okay so far

Typically we like to see a +11 before making a dose decision. Could you please post that when you get it? Thank you!!!! Doing great.

 

Re: EMERGENCY! EDIT: Looking okay so far

I say yes to going with regular dose at regular time

 

Re: EMERGENCY! EDIT: Looking okay so far

I've asked for some additional eyes on this and your SS. Will let you know ASAP. Thanks!!

ETA: consensus is you're good to go on shooting the normal 1u dose on time.

I'm thinking you won't need us tonight so this will be my last post. I would be sure and get a +2 and let us know if you need any help.

Good luck and hope to see you in Lantus ISG this week.

 

Re: EMERGENCY! EDIT: Looking okay so far

Thank you so much for sticking through this day with me! It meant the world!

 

Re: EMERGENCY! EDIT: Looking okay so far

Beth...you are so welcome. We're all in this together. We were prepared to stay up all night with you if it came to that...amazing group of people in FDMB.

 

Re: emergency!Update: Doing great!! Thanks for all your help

NICE WORK, ALL!!

 

Re: emergency!Update: Doing great!! Thanks for all your help

Dearest Beth, and, of course, you too, sweet Garland,

You both did great today!

Sometimes it takes a village to dance with a sugar cat. You had a metropolis today. It's why I love this Board...

Much love and countless grateful hugs for a happy ending,
Deb and Nikki -- and, Giz, forever dancing in my heart...

PS: Still imagining how far cereal can actually fly... ;o)