I just gave the wrong cat insulin!

Oh crap, I just gave my cat Benji, who is NOT diabetic, the shot meant for the new foster, Bam Bam (who looks exactly alike--both Russian Blues). It was about 0.75 units of Lantus and Benji had switched food plates with Bam Bam in the few seconds that I was filling up the needle.

What happens when you give a non-diabetic insulin? I assume that his glycogen is going to kick in and save him...I just gave him some Nutrical on top of the food he was already eating. Am I going to have to stay up all night testing him?

 

You'll be up for a bit, because he didn't start high.

First, get a test on him now to see where you're starting.

Get out your high carb food; if you don't have any, grab karo/honey/maple syrup to add.

 

I would test him now to try to get a "baseline" number. Wow, I'm not sure but I would think his liver will react? But to be safe, yeah, I'd probably try for a +2 to see what it looks like.

Carl

 

What happens is that you test now and in 30 min. If numbers are dropping, I'd go to the ER. If numbers are in the low end of the normal range now, I'd scoop up your kitty and head to the ER.

Sorry guys. You have very little margin for error with normal BG numbers. The good news is that it's Lantus and you have some time before onset. I don't know that I'd be comfortable trying to manage this at home. Bounces don't happen until after numbers drop and this cat's "normal" could be in the 40s.

 

If Sienne says go, go.

You might give him some high carb to eat on the way to the ER.

 

Thank you Sienne!

I'd never seen this before, and glad you are around.

Carl

 

I just gave him some Fancy Feast (he normally eats Wellness, Nature's Variety, etc.) and I poured corn syrup on it, he licked it all up. I'm going to do a bg now and going to go out and get some high carb food (what would be the best to get?) I also gave him some nutrical.

I'm going to hold off on ER for now since the only thing they'd do is give him glucose I think. I've emailed a friend who is an endocrinologist.

 

You'll need to keep testing and feeding high carb (NOT dry as it takes too long and lasts too long)

Fancy Feast gravy versions may work.

 

If you can find any Fancy Feast sliced in gravy flavors, they all look to be over 20% carbs. Beef sliced in gravy looks like candy. Or Friskees "Tasty Treasures" which are all 20% or more.

Carl

 

The ER doesn't give glucose. They'd use a dextrose drip (in other words, it's IV dextrose). Because it's an IV, it works very fast. Please keep in mind that an overdose of Lantus can be a 16+ hour ordeal.

This could be a non-event but if anything, I'd err on the side of safety.

 

It will be safer to take him to the ER, in case he goes into seizures. How close is the nearest one and how long does it take to get there?

You're going to need to feed 1-2 teaspoons of high carb every 15 minutes, probably all night.
And that may not be enough to keep up with the Lantus.

 

martica, unless i've missed it... i'm not seeing any numbers.
have you tested yet? if not, please do so and post the result.

 

Jill

Haven't seen any numbers - she shot a non-diabetic cat.

 

yes, i'm aware.

it's ALWAYS best to err on the side of caution. always. martica will have to stay on top of this tonight. if kitty begins to drop a trip to the ER is the way to go.

not saying what will happen here... can't say what will happen here without numbers, but i have seen a few of these (shot the wrong cat) on the FDMB before and they've turned into non-events. however, that doesn't mean martica should let her guard down.

martica, your meter is your friend tonight. test and test often. post your results. let's see where kitty's headed.

 

She said she was going to the store to buy HC food. Probably not back yet.

She posted that she was testing an hour ago, but never posted the number. nailbite_smile

Carl

 

Hi
I'm back. The first time I tried I didn't get enough blood and got an error reading and then he kept growling and struggling when I tried again. So no number at first. I went out and got the food and came back and he was BG 93 at 11pm (11:40pm) now. I believe I gave him the shot at 10pm, or maybe 9:45.

I got some dried Friskies. Dried has a higher carb load and therefore higher glycmeic index. It's more processed than wet which actually has real pieces of meat in it..so dried will breakdown and absorb more quickly (I have a phd in nutrition.) And from last I read on Binky's charts, many of the dried are 60% carbs.

I got the brand that had corn as it's first ingredient, then meat byproducts then soy, wheat, etc. So hopefully this is super high in carbs. I also got some crap kitty treats.

So got home and he ate a bunch of the crap dried and the treats. The other cats going crazy to get at it. I also got a syringe 3ml full of corn syrup and squirted than in his mouth. I'm not sure how much more he will eat as he is now not wanting it. So I will just syringe him full of corn syrup at regular intervals.

What I'm counting on is that since he is a healthy cat he will do a natural somygi rebound--that is when he starts to drop too low, his glucagon will be triggered (the hormone that opposes insulin) and cause the liver will kick out some glucose to counter.

And part of the reason that I'm not rushing him to ER is because I am in NYC. It will cost me at least $1000. In the last 6 weeks, I just paid for 3 dentals ($2100, $1900 and $1200) for Chloe, Elizabeth and Sebastian (Shane) and paid for Lenny's 2 week hospital stay ($14,000) from dying of hepatic lipidosis last June. I spent $20K on cat rescue last year and I can't really afford it. Since this is a manageable emergency I think, unless I really need to go, I'm going to handle it myself. Sucks, though.

I guess the thing that I'm not sure is, normally when a healthy body consumes food--and glucose--insulin is released to deal with it. So will his own insulin be kicking in along with the exogenous insulin I just gave him, making it a double whammy?

he seems fine although he's pissed that he has corn syrup all over his fur though. Paws crossed that he stays stable tonight. Would have to be the middle of the night as well

 

that's the $64000 question!
you'll just have to continue testing. i understand your reluctance to take him to the ER. an ER trip is expensive, but if there's any hint of a drop you really should go.

keep testing...

 

Um... feline hypo tx is teaspoons of gravy, not dry, every 15-30 minutes, so the cat doesn't get too full to eat, nor vomit from expanding pellets.

 

that's what i thought too Jill, that we've seen this done before here or on the old board but i couldn't remember what became of it. i too thought some were non-events but that there were some that just went straight to the ER to be safe. i want to say the doses were larger though too.

i'll be up for a couple more hours probably so i'll keep an eye on the thread Martica in case you need any help but here's hoping you won't

 

Hi Martica,

LIke Jill says, just keep testing. It's likely that junk food will boost him fairly quickly and probably last a while, but this is sort of "uncharted territory". At least it's the first time I've seen it. I've seen kitties that got too much juice because someone drew up 5 units instead .5, but I hadn't seen a civvie get a shot.

If you see a drop, it might come down to an ER trip, but I'm praying it won't.

I just had to comment...

I don't think anyone has ever posted something like that before, at least in the past 18 months or so. This isn't a "funny" situation, but that did make me laugh.

Carl

 

When my friend mis-read new syringes, he gave 10 units instead of 1. I didn't even consider trying to manage that at home and it was 2 days at the emergency vet. That may or may not be similar to giving a non-diabetic insulin. At least her insulin dose wasn't for a high-dose cat!

 

Thank you everyone.

Well good news for the moment anyway...his BG is 103...so 10 pts higher than 1 hour ago, or at least within the standard deviation, so not dropping. It's hard as heck to get any blood from his ear though. I've wasted a bunch of lancet sand test strips. I'm sure we'll get the hang of it over the next few hours though.

Actually my syringe of corn syrup is like 10ccs...a big fat syringe. I just got another half of it into him, and of course more on his fur--he is going to need a serious bath after this as he's not licking it off.

Yes, Carl, have to keep a sense of humor. He doesn't know anything is wrong, at first he thought he died and went to heaven with all the crap food that was being put down for him to feast on, and only he was getting it, not the other ones. And the other ones didn't know why I was being so mean to them. And that stuff smells to high heaven and when you put it in a drawer or cabinet the cats still know it's there.

I really wish this had been an AM shot!

 

I may have been too optimistic too soon.

He just threw up everything. All the multicolored pieces of the crap food. I guess I gave him too much and that corn syrup probably topped it all off.

He is now eating the 9 Lives I bought.

 

Holding within +/- 20 % of where you started is good.

Keep on trucking1

Keep on testing, then feeding modest amounts frequently (every 15-30 minutes) so he doesn't get too full to eat.

You could crunch up and moisten the wet food, so it won't swell and provoke more vomiting once eaten.

 

that and if he hasn't had it in forever it might be a bit of a shock to his tummy.

you have pepcid on hand? might toss a little of that in him just in case, might help keep later food down

 

yeah, he's not used to all those artificial flavors and food colors...plus I"m sure that mixing the corn syrup in with it probably was an awful concoction! I do have Pepcid will be testing him again soon.

 

just checking in before signing off for the night...
sorry to hear about the puke-fest.

you know the drill. if you set an alarm, you might be able to get some naps in between tests.
hope you don't have any problems and you're able to get to bed sooner than later...

 

+3.25 56

thank goodness he is hungry. He is eating again and I got more corn syrup into him.

I'm now going out to get more gravy flavors--luckily the drugstore is 90s from my back door.

 

Hi, I've been keeping up on your post. So sorry. I have two black & whites w/similar markings. i have late night visuals
of that unthinkable happening. If you can keep it to gravies and karo and no solid, you might keep the sugar in him, easier to digest. The fat of the gravy
will spread the sugar out longer. You are coming into the most vulnerable time. the peak of the lantus on a cat is 5hrs. My cat plunges down between 3-4 hrs.
You are testing on the 1/2 hr. I assume? I'm up. I'll hang for a while w/you. If he can't keep anything down, you will have to take him in. Of course you
know that, as you seem pretty knowledgeable. Just have to say anyway. Ok. My cat is on AB and I had to do a dose increase, so like I said, I'll be up and here
checking in if you need support.
Shelly

 

You are testing on the 1/2 hr. I assume?

 

Good morning from the UK,

Is it getting close to +5 now? (If I've understood timing correctly)

 

Ok at +4.5. He is back up a bit to 81

He is licking all the gravy off the beef sliced FF and seems to mot want the 'meat'. I gave him a bit of nutrical too

Im checking him once an hour as long as he is eating in that hour

I guess im not going to bed tonight

 

Actually it maybe that we sre further along than i thought. I forgot when i gave the shot and was estimating it was 9:45-10 pm. But i just noticed that i posted at 9:42 and i think i waited at least 30 min until i came onto fDMB....so if i gave hom the shot at 9:15 then we are mow +5.25 or maybe more, which would be good

 

That's good new. If he keeps the meat down, the protein will keep the sugars steadier. My daughter also type 1 diabetic...years of figuring
out the best way not to drop for the night. Helps to know for the cat too. You do have to keep checking, but good he's 81 & +4.5

You are doing a great job Martica. Scary...and must of so freaked you out right after shooting.

 

Shelly, I'm not resting easy yet since he could still backtrack, but thankfully he is still interested in eating...he really loves licking that gravy off

He has also been kneading his kitty bed...which means at least he feels good, and not like crap. Junk food feast for him tonight and the other cats are freaking cuz they don't get any!

It's now 3am. Trying to decide if I can sleep or not. Getting tired. For an hour even...

 

Yeah unfortunately, you can't really rest. You don't know his lowest point. some cats are late in the cycle. He could be one of them.

 

Whats his BS now?

 

Take his BS and maybe it spiked a little from all the junk and if so, sleep a little & set you alarm for next test

 

I hope you are awake. Can you give me an update?

 

We both fell asleep on the floor by his kitty bed. He got up to eat some more and I just took his BG

At +7.5 (i think) he is 66. So he dropped again. But at least a slower drop. I'm going to bring out the corn syrup again. He's not very hungry and I've opened 4 small cans of FF now, he's licked the gravy off all of them.

 

+9 = 60

but nibbling a bit and i just gave him a little more corn syrup

 

You've been doing an incredible job. I really hate to tell you this but you will need to monitor past the 12-hour point. Because Lantus is a long-acting insulin and we have no history on this cat, an overdose can last longer than expected. You will want to keep an eye on the numbers for at least 16 hours. Issues related to where the usual nadir for Lantus falls don't apply. Hopefully, you'll be able to back off the frequency of tests but you'll still need to keep an eye on things.

 

Exhausted. Fell asleep on the floor again.

Benji is now +11.25 - 73

He is acting strange but maybe it's because I'm acting strange. Or maybe becaause neither of us got much sleep last night. He def. does not like the ear pokes in the least. And so tough to get blood from his ear.

 

Now that the sun is up, is there a regular vet available? Someone you trust will monitor him but not charge you hundreds of dollars?
Carl

 

If you have to, poke the vein directly to get blood. Be prepared to apply pressure in case it does bleed profusely.

And I second Carl - maybe see if a regular vet could do a day hospitalization on IV dextrose to keep him stable.

 

good morning! you must be exhausted!
benji hasn't had anything to eat since a little food and corn syrup at +9 and he's 73 now?

are you able to stay home this morning?

 

martica, i have an appointment in a few minutes, but i'll check back later to see how things are going.
since benji is not diabetic, you're looking for him to stabilize in normal numbers that are not influenced by food or syrup.
hope you're able to sneak a nap in sometime today...

 

Ok we've both snuck in a few minutes of sleep here and there

No, Jill, Benji has pretty much been eating a little something every hour or two thruout the night--whether it was the gravy from the food (and i went thru 6. Of the 3oz cans..he ate a little bit of the actual meat from it at around +9/10. Also i was giving him sporadic bits of corn syrup and/or NutriCal when i was seeing those dropping numbers

At +11 i gave him some of the healthy stuff-- he was no longer intered in any of the crap dried or FF. So I gave him some BG low carb no grain and he ate maybe 2-3 oz

He was acting like he was feeling pretty bad--went into the closet and was meowing at me and sittingvery upright for a long time--so wondering if maybe his tummy hurt or he just felt like crap from the junk food binge---and maybe all the corn syrup/NutriCal too--at this point BG was 73.

Finally he settled down and slept on the bed with me and GOOD news!
At +14 he is 232! (Now im worried about the opposite)

Can we assume that he is safe now? And i should spot check but can stop feeding?

Oh and in answer to the $36k question--the endocrinologist tolme that giving exogenous insulin will cause his bidy to downregulate its production of its endogenous insulin---so no dbl whammy. I guess it then boils down to how big the dose was--and in this case it was still on the smaller side

So my guess is that he did not drop much lower than 56ish--and probably prevented by all the calorie sources-
--which perhaps would not have even been necessary if i had not overstuffed him so fast and caused h to puke a huge amount of food.

THANK YOU for all your feedback and support thru the night. It helped keep me on top of things

 

Oh and i work partly from home--lucky. I have a meeting and will be gone from 1:30-5:30. Them he 30ish min then out again from 6:15-8

 

And now on to new concerns. With all this fiasco, I was 2 hours late in testing my 2 diabetics--Sebastian and the new foster I've had for 3 weeks--Bam Bam. I got both their shots ready (0.25 dose and 0.6/7 dose) and then tested them. Their numbers were not too bad. Bam Bam was 398--not as high as I would have thought, esp given that he had eaten a bunch (incl some of the crap left out food)

I gave Sebastian his shot. All good. Then did Sebastian...then a little while later I noticed a shot on the plate and I pushed it and insulin squirted out. So I think I gave Bam Bam Sebastian's used-up syringe...with nothing but possibly bacteria in it :cry:

Now I have to watch Bam Bam the rest of the day/night...

I think I'm living proof that having more than one diabetic cat is a big no-no, or at the very least high-risk. In a span of 14hrs I just shot the wrong cat and then gave the other cat the wrong needle.

 

Hi Martica,

I have been reading all your posts about Benji, but did you ever remember to give the shot to the foster, BamBam? I am sure you probably did, but did not see if you mentioned that.

Hope all turns out okay. Sending prayers to you and Benji!

Jean and Charcoal (GA)

 

Hi Jean
YEs, I IDID give Bam Bam his shot last night after I accidentally gave it to Benji

BUT I don't think he got anything this morning..although I want to give it a few hours before I reshoot just to make sure...in case there was some residual or something in Sebastians....So he may spike into the high 400s or worse by the time I give it to him, but under the circumstances I think we will all survive this past 24 hrs!

Benji just peed and is now wshing himself...hopefully his own insulin is now kicking in and regulating his high numbers Am not going to test till later today, give his ear a break, plus I have to leave now for my meeting...

sigh.

 

Give yourself a break - you've very sleep-deprived at this time!

To prevent future mixups, you might color code your syringes with some easy peel sticky tape, or post-its. Or maybe have color coded boxes to put the prepared syringe in.

 

I think that I need to put a collar on the diabetic cats. (I have several grey cats--obviously because I miss my angel Fred) and my nightmare is if a cat sitter did the same thing..They are all indoor so no collars, but I guess now, they get collars, and yet maybe different shot times too for the 2, I was trying to get more efficient about it, but maybe that is obviusly a bad idea.

OK so at +20 Benji is now 98....So he dropped from 232 to 98 in 6 hours, and presumably this is from his own endogenous insuin kicking in to regulate himself. He is hungry now so I'm gonna feed.

Bam Bam--who I think entirely missed the shot is only at 416...so only raised 17 pts on 6hrs...not as bad as I feared....not sure if that's the 'shed' offering residual protection or what...but anyway, hopefully all will be back to normal. sigh.

thanks everybody for your help and support! this board is a godsend!

martica

 

thats what I was thinking. Colour coordinate everything. I have two diabetic cats.. one gets 0.1IU and the other 7Iu. I mess it up and it would be really really bad so I am super careful.. and always worried!!

 

When I was a kid, we had a couple of black cats no one could tell apart. My brothers solved the problem by taking one of them and snipping the hair off the tip of their tail. Thus one had a "flattop" on the end of their tail, and the other didn't. That might be one way to "color-code" your cats!

 

good idea about the tail clip, Ithought I could tell them apart because Bam Bam is pretty boney, but obviously he's filling out in the past 3 weeks since he's now being treated and well hydrated, etc.

 

I'm just getting around to reading this thread, Martica. Yikes! I'm so glad the only casualties were Benji's ear and your sleep. You and the crew here at FDMB did a great job.

 

Hi Martica,

Oh, my heart really went out to you when I read your first post here....

I remember this happening to somebody on FDMB a few years back, and at the time I thought, '"Well that's just crazy; how could anyone make a mistake like that?" And then, just a couple of months later, I almost injected the wrong cat.... :shock:

It was a real 'wake-up' call (as well as a lesson in humility....) And the cat I almost injected looks nothing like Bert. Bert is black and the one I nearly injected is tabby and white!!! I recall that all the (5) cats were eating their breakfast...I filled the insulin syringe to give to Bert...bent down into the huddle of cats, and then I thought...."Oh, Bert seems to have lost a bit of weight..." and suddenly realised that I was holding onto tabby and white fur.... I think I was still shaking when I went to bed that night, not quite able to comprehend the mistake that I almost made....

Huge (((hugs))) to you from the UK, Martica. I know how easily that kind of thing can happen...

Elizabeth x

 

Wow! Just read your post. That must have been a night mare for you! Glad your kittys came out okay. Close call there. I like the idea about snipping the end of the tail.

 

Thank you Debby, Elizabeth and Sue.

Now after last week's fiasco, Bam Bam, the cat who was supposed to get that shot last week--has been diagnosed with pancreatitis and is not eating...did another post elsewhere...sigh. I have too many cats. No more cat rescue for me, I can't handle this!