? Missing a shot

My husband has been admitted to the hospital and I can't leave until the doctors come this morning. I was able to give his PM shot. What will happen this morning if I can't give his shot at 8:30am?

 

If you have to miss the shot then don't worry about it. Right now you have more pressing needs to deal with. You can get back on schedule later.

Prayers for your husband and for you.

 

Sending prayers for you and your husband. Just count it as a skipped shot. Jett can get back on track later.

 

Prayers for your husband. I've been in your shoes with my mom. You skip the shot and do what you have to do. One time I did two 18 hour shots. Other tines I had to skip.

 

Praying for you and your DH

 

Extra prayers from here. Agree just to skip this way you have one less thing to worry about today. Jett will be fine

 

Unless your kitty is recently recovering from DKA, it's not a problem. Just shoot at your usual PM time. You might want to think about lining up a petsitter if you think your DH will be in the hospital for a bit. It may help to take the pressure off re. shot time.

 

Thank you, everyone! Huge relief to see your comments. I am home for a brief period of time at +4 after my normal AM insulin shot, which did not occur this morning. Should I test him now and shoot in case I cannot test/shoot tonight? Things are not resolved at the hospital, so I don't have many options with pet sitters given the short notice. Thanks for your help!!

 

You could shoot now, especially if you don't know when the next time will be at this point. Just notate the new time you shot and make sure you don't shoot any earlier than 12 hours after this time.

Sending more prayers and hugs for you and DH

 

The Lantus pool will get refilled. Dose has been increased so he already has some ''bonus'' added.

Sad for your husband, hope it's nothing important.

*once back home, seek around to find a backup in case it happens. Being nice with someone
or exchanging services can pay back. (for shooting, not your husband)

 

Ok. I just tested Jett at +4 the normal AM shot (which did not occur) and he is 210. I'm concerned now about giving him a shot right now, but I may not be able to make it back for the 8:30pm shot. I am freaking out.

 

To make things simpler you could give 1.0 unit as a much reduced shot. It is at least some insulin which would be good because of the DKA episode but you won't have to worry as much. You could also leave down some HC food before you go back to the hospital.


ETA For other people reading this..this opinion is because of the circumstances and not the usual protocol that is followed

 

Thank you! I will do that - give a lower dose and leave out some HC food. I have dry food (30% carbs) and wet food (17%). Should I leave out both or is the dry food too much??

 

You've got so much going on right now. I think you should just skip so you don't have to worry about Jett going too low. He'll get back on track. Focus on your husband. Sending prayers.

 

Ooops. I cross posted with Mary Ann. She has a good idea too.

 

With earlier DKA in the mix I would rather see some insulin than a skip

 

http://www.felinediabetes.com/FDMB/threads/help-missed-dose.139808/

Second post :

''No need to panic.
Better too high for a day, than too low for a moment.
Just pick up back on schedule.''

 

I didn't realize about the DKA. Some insulin is a good idea.

I'd just leave the wet food out, not both.

 

With Jett having had a DKA episode it is better to have a low dose on board than nothing.

 

Thank you!!! What is DKA?

 

Unless I am mixing up the information I seem to remember Jett having a DKA (diabetic ketoacidosis) episode where he had to be in the ER and treated for it. DKA happens when numbers are too high for a period of time, not eating properly and an infection or any combination of those. I certainly hope I am not mixing up the wrong information with someone else.

 

Just realized it, you're right.

 

If you vet is near, see if his assistant can shoot at your place or at his clinic.

Us, with sick pets are gold mines to vets.

 

Hello - it is easy to get confused....Jett hasn't had a DKA episode that was treated by ER. He had low numbers on Aug 5th (low of 33) with no symptoms. He was diagnosed on July 6th with hi numbers and ear infection, but we never found ketones in his urine. I have the 1.0 unit ready to go.

 

Now, I am nervous that the 1.0 unit shot will drive him lower and I won't know it. When you say "depot" insulin, does that mean that it is released slowly over time?

 

Depot insulins like Lantus are like a "time-release" where insulin is slowly released into the system. If you are really concerned and considering that I made an error with the DKA you could skip the shot if that would make you more comfortable. The reduced shot should be safe, but since you have no idea when you could test again skipping would be okay as well.,


ETA With a skipped shot Jett's numbers will go up higher but that can be dealt with later.

 

If Jett is eating well... the normal amount everyday... there's a little less worry about him going into DKA.

PJ, do the best you can. Reduce the dose or skip as needed. Leave food out for Jett day and night.

I went through something similar when my DH was hospitalized with a brain aneurysm in 2011. You can see how far off shot times were and the inconsistent dosing that happened during this time on her 2011 spreadsheet beginning on 11/07/2011 and ending on 11/23/2011:

https://docs.google.com/spreadsheets/d/1ooNFj_Fd7be3QQJ41bl8fXka3QkSo_H1UIONkEh_2I8/pub?output=html#

It didn't take long to get back into a normal routine once the crisis was over.

Hugs for you and prayers for your DH...


ETA: Test for ketones when you can.

 

Sending more prayers to you and your DH.

 

Good morning - I was able to test and shoot late last night at 1:52am. I wasn't certain what to do this morning, so I only shot 1.0 unit at 9:21am, since it was not 12 hours from the PM shot yesterday. I hope that was the right thing to do. I didn't want to jump back up to his normal dose, since I don't know what the rest of the day/night will look like at the hospital.

Thanks for helping us through this tough time.

Patti + Jett

 

I just logged on. I'm sorry no one responded to your post this morning. You're probably at the hospital by now. I hope things are going as well as can be expected.

Based on the info on your spreadsheet, I think this is the timeline for the last few shots (rounded to the nearest quarter hour):

(1:15 pm) 08/16 -- 210 @ PM +15 shot 1u
(1:52 am) 08/17 -- 545 @ +12.5 shot 1u
(9:21 am) 08/17 -- 415 @ +9ish shot 1u

Generally speaking, you don't want to shoot any more frequently than every 12 hours. Although, given the reduced dose and the high number this morning I probably would have made the same choice. However, keep in mind that one usually doesn't want to shoot any more frequently than every 12 hours.

Since there are so many unknowns as to what will happen at the hospital and when you'll be able to return home... erring on the side of caution is always a good idea when it comes to dosing. Making sure Jett always has food available is something else that will help on the off-chance his numbers drop. Testing for ketones as often as you can is another good idea since you'll most likely have to run him in higher numbers than usual.

Last, but not least... try to take care of yourself, too. The pressure, the emotions, the physical toll... I have a good idea of how hard it is. There might be times where you might even have to skip a shot for no other reason than needing sleep. There's no right or wrong answers here. Do what you have to do... what works best with all you're dealing with.

 

{{{Patti}}}

I'm so sorry your DH has been hospitalized. I know you are under so much stress. You have lots of people here pulling for him, and for you and Jett. Jill has given you some great advice. Just do what you can, and don't forget to take care of YOU! You'll be no good to either your DH or Jett if you get sick or collapse with exhaustion. I wish I was closer so I could help.

I'm sending lots of healing vines and prayers for your DH, scritches for Jett, and s for you.

 

Thank you for all your support and kind words! I really appreciate it! Since I cannot give Jett's insulin shots within a consistent 12 hour pattern, should I continue with 1.0 units to be safe?

Thanks!
Patti + Jett

 

I think I would keep it at 1 unit for now. Do you have any sense of how long you will be unable to shoot consistently? Is there any chance of getting a vet tech from your vet's office to come shoot when you can't (maybe you shoot in am and they shoot in pm?). I am concerned about Jett's high numbers and the potential for DKA, but I know you are doing the best you can.

Have you thought about posting something on the Main Forum (Health) and asking if there is any member in your area that could come and shoot for you? I know we have a lot of members in TX, but it's a big state, so I don't know if any are close enough that it would be practical.

What does the "F" on the SS mean? Food?

 

Thank you!!! I will post on the Main Forum. Great idea! The "F" stands for fluoxetine. I have inserted a few comments on the dose, but I learned recently that if you are on an iPad, you will not see the comments inserted into a cell. I am worried about what this is doing to Jett

 

Good luck ! I sure hope you find someone! If I was a bit closer, I'd do it myself.

 

Yikes! 139.........Assume no shot and will give HC food.

 

First thing I would do is retest. Did you feed after that test? Make sure it's accurate. You haven't shot since 9:21 this morning, correct?

 

Correct. I am re-testing now. I gave him some Ziwipeak dry and wet food.

 

Re-test = 172

 

Are you headed to bed soon? If you can stay up a couple of hours, or can set an alarm and get up at +3, you might want to give him the 1 unit.

Next question: When would you be shooting in the morning?

 

Thank you, Tricia. I am dead tired but will try to stay up to give him 1.0 unit if he's above 200. Is that right? Should I give him a shot even if he is below 200? I would need to give him the AM shot around 7:30am because my husband is having surgery tomorrow. That translates to an AM shot in 6.5 hours from now, which I assume will not work! It's good that you asked me this question. I am thinking that I don't shoot until the AM?

 

Yes, I would go to bed and get some good rest (as much as you can, considering), and shoot 1 unit in the morning.

Are you able to test Jett for ketones?

I'll be praying for your DH.

 

I think I'd just skip it tonight since you can't shoot again that early in the morning and you'll want to be with your husband as long as you need to be tomorrow

If you skip now, you'd be able to shoot at 7:30

Prayers for you and your DH!

 

Thank you for the much needed prayers! I have the ketone strips ready. I hope he pees soon!

 

Hi, So sorry about your DH. Sending lots of vines to you both. I found a vet tech who does pet sitting so could come and test/feed/shoot twice a day by calling the various vets in town and asking if they could recommend someone. I also had success that way years ago when I had a CRF kitty on fluids twice a day. I know you don't have time to call everywhere, but thought I would suggest that.
Big hugs and vines to you....

 

Sending prayers for your DH's surgery.

 

Sending prayers for you and DH. Positive energy that the surgery goes well.

 

Good morning - do I shoot 1.0 unit this morning or go back to his normal dose? I have no idea what time I will be back home tonight.

Thanks
Patti

 

Jett may be bouncing from the blue numbers last night which is fairly normal. I would advise just giving the 1.0 unit and retest whenever you are able.


Sending lot of prayer and for you and DH that the surgery goes well.


ETA Sorry I did not see what your AMPS number was I was looking at yesterday's numbers. Could you post the PS number. ALSO HOW LONG AGO was the last shot? These are important to answer before giving the shot

 

My AMPS # was "hi" this morning. Last shot was yesterday morning at 9:21am on 8/17.

 

Since you won't be home to monitor, I would shoot the 1.0 unit. Sending prayers.

 

Hello - I am home in time tonight to give the 12 hour PM shot after a "hi" reading this morning. SS is updated. However, I don't think I will be home in the AM at the 12 hour window to give a shot, so I'm wondering if I give 1.0 unit this evening?

BTW my husband's surgery went well today. Thanks for the thoughts and prayers!!

Patti + Jett

 

Patti

So glad to hear the surgery went well!

At this point I would suggest giving the 1.0 unit. Jett is still high but there is no way to know if he dropped lower during the day and I am sure you want to get some rest tonight. If you can't do the AM shot in the usual 12 hour time, you can always shoot anytime after the 12 hours if you think you will be able to work with the time schedule.

 

Thank you so much! I want to be at the hospital when the surgeon makes his rounds, so my plan is to get up super early and then leave the hospital after I see the doc and come home to give Jett his AM shot. It is good to know that I can give him the shot any time after the 12 hours, so I can get back on track tomorrow evening. Maybe it turns out to be 10am and 10pm.

You've helped me so much this week - I am so very grateful!

Patti + Jett

 

You can shoot any time after the 12 hour mark. It may mess up your time schedule but you can work on slowly getting it back to a better time, once things have settled down.

Sending more prayers and healing energy for your DH and lots of for you.

 

I'm glad your DH's surgery went well. Sending more prayers.

 

A BIG THANKS to everyone that helped me this week! I am still giving Jett 1.0 unit, even though I have been a little more consistent with his shots over the last few days. Should I stick with the 1.0 units, even though his #s are really high?

Thanks,
Patti

 

Hi Patti.

I'm so glad your DH's surgery went well. I hope he is on the road to recovery with no detours.

Are you going to be able to continue to shoot consistently, and will you be able to do a couple of mid-cycle spot checks? If the answer is yes, I'd go back to the last good dose (1.75). If the answer is no, we'll have to see what would be best.

 

Thank you, Tricia. I don't think I will be able to do mid-cycle tests, since I'm at the hospital all day (at least for this weekend). Should I stay with the 1.0 unit since I can't monitor him during the day?

Thanks,
Patti

 

Patti with not being able to do mid cycle tests, it would be easiest to leave him on the 1.0 unit. He probably needs more insulin, but it is a good idea to be able to do several tests during the cycle when you increase the dose.

 

You got that right!

 

Wet food only, I think. My experience is that the dry food has too long an effect - like a full day to day and a half.
Glad to hear your hubby's surgery went well. What a lot you have to deal with. Whew. Hugs.

 

I think it's safer to stick with the 1.0 until you can start getting a mid-cycle test it two. Better too high for a day than too low for a minute.

I hope your DH is recovering well.