? Which sticky logic to use? Are skip and low the same?

Discussion in 'Lantus / Levemir / Biosimilars' started by apple, May 5, 2017.

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  1. apple

    apple Member

    Joined:
    Apr 15, 2017
    Pulled from the sticky:

    Question?

    What is the thought process behind miss a dose vs giving too low a dose on purpose?

    Im thinking based on the stickies, if you skip a dose, you resume at the regular dose the next scheduled time. If you reduce on purpose you give the regular dose at the next scheduled time. Please see example below.

    In this instance Id put reduced and skipped in the exact same thought process and give full dose at next scheduled time?
    Thoughts?


    OR

    If you miss a dose do you start over at 1u? If you miss a dose do you start at 1u and move up the scale at .25 u until you are back at regular doses?

    I'm thinking about when my mom watches him she might dose low to avoid a hypo and. keep his numbers up, IF she can give him his dose at all or she may skip dose.

    It would be 1 dose this applies to. If a shot is skipped, do you start all over? If a shot is reduced in units, do you start all over? I'm not talking about reduced units to hone in on a fine tuned dose.

    Below from sticky:
    If the preshot number is far below usual preshot numbers:
    • Do you need to stay on schedule? Then skip the shot.
    Starting Dose:
    • 1u BID if kitty is not on a wet/canned low carb diet

    It would be one dose and in a rural area. The regular vet has an answering machine checked at points throughout the night. No 24hr services and no time frame when the vet may call.

    Thanks
     
  2. apple

    apple Member

    Joined:
    Apr 15, 2017
    Could I draw up a syringe and leave it in the fridge for her?
     
  3. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    If you miss a dose, the next dose you would shoot the same units of insulin that you were currently shooting as long as the next Pre shot number was a number you could safely shoot.

    Is you mom going to be testing to make kitty is safe before she shoots? If not, I would reduce the dose to what we call a vacation dose so that while you are away, he is safe. How long will you be gone and when do you leave?

    It is not advised to preload syringes as the insulin gets contaminated by the lubricants that are used in the syringes to help them glide better. What would be a better idea would be to use some colored water and draw up your dose and let that be her guide.

    Can we get you to start an SS? It is hard to advice with dosing without looking at a SS with your numbers and dose units.
     
  4. apple

    apple Member

    Joined:
    Apr 15, 2017
    My mom won't test. She said no to that.

    It would be one overnight. I'd do the am dose, she would do pm and I'd do next am. The over night with no vet is the worry. Time line two weeks.

    SS is a redo project. Work got the latest docs phishing .
     
  5. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
     
  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I'm not sure I completely understand your question so if my response doesn't make sense, my apologies.

    My kitty was not one who would allow any of my sitters -- all of whom are experienced with handling cats -- test. Ever. They felt lucky to be able to give her a shot -- Gabby was very food motivated which allowed them to give her a shot while she had her food in her bowl. Testing -- well, it was questionable whether they would have had all 4 limbs intact it they tried. As a result, when I travelled, I reduced Gabby's dose so there was a very limited chance that her numbers would drop dangerously low.

    Skipping, as a one time option, is a possibility. We generally discourage skipping if a cat has other medical issues (e.g., a current history of DKA or the presence of ketones, recovering from an infection). Other than specific situations, skipping a shot is no different than if you gave a fur shot. Chalk it up to circumstances and shoot your usual dose at the next shot time.

    Skipping a shot or reducing a dose when your traveling -- in either case, return to your previous dose once you're back. If you go through Gabby's spreadsheet, you'll see the areas in gray where I was traveling. I returned to my usual dose.

    Rather than pre-filling a syringe, it may be helpful for your mom if you make up a "dummy" syringe and use colored water so she can more easily see how much insulin should be in the syringe. You can also take a close-up photo and send it to your mom so she has a comparison. If it were me, I'd have her fill a syringe and shoot at least once where I could monitor the process and offer any suggestions.
     
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