? 02/18 urgent - acc gave insulin more than needed

preshot am bg (9:45am): 234mg/dL - gave high calorie meals (feline natural freeze dried raw with gluco powder sprinkled on it) immediately

10:17am (@+0.5) 236mg/dL - did not give any food in this time

10:36am (@+0.8) 229 - gave Temptations

11:02am (@+1) 216 - (12.0) - did not give any food in this time

11:48am (@+2) 176.4 - gave water mixed with gluco powder and treats, Temptations


I usually draw insulin(lantus) up to 3-5u and adjust up to 1.5u. For the record I have severe adhd, I take medication for it but my brain is still clumsy with little details. I was in a rush & overstimulated this morning before work I skipped the “adjusting” step and injected insulin. Fortunately, I stopped in the middle of injection and did not completely inject all of it (gave half of what’s in the syringe). It just felt weird that I pushed the syringe pump expecting to stop pushing at 1-2 seconds but it just kept going. I don’t know how much I gave but at least > 2.5 units. her prescription dose is 1.5u. I've been giving insulin for almost 2 years and I have never done this..I feel horrible.

I told my supervisor I cannot go to work today obviously, cancelled all my plans & have been monitoring her bg this this morning. Miho's situation is a bit tricky because she is on chemo atm due to ibd/small cell lymphoma, and her stomach gets very angry when I give sugar (or honey, syrup etc) she almost always has severe diarrhoea to the point she leaks everywhere. For some reason sugar does not raise her bg as well as cornstarch (glucopowder), so right now im giving gluco powder mixed with treats. If her bg drops severely i will give her corn syrup.

I really would like to resolve this issue without having to take her to the emergency. Any guidance or advice would be appreciated, thank you. I will be updating her bg soon.

 

Hi Sophia,
We are here to help you. I’m glad you posted.
I’m a bit confused as to are up to at the moment. Is the SS up to date?
I’m assuming you are in the am cycle as you said you did not go to work. But I can see in the PMPS column you have 2.5 U given and 4 Bg numbers.
Can you tell me which cycle you gave the extra insulin in and how far along the cycle you are…thanks.

 

hello!

sorry. I was panicking I acc put the numbers in PMPS. I fixed it now

 

So how long after the insulin are you now?

 

12:23PM (@+2.6) 167.4 mg/dL (9.3 mmol/dL)

 

I gave insulin at 9:45am, so about 2.5 hrs. i've updated her numbers just now

 

Have you done any BG tests since you gave the insulin? I can’t see any on the SS

 

Sophia are you still there?

 

@+3
133.2 (7.4mmol)

i'm giving her water mixed with gluco powder, a little bit of energy gel (vetsense) and high calorie treats. please let me know if i absolutely need to give her corn syrup

 

yes i was just giving her gluco powder and nausea medication. i am updating her numbers here first and then SS. Can you see the numbers now?

 

It looks as if you are putting all the BG tests into the preshot column instead of the +1 +2 +3 etc column.
I’m going to ask @Bandit's Mom if she can help you with the SS. She may not be around for an hour.

Do you have some normal low carb food or some medium carb food (around 12 % carbs) that you can feed.
I would feed her those at the moment. There is no need to feed corn syrup at the moment.
Giving her some normal food may help keep the BG from dropping too fast.
Test again at +4 and post the result please

 

it's okay, I understand what you are saying about the spreadsheet without further guidance, thank you for telling me. I will fix it now.
I have fancy feast but she doesn't eat by-product wet meat from commerial brands.. I sprinkled glucose powder on her regular meal to add carb plus high carb treats (greenies and temptations) and glucose water. will update at +4

 

@+4
126

she's eating fancy feast + gluco water!

 

She has not dropped much from +3 to +4 so that is good. Test again at +5

 

she was also hiding when i went to measure her bg, she does that when she's not feeling so good - and her pupil was slightly dilated but she was willing to come out and eat everything i gave her which is good

 

+5
142

her bg finally went up from 126 to 142! do you think it means her bg hit nadir, now it's going back up? should i keep monitoring?

 

Possibly. It could also have gone up with some of the food you fed if it contained glucose or other high carb ingredients.
Either was, it is good she has gone up a bit. I would still continue to monitor for another couple of hours to be sure.

Also I am concerned you are rarely getting in any tests in during any of the cycles and none during the pm cycles.
Lantus dosing is based on how low the dose takes Miho, not the preshot BG.
Are you able to get any tests in during the cycles?
A before bed test is a good habit to get into.
Also you don't seem to have a dosing method
Have a look at these TWO DOSING METHODS
If you are feeding any dry food at all you will have to do the SLGS method.
The TR method requires you to test at least before every dose and at least once every cycle.
I would really recommend you look at the dosing methods as they are a proven way to make progress.

 

+7
124

she's dropped from 142 to 124. you're right it was a momentary rise. I gave her gluco water and greenies.. do you think I should skip insulin tonight?

I've read the link you posted but I'm not sure what dosing method fits Miho's situation. Internal medicine vet advised to do a full blood glucose curve at home after switching her diet (she's on raw/freeze-dried raw atm) to low(er) protein and low phosphorus food. She also advised 10% reduction when feeding her as she is a little stout now. Usually low protein/phos are very high in carbs. next week I will give her wet food (+ homecooked prescription diet from the vet nutritionist) first to try, and if she doesn't eat it then give dry prescription diet from royal canin/hills. Not sure how this will impact her numbers. Before bed time test sounds good I will do that.

 

+8
124

Bg hasn't changed but she was hiding again under the bedside table until she saw me she's eating a bit & seems okay but pupil is still a bit dilated. I hope her numbers are stabilised soon, i really don't want to keep giving her starch water given her sensitive tummy issues

 

+9.5
158

her evening insulin time is in 2 hours, i'm not sure if i should give insulin tonight.. if the numbers aren't not too high i might skip.

 

Let’s see what the presbot BG is before deciding.

 

Are you just giving her normal food now….also don’t feed for the 2 hours preshot.

 

yes I stopped giving her high carb treats/carb water at +8.

 

I notice in your remarks column you said you only feed her twice a day?
Cats often do better with a couple of small snacks during all the cycles. You could get an automatic timed feeder to give the snacks.

 

twice a day was my plan (she needs to come down to 4.5 - 4.8kg, she's 5.4kg now) but yeah that wasn't happening. she's fed 3-4 times a day in small meals.

her PMPS is 216, similar to the pre-shot morning numbers. She did eat a bit of normal food in the last 2 hours, so her real bg might be slightly lower. IDK whether to skip or not :s? i feel like her bg is going to skyrocket tomorrow w/o evening dose since she consumed a lot of carb today

 

I’m glad you are feeding her more than twice a day. It is better for the pancreas.
I would At least give her some insulin even if you don’t give the full dose. Are you planning on getting a few tests in tonight?
If you have extra insulin this morning the depot could be a bit fuller so could influence the first half of this coming cycle

 

yes I am. I will give 0.5u tonight, and test few more times before bed

 

Ok. Let us know how you go tomorrow. Well done today keeping her safe.

 

all thanks to you! thank you for your guidance saving my fur baby, I appreciate it a lot. xx

 

Very happy to help anytime.
I’m so glad she is ok