2 missed doses

Discussion in 'Lantus / Levemir / Biosimilars' started by Kshoopla, Mar 31, 2024.

  1. Kshoopla

    Kshoopla New Member

    Joined:
    Nov 17, 2023
    Hi, hope I’m posting in the right spot. My cat gets .5 units of Lantus Glargine at 11am and 11pm. Yesterday after his morning shot, we had a family emergency that took us out of town for the night, and I only expected to miss his night dose. Unfortunately we didn’t get home until 2pm today. I gave him food and his .5 units. I should have tested him first, but I was eager to dose before he got sick. He was not lethargic, but I didn’t want him to end up sick by nighttime. My question is if I should wait until 11am for his next dose, or test him tonight and give a shot at around midnight or 1am? And if so, a full dose or less? I found info about missing one shot, which I know is ok once in a while, but not 2. And of course I couldn’t ask my vet today. Thank you!
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    With Lantus, you want to dose as close to 12 hours apart as you can. You can move shot times 1/2 hour once per day or 15 minutes per shot to get back on time.

    Are you home testing his ketones? Might be best to get a recent ketones test with the skipped doses and his history.

    Always test before you shoot, you need to make sure it's safe to shoot and it only takes a couple minutes to do. I see you haven't been testing him very much, much less before every shot. You can test him now, and again before you shoot later tonight, or rather in the wee hours tomorrow morning.
     
  3. Kshoopla

    Kshoopla New Member

    Joined:
    Nov 17, 2023
    Thank you! I guess I stopped testing as much because he takes so little insulin, and he’s needed it every time except for once when he was under 200. I will get back on it!
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Glad to hear you will step up the testing. We've seen cats go hypo on even smaller doses. :eek:
     
  5. Kshoopla

    Kshoopla New Member

    Joined:
    Nov 17, 2023
    Oh wow ok!!!
     
  6. Kshoopla

    Kshoopla New Member

    Joined:
    Nov 17, 2023
    @Wendy&Neko Hi, there, can I ask you a quick question to follow up on this message thread? I got back on track after missing two doses of Stan's insulin, so we're back to our normal times. I will be able to complete a 12-hr glucose curve on Saturday to analyze his current .5u dosage. Until then, I'm concerned that Stan's number at +7 hrs today is already at 422. Would you recommend that I go ahead and increase his dose to .75u and hold it for a week, or wait until I complete a full glucose curve? Thank you so much again.
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    That 422 tells me one of two things. Either he went lower last night and is bouncing. Or his dose is too low. I'm afraid that without any PM data, we can's say which is true. Many cats go lower at night. Would it be possible for you to get at least a test before you go to bed at night, if it's at least 2 hours after the shot? And you do need to try to get into the practice of testing before you give insulin, both AM and PM. There just isn't enough data for me to say if the dose is too much or too little.
     
  8. Kshoopla

    Kshoopla New Member

    Joined:
    Nov 17, 2023
    Thanks, I’m definitely going to start recording more info. We did just test before his 11pm shot and it was 394, so we gave him his regular dose. Last night at 11pm he was 410. I’ll get that curve done asap! Thanks!
     

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