? Missed Dose

Daphne'sChallenge

Member Since 2023
This morning I tested my cat (149), fed her and then forgot to shoot her. When I remembered, it was +4.5 hours and I gave the shot. She typically eats now, and I just checked her, and found she was at 45! I've given her a couple of tablespoons of a higher carb Fancy Feast grilled chicken in gravy. I imagine I should check her in an hour and see where she is then. I'm very confused about when to feed her her normal low carb second meal of the day.
Also, should I check her at +12 after the late shot (11:00 PM) and feed her then and shoot if she is above ??? what number?
 
A reduction to .75 has been earned going forward. That’s a very low number for the AT. Did you recheck in case it was a bad strip? Since you won’t he able to shoot more than a half hour early every 24 hours I would skip the dose tonight and shoot .75 in the morning. It will be a good opportunity to change the shot time if you want. When you get a BG under 68 you need to feed some hc like you did and recheck in 30 minutes. Then if still green feed and recheck again every 20-30 until over 68 and staying there without hc or mc food. The BG can fall again after eating. Even with the depot in play she was getting too much insulin. I’ll link the sticky on handling low numbers for you.
 
Are you able to test at +2-4? Waiting until +5 is not allowing time to prevent a drop under 90 which is the reduction BG and definitely not to prevent a BG under 68. If the +2-3 is showing a drop you would want to give some mc.
 
Oh and please remove the 911. Change that to a question mark. We save the 911 for a hypo emergency and thankfully Daphne is ok.
 
Thanks for your help. I've tried to change the 911 but cannot.
She jumped up to 105 just 15 min. after a Tbl. of the high carb. No I did not think to test again after the low reading. I'm still learning. Are you suggesting that I start routinely testing her at +2 - 4? Many days I'm able to do that as I am retired.

So I will skip her second dose today, and go for .75 tomorrow AM. I'm also going to continue checking her over the next couple of hours, since I hope to give her her low carb second meal of the day.
 
Sounds good. The test between +2-4 will help figure out when she onsets, the lantus kicks in. At onset if the bg is lower than the preshot it might be an active cycle like today. You can then feed to prevent a drop under 68. If that test is a lot higher, the cycle will likely not be an active one and more tests will not be needed. I know with SLGS tests other than the preshots and the 7 day curve are all required but tests are night when many cats go low will help fill in the other half of the picture. These extra tests will also help figure out patterns.
 
So I will skip her second dose today,
Hi Karen
Can you please put in the U cell NS meaning no shot
Good luck with the reduction tomorrow morning :cat:
@Daphne'sChallenge

If I were you I would start posting on the Lantus Forum everyday, there are more eyes on the Lantus Board
Posting on the Lantus in your Title you would put
Date Daphine AMPS # and and other tests after that, and you can continue with the PMPS in your title and tests after that.
To add the additional tests. Look to the right ,tap on Thread Tools, then tap on Edit Title ,add your tests then tap Save
We also like link our previous days posts to our new post in case anyone needs to go back and read something

Previous post
https://felinediabetes.com/FDMB/threads/3-25-24-daphne-amps-387-7-62-8-109-dose.288092/#post-3164896
 
Last edited:
Diane,
You are so kind to reach out to me. I'm feeling overwhelmed by this whole thing. I cannot stand doing all these ear pricks. I am hoping that I can get by with as few as possible and get Daphne on a dose that works for her. I am feeling like this is just way more than we bargained for.

Maybe tomorrow morning I'll feel like I can tackle this, but I'm all in tonight. Thank you for reaching out.
 
@Daphne'sChallenge

Hi Karen, yes it is a little overwhelming in the beginning, believe me it will get easier.
I know you don't like doing more ear pricks, but it's the only way to keep Daphne safe and you don't want to miss a reduction .
Is she ok with the ear pricks?
Her numbers are looking good though.
I see you have her FF grilled chicken in gravy 12% carbs

If you ever need higher carbs than that
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

I see on one of your posts a suggested an auto feeder

Here are some suggestions
You can order an auto feeder to set to open at certain times for your kitty to eat if you are out of the house for awhile
They have them for wet food

some info on auto feeders always add a little water to the wet food
Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28?tag=felinediabetesfdmb-20

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1

You can even order the stainless steel inserts for the 5 slot if you don't like your kitty eating out of plastic, from what I have heard plastic could cause acne on some cats
https://www.amazon.com/Cat-Mate-Sta...36-830d-6cc20f385409&pd_rd_i=B0B3MS1MWR&psc=1
 
Last edited:
Thanks for the food pointers. When I went to the grocery, the only thing I could find that was higher than the pates were a couple of kinds "in gravy." I'll have to visit Chewy and shop.

It takes 2 of us to get a blood prick because Dash now runs and hides when she sees us coming. We have to catch her off-guard, then my husband holds her while I do the rest. Thank goodness she's a docile girl, so there's no biting, hissing, or scratching. I wonder if I'm supposed to hold the lancet a certain way because with a magnifying glass I can see that the tip is curved. So many questions.

I didn't buy the feeder yet because we are home a lot, and I haven't figured out how to time those extra meals. I would really appreciate advice on that. We've noticed that she comes back to her bowl around 3 hours after the 6:30 AM feeding, so maybe that's a time to have one drop. How do people time these meals?

We sprung for the special sand so I could test ketones and we put the new box beside her old one, but so far, she hasn't used it. I guess we'll put away her regular litter box so I can force her to use the other one.

So. I'm not feeling very successful with this. It does, however, look like taking her off her supplemental dry food is having a big impact on her numbers, and I'm grateful for a sense of certainty around that.
 
I wonder if I'm supposed to hold the lancet a certain way because with a magnifying glass I can see that the tip is curved.
I'm glad you asked that
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with :cat:
You know how the lancets gave those little squares or holes on each side , On mine one side the holes are smaller and that is the side it is curved upwards ,so I don't even have to hold the lancet under a light to see it . I just look at the smaller holes and I know that's the side I will poke with
 
Last edited:
It takes 2 of us to get a blood prick because Dash now runs and hides when she sees us coming. We have to catch her off-guard, then my husband holds her while I do the rest. Thank goodness she's a docile girl, so there's no biting, hissing, or scratching.

Maybe try giving her a small treat first so she won't run and hide, she will associate getting a treat so you can test her , you can give her one also after you test her
Click on this link and look at post #6. Numbers are to the right
You can get any freeze dried treats ,information is there
https://www.felinediabetes.com/FDMB/threads/brand-new-many-questions-3.255627/#post-2878703

Freeze dried treats that only contain one ingredient (themeat or fish) is zero carb and fine to feed to a diabetic :D
 
I didn't buy the feeder yet because we are home a lot, and I haven't figured out how to time those extra meals. I would really appreciate advice on that. We've noticed that she comes back to her bowl around 3 hours after the 6:30 AM feeding, so maybe that's a time to have one drop. How do people time these meals?

Most of us feed the larger meal at AMPS , you can feed her a few teaspoons of her low carb wet food @+3 and @+5
Same goes for the PM cycle
Some feed @+2, and @+4


Just remember
Anytime you get a BG below 90 when you are following SLGS you need to reduce the dose by 0.25 U

From the Lantus /Glargine about SLGS

Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
 
Last edited:
Karen on 4-2 when you got that 71 @+5 during the day cycle you should have reduced her dose that night PMPS :cat:
So anytime you get a BG below 90 when you are following SLGS you need to reduce the dose by 0.25 U
 
Thanks for the food pointers. When I went to the grocery, the only thing I could find that was higher than the pates were a couple of kinds "in gravy." I'll have to visit Chewy and shop.

It takes 2 of us to get a blood prick because Dash now runs and hides when she sees us coming. We have to catch her off-guard, then my husband holds her while I do the rest. Thank goodness she's a docile girl, so there's no biting, hissing, or scratching. I wonder if I'm supposed to hold the lancet a certain way because with a magnifying glass I can see that the tip is curved. So many questions.

I didn't buy the feeder yet because we are home a lot, and I haven't figured out how to time those extra meals. I would really appreciate advice on that. We've noticed that she comes back to her bowl around 3 hours after the 6:30 AM feeding, so maybe that's a time to have one drop. How do people time these meals?

We sprung for the special sand so I could test ketones and we put the new box beside her old one, but so far, she hasn't used it. I guess we'll put away her regular litter box so I can force her to use the other one.

So. I'm not feeling very successful with this. It does, however, look like taking her off her supplemental dry food is having a big impact on her numbers, and I'm grateful for a sense of certainty around that.
This is a bit long, so read as you're able, I know it's a lot to digest and super stressful at the beginning.

When I first started with Kit, it took me probably a month or longer to get her to settle down even a little for testing - and there were so many tears (from me) and since she's got tortitude in spades, lots of hissing and growling and swatting from her. And it's so stressful, I get that. The more you do it, the more you both get used to it (hopefully). You DH being able to help is amazing - Kit was first diagnosed in 2019 (remission mid 2020), and came out of remission a year ago, and my BF only just in the last month was okay with learning to shoot. He doesn't want to test at all because he's scared he'll hurt her (or vice versa). Her being docile for it, even while not wanting you to do it is such a good thing!

And they pick up on our emotions (which I know are hard to temper in a stressful situation). I talk to her in a soft voice (and now that it's been so long, sometimes a ridiculous silly voice), and sing made up songs to her (which is also not just a shot time thing anymore - I think they're hilarious, she tolerates them begrudgingly).

One thing I remember doing is gently rubbing her ears and touching them at times I wasn't testing her. And treats at shot time can also be a big help if they're treat motivated.

As far as food - there are some basics as Diane mentioned, but every cat is different on when they have their onset and when they nadir. And depending on how in depth you end up getting into it will also affect that. Kit is on TR, because testing her is one thing that I have control over in a somewhat crazy and what feels like slightly out of control life. But also, her food is something that I can control. Because I have the data I have, I know that she likes to do a big ol' drop at +2. So, I've been experimenting since last fall with ways to counteract that drop (big drops can cause bounces, and she likes to get a in a drop/bounce cycle that takes forever to clear). Her schedule is to be fed 2-3% at shot time, 7% at +1, 9% at +1.5, and then whatever I think she needs at +2, +3, +4. Sometimes she doesn't eat past +3, sometimes she'll still have food up to +6. But it all depends on what numbers I see. I also leave her food dishes out until I've decided the time for food has ended. So she'll get food at shot time, probably won't eat it all, but I leave it out so she can come back and graze, because I know she's more of a grazer. But those things will all be reflective of what you notice in your cat. And writing it all down helps so much (my memory is not the most stellar).

I also don't use a feeder (own one, haven't used it). Kit's not super motivated to run to the feeder to eat, so I just haven't done so yet. If you've noticed that she's running to eat at +3, maybe try to get a test then to see what her numbers are like. And if she's dropped lower, maybe feeding at +2.5 is a way to smooth the drop some.

I know it's so stressful right now, but even just being here is means you're doing so great! And it does get easier. As you get more accustomed to the basics, try other things. Even testing some is more than a lot of diabetic cat owners do. :bighug::bighug::bighug:
 
Karen on 4-2 when you got that 71 @+5 during the day cycle you should have reduced her dose that night PMPS :cat:
So anytime you get a BG below 90 when you are following SLGS you need to reduce the dose by 0.25 U


Thank you so much.
This is a bit long, so read as you're able, I know it's a lot to digest and super stressful at the beginning.

When I first started with Kit, it took me probably a month or longer to get her to settle down even a little for testing - and there were so many tears (from me) and since she's got tortitude in spades, lots of hissing and growling and swatting from her. And it's so stressful, I get that. The more you do it, the more you both get used to it (hopefully). You DH being able to help is amazing - Kit was first diagnosed in 2019 (remission mid 2020), and came out of remission a year ago, and my BF only just in the last month was okay with learning to shoot. He doesn't want to test at all because he's scared he'll hurt her (or vice versa). Her being docile for it, even while not wanting you to do it is such a good thing!

And they pick up on our emotions (which I know are hard to temper in a stressful situation). I talk to her in a soft voice (and now that it's been so long, sometimes a ridiculous silly voice), and sing made up songs to her (which is also not just a shot time thing anymore - I think they're hilarious, she tolerates them begrudgingly).

One thing I remember doing is gently rubbing her ears and touching them at times I wasn't testing her. And treats at shot time can also be a big help if they're treat motivated.

As far as food - there are some basics as Diane mentioned, but every cat is different on when they have their onset and when they nadir. And depending on how in depth you end up getting into it will also affect that. Kit is on TR, because testing her is one thing that I have control over in a somewhat crazy and what feels like slightly out of control life. But also, her food is something that I can control. Because I have the data I have, I know that she likes to do a big ol' drop at +2. So, I've been experimenting since last fall with ways to counteract that drop (big drops can cause bounces, and she likes to get a in a drop/bounce cycle that takes forever to clear). Her schedule is to be fed 2-3% at shot time, 7% at +1, 9% at +1.5, and then whatever I think she needs at +2, +3, +4. Sometimes she doesn't eat past +3, sometimes she'll still have food up to +6. But it all depends on what numbers I see. I also leave her food dishes out until I've decided the time for food has ended. So she'll get food at shot time, probably won't eat it all, but I leave it out so she can come back and graze, because I know she's more of a grazer. But those things will all be reflective of what you notice in your cat. And writing it all down helps so much (my memory is not the most stellar).

I also don't use a feeder (own one, haven't used it). Kit's not super motivated to run to the feeder to eat, so I just haven't done so yet. If you've noticed that she's running to eat at +3, maybe try to get a test then to see what her numbers are like. And if she's dropped lower, maybe feeding at +2.5 is a way to smooth the drop some.

I know it's so stressful right now, but even just being here is means you're doing so great! And it does get easier. As you get more accustomed to the basics, try other things. Even testing some is more than a lot of diabetic cat owners do. :bighug::bighug::bighug:


This is all so helpful. Daphne is a grazer, and always has been. I, too, leave the AM feeding out because she returns to the bowl off and on during the morning, usually around +2-+3.
 
Thank you so much.



This is all so helpful. Daphne is a grazer, and always has been. I, too, leave the AM feeding out because she returns to the bowl off and on during the morning, usually around +2-+3.
Oops. I switched windows to look at her graph and then couldn't continue to write. So, today Daphne dropped from 229 to 140 in 2 hours. I imagine this is considered a big drop, right? When you say they "bounce," I imagine you mean that the glucose shoots up again? I don't have this vocabulary yet. I will check her in another hour if I'm able. My husband is out.

Despite appearances to the contrary, I am reading the content here but not mastering everything yet. I did buy the freeze-dried Pure Bites, and she's loved the chicken flavor. I've treated her post prick and given these as snacks when she's hungry and I'm trying to keep her feeding at +12 and not sooner.

I'm not clear about feeding her in the afternoon because at +8 and +9 she really wants more food. What are the thoughts on that? Will feeding her then mess up the PMPS reading?
 
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
I had to set up a brand new AlphaTrak3 that they sent me at N/C because I bought my first one as they were phasing out the earlier model and can no longer get test strips. I missed +3 test and am now at +4. She's at 129 so I gave her a couple teas. of food.

When you say to "link this post" to it, am I copying my original post? Not only am I learning to deal with a diabetic cat, I'm learning how to navigate a forum.
 
I had to set up a brand new AlphaTrak3 that they sent me at N/C because I bought my first one as they were phasing out the earlier model and can no longer get test strips. I missed +3 test and am now at +4. She's at 129 so I gave her a couple teas. of food.

When you say to "link this post" to it, am I copying my original post? Not only am I learning to deal with a diabetic cat, I'm learning how to navigate a forum.
Just go to the top of the page , the link you will post is all the way up top above that pic of the cat on the left hand side
//felinediabetes.com/FDMB/threads/missed-dose
Do you see it
Just copy and paste that to your post for today
So when you start a new post every day just copy and paste your previous days post to your new one
@Daphne'sChallenge
 
Back
Top