Stupid Pet Owner Tricks

As regular readers are aware, my LGS, the former Kitten from Hell, has been dealing with some serious medical issues over the last couple of years, the most recent being diabetes. She had been well controlled with twice-daily shots of insulin, although recently her blood sugar numbers have been climbing into the high 200’s to mid-300’s (high-normal for a cat is around 140).

I’ve also got a foster cat with diabetes, on a different insulin that uses a differently graded syringe. Insulin is measured in “units”; one unit is a standardized amount of activity rather than a concentration. Insulin comes in “U40” and “U100”, with the measurements for the U40 being 2.5 times bigger than the measurements for the U100. That makes it important to keep the syringes well marked and separate. Using a U100 syringe with U40 insulin would under-dose, while using a U40 syringe with U100 insulin would over-dose, potentially with fatal consequences.

My excuse is that I was tired Wednesday night, and in a rush to medicate the three cats I have that require medical attention before I called it a night. It was close to midnight when I grabbed the most accessible cat first, which happened to be LGS, got a blood glucose reading on her, and then pulled up 3.5 units of Glargine U100 and administered sub-Q. I set the used syringe down on the counter, fed the cat, and went back to properly dispose of syringe when I saw that it had a red cap. The U100 syringes I use have orange caps. The U40 syringes have red caps. LGS was supposed to have gotten 3.5 units of insulin; I’d just given her slightly less than nine units.

While high blood sugar is not healthy in the long run, low blood sugar can kill quickly. I have an emergency kit for just suck problems; I’d never though I’d need to use it because of my own stupidity. The quickest way to bring an animal’s blood sugar up at home is to administer Karo syrup or some other high-sugar syrup (even maple syrup will do in a pinch). If the animal is alert enough, you can syringe a little into their mouth for them to swallow. If they aren’t alert enough to swallow, you can rub it on their gums or put a little under their tongue and it will be directly absorbed.

Since the sugar acts quickly and lasts a short time, there’s no point in giving it immediately after giving too much insulin – the sugar will have left the cat’s system before the insulin has a chance to start working. I had a long night of cat watching ahead of me. I checked her blood sugar hourly at first, fed her whatever she wanted to eat, and watched for signs of disorientation or incoordination that would indicate her blood sugar was dropping. Her blood sugar dropped from 285 down to 145 in the first three hours. After that I started doing tests every 30 minutes to make sure I didn’t wait too long to administer the sugar solution. Surprisingly, after another hour she hit her lowest reading of 131, and an hour after that her blood sugar was still holding level in the high 130’s. For whatever reason, what should have been an overdose turned out to be nearly exactly the right dose for her. I never had to give her the sugar. At six in the morning, with her blood sugars still holding relatively flat, I went to bed for a few hours sleep before I had to go to work.

While I was lucky, this may not be great news in the long run. Her abnormal reaction to the insulin could represent an increased insulin resistance developing. This could be caused by an illness like hyperthyroidism or pancreatitis (which LGS has a history of). She could also have some sort of infection that isn’t obvious. While we weathered the immediate crisis, LGS and I will have an appointment at her veterinarian’s next week.