Avoiding Hypos

Successfully treating diabetes while avoiding hypoglycemia is the goal of every living creature suffering from the disease. Though Drs. Fleeman and Rand wrote the article focusing on diabetic dogs, much of the advice applies to all pets with diabetes.

Insulin

When in doubt, DON'T! If there's ever any confusion about whether or not insulin was administered, the injection should be omitted. Missing one shot will not harm your pet, while hypoglycemia can kill.

Partial doses, missed shots, fur shots, etc.

If you have only administered a portion of the insulin injection, do not try giving more. You are not certain actually how much insulin really went where it was meant to. Trying to draw more to make up for the error may result in a total of too much insulin being given--the result being hypoglycemia.

Even if every last drop from the syringe went into the fur and not under the skin, the safest thing to do is to leave it at that, not giving any insulin until the next scheduled dose is due. Missing one shot will not result in permanent damage nor will it mean that your regulated pet will become un-regulated and you will have to begin all over again. It may mean some higher than usual blood glucose values for possibly 2-3 days which can be handled by staying with your usual dosage & insulin schedule.

This is far better than treating a hypo or having the pet wind up at the vets or ER trying to overcome the effects of too much insulin. People with diabetes sometimes have similar mishaps and handle them much like this.

More than one insulin

If you are using more than one insulin to manage your pet's diabetes, you likely have a faster-acting one and a slower-acting one. Mistaking either of them for the other can result in hypoglycemia if the wrong insulin is given.

Keep them in separate places in the refrigerator, put large labels on each one "slow-acting" and "fast-acting", any helps of this nature can avoid this sort of accident. Before drawing an injection of either of them, take a minute to read the name and label on that insulin three times before drawing from it to be certain you have chosen the right vial.

Dosing mishaps

Dosing Mishaps, Vomiting, Diarrhea: If you've given too much insulin, given insulin to the wrong pet, had a vomiting or serious diarrhea episode, you will likely need to do what's called "feeding the insulin". This means getting additional food and possibly a dose of syrup into the animal to try to ward off a hypo event. What you are trying to do is to get the food or sugar into the pet before the insulin which the body does not have enough food in it to cover peaks; this is when the chances for an acute hypoglycemia event are the greatest. A look at the Vetsulin page "Feeding Schedule" can further illustrate this. Those using once-daily shots are instructed to feed the second meal of the day (no insulin given) at 6-8 hours after morning meal when insulin was given. This second meal is scheduled to take place around the approximate time the insulin is working hardest, or peaking. This meal is fed so there will be enough food to match the peak action of the insulin and is meant to prevent the animal going into hypoglycemia. As in the example on the wiki Talk page, it's necessary to contact your vet the moment you realize there may be a problem and follow his/her advice with regard to treatment. The sooner corrective action is taken, the easier it is to either avoid or manage a serious problem. The dog in the example did not need to go to ER because his caregiver took proper action when she realized something was wrong.

Further Reading

• Beyond Insulin Therapy: Achieving Optimal Control in Diabetic Dogs Drs. Fleeman & Rand-U-Queensland 2005