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We accidentally gave our pug a double dose of...

Resolved • Response time 2 minutes

20 Feb 2015

We accidentally gave our pug a double dose of insulin. If I stay up with her and give her honey every hour will that keep her safe from insulin shock?
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20 Feb 2015

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Dog Veterinarian's response
20 Feb 2015
Dr. Emily
Dr. Emily
Associate Veterinarian
Dr. Emily :

Hello! My name is***** am here to answer your questions today to the best of my ability. Answers given are for informational purposes only. Do you have a glucometer at home to check blood sugar levels?

<span class="JA_chatAuthorName"Customer: I don't. Dr. Emily :

Ok, that's ok, we can work through this. What type of insulin is she on?

<span class="JA_chatAuthorName"Customer: I am more than a hour away from an emerg vet hospital so I'd really like to keep her safe at home if possible. I'm totally prepared to stay up all night with her!<span class="JA_chatAuthorName"Customer: Caninsulin 4 units every 12 hours with a 1/2 cc syringeDr. Emily :

And also, how long ago was the insulin given

<span class="JA_chatAuthorName"Customer: 1.5 hours ago, approx Dr. Emily :

ok, and so far is she acting ok? Any changes in alertness?

<span class="JA_chatAuthorName"Customer: I've looked up the signs and symptoms of a hypoglycaemic crisis and am watching for them.<span class="JA_chatAuthorName"Customer: Yes she's acting very normal. It's her normal bedtime so I'm constantly talking to her and engaging her to make sure she isn't lethargic without me noticing <span class="JA_chatAuthorName"Customer: Hello?Dr. Emily :

Ok, you're doing a great job. Caninsulin is considered a "lente" insulin which means the effects can last for about 12 hours. The effects start more quickly and then taper off. What I'd like you to do is give the honey or karo syrup more frequently in the beginning here

<span class="JA_chatAuthorName"Customer: Ok great. So how often and how much?Dr. Emily :

Sorry about the delay there. I aplogize.

<span class="JA_chatAuthorName"Customer: No prob. I just don't want time to run out without getting an answer about what to do. :-)Dr. Emily :

oh ok, don't worry -- i'm big on pausing the timer

<span class="JA_chatAuthorName"Customer: Didn't realize that was possible was just watching the clock and was worrying as we've just hit the 10 min mark now Dr. Emily :

interesting. My end says time left in chat 9 minutes but doesn't count down b/c it's paused. This type of insulin generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 18 hours. This being said, for the next 4 hours, it would be best to give the honey or karo syrup every 30 minutes, about a tablespoon at a time. This will give us a buffer so we do not have blood sugars crash

<span class="JA_chatAuthorName"Customer: Ok great. And then after the next 4 hours?Dr. Emily :

Then for the next 8 hours, it would be best to give 1-2 tablespoon every hour. It is better to temporarily have blood sugars be too high than have them go too low.

Dr. Emily :

That will take up to about the end of the effective time zone, plus a bit more. Getting back on the regular food and insulin schedule will be a little tricky in the morning. You can feed breakfast like normal and give a half dose of insulin. Then at dinner do the normal meal and give the whole dose.

<span class="JA_chatAuthorName"Customer: Ok that's super helpful. If by chance she stops wanting to eat the honey should I just try to force feed it?Dr. Emily :

Do you have karo syrup? That can rubbed on her gums as well but it is more tedious

<span class="JA_chatAuthorName"Customer: Ok that's super helpful re: the morning. <span class="JA_chatAuthorName"Customer: No but I'm assuming I could make a high concentration sugar syrup?Dr. Emily :

And you know what signs to watch for just in case of hypoglycemia? If you feel she is showing these signs, you can give more or extra doses of the honey/karo.

Dr. Emily :

Yeah, that would be fine too.

<span class="JA_chatAuthorName"Customer: And I don't mind tedious if it will keep her safe!<span class="JA_chatAuthorName"Customer: Ok excellent. Thank you so much for your help!!!Dr. Emily :

Also, keep in mind that she probably isn't use to staying up all night so if she's tired, that can be normal too -- not to point out the obvious

<span class="JA_chatAuthorName"Customer: Yes that's what I'm worried about - discerning the difference between sleepy and lethargic. Are there any tell-tale signs that would help me figure that out? Is it ok to let her sleep at all?Dr. Emily :

Now, I won't be up all night but sometimes my puppy needs to go out during the night so if that happens, I'll sign on and check on you if you've posted anything.

<span class="JA_chatAuthorName"Customer: Ok thank you very much. If there are a any last thoughts you have about telling the difference between normal sleepiness and lethargy that would be awesome. Dr. Emily :

The typical signs are listlessness, depression, staggering gait, muscular weakness, and tremors-especially of the face. Stress can also make it worse so keep her calm. The signs can be difficult if she's sleepy, but you can definitely let her rest. When you wake her, have her get up and walk around so you can track her movement, be sure she isn't staggering, swaying in the back end, trembling as she's walking. Have her look at you (or a treat) and make sure she looks physically bright and alert and will track the movement of the treat or you

<span class="JA_chatAuthorName"Customer: Great - that's immensely helpful. Thanks so much. I feel hopeful that I can get her through this without anything bad happening (save me losing a night of sleep!). Dr. Emily :

Maybe you should have some honey too

Dr. Emily :

After your chat is over, it will be switched to Q&A form so you can post after as well.

Dr. Emily :

I do appreciate feedback so if you have a chance to rate our conversation, I would appreciate it.

20 Feb 2015
Dog Veterinarian's response
20 Feb 2015
Dr. Emily
Dr. Emily
Associate Veterinarian
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
20 Feb 2015
Dog Veterinarian's response
20 Feb 2015
Dr. Emily
Dr. Emily
Associate Veterinarian
This is the format where we can continue to converse. Wanted to be sure you saw it. I'll be on for the next hour or so if you have any last minutes questions you thought of after the chat room ended. Let me know ok?
20 Feb 2015
Dog Veterinarian's response
20 Feb 2015
Dr. Emily
Dr. Emily
Associate Veterinarian
Just checking in. My puppy needed out as expected. Hope things are going well.
20 Feb 2015
Customer reply
21 Feb 2015
She made it through the night and is doing well! Thank you so much for your advice - it made all the difference!
21 Feb 2015
Dog Veterinarian's response
22 Feb 2015
Dr. Emily
Dr. Emily
Hi, I'm just following up with you to see how everything is going and see if I can assist further. Let me know, Dr. Emily
Dr. Emily
Dr. Emily
Associate Veterinarian
Avg. question only CA$30
Associate veterinarian at a small animal clinic
22 Feb 2015
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