When she has a fever over 100 I double her cortef. If there is a vomiting episode I double her cortef...but on this board I see that some administer the IM SoluCortef immediately upon vomiting. I never did. I did kinda watch her...if she was having recurrent vomiting or related diarrhea, I did give her the IM. But knock on wood, it hasn't been in the past 2 years. We usually ended up meeting our very cautious endo in the ER after a bad vomiting episode, who usually kept her for a day or two in the hospital. I never brought her to the ER where she was sent home that day. When she got stitches in her lip, I gave her a double dose of oral cortef. and definately when she had to go under any type of anesthesia she got mega doses of solucortef. Even when they put her under anesthesia for her VCUG. I'm not saying I freely dole it out, but when she is ill, (knock on wood she hasn't been) I do watch her and am more comfortable now doubling by myself rather than consulting the endo each time. If it is prolonged I call him immediatly. Eileen