2/28 Sebastian AMPS 267 +3 337 +6 187 +10 236

Justin & Sebastian

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Yesterday

AMPS 267

Small pool of vomit with a little bit of undigested food. Didn't eat much overnight. I'm going to feed him only FF Gravy for breakfast. I keep trying to force it by mixing in the Wellness core and I think it's putting him off it. Also adding in the probiotic today too.

I'll get a ketone check a little later, though I'm pretty positive it's not that. Last check was lo and he's not showing any signs he normally does, he hasn't been overly thirsty, in fact his drinking and urination volume has been a lot closer to normal lately, his fur and gums look good, he's talking, etc. I think I read my meal guide wrong yesterday and overfed him so that might have been the issue.
 
I'll get a ketone check a little later, though I'm pretty positive it's not that. Last check was lo and he's not showing any signs he normally does, he hasn't been overly thirsty, in fact his drinking and urination volume has been a lot closer to normal lately, his fur and gums look good, he's talking, etc. I think I read my meal guide wrong yesterday and overfed him so that might have been the issue.
Great that he is showing some positive signs with his fur etc

The point of checking the ketones is to be able to nip the situation in the bud, by the time he is showing symptoms of DKA you are reaching (if not already reached) a crisis point, and are likely facing another er visit. It's important to stay ahead of the game and be proactive.

I'm glad that everything was OK I must admit I was extremely concerned that you were not able to monitor the last 36 hrs or so, and shooting 5u blind scared the bejeezus out of me. You have to remember that we don't know if 5u is too little or if indeed it might be too much.
You want to be in a situation where after x amount of cycles, you can safely take the dose up, but with all that missing data, it makes it much harder to make those decisions, not to mention that it's a risky strategy given all that has gone on.
I don't expect you to get a test every hour when the numbers are high, but a +3 perhaps and one other somewhere later in the cycle +6 (or +9 when you wake up in the morning) in my opinion should be a minimum. That would at least ensure that you don't miss any lows and makes dosing decisions much easier. Just because he's yellow/pink today does not mean he was like that yesterday.

I want to point out that this is cycle 5, depot is building, and as long as he is not bouncing from a low that you missed in the last 36 hours we would be expecting some sort of movement in numbers. So watch out for sudden drops and follow those up if needed.
 
You want to be in a situation where after x amount of cycles, you can safely take the dose up, but with all that missing data, it makes it much harder to make those decisions, not to mention that it's a risky strategy given all that has gone on.
I don't expect you to get a test every hour when the numbers are high, but a +3 perhaps and one other somewhere later in the cycle +6 (or +9 when you wake up in the morning) in my opinion should be a minimum. That would at least ensure that you don't miss any lows and makes dosing decisions much easier. Just because he's yellow/pink today does not mean he was like that yesterday.
Yeah, I plan to do +3 +6 and +9 going forward. He's still on a pretty high carb load with the wet food right now and still not feeling 100% so I'm hesitant to do any more dose increases until we get his carb load down and the nausea gone.
 
o I'm hesitant to do any more dose increases until we get his carb load down and the nausea gone.
I understand your apprehension but you need to let the numbers guide you, if his numbers are up then it may be an indication of not enough insulin. (this is a big concern with his history)
Feeding more carbs may mean you need to shoot more insulin, then as you reduce carb load (do it very slowly) you would bring the dose down.
It's key that he gets enough insulin.
 
+6 is 185, nice little drop. Got a urine stick under him a couple hours ago, negative ketones and BG was 3+, so we're dropping back down towards the renal threshold. Weight is down an ounce from yesterday. He's had a decent appetite today, he ate most of his breakfast on his own, then I syringe fed him a little and he licked the rest off the plate, and I think he's going to finish his lunch on his own. Had a little episode earlier where he jumped off his chair and was gagging like he was about to hurl but he kept it down.
 
That's quite a sharp drop into +6, a drop averaging out at 50pts an hour is quite steep. I wouldn't wait too long for another test, I might have gone for a +7.
When they start to drop fast like that they can build up quite a bit of speed.
 
That's quite a sharp drop into +6, a drop averaging out at 50pts an hour is quite steep. I wouldn't wait too long for another test, I might have gone for a +7.
When they start to drop fast like that they can build up quite a bit of speed.
Okay I'll keep that in mind next time I see a drop like that. He gets lunch right after the +6 and with it being the HC food I knew he would be getting another little bump.
 
If we knew for certain that this was a good dose, then we could feel more confident that the HC would do the trick, but even then if they are angling for a dose reduction that won't always hold true. I once had to feed George 9ounces of 28%carb over about 4hrs, and I could barely keep hin up above the 40s.

And this was a dose that I had got to by conventional means by following TR.

Part of the problem is that their insulin needs can and do change, add to that that we haven't got to this dose in a methodical manner... .... We just can't be sure what he's going to do, so at least for the time being my strategy would be to followup ant significantly dropping BG, no matter what you have fed.
If you can be methodical about this now u hope that you will soon get to a point where you can see what's coming next.
 
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