09/30 Ivana AMPS=317, +2=319, +4=281, +6=313, +8=317 ketones=0.2, PMPS=254, +2=270, +4=283

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Tara & Ivana (GA)

Tara & Ivana (GA)

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Yesterday's post

So Ivana has just had her 7th shot at 1.25u. According to TR, because it's been 3 days and her nadir is 11.1-16.6 we should increase by another 0.25u for a total of 1.5u (which was her dose when she first started insulin). You guys think that's fine to do as of tonight?
 
Yes, unless she shows you something today, I'd increase to 1.5 tonight...You could have gone with the 1.5 this morning too, but hopefully "something" will click and by tonight she'll be doing so much better that you don't need to increase! (there's always hope!)
 
Again today, her mid-cycle is higher than her pre-shot. Will keep testing this arvo, but really not liking her on this dose - increasing tonight for sure.

Also, how often should I be testing for ketones? I haven't actually done that yet. Although it was done at the vet when she was diagnosed and it was negative.
 
There isn't a particular guideline on when you should test for ketones. Some people test regularly. Some test whenever the kitty seems ill. Take a look at the "New to the Group?" sticky - down at the bottom in the single topic posts there is one on ketones and dka. It would be good to understand some about it, and I'd go ahead and get one test now, just because. It's good to test sometimes, just in case.

I like to give people the guidelines so they can see where suggestions are coming from. This is from the Tight Reg Protocol sticky:
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Ivana's had most of her nadirs over 200, so I think she fits in the section I've highlighted above - nadirs 200-300, increase the dose by 0.25u.
 
Ketones and glucose from the same (ginormous) drop of blood - Ivana sure is a good bleeder!

Blood ketones = 0.2. I'm not sure what that means, though. According to the instructions that came with the strips that's below the 'low' level.
 
More than you probably ever wanted to know about ketones: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters.

An excerpt from the above post:

When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra meters?

The latest studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter:
Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).pdf
Measuring ketones - JSAP_Zeugswetter - 2012.pdf

No worries at this time...
 
Psychically willing hubby to hurry up and get home from work so I don't have to do Ivana's shot myself haha. Though I guess that tells me that I need the practice ;-)
 
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