Re: 1/15 Mikey AMPS 312 +6/363 PMPS 365
Just curious, and because Mikey is a DCIN foster cat, maybe I should use my DCIN log-in when I ask this, but DCIN case managers try not to become involved in dosing issues once a DCIN client is established with an FD forum. But (again) because Mikey is a DCIN foster (more than a DCIN client), I feel compelled.
When I look at Mikey's spreadsheet overall, I see that he did much better on 1.5U. In fact, it looked like he might be flirting with OTJ. On the 12/1/11 PM cycle, he "earned" a dose reduction to 1.25U, and that when everything went haywire. He almost recovered (from the 12/2/11 AM rebound) on the 12/3/11 AM cycle, but he's been sitting mostly in pinks and yellows since then with a sequence of dose increases to now 2.5U, maybe 2.75U.
I am not trying to Monday morning quarterback, just looking at the big picture. Has something changed since his good run on 1.5U? I know he is on eye drops with steroids, but that is only since late last week. I know that the insulin vial he was using was old and possibly compromised, and I believe that Jenn changed to a new pen somewhere after 1/7/12, although I don't see it in the notes section of Mikey's SS. That change (if made) doesn't appear to have changed his numbers.
Mikey needs a dental and will get one on 2/1/12, but the condition of his mouth has been a constant since he's been with Jennifer.
So my question comes down to---is it possible that Mikey is in chronic rebound? Might it be better to step back and reconsider the 1.5U dose instead of the series of small increases. If the answer is no, my follow-up question is "why not."
If the answer is yes, I would caution Jennifer to be sure to watch the ketones. He showed trace/small ketones once (11/21/11) when he was in the midst of his diet change, having diarrhea, and didn't get any insulin the day before. That quickly resolved. However, when doing a "do-over," it is always wise to watch for ketones and be prepared to give SubQ fluids.
