11/27 Rosie AMPS 224 +5 184

[Carol in Chicago]

BG numbers are still too high even with recent increases. I'm thinking this is an issue with medications having some sugar in them. I'm not seeing massive spikes - just numbers trending higher than I would expect.

She is eating well and made a (very) impressive LB deposit today. Once I have a way to manage the constipation problem, I'd like to get the p-binder started again but want to minimize the number of variables.

Previous.

 

[Wendy&Neko]

I am glad you are seeing some good LB action for Rosie. Are you still giving enemas?

Good to see you keeping on top of the increases. Which meds do you think are have sugar in them?

 

[Carol in Chicago]

I am glad you are seeing some good LB action for Rosie. Are you still giving enemas?

Good to see you keeping on top of the increases. Which meds do you think are have sugar in them?

Thanks @Wendy&Neko. Yes - enemas are being done at home as needed. Thus far, not every day, but when the LB action tapers off or there is obvious straining, I will intervene. Right now, I think it is much like a dose increase, I just mention, "If there isn't something in the box, we are going to have to work on it" and like magic, we have only had to do one at home so far. I wish I would have know how easy this was to do, it would have saved both money and stress to do them at home.

With regard to the medication, I'm having Cisipride and Ranitidine compounded for GI motility. The pharmacist knows she is diabetic, but I wish there was a way to confirm both medications are really sugar free. The next suspect is laculose. Rose is now receiving this orally for constipation. The prepared product does have some lactose listed on the label. If she is going to need laculose for the long term, I need to see if I can have it compounded in a sugar free form. Right now, she is getting 1.5ml 2x / day orally. Rose has also been on ABs for some time (amoxicillin). This is the familiar pink liquid. The ingredients for it include sugar. She gets 2ml 2x / day because of a high WBC thought to be due to a kidney infection.

With these medications in the picture, would you do anything different with regard to dosing or continue to make .25 increases based on standard TR protocol?

 

[Carol in Chicago]

Just an update after speaking with the pharmacist. No luck getting lactulose sugar free - all forms available to him have some form of sugar in it.

However, I was surprised by what he told me re: antibiotic. I have refilled the same ABs for Rose several times (each with the same reconstituted pink liquid from human pharmacy). This is bad because the product has sugar in it and it is reconstituted with water. The reason these only last 2 weeks is the water. He can reconstitute with oil and then add a species appropriate sugar free flavor (i.e. chicken). He is telling me that an oil suspension would remain effective for up to 90 days. If I need to continue ABs for Rose, I will try this instead of the pink stuff!

Always more to learn....