12/17 Pepper AMPS 190, +3 367, +5.75 358

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Nancy&Pepper (GA)

Member Since 2012
yesterday

Well, Pepper did decide to go down again. I was exhausted and didn't get up to test during the night, but he usually nadirs quite late in the pm cycle, so perhaps he didn't go much lower anyway. However, I had been planning to increase his dose this morning by .5u, so I went ahead and did it, since he usually doesn't stay low anyway and his numbers have been generally high. If that was a mistake, please someone let me know.

Also, I have started to notice that every time I give him sub-q fluids he goes much lower in the pm cycle (I gave fluids yeasterday). I added a note to Pepper's SS in the remarks column for each time I have given fluids since 11/01/12 (I had just been jotting it down in a notebook). Is it the fluids making him go lower? What does this mean? Is there something I should be doing that would help him go lower all the time?

One last thing - late last summer, Pepper's vet said Pepper's potassium was low and suggested giving potassium by adding it to his sub-q fluid bag. I did that for a while, then I admit I forgot to have it added to the last couple of bags. Then I read (I think at Tanya's comprehensive CKD site) that adding potassium to the bag can sting, plus I have read here that potassium levels should be monitored if supplements are given. No monitoring was done. Anyway, Next time i talk to the vet, I was going to ask about potassium, but i wondered what form of supplements people here have used, and how often they were monitored by the vet.

Thanks.
 
Re: 12/17 Pepper AMPS 190 - some questions, the sub-q effect

As far as increasing, I would want to see what the rest of the cycle looks like. There's a lot that can happen in 12 hours.

Fluids will often cause a temporary drop in numbers. Adding fluids acts to "dilute" the glucose in the blood so numbers will drop. I would just be attentive to how much of a drop you're seeing so you don't end up giving fluids and the effect occurs at nadir.

Personally, I would not give potassium or any electrolyte without there being a plan in place for monitoring. Potassium supplementation without any follow-up could be dangerous. Too high or too low values for potassium can be critical.
 
Re: 12/17 Pepper AMPS 190 - some questions?

Thanks Sienne. So it's just the fluids diluting the blood glucose and it's not actually the insulin working better with fluids. Then, in reality, his blood glucose isn't really going down at all. Darn!
 
Re: 12/17 Pepper AMPS 190 - some questions?

I wouldn't necessarily draw that conclusion. Lantus is not considered a "potent" insulin. In practicality, what that means is that it doesn't "yank" the numbers down. It's gentle. However, once the numbers are lower, it can better latch on and help to bring the numbers down further. So, if the fluids are helping to bring the numbers down, it may help the Lantus to work more effectively. That's why I was commenting that you may want to be careful to not have the effect of the fluids timed so it overlaps nadir.
 
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