Re: 2/14/11Choco amps 138, +1 158, +2 157, +3 126, +4 85
Venita and The Boyz said:
Maria,
I think people are concerned about lowering Choco's dose because of his past DKA. However, I don't see the sense in giving him a dose that you think might be too much for him (and you) and then "correcting" that dose with high carb food early in the cycle.
With all respect to Venita, to me there is no sense in NOT giving sufficient insulin. Correcting with higher carb food is exactly how a cat who is one week out of DKA should be handled. They need enough insulin and food to help prevent relapse. If the cat is responding so well to a dose that they need to be given more (or higher carb) food to counteract the insulin, then that is what needs to be done. I have actually been concerned that Choco's dose has been reduced too much since he has been home, so I'm glad he has been able to hold this dose for a few cycles. Maria is doing an excellent job of monitoring and feeding the curve, so it makes sense to continue being aggressive as long as she is home. Additionally, the data she has collected over the past few days is making the picture a lot more clear about what should be recommended for when she goes back to work. She even had the foresight to try not forcing food today to see how he managed his own curve without her prompting. That was a GREAT idea, by the way. :smile:
While it appears that Choco is almost done with this dose, and he might even earn a reduction tonight, it does not look like he is so far above dose to be in danger when she goes to work. He is getting nearly perfect Lantus curves, and I don't see a reason at this point to back down. So many times, we see beans who back off too quickly when their cat first starts getting good numbers, just to see them lose momentum and head back to yellow and pink. You can look at my Lucy's spreadsheet her first time running down the dosing scale (I think it was October 2009) to see what I mean.
Cats that are only one week removed from a DKA do require more intervention and more aggressive treatment than a regular diabetic cat. My SOP is to apologize to the bean in advance but say "sorry, you do not have the luxury of easing into this the way some peopl do." If I didn't say that to you right off the bat, Maria, I apologize. We had two new DKA kitties show up in LL the same day and I know I posted that to one of you.
If Choco does earn a dose reduction despite Maria's efforts, then I would never recommend that she hold the dose anyway. So far, though, his numbers are safe.
Sorry to post and run, but I have an appointment in a few minutes.
because of his numbers getting down to where they are and me not being able to be here to help him. At least if I shoot him with 1.25 tonight, I can see how much difference there will be in the morning.
