5/22 Copernicus AMPS 397

[Krista & Copernicus]

Sorry I didn't get an update done last night. I fell asleep. I do value this group so much and trust you all. I know you said go 6.5 so I did. Then the doctor called right after and said go to 7. (I had one vet drop us bc I didn't follow her instructions). So I did what the vet told me. I'm trying to do what everyone tells me. Anyway, I don't think I can trust the last couple days of his Libre. I was awake all night testing him and I couldn't get the AlphaTrak or KetoMojo to show anything remotely close to the low numbers like on libre that kept saying sensor error. He's acting ok. Hungry. Just drank water. BUT then he threw up saliva and water?! Now I don't know what to do about dose!

 

[Staci & Ivy]

Hi Krista, does his phone match your phone with the Libre readings?

It “appears” he was hitting some lows on the Libre and bouncing up from those lows.
It could be that the Libre is coming loose and giving errors.
It’s so good you can manually test him to be sure
It’s good he’s hungry and eating. How are the ketones?

It sounds like maybe he ate too quickly and puked. Has that stopped?

With the dose it seems best to give a dose several cycles to “catch up” to evaluate how low (nadir) the dose is taking him.
If we change the dose after 1 or 2 cycles, we can’t know what the dose is doing and we don’t want to go past a good, safe dose for him.

Slow and steady seems to be the safest protocol.

I’m wondering what everyone suggests for dosing here? @Marje and Gracie
What do you think?

I hope you both have a calm day

 

[Krista & Copernicus]

Hi Krista, does his phone match your phone with the Libre readings?

It “appears” he was hitting some lows on the Libre and bouncing up from those lows.
It could be that the Libre is coming loose and giving errors.
It’s so good you can manually test him to be sure
It’s good he’s hungry and eating. How are the ketones?

It sounds like maybe he ate too quickly and puked. Has that stopped?

With the dose it seems best to give a dose several cycles to “catch up” to evaluate how low (nadir) the dose is taking him.
If we change the dose after 1 or 2 cycles, we can’t know what the dose is doing and we don’t want to go past a good, safe dose for him.

Slow and steady seems to be the safest protocol.

I’m wondering what everyone suggests for dosing here? @Marje and Gracie
What do you think?

I hope you both have a calm day

Thank you for the kind words. Not a calm a.m. Yes his phone matched my phone for the most part. He didn’t eat yet, because I was fasting him for his AMPS. So I think it was simply drinking too fast. I heard back from the vet on fluids, and I was told no again. He said if he’s dehydrated his glucose isn’t under control. I think we all agree with that statement. His gums are dry and sticky, I am thinking he will end up back in the ER without the fluids, but we don’t have any savings left for a third ER visit.

 

[Staci & Ivy]

Thank you for the kind words. Not a calm a.m. Yes his phone matched my phone for the most part. He didn’t eat yet, because I was fasting him for his AMPS. So I think it was simply drinking too fast. I heard back from the vet on fluids, and I was told no again. He said if he’s dehydrated his glucose isn’t under control. I think we all agree with that statement. His gums are dry and sticky, I am thinking he will end up back in the ER without the fluids, but we don’t have any savings left for a third ER visit.

This is complete negligence by denying fluids.
I’m so outraged I don’t know what to say.
Are you near one of your vets right now that you can call and tell them what you’ve just shared and plead for fluids? Or take him in for some and ask for a script?
And or ask for the director of the practice to discuss immediately???

 

[Krista & Copernicus]

This is complete negligence by denying fluids.
I’m so outraged I don’t know what to say.
Are you near one of your vets right now that you can call and tell them what you’ve just shared and plead for fluids? Or take him in for some and ask for a script?
And or ask for the director of the practice to discuss immediately???

The primary vet said we have to bring him in for an appt.

 

[Staci & Ivy]

Well if they will give fluids and a script, I’d do that.
But get the ok they will agree to the script.

 

[Krista & Copernicus]

I can't get the ok before the appt. A scheduler can't answer that. Without getting too personal, we just can't afford another vet visit. He's been going to vets for the last month and all 3 hospital stays were in the thousands and tens of thousands of dollars each. I can try some pedialyte maybe?

 

[Staci & Ivy]

I can't get the ok before the appt. A scheduler can't answer that. Without getting too personal, we just can't afford another vet visit. He's been going to vets for the last month and all 3 hospital stays were in the thousands and tens of thousands of dollars each. I can try some pedialyte maybe?

I’m not familiar with using Pedialite

I understand about the financial situation

 

[Marje and Gracie]

He said if he’s dehydrated his glucose isn’t under control.

I’m sorry but there are so many other reasons why he could be dehydrated. I would also be asking for the director of the practice especially because he has had pancreatitis a few times and that is a solid basis for giving fluids. When my Gracie was first diagnosed with FD and her BG was high, my vet prescribed subq fluids to help support her all around. Subq fluids will also help keep the ketones down as you get to a better dose.

Perhaps tell them because his BG is high, he cannot possibly drink enough water to keep him hydrated. Honestly, this is just abuse. I’m also really surprised that, if you have a relationship with a vet, they won’t prescribe subq fluids without you having to bring him in especially considering his latest history. Don’t just talk to the scheduler or a vet tech. Ask to speak directly to the vet.

I think you have to decide whether you are going to follow their dosing advice or ours. Staci is correct you have to let a dose settle and, while we do get to a point where we raise by 1u, he’s not quite there yet. I would have given 6.5u a bit more time. Since you’ve given 7u twice, just try to stick with that for four cycles unless he drops below 50.

But again, you have to decide. It’s not doing him any good if you are trying to follow their advice and ours.

 

[Marje and Gracie]

@Krista & Copernicus if he doesn’t come down into yellow tonight, I’d increase his dose to 7.5u bid tomorrow morning. Let’s hold it four cycles and reassess unless he drops below 50.

I believe you got fluids? How is he doing?

 

[Krista & Copernicus]

He perked up a bit. I also think the zofran helps. He is eating so that's good.

 

[Staci & Ivy]

He perked up a bit. I also think the zofran helps. He is eating so that's good.

That’s great!
Did he go any lower overnight?