Bryant’s latest numbers-new curve

[David McGuinness]

It’s been 2 months since diagnosis and I wish I felt like we were making better progress treating him. I’ve had a rough two weeks keeping up with his shot and feeding schedule but I am home all day today so I stared a curve with updated posted numbers. His AM and PM numbers still seem very high and the few in between tests I’ve been home for didint indicate much change. I did not go to 5u as my vet wanted and have slowly gone up to 4.25u the past few days. I’m worried with my work schedule being gone 8-12 hours some days I’m not home to observe him at this dosage. I do have a roommate to feed him in between testing so he’s not going more than 4-5 hours some days w/o food. I’ve observed a waning appetite some days and some days he eats everything. I’m not sure if it’s just he’s aquiring more affinity for certain flavors of the food or if he’s nit feeling well at times. He has vomited a few times, usually it’s after eating one of the seafood types of Friskies or FF!

 

[Rachel]

I found mine couldn't tolerate seafood flavors either. I took them completely off seafood and they did better...still some throwing up but not by ALL and not as often.

For food, you might try keeping track of his appetite and what food he has on those days. That'll help you determine if there are just some flavors that are less desirable.

Honestly, it looks a bit like bouncing to me...possibly just with some really long bounce cycles. You sometimes get low numbers (and low in his case could be even just pinks...low means anything lower than what he's used to). Then he seems to sit in higher numbers after that. There's not a whole lot of wisdom to offer right now...I need to think about it a bit and I have to head to work in a minute. Let's see what others say and I'll pop back by in a bit to see if I've got any ideas.

Are you testing for ketones pretty regularly?

 

[Djamila]

That curve shows a pretty good response to the insulin actually, although clearly higher than you want to see. But he decreased well over 50% during the cycle. I do agree with Rachel that there are some hints of bouncing, although it's hard to be certain. It could just be some inconsistent responses.

Here's the dilemma - since he's already getting a good drop from pre-shot to nadir, increasing the insulin could cause more bouncing. However, his nadir and pre-shots are still way too high, which means an increase is probably the best approach anyway.

I'm curious if he went down anymore after +8 since he was still dropping at that point...and it looks like on the 2/21 PM cycle to 2/22 AM cycle that he was still dropping at PS which looks like he's getting some long duration. However the curve you did on 4u on 2/8PM makes me think the duration is more related to the larger dose size and not because the dose is too high.

Are you home this weekend? Normally when the nadir is still over 200, you can do increases of 0.5u instead of 0.25u. However, considering the impact you're seeing on the 4.25u dose, I think I would recommend increasing to 4.5u tonight, and possibly 4.75u Sunday morning (if you're around during the weekend and can get some mid-cycle tests in. If you can, I would scatter the tests between +5 and +9ish (that's a guess) since it looks like his nadir may be later than is typical.

And I second Rachel's suggestion to make sure you're testing for ketones regularly at home. Please forgive my poor memory if we've already talked about that. If we have not already talked about it and you're not sure what we're telling you to test for, please ask. We'll be more than happy to give more information on that.