Bubba's vet visit 1/5/13

[chubbabubba]

Hi All,

As some of you may know, Bubba had trace ketones mid Dec and at that time he was put on Humulin N 2 units 2x daily to bring the numbers down
The plan was to start Lantus ( already bought it) once ketones and numbers were more stable.
His numbers did come down, but not as much as we would like. The last two days he was acting strange, sluggish, sleepy.
Just out of it. I continued to home test for ketones as well which are at neg- trace. His numbers were climbing especially by morning the last few days to 400.

We went back to the vet this morning for blood work- Total Body Function ( still waiting) Already had CBC
Chest Xray/ Stomach - Good
Urine- Sugar in urine and trace ketones
Temp- Ok
Drinking ok, eating ok

He felt for Bubba at this time he wanted to increase his dose due to the urine results for the next few days from 2u to 3 starting tonight.
He does not want to mix the Humulin and Lantus at this time. Tells me that we will move to Lantus but just not yet.
I know Humulin is not popular around here and its freaking me out that we are still using it.
I must admit, the Dr wanted to go higher on the N but I felt that 4 u was way to much to start.
( When we first started)

I know he is at 2 u but I am a wreck with the increase to 3. By looking at his numbers he is not having many lows and its taking its toll.
I am afraid of the increase, and will be awake all night. Bubba is at 23lbs so perhaps he needs a bit of a jolt. I dont know.
I know it may be hard to give advise or feedback as N is not used , But if you have any feedback that would be great.

Strangest thing- 12/31 in the am Bubba did not get his insulin, pretty positive it was a fur short- Glucose was lower that day then most before? Could the missed dose be affecting his numbers right now?

 

[BJM]

The N only lasts 6-8 hours, leaving 4-6 hours without insulin, so of course he'll be high.

If you can't test and shoot every 8 hours, you should switch to the Lantus now.

What is his ideal weight in kilograms and is he underweight? The starting dose may be calculated as 0.25 units per kg of the lower of his current or ideal weight.

 

[chubbabubba]

Bubba is overweight, his ideal weight is 17lbs . I know that the lasting time is lacking in the N.
the vet does not want to mix the two yet or switch due to the trace ketones.
Its so hard to know what to do.

 

[BJM]

You don't mix them; you do one or the other.

You'd get better coverage (about 12 hours) per shot so you'd be less likely to have issues with ketones since you wouldn't have time with no insulin.

With 17 lbs=7.7 kg, his initial dose would be just under 2 units (1.93).