Charlie amps 595 +2 543

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EllieKozak

EllieKozak

Member Since 2014
Hello friends. Seems like when Charlie takes one step forward he takes 2 steps back. He is really high today. Hoping he will come down soon. Wondering if we needs to start using R again? We were doing so well. He's still acting good. Haven't been able to catch him going pee to check for ketones yet today. Will keep a close eye on him today.
 
At the moment, his highs are from 2 causes - one is that his blood sugar got down into normal numbers day before yesterday, and he's not used to it. His body reacted big time! This bounce could last up to 3 days, which would be sometime tomorrow - of course, it could clear between now and then, too. The second reason is from the reduced dose - as you've seen, even a quarter unit can make a difference, and combining the 2 reduced shots with the reaction from the normal numbers is resulting in today's 500's.

I wouldn't use the R at this point, however. If you'd caught it at the 404 the first test after the 165, that would've been ok. But at this point, he'll be clearing the bounce before long and recovering from the reduced insulin shots, and if you add R while he is high as he's clearing the bounce, he could come barreling down like a freight train. We want him to come down slowly so that it doesn't set up another bounce immediately afterwards.

Is he acting ok? eating ok?

Let's see if there are other opinions about it, though. Maybe someone else has another idea.
 
Good Morning ~O) ~O) :cool:

Glad to hear Charlie is acting good - all Ps in place? How is his appetite?

Any chance he got into any 'contraband' ?

You have mentioned difficulty catching him at the LB to test his urine for ketones before.
That being the case I strongly recommend you get a glucometer that reads blood ketone levels as well.
You can continue to use the meter you currently use for BG testing and use the one to measure blood ketones just once or twice a day.
The strips for those meters are pricey, however not as pricey as another trip to the ER for DKA.

I'm not sure why you reduced the L dose on 09/25, however am glad you brought it back to 5u.
Dose hopping with a long acting depot type insulin can result in wonky numbers and is likely contributing to the numbers you are seeing.

My $0.02-
Regarding R, unless Charlie is throwing ketones, keep it in the fridge.
He is bouncing from the low numbers on 09/26 and the AM cycle today is the 4th cycle since.
He is also settling back into the 5u dose (3rd cycle since increasing on 09/27/AM).
Be patient - after the green he saw on 09/22 It took 6 cycles before he saw yellow.

Stay focused on getting Charlie to an L dose that does the trick by following the TR guidelines.
He may need a reduction or he may need and increase - the numbers will be your guide.
Be vigilant - do not open the door that invites ketones back in.

Do what you have to do to test on the overnights. It simply must be done.
Not doing so puts a kitty following an aggressive protocol like TR, at risk due to missed low numbers.
Having wide open spaces on the ss can lead to dosing adjustment errors.
Errors that have potential to keep Charlie stuck in constant battle against ketones.

Here in Lantus Land there are many kitties that have achieved healthy regulation and over 300 kitties, mine included, that since 2008 have gone OTJ.
Each of us had to sacrifice some sleep and eliminate "wide open spaces" on the ss to get our kitties safely to where they are today.
Speaking for myself - it was well worth it - without a doubt. :cool:
 
Re: Charlie amps 595 +2 543, +4/513,+6/453

Charlie's numbers slowly going down. The reason I decreased him to 4.75 was at the suggestion of the internal med specialist. I now know that even a few drops makes a huge difference. I will resist the urge to use r. Will check again at +8. And I have ordered the blood ketone monitor it just hasn't come in yet.
 
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