Joanna & Bix said:
Hi! I would add a line in your spreadsheet between the 7/2/10 entry and the 10/14 entry briefly explaining the DKA. Took me a while to realize there was a gap in the dates, and I would have inadvertently given you bad advice had I not finally connected the dots. Granted that might just be me :roll: but seems like it would be useful to make it more obvious.
Hi there-- I went ahead and put in a blank line with some information in between the July and October time frame to make it more consistent and understood. I also added the link to his story to make it more obvious. Thanks for the suggestion!
Joanna & Bix said:
Because you are getting a good U-curve many cycles, and it looks like you are testing his blood for ketones and are seeing some, I'd lean toward raising the dose a bit, maybe try 3.2. Especially looking at the a U-curve on the 297 PS and the nadir was only 156, that's where I'm thinking the dose is a bit low, even though you did get perfect #s that one cycle. You want something like a 60-65% drop from PS to nadir, and the 296-156 is around 50%, so it seems like there is room for a slight dose increase.
Here is where I get paranoid. I am so paranoid when he drops to the 100s when it is the middle of the night. DoDo tends to have a late nadir and it worries me so much that if he is already that low will he get even lower and I wont be awake to check him.
On the 297 preshot I gave him a very skinny 3.00...that obviously just didn't work for him. On the 412 preshot I gave him a fat fat 3.0 and because I panicked at the 126, I gave him some Hill's AD and still didn't get any sleep since after a tablespoon of AD he was still going lower. Maybe I am just too paranoid. I don't know. *sighs*
Joanna & Bix said:
Since it looks like you are around a fair amount to get in spot tests (do you get any sleep? :YMHUG: )
No, I got no sleep last night. Nor did my mom. She is in the downstairs bedroom and he pretty much lives with her. He sleeps with her so I end up calling her to wake him up and test (usually not so bad she gets off of work at 1-130am and she works from home in her bedroom too). Last night was dreadful. *lol* Neither one of us got any sleep and well.. ok NONE of us got any sleep. DoDo is pretty zonked out this morning too. Luckily I work from home as well, so I don't have to get out of my pajamas and since my commute is 15 seconds from my bedroom to my office and the only traffic is stepping over a kitty in the morning-- I could sleep in later than usual. I don't think I got a solid more than one hour of sleep until 5am this morning. Then I got to sleep until 830. Last night, we pretty much woke up every hour.
Joanna & Bix said:
I would take an approach of giving a bit more insulin, and keeping the hypo kit handy just in case you overdo (not saying to jump up to 4u or anything like that, but just to err on the side of more insulin rather than less, given the ketones). If you see #s a little lower than you like, or good #s but too early in the cycle, you can often balance it with a couple bites of LC food, or if needed 2 or 3 bites of higher carb food. If needed often you can keep them in a trough of good #s without going too low, and keep the ketones at bay. Of course I'm not saying to intentionally overshoot, but with ketones you don't have the luxury some of us have of going light on the dose if we're not sure about it, etc.
Hope that made sense.
I would also keep posting on Health, especially if you have any crises. There is more traffic there, and some PZI experts who don't visit this forum regularly. Of course post here too
but don't hesitate to post on Health as well, especially with ketones in the picture. (Disclaimer: I don't have ketone experience!!!)
Well, I definitely learned that a skinny 3.00 is just not cool. *lol* It does not work. I have the u-100 syringes but I don't really *get* them so I have to eyeball the fine tuning. I think I need better pictures or something.
Yesterday was the first time we tested for blood ketones and it ended up at the .4 which the meter says is okay-- although for a human. Meaning nothing to really be worried about for the most part. When I test his urine, it still stays in the tan. The blood ketones I do on the days where I can't get him to pee for me. For the most part he remembers back when he was sick ages ago when I would take him to the bathroom since he was too sick and feeling bad that he was too intimidated to go on his own from the other cats. But if I don't catch him right, he just cant urinate.
You are right my vet said that since we know he will throw ketones now it is so vitally important that regardless if he has not eaten anything he still needs his insulin PERIOD. She said some cats not as vital, but little DoDo still needs his insulin since he will get so high without it. I can't do the little meal of LC when he is lower-- he just wont eat that much and from past experience it just wont move anything. Hence, why I stick to the tablespoon or teaspoons of AD (i actually measure it out with a real measuring spoon). He loves it and will eat it most any time. We gave him 2 tablespoons last night when after the hour of the first one he still was going down and down.
I think maybe what I need to do is do the larger volumes of insulin (where I am not petrified of doing it) during the day while I am awake. I work from home now with the exception of some rare days-- so I should be able to test and tinker with him at all. I have to figure out something so I can sleep at night, for all three of us.
Also-- I need to get him regulated because I HAVE to go on a business trip for a week soon. It was going to be the end of this month, but since his DKA episode I am moving it to November.
