Frustrated still ..... could you look at my SS

[nancy and payne]

On my continuing saga of my ketone prone, newly diagnosed sweet girl Payne,
we are still having high numbers, despite a very set shot & BG schedule and food
and treats in the very low carb range.

In the 8 wks. she has been diagnosed she has had DKA 3X and been in the hospital
all three times. But with learning so much here and applying as much as
possible, she has been at home almost 4 wks. with two ketone incidents we were
able to treat at home.

She is on ProZinc 3u bid and 1u of NovolinR 1u bid. She was also diagnosed with
IBD and infection of some sort. She was given pred 5 mg. recently reduced 2 1/2 mg.
tylosin and pepcid sid. Her 45 days on ProZinc was Thanksgiving .....

As bad as her #'s look she is doing great! She has gained weight, her fur is growing
out beautiful and she is playing! She did the crab dance this a.m. with brother
and is searching out sun, of which there is none. (near SF

But her #'s are getting worse! I know that is not good ..... my vet wanted to wait
until she has been on the reduced pred. before we mess with her insulin, I'm
not sure. But I don't know enough about any of this to figure it out.

I see that her
#'s are high before her shots and they go down after but shouldn't the insulin
hold enough so that her pre #'s don't go up to the high 300's-400's? We had constant
ketones before the NovolinR was added and yet it is a short acting insulin? But
when she has ketones we give her extra Novolin to get past it.

So? does she need more insulin? does she need less? what do the #'s say? I do
the SS, I look at the #'s and it makes no sense .... this is why I didn't become a
doctor. (well it was really because I hated blood/needles .... irony here)

Any input would be greatly appreciated.
Nancy and Payne (who is leading the attack on the Christmas tree :roll: )

 

[Blue]

I am not familiar with this insulin but my main question is why have you never changed the dose despite the high numbers, and why are you using R?
If the BG numbers are high, raise the dose by small increments.

You need to get her numbers lower and if nothing's changed on this dose by now, it's not going to change.
I don't know about this insulin but on Lantus/Lev, if there's no change after 6 shots, the dose is raised.
I think you have passed that 3 day mark on this dose.

Why not try to raise the dose and see what you get in the way of better BG readings?

 

[Anonymous]

i thought you were using pzi, not R. also it is possible this dose is too high. it's best to get info from pzi users on this.

 

[Joanna & Bix (GA)]

I would consider PMing Carolyn & Spot to see if she can drop by and give you her input on dosing. If I recall, she was following along earlier, and I gather she has experience with both PZI & R.

High PSs can be a sign of several things, among them too little insulin, and liver training (which is the result of enough time in higher #s that their body forgets that blue & green #s are good, and hence sends out the alarm that the #s are dangerously low, when they aren't). There are other reasons too, and I'm to brain-dead right now to digest a spreadsheet, those are just some that we see a lot. If the R is bringing her down nicely but the PZI is not enough, that would lead to a high PS. I think Carolyn had suggested the PZI dose is too low and the R dose may be too high, but I'm not sure if I correctly recall/understood what she said.

Just FYI/disclaimer, I have no R experience/knowledge, and no experience interpreting the #s when R is in the mix.