Have question on TID dosing

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Good boy! Glad to see he's down from HI....now keep on coming down, Sid.

The SS is much better now, thanks for fixing that, Lydia. :smile: I'll keep checking in...
 
GREAT!, so I want to make sure I am reading SS correct. AT 8:30 Sid's BG was 397? I am guessing between 10:30pm & 11:30ish pm he will start raising. If you do decide to shoot. Be ready to be checking him late night maybe around the 2am mark. I am usually up, so I will keep checking, ok :)

Actually, I went back to look at SS. Since you're still at 0.8 anything can happen. He may not drop til 11pmish? We just need to keep an eye on him. You just need to catch him on his way up agian, so he doesn't fall into the seesaw.
 
Actually at 740 he was 397 and then at 810 he was 309. If I shoot him again tonight then that is 4 times today. I was thinking about giving him a small dose of R maybe .25 if he shoots up later. For him the R brings him down and only lasts 2-3 hours. If he shoots up atmidnight then it would allow me to give the next dose of prozinc at 4-5 am.
 
ok, great! I am trying to go through all my notes. Are you or where you going by Dr. Hodgkins' sliding scale? I am trying to remember what Pru was on. I think we were more aggressive since I was with her 24/7. We need to figure out what your work schedule is like for the next few days. I think my scale was to shoot if +7 or +8 was under 200, but Sid will be a little different. The main thing right now is to see where his nadir is at.
 
Forgive me, but what is the R? Again, you know your baby better than anyone. I am not familiar with balancing other health issues with FD, but I know in the beginning times will be all over the place due to when insulin is needed. That's this crazy dance @-) I think there are a few things you need to work on while handling the TID and that's his feeding times. It might be best to make sure you add water to his wet food, so he can eat whenever he wants. I was reading that they need at least 10 to 20 small meals per 24 hours. PZI tends to peak at around +5 - +7 so you should be testing to first learn when that low point or "nadir" of the curve happens most. I know it's risking DKA by not giving insulin at any time. You just need a good few days of staying on top of the BG's and seeing where he starts raising. Once we can get to that point... we can figure out if you need to reduce dose by 0.1 units or increase dose by 0.1 units.

I'll be back to check in!
 
I have not heard of Dr. Hodgkin's sliding scale so I will have to look that up.

Food makes Sid spike way up so I definitely cannot allow him to free feed unless I'm missing something.

R is a very fast acting short duration insulin that is typically only used to supplement a longer acting insulin. It is also what is used in hospital to bring cats down during DKA. It has to be used with a lot of caution because of how fast it can drop cats. I know how careful I have to be with it as I have given it to Sid many times. It drops him very fast so I do not give him any unless he is HI. The only time he ever had a problem with it was at the vet - (their fault) because they gave him 1U when he was only 300. He went down to 30 but some food got him back up. I'm thinking tonight he is going to be Hi by about 12 am if not before. I don't want to give him anymore Prozinc until 4 or maybe 5 am depending on his bg level. A small amount of R could tide him over to keep him from being Hi for hours.

I just checked him and at 3.5 (9:20) he was 195
Then at +4(9:45) he was 285 - so he spiked up 100 points.
Maybe this is from his dose of prednisolone at +2.5?
 
ok. I am sure you know what you're doing with the R. I just was not familiar with it. just remember that if his number were stable and you were to shoot at +8... that actually brings you into Monday 2/20, so it's not like you're shooting 4x a day, ok :smile:

let me look up Dr. Hodgkin's for you. be right back! here it is: Yourdiabeticat.com

http://yourdiabeticcat.com/protocol.html

Another thing that has me thinking is that.... if you have to keep using the R time to time, you may not be able to find his true nadir. This makes me think that you may have to bump to 0.9 or even 1.0 - The thing with TID ... you want to keep Sid away from the rollercoaster. Again, please know that whatever info I offer is for you to file and use wherever need be. I am only trying to give you info that can help.

You're doing great, try not to skip a shot. You really CAN restart his pancreas, (about 70-80% of cats can do it) but it takes 8-10 weeks of this tight regulation to do it.
Think of pushing your child on a swing. How hard you push matters a bit, but WHEN you push is the most important thing. If you keep pushing at the right time, you don't need to push very hard. Same thing with 8-hour insulin doses. If you wait till 12 hours, it's the wrong timing and you have to push a lot harder.

I know you have other issues to balance, so please know that I understand the challenge you're taking on. You're doing GREAT!!!!!
 
Lydia, it's always your decision how much/when to dose. I can only help you with my own experience as well as what I have learned from others along the way, and I don't have enough knowledge about R to be comfortable giving advice about it. I know you have experience with it....I think that's your call.

At least he made it to blue tonight....now stay down there for a while please, Sid!
 
@10:15 318
@10:45 306 gave SQ fluids.

I know exactly what you mean about how R can affect the nadir. The only problem is if he gets too far off the 4am 12 pm 8pm schedule I wont be able to do the TID and it might be worse to miss a shot than have a small amt of R to bring him down briefly. The R could help avoid the rollercoaster as long as he does not get too much too close to the Prozinc. I could be wrong though. I will way and see what he is doing as the night progresses.
 
Ok so at +6 he was HI - so I gave him a fat 0.25R along with a small meal. I will monitor him throughout the night and at 4:00 am or 5:00 am will give the Prozinc. I will be watching him closely. :YMSIGH:
 
I'm heading to bed, Lydia. He stayed down there for a while before he zoomed up! Good luck with the R. I'll check in with you in the morning....I would start a new thread, this one is getting long. :smile:
 
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