Marshmallow Cat
Member Since 2017
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? Help? Post-DKA Lantus dose adjustment?
- Thread starter Marshmallow Cat
- Start date
Hello and welcome. Did SweetPea get down to 121 (or lower) yesterday on her second day back on Lantus? I see that 121 at +2, then no more tests after that. I suspect she went lower and today she is bouncing. Bouncing is a temporary condition of higher numbers that are a reaction to going lower. Has she been on the same dose of Lantus since she started back on it three days ago?
The best way to know what to do with her dose is to gather more data. Do you have any test data from before her hospitalization? In addition to tests before every preshot to make sure it's safe to give insulin, I would try to get at least one addition test each cycle, including the nights. A before bed test is a good one.
Are you home testing her urine or blood for ketones? That can also help guide us on what to do with her insulin dose.
The best way to know what to do with her dose is to gather more data. Do you have any test data from before her hospitalization? In addition to tests before every preshot to make sure it's safe to give insulin, I would try to get at least one addition test each cycle, including the nights. A before bed test is a good one.
Are you home testing her urine or blood for ketones? That can also help guide us on what to do with her insulin dose.
Sandy and Black Kitty
Member Since 2009
I recommend a minimum of once per day. My boy BK once went from negative to large in exactly 24 hours.
You see the way DKA works is that when there is not enough energy from food making it into the cells, the body will breakdown fat and protein to try and fulfill the need for more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA.
Regular testing is your best defense.
Forewarned is Forearmed.
Bron and Sheba (GA)
Member Since 2015
Here is your thread from the main forum about DKA
http://www.felinediabetes.com/FDMB/threads/cat-coming-home-after-dka-please-help.211476/
I am sorry the vet didn't give you some cerenia and/or ondansetron for nausea.
You need to make sure SP is not nauseated if you give the mirtazapine.
How is her appetite?
ETA you have a 284 @+9 further down your SS which looks like it was meant to go further up in last night's line. Can you check that please?
http://www.felinediabetes.com/FDMB/threads/cat-coming-home-after-dka-please-help.211476/
I am sorry the vet didn't give you some cerenia and/or ondansetron for nausea.
You need to make sure SP is not nauseated if you give the mirtazapine.
How is her appetite?
ETA you have a 284 @+9 further down your SS which looks like it was meant to go further up in last night's line. Can you check that please?
Sandy and Black Kitty
Member Since 2009
I recommend a minimum of once per day. My boy BK once went from negative to large in exactly 24 hours.
You see the way DKA works is that when there is not enough energy from food making it into the cells, the body will breakdown fat and protein to try and fulfill the need for more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA.
Regular testing is your best defense.
Forewarned is Forearmed.
Bron and Sheba (GA)
Member Since 2015
@Wendy&Neko and @Kris & Teasel @Sandy and Black Kitty can help you will dose adjusting associated with DKA and probably others who don't come to mind right now.
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Bron and Sheba (GA)
Member Since 2015
I don't think people here will agree with what the vet says about holding the dose for a week or two when there is DKA in the picture. With DKA you have to ensure there is enough insulin and enough food for SP so that ketones don't reappear and that means assessing the situation constantly.
Six cycles of data of data on this dose should give us a better idea of what is happening. How late after the shot is your bed time? Can you get a test then?
If SP is bouncing from however low she went yesterday, it can take up to six cycles for the higher numbers to go down.
Good news on the low ketones and good appetite. Are you adding water to her food or giving fluids to help flush out any ketones?
If SP is bouncing from however low she went yesterday, it can take up to six cycles for the higher numbers to go down.
Good news on the low ketones and good appetite. Are you adding water to her food or giving fluids to help flush out any ketones?
It’s OK to give extra calories while she is recovering from DKA. If she has lost weight, you want that out back on, several smaller meals are easier on her pancreas than two large ones. You can do a second meal somewhere in the first half of the cycle.
As for the curve, it may not be necessary. A good test to get is the +2. For many kitties, it the +2 is the same as the preshot, you will get a normal Lantus cycle with some downward movement. Another test around nadir would be good. Quite a bit lower means an active cycle needing extra testing. A +2 above the preshot means a quiet cycle and not as much testing needed. As you learn her onset and nadir in Lantus, you will learn when are the best times to tyou st SP.
As for the curve, it may not be necessary. A good test to get is the +2. For many kitties, it the +2 is the same as the preshot, you will get a normal Lantus cycle with some downward movement. Another test around nadir would be good. Quite a bit lower means an active cycle needing extra testing. A +2 above the preshot means a quiet cycle and not as much testing needed. As you learn her onset and nadir in Lantus, you will learn when are the best times to tyou st SP.
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Sorry, iPad typo,should be onset. That’s when the insulin starts to take effect, typically 2-3 hours after the shot,