Need some input on Sam's numbers

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KristenP&Sam

KristenP&Sam

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Since I returned from my trip, Sam's numbers have risen and his curves have gotten flat. I've upped his dose a bit, but it doesn't seem to be helping. Nothing's changed food wise, the only real difference is that he hasn't had sub-q fluids in awhile, but then he hadn't had them for awhile before I left on my trip either.

I'd love some ideas. I'm getting frustrated, especially since I thought we were headed in the right direction. Also, it wasn't my DH's handling of the insulin while I was gone since I prefilled syringes for him so he wouldn't have to mess with that himself.

PS. I've been checking for ketones and so far, nothing. Might be close to trace but seems more tan than pink.
 
Hhmmmm. Nothing has changed - no different food, treats are the same, no change in litter box habits?

I wonder if he is going down low at night and bouncing back up again? I guess I would try a night time curve and daytime curve and see if that gives you any ideas.

Glad you are back. We missed you! :mrgreen:
 
I probably still won't be here with great regularity (except when I can). This is going to be one of the busiest years of my life, getting busier as it progresses, just another reason I was hoping to get Sam into remission. I almost tested him last night but I was so beat I couldn't drag myself out of bed.

Maybe Monday night I can do an evening curve.
 
Hi Kristen,

I havn't been around much lately so I'm not up on your history except you're ketone history.

It looks like you were getting good results on .5 unit. Why the sliding scale now? Usually the sliding scale comes into play when you have achieved some regulation and consistant numbers and then the sliding scale to do some fine tuning.

High flatish curves usually indicate too much insulin although you are getting a drop during the cycle.

With Prozinc any dose increase/decrease will cause wonky numbers for a few days so you will need some consistancy. I think I would go with .5 unit for a few days to even out Sam's numbers, get some even AMPS & PMPS and re-evaluate.

Hang in there.

Robin
 
Robin, I've basically just been reacting to his higher numbers and I keep hearing my vet's voice wanting me to up his dose. I'll cut him back to .5 tomorrow and stick with it for a few days to see what happens. It's so hard to see those higher numbers and not react, you know?
 
I know it's hard, it seems backwards.

They used to tell us back in the day to "put on the hand cuffs" and shoot a regular dose into a bounce because the bounce will clear by itself. Adjust the dose, let Sam get used to it, adjust the dose, let Sam get used to it. As his numbers come down lower the dose and let him get used to it.

When I got here this time I stomped around saying "I want him regulated, and I want it now", but we need to be the tortoise in this race/sugar dance not the hare.

You guys are doing great and have been getting really good advise and guidance.

Hang in there.

Robin
 
I'd tend to agree. You got some perfect nadirs on 0.6 and I'd be hesitant to push the dose up from there, and I'd even consider pulling it back.

When you look back to 1/31 to 2/2, the two days of good nadirs followed by day three that is high and flattish makes me think that dose might be too high and 2/2 may have been a bounce from unseen results the night before. Of course then it's confusing that you see normal U-curves since then, which don't suggest the dose is too high.

Just given earlier results though (and that 57 nadir back on 1/25 after just 0.3?!?), I would lean towards lowering rather than raising the dose. If the #s just go higher you can raise back up quickly, I wouldn't spend a lot of time at lower doses if the #s stay high, but I'd give him a chance to show you some of those pretty green nadirs if he wants to.
 
I took him back to .5 today and will keep him here for 72 hours to see how that plays out. Hopefully with good results. I worry though, since the numbers had actually begun to rise on the .6 dose - which is what prompted the vet to want us to raise it.

And yes, I do suffer from "I want him regulated now" syndrome. It's hard not to. My husband tries to take care of Sam when I'm gone, but it's not the same (as you can see on Sam's SS from the missed shot and lack of bg readings). Sam just runs from him. At least DH has no problem giving Jack his inhaler! Also, while I was gone, DH called the vet tech/cat sitter we use because he couldn't get Sam's shot done at one point, and she told him to stop testing! I'm going to have to have a word with her. If she wants to stay in our employ, she's going to have to lose that attitude or I'll find someone else.
 
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