New vet, change insulin? Big swings on HUMULIN N variant

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akbahsMum

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Another hypo episode with Ak this morning, ... I guess it is still called "hypo" when he seems perfectly normal, but his glucose gets down to 37.8.
Happened last night, and again this morning. I've been calmly administering honey and gravy from a high carb wet food, I also gave him 9 crunchies (bits of "kibble").

- He has been on 3 units of a Humulin variant (Protaphane) since end November 2011, most of which time he has not been home tested.
- I recently joined FDMB, and started home testing in a systematic way
- Main change is that I started them both on wet food, "whiskas loafstyle" which maybe is low carb, going by reports gratefully received from other Australian sugarcat mothers. Began that yesterday, 19/1. Decided to do a spot check for blood glucose yesterday evening, and found first hypo of my knowledge. Looking at the blood glucose curve I did the day before however, there's a fair change there. But not much data to go on really.

I gave 0.25 less insulin this morning, bringing me to about 2.75units , but I am loathe to make any big changes without seeing a vet.

Questions in my mind are:
1. I wonder if this is new? (given that Akbah appears "fine", maybe this has been going on for ages and I wasn't testing) .
2. Or maybe its because he's on low carb wet food and "it works"?

Our vet is on holidays till 30 Jan. I would prefer to stay with him, because he knows us and we know him. But I *really* want to change to a slower acting insulin.
I could go down another 0.25 tonight (down to 2.5 units) but I think that will probably still be too high. And then there is still the problem of the insulin "wearing off" before the 12 hours is up. But I also know that you can't make sudden changes too frequently.
I could go to the bigger 24 hour vets down the road, and ask for advice, especially, Lantus.
Or I could wait for my vet, 10 more days.

I thinks its time to go to the vet down the road, isn't it.
So sorry about all these long posts. I don't have anyone to ask but this forum at the moment and I'm a bit confused.

Nat
 
Re: New vet, change insulin? Big swings on HUMULIN N varian

Hi Nat

without that curve data it is hard for us to comment. Your dose reduction may or may not be enough, and its hard to know if there are any complications from him going on lantus for another 10 days...I've not read your posts before so here are some questions for you - has he ever had ketones? is he relatively healthy? Playing and preening and all the rest? If you think your current vet while switch insulins, then you may be just fine waiting (but monitoring). If you think there is little chance, I'd suggest going to the place down the road. I know its tough, so ultimately you have to decide what is best for the short term but also long term vet care.

We have one or two folks in Aus...where in NSW are you?

Jen
 
Re: New vet, change insulin? Big swings on HUMULIN N varian

Hi Jen
I'm in Sydney.
I'm looking at his work up from his tests in December: I can't see ketones, but I do see it said "ketosis evident".
Wouldnt be surprised, he's in the 400s each morning by the look of him. Vet also said he had "some liver damage".
In December he was really sick, now he's pretty good. He was very thirsty this month, which is why I started looking for answers online.
Today he's happy. Being in the 30s seems to suit him ;-) Though he hasn't "played" in a long time, he now walks around the house talking to people, a change from lurking under the bed.
I think vet might switch. But daily hypos while we wait...?
 
Re: New vet, change insulin? Big swings on HUMULIN N varian

he gets decent duration but steep drops. The food change could be causing the drop in numbers and subsequent rebounding (liver trying to protect itself). I'd seriously consider a further drop in that dose to be safe but just a little, and you need to start monitoring his urine for ketones. Ketones happen when there is insufficient food/insufficient insulin/infection, and can be life threatening.

liver values get affected especially when first diagnosed but typically recover (the liver is an amazing organ).

I stayed in Sydney back in 1993 and loved it :)

Jen
 
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