Kate & Toby
Member Since 2019
Hi All,
I would really appreciate some opinions on Toby's spreadsheet, his BG has been all over the place, I sent it to his endocrine specialist and she has suggested I drop his dose for 10 days to see if we can even out the highs and lows.
This is what she said:
I’ve looked at his chart with a colleague, for the two heads being better than one approach. We feel that he could be suffering from Somoygi overswing, at least in the last few days when he is repeatedly very high. Overall, his control looks the best when he was on 1.5 units twice daily and we shouldn’t overlook the fact that previously, when he was getting 2.25 units, his glucose went into the green (3mmol/l level).
So I think that you should go back to 1.5u twice daily and try really hard to not measure too many BG’s (perhaps do a couple around the nadir time if you feel reassured by doing that) for about 10 days but then perform a couple of days of curves This dose reduction should eliminate the risk of Somoygi overswing.
The longer acting insulin I would consider would be Glargine. He is doing so well clinically at the moment that I am loathe to change him but that would probably be my next step if we feel we are not winning with the PZI.
Most cats that become ketotic do so because they have another disease that leads to a big change in insulin requirement. It seems most likely to me that Toby developed pancreatitis which lead to his recent DKA. We can’t prevent him getting pancreatitis in the future unfortunately and if the disease is grumbling it may lead to variability in his insulin need. I think it is wise to screen for it but bear in mind if he develops it, it is more likely due to another disease rather than due to the wrong dose of insulin alone.
Tagging Linda @MrWorfMen's Mom as she has kindly been helping me with Toby for a few weeks.
I would really appreciate some opinions on Toby's spreadsheet, his BG has been all over the place, I sent it to his endocrine specialist and she has suggested I drop his dose for 10 days to see if we can even out the highs and lows.
This is what she said:
I’ve looked at his chart with a colleague, for the two heads being better than one approach. We feel that he could be suffering from Somoygi overswing, at least in the last few days when he is repeatedly very high. Overall, his control looks the best when he was on 1.5 units twice daily and we shouldn’t overlook the fact that previously, when he was getting 2.25 units, his glucose went into the green (3mmol/l level).
So I think that you should go back to 1.5u twice daily and try really hard to not measure too many BG’s (perhaps do a couple around the nadir time if you feel reassured by doing that) for about 10 days but then perform a couple of days of curves This dose reduction should eliminate the risk of Somoygi overswing.
The longer acting insulin I would consider would be Glargine. He is doing so well clinically at the moment that I am loathe to change him but that would probably be my next step if we feel we are not winning with the PZI.
Most cats that become ketotic do so because they have another disease that leads to a big change in insulin requirement. It seems most likely to me that Toby developed pancreatitis which lead to his recent DKA. We can’t prevent him getting pancreatitis in the future unfortunately and if the disease is grumbling it may lead to variability in his insulin need. I think it is wise to screen for it but bear in mind if he develops it, it is more likely due to another disease rather than due to the wrong dose of insulin alone.
Tagging Linda @MrWorfMen's Mom as she has kindly been helping me with Toby for a few weeks.
