Scratchie and dose

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Scratchie'smom

Todays Condo on Relaxed

Sorry to be a bother but have some questions. To make it short - I think Scratchie is now considered DKA. Back at the end of April I switched him to Lev and didn't give him enough insulin and he developed ketones - where since his dx in February of 2012 he has always shown negative. My bad and we paid for it. The ER hospital said I caught it very quickly, he was there over night then at the vets for 8 hours, been home since - no ketones.

Put him back on Lantus but he just bounces and doesn't get anywhere so an angel sent me some more Lev and I switched him back to that. Ok now for my question. He is on 3.25u as you can see. I work a minimum of 10 hour days and can't always ( in fact very seldom) get home to test him. That was quite a drop today!!!

My question is this if he holds to the blue we got tonight for a bit. If he is still on this dose, and I see a number below say 150 (at AMPS) and know that I am not going to be home to test him, can I do a 'reduced dose' shot? What does he need to go down to in order to earn a reduction? Is it 40 now since he is long term. Not trying to count my chickens before they hatch, just want to be prepared in case no one is available...

Previously he holds blue for about 6 hours then he would go back up. I'm going to test every 2 hours tonight to see what is going on and maybe those questions can't be answered until then but thought I would ask.

Thanks - Jo
 
It might be too soon to tell how he is responding to lev, but it looks like he climbed from the 166, so shooting the full dose was safe there.

I reduction would be "earned" on a number below 40 (protocol) or below 50 according to some. I go by "somewhere between 40 and 50" based on other things happening in the cycle like steady numbers, swings, rebound, etc.

Scratchie may be a late nadir kitty with a low at +12. Best to just keep gathering data when you can. When I worked I could not test during the day at all so I tested before every shot (of course :mrgreen: ) and did a before bed check. Sometimes that "inspired" me to set the alarm for another test in a few hours, but I rarely did that unless the kitty was heading lower earlier. You can get your spot checks and curves on the weekends/days off.

You can do a reduced dose shot if he is at the point where you would worry during the day and don't have date to show how he would do, just don't reduce that much because you don't want to be flirting with DKA again. (BTW, he isn't "DKA now", just "prone to DKA") Since he has had it before you want to be cautious with making dose reductions. How is his hydration? Do you add some water to his canned food? That can help. I add a lot of water to my cats' food. I mix 3 cans of food together and add about a 2/3 can of water to that.
 
Thanks Sheila!!

His hydration is great and my DH is home during the day to watch the food, replenish as needed - he just won't do the testing. Glad to know he is prone to DKA and not considered DKA! He climbed back up and leveled off in the low 300's.

Again thanks for your help and answers to my questions....

Jo
 
I don't think they would let you take him home if he was DKA... My Sneakers threw ketones for MONTHS until the insulin got high enough so I was VERY watchful about food and water being available.

Have you tested for acro or IAA? I tried to look on your profile and it didn't say and the other one I didn't have permission to view. Scratchie just might be a high dose kitty and until the insulin gets high enough will continue to show ketones.
 
Scratchie is interesting. He spent almost 18 months up in the 300s or above on Lantus. Started him on Levemir and he dropped into the 200 and developed ketones for the first time about a month ago.

Luckily Jo has always tested for ketones on a regular basis so she caught the first sign of ketones and saved a really difficult case of DKA.

He responds well to Levemir. We just started with a higher dose this time.

Claudia
 
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