Shaikha 6/6 t.i.d. + midcycles

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wombat88

wombat88

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Still working on getting her numbers a bit lower and more balanced. She's still on antibiotics for a UTI. Doing pretty well there I think other than slightly softer stools from them, but I'm increasing probiotics to try to compensate. I plan to give 0.8U each time today to see how she does, since her numbers have been zooming a bit towards the end of the day. I plan to do midcycles to try to catch nadir, which has been happening early with her. Hoping for a great day, number-wise!

6/5 PMPS = 340, gave 0.8U
6/6 numbers:
AMPS = 186, gave 0.8U
+2.5 = 206
+6 = 194 (am guessing nadir was around +4, but we'll see what MDPS shows)
MDPS= 169/198, gave 0.8U (first test seemed low, so retested and got higher number -- may have been fluke due to small blood sample first time)
+4 = 161
+6.5 = 361 (ick)
PMPS = 450, gave 0.8U (double ick!)
 
She seems to be doing okay, though I'm concerned about the quantity of water she is drinking. Her hydration seems good, but even with the diabetes the water consumption seems out of proportion for what it should be. Her UTI may be playing a role but am not convinced that explains it. Will take her back to the vet on Thursday for renal function tests, but am scared what we'll find. I don't think she'll be crazy-high, but I don't think the news will be good. With her being on steroids, there isn't much we can do but hope it doesn't get much worse since stopping them always triggers a relapse of pancreatitis. I plan to call Royal Canin shortly to find out the phosphorus content of the food she's eating. Am hoping it isn't too bad, but if it is and her phosphorus is high we'll just have to deal with it using binders.

Her glucose followed an odd pattern this AM, but I also kept her on the higher dose so it may just take a little while to sort through. It did hold her longer though this time, compared to the lower doses where she peaked really early and then ramped up quickly.
 
Water comsumption was a worrysome symptom I saw with Harley but that can be attributed to all sorts of things. I think with Shaikha and you it will be more of a balancing act and treating the most serious issues first and the others second. You are doing such an awesome job with her already.

Interesting AM cycle, can't wait to see the next cycle.
 
Hmmm, wonky MD +6.5 there, darn. If you don't have another explanation, like she snuck some HC or was feeling poorly or something, I might try reducing the dose a hair. You got no rise at all from the AM nadir to the MDPS which is great, but makes me start to wonder if either the dose is a tiny bit too high, and/or if maybe she is outgrowing +8 shots. I probably wouldn't space the out more unless she got a green nadir and then wasn't shootable at the next +8, there's the proof she's outgrown TID, but still it does look like maybe improved duration, which is nice to see. And then maybe b/c of that the dose is a little too high? With all her other issues though, I'm hesitant to say that for sure... just throwing it out as a thought.
 
She definitely followed a weird pattern today, that's for sure. I didn't catch the nadir again, but am assuming it was earlier or possibly the +4 was nadir. I'm sort of doubting that though because 2.5 hours later she was already up to 361. I'm going to have to start doing checks at +3 or +5 to see if I can bracket it, but I think she's just being unpredictable.

Tomorrow I'll be in a larger city for an appointment so I plan to do some shopping for food. She's eating the venison but not if that's all she gets, so Ive had to mix it with the other higher carb food. She seems to prefer that one, which is weird because previously she adored the venison. Her appetite is a bit better but I'm sure the antibiotics are playing a role.
 
Joanna & Bix (GA) said:
Hmmm, wonky MD +6.5 there, darn. If you don't have another explanation, like she snuck some HC or was feeling poorly or something, I might try reducing the dose a hair. You got no rise at all from the AM nadir to the MDPS which is great, but makes me start to wonder if either the dose is a tiny bit too high, and/or if maybe she is outgrowing +8 shots. I probably wouldn't space the out more unless she got a green nadir and then wasn't shootable at the next +8, there's the proof she's outgrown TID, but still it does look like maybe improved duration, which is nice to see. And then maybe b/c of that the dose is a little too high? With all her other issues though, I'm hesitant to say that for sure... just throwing it out as a thought.
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It's really hard to say with her. She can be so unpredictable. Most times she seems to nadir early but other times she seems to have gotten duration. I can't figure it out. I'm not sure I want to stop t.i.d. just yet because in the evenings we are in the 300s each time. I'm guessing tonight she may even be in the low 400s. Could be the infection throwing things off, or just her normal weirdness.

EDIT: No change in anything. She didn't get into dry food or anything else. I've been very careful about that. The last time she got food was right before her mid-day shot. Unless she really had an early and low nadir, like at +3, I can't explain the PM values.
 
Oh yeah I would not stop TID, she is doing so much better on it. If you did shift it at all, I would do something like +10s. But I'm not advocating for that. You do want to shoot on a rising # though, and if she is super flat that might be a challenge. But most cycles it seems to be clearcut that she needs the next shot. I might experiment with 0.7 though on a lower PS and see if it gives her a good nadir or not.
 
Thanks, Joanna. That's what I was thinking too. I think some of this may be the infection and possibly renal issues. What I may start doing is shooting 0.7 if the value is below 200 (not too low obviously) and ensuring we've got rising numbers if she seems to be lasting longer than normal. I've done that, but will ensure I always do. She's sporadic though -- great curve one day and then flat the next, or zooming after being nicely behaved prior to then. It may just take her a while to settle in. But heck, when it all comes down to it, I can't fault an occasional 300 or even 400 compared to what I was getting for so long! I never thought I'd see yellows and blues like that. Definitely not blues. She didn't seem to have it in her. Ha! If we could get her trending lower that would be a good thing, but considering we've only been at t.i.d. for 11 days I think she's doing pretty well -- especially compared to her spreadsheet before that! :shock: And of course the infections throw a wrench into the works too. She seems to be feeling a bit better but I know she's not 100% and she still feels slightly warmish to me. We'll see how her urine looks on Thursday and re-evaluate the antibiotic we are using then.
 
Rob & Harley said:
Water comsumption was a worrysome symptom I saw with Harley but that can be attributed to all sorts of things. I think with Shaikha and you it will be more of a balancing act and treating the most serious issues first and the others second. You are doing such an awesome job with her already.
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I used to joke, not so unseriously, that I wish we had at least a few working systems with my GA Tabriz. That also seems to be the case now with Shaikha. Too many things not working as they should and trying to balance it all. We'll get there, and yes I agree about trying to manage the most serious things first and the other stuff just has to wait.
 
My first thought seeing your AM #'s was that the dose was a bit too high but I seem to be the one always touting that so I wanted to see what happened next. If it were me I would drop to .7u and see if that gives her a better u curve.
 
Rob & Harley said:
My first thought seeing your AM #'s was that the dose was a bit too high but I seem to be the one always touting that so I wanted to see what happened next. If it were me I would drop to .7u and see if that gives her a better u curve.
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I didn't change her dose today, in part because I think she's not feeling so great. Will take her to the vet tomorrow but I think the UTI is not clearing up as it should be. This may be playing havoc with numbers too. She feels warmish to me and seems lethargic, which is a worry.
 
Awww, hope she is doing better soon. Those PM spikes certainly are a puzzle. Dose too low? Dose too high? Random wonkiness (or not so random, just unexplainable). Anyway, I think her #s overall are pretty good, so that is amazing compared to a couple weeks ago, like you said. Focus on the good stuff :mrgreen:
 
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