? Unexpected low PMPS 9.1, dose advice please, now +2 30.6

[Alexi]

So a brief recap. Cappuccino was diagnosed 2 months ago and has been on caninsulin from diagnosis, usually 2 units twice daily, attempts to increase her dose resulted in either a hypo or a bounce. She has been seen by a specialist who found some evidence of fatty liver and pancreatitis as well as a urine infection and recommended a change of food from Felix in jelly to Purina DM canned and high dose antibiotic. I am still awaiting some test results.

Over the past week she has been on the antibiotic and I have transitioned her food, today being the first day she has had the Purina DM only. Her liver appears to have shrunk and she is more lively than I have seen her in years!

She is hungry and her poops have firmed up. She has never had ketones and I'm going to try to get a dip this evening. I checked her PMPS as usual and it was 9.1, so rechecked and it was 9.8. I knew treating the UTI and transitioning her was likely to bring her levels down but this was a bit unexpected!

I have not given insulin tonight but wondering what to give in the morning. I was thinking above 20 - usual 2 units, but not sure how far to drop her dose if it is less than this. I was planning a curve this weekend. I do have to pick up more insulin in the morning and can speak to the vet if needed.

Help!

 

[Alexi]

Now at +2 she is just over 30, the only other time I skipped a dose she was ok by the next cycle (skipped as unable to monitor post hypo), not sure whether to leave her or try a small dose of insulin now, she is fine and I will check again in another hour.

 

[manxcat419]

I think it would depend on whether or not you can adjust your next couple of shot times if necessary to shoot later, depending on what duration you're generally getting on Caninsulin. If you're only typically getting an 8-10 hour duration, you might be able to shoot now and then get right back on track with your next shot. On your spreadsheet it looks as though her shots may not be lasting the full 12 hours a lot of days.

 

[Alexi]

Yes I can adjust the times, it looks as though it usually lasts about 10 hours, I was thinking of giving one unit now and then making a judgement on the APMS number, I do have to do a curve on the new food but I can wait until she settles.

ETA: gave 1 unit at +2.5 given that she dropped so dramatically today

 

[manxcat419]

I think that's a good decision. And based on where she is at your next pre-shot time, you can either get back on schedule or adjust back to your regular time over the next couple of days.