5/12 Sebastian AMPS 223 +3 295 +6 271 +9 276 PMPS 274 +3 290 +6 271 +11 249

Yesterday

AMPS 223. Blood ketones 0.9. Little bit better numbers today. Hopefully they continue moving in the right direction. No vomit. Diarrhea in the box at +6 but none this morning so we'll see what the next BM brings. If nothing else he's holding it longer. His body feels a little less bony so I think the weight gain is legit, hopefully that keeps up too.

 

Just had a BM. Very soft and loose but it's at least in clumps, definitely better than before which was just soup and very little even remotely solid.

 

Nice update, come on down Sebastian
Have a great day

 

295@+3. Dangit why won't this BG come down.

 

Hope Sebastian feels better! At least, his numbers are so much better that last year at the same time!
Let's hope for some nice blues and greens today !

 

271@+6. Blood ketones: 0.9. Ketones holding steady, weight is up slightly. BG still high. Starting to look like maybe this isn't a bounce and is just too low a dose? Don't really know what was with the dip to 72 the other day, maybe it was a result of all the vomiting and diarrhea and he just didn't have enough food in him. I'm thinking if he's not down by tomorrow AM I should up to 3u.

 

276@+9. His appetite seems to have tapered off a bit as the day has progressed, he devoured breakfast + an extra 1/8 can, but he still has a bit left in the bowl from lunch. Past couple days he's been really hungry which I assumed was because the food was passing through him so fast. Hoping that this decrease in appetite back to normalcy means he's actually getting nourishment and the ketones will be down when I check at PS.

 

I'm not liking his numbers either, I was hopeful when I saw the lower yellow start this morning....

I have been wondering about that green???? If he was absorbing less of what he was eating, it's conceivable that could make his numbers lower....if only we knew for sure.
The difficulty with lantus is that it takes a while for you to see the effect of a dose, and, just to complicate things further, sin some kitties, a dose increase, elicits an immediate increase in BG New Dose Wonkiness.

I'd feel happier if those ketones were showing signs of coming down, and I can understand you wanting to take the dose up.

Things to consider, before taking another increase

• are ketones still present?
• are ketones trending up or down?
• how is his appy
• any other systemic stress going on.

In the absence of ketones I would probably hold the dose.
DKA history and Ketones present, would sway me toward a further increase, but if you do go down that route bear in mind that you will not have seen the full effect of the 2.5u dose yet. Maybe with tonight's cycle and tomorrows amps you will get a better feel. If you were to see him go blue tonight or tomorrow I would hold the 2.5u for at least a further cycle.

If you do take him to 3u, I think you should then hold that dose (as long as ketones are low/or absent and he is well) for at least 6 cycle, wouldn't want you to overshoot with the dose by taken him up to 3.5, which saw him flirt with pretty low BG, just a few days ago.

 

AMPS 274. Blood ketones 1.1.

So, ketones are still present and trending up a little. Appetite is good, he's eating all his food. No vomit, stool is still pretty soft and runny, better than it was but still a lot of room for improvement.

I don't want to go above 3 since we saw that 3.5 was too much but I have half a mind to increase him to 3u tonight. If he happens to go blue tonight or tomorrow AM I'll back down but with the ketones still there and not dropping, I want to get ahead of it and get this BG down ASAP. I think I'm going to give him another sub-q bubble tonight also, that seemed to help bring the ketones down a bit last night and he's probably still losing a little extra fluid from the soft BMs.

 

So I'm looking at the numbers again and last night's cycle looks like a normal, late nadir cycle. Started high at 287, dipped down to 223 for a +12 nadir, then rose back up to 295. Don't know about today's flat 70's, I haven't seen NDW enough to recognize it. But I'm definitely feeling fairly confident that 2 was just too low a dose.

 

290@+3.

 

271@+6. Boy am I getting real tired of seeing 270/290. Blood ketones 0.4 though. Sub-q does a good job of bringing those down.

 

The Subq's help to flush them out. I'm glad they've come down.

 

249@+11