? Feedback on dosing would be appreciated.

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Kitty Anderson, May 17, 2019.

  1. Kitty Anderson

    Kitty Anderson Member

    Joined:
    Feb 27, 2019
    So my Princess Kraken had a let's fool my owner that I might be in remission few days with AM and PMPS in the greens with the lowest reading on day 3 AM of 3.5 (63).
    Per advice on main forum we tried drops dose but second drop dose was clearly more than a drop (practised probably 30 times.. Not enough) and she went down to low. After starting drops and doses her numbers basically got worse, although correlation is not necessarily causation.

    She went back up to yellows with a pink so we returned to her previous dose with DH under orders to reduce at the first blue number and hold there even if she went up to yellow. A 171 and reduced to 0.2. After a 7.8 (140) and a drop dose I told DH to reduce to 0.1 and hold
    Currently our thought process is keeping her at 0.1 units. DH tried a 0.2 yesterday when she went up to yellow as he couldn't reach me (in meeting) .. But a 0.1 this morning with orders to hold.. With a comparable PMPS. I'm actually thinking that a 0.15 dose would be more appropriate, but trying to teach DH caliper dosing via phonecalls.. Videos and articles didn't really work. He is not confident in being able to use it accurately.
    I'm travelling for work and won't be home until May 28th when we will go through all that together for finer dosing control.

    I would really appreciate some advice or feedback from someone who is expierienced with this particular insulin, canininsulin. It honestly is looking like the lower the dose.. The more stable the numbers. She also has CKD so keeping her stable and low will help prevent even more kidney failure.

    For slight context, I travel for work 6 months a year. DH has non existent English in medical issues, and just limited knowledge about medical issues in general. Currently I am basically making all care decisions via her spreadsheet and 2 to 3 phone calls a day. DH is an amazing carer and does anything requested to the absolute best of his abilities. When it comes to her insulin management our new vet is basically leaving it with me, saying I'm making good decisions and that she is doing very well. Her numbers are reasonably good I think, but I feel that there is something floating around that I am not grasping.

    Her old chart is when we were following our old vets reccomendations but home testing 13 times more á week than reccomended. The reccomendation was to bring her in weekly for a spot check. We honestly did not know better and trusted our vet. She kept getting sicker and sicker and sicker. I came home from a trip and broke down seeing her and spent days reading everything I could on this forum and changing everything about her care almost. Comparing her numbers now on 5 to 15% of her old doses then we are extremely lucky she is still alive. She went from quite fine except loosing weight and drinking more.. To barley being able to walk on old dosage. And in 4 days on my dosing was able to walk and jump a bit.. A couple of weeks and was doing much better and didn't need step stool to get in bed.. And a 5 to 6 weeks right back to her old self. Her CKD got much worse on vets dosing as well... Probably due to the renal strain.

    The dosage chart on the bottom of her spreadsheet is I am completely unavailable at dose time (I'm usually able to receive a text of her number and confirm a dose) scale for DH for the first weeks I was away.

    Currently in timezone CEST.
     
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  2. Kitty Anderson

    Kitty Anderson Member

    Joined:
    Feb 27, 2019
    Úffff.. So I was speaking at test and dose.. And DH got a 15 (270) and panicked a bit and dosed 0.3 of a unit.. He's home to check and feed so a safe dose per se..
     
  3. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Hi Princess Kraken's mum!
    While I didn't use caninsulin, I looked at her SS and it looks wonderful! :) I do not think she's quite ready for an OTJ trial (off the juice) and think you should hold the drop dose. Do you have any idea what was different 30 Apr - 10 May? Or maybe her CKD was causing some symptoms? What stage CKD is she? Are you reducing phosphorous in her foods? How much depends on what stage she might be.
     
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  4. Kitty Anderson

    Kitty Anderson Member

    Joined:
    Feb 27, 2019
    Ooh.. She definitely nowhere near OTJ at the moment.

    For the pinks on 30.04 to 01.05 there is no logical reason I can see other than its a bounce.

    The one on May 09th.. She got into her sisters dry food. First time since Dx.

    But just looking at the numbers.. As soon as she got her first drop dose after 8 cycles with no insulin, the very next reading she was far higher in BG than off insulin. Going from 101 PS before the drop dose.. To 167 PS after the drop dose. Today I'm kicking myself for not having held off a bit longer to see what she did. Then her BG just got more out of control as she was raised in dose. Correlation does not equal causation but if she was headed into remission and I gave her a hard hitting insulin nd spiraled her out of control.. Well yeah.. I guess I'll never know for sure. Just feeling a bit beat down.

    Shes early stage CKD.

    Talking with a vet friend of mine in Germany last week, who has diabetes experience, she was asking why I started dosing again with those numbers. I couldn't really give a rational answer other than being scared.
     
  5. BBelshan

    BBelshan Member

    Joined:
    Feb 11, 2019
    Sorry I don't log in as often as I should. The chart is looking really good lately. I know it's hard not to chase the numbers when they start climbing, but maybe hold the does at .1 or .15 (if possible) for a few cycles on some of the slightly higher days and see what the nadir looks like and see if the PMPS naturally goes back down. There might be an ebb and flow to the numbers and over all it looks like she does well on the smaller dose. If she climbs to the yellows and stay in the yellows, that is when I would increase.
     
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  6. Kitty Anderson

    Kitty Anderson Member

    Joined:
    Feb 27, 2019
    Thanks. We are holding at 0.1 at the moment.

    I'm on mission until next Tuesday, DH is not having success with figuring out Caliper dosing at the moment but I'll go through it with him next Tuesday evening. I'm home from work for over a month this time, longest stay at home yet this year, so we have a full month to work on stuff before it's back to advising from afar.

    But with these small doses and being on the smallest dose DH feels he can really administer. The drop dose stresses him a bit... Then we really need to get him comfortable with caliper dosing.
     
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