Sally recent DKA; AMPS 91, +6 326, PMS 253

Sally had pancreatitis/dka. She has been home since Thursday night. All her outward signs have improved, testing daily for ketones. We have been instructed to give .50 if pre shot is over 250 and .25 if under 250 till we do a curve next week. This am her AMPS was 91. We fed her, her appetite is normal, and are stalling. We know dka changes the scenario of what we would normally do, which is skip the shot. I was thinking of doing .125 as a token shot or seeing what she is in an hour and doing .25. After some high numbers yesterday wevwere surprised by this and so tired from this past week we are afraid of making the wrong decision. She drops fast. Can someone advise? We had weaned her off insulin under vet',s advise just before pancreatitis.

 

If you haven't fed, test again to see if it's coming up. If she is coming up, I would give "some" insulin. Have you gotten any more tests since 6/26? The SS hasn't been filled in since that date.

 

Hi thank you so much. Just tested and she is 175 so I gave her .25. We had fed her already, now I remember reading not to feed and see if she is going up. Head muddled from lack of sleep. i hope I didn't screw that all up....yes we have done testing since she came home. I 'll have to see why you can't get that info. Yesterday she spent most of the day in 400's, so the 91 was unexpected.

 

I'm glad you shot. Keep testing to stay on top of things.

I noticed the SS said Sally - old. Did you create a new SS?

 

I just updated the link to the updated ss.

 

I recommend that you do not skip a dose at night. Keep giving 0.25u in morning and at night and see if it can make her numbers more level. We want to keep her safe and not risk another DKA.

 

Yes I agree about the night shot. You think you are starting to get a handle on it then you find out you've been wrong.
The ER vet had gone thru our ss with an internal med specialist and they came up with the temporary plan to do either .5 or .25 based on preshot. Seemed odd to us to change based on pre shot but thought it was to keep her on as much insulin as possible till we get her back into feeling better and till we do another curve in a week. So confused.

 

Lantus is a depot insulin and cannot be administered like that. That's why I think it's better to try 0.25u both morning and night to see if you can keep her in better numbers and not risk needing to skip.

 

That's what we thought too. We regret to say the least ever lowering her dose from .25 twice a day. I think she would have done well on that. We were getti ng less bounces on lower numbers and were afraid of what the bounces were doing to her body and as a result I believe we created the pancreatitis and dka. That's much more serious than wondering about long term effects from bouncing.

 

Gave .25 tonight.