Xuxu, 3/17/13, LO crashing

Xuxu was really crashing this time, fast breathing, drooling. We had been laying in bed half awake and hadn't called for him yet. He was sort of hidden under a chair. I just caught a glimpse of his body hair moving up and down fast and I knew what it was. He's recovered again. But it was strange that it was the 11th hour. I'd seem him at 10 hrs when I woke up for a bit and he was moving around and seemed fine. I'd dosed off again thinking I had 2 hrs until his next shot.

It was my fault, I gave him the .25 without drawing out any drops when he was at 528. He seems to be dropping over 500 pts for .25.

 

Wow. Poor baby.

 

He seems to have done fine overnight. He's at 574 @11 hrs, so I went ahead and gave him .25-8drops. I feel fairly comfortable shooting him at high 500s but I'm not going to do a full dose below 550.

BJ. So in light of the past couple of days, do you still think split dosing would work? If I gave him a couple of drops at 2-3 hrs, given that he reacts immediately, wouldn't that just drive him lower? What if I gave him a couple of drops when he is rising, around 300. That might keep him down. I don't know the level that ketones start kicking in. He did have a small amount at 550 the other day. It may be all I can hope for is to keep him low enough to not get ketones, but hi enough he won't crash when I'm not there.

 

Charting new territory here.

My thought was 1-2 drops, wait about 3 hours, check and do another 1-2 drops to see if it'd spread out the effect a bit more rather than 1 steep low - sort of 2 less deep, but still steep drops on a schedule you might be able to do if TID isn't possible.

 

Ketones come from a combination of not enough insulin, an infection of some kind and not eating.

You can get ketones even if their numbers are in the low 200's, it doesn't really have anything to do with their bg's.

Keep an eye on them, test often, ketones can go from bad to worse very quickly.

 

Thanks Bob, I didn't know that about ketones. I thought it was just lack of insulin. He was getting his URI back again but the clavamox I restarted last Fri seems to have it under control again. He wasn't eating as much last night, not unusual after he's crashed. so I gave him a mirtazapine and he is eating more this morning. The good think is I haven't had to give fluids in 2 weeks. He's getting enough water from drinking and the wet food. Plus all his meds are liquid except his orbax.

BJ, He really doesn't seem to have a steep drop with the PZI. Today it's taken 5 hrs to go from 574 to 461. It's really stretched out the curve, which is why the nadir at 11 hours yesterday caught me off guard. A PZI curve seems to last 18 hrs for him. I'm going to monitor him 2 hrs today.

 

It may not be a fast drop, but he goes really, really, low. That also was part of the reason to try split dosing - to keep from having the entire dose hit its maximum effect at the same time.