12/1 Jackson AMPS 343 +1 404 (+1.5 355) +5 321 +9 315 +11 308 PMPS 325 +2 280 +5 214

https://felinediabetes.com/FDMB/thr...-6-274-8-5-363-9-5-395-pmps-416-3-349.271316/

Well, I messed up a bit this morning. Woke up being stomped all over by the other young cat that stayed in my room last night, looked at the clock on the wall to see what time it was, and promptly panicked (thought I had to leave for work in 15 minutes). I saw the hand on the “30” mark and was convinced I’d somehow slept through my alarm. I bolted out of bed, shoved food at Jack, gave him his shot, threw some scrubs on, and was on my way literally out the door when I realized it was still dark outside.

Yep. I was woken at 5:30, not 6:30. So… not only am I out 30 minutes of sleep, Jackson’s AM shot was given 45 minutes too early.

I’m not sure how much to worry. It was a decent preshot number. And I can’t un-shoot it, obviously. But it means he’ll be “late” on his evening shot. Maybe I should back that up by around 20 minutes over the next two cycles… less variation than waiting a whole extra 45 minutes longer one time?

On a plus side, I just caught a nice fresh strong pee to test. Still ketone negative.

 

Glad the ketones were negative. If you can do 20 minutes that is better than 45 minutes. You can safely move the shot in one 30 minute increment per day and two 15 minute increments.

 

….well that was the ideal. I ended up giving the PM shot barely by normal time. Work got a little crazy, and I stayed late. Also, the cousin who usually gives shots if I’m not home also wasn’t home. So… not ideal. I know. I fully intended to stretch the shot time differential out over a couple or even three doses.

The best laid plans…

Just going to sit with him for a while now. But he’s been pretty stable most of today, although in pinks.

As for his ketones, I’m always happy to see negative. However, by now I’m starting to kind of expect it too. Despite starting insulin therapy after a DKA episode, he hasn’t thrown ketones once since I started urine testing. I’m kind of wondering if maybe he really isn’t going to be normally prone to them, and if that episode was instead a very specific response to being an untreated diabetic with a concurrent illness - they said at the hospital that he did have an inflamed pancreas when he came in. And his appetite and body language still wasn’t right for the first week or so after coming home. But those are normal now.

In fact either his diet change, insulin, or both has had an unexpected side benefit - his long-time dandruff is gone, fur all soft and smooth. He also seems to move with less achiness. Despite continuing to have higher numbers, he appears and acts healthier than he has in years. (And no, he wasn’t diabetic that whole time; his last blood test before diagnosis was glucose normal about 6 months prior.)

 

Considering his history of DKA, I wonder if you want to go back to 1.5U tomorrow itself rather than wait another 2 days. You don't want glucose toxicity setting in. You are testing enough to keep him safe. The SLGS is on account of him being fed dry food.

Going to tag @Wendy&Neko for confirmation.

 

Please, yes, confirm. I have been specifically suggested to increase earlier, and also specifically told not to. I’m fine with an increase, myself; he’s not showing any signs of bouncing now so I think we at least have an idea what’s really happening (or not) with this dose.

Definitely don’t want glucose toxicity back! We only just broke it!!

 

Yes, he was fast-tracked a month ago because of the history of DKA and because he was staying flat and high and needed to break through glucose toxicity.

 

He was fast tracked until he got to a better dose, which he did. And then started seeing reduction. So the urgency isn't as much there now, as long as he stays negative for ketones. I'd also like to see the dose held at least six cycles after the last blues, so you don't end up increasing during a bounce breaking cycle. Which should be sometime tomorrow. So I'm suggesting you wait at least another day.

 

Okay, that’s the plan then, I’ll hold. Looks like he might even see some higher blues again tonight possibly… he’s at 214 right now. I’m going to bed though - exhausted. Will find out in the morning where nadir ended up. The Libre graph is really useful for that…

Good night all! Thanks!