? 9/02 Dak: AMPS 370, +6 365, PMPS 372, +3 438, +3.5 452

Jeremy & Kate

Jeremy & Kate

Member
Another pink pancake day, before Dak's PM shot... Needing some advice on what to do next to help with Dak's numbers (BG and ketones). Is there something that we are missing, should we continue on TR and increasing his insulin amount, or should be reset back around 8.5 or 9 units twice a day?

Current state of Dak: He has been diagnosed with IBD (confirmed with tests, labs, endoscope) and has had DKA (multiple ER visits). We check his ketones around every meal, since he has had DKA in the past. We just stopped giving him cerenia, to see if we have been masking nausea with it (to see if that would help explain his numbers not getting better). He seems to act ok/normal and has not had any diarrhea this whole time. He eats all of his meals without an appetite stimulant. We have been feeding him at least double his calculated calories for this ideal (13 lbs) and current weight (11.4 lbs). We have been giving him sub-q fluids to help battle ketones, and planned to get him off of fluids, until we had a fur shot.
 
Would you mind putting DKA and ongoing ketones into the signature please so everyone who helps is aware.
I haven’t been following Dak closely since you came to the Lantus page as I am mostly on the main health page. I see he is up to 12 units. Has testing for Acro been suggested?
Do the vets have any ideas why the ketones are hanging around?
I would not go back in dose at all, that will do nothing except create problems. You are testing enough to know you have not gone past the best dose.
I would continue with TR. you haven’t reached the best dose yet.
See what others think
 
In your previous post here: https://felinediabetes.com/FDMB/threads/7-23-dak-amps-392-6-386-pmps-382-3-405.292446/ I did suggest the testing for acromegaly and IAA. Did you pursue those tests? There treatments that could lower the dose he needs if you find he is positive for acromegaly.

Now that he's over 10 units in dose, I'd increase by 1.0 units at a time. Think of the increases as a percent of the total dose and go 10-15% of dose as the increase amount.
 
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