Benny Post DKA 4 weeks update

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Kindagot

Kindagot

Member Since 2021
Starting a new thread for Benny.

old post https://felinediabetes.com/FDMB/threads/benny-post-dka-at-home-being-tube-fed.255834/#post-2887705

Very happy in himself today. Wanted to go out. Allowed him for 10 minute supervised sniff of the garden. Eating well, not sure about his numbers. Upped dose to 2.25 units yesterday and he dropped low quite quickly at +2 according to sensor. Was in the 6's at nadir, when he had some temptations and ate a lot of FF pate.
@Bron and Sheba (GA) is this a bounce today or will the updose take a while to settle do you think?
 
Kindagot said:
Starting a new thread for Benny.

old post https://felinediabetes.com/FDMB/threads/benny-post-dka-at-home-being-tube-fed.255834/#post-2887705

Very happy in himself today. Wanted to go out. Allowed him for 10 minute supervised sniff of the garden. Eating well, not sure about his numbers. Upped dose to 2.25 units yesterday and he dropped low quite quickly at +2 according to sensor. Was in the 6's at nadir, when he had some temptations and ate a lot of FF pate.
@Bron and Sheba (GA) is this a bounce today or will the updose take a while to settle do you think?
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I was just starting to write on your old thread when this one appeared.
Great to see those blue BGs last night.
Yes he is bouncing from those blues, which is to be expected, as he has got used to being in the higher numbers and his body now thinks the higher numbers are the good ones. He has to relearn that the good BGs are the green ones! So you can expect some more bouncing until his body gets the message,
Stay with the 2.25 unit dose…it’s working.
 
Fiona -

You might want to consider posting on the Lantus, Lev, and Biosimilars board. Since you're using glargine, I think you will find a good deal of information and support there along with a great deal of expertise with the insulin you're using. Given Benny's history of DKA, we're typically more aggressive about dosing when numbers are high. It's also where you'll find information on dosing.
 
Three nights in a row blue BGs. He’s clearing the bounces quickly. Looks like the low carb food only is helping bring down the BGs .
Good idea to start posting on the Lantus forum now. Are you still testing daily for ketones?
 
Bron and Sheba (GA) said:
Three nights in a row blue BGs. He’s clearing the bounces quickly. Looks like the low carb food only is helping bring down the BGs .
Good idea to start posting on the Lantus forum now. Are you still testing daily for ketones?
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Yes I am still testing for ketones. I will start a new thread on the Lantus forum. I still worry he will go too low in the night though! Touch wood I have both Billy and Benny sorted on the wet food front now. Billy had the echocardiogram done today and has not got cardiomyopathy, however he does have high BP and is now on medication. Which reminds me...time for drug rounds!
 
Kindagot said:
Yes I am still testing for ketones. I will start a new thread on the Lantus forum. I still worry he will go too low in the night though! Touch wood I have both Billy and Benny sorted on the wet food front now. Billy had the echocardiogram done today and has not got cardiomyopathy, however he does have high BP and is now on medication. Which reminds me...time for drug rounds!
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Thats great he doesn’t have cardiomyopathy. The BP can be managed with medication. also good they are both now on fully wet food and no ketones.
The SS is looking better with more blue BGs.
I’ll keep an eye out for you on the LLB forum.
I think we can think about an increase in dose as well.
 
@Kindagot Wow….have just seen that lovely run of green BGs overnight! Fabulous!
Don’t increase the dose. Stay with 2.25 units

also no need to give glucose or high carb food unless he drops under 50 (2.8)
You can just feed some low carb and test again in 30 mins.I know you get nervous with those lower numbers but they are healing numbers!
 
Hi @Bron and Sheba (GA) I was nervous all night! He dropped to 2.9 at +2.5. I fed him 1mg of glucose and offered food. He ate some FF gravy about an hour later, he was 4.7. I think my 2.25 might have been more towards the 2.5 than the 2. I am going to mark the syringes with red Sharpie today! I will take your advice with the low carb and try not to panic ( although I thought about this last night, I do not want to skew his BG by giving him high carb every time he goes low, hence I only gave 1ml of dextrose solution)
 
Kindagot said:
Hi @Bron and Sheba (GA) I was nervous all night! He dropped to 2.9 at +2.5. I fed him 1mg of glucose and offered food. He ate some FF gravy about an hour later, he was 4.7. I think my 2.25 might have been more towards the 2.5 than the 2. I am going to mark the syringes with red Sharpie today! I will take your advice with the low carb and try not to panic ( although I thought about this last night, I do not want to skew his BG by giving him high carb every time he goes low, hence I only gave 1ml of dextrose solution)
Click to expand...
I can’t see the 2.9 at+2.5 in the SS. Except in the remarks column. Did you forget to add it? If you can add it to the SS it would be better. To do that you just stack the numbers in the square. So you would put 5.4 +2; 2.9@+2.5. Then you have to add the numbers manually in the US SS.
I know green BGs are scary in the beginning but you will soon grow to love them!

Once his pre shots drop down to better numbers, you will find he won’t have the big drops and will have flatter curves.
He is having quite big drops at +1 and +2. What I would do is give him a snack about 15 to 20 minutes before +1 and +2 to see if you can slow that drop and therefore the bounce. It is called feeding the curve and is a strategy we use to try and get cats into better numbers when they drop quickly then bounce.
 
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