Sweet Bob the Yorkie has passed 08.08.13

[SeattleCraig]

7:30am - "hi" - twice - meaning over 600.
9:00am - 1/4 unit
11:30am - 313
noon - keto strip "small" amount; subQ fluids
2:30pm - keto strip down to "trace" amount
2:45pm - 231
5:45pm - 328
8:30pm - 423; more subQ fluids

[Patty]

Wow Craig. I have often wished for syringes with 1/4 or better 1/8u markings since Ali's so sensitive to insulin doses. Looks like you'll be another wishing for the same.

I like the lower number but don't like how far he's come down in the course of the day. I'll let Natalie help you through with a plan, but I'm thinking 1/8u and/or multiple feedings to balance the insulin in the future.

[k9diabetes]

I definitely think you should skip insulin tonight. See what the blood sugar is tomorrow.

It is possible that even without insulin his blood sugar will continue to drop because the excess from a rebound is finishing washing out.

If he can't get by without insulin, then I'm thinking that possibly 1/4 of a unit once a day in the morning - because he can be supervised when given in the morning - would be worth a try. We did that for a while when Chris was honeymooning. Twice a day was too much but once a day worked well for a while.

But let's see how he does without insulin.

If this is recovery from a rebound, his blood sugar could definitely return to normal on its own.

Natalie

[SeattleCraig]

I will skip tonight.

I've upped his fluids a bit to help with the ketones, and it seems to be doing the trick.

What if one of his late night (or middle of the night) tests come back in the 500's, or completely off the chart (>600) like earlier today? Should I still wait until tomorrow morning?

BTW, Patty, I don't think I could pull off a 1/8 unit with these needles.
The 1/4 unit was too tiny to really know how accurate I was. I just know I took it to 1/2 unit, then pushed as gently as I could until it looked right. It took a few tries to get it to where I was comfortable that it was about 1/4.

[k9diabetes]

I wouldn't give him insulin in the middle of the night. I would wait until the usual time. This is an opportunity to oberve, not intervene unless there's an emergency, and even if he goes high for a few hours he should be okay.

I'm hoping his blood sugar will drop to normal or close to normal. If he rebounded last night, his blood sugar might still run somewhat high for another 24 hours but we will see.

Natalie

[AlisonandMia]

I believe NPH can be diluted - maybe this is a situation where this could be warranted.

http://petdiabetes.wikia.com/wiki/Diluting_insulin

Alison

[SeattleCraig]

7:30am - "hi" - twice - meaning over 600.
9:00am - 1/4 unit
11:30am - 313
noon - keto strip "small" amount; subQ fluids
2:30pm - keto strip down to "trace" amount
2:45pm - 231
5:45pm - 328
8:30pm - 423; more subQ fluids
time for dinner.
still sitting tight here for no dose tonight.

[MaryLea]

Best wishes to you, Craig! We've had our first experience today with a big drop in BG readings. Don't know whether to stay up to take another reading at midnight or not.

[SeattleCraig]

11:30pm - hi (>600); 1 more subQ. Alarm set for 2:30am for another test.

man, I hate this. Poor little guy.

[k9diabetes]

Okay, 1/4 unit it is. Seems like as long as you can measure something less than 1/2 a unit, you should be okay.

When is he scheduled to see the vet again?

I wonder if he could be a little Addisonian - that's low levels of cortisol. Could help explain why he was so ill and also his high sensitivity to insulin.

I wouldn't try to bring his blood sugar all the way down. Instead, I'm hoping that 1/4 unit will hold him steadily in the 200-400 range as it did yesterday. Because so far, 1/2 a unit looks like too much and I'd like to see the vet involved again regarding how to proceed from here, not only with his blood sugar but with seeing how his kidney values are doing and considering something like Addison's disease.

Getting him back to regular food would also probably allow him to use an easier to measure dose of insulin.

Natalie