Last updated: Mon, 31 May 2010 02:38:58
It is now Sun, 19 Sep 2010 03:28:55
Last updated: Mon, 31 May 2010 02:38:58
It is now Sun, 19 Sep 2010 03:28:55
[cku100405-603d15.jpg] Kumbi BG curve, 5 April 2010
Preparing for dental surgery, we did a full geriatric blood panel on Kumbi. His liver values were very poor, so we're not going to risk anaesthesia before working to improve those values.
The vet who prescribed the Chinese herbs he's on instructed me to monitor Kumbi's glucose levels, as his insulin requirements may be lowered while taking these herbs.
I've been monitoring, then, since starting him on the meds, Thursday 1 April, 2010. I gave the usual dose of insulin that evening, and began monitoring the next day. On that first full day of the meds, Friday 2 April, Kumbi's glucose levels were dramatically lower than they've been when I've done curves before.
I surely was glad the vet told me to monitor! And I cut Kumbi's insulin dose in the morning, and with continuing glucose levels lower than usual, I cut it again in the evening. But then Kumbi's glucose levels went higher than usual, so I began raising his dose, and over the course of the next few days, brought him back up to nearly what he'd been receiving (7.5 units) before I started him on the Chinese herbs.
By Monday 5 April, I had brought him back up to 7.0 units. And now I really wanted to have some idea of what his numbers were looking like all day, first, to make sure he wasn't dropping so low as to rebound, and second, to prevent a hypoglycemic episode.
Meantime, my regular vet and I consulted by phone Saturday evening, and the vet said I was doing fine managing the insulin doses.
So, on Monday 5 April, I went through the motions of running a glucose curve on Kumbi, taking readings every two hours.
However, my vets have always taught me that glucose levels fluctuate in the rpesence of infection (here, teeth), and also when the dog is on antibiotics (here, Clavaseeptin).
So, the curve plotted in the chart above isn't one that represents anything apart from fluctuating levels. All the same, I felt I needed it, to make sure Kumbi doesn't drop into hypoglycemia, nor go so high as to get into diabetic ketoacidosis. High is safer than low, so any dose increase I might make is something I'd watch, to prevent Kumbi from dropping too low.
I'd taken readings every day since startng the herbs, and continued doing so every day following the 5 April curve. The next chart is from Thursday, 8 April; Kumbi is still running with quite high levels, even though by Thursday, I'd brought his insulin dose back up to 7.5units, which had been a stable dose for him since 18 January 2010.
The next chart, then, is from one week after I started the liver meds with Kumbi. All the while, too, he's been on Clavaseptin (since 23 March 2010). This one concentrates readings in the afternoon, when Kumbi typically reaches his nadir (low glucose level of the day).
[cku100408-603d09.jpg] Kumbi BG mini-curve, 8 April 2010
[cku100409-603d07.jpg] Kumbi BG mini-curve, 9 April 2010
Kumbi has always hated procedures. Including even having his harness put on, so we can leave the yard safely. All the same, he is always cooperative when I test his blood sample. Good boy, Kumbi!
BUT! After a week of testing every day, sometimes with so many readings it's almost like a full curve, Kumbi began to show the stress of it all. Like all dogs who are close household copanions, he watches everything I do. He likse being a Sentry anyway, but by now, he was most aspecially alert and on-watch, and making clear attempts to avoid another prick from me.
By Friday aftenoon, 9 April, after Kumbi had been on the meds for a week, his glucose levels began to soar, at increasing rates of speed. I'm making a passably-educated guess that the soaring glucose levels are the result of stress at being pricked once, twice, several times too often for his comfort.
I exercised my greatest self-control to avoid doing more checks after his glucose rose so high at 7 p.m. I WANTED to test, but more, I wanted Kumbi's stress hormone levels to drop, in case all this testing was causing the rises.
I ran two tests on Saturday, 10 April; one just before his morning insulin, at which time he was at 27.5 mmol/L (496 mg/dL) - and then again at what is often his afternoon low, around 3 p.m. - and that reading was the same - 27.5 mmol/L (496 mg/dL).
And then, with my vet's permission, I stopped testing. Instead, I'm watching clinical signs, though I always do that anyway. My regular vet and the locum who prescribed the Chinese herbs will be conferring on Wednesday, 14 April, and we'll go from there. I will, of course, test if I become worried, but the longer I go without testing, the better Kumbi will recover, if it was indeed stress hormones that set off the dramatic rise in glucose levels on Friday 9 April 2010.
You can compare the readings on these curves and minicurves with earlier ones, at Kumbi's recent curves.
Charts of the days before and between these three should soon appear also.
Updates will follow - somewhere!
