Last updated: Thu, 13 May 2010 16:12:20
It is now Mon, 9 Dec 2013 14:50:00
[cku100510op-bgs209c3.jpg] Kumbi BG curve, 10 May 2010
I can see why my vets say (usually), don't bother to take glucose curve tests when the dog is fighting infection and on antibiotics.
A curve like this one can make me scratch my head, and wonder what I'm doing wrong. Such sharp changes in glucose levels; often steep in slope. And those soarings in the evening just, somehow, FEEL bad to me. Kumbi doesn't seem unduly uncomfortable, though.
My vets suggest it's not (Somogyi) rebound (overswing), where the liver kicks glucose into the bloodstream in response to perception that glucose levels are running too low for safety.
Most of the time, while Kumbi is being given Chinese herbs that can change his insulin requirements, we've been keeping Kumbi on the same dose of Novolin-NPH insulin he had been on since 18 Janurary 2010.
I've been giving him these herbs since the first of April, 2010. The following morning, 2 April, his glucose was surprisingly low before his breakfast, and I reduced his dose a fair bit that morning. But then it seemed wise to return to his normal dose of 7.5 units, and I ended up doing that.
That is, until Tuesday, 4 May, when, near his suppertime, I thought his levels weren't coming up as quickly as they should. And I FELT as though it were "reboundish," - and that evening, I cut his dose from 7.5 to 7.25 units, thinking I'd hold it there for a week or so, to see what happens.
But then, on Mother's Day, Sunday 9 May 2010, I suddenly thoguht perhaps I should not have cut his dose back, and that day, I gave him 7.5 units, morning and evening.
The next morning, Monday 10 May, when his glucose levels were very high in the morning before feeding, and worse half an hour later, just before giving insulin, again I thought maybe this was rebound, and I cut his dose back to 7.25 units of Novolin-NPH insulin, where, as I write this, Tuesday, 11 May 2010, I am holding it for now. I wondered if I'd set off the large morning swings by raising his dose the day before.
Return to Kumbi's no-soar chart, 12 May 2010
Hypoglycemic episodes - the dropping of glucose levels to the point where the dog becomes unstable - trembling, staggering, later perhaps going into seizures, coma and death, if nothing is done - are to be avoided. In principle! And in practice, too! Kumbi has not once had a hypoglycemic episode - a "hypo."
Today, I'm thinking perhaps really, all I should do is test often enough, at particular times - at the times Kumbi typically drops to his lowest glucose levels - to be able to take action of some kind if need be. That preventive action is just as likely to be cutting his insulin dose back
Though the chart on this page amply illustrates fluctuations I would rather not see, so does his chart from two weeks ago, Kumbi's chart, 26 April 2010.
I am struck by how consistent Kumbi is with his responses; this chart and the one from two weeks ago are very similar in shape.
[cku100510op-bgs210c3.jpg] Snack but no insulin!, 10 May 2010
Now, really, how could I have missed this!
Easy. Thinking in the past. Here Kumbi's soaring glucose levels - from five in the afternoon - repeated throughout most of April and May so far (to date as I write this on 11 May 2010) - have a perfectly reasonable, and even OBVIOUS, explanation!
Kumbi and I dedicate this picture to Linda and Ladybug. After all, we just told them Ladybug's puppy milkbone was likely raising her glucose levels, yes, even a couple of hours before the glucose test.
And what about US? HEY! Same situation!
I looked at this chart, and I looked at the one from 26 April - and remembered the others - and FINALLY, asked myself, "Now, WHAT is happening at five in the afternoon? Or, better, what is happening at THREE in the afternoon?"
BAM! I have my answer! SNACK!
And Tech Nyla had even remarked, on seeing the numbers, "He's running out of insulin."
Dear Kumbi; I'll find you some little tiny treat, instead of a snack! Without Kwali to set you off, you're not dropping so much in glucose levels on walks. Then you ALSO don't need the snack boost!
I'm not ashamed of my red face. My face is always going red.
Now we'll see how things go!
Updates will follow - somewhere!