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Old 06-16-2020, 07:24 AM
juicy juicy is offline
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Join Date: Nov 2016
Location: Sydney, Australia
Posts: 3
Default Re: Elderly long-term diabetic having weird episodes

Thank you both again so much for taking the time to reply and give your advice and encouragement. Again, I'm sorry for not being able to respond sooner. I really am so appreciative of your time and kindness.

Things have been very up and down with Juicy over the last few days. Both of you flagging the high insulin dose was so helpful; it really highlighted that as an issue that needed to be addressed. With her ongoing poor eating, we ended up at 12 units AM/PM, and that was giving a more predictable curve.

Mo, your advice about giving her time to adjust to the insulin dose has made a big difference - I think it has been key to getting a more reliable curve. I really can't thank you enough.

Jesse Girl, the way you have managed your Jesse through ten years of diabetes is amazing. I am so grateful for the information about her meals and insulin management. You mentioned that rapid insulin might be helpful on an intermittent basis, which is something I have heard about from human diabetics, but it has never been discussed for Juicy by either her regular vet or specialists she's seen. I think that would be ideal for her, but I'm not sure how to go about that without some vet input - the first step will be talking to her vet tomorrow. Her insulin is Mixtard 30/70, which is the usual 12-hour action insulin, I believe.

The care you put into Jesse's diet is obviously a huge part of her wellbeing; Juicy has been through a lot of different diets over the years, and leading up to this, she was having a combination of cooked meals and prescription diet; after all this started, I started cooking her a simple casserole of potato and turkey or chicken, but the cycle has continued - she would eat well, then have severe symptoms the next day and poor appetite for a couple of days, then start to feel better, eat well again, and repeat.

She had a couple of very bad days over the weekend, and has lost almost another kilogram. She was very weak and lethargic. While we were back at the vet, I picked up some of the Hills ID tinned food and she has been eating that in small but regular amounts so far. With the return of regular meals, her blood sugar curve has started to rise and 12 units does not seem to be enough. We are currently back at 15 units AM/PM with the lowest point in the BG curve about 13. As she began to eat these small meals, she started having more energy to get up and move around, and there was a big improvement in her energy level after 48 hours, but with the rise in the BG, the lethargy has returned. I feel very cautious about increasing her insulin, but am also very keen to avoid these prolonged periods of high blood sugar because she seems very affected afterwards

Another thing I'm concerned may be causing an issue is delayed stomach emptying; from what I've read, she seems to have many the symptoms. She's had GI issues for a couple of years now that come and go and are part of that set of things that are never really resolved. Once she's eaten a small plate of food, she starts to cough and although she tries to eat more, she can't seem to manage it. Then, a couple of hours later, she'll go back searching around her food bowl, wanting to finish the rest. One of the strategies for dealing with that seems to be smaller meals more frequently, dosing insulin more frequently.

However, I don't actually know if that's what's going on. I believe the delayed emptying can be caused by cranial nerve dysfunction, and I know that some of her other cranial nerves have already been affected with the Horner's syndrome, etc. She has also been sneezing a lot during this time - the vet has checked, and there's no sign of anything, but it hasn't stopped and over the weekend, she almost had a couple of episodes of reverse sneezing, wheezing with it.

She often seems confused and disoriented at the moment. I am so thankful that she is up and moving around again, but she still seems very far from where she was six weeks ago.

I'm planning to speak to her vet again tomorrow. At the moment, it really feels like we are operating without a compass, so to speak.

My apologies for the long and I'm sure very muddled post - at the moment, everything seems relevant, even when it's probably not.

Thank you so much again for all your encouragement and kind words. I really am incredibly grateful for all your insights and advice - it means a lot.
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