Starting invokana Dr Kellon please
|
Suzy Berkowitz
Dr Kellon, I finally received the invokana 300mg tablets and have lots of questions about getting Scout started on it. While waiting for the invokana to arrive I increased the metformin to every 8 hours. His insulin taken on April 10 was 57.17 down from over 200. His ACTH was 27.3. I checked his triglycerides on March 30 and it was 68 with a reference range of 14-65. Scout is approximately 181kg. How do I transition from the metformin? I’ve been giving it to him 9am, 5pm, 1am. With the prascend at 5 pm also. Can I sub in the invokana dose at 5pm and then discontinue the metformin after that? Should I still give him the metformin dose in the am of the day I am to start the invokana? Can I give the same time as the prascend? Should I start him on the L-Carnitine? Can I start him on a quarter tab which would be approximately 0.4mg/kg since his insulin is not in the danger zone and it will be easy to quarter the tablet? How does the unused portion have to be stored? Thank you so much. Suzy in Fl 2020 |
|
|
|
You can give the AM metformin the day you start Invokana and give it with Prascend. Yes to starting L-carnitine. Is he still only eating cubes and Stabul 1? How much of each? Can he eat hay? Will he eat beet pulp?
-- Eleanor in PA www.drkellon.com |
|
|
|
Suzy Berkowitz
Dr Kellon, Scout gets 1 cup of Stabul 1 that he sometimes eats sometimes doesn’t. He shares his pasture/ stalls with a mule and I feed 13 lbs a day of the cubes between them that I have to break into small pieces. A bucket in each stall and 2 buckets outside where they come and go as they please. He is not a great eater, so the mule probably gets alot of Scouts share. Our setup is the barn is in the pasture so they have access 24 hours to graze the typical south Florida field. Scout doesn’t like wet stuff so I have never tried the beet pulp. He can’t eat hay. The L- carnitine is on its way. I ordered from the link you provided. How much should he get? He got his metformin dose this morning and I will start the invokana this evening at 5 pm. Is the 75mg dose correct? Thank you
-- Suzy in Fl 2020 Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout Scout Photos: https://ecir.groups.io/g/CaseHistory/album?id=260915 |
|
|
|
He should get 4 grams/day of carnitine. Assuming this is a full size mule they are obviously using the pasture for nutrition. Yes, the dose is correct. Check his insulin and triglycerides after a week and keep a close eye on him for attitude changes, sudden weight loss.
-- Eleanor in PA www.drkellon.com |
|
|
|
Suzy Berkowitz
Thank you so much.
-- Suzy in Fl 2020 Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout Scout Photos: https://ecir.groups.io/g/CaseHistory/album?id=260915 |
|
|
|
Suzy Berkowitz
Dr Kellon. The L-carnitine got here today. I want to confirm I’m just going to weigh out 4 grams and give daily. Thank you.
-- Suzy in Fl 2020 Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout Scout Photos: https://ecir.groups.io/g/CaseHistory/album?id=260915 |
|
|
|
|
|
|
|
Cindy Giovanetti
Dr. K, what is the purpose of the Carnitine that’s recommended for horses on Invokana?
Cindy
_._,_._,_ -- Cindy, Oden, and Eeyore, North Texas On ECIR protocol since 2/19 https://www.facebook.com/LifeWithOden/ History: https://ecir.groups.io/g/CaseHistory/files/Cindy%20and%20Oden Photos: https://ecir.groups.io/g/CaseHistory/album?id=91125 |
|
|
|
Hi Cindy
Dr Kellon reviewed this study a few days ago along with the recommendation of when to use: https://ecir.groups.io/g/main/message/277166 -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
|
|
|
Suzy Berkowitz
Thank you
-- Suzy in Fl 2020 Scout Case History: https://ecir.groups.io/g/CaseHistory/files/Suzy%20Scout Scout Photos: https://ecir.groups.io/g/CaseHistory/album?id=260915 |
|
|