Dropping Fast

Discussion in 'Lantus / Levemir / Biosimilars' started by Giomax, Jan 30, 2019.

  1. Giomax

    Giomax Member

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    Dec 29, 2018
    Max is doing pretty well on TR but since I'm often not home to monitor he's just going too low for my comfort. Wendy recommended switching to SLGS. I've read the sticky. But can someone please help me out here? How on earth am I supposed to dose in .25 increments? What should his new dose be? 5.75? How?
     
  2. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Tagging @Wendy&Neko

    I am not sure on the dosing. I think it changes when over 5U.

    As for increment dosing I used calipers.
     
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  3. Giomax

    Giomax Member

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    I went down to 5.5 ;----;
     
  4. Sue and Luci

    Sue and Luci Well-Known Member

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    Have you looked into the calipers yet? There's a great article on here about how to use them and getting those tiny increments. I 'think' Wendy may have sent you the link the other day? Very helpful in measuring the .25 increment on the syringe. As you can see from Luci's SS we're using .25 frequently - I couldn't have gotten that dose right without calipers....

    Congratulations on Max hitting that nice string of greens last night - sorry he had to wait until the middle of the night to do that...he does seem to be responding very well to the insulin!

    I got calipers from Amazon but then found calipers at Harbor Freight that were smaller/lighter and cheaper - they work just as well for $14. There's a digital display for setting the increments which makes it easy to change it back and forth (story of our lives here)...

    These are the calipers I bought: https://www.harborfreight.com/4-in-digital-caliper-63710.html
     
    Last edited: Jan 30, 2019
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  5. Olive & Paula

    Olive & Paula Well-Known Member

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    Digital calipers are great. I use them no matter what dose I give. Make sure they have the locking button. That way you only have to reset when dose changes. Once set you don't even have to turn on the display until you need to change the setting.
     
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  6. Giomax

    Giomax Member

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    It's funny (frustrating ) because his numbers on 5.5 units were on the high side, but way lower on 6 units. Too low for me to feel comfortable going in to work. I went back down to 5.5 this morning. I'll try that again for a few days and see what happens. If high like before, will go to 5.75. Seems crazy a quarter of a dose! Insulin is so touchy.
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    My suggestion was if you are feeding kibble, then switch to SLGS. That was an important part of the suggestion. You cannot follow TR unless it’s an all low carb wet food or raw diet. Yesterday you were thinking about leaving out kibble during the day. High carb wet food for safety is an alternative if you want to stick to TR.

    I hope the 5.5 units works for you this time. Just because a dose didn’t work once doesn’t mean it won’t work the second time.
     
    Last edited: Jan 30, 2019
  8. Giomax

    Giomax Member

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    No kibble today, just 5.5 units instead of 6. Sorry, I don't really know what I'm doing, just going with what feels right ;------;
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    It takes a while to learn the nuances. This is all still pretty new for you. :bighug: Just keep asking and we are here for you.
     
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  10. Giomax

    Giomax Member

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    Max is 522 at +9 -- ha! Damn, this sucks. He's as high as when he had no shot at all! He had maybe a 1/4 cup of kibble last night but none at all since then. I don't get the feeling that this is a bounce either.
     
  11. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Definitely a bounce! Max is not used to greens, much less at least three hours of them last night. Could be a little bit of that high carb food still working in his system too, dry takes a while to go away.
     
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  12. Giomax

    Giomax Member

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    Last edited: Jan 30, 2019
  13. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Yikes! That's quite the drop. Do you have any high carb wet food? If not, add a drop of honey/karo to a tsp of his wet food, and test again in 1/2 hour. He's dropping too fast. And by the way, the numbers on the SS for today after the AMPS are down one row.

    As for reduction, I am going to hedge. First, the numbers you are seeing now are from the 6.0 unit depot. The larger depot can influence 4-6 cycles after a reduction. Second, we need to resolve the question of SLGS or TR. The decision on dosing method is up to you, and the answer as to whether a reduction is earned depends on the dosing method.
     
  14. Giomax

    Giomax Member

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    I've decided on SLGS I think. Still feeding him all wet food (unless he drops crazy like he's been doing, then I chicken out and give him a kibble snack). So I shouldn't reduce tomorrow? I want to go to 5 units. Can I do that? It feels like the right thing to do for now. I'll be gone almost 12 hours tomorrow.
     
  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    SLGS says to reduce immediately if you see an under 90. For safety, 5.0 units is fine.

    High carb wetfood can work as well as dry food at raising numbers, with the added benefit that it doesn't last as long in the system. You can even get wet foods over 20% which should good for giving him a good boost.
     
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  16. Giomax

    Giomax Member

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    I'll have to invest in some medium and high carb wet foods. Do you know of any off the top of your head? For now I just gave him some FF with kibble mixed in. I'll be testing in 30 minutes.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Weruva Grandma's Chicken Soup is 21% and is one I did. If you do Fancy Feast, their Medley's in Gravy white meat/chicken/tuna broth and whitefish and shrimp recipe gravy are 20%. Their primavera line tender turkey in classic sause is also 20%. As is the Gravy Lover's beef, and most of the Delights with Cheddar. All of the Medleys Tuscany are 20% and above. Take a look at the sortable cat food list, and put a max 25% in carbs and see what comes up.
     
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  18. Giomax

    Giomax Member

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  19. Giomax

    Giomax Member

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    Just fed a spoonful of wet food with some corn syrup.

    +15 minutes after last test and we're to 73, thank goodness. Testing again in 15.

    +15 and we're at 115. I missed where you said to feed only a DROP of corn syrup. I gave him maybe half a teaspoon! Maybe a bit more? Is he gonna go way too high now? Heck...

    Plus he had the dry food earlier as well! Somebody really needs to physically be beside me and guide my hands for me. They have no idea what they're doing...
     
    Last edited: Jan 30, 2019
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  20. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Take some deep breaths; you can do this. Proceed slowly while thinking about every action you take having a reaction.

    If you haven't already, print, read and re-read the sticky notes on treating a hypoglycemic / drop in BG event.

    The goal is small adjustments to control BGs in gradual increments...
    Way too low? A drop or two of honey or karo syrup on the gums or in a small (tsp) amount of food will typically and gradually increase the BG to a safe range. This small portion may need to be repeated until BG becomes stabilized.
    If kitty is not conscious because BG is in a freefall, go to ER ASAP.
    Kitty may bounce high due to the karo syrup and kibble, which may then cause a reaction of a sharp drop in the BG, so frequent testing to monitor is necessary.
    You can do this!

    @MrWorfMen's Mom
    @Webdy&Neko
     
  21. Giomax

    Giomax Member

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    Thanks @Joanne&TinySole! Sadly, I don't have a printer, but the stickies are always pretty easy for me to access.

    I'm going to test again in about 15 minutes. I do need to go to sleep very soon thought. I work an opening shift in the morning ;-----;
     
  22. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    The goal is to regulate the BG. If you cant test because of work, it is best to let Max run a little higher.

    I'm not sure how or why he went so low - I'll take a look at your posts and spreadsheet.
    The long-term advisors here have excellent experience and you can trust them.

    I did SLGS because I was too terrified to do TR. Either method can get Max OTJ.
     
  23. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Please stay vigilant. The corn syrup -although you gave him a lot as understand it, does not last very long as an influence to keep numbers up.
    You need to make sure Max can hold his own above 50 for at least two hours without any high carb, medium carb. Put on some coffee, I'll stick around with you until either he's in the clear or someone else can take over if I need to sign off.
     
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  24. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    Try to test in the middle of the night, if possible.
     
  25. Joanne&TinySole

    Joanne&TinySole Well-Known Member

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    :bighug::bighug::bighug:
     
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  26. Giomax

    Giomax Member

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    I have no idea why he went so low. He was in the 400/500 range before his PM shot, and then three hours later.....boom! Super drop. And he just kept dropping. It's extra weird because his nadir is never at +3 or anywhere near the beginning of the cycle.
     
  27. Giomax

    Giomax Member

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    I wish I could put on coffee and stay up all night, but I work at 7am tomorrow. He's not been below 50 yet--almost, but I caught him in time. No doubt he would have dropped into the neon greens had I let him.
     
  28. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Not sure either, but maybe a combo pack of Max clearing a bounce and the depot filling up again after the skipped shot. Hopefully someone more experienced than me will take a look at the spreadsheet and give you feedback about that.. For now let's concentrate on making sure Max is safe tonight :bighug:
     
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  29. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Missed that tag. ;)

    Over a 100, you can wait for an hour for the next test. Can you wait up another hour? He could have been breaking a bounce today, hence the fast drop. Or it could be that this is the 5th cycle after the skip so the depot is building again, or both. Hmm, I see Barbara nailed that one as I was typing. :)
     
  30. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Yes, I understand your situation and I appreciate that. I'm not trying to be a hand wringer here but a drop from 402 at PMPS to 81 at +3 is nothing to play around with.
    You need to make sure Max is holding his own for two hours after any medium or high carb has been given
     
  31. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    I will defer to any suggestions Wendy has here for you as she is more experienced then me and was one of my main mentors. I'll stay on so I can keep learning :bighug:
     
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  32. Krystina & Nelli

    Krystina & Nelli Well-Known Member

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    Which ones do you have... need to buy!
    Thnx :bighug::stop:
     
  33. Giomax

    Giomax Member

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    Just tested again and we're at 112.

    Dropping since last test??
     
  34. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    At what + time are you? How long since he got the corn syrup? If you can, it'll really help us help you if the spreadsheet is kept up to date, or at least the subject line on your post.

    You can also take the 911 off now, you have eyes on your post.
     
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  35. Giomax

    Giomax Member

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    Gosh, I don't even know. I've just been typing the numbers out on this thread as I get them. How do I update in 15 minute increments on the spreadsheet? Thanks so much for your support, guys!
     
  36. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Agreed! One of the most important lessons I learned here was to get a +2 or +3 every time!
     
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  37. Giomax

    Giomax Member

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    @Wendy&Neko Right now we're almost +6 on the evening cycle.

    Corn syrup was given about an hour and a half ago and he's been snacking on his wet food since.
     
    Last edited: Jan 30, 2019
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  38. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    I'm trying to deconstruct your posts. Does this seem right?

    PMPS 402, +3 81, +3.5 62, +4 73, +4.25 115, +5.5 112
     
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  39. Giomax

    Giomax Member

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    PMPS 402, +3 81, +3.5 62, (CORN SYRUP) +4 73, +4.25 115, +4.75 112

    ^ If that's not correct, I'm sorry. I'm very tired. :'(
     
  40. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Close enough I think.
     
  41. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Screen Shot 2019-01-30 at 9.03.43 PM.png 42233[/ATTACH]
    Here's an example of an entry for two tests in one cell
     
  42. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    These cats have a way of throwing a wrench in the works sometimes. You are doing good keeping Max safe tonight :bighug:
     
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  43. Giomax

    Giomax Member

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    30 minutes after last test and we're at 119.
     
  44. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    That's great! Looks like the last corn syrup was given about 2 hours ago? If that's the case an he's only had LC wet food since then and he's in safe numbers you are probably good to get to bed soon after one more insurance test.
     
  45. Giomax

    Giomax Member

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    I plan on testing again in about ten minutes. He's not only had wet FF. He's had some dry kibble mixed in as well.
     
  46. Giomax

    Giomax Member

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    +30 minutes after last test and we're at 125

    I set my alarm to an hour from now. Gonna try to get some small sleep, then another test.
     
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  47. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    OK, I just wanted to make sure everything was low carb for the past two hours at least before your last test and heading for sleep.
     
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  48. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    Remember to reduce tomorrow :bighug:
     
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  49. Giomax

    Giomax Member

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    No, it hasn't been. He's had a little dry kibble bits.
     
  50. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    That is exactly what I would do for safety's sake. I will check back in on you in an hour
     
  51. Giomax

    Giomax Member

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    ^ Thanks!
     
  52. Bear & Lora

    Bear & Lora Well-Known Member

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    I am so sorry this low BG event is before your morning shift.
    Keep in mind Max is a bouncer too and you keep food out for him while at work.
    There is a good probability he will bounce, not written in stone though, ECID.
    If Bear had food out at his low BG event I know he would have eaten on his own and raised his BG.
    Just a few constructive thoughts to hopefully ease your anxiety at least a smidgen. :bighug:
     
  53. Olive & Paula

    Olive & Paula Well-Known Member

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  54. Barbara & Uncle (GA)

    Barbara & Uncle (GA) Well-Known Member

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    @Giomax Haven't seen any more posts. Hope you and Max are okay. Going to sleep soon unless I hear back :bighug:
     
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