9/18 Chino|AMPS=108|+4=116|low 60s and LOTS of carbs|PMPS=249|+4=287

Yesterday..

2nd day on Levemir. Yesterday, 12 units took him down to 50 during the day, then squashed his bounce on the PM cycle and took him from 437 to 108. I was hesitant to give 12 units again this morning, since his pre-shot values were in the 300's for the last 2 cycles, but I couldn't delay, so I'll be getting a +2 in a few minutes. I hope it's higher than the AMPS. I have a 2.5-hour conference call starting at +4.5 where I'll be presenting, and I can't easily ask everyone to wait while I check Chino's BG/intervene if necessary.

 

+2 = 215. Next check at +4.

 

Be good Chino!! Surf safely for dad

 

Ride those waves safely Chino!

 

+3 = 169. There's his onset.

 

Glad you held off on the R and he sure gave another great performance. IMHO, you'll need to give him time, test as you have been to collect L data and if needed start from the beginning on a new R scale. ECID of course but once Doodles switched to Levemir, I used R twice...the first time it did nothing the second time it tanked him and set off a nasty bounce. After that...my R stayed in the fridge.

Surf now Chino, daddy has things to do.

 

+4 = 116. He's dropping faster than I'd like, especially since I'll be getting on that conference call soon. I gave 1 tsp gravy from MC 14% with his +4 meal, hoping it will slow the drop, though I'm ready to give HC if he's under 70 at the next check.

 

Thanks. If I give any R, it will only be if he went low enough to bounce on the previous cycle and is still rising (and over 350) after the expected onset. I'll gauge his response to 0.5 units before going any higher.

 

+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)

I notified the team that I need to step away test every 30 minutes... this is not good.

 

AMPS = 108 (1st meal LC 5%)
[3rd cycle on 12 units Levemir]
+3 = 169
+4 = 116 (2nd meal LC 5% + 1 tsp MC 14% gravy)
+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)
+5.5 = 66 (2 treats w/1 tsp HC gravy)

If he's at 70 or above at +6, I'll repeat and test again at +7.

 

Wow. I know you so don't need this right now with your conference call. I wonder if a reduction is in order? Technically he didn't go below 50 yesterday but damn close and with meter variances and steering he probably would've have gone below? I suppose if you're around to monitor you can see how it plays out.

 

AMPS = 108 (1st meal LC 5%)
[3rd cycle on 12 units Levemir]
+3 = 169
+4 = 116 (2nd meal LC 5% + 1 tsp MC 14% gravy)
+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)
+5.5 = 66 (2 treats w/1 tsp HC gravy)
+6 = 63 (3 treats w/2 tsp HC gravy)

 

Yep, I'm definitely going to reduce. At a good dose, I shouldn't have to feed HC every day just to keep him safe.

 

Agreed! So congrats on the reducie!!!

 

AMPS = 108 (1st meal LC 5%)
[3rd cycle on 12 units Levemir]
+3 = 169
+4 = 116 (2nd meal LC 5% + 1 tsp MC 14% gravy)
+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)
+5.5 = 66 (2 treats w/1 tsp HC gravy)
+6 = 63 (3 treats w/2 tsp HC gravy)
+6.5 = 60 (3 treats w/2 tsp HC meat/gravy + 3 gtt Karo)

 

AMPS = 108 (1st meal LC 5%)
[3rd cycle on 12 units Levemir]
+3 = 169
+4 = 116 (2nd meal LC 5% + 1 tsp MC 14% gravy)
+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)
+5.5 = 66 (2 treats w/1 tsp HC gravy)
+6 = 63 (3 treats w/2 tsp HC gravy)
+6.5 = 60 (3 treats w/2 tsp HC meat/gravy + 3 gtt Karo)
+7 = 64 (same)

 

Well, at least the HC is keeping him from diving into the really scary territory. Sheesh, Chino, way to make a point!

Hope the meeting isn't being too disrupted-- you're doing great keeping him away from the sharks!

 

AMPS = 108 (1st meal LC 5%)
[3rd cycle on 12 units Levemir]
+3 = 169
+4 = 116 (2nd meal LC 5% + 1 tsp MC 14% gravy)
+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)
+5.5 = 66 (2 treats w/1 tsp HC gravy)
+6 = 63 (3 treats w/2 tsp HC gravy)
+6.5 = 60 (3 treats w/2 tsp HC meat/gravy + 3 gtt Karo)
+7 = 64 (same)
+7.5 = 69 (same - 2 tsp is all that was left in the can of HC)

At this point yesterday, I only had to intervene once more before he started rising on his own. So if he's in the 70s at the +8 check, I'll give dry treats w/Karo and test hourly until he bounces. We'll decrease to 11 units tonight.

 

AMPS = 108 (1st meal LC 5%)
[3rd cycle on 12 units Levemir]
+3 = 169
+4 = 116 (2nd meal LC 5% + 1 tsp MC 14% gravy)
+5 = 67 (3 dry treats w/2 tsp HC 20% gravy)
+5.5 = 66 (2 treats w/1 tsp HC gravy)
+6 = 63 (3 treats w/2 tsp HC gravy)
+6.5 = 60 (3 treats w/2 tsp HC meat/gravy + 3 gtt Karo)
+7 = 64 (same)
+7.5 = 69 (same - 2 tsp is all that was left in the can of HC)
+8 = 74 (3 dry treats + 3 gtt Karo)

 

So much for an uninterrupted work day
Great job steering him

 

+9 = 100

Last night, I said I was going to get a +3 instead of a +2 tonight... but I think a +2 and +4 might still be more helpful. The difference between +2 and +4 tells me how fast he's dropping, which will help me determine when I need to test again. On Lantus, he would often go down by 50 in the first 2 hours, then go down by 100 over the next 2. It looks like he followed a similar pattern between +4 and +6 last night.

 

Good luck with the reduction. Today you've got part of the Lantus depot and part of the Lev depot, so might not be representative of what it looks like when it's all Lev.

Cat's don't drop at the same rate each hour. But the difference between the +3 and the +4 gave you a good idea on how fast he was dropping today.

Good plan to try a smaller amount first. I found a good time to give R with Neko on Lev was after her Lev nadir and on the way up. Often that was around +10. Then all the R action would by out of the way by the time Lev onset hit. Both Neko's R and Lev onset were later than Chino's.

 

Yes, I understand that. Chino tends to speed up after the first 2 hours and sometimes doubles the pace over the next 2 hours. Knowing that allows me to calculate when he'll be close to the danger zone, assuming he drops as quickly or continues to speed up, so I can set my alarm for an hour before that time and catch him before he crashes.

 

11 units looks like such a small dose after giving 15 units just 2 days ago! It will be interesting to see where his daytime nadirs fall when he's not getting carbs twice an hour for 3 hours straight.

 

Cats can change their pattern when they switch insulins. Neko did, drove me crazy cause I thought I had her all figured out.

 

Right now, keeping him safe is the most important thing. Tomorrow is going to be busier. I can't do this again. I don't want to be in a position where I have to choose between compromising my job and compromising his health. If he stops dropping into the normal range after the decrease, I'll just increase again after 6 cycles w/o green. But decreasing until he stabilizes feels less reckless than frantically trying to keep him from going hypo.

Is there a pure-glucose alternative to honey or corn syrup? Fructose contributes to insulin resistance in humans. Only the liver can process it, where it's converted to fat (triglycerides), while every cell in the body can utilize glucose. Not sure if it works the same way for cats, but I don't want to take chances if there's another option.

 

Wow ... Chino is really responding to levimir. Hope tomorrow is a little less eventful. Good luck with the decrease!

 

Safety is the number one consideration, at this point a reduction is a good idea.

I have bought pure glucose in the baking section. It is used in candy making to prevent crystalization. I had to go to a specialty store. I wonder if you could make your own with sugar and boiling water. Not sure what the concentration would be. How about maple syrup?

 

What a reaction to Lev! Your must be exhausted!

 

Sugar is 50% glucose and 50% fructose, but I'll check baking specialty stores. (I haven't seen it in regular grocery stores.) Thanks!

 

How great would it be if his onset is consistent? The Lantus daytime onset was around +4 (on the days that the BG went down from there instead of up) and evening onset was +2. He's only been on Levemir for 2 days now, but 3 cycles in a row have shown an approximate onset of +3. If Levemir can give his cycles just a little bit of predictability, I'll be ecstatic.

I have to be on a call at 3 AM (+8) for work, though at the rate that he's dropping/speeding up, I don't think I can safely wait that long to test. Next check at +7.