Bella is down to 228!!!

Hey everyone! An update on my beautiful girl Isabella here

She is down to 228! As you can see on my spreadsheet, her numbers have been falling out of the sky the last couple days. If you missed my post, she received a depo shot on 3/11 which the vet believes is what caused her diabetes. He called a few nights ago and said it should be wearing off, and he was right! She is really acting like herself again and I am so happy

Question for you all. My vet said not to administer insulin if she read 200. She is so close to that I'm a bit nervous about giving her any. I have not been able to test for ketones/glucose in her urine yet today, and she is supposed to have her shot in the next 30 minutes. What would y'all recommend? Maybe 1/2 dose? I'm supposed to do a curve on her Sunday.....

 

If you're concerned then maybe a partial dose.... Try 0.5

 

I think that yellow is high enough to give 1 unit but I recommend that you do some extra tests this evening. If that makes you nervous, you could drop the dose to half a unit.

 

First of all, great job getting started with home testing and setting up a spreadsheet! It's really difficult to give a recommendation for dose without any mid-cycle numbers to show what happens at the nadir (lowest point in the cycle). I think for now you should either contact your vet - or if they're closed for the evening, go with what you think is best. After you get the curve this weekend, we will be able to better help.

If you can get any mid-cycle numbers before Sunday, that would be great too!

 

Yep I think you could go with 1 unit, but if you are worried, drop to 0.5.

 

Thanks, guys -- my gut said 1/2 dose. I emailed her vet and let them know she was down to 228. I will do 1/2 dose just to be safe, and if she's gotten higher in the morning I'll do a full one.

I'll certainly try to get something tomorrow! We have a full day but I will take numbers when I'm home

 

I get up earlier than I need to in order to test/shoot, and then be able to get a test a couple of hours later before I leave for work. Reverse of that - if you get home by +8ish, you can grab a test then. Or grab an extra test before going to bed at night. Anytime you can sneak in extra tests, they are really helpful. I know it's tricky with work schedules. But seriously, great job getting started with all of this! It does look like Bella's numbers might be coming down a bit!

 

Hope this is a good sign for Bella! The depot shot was for allergies, yes?

 

Yes, it was. She has a really bad flea allergy and apparently Advantage II was not good enough for her. She's on Cheristin now.

Well, guys, the victory was short lived. I gave her 1/2 shot, but about an hour after that I got an email back from her vet -- she recommended going ahead with the full, so I gave her another 1/2.

This morning she was at 456 I guess it messed her up. We'll keep steady with 1 unit from now on.

 

Oh goodness! Was it an hour between the two shots? Like you said, that can kind of mess them up. Insulin isn't like taking an advil or even an antibiotic - t's a very powerful hormone, and even slight changes (timing, dose, food, stress, etc.) can have a big impact. You're right that keeping the dose (and timing) consistent is important.

One important note though: If the pre-shot number is ever below 200, you do need to skip the shot. Especially right now without any mid-cycle numbers, and with only a few days of data. Later we do sometimes shoot at lower numbers, but only with a lot of data, and time to monitor the cycle.

Hang in there and always feel free to ask when you have any questions or doubts. This whole thing can be a little tricky, especially at first!

 

It was a bit over an hour. I didn't know this was so tricky

Her AMPS numbers yesterday and today have both been around 450, so maybe she is stabilizing. Today is curve day, so we'll have more data to work with after today. The low numbers really got my hopes up, I should learn my lesson from that

 

We all do that, no matter how long we're here. Every low number makes us hope that the next one will be just as low.

Hang in there! Getting a curve today will be great, and then we can start working on the dose to get Bella into some better numbers.

 

Alright! Her curve is almost halfway done (we are coming up on +6 now). Her lowest was at +4, where it was 87. It is so good to see the insulin taking her down to normal levels! She is quite unhappy with me today due to all the poking though.

 

Just for future curves, you can just do every 2 hours . 87 is a very nice nadir though! She may bounce back up close to her AMPS since the 87 is kind of foreign to her body and might not be used to "normal" BG levels. Great job getting this done though!

 

I'll keep that in mind. I hope she doesn't bounce too much.

If she is dropping to 87 during the day, does this mean she probably shouldn't have an insulin increase? I know it's definitely a question for my vet, and we have an appointment tomorrow to discuss the results, but I'm bracing for the worst since her numbers have been so high.

 

I would say the dose is perfect for now. Those high double digits are what you are aiming for. The preshots will come down eventually.

 

Awesome!!! Alright. That is great to know

 

Look at your chart. In just a week her preshots are 200 points lower than you started. Just keep going.

 

True, I hope this steroid shot is wearing off!

 

Now that you've hit the rising numbers, it is really okay to go to ever two hours for the next tests. No point in stressing out Bella once you see the curve go back up.

I'd be interested in hearing what the vet says tomorrow. If she suggests a small increase (.25u or smaller), it might be okay to try as long as you can monitor. That's a really nice nadir, but it's a little early and she headed back up pretty quick, so there is still room to improve.

However, it could also just be a matter of holding the dose a big longer to start to see an improvement. As Janet said, she's showing some better pre-shot numbers already at this dose, and it might just take some patience right where you're at. Especially since the steroid may be a factor.

If the vet tells you to increase by 1u (a common vet recommendation), just smile politely and ignore her.

I'm really curious what everyone else will say about this too. I think there's a few ways to think about it.

 

I would have to agree with Janet, she definitely doesn't need an increase right now. Holding the dose for a while should help lower those PS numbers. When you can, would also try to get readings between +4 and +7 as often as you can.

 

This is a good point. I will do that for the rest of today.

There will be some debating then my vet is really good though, and I doubt she would recommend anything the data didn't support.

I will start trying this at night. She gets her shot about 7 so that would be 11 and 2 (yuck but doable).

Thank you all again so much for your help. It has made me so happy to just see Bella acting like herself again

 

At night, just get the 23:00 (+4) and if she's at a good number, and hasn't dropped too much, you can go to bed. That's what I do with Maury. Most of my PM cycles have between +3 and +4 readings, unless he's low. Then I stay up. It has become part of my "going to bed" routine. I was so tired a few nights ago and even on auto-pilot mode, I sat on my sofa with Maury, thought came into my head "I have to test him before bed". Woke up a little more and realized I was already getting the test going .

 

Glad to hear Bella is acting like herself again!