? Dosing advice for newly diagnosed, hovering around 200?

Hello Friends,
Many many thanks for all the help I've already received.

Tigger's spreadsheet is up-to-date but a little wonky, sometimes with multiple readings in the PS boxes as I waited to see if BG was rising. I tried to keep everything clear by adding +13, +14 tags there.

Mr.WorfMen's Mom helped me readjust after Tigger was newly diagnosed (2 weeks ago), was prescribed 4 units of Vetsulin 2x/day, and crashed. After 1.5 units still seemed too high, I dosed just 1/2 unit for several cycles. Starting on 12/23/19, I bumped up to .75 unit in AM. I kept the PM dose at .5 to be safe. (Tigger seems to drop lower at night, and I was away from home on nights of 12/23 and 12/24). For both those nights I DID come home to test, feed, and give her insulin.

Yesterday was the third AM dose of .75, and I was home a lot for testing day and night. As you can see, Tigger stayed in the blue (unless I missed a green or yellow somewhere along the way) for 24 hours straight. Our 209 reading was at +25 hours. Since then, she has been around 200 the times I've tested; it's now +32 since her last dose.

So--Yikes. I assume I shouldn't keep skipping but also don't know how to understand these numbers/patterns. I wonder if I should return to her 1/2 unit tonight?

Also, a couple times, it also took her around +13 or +14 to get over 200. . . . So my dosing times are now all off. If she should get a dose tonight, I would love to give her one in the next hour or so, to try and return to a normal AM/PM schedule. . . . My AM/PM morphed into noon and midnight after a couple of stalls a few cycles back.

If anyone's around with advice, Tigger and I would be super grateful!
Kerri

 

Hi Kerry,

Those are great numbers for Tigger, considering he has not has any insulin. @MrWorfMen's Mom is out of town for the day and I do not have enough knowledge of Vetsulin to advise. I'm bumping your post up to the top of the forum.

After a skipped shot, you can shoot insulin at your normal time the next cycle.

 

Thank you so much!

 

My update: after another two hours, Tigger was at 215. I went ahead with 0.5; hopefully that's a good decision.
Thanks, all!

 

Tigger is looking absolutely fabulous and you've done a great job making dosing decisions.

Given you've been skipping shots or having to stall and shooting late a number of times lately, I think I'd stick to the 0.5u dose again and lower your no shot limit to 150 provided you can monitor Tigger. If BG is below 150 at pre-shot, then either stall or if over it's over 125, you could try 0.25u but only try this if you can monitor until we see what Tigger does.

 

Thank you so much, Linda! One more question if you have a chance. . . . She was only at 103 at +13 this morning. . . . So I have skipped again. If she gets to 150 or higher this evening (which I imagine is likely), I'm thinking to just give .25? In hopes that she'd be high enough for a morning dose the following morning. My thinking is that if I need to skip doses, it would be nice if the evening dose was the skip and the morning dose given. So I thought maybe dropping to .25 tonight could help us get that on track? I hope that question makes sense.

So very grateful to you!

 

That sounds fine. Being a bit conservative until you hone in on the right dose is fine. It looks like Tigger is on a mission right now. Interesting that 103 at +13 again. If 0.5u causes skips, 0.25u is the next step.

 

Thank you so much! And gosh. . . . Now she's just at 145 at what I was hoping would be PSPM to get us back on a normal schedule. I am thinking to skip one (hopefully last!) time and see what things look like in the morning. I'm afraid even .25 tonight might mean another morning skip. And I would so love to get her back on a nice, safe, normal-time morning dose.

Thank you again for all your help. You have been a lifesaver. Truly.

 

It sure does appear Tigger is on a mission. Another low pre-shot! WOW! Let's see what tomorrow morning brings.

 

A mission, yes! I skipped again at 127 (AT) / 103 (HM) this morning, and then got a 79 (HM) four hours later. That's +38 hours since her last dose.

I never thought to mention: My vet initially gave her antibiotic shot for UTI. . . . He found that her bladder was tender and thought she didn't fit typical profile for diabetes. Two weeks after antibiotics, she was feeling better but still peeing double her usual amount. That's when he checked for diabetes--BG 450, and sugar in urine he said was 1000? And we started the Vetsulin. He also gave another shot of antibiotic. I also remember she vomited once in early Nov., which is super unusual for her. She has only thrown up or had a hairball 4 or 5 times in her life, knock on wood.

Maybe Tigger's little body is healing up from whatever was going on.

 

Didn't the vet run a fructosamine test? Infections will elevate BG and it's possible that the clearing of the infection and ?change of diet have caused her to go into remission. The fact that BG came down on it's own 4 hours after regular pre-shot time is a very good sign. Just keep testing and see how long she goes with BGs too low to shoot. If she can stay in good numbers, it may be time to start counting cycles without insulin to see if she can maintain good enough numbers to be considered in remission.

 

I don't think he did fructosamine. . . . If he did, he didn't mention. (I also think the infection had been going on for a good while before I even realized it.)

Tonight I see 153 on my cat meter / 115 on human. . . . Even though I'd been thinking before that 150 = shoot, maybe I should just sit tight tonight and grab a few more tests? She just had a nice meal. . . . I can check her in 2 - 3 hours and see how she's dealing with it?

 

Sounds like a plan. Those numbers are very close to normal albeit high normal. Check again about 3 hours post her meal and see if BG is down from pre-shots. If BG is lower, it means her pancreas is starting to work better than it has been which is great news.

 

Thank you!!!

 

Wooooo hoooooo! I was afraid I might doze off before +3. . . . So I grabbed a +2. . . . Human meter down to 99. Yay for Tigger!