new to all of this.....

Discussion in 'Feline Health - (The Main Forum)' started by Jade77, Jul 15, 2013.

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  1. BJM

    BJM Well-Known Member

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    The cat's metabolism is much faster than a dog, so N type insulins don't last 12 hours for them - more like 6 - 8 hours, leaving 4-6 hours with no insulin. And you just fought off DKA, so we want to get insulin in him whenever he needs it.

    A half bathroom and a big towel may go a long way towards helping get the tests and shots done. Set up everything in there, including a low carb treat. Bring the cat in and shut the door. Burrito wrap the cat if he's too squirmy, otherwise, just put it on your lap.
     
  2. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    ok great I will be here looking for you!

    Did he fight when you tested him? Did you give him a treat (very important)?

    The reason we are suggesting you shoot every 8 hours is because of the ketones issue and that this insulin wears off fast in cats - we dont want him going too high again and making the ketones worse (keep trying to get that urine test!!) However lets see what he does on this dose first.. if he gets high (350+) by the 8 hour mark then you will probably want to shoot him again.

    Karo syrup is to bring his blood sugar up fast if he drops too low (ie under 40) as we dont want him going too low and having a hypo instead! Humalin N is a harsh insulin in cats and is hard to manage so we do want him on a good cat insulin like Lantus or Levemir asap - will make your life easier too. Check out the savings program : http://www.lantus.com/sign-up/offers.aspx

    BJ - are you sure about the food withholding? This cat is DKA!
    Wendy
     
  3. BJM

    BJM Well-Known Member

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    I'd rather she could shoot 3 times a day than pick up the food. Maybe pick up at +6/7?
    If there isn't insulin to match the food, the glucose just rises and fat gets broken down anyway.

    If the +3 or 4 is way above 150 and +8 goes right back up to where it started or higher, we'll want to take it up to 1.5 at the next shot. Yes, a 0.5 unit increase - because of the DKA, we don't want to go too slowly.



    (And if she didn't need sleep, or there was someone to alternate testing and shooting with her, an every 6 hours test/feed/shoot might be preferable.)
     
  4. Jade77

    Jade77 Member

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    I'm not sure what you guys are talking about here. All those numbers make no sense to me...his bgl was 443 before I have him the insulin, wont it still be pretty high when I test him in an hour? Should I be feeding him still or no? And how often am I going to have to test and shoot? Because there is only one person here at a time on any given day, except for my one day off a week (which was today.) does the other humulin last any longer than the N version?
     
  5. Jade77

    Jade77 Member

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    Also Wendy, the cling wrap in the box was a fail lol. He put his paws on that and said "uh uh" and peed on my bathroom floor instead. I did put a strip in the pee on the floor and the color says negative, which makes no sense to me because two days ago it was in the "very high" color category. Does the urine have to be super fresh? because Im thinking he probably did that shortly after I left for the store, about an hour ago.
     
  6. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Not sure if the ketones evaporate but negative is better than positive for sure! hmm.. what a little troublemaker.. ok - is your litter clumping? can you get a non clumping version of the same type?

    Bj and I were trying to work out if you should feed him still or not. We decided yes, should feed him now until +7. (Thats 7 hours after his shot time) - we dont want him starving.

    Testing - For today we want to see what effect the humalin is having so we need that +3 test ( three hours after shot time) to see what he is doing - the insulin should have kicked in nicely and should have brought him down... We may need another test at +5 too depending on that number. This is just for today and tonite again if you give another shot at +8.

    FYI We always need to test before every shot as you dont want to shoot under 200 (yet) as he may drop too low. We will play it by ear tonite to see what to do tomorrow morning when you are at work.

    Lantus lasts 12 hours and is a much better insulin. Did you see the savings card I had linked above?

    let me know about the reading for that +3 test.

    Wendy
     
  7. BJM

    BJM Well-Known Member

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    Go ahead and feed if he is hungry.

    Humulin or Novolin N both last about 6 to 8 hours in the cat. Best control is giving insulin every 8 hours.

    Humulin or Novolin R both last about 2 to 4 hours in the cat. It generally is used in special situations, not for regular use.

    Lantus, Levemir, & ProZinc about 12 hours in the cat.

    Nadir = lowest glucose level between 2 shots.

    AMPS = morning pre-shot test
    PMPS = eveing pre-shot test
    +3 = 3 hours after shot

    The urine for a test must be fresh.
     
  8. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Where's that test you promised me.. Nag nag lol!
     
  9. Jade77

    Jade77 Member

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    It is clumping, but I literally have 12 cents in my bank account til I get paid fri..then I have to deposit the check (new job, no DD yet) so until then I will keep in in my larger bathroom after he drinks a bunch of water and get him to just pee on the floor and test that way for a few days. I went out and got a box of syringes (I only had 3) so that drained me. Unfortunately I am going to have to go with the cheaper 8 hour humulin until NEXT payday, because most of my check will go to rent and past due bills. If I can get up every 4 hours to feed a newborn, I can give him a shot every eight hours til I can afford the 12 hour insulin. He is already looking more lively, swishing his tail, and even jumped at the chance for wet food, which he has refused to eat for days. And he looks to be drinking more water too. My fiance is almost finished with my daughters dinner, then we will do another blood test. Also, I just fed him, then realized that the food could make his levels go up..should I wait to test or do it now?
     
  10. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Great! Do it now please. I know you are nervous but you did it before and it was fine, just remember the treat,, for both of you!

    What we are doing now is trying to keep him and safe and work out how this dose is working..

    And you are totally right with the newborn analogy. Many newbies complain about getting up middle of the night, not realizing what a baby is like! And then they wonder why the cat isn't regulated and /or has as hypo. You are ahead of them already!

    Now a test please. Thanks
     
  11. BJM

    BJM Well-Known Member

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    With N insulin, you want to test, feed, wait a good 20-30 minutes for the food to hit the bloodstream, then shoot.

    Mid-cycle tests may be done as needed. It takes about 20-30 minutes for the food to increase glucose levels.

    If you want to pm me, there are a few of us who may be able to help out a smidge with diabetes supplies.
     
  12. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    BJ, we are just waiting on a mid cycle test right now to see how low its bringing boots.
     
  13. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Hey! Where's the test jade? Don't make me nag... You promised me a test.
     
  14. Jade77

    Jade77 Member

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    Nag away! :) It took a a few tries again :/ and when we finally thought we got it, we got an error message saying not enough blood. BUT just got one, and it said 108. That is a LOT lower than 443 or whatever it was earlier...is that bad?
     
  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    GREAT JOB!

    He dropped quite a bit but nothing too low. So I think another test in two hours would be good and we can go from there.

    This 1 unit is looking good for now. Depending on the +5, we may go to every 12 hours too... But let's see.

    Wendy
     
  16. Jade77

    Jade77 Member

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    So another test at 1130pm EST. Do-able. Gabe said he'd even stay up with me (he works really early) to help with the test again, cause boots does NOT like it, treats or no treats!
     
  17. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    He should get used to it. Gabe too ..lol. Meanwhile practice playing with his feet and giving a treat even when you don't shoot. Get him used to it. That's half the battle.. It's not the poke they don't like.. It's attention when they don't want it.. Mama.. Leave my feets alone!! Iol

    See you at 11.30pm.


    Wendy
     
  18. BJM

    BJM Well-Known Member

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    Very often, as the Humulin N wears off, the glucose may zoom up. That's normal for that insulin.

    If he stays low enough, you may be able to go with every 12 hours. Just have to see.

    What are you feeding him?
     
  19. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    I used Humulin N for a few months. It was prescribed as twice a day dosing and Gabby was post-DKA along with hepatic lipidosis. IMHO, I would be reticent to suggest dosing 3 times per day without test data that indicates a deviation from standard care is needed.
     
  20. BJM

    BJM Well-Known Member

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    And that is exactly why we've asked for mid-cycle test data - to help figure out what will be optimal for this post DKA cat.
     
  21. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    hello jade. welcome to the FDMB! someone asked me to take a look at your thread.

    did your vet tell you Boots was in diabetic ketoacidosis or throwing ketones when he was diagnosed with diabetes?

    please correct me if i'm wrong. every time you've been able to test his urine for ketones since monday the urine was old???
    the results from "old" urine are not valid.

    urine must be fresh for valid results when testing with ketostix.



    the advice you've been receiving is based on your kitty having been in DKA and throwing ketones since then.
    please clarify. those making dosing suggestions may want to re-think their strategy depending on whether there is actually a recent history of DKA and/or kitty is currently throwing ketones.
     
  22. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    One "old" urine test a few days ago showed high ketones. the second one, another "old" test today showed none...

    Suggestions for getting a test from a cat that is secretive and refuses to use a litter tray with unusual items in it?


    Wendy
     
  23. Jade77

    Jade77 Member

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    Hello! The package said it should be fine as long as the urine is no more than an hour old, which it hasnt been both times I tested. I can't follow him 24/7 to see when he pees, I have a toddler who needs my eyes on her most of the time. I pay attention as best I can. But the urine on my bathroom floor both times was only anywhere from 30 to 45 minutes old. When I saw the vet she said nothing about ketones in his urine, just that he had extremely high blood sugar, was diabetic, and needed insulin and constant testing until he is regulated. It was 2 or 3 days later that he all of a sudden stopped eating, drinking, moving, making noise..pretty much everything but laying in one spot of the floor for 12 hours straight. I cannot afford another vet visit, which is why he has not gone since the diagnosis and scrip last week. We will be testing his blood again in about 30 mins.
     
  24. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Interesting. That must be new. My cat is prone to ketones/DKA so I've tested for ketones a lot over the last 7 years. Every brand I've ever used has said the urine sample must be fresh to obtain a valid reading.

    So, Boots has not been in DKA, no known ketones at diagnosis, has thrown ketones, but was not throwing ketones as of the last urine test.

    The only way I'm able to get multiple ketone tests done daily was to move litterboxes into the areas of the house I most frequent. I keep old soup ladles in those locations... ready to use as soon as she begins to pee.




    Edited to add:
    Please start a new thread in the morning. It's difficult for others to wade through so many pages when they're asked to weigh in once threads get past 1 - 2 pages. :mrgreen:
     
  25. Jade77

    Jade77 Member

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    I work. A LOT. Im not really home much. Okay, Wendy I got another reading and now Im worried because it said 50, and that's waaay low, isn't it? But he isn't acting funny. I dont know what is going on.
     
  26. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    50 is low. Where are you in the cycle -- how many hours from your last shot? Please give your cat a teaspoon or two of high carb food and re-test in 30 min.

    Here are instructions for handling low numbers.
     
  27. Jade77

    Jade77 Member

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    High carb food? Not sure what that is. Im pretty sure I dont have any..I only bought low carb food. He got his shot at 6 mp so it's been almost 6 hours. First test (before shot) was 443. 3 hours after the shot was 108. This is two hours after that.
     
  28. Jade77

    Jade77 Member

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    At some point I have to get some sleep! Ive been up since 6 am with my kid, and I have a 10 hour day tomorrow...
     
  29. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    By high carb Sienne means a gravy cat food. If you dont have any a couple of spoons of the friskies pate mixed with a drop of syrup will work. We dont want him dropping low and may have to bring him up . Please test again in 30.

    Also given this I am thinking (unless the others say otherwise)

    1. Shooting every 12 hours will be safer
    2. Tomorrows dose is reduced to 0.5 since you wont be home. Unless the others object... or unless he is under 200 when you won't shoot at all.. right?

    Wendy
     
  30. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    if you don't have any food that has a gravy base, then add several drops of either Karo syrup, honey, maple syrup, etc. to your cat's food. You want to raise the numbers by using something sweet that will work relatively quickly.
     
  31. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    You might need to be up another hour or so to make sure he comes up into safer numbers. Unfortunately this insulin does this kind of thing. On the bright side it means the insulin is working well and he should be feeling a bit better. Another reason you want the lantus!... although once we get the right dose on the humalin it shouldnt be quite as bad...

    We will want the next test for his numbers to have come up a bit. and then another test 30 mins after that to make sure he stays up. Then you should be good for bed.

    Boots wants to keep you busy - maybe he is jealous of your kid getting all the attention ;)

    I am up at 6am. But I will be here for his next test at 12.20am EST. You arent alone with everyone here!

    Wendy

    PS they dont always act funny with a hypo - and then the next minute they are having seizures.
     
  32. The dose was 1 unit, correct?

    PMPS 443
    +3 ~ 108
    +5.5 ~ 50


    The dose needs to be lower, in my opinion. 1 unit dropped the BG by almost 400 points.
     
  33. Jade77

    Jade77 Member

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    yes, one unit. Unfortunately the numbers dont mean much to me, I don't understand them.
     
  34. Jade77

    Jade77 Member

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    And I know about the lantus, but it just is not in my budget. Not for a few weeks anyway. My bills to keep the roof over our heads has to come first.
     
  35. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    For sure, I just wanted you to be aware it's not always like this! Anyway did you give him the food with syrup?
     
  36. Jade77

    Jade77 Member

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    not yet, Gabe went to the 24 hour Kroger to get some gravy food, because he isn't eating the stuff I put in front of him.
     
  37. Jade77

    Jade77 Member

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    Im going to start a new thread, Ill just call it Boots
     
  38. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok but first rub a little syrup on his gums and give him some chicken bits.

    Can you test now or you need to wait for gabe to come home?
     
  39. OK, as soon as Gabe gets back, give him a couple spoonfuls of the high carb food, and then test him 30 minutes after he finishes eating.

    At +6 hours after the shot, the insulin should be wearing off. The goal at this point is to get the number higher and let you get some sleep.

    Tomorrow morning, my suggestion would be to test, and feed him his regular food. If you see anything lower than 200, skip the shot. If you see anything less than 400, I would suggest no more than 1/2 a unit dose.

    You'll be at work after the shot, right?
     
  40. Please don't start the new thread until tomorrow morning? Since we are all "here" already?
     
  41. Jade77

    Jade77 Member

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    I need to wait for Gabe. Boots is now getting less nice about all this and is fighting me on it. Gabe just got home, Ill give him a bit of food, wait a bit, restest, and post right after k?
     
  42. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Better to get a test now, see if he came up on his own?
     
  43. Jade77

    Jade77 Member

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    Im going to give him the food first. Hes already munching it anyway lol
     
  44. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Don't give him too much of that gravy food yet.. A few spoons. We don't want him to spike on the high carb. This is just enough to get him out of the danger zone, not set his diabetes back.
     
  45. Jade77

    Jade77 Member

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    Carl- he had his first shot at 6pm, and 12 hours later is 6 am, is this when I will give him the next one? Do I test his blood first? Im sure not many of you will be on at 6 am. How do I know if I give him the dose or not? Do I only give him .5? And I will be here til about noon, I work from 1230pm til about 1130 or midnight most nights (EST), so Ill be here for a bit after.
     
  46. Jade77

    Jade77 Member

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    I only gave him about a tbsp of it, and put water next to it as well. He's almost done, so I will retest at 1AM and post the result
     
  47. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Ok good.

    Always test first and do as Carl said for dose ie no shoot if under 200, give 1/2 unit if over 200. Shooting without testing first is like playing Russian roulette with a hypo gun... Or driving with a blindfold.

    Shot time could be 6am since that's 12 hours.... but will you be home at 6pm tomorrow? If not you might want to stall tomorrow mornings shot till a better time you can be home for ... both day and night.

    Wendy
     
  48. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    A test now would be good though.. As I said we don't want him going low and we need to know what he's doing so you can go to bed, you wait till 1am and we might even need a test at 1.30 cos we need two rising tests in a row. Do a test now and that's one down,.
     
  49. If you go past 6am, that isn't going to be the end of the world. This type of insulin is NOT dependent on a strict 12 hour schedule. It will be worn off by then.

    The sequence with Humulin should be test, then feed, and then give the shot about 20-30 minutes after he is done eating. That allows you to know that he's eaten well before you give him the shot.

    I would only give him .5u, and only if the number is above 200 (which I expect it will be).

    As far as when to test after the AM shot? I would test about 3 hours later, 4 at the most. The insulin should have reached onset and started pushing the numbers down pretty well by then. That gives you time, if you see a low number, to feed him before you have to leave for work to make sure he doesn't go much lower while you are gone.
     
  50. Jade77

    Jade77 Member

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    Jul 15, 2013
    okay, test done, it's back up to 108
     
  51. OK, Great!!!

    That is the food, and it's the insulin wearing off like it should be doing by now.

    Here's what I would do.
    Give him another snack and he can eat it now or later.

    Get some sleep.

    In the AM, test him when you get up, and feed him.
    If you see a number over 200, you can give him .5u, if lower than 200, smile and skip the shot.

    Test him about 3 hours after the shot and let us know what you get.

    Start a new thread in the morning.


    Does that work?
     
  52. oh, and if you can catch him peeing and check for ketones, that would be awesome too.
     
  53. Jade77

    Jade77 Member

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    I will try to catch him peeing tomorrow. So should I stay up and test him again in 30 minutes? And you mentioned to give him the insulin close to a time so I can give it to him again when I get off work, but I won't be off work any night of the week before 1030..usually it takes up to or exceeding an hour longer than that. I gave him his first does at 6 mp, so if I gave him another at 11 am or noon, that's too long, isnt it?
     
  54. First, you can test in 30 if you want to, but I don't think it's critical that you do so. I don't think the number is likely to drop down again at this point, especially if you give him a bed time snack.

    Your schedule does make things difficult.

    The big issue seems to be that you can't give the PM shot until you get home from work around 11 PM, right? Then in that case, you should probably hold off on the morning shot until 11 AM. But then you won't be home to test during the 12 hours after the shot in the morning. Well, here's what it comes down to in my opinion...

    You can only do what is possible for you to do. You can't be two places at the same time. I guess my advice would be to dose conservatively, which is why I think .5u makes sense. You could test him around 10:30am, give him .5u at 11AM, and test him just before you go out the door as well. And then when you get home, you can test, feed and give the PM shot. Maybe be able to get a test or two after the late night shot? It's important that he get insulin, but it's also important to do this "safely", especially with a faster acting insulin like Humulin. In a perfect world, you'll be able to switch to a more "gentle" longer lasting insulin. But until then, you just need to do what you can to keep him safe and treat the illness.
     
  55. Jade77

    Jade77 Member

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    Jul 15, 2013
    I will just get up at six am and test, if it's under 200 I will give him the .5. My fiance Gabe just agreed to test and give him the shot at 6 pm if needed. But if its still lower, I will go back to bed and test again at 8 or 9 when my little one wakes me up and give it to him if hes over 200 at that point.
     
  56. I'm sure you already thanked Gabe, but tell him thanks from me too :smile:

    That sounds like a good plan.
    Now get some some sleep! :D
     
  57. Jade77

    Jade77 Member

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    Jul 15, 2013
    I'm sure no one is awake at this ungodly hour, but I did a test at 530 am, bgl was 359, so I gave him .5 of the insulin and some food, and Im going to try to get a few more hours sleep and will test again at 9 am.
     
  58. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Good job last night!

    It looks like you'll be able to do the 12 hour dosing with about 0.5 units, too. That is great, as the every 8 hours thing gets old fast!
     
  59. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Good job to everyone last night!

    Wendy
     
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