Oct 22 Felix AMBG=81, 75; +13=66, 63; +14=67, +18=530; PMPS(+20)=592, +3=508

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Are you still stalling? Sorry someone with a but more experience is checking in yet, but I think with SLGS, you'd want to NS an 81...are you home to monitor? Looks like Felix has had some large drops on this dose, so not sure shooting would be a good idea...
 
Yes, still stalling (poor hungry boy) and will retest in a few minutes. I will be around, but yeah, at the rate he's been asking for reductions....

I'm wondering at what point I'd feed not just because I'm stalling but because I want to turn the drop around. And because he wants me to!
 
+18=530

He's really shot up. At this rate and with his history of DKA, I don't feel comfortable waiting for his regular shot time and I'm thinking of giving it by his usual +8 time (i.e., today's +20) even though it'll take several cycles to get him back on schedule. I'm also thinking of doing one more dose of 4.75 before taking the reduction.

Opinions welcome.
 
I didn't retest! I always think of that immediately when I get a surprise low, but it didn't cross my mind when I got a surprise high. :rolleyes:

However, I did now (about +18.75) and it's 516, so it was real but at least maybe he's leveling off.
 
Eep! Well, OK, that's a real number, then!

You're right to be extra-cautious with ketones in the mix. One option (a little late now) we sometimes suggest is to do two 18-hr cycles, which would get him on track quickly, but it does give him another cycle with a gap in insulin coverage. So I think I like your idea of getting him back on 12-hr schedules asap better, but are you sure you want to put yourself 4hrs off your usual schedule? Evenings won't be so bad, but mornings, yikes!

How is he doing otherwise? Is he showing any signs of anything being wrong that might have put him in these high numbers (ie. something other than bouncing from the greens this morning and possibly lower in the overnight)?
 
We did do two 18-hour cycles at the end of September, and nice as it was to get back on schedule so fast, I shot a mid-yellow and he was over 500 by 18 hours later, so I'd be worried how high he might go if he's trying to overcome these 500s at shooting time (although maybe it doesn't work that way).

Anyway, yes, I feel keeping the cycles closer to 12 hours may be best. I've been testing at awkward times lately, so shooting shouldn't be worse, provided he'll eat a bit (and he's good that way!).

He's sitting by me, feeling fine. His ear looks a little tender from the testing, though. :(
 
With the 18 he cycles tend to mess them up for longer.

If your schedule allows it then nothing wrong with what you are suggesting. I think with dka if it were me I'd prefer that option.
If he was still very high you could maybe shoot tomorrow morning at +11??
If he comes back down then stick to 15min per cycle, or 30 min a day.
 
Sorry--I got pulled away from the computer for a bit....

Thanks so much for your advice, everyone!

He was 592 at +20, and I shot 4.75u. I plan to take the reduction to 4.5u in the morning, but probably 12 hours from now rather than the regular time (which would be +16). Early mornings for me this week! :confused::coffee:
 
That’s best as long as you can do it. Depending on the numbers you might consider going back to your time in 45 minute increments. This is only for Susan given her situation. Nobody should else should consider moving the time more than 30 minutes every 24 hours. If thinking about this list first.
 
Thank you for saying that! I've backed him up in 15-minute increments before, but I was wondering since this will be stretching forward instead of backing up, if I could maybe adjust by 20- or 30-minute intervals: I've gotten the impression that, with Lantus, being a little late isn't as bad as being early. So how about shots every 12.5 hours until he "catches up" with his regular time? I'm just concerned if I'm not close enough to 12, I'll have no idea if this dose is working and won't really know what Day 1 is for assessing that. As you said, "depending on the numbers" will be a factor, too.
 
I think we have to see where he is when you want to shoot. Shooting 30 minutes early the next cycle should be fine. Then you need to see what Felix does during that cycle. .
 
+3=508

I'd be shooting at +12.5, so 30 minutes late for that cycle (which will land at 5:00am US Pacific time), although 3.5 hours earlier than his usual time. Yes, we'll see where he is by then. Looks like he's begun to respond to his shot.
 
I wouldn't shoot that early. An hour early would be the earliest I would consider and only if the BG is high enough.
 
Delaying by 30 min every cycle may act as a reduction, so it might see him run higher than you like,bgiven the dka.
You might have to wait and see where his numbers are.
 
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