10/12 Topper Can Someone Help Me Please

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=102620
I haven't been here for so long due to no computer. I've just spent over 2 hours updating Topper"s SS on a horrible computer!!

I need help! I do not know what Topper is doing. Please look at his SS and tell me what to do. I can't keep delaying shots.

Please remember I am not shooting low. I'm following SLGS.
It's been 3 hours since Topper testd 112 for a PS. I did NOT shoot. He is now 145. I'm hoping at this point to get back to his regular 11pm shot time...

Please tell me how much insulin I should shoot.

I put on the SS that he got sick again with fever and vomiting He was only on the cerenia and bupe two days. Only thing now is the Orbax.

Hi Jan, good to see you! I'm sorry Topper has been sick. I can't help you with dosing advice but hopefully someone will come along who can.
Liz

Hi Liz. I'm really upset.

11 pm is in two hours, right?
Is Topper eating okay the past couple of days?
I think this may give you a great chance at getting back to the 11pm schedule. Let's see what his number is at that time?

I'm also thinking you could stay with the same dose you shot this morning.

Thank you Carl, 11 pm is 3 hours. Topper has been feeling great the last few days. Eating normally.
I just don't know what is going on and I'm worried I'll give him too much insulin.

Hi, Jan.

Sorry about the computer headaches. Just to clarify, you can shoot low with SLGS. The difference in the protocols is the length of time that doses are held. Kitties can go OTJ on SLGS. If a kitty is moving down the dose ladder, you will have to shoot lower numbers.

From my perspective, you are experienced with managing Topper's numbers. It may make sense for you to work your way down to shooting lower numbers rather than skipping. On Health, they suggest that for a newly diagnosed cat, you don't shoot lower than 200. On this board, we use 150 as a "post and ask for help" number. Given your experience, you could have easily shot on time last night. If you are uncomfortable with shooting late or skipping, the alternatives are to lower the dose or to gradually get more comfortable with shooting lower numbers.

One question for clarification, when you delay a shot, is your next shot 12-hours later? In other words, if you had shot on time tonight, you would have been shooting 5 hours later than your usual shot time. If you've been shooting at your usual time, it would explain why you're seeing lower numbers. An early shot acts like a dose increase.

I'm delaying until the bg comes up to a number I'm comfortable shooting. I'm not understanding your question, but at any rate, I'm not shooting early.

Jan,
I'll still be up at shot time if you need help.

What is going on? To me it looks like Topper is doing better. The lower numbers at what would be his normal shot times are actually a "good thing"

I know that it is kind of hard to get past that "shooting below 200" hurdle. I agree with what Sienne says. You have a great deal of experience managing Topper's diabetes, and at times, you didn't"need to skip" , although I understand why you might think that way.
Tonight you are likely to see a number at 11 that you feel good about shooting 2u on. And you can also consider lowering that "no shoot" number gradually. But only when you feel comfortable with it. I can promise that there will always be someone around to help you out with it.
Carl

What I'm not clear about is when your usual shot time is. Here's an example. If your usual shot time is at 9 AM and say that's the time you shot yesterday morning. You shoot 2 hours late last night -- at 11:00 PM. Did you shoot at 9:00 AM this morning or at 11:00 this morning (the delay this morning notwithstanding)?

Sorry Sienne - duh! When I delay a shot the next shot time is 12 hours from that time.

Carl - I don't have a computer which is one reason I don't want to shoot lower, if I need help I probably can't get to a computer. Plus I'm not well at all and can't be available to Topper sometimes.

I know I need to shoot at lower numbers. I just can't do the ideal thing. I also know the numbers I'm seeing a great and it's what I should be working towards which gives me tremendous guilt.
I don't know what to do...

Jan,
What you should NOT do is feel guilty or beat yourself up. Each of us can only do what it is possible for us to do. Given your circumstances, and you not feeling well, then you are doing all you can right now. There's no need to feel guilty.

You are keeping Topper safe. That's what really matters. It's great to let everyone know what your situation is. That is your reality, and we can all work with that

Jan -

Thanks for clarifying. There's a good possibility that what you're seeing is a too full depot. If you have the time to wait this out, the numbers may drop a bit. You can always reduce the dose by another 0.25u if you need to.

Are you using a timed feeder? If you're going to be out of the house for periods of time, a feeder may help to alleviate your worry since food would be available for Topper while you're gone.

I do have a timed feeder but Topper doesn't always eat on his own. He has stomach problems and I never know when that will flare up. No matter his bg, the only way I can get food into him is with a syringe.

I just gave him his shot. His bg was 190. I went ahead and gave 2u again. I just lowered the dose last cycle, and thinking the shed may be too full, which is why the 112 at +12. He did not actually drop low last cycle so I'm thinking I should not decrease the dose further for this cycle, but wait and see what he does with the 2u. If he's way low next PS then I will probably decrease a bit more. Does this make sense?

Yes it makes sense to me. What you want is a dose that gives you two things....
- A number you feel comfortable giving insulin on.
- And a nadir that is in the blue or green range. Numbers under 200 are good. The longer he spends time in blues and greens, the better he will feel and the more chance his body will have to heal.
I think 2.0 might do that for him.