Switching from vetsulin to prozinc: Part 12

Discussion in 'Prozinc / PZI' started by Lisa and Smoky, Apr 15, 2017.

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  1. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Onward to another chapter: Part 12. I'm in newer territory tonight with Smoky. PMPS was 120, this was 12.5 hours after his am shot.
    I need some suggestions or ideas on a dose for him tonight.
     
  2. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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  3. Djamila

    Djamila Well-Known Member

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    Did you already shoot?
     
  4. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    26 March PMPS 131 NS and +4 197
    13 March PMPS with AT2 116 NS and +2.5 295
    Since this is a PM cycle, I only looked at your other lower PMs. If it were me, I think Smoky would be OK with 0.25U, just to get a little bit in him. Can you get some additional tests tonight? At least 1 before bed?
     
  5. Djamila

    Djamila Well-Known Member

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    If not, the next step is to stall for about 20 minutes without feeding. So then the question is...did you feed him yet?
     
  6. Djamila

    Djamila Well-Known Member

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    This doesn't happen very often....but I'm going to respectfully disagree with Yong. I wouldn't shoot a 120. If you can't stall and re-test, I would skip.
     
  7. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    That too, I was too focused at looking at her SS. I should know to stall first! It's probably just an automatic reaction for me to do it :p
     
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  8. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Totally allowed :D
     
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  9. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    No didn't give shot yet. I thought I wld give him a break and skip tonight's shot
     
  10. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    That's OK too :). Can you try to get another test tonight still? To see how he does? It's good data to have and it's how I decided on my opinion, not professional advice in any way :cat:
     
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  11. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I just worked a 12 hour shift so am too exhausted to stay up and monitor him tonight. I'll be giving his budesonide before bed, that usually brings up his BG a bit anyway.
     
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  12. Djamila

    Djamila Well-Known Member

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    In the interest of peer review (I think different opinions are part of what makes this such a wise place), here is my thinking on the skip: We don't have any data from the evening cycle's nadir. Also, 120 is in the range of a normal, non-diabetic cat.

    If you wanted to stay up and monitor, it might be okay to give a small dose, but I don't think it would be worth it since the data is likely an outlier at this point.
     
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  13. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thank you for all the advice. I didn't know that 120 was in the range of normal BG for cats. It's funny that we want those lower numbers but then get scared to death when we finally see them.;)
     
  14. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky decided to have a BG of 184 for Easter Sunday AMPS after that nice BG of 120 last night.;) that's the thanks I get for giving him a break and skipping his shot.:p
     
  15. Djamila

    Djamila Well-Known Member

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    Lol...184 is still a great pre-shot number!
     
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Still a really good AMPS, Lisa! The steroid has to be helping even if you don't see weight gain.
     
  17. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    OK he threw me for a loop on the holiday.
    He was 138 for PMPS so am thinking shld I give insulin or not? I'm doing a curve tomorrow so don't know if I shld skip shot again
     
  18. Djamila

    Djamila Well-Known Member

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    Ugh. I hate the 130's. I feel like 120's are too low, 140's you can shoot (with a lot of data and experience), but 130's.....grrr.....

    Can you get a mid-cycle? If so, then maybe shoot a lower dose. The thing is, you don't want him to hypo tonight because that will throw off the curve. So if starts to go low, you'll need to steer with food and prop him up.
     
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  19. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Just a quick note to add: Smoky has not eaten anywhere as much as he normally does. He doesn't appear to be sick but only ate 4.5 oz for breakfast, 3 oz for lunch, and maybe 1 oz for dinner so far.
    I know that sounds like a lot but he has been eating twice that much daily
     
  20. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I can do a +3 or +4 test if that helps. I thought maybe 0.5 units for tonight. Or maybe even 0.25
     
  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Back on Jan. 29/17 AM you gave 1 u on a PS of 144 and got a green 58 as your low number. You could try 0.75 u or even 0.5 u if you don't want to get to the 50s tonight.
     
  22. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    You're right Kris but that was before he started taking the budesonide. The steroid may keep him from dropping too low if I give him 1 unit of insulin tonight
     
  23. Djamila

    Djamila Well-Known Member

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    So that might account for the low number tonight. What does your gut say? You've got three possible doses: .25, .5, or .75. I think you'd be fine with any of them since you can handle it if he starts to go low, but also last night's no shot didn't seem to throw things too far off. I think you're in the realm of numbers that just require some guessing, hoping, and the skill to handle it (which you have). I know that is absolutely no help at all though.
     
  24. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    No it is helpful actually. I'm trying to decide between 0.5 or 1 unit. I feel more comfortable with the 0.5 dose:facepalm:
     
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  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's true. Do you feel you can rely on that effect?
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Go with comfort!
     
  27. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    OK I just gave him 0.5U five minutes ago.
    When is a good time to do another check?
    He barely ate any of his dinner tonight. I fed him about 30 minutes before his shot
     
  28. Djamila

    Djamila Well-Known Member

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    I assume you're leaving the food out so he can go back and get more if he decides? If you're concerned about him not eating enough, do you have bonito flakes, fortiflora, or treats that you could crush up and add to the top? Maybe entice him to eat a little more?
     
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  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Maybe check at +2 to see if he's dropping?
     
  30. Rachel

    Rachel Well-Known Member

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    I vote for a +2. That way, you can at least get an idea of it he's going to drop early in the cycle.
     
  31. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    A +2 sounds good to me. I don't work tomorrow so can stay up a little late and keep an eye on him.
     
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  32. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    He doesn't like bonito flakes or fortiflora. He is a very picky cat, picked up his food about 30 minutes ago so I can get in a test later
     
  33. Djamila

    Djamila Well-Known Member

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    Lol...I wondered if there were any cats that didn't like fortiflora!
     
  34. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky BG at 106 for +2 hrs. He seems pretty hungry so I'm giving him some of his LC food to eat. He didn't eat much before his shot earlier tonight.
     
  35. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Is the 106 too low of a number for him to have at +2? I'm concerned he may drop too low by +6
     
  36. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It's not that low but you can give him a snack and test again at +3 and/or +4 if you can stay awake or set an alarm.
     
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  37. Djamila

    Djamila Well-Known Member

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    This is a terrible answer, but.....I don't think there's really any way to know without just testing later in the cycle. It does look like he's responding with just a little dose, so that's a good sign. But it could also be from not eating much. Since he's eating now, he may keep himself from going too low. If you're going to go to sleep, can you leave food out for him so he can keep grazing?
     
  38. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Sorry about that, I was taking a nap.
    I plan on testing him in 15 minutes and then it's off to bed.
     
  39. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I checked him at +5 and his BG was 98. I put a 3 oz can of FF in his petsafe feeder for overnight. It will close two hours before his AMPS.
     
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  40. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    April 17: Trying to do a curve today with Smoky but am a bit confused. I used the Relion meter and AT2 just for AMPS and PMPS today. I thought the AT2 usually reads a bit higher than the Relion does.
    AM reading on Relion at 199, AT2 at 135.
    I retested using both meters and got the same results. I'm not sure what to think or which number to give the dose by.
    Any ideas?
     
  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is puzzling! I suggest using the AT number because you do the curve with your AT meter. Maybe give 0.5 u again and see what happens?
     
  42. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Should I just do the curve another day? I haven't done one in a while so kind of didn't want to wait another week. I'm also testing him for ketones since its been a while since I did that.
     
  43. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Kris. I hope my AT2 meter isn't crapping out on me. I was also thinking no more than 0.5 units. He only got down to 98 at +5 last night so that dose seems safe enough to me. Plus he didn't even eat a 3 oz can for breakfast, he has been vomiting a little bit the last few days. I'll have to give him the cerenia for a few days.
     
  44. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Do you have a new battery for the AT meter? It should still be OK though - mine has been going strong over a year now.
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'd do the curve today because you're off and it would be good info to have.
     
  46. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I don't have another battery for it. I bought it at end of Nov last year so it's not really that old yet. I've only used it a few times.
     
    Last edited: Apr 17, 2017
  47. Djamila

    Djamila Well-Known Member

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    Have your test strips for either meter expired? It's probably fine. Someone else on here had the AT2 give them a couple of lower readings too.

    I agree that doing the curve is a good idea as long as you're giving insulin.
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    In a pinch you could try the ReliOn's battery in the AT. I think they all use the same kind. Open the back and have a look.
     
  49. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Kris. Good idea, I'll check it out.
    Smoky was negative for ketones but is being a brat about the food this morning. He won't eat the food that is good for his allergies and IBD so just gave him a can of FF. He is eating that now but it will probably mess up the curve a bit since I have to wait for him to eat and then wait 2 hours for next test.:banghead:
     
  50. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Nope, the strips are pretty new. I'm going to try Kris's idea and see if I can use battery from Relion in AT2 meter for curve today.
     
  51. Djamila

    Djamila Well-Known Member

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    So, first disclaimer: If you look at my spreadsheet, you'll see that I've never done a full, official curve. I test every two-three hours until he rises, and then I stop. So with that confession aside...I also just test through the snacks. Both of my kitties free feed, so rarely take more than a few bites at a time. So since they aren't eating a full can of food, that might be a factor, but I don't make them wait two hours without food for each step of the curve. I just let them eat like normal, and test at whatever intervals I want without worrying about the two hour fasting window. The only time I enforce that is right before the pre-shot tests. So all that to say, I think you can probably just keep going with your curve (if you want to), and not worry too much about the snack he just had.
     
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  52. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    What I usually do since he eats every few hours anyway is feed him, wait 2 hrs and test him, give him a snack, wait until he finishes that. I then wait 2 hours from then to test again. As a result I usually end the curve around +10. I end up waiting for him to eat and it moves the time up and I don't want to have to give his shot late. Does any of that make any sense? Smoky is severely underweight so I have to feed him a lot of food and it can take him a long time to eat it at times.
     
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  53. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    OK, I'm thoroughly puzzled now. My AT2 meter seems to out of whack today. I did a complete reset on it and checked test strips and even tried a different battery.
    I did a +3 test and the reading I got was 168 on the AT2 and 132 on the Relion.
    I gave him 0.5 units in am. The weird thing is his BG numbers so far today.

    AMPS: 135- AT2. +3 test: 168
    AMPS: 199- Relion. +3 test: 132

    Does anyone else think that it's odd that his BG seems to be climbing with AT2 meter but dropping with the Relion? Just a note to add: I used the same blood drop for the +3 test.
     
  54. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Difficult to say because with AT2 AMPS: 108 -162 +3 test: 134 - 201
    ReliOn AMPS: 159 - 238 +3 test: 106 -158

    I wouldn't try to read too much into them :) Theoretically it could be a flatter cycle than it looks ;)
     
  55. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I'm just wondering if the AT2 meter is working right. He doesn't have much of an appetite today. He usually eats at least 6 cans of FF per day. I might have to give him some meds to help with nausea and appetite.
     
  56. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    You have a control solution for AT2? For the record, my ReliOn and AT2 use same battery CR2032 :). And my Aleve Pain therapy tens unit! lol
     
  57. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I did run a control test on the AT2 and it came back within range. However, the control solution I have is old, 12/1/16
    Both of mine use the same battery as well. I tried swapping them but got the same results
     
  58. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Sounds like it is ok then :)
     
  59. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    What I don't get is why the numbers on the AT2 keep going up while the Relion meter shows him still dropping at +5.
    Unless he dropped really low by +2 and then his BG started rising by +3 already.
     
  60. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I think it's due to each meter having a 20% variation. :)
     
  61. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    That could be but it doesn't make me feel comfortable using the AT2 with the BG readings I'm getting todayo_O
     
  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is a mystery but I'm not sure it isn't down to the large variations occurring naturally as well as 20% meter variance. You might as well finish the dual curves to see how it plays out.
     
  63. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I came home from running errands to get in a +9.5 I picked up his food bowl upstairs but forgot the one downstairs. It was completely empty.:confused: the last test I did today was at +7.5 hours. I'll check him with both meters at PMPS and see what readings I get.
     
  64. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Updated Smokys SS,
    PMPS- 246( AT2)
    PMPS- 157(R)

    I think I'm supposed to dose by the AT2 meter reading, right,? So that might be 1.6 or 1.8 units?
     
  65. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Maybe go by the ReliOn numbers because that's what you regularly use and you can reference your data more easily.
     
  66. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I gave him 1.6 units tonight.
    I think he will be safe with that.
    I can check him before bedtime.
     
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  67. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    The Relion meter read 157 and I gave him 1.6 units. He's still not eating much so I gave him some pro plan true nature beef and liver in gravy. It's 6% carbs.He seems to really love it. I'm a little worried about him going too low on the 1.6 unit dose
     
  68. Djamila

    Djamila Well-Known Member

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    Ugh....I hate that feeling when you give a dose and then wish you could take some of it back!

    There's a gravy food with only 6% carbs?!?! I might have to go get some of that!
     
  69. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I got that food from Dr Pierson's newly updated list. I found the link to it on Main Health forum. He was 115 at +3 but the steroid I give him for the IBD usually raises his BG a bit overnight. I also left him a half can of food in his timed feeder for overnight.
     
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  70. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Or when you give a dose and wish you had given a little more :blackeye:. ProPlan true nature beef and liver in gravy, is this a pate? I'm feeling lazy so I am just asking you instead of looking up LOL
     
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  71. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    It's not a pate, more like a stew.
    It reminds me of weruva which he won't eat by the way. He loved the weruva for weeks and now he won't touch it.
     
  72. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I thank my lucky stars that Teasel and his sibs are really good eaters and not the least bit finicky. That makes up for all of Teasel's BG craziness! :);)
     
  73. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky was 143 for PMPS so think I will give him either 0.5 units or 0.75 units.
    What do you guys think?
     
  74. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    I gave him 0.5 on Sunday night with a BG of 138 and he was OK. I don't want to skip if I don't need to.
     
  75. Rachel

    Rachel Well-Known Member

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    Let me take a look at your SS real quick...
     
  76. Rachel

    Rachel Well-Known Member

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    I think 0.5 would be fine. As you say, you gave that a few nights ago and all was well...and he gave you a nice green that night!
     
  77. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Thanks Rachel,
    I was worried that 0.75 might be too much. I can't stay up late with him tonight so the 0.5 unit dose sounds safer
     
  78. Rachel

    Rachel Well-Known Member

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    Always go with safety when you know you can't stay up to monitor. That way, you can sleep soundly knowing he is safe. :)
     
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  79. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    April 19: Smoky BG was 187 in am
    108 in pm. What the heck just happened?:eek:
     
  80. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Who knows, Lisa? It's a lovely blue though!
     
  81. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Just a thought I had, should I be aiming for green preshot numbers? Or should I try to give a dose that allows for a high enough BG to be able to give insulin?
     
  82. Djamila

    Djamila Well-Known Member

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    This is just a theory...but I wonder what would happen if you lowered the daytime dose a smidge. Four out of the last five evening numbers have been either too low to shoot, or required a significant drop in dose. If you lower the AM dose a little, it might make it so you can give two shots again. That's preferred so that his pancreas isn't sputtering along all alone for 12 hours/day.
     
  83. Djamila

    Djamila Well-Known Member

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    In the short-term, you want two shootable numbers. In the long-term, you want pre-shots between 50-120 on a human meter, 68-150 on AT2. Those are 'normal' ranges, and indicate that insulin support is no longer needed. But as long as he needs insulin, the goal is two shots/day so his body isn't stressed half the day. Sometimes you can do that by adjusting one of the doses down a little. Sometimes you can do it by switching to an 11/13 schedule, and sometimes you can't do it because the numbers get all wonky and you just have to do the best you can.
     
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  84. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think your goal is blue PSs and a green nadir because ProZinc gives a smile shaped curve. Green PSs might give you a lime green nadir - not good!
     
  85. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    I think you are also prozinc member no.3 or 4 with this trend tonight :D
     
  86. Djamila

    Djamila Well-Known Member

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    Smoky, Pita, Maury, Frank,....anybody I missed? Yup, seems to be the trend tonight.
     
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  87. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    What? How did I miss the party?:p
    I didn't know there were so many of us tonight.
     
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  88. Djamila

    Djamila Well-Known Member

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    Oh geez....Sam. I missed my own cat! (hangs head in shame)
     
  89. Lisa and Smoky

    Lisa and Smoky Well-Known Member

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    Smoky BG at 176 for am test. Trying to decide dose so he has a shootable number tonight. I thought a reduced dose of 1.5 units might work. Anyone have any thoughts or suggestions for me?
     
  90. Rachel

    Rachel Well-Known Member

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    Hmmm...well it looks like you gave 1.6 on that same number 2 days ago and it got you a shootable, but lower than normal, preshot. Then yesterday, 1.8 got you an even lower and not shootable preshot. 1.5 might work...I'd be inclined to go 1.4 and see if that worked. I know I know, 1.5 and 1.4 are basically the same, but it just feels good to me lol. Of course, I have no idea if that will really work. Lowering the dose is harder than raising it and you kind of have to guess. If that doesn't work, you could go lower again tomorrow.
     
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  91. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I like the suggestion of 1.4 u or 1.5 u, Lisa.
     
  92. Djamila

    Djamila Well-Known Member

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    1.4 or 1.5 both seem like good things to try. So whichever feels better to you (although at this point, maybe you already shot anyway?).

    That's not a bad pre-shot after a night of no insulin!
     
  93. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    I gave him 1.5 units and left down some extra food for him this morning.
    Thanks for the dosing advice, I did read everyone's posts. The plumber came so couldn't respond right away
     
  94. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    I had another thought, gave him budesonide last night. The steroid raises his blood sugar so that coupled with no insulin. The 176 BG was really a surprise given those two factors.
     
  95. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    Smoky PMPS was 135. I would imagine it might have been lower had I not given him a reduced dose. I need to know if 135 is too low to shoot. What dose is a good one for him if not too low to give a shot?
    I have about 30 minutes to figure something out. Can anyone help me out here? I'm looking over his SS now.:bookworm:
     
  96. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    On your 4/16 PM cycle, you shot a .5 on a similar number and it was fine. You might even go with .6 since you still had a fair amount of safe dropping room on that cycle.
     
  97. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    That being said, a NS is always an option. I hate the 130's. I feel comfortable shooting in the 140s. I don't shoot in the 120's. But those dang 130's are tricky. Definitely grab a before bed test if you shoot anything. And go with what makes you comfortable.

    PS I love that you lowered the AM dose and are still just barely shootable tonight. :)
     
    Yong & Maury GA likes this.
  98. Lisa and Smoky

    Lisa and Smoky Well-Known Member

    Joined:
    Sep 6, 2016
    I could try the 0.6 unit dose tonight. He does get the budesonide before bed. The steroid does raise his BG a bit. I think sometimes that it also may even prevent him from dropping too low.
     
  99. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Wow! I gotta say Smoky is surely impressing me these days! I do think you could do a 0.5 or 0.6 as either would probably be safe with the budenoside on board. :)
     
  100. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You gave 0.5 u on 143 a few days ago as Djamila pointed out. You could try that or even 0.4 u.
     
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