Wondering if dosage should be increased

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Lynn & Rupert

Lynn & Rupert

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Hi, when someone has a chance, could you take a look at Rupert's SS? BG's numbers all over the place at first, but last 3 days, seem consistent. Maybe I am just getting better at it all and not screwing up as much! :banghead: His numbers seem high to me, but he seems to feel pretty good, eats well, still not his normal self, but better than before starting insulin. So, wondering if his dose should be increased yet. The first part of the SS, he was on a different schedule...started out at 11:00AM Eastern AMPS and 11:00 PM PMPS (I'm a night owl), then due to skipping shot due to low numbers, he was on a 1:00 AMPS and 1:00 PMPS. Skipped another shot due to low numbers and on 7/22 he started on a 9:00 to 9:00 12 hr schedule. Not sure the times matter, as long as shooting 12 hrs apart, but thought any info might be helpful. Thank you in advance for any advice. :bighug:
 
What would the ProZinc protocol say to do with nadirs above 150 mg/dL?

Exactly. Do that.
 
BJM said:
What would the ProZinc protocol say to do with nadirs above 150 mg/dL?

Exactly. Do that.
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I have read it and have a copy, but I thought it was best to get some advice before attempting to change dosage. I will increase the dose by what the sheet says. thanks BJM
 
Any 12/12 schedule will work.

Yes, I'd say increase. He is in ranges below the renal threshold (we think around 250) part of the time, so his pancreas can be healing, but he certainly has room to drop safely. I'd just be sure you can monitor the first cycle; Rupert has often thrown us a little surprise.
 
Sue and Oliver (GA) said:
Any 12/12 schedule will work.

Yes, I'd say increase. He is in ranges below the renal threshold (we think around 250) part of the time, so his pancreas can be healing, but he certainly has room to drop safely. I'd just be sure you can monitor the first cycle; Rupert has often thrown us a little surprise.
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I did increase his AMPS dosage by .5, his BG was 410 this morning. Ugh. :( I will test at +2 and will be around most of the day to test and watch him. I bought Ketones test strips, but haven't been able to catch him in the act. I might have to take him to a vet for a test. Worried because of his high numbers. I don't think I did a fur shot last night, his numbers were down at +4. Concerned about his numbers being so high this AMPS. I feel like I am losing confidence today, was scared giving him a shot this morning even. :nailbiting:
 
The 400s look worse than the 396 yesterday, but remember - it's only 4 points.

Oliver would never let us watch him pee. We ended up buying aquarium gravel. We'd put it in a clean box and leave him in a room with it. He'd have to christen the box; the urine wouldn't be absorbed by the gravel and we'd have our test.

His numbers are not that bad. Lots of yellows mid cycle with a little bump for preshots. For a new diabetic, he is doing fine. His body has to figure out how to make the insulin and the diet work together and then we will see progress. Remember, it's a hormone, not a "take this pill and you get results in 3 hours" It's a process.

We have some patience pants on the forum somewhere. Most new diabetics need them in the beginning. You want him better NOW! As someone wiser than I said once, It's a marathon, not a sprint.

You'll get there. You are doing everything right.
 
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Here you go - a stripe for every color in the spreadsheet and more. :D
 

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Sue and Oliver (GA) said:
View attachment 15762Here you go - a stripe for every color in the spreadsheet and more. :D
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Lol...love the pants! Wish I could actually wear them and look like that in them! ;) You are right, I need to be patient, I will chant "it's a marathon" in my head today. I had read about the gravel trick (I think it was BJM), guess I will try that, will have to isolate Rupie in the bathroom, since I have 3 others. I would feel better if I had a reading on the ketones for sure. Thank you so much for the pep talk, I needed it, been a lot of tears this morning. I am tired too, lot of late hours this week. I am going to breathe and take a chill pill! His +2 was down to 324, feeling better now. :bighug:
 
Hey Lynn - just checking. Did you give Rupert 1u this am or 1.5u? I saw in your comment that you increased the AMPS by 0.5u and your SS says 1u.
 
Merlin said:
Hey Lynn - just checking. Did you give Rupert 1u this am or 1.5u? I saw in your comment that you increased the AMPS by 0.5u and your SS says 1u.
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Hey Merlin, I gave him 1.5 this am. I need to revise his SS, thanks for pointing that out. BG was 324 @ +2 and just checkedd @ +4 and it was 201. Going to stay around and check his BG levels. How often do I check his BG's when dose is increased? Thank you very much!
 
When I change a dose, I like to see what it looks like at nadir. Rupert is dropping pretty good today. So if you could get a +6, I think that would give you a good picture of what that dose did today. Hopefully it is in the blue. In fact, he may already be in the blue at +5 but since you tested at +4, you could give Rupert a one hour break. Keep our fingers crossed!
 
Oh and one more thing. I do what you just did...test at +4 when I change a dose. For Merlin, a +4 is where he is going to tell me if he is going to be too low at nadir. So I like what you did already this morning.
 
Ok, whew, sort of nerve wracking changing his dose! I will do a test at +6 and see how he is doing. He did eat some, hope that is ok. Maybe won't get so low with some food. I usually feed him several smaller meals a day, so figured I would keep to his usual schedule. Thanks for the support and vote of confidence, feeling better now! :) :kiss:
 
I think keeping his schedule is very important. Merlin seems to want mini meals throughout the day too just like Rupert. In fact, it is like clockwork, every two hours. So when I know I am going to test, I try to feed around those tests. So he always need food two hours after his AMPS and I give it to him. Knowingly, he will want food in another two hours and if I am going to test at +4, I hold off his food for just a few minutes and feed after his +4 test. Same with a +5 or +6 test, I try and feed after the test. That way, the test is not influenced by food and it is also a reward for Merlin too. All he really wants is a tablespoon or two anyway, so it probably is not a big deal if he eats prior to a test but I still try to feed after a test without disrupting his schedule.

Yeah, agree, it is nerve wracking when changing a dose or if a number is right on the edge of a higher dose. That is when I test at +4 and at nadir. This will give me good information so when I get that number again, I can confidently shoot that dose again. The second time you give this dose with this number, it is less nerve wracking because you have good data that told you that he will do pretty good. You are doing great!
 
Merlin said:
I think keeping his schedule is very important. Merlin seems to want mini meals throughout the day too just like Rupert. In fact, it is like clockwork, every two hours. So when I know I am going to test, I try to feed around those tests. So he always need food two hours after his AMPS and I give it to him. Knowingly, he will want food in another two hours and if I am going to test at +4, I hold off his food for just a few minutes and feed after his +4 test. Same with a +5 or +6 test, I try and feed after the test. That way, the test is not influenced by food and it is also a reward for Merlin too. All he really wants is a tablespoon or two anyway, so it probably is not a big deal if he eats prior to a test but I still try to feed after a test without disrupting his schedule.

Yeah, agree, it is nerve wracking when changing a dose or if a number is right on the edge of a higher dose. That is when I test at +4 and at nadir. This will give me good information so when I get that number again, I can confidently shoot that dose again. The second time you give this dose with this number, it is less nerve wracking because you have good data that told you that he will do pretty good. You are doing great!
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thank you so much, I think I can do this now! xxoo
 
Yeah! He might have been a little lower at +5 or he might even go a little lower at +7 too. Glad to see the blues! So this is good information. Next time you get this number you can either shoot this number again or 1.75u or if you have u100 syringes, you can try 1.6u. I typically like to try a dose with a number twice to see if it gets me close to the same result before I change the dose on my sliding scale. So hopefully he will surf a little more in the blues this afternoon. Woo hoo!
 
When you're concerned about increasing, you can just fatten the dose a tad - pull up just a teeny bit more - and go with that.

Also, if you take the last week of numbers with mid-cycle data, order them by pre-shot levels, and then order by the lowest test you got afterwards around the nadir period, you can get a feel for the amount of drop you get with the dose you have used. That may let you consider a sliding scale where a higher pre-shot may get more insulin while a lower than usual pre-shot may get a lower dose.
 
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Thank you Merlin, BJM and Sue! He was back in the yellow at +9, but at least he hit the blues at +6 and maybe longer. Looks like a little more needed, like l.75 and I do have the U 100 syringes, so could try the l.6 U on that, but think I will stick with the 1.5 U at PMPS for tonight. See how it does overnight, since he usually goes lower then. As I get more experienced and better able to understand his charts, hopefully I can try the sliding scale method, BJM. I even got a Ketones reading! A little inconclusive, the color chart and his sample (got a good one) were a little hard to compare. Look like perhaps at worse a trace amount, I'll try for another one, but if I still not sure , I will have a vet give him a test Monday. I waited after he ate, had a cocktail, watched him like a hawk and hung up on a friend when I saw him headed towards the litter box! lol Thanks so very much Merlin, Sue and BJM for all your help! :bighug:
 
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