911 INJECTED TWICE!

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With Lantus we use the nadir for dose increase and decreases with consideration to the pre shot number. The pre shot number will tell you if it's safe to shoot and the nadir tells you how low the dose is taking him. So, during the PMPS cycle, suppose he were hitting some nice green numbers that you missed because you aren't testing and during the AM cycle he was bouncing and looking high and you would assume he needed a dose increase after you held the dose for 3 days in following TR or 7 days if following Start Low Go Slow (SLGS) method. That is why it is so important to test during both cycles.

Are you following TR or SLGS ?

Malachai is beautiful BTW!
Well I just started the SLGS method. I wasn't seeing the numbers I wanted so I started increasing every 7 days. I used to go every 10 days to 2 weeks but was told to not hold the dose for too long to prevent insulin resistance. I know I should be testing in the PM- it's just very hard with my schedule.
 
+6 261!
My hands are actually shaking from this test. I was so worried.
I'll post at +7.

Depending on how today plays out, so I dose him tonight? I'm assuming I should skip it right???
 
Kinda freaking me out that he didn't drop more during his nadir "hours." Like if he's gonna drop in the early AM hours or something when my vet is closed....
6units just seems absurdly high.
 
Because it's been an hour since the HC, I would test again at +8, see if he is still holding his own 2 hours after the HC
The effect of the carb can last for two hours and when it wears off we can see them dip, so lets see if he is still holding at +8.
 
+8 341
So he's staying pretty normal with his regular cycle? Thoughts? I just can't believe he never dipped below 200 on 6units! I'm hoping he won't drop tonight....I can't test every 2hrs :/
I'll call my vet to see if they have any suggestions for a good 24hr facility just in case.
What would be your next move? Clearly he's heading up.
Still not sure about giving him insulin tonight...
 
I think you can relax now for this cycle. Maybe get a +11 and post for advice on tonight's cycle.
 
It does seem like he's on his way up. And now that's not food influenced.

It's gone midnight over here so I'm headed to bed, Wendy's going to keep an eye on you now.

Glad you get to have a bit of a break.
 
Getting close to the +11 time, hope you guys were able to chill out for a bit!

Assuming he's still in safe territory, it might be a good idea to remove the 911 from the thread title for a little while. That way, if things get hairy later (hopefully not!) and you have to put it back on, people will see that there's a fresh situation going on.
 
Hi wendy,
I will be posting my +11 shortly. I would love some suggestions on his p.m. dose after we have that number.
Do I just 'edit' my post title and remove the 911? Is that how I do that? And later, if there is an emergency, do I just edit it again add re-add the 911 or start a complete new thread? Thank you!
 
Yep-- you can change the label by "editing" the title. If you need to change it back, do it on this thread since we're on the same day/situation (start a new thread tomorrow).
 
Getting close to the +11 time, hope you guys were able to chill out for a bit!

Assuming he's still in safe territory, it might be a good idea to remove the 911 from the thread title for a little while. That way, if things get hairy later (hopefully not!) and you have to put it back on, people will see that there's a fresh situation going on.
I'm try
Yep-- you can change the label by "editing" the title. If you need to change it back, do it on this thread since we're on the same day/situation (start a new thread tomorrow).
Okay he's at 380 at +11.
Unfortunately, I don't have many numbers at +11
 
Ok he's at 380 at +11.
Unfortunately, I don't have many tests in at +11 except when he was at 1.5 units and he had similar numbers.
I'm still a little uncomfortable giving him three units considering I won't be able to test throughout the night. What are your thoughts on dosing tonight?
 
Hi Nan,
Sorry I thought that previous response was from Wendy.
I can test until 10:45pm. Might be able to set an alarm and get one more in after but I can't be up all night testing tonight.
 
So, if I can put this all into + notation:

7:10am PST: shot 1: 3U
8:10 PST: shot 2 at +1, 3U
6:10pm PST + 11 (from shot 1, +10 from shot 2): 380
"shot time" (if you shoot) is at 7:15 PST (45 mins from now), that will be +12 from shot 1, +11 from shot 2
Can only monitor until 10:45pm PST (+15.5 from shot 1)

Whew!

Sandy, I am going to defer to you on any shooting advice here.
 
So, if I can put this all into + notation:

7:10am PST: shot 1: 3U
8:10 PST: shot 2 at +1, 3U
6:10pm PST + 11 (from shot 1, +10 from shot 2): 380
"shot time" (if you shoot) is at 7:15 PST (45 mins from now), that will be +12 from shot 1, +11 from shot 2
Can only monitor until 10:45pm PST (+15.5 from shot 1)

Whew!

Sandy, I am going to defer to you on any shooting advice here.

Yes! The above is all correct!!!
 
Should I be giving him his PM shot 1hour later tonight then? +12 from the SECOND shot?
My $0.02:
Being that he got a full dose again at AM+1 the count starts from there. That being the case if you gave the shot at +12 from shot #1 instead of +12 from shot #2, you would be shooting an hour early and overlapping the shots. That's the last thing you need. So if you shoot at +12 from shot #2 you will need to wait 12 hours to shoot your AM shot. Can your schedule accommodate that?
To get safely back to schedule you can pick up 15 mins each cycle or 30 mins each 24 hours.

All the above combined with your inability to test overnight....I think skipping makes the most sense.
 
Should I be giving him his PM shot 1hour later tonight then? +12 from the SECOND shot?

Like I said, I'm not one of those that can really give dosing advice, especially in an unusual situation like this one. However, given your monitoring situation, I do not think you'd want to give a late shot tonight. I think your choices are, shoot 3U, shoot a reduced amount, or skip the shot. You'd hate to skip given how high he is now, but I'm very nervous about shooting given the limited monitoring ability tonight. That double dose this morning could still create some activity tonight.

Going to tag @Wendy&Neko to take a look at things. Can you get a test at 7pm (what would normally be the PMPS)? It would be good to know if he's trending up or down right now.
 
I've been following this. Refresh my memory will 2 shots have an affect on tomorrow because of the depot? Even though I'm not a sugar mom anymore I still like to keep up with it.
 
Whoops, Sandy and I posted simultaneously! Coming at it from different angles, but I think we're in agreement that caution is in order here.
Being that he got a full dose again at AM+1 the count starts from there. That being the case if you gave the shot at +12 from shot #1 instead of +12 from shot #2, you would be shooting an hour early and overlapping the shots.

That's a good point. I was thinking more about the monitoring situation-- shooting at +12 from shot #2, Deena would only be able to monitor until +2.5, which makes me very nervous under the circumstances.
 
So he's staying pretty normal with his regular cycle? Thoughts? I just can't believe he never dipped below 200 on 6units! I'm hoping he won't drop tonight...
Hi! I came here seeing 911. I'm happy and surprised that his BG didn't drop with double dose! Either you or hubby gave a fur shot? ;)
 
I can test right now. That would be +12 from shot number one at +11 from shot number 2.

ill post and we can go from there.
I can skip it if recommended. Or I can also shoot a little at 8:15 and then inject at 8:15am.

Whatever is the SAFEST. I will be able to get a Pre-shot in the AM but I will not be around tmrw to test during the day so that is a concern too.
 
I agree that caution is best, given the ability to monitor. A skip is also an opportunity to drain the depot a little.

Has Malachi ever tested positive for ketones?
 
If you skip tonight, please do test @+2 to see how active the cycle could be even without the shot and try and grab a later test if you get up to go to the bathroom tonight.

I am so very happy that this cycle did not have him diving.

And not to beat a dead horse, but please start getting more PM test so you can get a complete picture of what is happening with the dose.

You did great today, Momma! :cat: :bighug:
 
So there's a lot coming from everyone.
Are we in agreement to skip the dose tonight? I just tested him at 401 at +12 on the FIRST shot. I can test again later (whenever is recommended) to see how the cycle is going without the shot if that's what the consensus is???
 
I agree that caution is best, given the ability to monitor. A skip is also an opportunity to drain the depot a little.

Has Malachi ever tested positive for ketones?
Jill he once had a very low reading for ketones (about 8 weeks ago at the vet) but I have since got ketone strips and he's always been negative.
 
Has he been eating well since then?
ETA: Acting normally?
If all has been well in the last 8 weeks, I think it'll be fine to skip a single shot. After all, even though we didn't see his BG numbers plummet, he received twice his normal dose today. Because Lantus is a depot insulin, we don't know what, if any, effect that over dose will have on subsequent cycles. All things considered, including the fact that you can't stay up to monitor tonight... I'd skip tonight and resume in the morning at your regular shot time.

However, if he's been "off", sick, or hasn't been eating well I think it would be a good idea to get "some" insulin into him at 12 hours after the second shot.

Just my thoughts.
Others may have different opinions...
 
He eats very well. No changes at all. He'd eat all day until he threw up if he could.

So we're all in agreement that I should skip the shot and I'll get a+2 or a +3 test to see how active the cycle is even without a shot? Correct?
 
I am glad to see all has gone well for your baby.
I have been watching ever since you put up the 911, but I didnt want to cause alerts to come up for those who have been with you in this and just make it hard for them to see what is going on.
But it appears things are calming for you, so I thought this was an ok time to just let you know, I am happy for your baby, that nothing horrible took place.
 
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