Squeak Long Curves

[Fly]

4mth Facebooker - First time Poster!

I am trying to understand my boy's numbers since being diagnosed with a Nasal/Sinus Fungus approx 2 weeks ago. Prior he largely had fairly flat blue curves, during the horrible vet visit weeks etc he was mainly yellow and spot checks indicated no big changes over the day. Now...it's greens to yellows and 4 skipped doses in a week.

Firstly, my goal is ONLY to stay around 4-8mg (72-145). Fighting the fungus is our first priority and if we can get on top of that I imagine the BG will start to go down anyway. Would like to follow TR but not shooting too low until I understand his ups and downs.

He has a few days with the regular 12hrs in between shots and then it drops and he can stay low for well over 14hrs (but it takes a while for the drop to start). Then due to missing a shot he stays high for a few days. Could this be an indication of:
- Depot being depleted and building up
- Dose too high
- Bouncing
- Anything else?

This latest dip he seems to have hit nadir around 14hrs after his last shot and is now on the way up. I know nadir can be long with lantus but I can't shoot when he is say 4.4 and heading down but it seems to take a long time to show any impact from the next shot.

The spreadsheet only includes his BG since it started to drop in the last week. But due to skipping with low BG several times, doses from 25th Jan aren't all at the 12hr mark - notes in comments. I changed focus to try and shoot when his BG is around mid blue after skipping a shot rather than waiting until the next normal 12hr shot time slot.

Spreadsheet is a mess but any thoughts. I am hoping some thoughts might tell me what to consider and look for.

Thank you,
Cherie

 

[Wendy&Neko]

With that 49 today, Squeak earned a reduction down to 1.0 units.

Is he on anything for the sinus proble. He could be healing and feeling better. Inflammation can raise blood sugar and maybe it's getting better.

 

[Fly]

Thanks Wendy, he is on Itraconazole (expected to be for months minimum) and Metacam (started 2wks ago, I am reducing down, currently around 1/2 initial dose).

Re-earning a reduction, I was planning to give less at next shot but wasn't sure about having 2 drops within a week when he is also having some yellow numbers. I have tried to look at the yellows as his body trying to balance out the lows and the missed dose but they just seem too spread out. If his nadir can be 14hrs after a shot, do you think that could mean the insulin is still playing a active role for 3-4days, rather than the more standard 2days?

I am expecting to be able to give him a shot over the next few hrs when he has dinner and am thinking of dropping just by 0.25iu. By his spreadsheet though I think I will need to wait 4days to let him settle and get any yellows out of his system before increasing again (which isn't TR).

Thanks
Cherie

 

[Wendy&Neko]

If he is going below 50, the dose is too high. The impacts of the larger depot lasts 4-6 cycles after a reduction, so he earned the reduction.

The low numbers at +14 means he could be getting good duration.

 

[Fly]

Ok thank you. At +18hrs he is only up to 88. I will wait another hr and than test and feed and consider a tiny shot depending on how much it increases.

Thanks.

 

[Dyana]

The remarks in your spreadsheet show you gave a shot at +8. Can you please add in the +8 cell how much insulin you gave at that time? In the PMPS cell it shows 0.50. Did you give him more insulin just 4 hours later? If you did, that can cause all kinds of problems with onsets and nadirs overlapping each other.
I have to get ready to leave for work. I hope someone else can help you with your spreadsheet, so it is more clear.

 

[Fly]

No shot was given in the amps. The dose for this is left blank and the comments state its +19hrs since last shot to clarify.

 

[Wendy&Neko]

If you don't dose, it's best to put "skip" or "NS" for no shot in the units cell. That way people know it's a deliberate miss, instead of just forgetting to enter the data.

 

[Dyana]

No shot was given in the amps. The dose for this is left blank and the comments state its +19hrs since last shot to clarify.

I saw that you shot at +19, however there is a 0.50 in the units column for the PMPS as well. Was that 0.50 what you actually shot at +19 and did not give more at "+12" (PMPS)? Sorry if I'm confusing you.

 

[Fly]

I saw that you shot at +19, however there is a 0.50 in the units column for the PMPS as well. Was that 0.50 what you actually shot at +19 and did not give more at "+12" (PMPS)? Sorry if I'm confusing you.

It was .50 at +19hrs. The spreadsheet doesn't really allow of such long curves so I add notes in comments but everyone has their own method of notes and shots at varying times.
But those long curves have reduced now anyway. The sinus fungus seems to be demanding a little attention again. We start an additional anti fungal med on Monday and have a quick vet trip next week so I'll be watching closely to see what it does to his numbers in case the larger and longer curves start again.