1/23 Shadow PMPS 384 +6 386 +11.75 147 +12.25 149 +12.5 123 +13 (AMPS)137 +1 136 +2 134

Christina Marie

Christina Marie

Member Since 2020
Woke up to do our usual morning routine and Shadow has decided that having been in the 300-400 range the past couple of weeks was for the birds and threw me yet another curve ball! We are up to 9U 2x of Lantus now. IAA test was negative. Still waiting for results on Acro test.

I have been stalling his shot with no food. Number hasn't really changed. We are about 30 minutes past his shot time as well. According to his spreadsheet and how low his nadir gets, I think he should be fine receiving at least a partial dose, but how much should I cut it by? He's only been on this new dose of 9U for 3 days.

I apologize for the empty days on his spreadsheet. We were out of town and I had someone else handling his insulin.

Edit: number getting lower by 12.5. Still stalling shot, but went ahead and fed him to get some food in his belly.
 
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I see back on 12/11 you had AMPS of 150 and gave 2 units instead of the usual 5.5
His depot will be full. It looks like he has had 5 doses of the 9 units so far.
Maybe he’s coming off a bounce from the yellow BGs 5 cycles ago.
What dose would you be comfortable shooting.
Remember you are shooting the BG in 2 hours time. How is his appetite?
 
Bron and Sheba (GA) said:
I see back on 12/11 you had AMPS of 150 and gave 2 units instead of the usual 5.5
His depot will be full. It looks like he has had 5 doses of the 9 units so far.
Maybe he’s coming off a bounce from the yellow BGs 5 cycles ago.
What dose would you be comfortable shooting.
Remember you are shooting the BG in 2 hours time. How is his appetite?
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Not sure on what dose I'd by comfortable with. The 9U seems to only bring him down by ~50 around the nadir, so I want to try and give him something that will keep him low and won't cause another bounce super high. I went ahead and fed him. His appetite is huge and he's always hungry and always willing to eat! Thankful for that at least. Is it possible for a bounce to take this long to level out even when waiting a week between dose changes?
 
There is not a lot of data, but he did drop to yellow 5 cycles ago and he could have bounced from that. The doses have nothing to do with the bouncing...it’s what triggers the bouncing which is either dropping too low, too fast or lower than they are used to.
I can’t stay up with you as it’s late here in Australia and I’ll be heading to bed before long so I would not like to tell you to give the full dose and not stay up with you.
Do you have plenty of higher carb food if needed and test strips and karo?
He will probably bounce from this blue preshot so don’t worry about that.
 
Bron and Sheba (GA) said:
There is not a lot of data, but he did drop to yellow 5 cycles ago and he could have bounced from that. The doses have nothing to do with the bouncing...it’s what triggers the bouncing which is either dropping too low, too fast or lower than they are used to.
I can’t stay up with you as it’s late here in Australia and I’ll be heading to bed before long so I would not like to tell you to give the full dose and not stay up with you.
Do you have plenty of higher carb food if needed and test strips and karo?
He will probably bounce from this blue preshot so don’t worry about that.
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Yes I have several cans of HC gravy lovers and some honey on hand. Would a decreased dose of 3U be okay or is that cutting it by too much in this situation? I am on the SLGS method
 
Christina Marie said:
Yes I have several cans of HC gravy lovers and some honey on hand. Would a decreased dose of 3U be okay or is that cutting it by too much in this situation? I am on the SLGS method
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I wouldn’t drop it by that much. If you can test during this cycle I would give 5 units.
I would get a +1 and a +2 to start with to get some data and then keep testing during the cycle. Are you able to do that. And are you comfortable with giving 5 units.?
 
Bron and Sheba (GA) said:
I wouldn’t drop it by that much. If you can test during this cycle I would give 5 units.
I would get a +1 and a +2 to start with to get some data and then keep testing during the cycle. Are you able to do that. And are you comfortable with giving 5 units.?
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Yes I am comfortable with that. I'll be available to him the entire time. This is the third time I've hit this situation and I just feel like I always decrease his dose too much when we see his numbers this low and it causes a huge bounce every time. I will go ahead with 5U and keep his spreadsheet updated. Thank you so much for your time!
 
Christina Marie said:
Yes I am comfortable with that. I'll be available to him the entire time. This is the third time I've hit this situation and I just feel like I always decrease his dose too much when we see his numbers this low and it causes a huge bounce every time. I will go ahead with 5U and keep his spreadsheet updated. Thank you so much for your time!
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It wouldnt matter what dose you gave him, it wouldnt effect the bounce. The bounce is caused by the lower then normal BG and if he’s going to bounce, he will bounce if you give 2 units or 9 units.
If you give a lower dose it could cause the BG to go higher for that cycle but not for 6 cycles....does that make sense?

When you get used to lower preshot numbers you will feel more comfortable giving the full dose. I know it is scary in the beginning, especially when you are giving 9 units.
Is there any reason why you are doing SLGS and not TR?
I will watch for the +1 and possibly the +2
 
Bron and Sheba (GA) said:
It wouldnt matter what dose you gave him, it wouldnt effect the bounce. The bounce is caused by the lower then normal BG and if he’s going to bounce, he will bounce if you give 2 units or 9 units.
If you give a lower dose it could cause the BG to go higher for that cycle but not for 6 cycles....does that make sense?

When you get used to lower preshot numbers you will feel more comfortable giving the full dose. I know it is scary in the beginning, especially when you are giving 9 units.
Is there any reason why you are doing SLGS and not TR?
I will watch for the +1 and possibly the +2
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+1 is 136, so really no change from AMPS. I will continue to monitor hourly! Thank you for staying up with me and keeping me calm for this low (low for us at least!)

Shadow and I are still navigating all of the things that come with FD and learning new things daily. I also had tests for IAA and Acromegaly done for him almost 3 weeks ago. IAA came back negative, and we are still waiting for his Acro results to come back.

SLGS just seemed like the better option for us until I was more educated and we had all of his test results back. 9U is crazy for me to wrap my head around, so I've been taking Shadow back and forth to the vet trying to figure out why he might require so much
 
I think TR would be a better dosing method for you to think about. You can increase the dose every 3 days if needed and if Shadow needs more insulin, it is better to increase the dose than to leave him in the higher numbers longer..
It is good he’s a good eater. Sheba was a good eater and it was so much easier if she was dropping into lower numbers as I could always get her to eat.
 
Bron and Sheba (GA) said:
I think TR would be a better dosing method for you to think about. You can increase the dose every 3 days if needed and if Shadow needs more insulin, it is better to increase the dose than to leave him in the higher numbers longer..
It is good he’s a good eater. Sheba was a good eater and it was so much easier if she was dropping into lower numbers as I could always get her to eat.
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+2 134, so no change still
At what point do I consider giving him a high carb snack? Is that something to wait for until I start seeing the number dip below 80?

Will give him more 7% carb in the mean time
 
Christina Marie said:
+2 134, so no change still
At what point do I consider giving him a high carb snack? Is that something to wait for until I start seeing the number dip below 80?

Will give him more 7% carb in the mean time
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I think I would give him a higher carb snack now because we don’t know how much he will drop when the insulin onsets and we want to have a bit of leeway.
Can you test again in 30 mins just so we can see if the insulin onset has started please?
 
Christina Marie said:
+3 is 151. We got a slight increase with the HC food
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That’s good to know he responds well to medium carb food.
Im going to head off to sleep now. It looks like he’s not going to bounce at this point, so you might get a nice flat blue cycle.
If he starts dropping you know you can feed him some higher carb food to bring him up higher. you have done a great job managing him.
I’m going to ask someone I know to keep an eye on Shadow for the next few hours. Give him a pat from me and tell him he’s been a very good boy please!
I’ll look on tomorrow Christina.
 
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