? Dosing advice please

Stephanie & Johnny

Stephanie & Johnny

Member
I am on day three of the Libre.

Thanks to the Libre, I’ve been catching some really low numbers in time to “fix” them.

Thankfully, when he hits these low numbers, he starts screaming at me in his “I demand treats” voice, which prompts me to check and see these numbers. I give him a bunch of Temptations cookies that he scarfs down along with some Delectables Stew and then start scanning and taking blood like it’s going out of business.

Fortunately, I’ve been able to avoid a symptomatic hypo event, but it’s still scary how fast it happens.

I never seemed to pick these lows up when I was manually testing before, but he also wasn’t alerting me before….so it’s all …I don’t know if it’s his diet. He really is not a fan and will ONLY lick the top layer of the wet food until the Fortiflora is gone. Or something else.

He’s doing great otherwise though! Lots of cuddles and lovings and a couple *audacity* side eye looks.

Johnny is on Prozinc. Was doing 2 units twice a day. Reduced to 1.75 last night and then 1.5 this morning. (Approximate numbers since my needles don’t have those markings, but definitely under 2 and over 1).

My spreadsheet is in my signature. I have a tab for the Libre and a tab for the Alphatrak.

His shot is due at 8. He just tested at 331 on the Libre and 462 on the AT.

I’m thinking of dropping back down to 1 unit for his PM shot tonight. Is this advisable?
 
Do you have any wet HC moving forward? The temptations aren't helping the wild BG swings as they stay in the system longer (same with dry food). What dry are you feeding?

57 on AT is pretty low, yes I would reduce to 1 just to be safe (ordinarily we reduce in 0.25U increments).
 
FrostD said:
Do you have any wet HC moving forward? The temptations aren't helping the wild BG swings as they stay in the system longer (same with dry food). What dry are you feeding?

57 on AT is pretty low, yes I would reduce to 1 just to be safe (ordinarily we reduce in 0.25U increments).
Click to expand...


Hi there!
Thank you for the reply! I have wet high carb food, but he wasn’t interested in anything but the Temptations. I didn’t think he was low enough to go full-on Karo syrup and/or high carb baby food since he was asymptomatic. I didn’t realize the Temptations issue and won’t do that again.

His actual dry food is Young Again. His wet food is the Weruva line that is on the diabetic/CKD friendly list. He hates it, but I sprinkle with Fortiflora to get him to eat at least some of it.
 
Stephanie & Johnny said:
Hi there!
Thank you for the reply! I have wet high carb food, but he wasn’t interested in anything but the Temptations. I didn’t think he was low enough to go full-on Karo syrup and/or high carb baby food since he was asymptomatic. I didn’t realize the Temptations issue and won’t do that again.

His actual dry food is Young Again. His wet food is the Weruva line that is on the diabetic/CKD friendly list. He hates it, but I sprinkle with Fortiflora to get him to eat at least some of it.
Click to expand...
Ok gotcha! Yes when they're that low absolutely anything they'll eat to bring them up.

Karo and honey, etc aren't reserved just for symptomatic hypos...once you hit symptomatic that's a guaranteed ER trip while giving the honey/karo/etc in the car. I would say if you're getting under 50 on the Libre/under 60-ish on the AT bust it out, but you also need to get some real food in there. The karo is a quick boost to get them up, but still need the HC to keep them up. We call 68 on AT the "take action" number, meaning need to start getting them back up with HC.

Still be careful to keep an eye on him, even at reduced doses.

Since you're feeding dry, you would reduce any time he goes under 90.
 
FrostD said:
Ok gotcha! Yes when they're that low absolutely anything they'll eat to bring them up.

Karo and honey, etc aren't reserved just for symptomatic hypos...once you hit symptomatic that's a guaranteed ER trip while giving the honey/karo/etc in the car. I would say if you're getting under 50 on the Libre/under 60-ish on the AT bust it out, but you also need to get some real food in there. The karo is a quick boost to get them up, but still need the HC to keep them up. We call 68 on AT the "take action" number, meaning need to start getting them back up with HC.

Still be careful to keep an eye on him, even at reduced doses.

Since you're feeding dry, you would reduce any time he goes under 90.
Click to expand...


Thank you! I gave him the 1 unit reduced dose 2 hours ago and his BC is coming down much slower now.
 
He appears to possibly be breaking a bounce, when that happens they can sometimes go a bit lower than they normally would. I'm not sure how the Libre works, but definitely get some midcycle tests and a +10 or +11 so you can see how hes coming into AMPS.

How was he diagnosed?

These are somewhat unusual sharp dives and bounces for ProZinc. That 1U to 2U increase by the vet was probably too drastic and it looks like that's what's shaking out right now, possibly the food change as well.

Just to confirm, you're no longer giving the Purina wet and dry?
 
FrostD said:
He appears to possibly be breaking a bounce, when that happens they can sometimes go a bit lower than they normally would. I'm not sure how the Libre works, but definitely get some midcycle tests and a +10 or +11 so you can see how hes coming into AMPS.

How was he diagnosed?

These are somewhat unusual sharp dives and bounces for ProZinc. That 1U to 2U increase by the vet was probably too drastic and it looks like that's what's shaking out right now, possibly the food change as well.

Just to confirm, you're no longer giving the Purina wet and dry?
Click to expand...

Hi there! Confirmed no longer feeding Purina dry. I cycle in the wet occasionally in an attempt to get him to eat, but mainly it’s the Weruva.

He was diagnosed initially with a blood test at the vet. I took him in because he dropped a bunch of weight and was scaring me. I actually thought it was his kidneys crashing. The initial diagnosis was on a Saturday, then he went in on the following Tuesday for additional confirmation tests, an X-ray, and his first curve.

I also think I may have caused his diabetes from using too much Tresaderm on his head a couple weeks prior for a skin outbreak. :/ I haven’t talked to the vet about that being a possibility, but from what I’ve been reading on the boards, it seems possible. We go back Wednesday morning for our next check up.
 
Overnight update…gave 1 unit for his PM shot. He did much better with a nadir closer to 182 (Libre human meter) rather than a super low sharp dip. I updated the Libre tab in my spreadsheet for his overnight numbers as late as I was able to stay awake.

This morning, his pre-shot was 317 (Libre human meter). I gave him a “fat” 1 unit dose. I will be gone most of the day for a client meeting, so I didn’t want to do the full .25 increase since I won’t be able to have eyes on him all day.

Which needles are recommended for Prozinc that have the quarter lines?

Thanks!
 
Stephanie & Johnny said:
Overnight update…gave 1 unit for his PM shot. He did much better with a nadir closer to 182 (Libre human meter) rather than a super low sharp dip. I updated the Libre tab in my spreadsheet for his overnight numbers as late as I was able to stay awake.

This morning, his pre-shot was 317 (Libre human meter). I gave him a “fat” 1 unit dose. I will be gone most of the day for a client meeting, so I didn’t want to do the full .25 increase since I won’t be able to have eyes on him all day.

Which needles are recommended for Prozinc that have the quarter lines?

Thanks!
Click to expand...
Unfortunately none have the 1/4 line, do you mean 1/2?

I'd hold this dose for about 4-6 cycles to let him settle down a bit, then think about an increase.

Are you testing for ketones?
 
Yeah, I’m definitely going to hold the Fat 1 unit dose for a bit.

I didn’t realize there weren’t 1/4 lines, but 1/2 would work. I just know there are different kinds of needles that work for different insulins. Very confusing.

I completely forgot that I need to get ketones testing supplies. ‍♀️ They are on my list but I got distracted by the low numbers. So much to keep track of.
 
This is crazy town. We are one hour per-shot and he is at 209. Just a couple days ago, 2 units would have been fine, but now 1 unit is seeming to being more than adequate.

Assuming he doesn’t peak up to 300 for shot time, how do I dose him tonight so he doesn’t end up too low or going up overnight?

The Libre tab is updated as of right now.
 
He dropped below 90 on the Libre so that's another 0.25U reduction. So 0.75U is new dose, I feel fairly comfortable with that as long as he's flat or headed up into shot time. Still needs a close eye because he's coming down in dose unusually quickly
 
Thanks! I need to get those 1/2 unit needles asap. Placing order now. Also - which ketone strips should I order?

Is there any chance that his dose is dropping quickly because his pancreas is “waking up”?
 
Stephanie & Johnny said:
Thanks! I need to get those 1/2 unit needles asap. Placing order now. Also - which ketone strips should I order?

Is there any chance that his dose is dropping quickly because his pancreas is “waking up”?
Click to expand...
Any urine ketone strips work, like Ketostix. They also make blood ketone meters if you think a sample is too hard to get, but those are on the pricier side (as are the strips).

It's possible. It could be a combo of food change, perhaps the diabetes was steroid-induced. And the higher doses were making him bounce.

Just snag one more test before shot if he hasn't eaten, just to make sure he's flat/rising.
 
FrostD said:
Any urine ketone strips work, like Ketostix. They also make blood ketone meters if you think a sample is too hard to get, but those are on the pricier side (as are the strips).

It's possible. It could be a combo of food change, perhaps the diabetes was steroid-induced. And the higher doses were making him bounce.

Just snag one more test before shot if he hasn't eaten, just to make sure he's flat/rising.[/QUOT
FrostD said:
Any urine ketone strips work, like Ketostix. They also make blood ketone meters if you think a sample is too hard to get, but those are on the pricier side (as are the strips).

It's possible. It could be a combo of food change, perhaps the diabetes was steroid-induced. And the higher doses were making him bounce.

Just snag one more test before shot if he hasn't eaten, just to make sure he's flat/rising.
Click to expand...

thank you! Double-checked and he was still 216. Gave as close to .75 as I could given the needle I have.
Click to expand...
 
You must log in or register to reply here.
Back
Top