01/19 Ethan AMPS 295, 185 +7.5

[Erin Ethan]

Yesterday's post.

Ethan stayed pretty high last night. I aimed to give him 1.75u this AM- although it looked closer to the 1.5u mark by time I squirted the air and extra insulin out of the syringe.

I asked his vet about the change down to 1.75u- she indicated she'd prefer to see him stay at 2u as he still spends a lot of time hyperglycemic and she's not too concerned about his drops as they are short & as long as we can monitor for symptoms.

Curious to hear thoughts on this? It was too late to change course by time I got her message this morning.

 

[Bandit's Mom]

I aimed to give him 1.75u this AM- although it looked closer to the 1.5u mark by time I squirted the air and extra insulin out of the syringe.

I'm assuming you draw 1/2 a unit more from the pen/vial and then squirt out some in trying to get rid of the air bubbles and measure the dose

I asked his vet about the change down to 1.75u- she indicated she'd prefer to see him stay at 2u as he still spends a lot of time hyperglycemic and she's not too concerned about his drops as they are short & as long as we can monitor for symptoms.

Well, you do want him to spend more time time in healing green. What we try to do is to "feed the curve" and prevent a reduction so that you can keep him on a good dose. So if you see a large drop at the beginning of the cycle like you did at +1 and +2 yesterday, you would feed a little higher carbs to flatten him out and prevent a drop below 50. It's not just lower numbers that trigger bouncing but also sharp drops.

It would have been good to verify that 43 with a meter since the Libre does give artificial lows/wonky readings, but I can totally get that you weren't able to test him with a meter.

Dosing based on nadirs and not on highs. I would stay with 1.75U for now. The good thing about TR is that you aren't stuck with a dose that isn't working. If the reduction doesn't hold you can go back up in 6-8 cycles. By then he has enough time to clear the bounce from that 43 yesterday.

 

[Erin Ethan]

I'm assuming you draw 1/2 a unit more from the pen/vial and then squirt out some in trying to get rid of the air bubbles and measure the dose

Yes precisely this - just with a bit of an over-squirt. The plunger is a bit "sticky" even though I did prime it before drawing up the dose.

It would have been good to verify that 43 with a meter since the Libre does give artificial lows/wonky readings, but I can totally get that you weren't able to test him with a meter.

Indeed- I do suspect it was not truly that low especially as he was behaving normally. I was so disappointed as the first test went so smoothly! But I have learned a lot and will keep practicing...hopefully in less critical situations.

I will keep him on the 1.75u and try to keep smoothing the morning drops. I think that would help bring his nighttime #s down as well.

 

[Erin Ethan]

Ethan's sensor completely stopped working this morning. Glad he got the lower dose.

Attempted a prick test while he was eating...got a drop of blood but not quite enough for the test. Going to let him relax for a little bit then try again. He's very confused as to why I keep playing with his ears.

 

[Bandit's Mom]

Attempted a prick test while he was eating...got a drop of blood but not quite enough for the test. Going to let him relax for a little bit then try again. He's very confused as to why I keep playing with his ears.

@tessa's mom was not able to test her at all initially and now she has switched from the Libre to the ReliOn. It just takes a little practice and a lot of treats!

 

[Erin Ethan]

Thanks @Bandit's Mom! We will get it done.

He's pretty good with the ordeal just twitchy/keeps flicking his ears and he looks up to stare at me every once in a while like...Mooooom??!

 

[Erin Ethan]

Success- sort of! Got the test to work. 185 at +7.5.

Unfortunately there was a lot of blood (relative to the other attempts) so I might have hit the marginal vein... The guilt is real .

When would be the best time if we have to take another test today?

(I know we need to work up to at minimum 4x per day but I want to let him get more used to it).

 

[Manuel]

Thanks @Bandit's Mom! We will get it done.

He's pretty good with the ordeal just twitchy/keeps flicking his ears and he looks up to stare at me every once in a while like...Mooooom??!

Sounds like Ethan is in good hands! For what it's worth, over time you will get better at pricking and Ethan may even come to like the test.

In retrospect, I was pretty terrible at testing during the first week and Emma was none too pleased. But now, she so associates the test with the freeze-dried treat that she purrs as soon as I open the cupboard where the kit is. She is grossly transactional and I love it for these purposes.

For me, I got better at testing once I realized that the poker has an edge - it's not fully symmetrical all the way round. I learned to hold and angle the poker correctly and poke just enough to make contact. Then, I found it helped to "milk" the ear from both sides, though I know some people do it differently. A single, small blood drop comes out now, compared to the gush of huge drops or none at all...

 

[Erin Ethan]

Thanks @Manuel...that is really encouraging to hear that he might even come to like it! And that eventually we'll find the right balance between almost no blood and too much.

We don't have any treats in the house at the moment, but I will buy some tonight and I will try to only give them to him when testing so hopefully he makes a really strong association like Emma.

I did see the "bevel" on the lancet- I tried to hold it so the bevel was facing up...although there was a lot of moving around so not sure if it ultimately went in at the most comfortable angle.

(PS. Saw your updates on Emma in the main forum, so glad to hear she's feeling better little by little ).

 

[Manuel]

Ah, once he starts expecting the treats it'll make a world of difference! Emma starts looking for the treat as soon as my Freestyle Lite beeps. Till then she'll hold pretty still, haha. And if (God forbid) I should forget to give her the treat and walk away, she will stay on the chair, sitting up expectantly until I deliver the goods!

And great that you already are paying attention to these things. For me I hold it in such a way that the angle of the lancet is angled down like a fountain pen. It seems to do the trick, allowing me to come down with the edge perpendicular to the ear. All the best to you and Ethan!