1/2 Jackson AMPS 413 +2 355 +4 299 +5 278 +6 263 PMPS 316 (FS) +3 384 +4 429 +5 397

Finally! At least a little bit of action! Still on the edge of 300, but on a downward trend. And just as noticeable to me, Jack’s body language. As his body is getting more fuel influx from the glucose breakdown, he’s visibly relaxing and getting more restful/snuggly. He was acting like he was starving, again, yesterday and early this morning.
 
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You might want to increase tomorrow morning to 1.75U. I know you are following SLGS but it looks like he is seeing some glucose toxicity and considering his history of DKA, you want to get him to good numbers sooner. With TR you can increase every 3 days till you start seeing nadirs below 200.
 
I’m not feeding like TR, though. And I do worry to drive him down too far (when he actually starts to respond.) But if you okay it, I can try. It does seem very difficult to bring down higher numbers, as I’ve heard/read, more so than keeping them in better ranges…

Yes, I’m noticing and worrying about the glucose toxicity. He doesn’t seem super prone to ketones, but he IS super prone to succumbing to glucose toxicity.

Tonight is an especial frustration. He was finally starting to respond, and then he got a fur shot. He’s already rising again. I cringe to think what his numbers will be in the morning… It’ll be like starting the whole past week of struggle all over again…
 
Okay yikes! Just scanned him again and not only is he higher, he is actively and rapidly (per Libre) climbing! Is there any safe way to get some (more, or any?) insulin into him? I’m starting to think he didn’t get any! (I wasn’t home and didn’t give the shot, my cousin did, and says she smelled it right away.)

If he keeps this up I fear I’m going to be forced to try it, wise or not, because he’s on a rocket ship with no tether!
 
Skye & Jackson said:
I’m not feeding like TR, though. And I do worry to drive him down too far (when he actually starts to respond.) But if you okay it, I can try. It does seem very difficult to bring down higher numbers, as I’ve heard/read, more so than keeping them in better ranges…
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I know you aren't comfortable with TR. Just suggesting that you increase faster till you break through the glucose toxicity and then you can switch back to SLGS. You cannot follow TR when feeding dry food anyway. What you could do is follow SLGS with a lower reduction point - say 70 - so that you can keep him at a dose where he sees safe higher greens.


Skye & Jackson said:
Okay yikes! Just scanned him again and not only is he higher, he is actively and rapidly (per Libre) climbing! Is there any safe way to get some (more, or any?) insulin into him? I’m starting to think he didn’t get any! (I wasn’t home and didn’t give the shot, my cousin did, and says she smelled it right away.)
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With a furshot you don't give insulin again because you don't know how much has gone in. I see he has been negative for ketones so that's good. Just feed him well and keep him well hydrated.
 
I already have the reduction point lowered to 70 (on Libre, at least). Although I have been thinking of adjusting it to 60. Although at this point the exact number seems a bit moot because he rarely sits in greens at all unless he’s either diving or climbing from a low. Maybe once we get him into a better range typically, I can fine tune it more.

I suspect it was a near total furshot - I kind of grilled her about it and it sounds like she went through both sides of the tent. (She feels awful about it, so I’m trying not to get too upset… I know it happens.) So I imagine some of the insulin probably dragged through, but I suspect half dose at most, probably not even that. But no I don’t know how much, and there’s no way to know. If he breaks 500 though I suspect I’m going to be hard pressed not to give him a half dose in a panic…

At least Jack is a very good eater and drinker both. That really helps this whole thing, I suspect.
 
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Okay he’s coming back down a little bit… still high, but coming back down means he did get some insulin (thank God)…
 
Skye & Jackson said:
I already have the reduction point lowered to 70 (on Libre, at least). Although I have been thinking of adjusting it to 60.
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I don't suppose he will let you verify a drop below 70 with a poke? The Libre can read lower than a human meter in the lower ranges of normal and we suggest getting a reading with a meter for readings that can affect dosing decisions.
 
He allows pokes as long as I do them here and there, not daily and especially not more than a couple in a row. So I tend to save them for when needed. Which is particularly when he’s reading low on the Libre. So far the pattern seems to be about a 20 point spread when Libre reads in the 50’s, I haven’t really tried it at 70. If I can actually catch 70, or 60, that would be a good idea. If Jack would be less volatile at lower numbers, I suspect he really should be hanging out in Libre 50’s, probably like earstick 70’s…ish. It’s hard to let him, though, because so far he so very rarely goes into any greens, never mind lower greens, without diving for the 40 and below realm.
 
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