10/9 & 10/10 Henry

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Angela&Henry

Angela&Henry

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10/9
AMPS 365 3.3U
+4 239
+6 251
PMPS 231 3.4U

Is there a full moon? Complete wonkiness so far today...he did get very frightened between 3-6 am this morning when there was a big storm with non stop lightning, thunder, rain and wind. But WTH?
not a fur shot, absolutely sure. No change in behavior, no excessive drinking or peeing
AMPS 408 3.3U
+4 1st check 460 2nd check 366 1 minute apart
+6 1st check 517 2nd check, tried a different meter, One Touch Ultra, 408 (*just for this check to compare..all other tests are with Bayer Contour we normally use)
+10.25 370 lowest hes been all day when its almost time for insulin to wear off.
 
So sorry Big Hen is doing wonky things. Without looking I think full moon is Wednesday. My understanding is the effects can go on either side of the full moon if you believe in that sort of thing, so this would qualify :(
Here’s hoping he’s back to better numbers real soon. Come on Hen, you can do it!
\M/
 
Yikes! Today's cycle defies logic. I understand the AMPS, but nothing beyond that. The daytime cycles on the 5th, 6th and 7th look nice. I don't get what happened on the 8th unless it was a reaction to the full dose the night before when he was blue.
If you take into account "variance" of the meter, it looks like Henry has been getting extra long duration for the past 4 or 5 days. Today is the picture perfect inverse curve, which usually means "too high of a dose", but he hasn't acted that was to the same doses before now.
Could his pancreas be kicking in during the last half of the cycle?
:? :? :?
I'm hoping Sue or Robin can help make sense of this....

Carl
 
Weird. When I see something like that, my tendency is to try a slightly lower dose the next cycle (i.e. on the next AMPS in Henry's case), and see if the results are better. Their insulin needs can be changing, and sometimes the dose becomes too high. If the results are worse, or you go back to a U-curve but it's too shallow, then you raise back up. It's really just trial and error, collecting data, and trying things til you figure out what works.

With Bix after a while I had an instinct for things, and I could often tell quickly from a small dose change if I was going in the right direction or in the wrong one. Sometimes wonky cycles are just wonky, and other times they are actually a sign the dose is off, you just can't say for sure from the data. With Bix, if he wasn't feeling well, his insulin needs would double very quickly, and then when he was doing better would go back down just as quickly.

I'm sure you will get things figured out, just hang in there and keep collecting data and adjusting as you go. Sorry it is not an easy ride. :YMSIGH:
 
I'd also try to get some nighttime data if you can on the 3.4. Might be he doesn't need that much after all (?) who knows - I don't like the higher AMPSs, I really thought raising the nighttime dose would bring the AMPSs down, but it doesn't seem to be doing that - I would try for PM data to see what is really going on in there, it's a puzzle why the AMPSs are worse now. I'd hesitate to just lower the dose though, as there's no real reason to believe he's getting low nadirs or something. In the AM if he hits a nice green then he gets a nice low PMPS, so in theory if he is hitting good numbers overnight he should be less likely to go high. You never know though, and every now and then a spot test will be really revealing.
 
weirder still...
+11 300
PMPS will be a 11:00 or a little after EST
How much should I reduce? AMPS is now 3.3, PMPS was raised last to 3.4. Maybe a 3.2 for AM dose?
 
Certainly looks like an inverse curve to me. I would tend to shave 0.1 or 0.2 off the dose, whatever feels right to you. It might be that with the higher night dose he doesn't need as much in the AM - in theory that is how it should work, you want to reduce the dose on a +10 shot compared to a +14 shot. So ideally the higher dose at night means a lower AMPS and then you can lower the AM dose a little hopefully and get a good nadir from there. But of course the AMPSs are high so it doesn't all quite add up right. I might try lowering the night dose a little too, maybe back off and see if that helps the AMPSs until you can get more data, and if you raise back up again, do it at a time when you can collect some nighttime data? I'm not sure, see what others say...
 
Wow, he might not be rising at PMPS....

Henry, what's up? :?

Carl
 
This makes no logical sense.... he dropped for 12 hours? What was pushing his BG down, or why did he get a late onset and THAT MUCH duration?

Have you seen this before, ever, Angela?

Carl
 
well, I will correct that..... he rose early but then dropped for six hours. Inverse curve I guess, but why? What makes the BG drop for that long when it seems like the insulin did nothig the first 6 hours? And if inverse curve = too much insulin, then why today? The dose has been the same for a while.

carl
 
I have seen the long duration before several times but not with the huge rise in the middle of a cycle and then dropping again that much.
What has been really weird a few times in the past is when I knew I had given him a fur shot in the AM, he would not rise maybe stay between 20 points of AM BG or drop a little, then he would have his normal PM dose and next morning he would be lower than normal. And when I had to skip his shot like when he was having a dental, I would take his BG that morning but no shot and when he got home BG was not that high for not having any insulin all day and then the next morning it was as low or lower than normal for him.
When we first started dosing in the beginning, he was on BID 1.5- 2.5 U and he got really high, flat numbers all day. Vet suggested we try SID, and he goo t better nadirs and really no higher in AM. I continued SID until around first of April, when I went back to BID starting at about 1.7-1.8. He was getting better numbers in the mornings, although the PM was always lower than AM. Gradually we've worked up to 3.-3.3 range again. For several months he was in upper 200's to lower 300's in AM. Just in the past 2 weeks is when we have hit an 400 or more for AM BG.
No change in food, amounts and never food an hour prior to testing.
 
I just went back and looked at Henry's whole history and now that you explained it, I understand your SS better. I still don't know what to make of his late behavior though. I'm wondering if there needs to be a bigger difference between his AM and PM doses? But the way you have them timed, that should be the effect anyway. The PM dose is "late", which should allow his PMPS to be higher. And it should act as a dose increase towards the AMPS which is only ten hours away. So even though the numbers (3.2 vs 3.3 or 3.4) are close together, the "effect" should be greater.

I finally figured out, however, why it's been hard for me to wrap my head around the concept. It is because it was the exact opposite of the way that my vet had me "attack" Bob's numbers. What you are doing, and I understand the logic of it, is you are dosing looking forward, trying to make the next PS come down.
When Bob went up from I think it was 2u BID (4 units total per day) to 5 units total per day, my vet directed me to make the doses 2u and 3u rather than 2.5 each shot. But what she told me to do was to shoot the 2u on the lower PS, and 3 and the higher one. With Bob, the PS was usually the higher number, so I was shooting 2u in the morning and 3u at night. She had me looking "backwards", and giving the higher shot in reaction to the higher PS. I was dosing "reactively", and you are dosing "proactively".

Just for the record, I don't think my vet's way worked too well either. Bob's numbers came down, but not in an orderly fashion, and at some point, I just decided on my own to start dropping the doses without her permission or knowledge. I did continue with the same strategy however - reacting to the higher PS with the higher dose after the fact.
It was only when I'd send in his data by fax, or we'd have a visit scheduled, that she learned what I was doing. Luckily, the results always backed up what I was doing, so she really couldn't make a fuss about it. All she'd say was "well it seems to be working". In fact, Bob was OTJ for a week or two before I presented her with his latest log. I just gave it to her and as she looked at it I said "Bob hasn't had a shot since July 19th, and those last numbers are what he's been since then." I made her cry, which was cool! Tears of joy, but it was cool.

Carl
 
carlinsc said:
This makes no logical sense.... he dropped for 12 hours? What was pushing his BG down, or why did he get a late onset and THAT MUCH duration?

Have you seen this before, ever, Angela?

Carl
Click to expand...

They can get a late drop like that if the dose is too high - not always an inverse curve, it can be just flat, and then a drop down at the end of the cycle. Or if their pancreas is working, that can extend the duration. Henry remains a mystery though. :mrgreen:
 
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