11/22 Yoyo PMPS 373, +2 314, +4 239 ,+8 228 AMPS 312,+2 252,+5 195

Good Morning and Happy Thanksgiving,

At his +2 last night he was high at 369, then he dropped at +4 and even more at +8. I was wondering if I needed to watch him closer after the +8 but I was figuring that he was going to start increasing around that time. Should I have watched him closer? Please let me know, as when his numbers do finally come down, I need to know when to be on the look out! That is the part I am not looking forward to. Too much fear is still in me.
 
He was steadily dropping during the PM cycle. It was not necessary to watch him closely because his numbers are still too high to be of concern.
If he had been approaching 100, you may have wanted to keep an eye on him moreso in preparation for the AM cycle. If he is steadily declining for the duration of a cycle, it's good to get a +10 or +11 so that you can see what's going in with the next AMPS or PMPS.

So, let's say you see something like this:
AMPS 250 +3 150 +6 125 +10 100

Now your PMPS is 95. You can shoot that 95 under SLGS, but in that case you would want to get a +1 in the PM cycle to see if he is still dropping or if he is starting to go back up.

Same scenario as above, but change the +10:
AMPS 250 +3 150 +6 125 +10 150

Now you know he is already starting to go back up so you are not as concerned about the +1. You can stick to your usual +2.

That is my understanding.

Maybe @Veronica & Babu-chiri and @Bobbie And Bubba can confirm or correct anything I've gotten wrong when they get a chance?
 
I think you did a good job monitoring last night. As Rosie said, if the numbers had been a lot lower, more frequent testing would be indicated. He has done that kind of cycle before on this dose, where he drops quickly to blues, then hangs out there a while,

Today is the seventh day on this dose, and so far no numbers below 150. That would mean an increase to 0.75 units tomorrow, provided you can monitor as you have been.
 
Rosie & Bailey said:
He was steadily dropping during the PM cycle. It was not necessary to watch him closely because his numbers are still too high to be of concern.
If he had been approaching 100, you may have wanted to keep an eye on him moreso in preparation for the AM cycle. If he is steadily declining for the duration of a cycle, it's good to get a +10 or +11 so that you can see what's going in with the next AMPS or PMPS.

So, let's say you see something like this:
AMPS 250 +3 150 +6 125 +10 100

Now your PMPS is 95. You can shoot that 95 under SLGS, but in that case you would want to get a +1 in the PM cycle to see if he is still dropping or if he is starting to go back up.

Same scenario as above, but change the +10:
AMPS 250 +3 150 +6 125 +10 150

Now you know he is already starting to go back up so you are not as concerned about the +1. You can stick to your usual +2.

That is my understanding.

Maybe @Veronica & Babu-chiri and @Bobbie And Bubba can confirm or correct anything I've gotten wrong when they get a chance?
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If a PMPS is 95 I won't be comfortable giving him his insulin at that time. Would I be able to wait until his number came up to 150. My Vet told me not to give him insulin if under 170. This is the part that is going to be hard for me to handle.
Wendy has written that tomorrow I should increase the dosage to .75 but I don't believe she is aware that I am trying the New Food Schedule. Shouldn't I give it another day or so? Please advise.
 
I am aware of the new feeding schedule. I don’t see significant differences so far. It’s up to you if you want to wait another day before increasing.
 
Wendy&Neko said:
I am aware of the new feeding schedule. I don’t see significant differences so far. It’s up to you if you want to wait another day before increasing.
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Thanks for checking in Wendy:)
Wendy is one of the most experienced members here so you can always feel confident in her judgement. Of course, it's also fine to wait a day or so until you feel comfortable with upping the dose. Plus, at that point there will be more people available to help if he drops lower than what you are comfortable with.

Debra and Yoyo said:
If a PMPS is 95 I won't be comfortable giving him his insulin at that time.
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That is unlikely any time soon. More than likely, you will have several experiences of shooting your "lowest preshot ever". So far, your lowest preshot is 237. One day, Yoyo may give you a preshot of 190. Then, one day 150. Eventually, the hope is you will get an opportunity to shoot a 90 because that's when Yoyo has his best chance of remission. That is most likely in the far future, though, so don't worry. By the time that comes around, you will hopefully not be as afraid as you are now.

If Yoyo ever comes up with a preshot number that makes you uncomfortable, definitely stall, don't feed, and ask for advice. You can stall as long as you like as long as you can maintain the new schedule and slowly work your way back. You should never shoot less than 12 hours from the last shot.

Yoyo's best chances of remission are to bring his numbers down into normal ranges of 50-99 (50-120?) and have him be in the greens for a while so his body can heal. Believe it or not, once Yoyo is in the greens, it gets easier because his numbers will be flatter and not have such big drops.

As for me, my vet had given me a cutoff of 220, then a cutoff of 180. I think my vet would eventually have lowered the cutoff more, but I'm not sure the vet would have felt comfortable letting me shoot the lower numbers that would lead to remission. At some point, I had to make a decision that I would continue to shoot lower and lower numbers so that I can give Bailey a chance to heal. I think when the time comes, you will be ready to do it too. :)
 
Rosie & Bailey said:
Thanks for checking in Wendy:)
Wendy is one of the most experienced members here so you can always feel confident in her judgement. Of course, it's also fine to wait a day or so until you feel comfortable with upping the dose. Plus, at that point there will be more people available to help if he drops lower than what you are comfortable with.


That is unlikely any time soon. More than likely, you will have several experiences of shooting your "lowest preshot ever". So far, your lowest preshot is 237. One day, Yoyo may give you a preshot of 190. Then, one day 150. Eventually, the hope is you will get an opportunity to shoot a 90 because that's when Yoyo has his best chance of remission. That is most likely in the far future, though, so don't worry. By the time that comes around, you will hopefully not be as afraid as you are now.

If Yoyo ever comes up with a preshot number that makes you uncomfortable, definitely stall, don't feed, and ask for advice. You can stall as long as you like as long as you can maintain the new schedule and slowly work your way back. You should never shoot less than 12 hours from the last shot.

Yoyo's best chances of remission are to bring his numbers down into normal ranges of 50-99 (50-120?) and have him be in the greens for a while so his body can heal. Believe it or not, once Yoyo is in the greens, it gets easier because his numbers will be flatter and not have such big drops.

As for me, my vet had given me a cutoff of 220, then a cutoff of 180. I think my vet would eventually have lowered the cutoff more, but I'm not sure the vet would have felt comfortable letting me shoot the lower numbers that would lead to remission. At some point, I had to make a decision that I would continue to shoot lower and lower numbers so that I can give Bailey a chance to heal. I think when the time comes, you will be ready to do it too. :)
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Thank you for telling me all that. Makes me feel calmer. It was mentioned on this site that if he gets under 90 at any time you lower the dose by 0.25 units when following SLGS. Any advise on this?
 
Debra and Yoyo said:
It was mentioned on this site that if he gets under 90 at any time you lower the dose by 0.25 units when following SLGS. Any advise on this?
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Yeah, I think that's the guideline for SLGS. Since you are new to this, I would probably suggest that you post a question and get input before making any dosing changes. That way you can get advice based directly on Yoyo's progress,
 
I like Yoyo's new lower nadirs. The new feeding schedule is definitely helping, just not enough. Notice, no more reds :)

I hope once you do the dosecrease, you can knock out those pinks completely off of his ss :)
 
Rosie & Bailey said:
Yeah, I think that's the guideline for SLGS. Since you are new to this, I would probably suggest that you post a question and get input before making any dosing changes. That way you can get advice based directly on Yoyo's progress,
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Ok, I haven't post a question yet. But I will learn. Hope you're enjoying Turkey Day!
 
Debra and Yoyo said:
Thank you for telling me all that. Makes me feel calmer. It was mentioned on this site that if he gets under 90 at any time you lower the dose by 0.25 units when following SLGS. Any advise on this?
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Wendy is seriously one of the most experienced and greatest advisor you can have

That being said, when she mentioned the 150 she was referring that in all your tests he has not had a value under 150 at any time during the day or night (not in his preshoot tests) so that gives you the idea that he needs more insulin that's why she was suggesting increasing the dose to 0.75

As for the 90 yes if at any time, again it does not have to be on pre shoot tests he goes under 90 that is the sign that you need to lower the dose in 0.25units, not to 0.25, well in you case since you are giving 0.5 it will actually be to 0.25 but let's say you are giving 1 unit then you would go to 0.75 u

Also right now you are having more o less high numbers and just starting, so not shooting or stalling if he's under 200 (at the presshoot test but he can be a lot lower during the cycle) is a prudent measure but as time goes on you will start shooting on much lower numbers because as Rosie mentioned you want him to have normal blood glucose numbers even if he never goes into remission because you want him to be ok, if you take a look at Babu's SS I shooted even with a preshoot of 70
 
Veronica & Babu-chiri said:
Wendy is seriously one of the most experienced and greatest advisor you can have

That being said, when she mentioned the 150 she was referring that in all your tests he has not had a value under 150 at any time during the day or night (not in his preshoot tests) so that gives you the idea that he needs more insulin that's why she was suggesting increasing the dose to 0.75

As for the 90 yes if at any time, again it does not have to be on pre shoot tests he goes under 90 that is the sign that you need to lower the dose in 0.25units, not to 0.25, well in you case since you are giving 0.5 it will actually be to 0.25 but let's say you are giving 1 unit then you would go to 0.75 u

Also right now you are having more o less high numbers and just starting, so not shooting or stalling if he's under 200 (at the presshoot test but he can be a lot lower during the cycle) is a prudent measure but as time goes on you will start shooting on much lower numbers because as Rosie mentioned you want him to have normal blood glucose numbers even if he never goes into remission because you want him to be ok, if you take a look at Babu's SS I shooted even with a preshoot of 70
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Hi Veronica,
Thank you for posting. So lets say, one day Yoyo goes under 90, his next dose should be decreased by .25units? Would I first write to Wendy and get her advise?
 
Veronica & Babu-chiri said:
Wendy is seriously one of the most experienced and greatest advisor you can have
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Absolutely! I am always so thankful when she comments on a post because she is so knowledgeable. There are so many people on this board that need help, though, that Wendy can't devote a lot of attention to one person.
Yes, you can tag Wendy in a post if you would like, but there are so many people on this board who can give you dose advise so don't feel like you have to wait if Wendy is not available. People who are not ready to give dose advice (like me) will tell you that. Most of the people who give dose advice have been caregivers for a long time, and you can feel pretty comfortable following their advice.

Debra and Yoyo said:
one day Yoyo goes under 90, his next dose should be decreased by .25units?
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Yes. Thank you @Veronica & Babu-chiri that the cutoff of 90 is not just for preshot. If he goes under 90 at any point in the cycle, you would decrease by .25 units. This is according to the SLGS protocol. I still do recommend that you ask for advice before making changes though because you are so new to this.

I think you have asked a question before. You put a ? prefix (choose it from the menu) and a brief description of your question into the title, and if you need an answer right away, include the words "need help" or "need dosing advice". There are soooo many people on this board who can help. You are in good hands :)
 
Rosie & Bailey said:
Absolutely! I am always so thankful when she comments on a post because she is so knowledgeable. There are so many people on this board that need help, though, that Wendy can't devote a lot of attention to one person.
Yes, you can tag Wendy in a post if you would like, but there are so many people on this board who can give you dose advise so don't feel like you have to wait if Wendy is not available. People who are not ready to give dose advice (like me) will tell you that. Most of the people who give dose advice have been caregivers for a long time, and you can feel pretty comfortable following their advice.


Yes. Thank you @Veronica & Babu-chiri that the cutoff of 90 is not just for preshot. If he goes under 90 at any point in the cycle, you would decrease by .25 units. This is according to the SLGS protocol. I still do recommend that you ask for advice before making changes though because you are so new to this.

I think you have asked a question before. You put a ? prefix (choose it from the menu) and a brief description of your question into the title, and if you need an answer right away, include the words "need help" or "need dosing advice". There are soooo many people on this board who can help. You are in good hands :)
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To tag a person, do you put @ infront of their name? Like you did with Veronica?
Aren't you eating turkey dinner yet?:joyful::joyful:
 
Debra and Yoyo said:
Thank you for posting. So lets say, one day Yoyo goes under 90, his next dose should be decreased by .25units? Would I first write to Wendy and get her advise?
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Yes according to protocol you decrease his next dose.

And of course you can ask in the forum (you can always ask in the forum ) but I would ask to the whole forum in general that would give you more probabilities of getting an answer fast there are a lot of people here that have been doing this diabetes thing for years, I know Wendy usually is monitoring everyone but as Rosie said there are many of us here so sometimes is hard for her to answer everyone fast

And no unfortunately down here Thanksgiving is not an official celebration so I'm at the office as usual

Happy Thanksgiving !!
 
Debra and Yoyo said:
Thank you for posting. So lets say, one day Yoyo goes under 90, his next dose should be decreased by .25units?
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Yes, as per SLGS, if at any time you get a test with a number under 90, you immediately lower the dose. You don't need to ask about it. If uncertain, as others suggest, just ask a general question.

Enjoy your Thanksgiving. Veronica and I live in the other two countries in North America where Thanksgiving is not celebrated on this days. Ours was last month.
 
Rosie & Bailey said:
Thanks for the correction :)
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All done cleaning up. Takes longer to clean up than it does to eat the foodo_O
Yoyo has had his .5 Unit of insulin for tonight. Tomorrow I will start him on .75 Units. Now I need to figure out the markings for .75 units on the syringe. (I just got comfortable knowing .5 units).:arghh:
 
Debra and Yoyo said:
Now I need to figure out the markings for .75 units on the syringe. (I just got comfortable knowing .5 units).:arghh:
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You will do fine, just take your time and double check :)

You can use some of your old syringes to practice. You will not have a line to work with, but rather you will be between .5 and 1.
Take your time and double check. Don't rush it. When I first tried to put Bailey on .5, I accidentally put her on .1 just because I was reading the syringe wrong. Luckily I was underdosing, not overdosing.
 
Rosie & Bailey said:
You will do fine, just take your time and double check :)

You can use some of your old syringes to practice. You will not have a line to work with, but rather you will be between .5 and 1.
Take your time and double check. Don't rush it. When I first tried to put Bailey on .5, I accidentally put her on .1 just because I was reading the syringe wrong. Luckily I was underdosing, not overdosing.
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I noticed that you use Prime ReliOn meter. I believe that is a human meter-right? Have you ever used the Veterinarian Alphatrak2 meter? My vet told me that human meters are about 50 points off. The Alphatrak2 strips are $1 a piece. It is crazy. I recently purchased the InsulinX strips but then I'm not sure how reliable they are either!
Are the strips less expensive with the Prime ReliOn?
 
Debra and Yoyo said:
My vet told me that human meters are about 50 points off.
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I did use Alphatrak2, and yes it was 50 points less on average in the higher numbers. In the lower numbers, the difference is much smaller. For example, the hypoglycemia cutoff on Alphatrak is 67 and on human meter it's 50.
I used the insulinx strips for a while to save money as well, and I found that it was quite close to the Alphatrak2 strips. I also tried petsure, a new strip introduced July 2018 specifically for the Alphatrak. Ultimately, I just couldn't afford to keep buying the strips for the Alpahtrak2 considering the amount of testing I do.
Prime ReliOn strips are 100 for $17.88 (50 for $9.00), and you can pick them up at your local Walmart so I can always just stop by the store if I find myself running low. It does take more blood than the Alphatrak2, but I'm used to it by now.
 
Here's a photo of how 0.75 units looks in a BD syringe hope it helps
Syringe-75.jpg
 
Wendy&Neko said:
Yes, as per SLGS, if at any time you get a test with a number under 90, you immediately lower the dose. You don't need to ask about it. If uncertain, as others suggest, just ask a general question.

Enjoy your Thanksgiving. Veronica and I live in the other two countries in North America where Thanksgiving is not celebrated on this days. Ours was last month.
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If I didn't thank you last night for your support, please accept all my gratitude and appreciation for everything and everyone!
I always appreciate your comments along with everyone elses. You have all helped me immensely in such a short time!
 
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