Re: 11/9 Bailey AMPS 308
actually bailey had a pmps of 148 day before yesterday on the 1unit - that's a super number, especially for being at the end of the cycle. she may have gotten even lower that evening, and the resulting high numbers you saw yesterday and this morning are from going low enough that she bounced.
you can spot a bounce this way (this only took me 6 months to learn and a bunch of people explaining it! i'm a slow learner!)
yesterday morning you had a 215 - then it went 235, 271, 270, and then 308 this morning - basically straight up. no curve. and then look backwards in the ss and the night before was that sweet little 148 12 hours earlier.
if you imagine that night-time cycle, starting at 148, bailey probably went down in a nice little curve, hitting something under 100 mid-cycle. that lower-than-usual number would've shocked her body. they get accustomed to whatever range they're in, and any sudden dip lower can set this off.
"HELLO WE"VE GOT A 911 HERE- BAILEY"S GOING DOWN!" yells Mr. Liver. Fortunately, mr liver has a storehouse of counter-regulatory hormones and stored sugar (in case bailey needs a little nommy sweets in the middle of the night) and when Bailey gets into a range of numbers lower than usual, Mr. Liver lets loose with the sugar and the hormones and sends Bailey on a rocket to the moon.
that's what you're seeing.
So, what to do now. don't increase. in fact, tonight i would drop back to the 1 unit, because once this bounce clears, which can take up to 3 days of high numbers if mr liver is super-active, then this dose is going to be too high. you are entering the phase of treatment that we say requires "Patience Pants." when you think you're seeing a bounce, you have to wait it out, then you can see what the dose really does.
also, make sure and get a +2 or +3 in the evening, every single evening, so you can see where the cycle is going and bailey doesn't get too low at night without being monitored. she's actually responding really well to the insulin. this bounce will clear and she will get lower. we want her to be safe when that happens.
if you have a question about it, edit your first post of today and put the Q in your subject line so it gets seen. otherwise, just drop back to 1u and be patient. you were seeing really great response on the 1 unit and you will again as soon as this bounce clears. tell the vet whatever you want, but really, most vets don't have a lot of hands-on experience with lantus and they don't necessarily understand the finer points of dosing and tweaking to get to off-the-juice - which i'm pretty sure is what you want to have.
you're doing great melissa! there's a lot to learn on these fine points of lantus. you're just a few days into it. hang in there and it gets easier.
and i love celi's blessing - i'll second it - here's hoping that's the last rough day of 2011 for you and your household!
I want her to get better, and my husband doesn't really understand why we aren't following the vet's advice and increasing the dose when her numbers are high. I will go back to the 1 unit. I know I am supposed to look at the nadir numbers, but the pre-shot numbers get me all freaked out.
