12/27 Quintus +11.75=59 +15=97 skipped AM, dose decrease => 1.75

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Steph & Quintus & L & O

Steph & Quintus & L & O

Member Since 2017
condo: http://www.felinediabetes.com/FDMB/threads/12-26-quintus-surfing-yellow-after-two-18h-cycles.188568/

I woke up to an active kitty who wanted to go out and had eaten quite a bit of his spare food during the night. So I tested, and no surprise, we're in lime green territory just before shot time -- again.

I am stalling and not feeding (I have learned) but I cannot exclude that he may have eaten these last two hours.

ETA: 30 minutes later, +12.25, 67 (no extra food given)

I see two courses of action:

- stall, and if he comes up enough within the next hour, take a reduced shot (I think he is clearly coming down too low on this dose)
- do two more 18h cycles, and then reduce

Thoughts?
 
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7.30 (=+12.5): he's playful :) and asking for food, so I gave it to him.

I'm leaning towards doing two 18h cycles, though by doing that I lose 3 cycles on a possible new dose. Advice would be most welcome.
 
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Chris & China said:
Since you're doing SLGS, he's earned another reduction

With the skipped shots and the 18 hour cycles, there shouldn't be much depot action left so I'd reduce down to 1.75
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Thanks! and how long would you stall to do the shot? I'm nearly an hour late now. He's definitely eaten slow carb food during the night, and some now.
 
I think if you can, I'd probably just go ahead and do the 18 hour cycles again

I can't in good conscience tell you to shoot a 67 when he's been fed and you're doing SLGS

I'm also headed off here in a minute so I think that's probably the safest thing to do

Just go with 1.75 at your next shot time...and Good luck with the reduction!!
 
Chris & China said:
I think if you can, I'd probably just go ahead and do the 18 hour cycles again

I can't in good conscience tell you to shoot a 67 when he's been fed and you're doing SLGS
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My schedule allows me to do the two 18h cycles again, that's not a problem. I also think 67 is "kinda low" to shoot, although what I'm seeing is that he is being pretty good at going to food when his BG starts to drop (as my vet said he would...).

In that case, I have two questions:

- do I do the 18h cycles with 2ui (which seemed to work well) or do I reduce already?
- when I reduce: 1.75 or 1.5? I know SLGS says 1.75, but the initial guidelines SLGS was derived from use 0.5 steps, and my gut tells me 1.75 might still be too high.
 
So... still flat, 2.5 hours before shot time. I took him to his food and he's eating (hasn't eaten since earlier when I mentioned it). Other than that he is doing great, went outside, played, grooming, sleeping, waking up, climbing on me, purring... A normal Quintus!
 
What is the reason for doing another couple of 18 hour cycles? I would just skip this shot, drain any remaining depot, and get back on schedule with 12 hour cycles tonight. And the new reduced dose of course. :D
 
Wendy&Neko said:
What is the reason for doing another couple of 18 hour cycles? I would just skip this shot, drain any remaining depot, and get back on schedule with 12 hour cycles tonight. And the new reduced dose of course. :D
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In the past, he has soared up high in the black after a skipped shot. the two 18-hour cycles worked super well to keep his levels in a nice place while things settled. I'd rather use that as a stopgap measure as my schedule allows it, and keep his numbers happy, than send him into the black while skipping a shot.
 
The problem with 18 hour cycles is that you are messing with 3 cycles instead of just one. Figuring out dosing becomes more difficult.
 
Wendy&Neko said:
The problem with 18 hour cycles is that you are messing with 3 cycles instead of just one. Figuring out dosing becomes more difficult.
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True, that was why I was hesitating. It means I'm "starting" on the new dose tomorrow morning instead of tonight. Hmm, I can still change my mind! Let's see where he is at in 10 minutes (+17)
 
Stephanie & Quintus said:
+17 he's at 119. Looking at the chart I can see that he's staying lower than the last times I didn't do the morning shot. That would indeed point me in the direction of skipping completely and shooting 1.75 tonight.
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It will also allow you to get a few days to get back on schedule, get the depot restablized and know where this new dose will take him before you have to go back to work.
 
God, these syringes are just impossible! I've opened another bag and it seems the plunger is a little less stiff, so I'm hoping it was just a "bad bag".

Has nobody else using BD micro fine syringes noticed a change in plunger stiffness over the last months or year?
 
Mandy & Rex said:
Have you tried pulling/pushing the plunger to spread the lubrication?
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yes, yes, I do it all the time, which is how I can tell that the plunger really is stiffer and I'm not imagining things. As I mentioned in this thread somewhere I think, it feels like certain bedroom activities with not enough lube vs... enough lube. I can barely twist the plunger in the new ones. I have a hard time pulling the insulin out. With the old ones I can push the plunger in with a finger. Should I do a video?
 
Stephanie & Quintus said:
yes, yes, I do it all the time, which is how I can tell that the plunger really is stiffer and I'm not imagining things. As I mentioned in this thread somewhere I think, it feels like certain bedroom activities with not enough lube vs... enough lube. I can barely twist the plunger in the new ones. I have a hard time pulling the insulin out. With the old ones I can push the plunger in with a finger. Should I do a video?
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I don't think a video is necessary. I have never used BD syringes, but I have heard so many complaints about them since I joined the forum 8 months ago. :(
 
Mandy & Rex said:
I have never used BD syringes, but I have heard so many complaints about them since I joined the forum 8 months ago. :(
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Oh, that's good to know!

I'm going to dig around for other brands. In the meantime I've written to BD (well, called them out on Twitter) and am going to go to the pharmacy where I bought them to see if they can help me get a complaint back up the chain.
 
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