27/04 Maggie PMPS 274 /+2 111/ +3 71/ +3.5 64/ +4 57/ +4,20 65/ +5 75/ +6 97 REDUCTION EARNED

[hellen_maggie]

26/04 Maggie _ AMPS 342 / +3 236 / +5 145 / +7 156

Hi everyone,
We had quite a long night yesterday. Maggie dropped close to the 50s , and I ended up going to work with no sleep, wondering how I would get through the day.
It was the first time she went that low (and that fast), and I handled it by feeding small, frequent high-carb snacks (kibble). Testing, feeding, testing, feeding....throughout the first half of the cycle. Thankfully everything turned out fine, and of course, as expected, she’s bouncing today. I’m really happy to see that she surfed in such nice, healthy, healing numbers yesterday but I can’t say I’m equally happy about the reduction we earned. This morning I reduced her dose from 0.50U to 0.30U. However, my gut feeling (and the data I have from the last time she was on 0.30U) tells me this dose might be too low for her. In hindsight, maybe I should have gone with a smaller reduction (perhaps 0.40U) but since I went by the book, all I can do now is put on my patience pants... I’ll see how she does over the next 3–4 days, and if needed, I may consider increasing again before completing a full week on this dose.

Also, I have what might be a silly question. Last night, right after I gave the shot, I noticed a tiny drop of blood on the needle when I pulled it out. I’m wondering if I may have hit a small blood vessel under the skin. I did a quick search and came across the idea that, in that case, the insulin could potentially enter the bloodstream more directly and act faster or more strongly. Does that actually make sense, or am I overthinking it?

I hope all the kitties are surfing safely today and happy Tuesday to all

 

[hellen_maggie]

And here is Maggie enjoying her nap, with her two bodyguards watching over her (in the background, her beloved brother Marley, and in the front, her cousin Cody).

 

[Staci & Ivy]

26/04 Maggie _ AMPS 342 / +3 236 / +5 145 / +7 156

Hi everyone,
We had quite a long night yesterday. Maggie dropped close to the 50s , and I ended up going to work with no sleep, wondering how I would get through the day.
It was the first time she went that low (and that fast), and I handled it by feeding small, frequent high-carb snacks (kibble). Testing, feeding, testing, feeding....throughout the first half of the cycle. Thankfully everything turned out fine, and of course, as expected, she’s bouncing today. I’m really happy to see that she surfed in such nice, healthy, healing numbers yesterday but I can’t say I’m equally happy about the reduction we earned. This morning I reduced her dose from 0.50U to 0.30U. However, my gut feeling (and the data I have from the last time she was on 0.30U) tells me this dose might be too low for her. In hindsight, maybe I should have gone with a smaller reduction (perhaps 0.40U) but since I went by the book, all I can do now is put on my patience pants... I’ll see how she does over the next 3–4 days, and if needed, I may consider increasing again before completing a full week on this dose.

Also, I have what might be a silly question. Last night, right after I gave the shot, I noticed a tiny drop of blood on the needle when I pulled it out. I’m wondering if I may have hit a small blood vessel under the skin. I did a quick search and came across the idea that, in that case, the insulin could potentially enter the bloodstream more directly and act faster or more strongly. Does that actually make sense, or am I overthinking it?

I hope all the kitties are surfing safely today and happy Tuesday to all

Hi Hellen, you were right to reduce Maggie’s dose. Congratulations on the reduction
When following SLGS, we reduce by 0.25 units at the next time a dose if given.
Here is the protocol with information as a reminder
Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Is there a reason you reduced to 0.30 units instead of 0.25 units ?
Are you doing a form of custom dosing? Are you using calipers to get these tiny increment doses?

Per the SLGS instructions, you would hold the reduced dose for a week then see where her BG is to decide whether to increase or not.

Otherwise, you could consider doing TR and then you could increase faster, if safe, with the data showing how she’s doing.

If possible it’s best to use a medium or high carb wet food instead of dry kibble to help with a lower cycle to bring up her glucose.

Those are just my observations. Please let us know what you think.

Yes, your theory on hitting a blood vessel sounds very possible.

I hope you get through the day on with little sleep. I know first hand how hard that is
Sending you and Maggie lots of hugs
You’re doing a great job

 

[Staci & Ivy]

And here is Maggie enjoying her nap, with her two bodyguards watching over her (in the background, her beloved brother Marley, and in the front, her cousin Cody).

Maggie and her bodyguards are adorable
She’s a lucky girl to have such sweet buddies

 

[hellen_maggie]

Hi Hellen, you were right to reduce Maggie’s dose. Congratulations on the reduction
When following SLGS, we reduce by 0.25 units at the next time a dose if given.
Here is the protocol with information as a reminder
Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Is there a reason you reduced to 0.30 units instead of 0.25 units ?
Are you doing a form of custom dosing? Are you using calipers to get these tiny increment doses?

Per the SLGS instructions, you would hold the reduced dose for a week then see where her BG is to decide whether to increase or not.

Otherwise, you could consider doing TR and then you could increase faster, if safe, with the data showing how she’s doing.

If possible it’s best to use a medium or high carb wet food instead of dry kibble to help with a lower cycle to bring up her glucose.

Those are just my observations. Please let us know what you think.

Yes, your theory on hitting a blood vessel sounds very possible.

I hope you get through the day on with little sleep. I know first hand how hard that is
Sending you and Maggie lots of hugs
You’re doing a great job

Hi Staci,

Thank you again for your thoughtful guidance.
To be honest, I’m not strictly following the protocol “by the book,” in the sense that in the past few adjustments I’ve been increasing or reducing by 0.10U. I guess it’s a bit of a custom approach based on how Maggie has been responding. However, yesterday she dropped quite low for our usual range, so I decided to take a slightly larger reduction than I normally would (0.20U instead of 0.10U).

To measure these tiny doses, I’m using the attached insulin ruler, which has honestly been a huge help in keeping things as consistent and accurate as possible. For what it’s worth, I’ve noticed that the markings on the syringes are not always precise and can sometimes vary quite a bit, so this tool has really made a difference for me.
I would really love to transition to TR, but unfortunately that’s not an option for us just yet. As Wendy mentioned in a previous post, I would need to completely eliminate dry food. At the moment, Maggie’s diet is around 10% carbs and consists mostly of air-dried food with a small portion of kibble. I do hope we’ll eventually be able to remove kibble entirely, but I have a feeling Maggie will be the one calling the shots, her stomach is definitely the boss in this situation!

Right now, I honestly can’t wait to get home and get even 1–2 hours of sleep, because I’m completely exhausted Hopefully Maggie will allow it!

Thank you again for all your support and care

 

[Staci & Ivy]

Hi Staci,

Thank you again for your thoughtful guidance.
To be honest, I’m not strictly following the protocol “by the book,” in the sense that in the past few adjustments I’ve been increasing or reducing by 0.10U. I guess it’s a bit of a custom approach based on how Maggie has been responding. However, yesterday she dropped quite low for our usual range, so I decided to take a slightly larger reduction than I normally would (0.20U instead of 0.10U).

To measure these tiny doses, I’m using the attached insulin ruler, which has honestly been a huge help in keeping things as consistent and accurate as possible. For what it’s worth, I’ve noticed that the markings on the syringes are not always precise and can sometimes vary quite a bit, so this tool has really made a difference for me.
I would really love to transition to TR, but unfortunately that’s not an option for us just yet. As Wendy mentioned in a previous post, I would need to completely eliminate dry food. At the moment, Maggie’s diet is around 10% carbs and consists mostly of air-dried food with a small portion of kibble. I do hope we’ll eventually be able to remove kibble entirely, but I have a feeling Maggie will be the one calling the shots, her stomach is definitely the boss in this situation!

Right now, I honestly can’t wait to get home and get even 1–2 hours of sleep, because I’m completely exhausted Hopefully Maggie will allow it!

Thank you again for all your support and care

It’s certainly ok to take a larger reduction if BG is too low and you need to get out the door to work and can’t monitor closely. Safety first, always.
I’m glad you are using a ruler.
You’re right, syringe markings can definitely be inconsistent. Have you thought about using a digital calipers for precise measuring?
I use one and find it very, very helpful, due to mismarked syringes, which could be very catastrophic if the dose is incorrectly measured.

I forgot you are still using dry food so you are correct per your discussion with Wendy that TR will not work for the moment for Maggie.

You probably should put “custom dosing” in your signature and on your spreadsheet, so that people know you are not strictly following SLGS.