3/15 Sid dose question

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Lydia & Sid & Jake(GA)

Lydia & Sid & Jake(GA)

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What I really want to know is on nights like last night when Sid is over 400 and stays that way until the PZ kicks in, if I should give him just a tiny drop of R to bring him down a little until the PZ starts going. I've been finding it is about 3 hours. I spent a lot of time putting water in the dose and practicing putting out drops until I only had about 2 tiny drops left in the syringe. That is the amount I gave Sid the last time I gave him R. He did drop a bit fast, but tonight on no R, he dropped about 150 pts in an hour. I did feed him the small meals too.

Hopefully the SS is not confusing. sid worked himself back to BID but I'm still on the TID format in case there are days he has to have 3 shoots. If enough go by without a 3rd one, I will go back to the BID format.
 
PZI is really quiet tonight, Lydia, and the beans who have TID and R experience aren't around. Wish I could help, but I have no experience. Maybe post on Lantus also - it seems busier.
 
Hi Lydia,

So you didn't give R on 3/14? If not, it looks like he cleared that bounce pretty quickly without it. If he's going to clear bounces that fast, without a rise in ketones, it's probably best to try and hold off on the R, and see what he's doing on ProZinc alone. Assuming you didn't shoot R, I find it pretty impressive that the PZ was able to bring him down to 279 @ +7...from a 600+ "off the meter" reading @ +3. That would never happen with Marilyn if I didn't intervene.

I know how hard it is to see those high numbers (I screwed-up Marilyn...and she's in them right now), but as long as you have a handle on Sid's ketone status, some consistency using only ProZinc might be what Sid is looking for? He certainly doesn't like it when he goes too low...at least what he considers "too low" for now. The R usage has given Sid some pretty nice cycles...but it has also caused some bounces the following cycle. When that happens, you're in a vicious circle. With Sid's infection clearing (it is clearing, right?), he may start surprising you...but you won't know unless you can see his PZ data clearly.

IMO, I would gather some nice "clean" PZ data for a while, and take it from there. Of course, you already know, if he throws you some worrisome ketone numbers...you have to do, what you have to do...and worry about the R bounce later.

I hope this helps...and I hope you guys are holding up okay.

Deb
 
Hi Lydia,

I agree with Deb, I would hold off on the R as long as the ketones stay away. I know it's hard to see those high numbers, but he seems to be holding his own on the ketones, even with the bounces from the PZ. What concerns me about using R with Sid is that he can get a pretty big drop from R, even a tiny dose. If the bounce clears and the PZ kicks in on top of the R, you could be fighting to keep his numbers up. Sid can dive dramatically....I don't think it's worth the risk. Also, using R makes it hard to see how the PZ dose is working.

Getting back to the food discussion from a few days ago...I know you said that the food you thought was HC was not, you could try a couple of different options to increase the carbs if you need to....either add some karo to his regular food, use some of the FF grilled gravy with his regular food, or just use the FF grilled. As always, you will need to experiment to see what works for Sid. I really think that feeding the curve will be an essential piece of getting and keeping Sid in better numbers. He certainly keeps you on your toes, Lydia!

I hope you are having a great Friday!
 
Hi Lydia, Sorry I haven't been around. I also agree about holding off with the R. You want to get some true numbers using Prozinc. It looks to me as if 1.6 would be a good starting point. Keep in mind that when you increase or decrease... it will throw his numbers all out of wack, so try to stick to the same dose until he goes lower than BG 40ish and when you see his BG high... check for ketones, but if you can stay with the same dose a few days so it settles in then that could get him back to some true numbers.

I would also increase or decrease only by a .1 either go to 1.7 next or 1.5 I found with Pru if you jump more than that... it will throw numbers off a lot.

Sending good vibes your way. ((((((HUGS))))))
 
Hi everyone!

Thanks for your thoughts! I really appreciate the advice. Yes, I agree with you all. I won't use R unless ketones appear again.

I haven't yet updated his SS but last night at +7 he was down to 34. Took me by surprise!! I gave him some hc and he rose up to 64 within 30 minutes. So this morning I gave him 1.5 even though I hadn't yet read the replies, so Michelle, I was thinking the same thing to only reduce by .1 instead of .2! I am going to try my hardest to keep him to the same dose for a few days. I just hope he doesn't drop like that again today. It's completely unexpected. I was trying not to test him every hour because he poor ears are a bit bruised and then he goes and has a number like that and I wish I would have tested him more to catch it earlier. Tonight I"m going to test every 2 hours.
 
Hi Lydia,
Are you still shooting IM? I ask because it seems like lately Sid is getting longer duration and a later nadir than he had been a while back. Which is a great thing!

Carl
 
Yes Carl! I am still shooting IM. Too scared to go back to SQ and risk Sid not getting any insulin. A couple of weeks ago I thought I needed to switch to levemir to get the duration... I read in the wiki not to shoot levemir IM so I gave his first dose to him SQ and he showed NO reaction whatsoever to it. Maybe someone could argue the dose was not enough or a shed needed to grow or whatever, but to not even drop even a little for hours? It confirmed my belief that not only is the Prozinc working well for Sid, but shooting IM is working very well too. He has gained 2 pounds and is now up to 6 pounds too :-D I have increased his dose and we were up to 1.8 until he threw a 47 and then last night he threw a 34 so I am back to about 1.5. :-D Still trying to figure him out.
 
I also agree with Michelle about adjusting by 0.1u and allowing a few cycles for it to settle at this point. Sid is close to a good dose, so those tiny adjustments can have a big effect. I used 0.1u adjustments with Mr T on ProZinc and he responded very well to it when he was in decent numbers.

Nice catch on the 34! I'm guessing that the pneumonia is clearing up, I see his respiration rate is down into a more normal range. It looks like Sid is moving in the right direction....thanks to your attentive care, Lydia. :-D Is 6 pounds his normal weight?
 
Laurie,

When I adopted Sid in May 2011, he was about 7.5 pounds. He is an extremely small male. About 1/3 the size of my other males.


So I have to let you all know what a bad bean I was today. I was debating if I should create a new post for today or just reply to this post so I'll just reply here. I did not read the posts about not giving R until after I got up at 5:00 am and tested Sid to find him over 500. I was very afraid he would stay Hi for a while so I literally gave him 2 very tiny drops of R and he dropped a lot! I don't think I can even post how much he dropped in 30 minutes because I feel sohorrible about it. Then he was Hi for most of the day. So tonight I just gave him the prozinc (1.6 U) because he was HI but I probably should have stuck to 1.5. I will update his SS. Poor Sid. I felt guilty all day - I was an hour late to work, then I checked on him at lunch, then I left an hour early to work from hom so I could give him his insulin an hour early. I did learn an important lesson as I posted earlier. I am not going to give him R even if he is HI unless there are ketones more than trace present!!!! I promise. I did not expect such a dramatic response but I think the infection is clearing and he is responding more to the insulin. Let's just hope he can settle down a bit and not keep dropping to the 30s... and then spiking up so high.
 
I knew he was small, Lydia....I wasn't sure about his normal weight.

(((Lydia))) I know you worry about the high numbers, and with his DKA history, I don't blame you. Feeling guilty doesn't help Sid, please don't beat yourself up....Sid is ok, and you learned from the experience...that's what is important. I hope he clears the bounce soon.
 
Oh Lydia, I feel for ya! Breathe... Sid will be alright. Being that you gave the R plus bumped to 1.6, I would go to 1.5 tomorrow and start there. You already know 1.6 for a few cycles brought Sid to 34, so stick with 1.5 this weekend. His number will be a bit out of wack due to the R and 1.6

Please post on Sid's SS as soon as you check BG levels etc, so we can have a reply waiting for you. That would help us so much :-D I hope you guys are having a good night. I'll check back in the morning! ((((((((HUGS))))))))
 
So glad to see SId is getting better, and the ProZinc is working for him. It's amazing the things we learn about our fuzzy loves!

Keep up the great work! I'm sure SId appreciates it too! :-D
 
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