4/11 - Oh Molly!!!

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Michele&Molly

Michele&Molly

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Ask me what Molly ate today - go on, just ask me!

2 can LC FF
2 cans HC FF
1 handful of dry food

Your thinking i'm nuts right? That i lost it right?

Nope.

I tried to get her numbers up all day and when i finally thought we were rounding the corner to higher numbers she gives me a 35 at +9.5. I never even saw a 35 before!

Oh i'm sure she's going to be skyrocketing by tomorrow but i had to do something to get her numbers up.

She's been doing well on the 2u (reduced from 2.25u). Yesterday at her highest she was 278 - all good right. Have no clue what happened today -

amps 125 fed and shot 2u
+4 116
+6.5 54 fed hc food since i knew she was going to go lower given the time
+7 96
+8.5 80
+9 73
+9.5 35 more hc food and some dry food
+10 87
pmps 189 fed (she didn't eat much since she's eaten all day), shot 1u.

It's been another long Molly day.

Off to update SS.

Comments? (please).
 
And no, she has no lost any weight (sorry i haven't answered your question Pamela).

I see i def. need to raise the cutoff point again. I shot 2u on a low number this am (125) and she hit the deck (not literally, thank gosh!). While i understand 50 warrants a dose reduction, do you think it's safe to shot 2u if she's over 200 at pre-shot? I totally understand dose should NOT be decided on pre-shot numbers but i can't ignore the pattern that shooting on low pre-shot numbers causes her to go too low.
 
Michele&Molly said:
And no, she has no lost any weight (sorry i haven't answered your question Pamela).

I see i def. need to raise the cutoff point again. I shot 2u on a low number this am (125) and she hit the deck (not literally, thank gosh!). While i understand 50 warrants a dose reduction, do you think it's safe to shot 2u if she's over 200 at pre-shot? I totally understand dose should NOT be decided on pre-shot numbers but i can't ignore the pattern that shooting on low pre-shot numbers causes her to go too low.
Click to expand...

What a day it has been for you and Molly!

Wow, great curve....but yeah, the 35 would have been a little low for my comfort level for sure! But still...she is reacting to the insulin very well now. Soooooooo, what has changed?

So she hasn't lost any weight. You changed the feeding times to coincide with the shot and that was good, but that was a while ago. I am just thinking that she has broken through all that glucose toxicity that built up when she was in the high 200's and also 300's and now her pancreas can sorta function again.

Also, shooting on those lower numbers has helped too.

Again, their dosing needs do change, all the time. So now you have to decide what your new strategy is going to be. And since you have to work.....darn, you need to play it safe without letting her get back up into those pancreas damaging higher numbers.

Maybe you need to raise your cutoff point again (I think Sheila mentioned that before).

Levemir should not normally be dosed on a sliding scale, but it works better for you for your comfort level and the fact that you are gone all day during the week. But it makes for seeing a pattern with Lev really difficult. It would be nice if you could find the exact right dose that will keep her level throughout the day. And tonight you shot another reduced dose of 1.0 unit so tomorrow she may very well be high (along with the HC food given) and a another reduced dose won't be able to bring her down enough. :(

I would hate to see you backslide now that you are seeing some good numbers.

Maybe try 1.75 units from now on even if her preshots are a little on the low side. Try to get some consistency here.

Anyway, you did good girl.

BTW quite possibly that wasn't a REAL 35....have you done a control test on your meter? Test yourself too and/or one of your civies. Do you have another meter to compare to on hand? When you do get those low numbers (35) test again to be sure with the same meter.

See what others say.
 
Completely agree because Tilly indicates a below 50 needs a .25U decrease, so that would put her at 1.75U.

I am so happy to see her throw a 35, to be honest. I've seen it so many times for Gandalf I don't have a freak out when the 30s show up, in fact, it says to me that you're on the right track, between the dose and the food schedule.

I get way more upset now about 300s than 35s. This is pretty normal with the longer acting insulins. But nothing at all wrong with 1U tonight because that was kind of out of left field and you are cautious, which is serving Molly very well.

SO proud of you!!!
flip_cat flip_cat flip_cat flip_cat flip_cat
 
I would also go with the dose reduction to 1.75u on a consistent basis - what are your cut offs again?

You WANT to be shooting low PS, just not sending them to the basement.
 
Little high today but i have to admit, i expected her to be a lot higher after all the fun yesterday.

4/12
amps 277 fed and shot 1.5
+10.5 265
pmps 263 fed and shot 1.75

I wish i would have shot 1.75u this am but 1. i was still a bit gun-shy and 2. I hadn't read all your responses yet.

I agree with all your explanations that 1.75 is the most appropriate dose. I do need some kind of cut-off though -i agree, lev should not be used on a sliding scale but data indicates that when i shoot on a low number she goes too low. Now i just need to determine what pre shot number constitutes shooting on a low number? 150 seems to be it, according to her spreadsheet.

What your opinion on:
anything above 155 - shoot 1.75
anything below 155 - shoot 1.5

I value your opinions - thanks in advance.
 
I think you are probably just going to have to "test" that cut off point.

My understanding of the best way to use Lev is to shoot a steady dose, until the nadir is below 50 and then reduce the dose - and leave it reduced. See if the kitty can continue to hold good numbers and if not go back to the last good dose.

So, Molly earned a dose decrease, according to the protocol, so leave her at 1.75u until she drops too low again.

What I think will happen is that the lower her numbers and the lower the dose, the lower you can shoot her full dose and not risk sub-50 numbers. Really, I would not consider anything above 40 as a risk.

Now, I say all that having just lowered this morning dose for Jed because he was 159 instead of the usual 300s. I shot .4u instead of the .5u I have been giving for the past few days. So, go with your comfort level to some extent.

Does that actually help? Ha, sort of rambling. Noticed your April Fool's Day joke in her SS. Cute. :lol: And it only took me 2 weeks to notice it. ohmygod_smile
 
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