? 4/29/20 Nell AMPS 441 Overnight low 61. Dose & Lantus Q’s

Nell

Member Since 2020
Please can someone tell me whether I’ve done the right thing... or thoughts on what to do next.
Last night Nell’s PMPS was 243, an hour after her shot it went lower and by +4 it was 61 (I gave her a little high carb food and her numbers started to rise). Just after +6 the Libre sensor died and as I can’t ear prick her on my own had no idea what happened to her #s between then and managing to get a pre-shot test of 441. Despite the low nadir I gave her the shot at her previous lower dose of a fat 1U (we had increased to 1.25 the morning of the 27th)
 
I also have some issues regarding the handling of the Lantus:
The little vial the vet gave me holds 3ml. I assume it is a refill cartridge? (I am in Australia). Her written instructions were:
- to store it upright the door of the fridge
- prior to every dose the insulin should be mixed by making a fist around the bottle and slowly rotating your wrist back and forth about 20 times. Do not shake the bottle harshly.
- to draw the insulin first pull back on the plunger to the dose, turning the bottle upside down, placing the needle into the center of the stopper, injecting the air in your syringe into the bottle to avoid creating a vacuum, and then drawing the correct amount into the syringe. While the syringe needle is still in the upside down bottle, tap the syringe to force any bubbles or air to the top, squirt those back into the bottle and again draw out the insulin to the correct dose. Then remove the needle from the bottle.
- once the needle is fully inserted into the skin, press the plunger all the way down and then pull the needle out of the skin.

The instructions seem to be at odds with those in the sticky in this forum. Please can someone help with the correct handling of the Lantus. And, please can someone explain to me or show me exactly what a fat 1U and 1.25U looks like in a syringe without .5 markings on it. I’m worried I may have given Nell a bigger 1.25U than I realised. Thanks.
 
Lantus should not be rolled. Just store it in the fridge where it won’t be bothered. The difference between a f1 and. 1.25 for me required digital calipers. You just want to be consistent. Before I got calipers I used a used syringe and water with food coloring and practiced counting drops of colored water. You could also keep one filled to a fat dose and measure your insulin syringe by that. I hope this helps.
 
Lantus should not be rolled. Just store it in the fridge where it won’t be bothered. The difference between a f1 and. 1.25 for me required digital calipers. You just want to be consistent. Before I got calipers I used a used syringe and water with food coloring and practiced counting drops of colored water. You could also keep one filled to a fat dose and measure your insulin syringe by that. I hope this helps.
Thanks Tiffmaxee. What about injecting air into the bottle?
 
Ruth if you ever get stuck again with a low number and can’t test again for whatever reason like you did last night, you can always abort the cycle....that means you give high carb food to bring the numbers up higher and safer.
You could also abort a cycle if the numbers were low and you had to leave the house for several hours.
It is not something to do often but is a good thing to have in your back pocket if you ever get stuck.
I also agree with Elise with what she’s said about handling insulin.
 
Ruth if you ever get stuck again with a low number and can’t test again for whatever reason like you did last night, you can always abort the cycle....that means you give high carb food to bring the numbers up higher and safer.
You could also abort a cycle if the numbers were low and you had to leave the house for several hours.
It is not something to do often but is a good thing to have in your back pocket if you ever get stuck.
I also agree with Elise with what she’s said about handling insulin.
Bron when you say abort the cycle do you mean give high carbs and then not give the shot at all? I was worried about giving her nothing with such a high pre-shot am reading. Should I stick with the 1+U for the time being do you think?
 
Bron when you say abort the cycle do you mean give high carbs and then not give the shot at all? I was worried about giving her nothing with such a high pre-shot am reading. Should I stick with the 1+U for the time being do you think?
What I mean by aborting the cycle is that when you got the 61 and then you couldn’t test again because of the failure of the Libre, You could have just fed some more high carb so that you knew that Nell’s numbers would rise ....that is in place of testing and feeding more if needed.
It is not something you do at the end of the cycle as the insulin is normally wearing off. You can do it if something happened to stop you testing further and you knowthat the numbers are low.
It has nothing to do with the next shot really.
Do you have the Libre in place again, or are you being able to test Ok yourself?
There was no need to reduce the dose this morning as Nell didn’t drop below 50.
Have you decided if you we going to follow Tight Regulation or Start Low Go Slow yet? That will make a difference to the advice I give.
 
I had decided to go with TR as long as I’ve got a Libre fitted. Unfortunately it is not in place and she won’t let me test her (she gets terribly stressed and turns feral) which was why I was reluctant to hold the dose - she’s not making it easy. I can hopefully get the new Libre fitted tomorrow - so I’m at a bit of a loss as to what to do in the meantime...
 
Are you offering her something to eat as you test?
Try getting down in the floor on your knees and sit on the back of your heels, and put Nell between your upper legs so she is facing the same way as you...her tail closest to you. Have everything ready to test. First I would trial putting the strip into the meter and seeing how long it lasts before it times out. With mine I had plenty of time To push the strip right in, put Shebas treat in front of her, prick the ear and get the blood before it timed out.
So have everything ready beside you with Nell between your legs. If you have an arm each side of her she will be hemmed in without being held. Put the food in front of her, prick the ear and get the blood onto the test strip. If you can’t get it onto the strip, try getting it onto your thumb nail and Transfer it to the test strip.
 
Are you offering her something to eat as you test?
Try getting down in the floor on your knees and sit on the back of your heels, and put Nell between your upper legs so she is facing the same way as you...her tail closest to you. Have everything ready to test. First I would trial putting the strip into the meter and seeing how long it lasts before it times out. With mine I had plenty of time To push the strip right in, put Shebas treat in front of her, prick the ear and get the blood before it timed out.
So have everything ready beside you with Nell between your legs. If you have an arm each side of her she will be hemmed in without being held. Put the food in front of her, prick the ear and get the blood onto the test strip. If you can’t get it onto the strip, try getting it onto your thumb nail and Transfer it to the test strip.
I’ve tried everything in the book Bron - it always includes treats... I cannot believe how difficult she is. I will keep trying
 
I’ve tried everything in the book Bron - it always includes treats... I cannot believe how difficult she is. I will keep trying
Yes please keep trying because you will get there.
You are probably stressed too and she is picking up an that. Try humming or singing as you get prepared and do it...it works and will lower your stress.
If you can’t test maybe stay with the 1+ dose until you get the Libre fitted And use the time you have it fitted to get the testing down pat.........you can do it...I promise!
 
Yes please keep trying because you will get there.
You are probably stressed too and she is picking up an that. Try humming or singing as you get prepared and do it...it works and will lower your stress.
If you can’t test maybe stay with the 1+ dose until you get the Libre fitted And use the time you have it fitted to get the testing down pat.........you can do it...I promise!
I wish I had your confidence! If I get a pre-shot test what would be the next most important time to test?
 
OK thanks Bron that was what I thought too. I managed to get a test not long ago - it did take two of us and she’s very miserable... poor girl.
Success!:D
I can also promise you that you will have a much closer relationship with Nell once you start testing.
 
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