5/12 Silver AMPS 155 +4=337 +6=311 +8=284 +10.5 310 +7=250

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Juliet

Member Since 2017
Yesterday

So because he is still blue after no shot in 24 hours again - and we have had two skipped shots in as many days I have reduced his dose to 3u. He clearly is on too much insulin now and I need to find a dose I can safely give twice a day when I am gone. The 34 last night was a little low for comfort. If it backfires on me I can always go up again. I checked ketones and its just 0.3 so nothing to worry about there.
 
carfurby said:
I hope this dose will keep Silver surfing safely. Glad the ketones are so low. How is Silver feeling?
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Silver is feeling great! So much better and back to his normal self. Doing curve today but went b2b and now I've completely slept through the +2. +4 in 20 mins.
 
Ok so now I know that was a bad decision this morning to reduce to 3u. I guess the depot is well and truly drained. Back to 4.25 tonight then until he earns his way down. Will just have to see it as a partial fur shot this morning and get him back on track tonight.
 
This could just be a bounce from yesterday's low. I would hold off on making this evening's dosing decision until you see what his PMPS is tonight. It would also be helpful to get a few tests throughout the day to see if he is in the process of breaking the bounce on his way into PMPS, since he seems to be breaking bounces very quickly now.
 
Amy&TrixieCat said:
This could just be a bounce from yesterday's low. I would hold off on making this evening's dosing decision until you see what his PMPS is tonight. It would also be helpful to get a few tests throughout the day to see if he is in the process of breaking the bounce on his way into PMPS, since he seems to be breaking bounces very quickly now.
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Yes I said earlier I am doing a curve today. I just slept through the +2. Tonight's shot has to be 90 mins early too but dropping to 3u was definitely too much I think. I will see where he is at later today.

Yes I know the early shot counts as an increase but I generally am an hour late or early for the pm shot so it should be fine.
 
Juliet said:
Yes I know the early shot counts as an increase but I generally am an hour late or early for the pm shot so it should be fine.
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Yes, but with that big of an increase an early shot could cause him to go really low. I'd be very careful if you do that and plan to get extra tests in tonight. Or you may want to wait until morning to increase.
 
carfurby said:
Yes, but with that big of an increase an early shot could cause him to go really low. I'd be very careful if you do that and plan to get extra tests in tonight. Or you may want to wait until morning to increase.
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Okay - question - what if today really HAD been a partial furshot - you would never say don't give usual dose at night right? Its not "a big increase" - just his usual dose - in fact a reduction from his usual dose which is 4.75. I skipped shot last night so technically he should have got 4.5 this morning. If I had given a fur shot, I would just give the 4.5 tonight. However, I think he does need a bigger drop than just 0.25 as discussed yesterday - and was told 0.5. So as we don't base dosing on preshot - it will depend how much he comes down in this curve as to what I dose tonight, knowing that the morning shot will be 90 mins late to keep on normal schedule.

The reason for the early shot tonight is that I am going out at 4:30 pm. Will not be home until very late. I did the exact same thing on Wednesday night and all I saw was a low AMPS as he nadirs late - it means his preshot is lower if I am late.
 
Juliet said:
Okay - question - what if today really HAD been a partial furshot - you would never say don't give usual dose at night right? Its not "a big increase" - just his usual dose - in fact a reduction from his usual dose which is 4.75. I skipped shot last night so technically he should have got 4.5 this morning. If I had given a fur shot, I would just give the 4.5 tonight. However, I think he does need a bigger drop than just 0.25 as discussed yesterday - and was told 0.5. So as we don't base dosing on preshot - it will depend how much he comes down in this curve as to what I dose tonight, knowing that the morning shot will be 90 mins late to keep on normal schedule.
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Any time someone shoots early, I caution them because it acts like a dose increase (which you said you realize that it does). I would have still pointed out you should be cautious because you would be shooting early. You know Silver best, so it is your decision. I just want you to consider all things.
 
carfurby said:
Any time someone shoots early, I caution them because it acts like a dose increase (which you said you realize that it does). I would have still pointed out you should be cautious because you would be shooting early. You know Silver best, so it is your decision. I just want you to consider all things.
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I am. But I don't really know what to shoot yet. These pinks aren't good and I believe are a result of dropping dose too far. When he bounces he tends to bounce in the same cycle so I don't think this is a bounce but I could be wrong.
 
What a difference a dental can make :cool:

This is an unpredictable phase - trying to gracefully come safely down the dosing ladder in the face of drastically changing insulin needs in reality is. more like tumbling and stumbling.

We went through it after BKs first and second dentals. February 2009 and late June 2009 were particularly challenging. You can see all the craziness on his ss- skipped shots, stalling, delayed shots, early shots, .5u reductions, BCSs galore and even a BCS that became the next dose.

Play it safe- particularly since you are not able to monitor closely during the work week and Silver does not have access to food while you’re at work. You can always easily go back up if you make a dose decision that turns out to be too conservative. Don’t let a few pinks freak you out.

“Better a day too high than an hour too low”
 
Sandy and Black Kitty said:
What a difference a dental can make :cool:

This is an unpredictable phase - trying to gracefully come safely down the dosing ladder in the face of drastically changing insulin needs in reality is. more like tumbling and stumbling.

We went through it after BKs first and second dentals. February 2009 and late June 2009 were particularly challenging. You can see all the craziness on his ss- skipped shots, stalling, delayed shots, early shots, .5u reductions, BCSs galore and even a BCS that became the next dose.

Play it safe- particularly since you are not able to monitor closely during the work week and Silver does not have access to food while you’re at work. You can always easily go back up if you make a dose decision that turns out to be too conservative. Don’t let a few pinks freak you out.

“Better a day too high than an hour too low”
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Agreed. But I think this dose decision WAS a bit too conservative?
 
Juliet said:
Agreed. But I think this dose decision WAS a bit too conservative?
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Maybe however better to err on the side of caution.

Keep in mind that 34 got his defenses up and it was less than 24 hours ago. One other unpredictable piece of the picture is the time it takes to clear a bounce- they can clear up faster and if he is on a mission the day will come when your waiting for a bounce and it never happens.

See how the rest of the cycle plays out.

My $.02-
Right now I’m feeling 4u might be good but what happens between now and PMPS could change that.

I know you are going out tonight; when do you expect to return (PM+?) ?
 
Sandy and Black Kitty said:
Maybe however better to err on the side of caution.

Keep in mind that 34 got his defenses up and it was less than 24 hours ago. One other unpredictable piece of the picture is the time it takes to clear a bounce- they can clear up faster and if he is on a mission the day will come when your waiting for a bounce and it never happens.

See how the rest of the cycle plays out.

My $.02-
Right now I’m feeling 4u might be good but what happens between now and PMPS could change that.

I know you are going out tonight; when do you expect to return (PM+?) ?
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I'm going to do a +8 in 20 mins then his shot will be at +10.5. I should be home at +6 or +7. I think that is okay as I will feed him his meal at shot time that brings him up for 3 hrs. His lowest tends to be preshot so it will be the next morning I'd be wary of. However. I'd also be feeding him when I got home which is considerably later than when he would normally get his bedtime snack. I am leaning towards 4u as well as it's a good 0.75 dose reduction but more than he got this am. Last night I was also thinking 4u so I don't know why I went with 3u this am.
 
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Not such a good day for numbers...let's hope tomorrow is better once his depot stabilizes again.
 
Juliet said:
Not such a good day for numbers...let's hope tomorrow is better once his depot stabilizes again.
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He was safe while you were gone.
Your morning shot will be PM+13.5 so you can get back to schedule, correct? It will be interesting to see where he is at by then - it would be nice if the numbers will permit you to string a couple cycles together at the the same dose.

Its not easy - during the 2 free falls down the dosing ladder BK experienced I felt like I was driving down a steep hill with one foot on the gas and the other on the brakes trying to avoid disaster
 
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