5/15 Duriel AMPS158,+10 114,+11.45 107, PMPS152

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I ended up waiting 1 hr after feeding at 4:45pm (EST), retested got 152, and shot .5unit. Changed the spreadsheet to make AMPS+12 into +11.45, and the PMPS was done at 5:55pm. I will keep feeding Durie at 5:45am/pm for the next few days because of the 1hr delay in medicating today (normally she gets shot at 4:45am/pm). I will also keep the dose to .5 -- it seems that .75 is too much, at least according to the results of the last 5 days.

Any thoughts?
 
No dose advice from me, but you might want to use the little ? icon on your opening post and edit your subject line with something like dose? so you get some expert eyes on your spreadsheet. Great numbers!
 
Okay, thanks for the advice on using the "?" icon. I am very afraid of Durie going hypo, so I will keep her at .5u/shot for the next 5 days and see what her nadir looks like (it seems to come very late, at or after +9). But I will test between +4 and +11 to be sure.
 
Hi - I don't think I've stopped by your condo before. No advice from me, but it's good to see those mid-cycle tests so you get a better idea where Durie is going and you'll be more confident you won't miss low numbers. I hope someone else will comment, but if Durie's values go back up, you might not want to wait 5 days to go back to 0.75u. See how it goes for the next couple cycles and those mid-cycle tests will tell you a lot!
 
Ok, I won't wait 5 days, I'll just test lots over tomorrow and friday to see what's happening. Yes, my fear is that she'll go very low while I'm out... especially since her nadir time is not clear yet. Thanks for the ideas.
 
In addition to Lisa's suggestions, I'd like to offer a reminder. When you're adjusting dose with Lantus, you don't adjust based on the pre-shot number. Those numbers are important so you know that it's safe to shoot, but you base your dose changes on the nadir. It's why we're encouraging you to get spot checks throughout both the AM and PM cycles. Without some reference point, it's very hard to know if, in fact, Duriel's numbers are lower than what you're seeing at pre-shot times. I'd think about grabbing a test when you can -- before you leave the house, when you come home, before bed, etc. Getting random checks at various points during the day will help to fill in the white spaces on your SS.

We all understand your apprehension about low numbers. You'll get more and more comfortable shooting lower numbers the more you see Durie spending time in lower ranges and know that you can steer those numbers with food. It's a process!
 
Thanks for all the advice. Just one more question today... if Durie's pre-shot test should fall between 40-90mg/dL, what are my options if her usual dose is between .5 and .75 units?
 
Based on your SS and number of tests you are getting, I would not shoot numbers in that range. You have a few options including skipping the shot. Depending on your mid-cycle tests, you may be able to shoot on the very highest end of that range, but it would be much better to stall the shot and take more readings to see if Durie's values are increasing so it would be safe to shoot. I generally *always* got a +11 because Leo was so bouncy. To really understand his cycles, I tested 4 times a cycle: PS, +1or+2, +5or+6 and +11. Then I had a much better idea what would happen if I was faced with a lower BG.

Here is a sticky that talks about these situations STICKY: LANTUS & LEVEMIR - SHOOTING & HANDLING LOW NUMBERS

If you have a +11 that is lower, you will have time to add that value to your condo, add the "?" to the condo and ask for shooting advice.
 
There are certain very rare exceptions (i.e., a cat with a late nadir) where anyone would give insulin with a pre-shot number that's less than 50. Over time, you'll be able to shoot progressively lower numbers.
 
Thanks all. I am reading the "Handling low numbers" info now. And I've tested Durie a couple of times since 6pm.. she is 186 at +3, and 180 at +5. I will try to test her at some point overnight also.
 
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