9/17 Olive Had to skip AM injection. Gave PMPS+6 and will walk her forward later

[OlivesMom]

https://www.felinediabetes.com/FDMB...amps-bg-479-food-ratio-increase-today.235412/

Last night's BG drop was beautiful! Nice and slow and so steady I could peg what the numbers would be before I tested. That's never happened before. Only, she continued dropping past the Nadir into +9 reading of 98. Something I've noted before that I've seen happen. So am I to guess her nadir is actually more like +9 rather than the "standard" +6? And if that's the case, isn't that a bit far into the cycle??

I knew by +10 that she wasn't going to reach above the 200 mark for injecting, even though I got her to eat a tablespoon of food, and I was right. She's only at 143+12 so I'm stalling, something I hoped I wouldn't have to do. She's had such a nice, gentle, and steady past 24 hours I didn't want anything to rock the boat and create another bounce. But I have no choice to allow time for her BG to rise over the next few hours.

I have increased the food ratio to 1 tsp Raw to 3 1/2 tsp DM. Will continue this ratio all day unless I notice discomfort and if that were to happen I will go back to yesterday's ratio.

Something positive must be happening for her numbers to be reacting this way over the last 24 hours. If anything, she's had some nice healing numbers over the last 5 hours or so.

 

[OlivesMom]

Hmm, I'm debating what to do at this point. I spoke with my "NICE" and original vet about Olive's BG and what to do about the injection at her current levels. It's a toss up. I told the tech (relayed info to my vet) that I'm also verifying BG numbers with the AT2 during times of low numbers and times like these when I'm stalling, just to see what the AT2 says as another aid in helping me decide what to do. She LOVED that idea. So she knows the human meter is what I use in my daily charting as I can't afford the strips for the AT2 which they understood. She said even with the AT2 her current BG is fine to skip the shot if I think by giving it will send her too low. As she said, only I know Olive. She also said it's okay to stall a shot by up to 4 hours but then it has to be skipped if the numbers still aren't good enough. But if a shot is given past the original injection time that you can't give the next cycle shot under 10 hours from that time. Good to know. So it's up to me...skip or inject. They already know she'll bounce again if I skip, but nobody wants her to go too low either. Ugh. What to do at this point...Think I'll wait 15 minutes and retest and make my decision then.

 

[OlivesMom]

Decided not to chance giving the injection. When I retested she'd actually dropped a few points from 204 to 200. I know there's a margin for error with the meters but after 2 hours of trying to get her BG up and it had only gone up by 50 points, I was too afraid to give the injection and risk a hypo. Past experiences have shown she goes too low when giving the injection at around 225. She just hit 200. I was finally able to feed her breakfast. Will see how she does today. I dread the bounce, but there's little I'm in control of at this point.

 

[OlivesMom]

Ugh! I should have given the shot. She's jumped to 483 since I made the decision 2 hours ago not to give the shot. I absolutely hate not knowing what to do at times. I made the wrong choice. Now we begin all over again with the bouncing that's to come. I didn't think for one moment she'd jump so quickly after eating breakfast. Then again, today she's up to about 75% DM now and I bet that played a role. She's got 7 1/2 hours before I can inject. You think it would be okay to inject an hour ahead of schedule just to help lower the BG a little faster today or should I continue with the 9PM like always? I wasn't sure if an hour ahead would hurt or not and the last thing I want to do is more harm today.

 

[Wendy&Neko]

Olive needs her insulin. When you shoot lower numbers with Lantus, the cycles are a lot flatter. On the 8th when you shot at 220, she had a lovely cycle. I think you'd be fine shooting 200 or even a little lower. Lesson learned for next time, don't beat yourself up.

And yes, you can shoot anytime now as your PMPS shot as it's been more than 12 hours. Just be aware tomorrow also has to be at least 12 hours later.

 

[OlivesMom]

I think you'd be fine shooting 200 or even a little lower. Lesson learned for next time, don't beat yourself up.

Thank you for the feedback. I get so frightened of her dropping too low, but I will definitely know for next time to just go ahead.

And yes, you can shoot anytime now as your PMPS shot as it's been more than 12 hours. Just be aware tomorrow also has to be at least 12 hours later.

So I could shoot at this very moment and pretend it's the PMPS? That would mean having to walk her forward towards getting back to the 9am/9pm schedule, right? I don't know if you're in the USA or not. I'm in central time. It's 2:25pm here. Just to clarify...if I shoot at 3pm which is +6 past her normal injection time, then I would then give her AMPS at 3am in the morning which would be 12 hours later? So I'd have to slowly move her injection time forward after this until she's back on schedule, correct? I want to get this right. I just can't stand the idea of her being so high for 6 1/2 more hours.

 

[Wendy&Neko]

I am west coast of Canada, buried under all that American west coast smoke from fires, so you can't see me waving.

An option that might work for you is two back to back long cycles. So shoot at +18, then +18, that will bring you back on schedule. But I like your suggestion better because two long cycles will probably disrupt thing worse. Or you could move to a +20 and wait a couple more hours. You have to pick times that work for you and sleep. If you shoot her at 3AM (or 4AM), then you might have to get up and monitor a couple hours later. It's a trade off.

 

[OlivesMom]

I like your suggestion better because two long cycles will probably disrupt thing worse. Or you could move to a +20 and wait a couple more hours. You have to pick times that work for you and sleep. If you shoot her at 3AM (or 4AM), then you might have to get up and monitor a couple hours later. It's a trade off.

I don't mind going without sleep. I've learned to sleep between testing and grabbing whatever I can get. Olive is the important thing right now. I think I'll go ahead and shoot in 20 minutes time, which would be +6 from her original AMPS. Then I'll shoot again at 3am and work her forward to the original time of 9AM/9PM. Knowing she's going to continue to rise even through +8 if I shoot now, at least this will give her a little head start in the right direction. I'll worry about getting her back on track later. Getting her back to those lovely blues again is my goal. I monitor her frequently anyways, so I'm up at all hours and it's really not a big deal for me.

I am west coast of Canada, buried under all that American west coast smoke from fires, so you can't see me waving.

Canada. Nice. I can FEEL you waving. My friend was evacuated when the fires hit Oregon. Her house is still in danger of burning down. But at least she and her husband got out safely. It's scary that way.