Beau - 7/30 - lower dose at 1.0U BID prescribed

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alicia.1771

alicia.1771

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So my vet called this morning and said she had chatted with an internist regarding Beau's curve and think it's a good idea to decrease his dosage to 1.0U BID. The internist said it will be good to see a nadir around 80 for him so that' our goal. At first she said if his +6 is < 70 then skip his PM shot, then I asked what if his PMPS is a shootable #? Then she said to go ahead and give his PM shot if > 150 and skip if < 150.

I gave him a skinny 1.0U this morning because he was only 171. I was going to check his BG at +2 so I can monitor his response to the decreased dosage today but completely passed out due to sheer exhaustion these past 2 weeks :oops: I just tested him at +4 and he is at 287 :shock: I am pretty sure I didn't give a fur shot this morning so not quite sure what's going on??? I will continue to monitor throughout the day and post his #'s.
 
I'm impressed they wanted you to adjust like that, actually. You don't see many vets that want to get them down into greens or tell you to shoot if less than 200, so they seem clued in which is good. Beau was through a lot yesterday so some of what you may be seeing is a reaction to that stress. At the next dose just give him what the vet prescribed and let's see how it goes. I doubt this is a bounce of some sort, but it may well be that 1U may end up not being enough insulin if he ends up staying high or flat on this one. He's new to this and figuring out where he needs to be can be a bit frustrating. Hang in there!
 
Hi Wendy - I'm also hoping his #'s today are due to the stressful day he had at the vet yesterday as well as the terrible bruising on his thighs, which I would consider as a "stress" to his body. Hope he will start his healing path and adjusting to this new dose.

His +6 is still flat at 288. Since I have gotten a few suggestions to hold his dosage consistent for a few days from people on this board, I think it will be a good idea to continue to give 1.0U if he is at a shootable # > 150 to see how he is responding to this lower dose. I will also check for ketones if I can catch him pee today.

Anyone think he may be experiencing a somogyi effect? I'm reading up more on it and looking at his spreadsheet the only dip into the green zone outside of normal nadir time seems to be after his 7/27 PM shot which had a prolonged effect lasted to his 7/28 AMPS at 66. But he had a nice looking curve at the vet yesterday so unless it takes a few days for the somogyi effect to kick in and I'm not quite sure what's going on with him today.
 
The higher and flat numbers you are seeing mid cycle today are probably due to the greens you saw yesterday. I personally think your curve yesterday was beautiful at the 1.25u dose. But it depends on your comfort level with that 68. Most don't recommend reducing a dose until you get around 50 for a low point. You should start to see a regular U shaped curve here in the next cycle or two.
 
I don't see signs of Somogyi rebound - that is like a spike up into really high numbers, you aren't seeing that at all. My guess is the dose is too low now - you just aren't getting a drop.

I would be experimenting with doses in the 1 to 1.25 range. The 1u the night of 7/28 looked promising, but it hasn't since then, assuming tonight's PS continues the trend up. You are just fine-tuning now to try to find the sweet spot, so that is great!
 
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