Boo Radley 6/10 Who is this guy?

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Jessica & Boo Radley

Jessica & Boo Radley

Member Since 2011
What a difference less insulin makes. It's like the light has gone on....so different than the tight regulation protocol and makes so much more sense!

We settled very nicely at 2.0 and after a few, found it was still a tad too much, so we dropped to 1.75 last evening. Tonight, I go to shoot and his bg is 121, which is a low starting number for Boo. To try to avoid causing a bounce, I shot a reduced dose of 1.0 this evening. At + 3.....he's already at 43 :shock: :shock:

I'm comfortable handing the low numbers, I'm just curious what your thoughts are to tomorrow''s dose. Do you think what I'm seeing tonight is still being affected by the 2.0 dose a few days ago or do you think 1.75 is still too much for him right now? I'm sure we'll bounce tonight so I don't think tomorrow's AMPS will be much guidance.
 
I've never had a hypo on ProZinc or here... that low at +3 is scary to me. Do you have your hypo stuff ready? My understanding is nadir on Lev is about +8 or +9... looks like it might be a long night for you??? Good luck!
 
Hi Jessica,
Most likely what you saw tonight was the result of longer duration. Too much insulin can also cause a longer duration than the right dose will without necessarily taking them too low. If you shot the 1U at +12 most likely his BG was still dropping, hence the 43 at +3. It's also not unusual to see a +3 in the low greens. You are definitely getting him on target quickly since you've begun lowering the doses!

Try to to stop the drop with his regular food first, not high carb food just yet. Unlike fast dropping insulins, Levemir tends to "hang" so although yes the typical nadir is +8 to +10, he will probably reach a plateau. The key is to bring him up with food, but not up so much with high carb food that he ends up in the reds by tomorrow morning. You need to test every 15-30 minutes right now though to determine where he's headed from that 43. Glad you're comfortable with the low. You probably know the drill.

And yes, you're also seeing the carryover from previous doses at work. Sometimes it can all catch up to them at once. I think you could probably stick with 1U in the morning, stay with 1U for 3 days, get some mid-cycle numbers then and see where his cycle is at overall to determine the next step in dose, if necessary.
 
Wow!!
nice preshot, but I would have been scared to shoot the 1 unit into the 121
Is it because Lev is a long lasting insulin that you were ok with shooting?
 
Definitely because of the long acting insulin but probably more so due to the fact I'm pretty comfortable with how Boo reacts. I've shot in the 60's before, but definitely knew it was a rising number and knew what to expect from his cycle.

Every now and then he throws me a curve ball, but in general, I know that a shot has about a +3.5 to +4 hour onset of action with him and that his nadir is generally somewhere between +6 & +8 hours. Historically, he's also never been a hypo kitty. Rather, he's a bouncing cat; the upside of this is that when he gets a lower than normal number he generally produces enough (usually more than enough :lol: :lol: ) glucagon to cover himself. I haven't used high carb food on him since last fall and even then, I probably didn't need to. That's Boo - ECID and many of them do need high carb to bring them up!

For him to drop +3 after a shot last night is unusual and Vicky is probably right in that the overlap was still active.
 
Wow - thanks for the lesson! Maybe one day we'll see such low numbers! In the meantime, I'm excited w/ a pink preshot!
 
I think learning that shooting a "low" PS is safe is one of the hardest reprogramming skills to learn after switching from a faster acting insulin. It took me forever - and just when I started to do it wouldn't you know that Beau's pancreas was getting in on the action and he would plummet. Having data is the key.

Denise, these insulins take longer to onset and then longer to fade and that is why, after gathering data, you can shoot a low number. You do want the first few times you do it to be when you will be there to get some spot checks and monitor things, but once you know how your kitty will react you will know you can either safely shoot a full dose or not. I still reduce the dose a bit on really low PSs and I do skip a shot or shoot a lower dose a few hours later. It is better to give some insulin than skip altogether, but you have to make adjustments to the dose a lot of them time, especially if you shoot later because you are not shortening the cycle.
 
Big drop again tonight. My days as of late at any dose have been so short....it's hard to base what's happening on anything specific. Very unBooish.
 
So, what are you thinking for new dose? 1.25u? 1u?

Maybe he won't bounce into the 300s tomorrow morning since the low tonight wasn't quite as low....?

I'm actually thinking 1u since the drop tonight was so much bigger than last night because he started so much higher.
 
I shot1.25 this morning....probably more out of apprehension than logic. I agree that with the drop, a bigger reduction is definitely warranted, I'm just leery of ketones with dramatic changes and also of him holding these lower numbers - new territory for us so I think I'm OK with going backwards slowly and cautiously.

He ended up as low as 57 last night and we had a whopping :shock: 410 :shock: to begin our day!
 
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