Boo Radley 6/26

Status
Not open for further replies.
Jessica & Boo Radley

Jessica & Boo Radley

Member Since 2011
I worked the past 5 days....I've never done that many 12hour shifts in a row and am pretty sure I won't again ;-) ;-) I slept 12 hours last night catching up :oops: :oops:

To refresh, we raised the dose to 1.25 last week to see if the flat numbers at 1.0 were from too much or too little insulin. For the days I work, I shoot the morning dose and my DH shoots the evening one. I wanted to stay at 1.25 for longer than my normal 5 cycles just to see if he actually needed more time. We had some dips and bounces early on which would have in the past stimulated me to drop the dose; instead I held. Yesterday morning, I woke to a 235 and knew my DH would also be gone all day, so I shot a 1.1 instead. As he was getting ready to leave for work, he tested Boo and got a 57 @ +4 :shock: :shock: , so....subsequently decided to stay around and watch/test him. No high carb food was fed and he ultimately managed himself quite well.... yet again (go Boo go)....until the big (but expected) bounce.

I'd love some feedback for the last week and thoughts about what we should do next!
 
First of all - OMG on that much work!! That's 60 hrs in 5 days, right? Yikes!

OK - on his dosing - I know you will think this is crazy, but you might want to try 1.2u if you can get that fine a difference from 1.25u and 1.1u. It's possible that 1.1u will hold him, but I doubt it.

The 1.25u looks good and might just need to be held longer to even things out. Mid 50s are perfectly save, although I don't aim for anything lower than 70-80, I never worry about them. It isn't unusual for some rebound to happen from 50s and 60s until he gets used to those normal numbers. I think the low 200 PS was the beginning of that, but you reduced on it. The 50s after that come from the previous dose, but the 1.1u AND a bounce added up to 400s. I'm just thinking that 1.2 might bring him to upper 60s or 70s and that would be perfect.
 
They're called 12 hour shifts...but we get there 30 minutes early and usually stay about an hour late, so it's closer to 70 hours. I'm not so sure it's so much the time, but the demanding nature of being on your feet all day, running around, constant critical thinking.... I'm very lucky to have a supportive DH; on my stretches, I can do no more than go to work, come home jump in the shower and climb into bed! He more than fills in my missing gaps in our life :lol: :lol: . Ahhh but the upside is now I"m off until next Monday :-D :-D I don't typically work more than 3 straight, but with the loss of Simon last week, I was in search of a distraction.

I don't think that dosing idea is crazy at all. I took that reduction that morning because neither of us were going to be home and historically, when he's on a downward cycle, he usually goes down, down down. In all honesty, I didn't expect my DH to shoot the same reduced dose that night, I was still in the mindset of holding the 1.25 another week to see if he settled a bit more. Just miscommunication on our part. I was leaning towards going back to the 1.25 for a bit longer as originally planned, so may try.

In the human world.....insulin protocols are changing as we speak; . We used 50 as our magic number to initiate protocols to prevent hypoglycemia; the number now is 70. I think I've said this a few times, Boo seems to go the other way with highs and lows. I don't worry much about the lows (I see some people immediately break out the karo and high carb), he tends to manage them himself. The downside, is that management always always involves a healthy bounce!
 
I'm tired just THINKING about your shifts. MANY many years ago, when I was MUCH younger, I worked 6-10s. I lived for rainy Saturdays or Mondays, so we actually got TWO days off.... because even then, I had to sleep through a day to recover. A second "weekend day" was over the top!

Sounds like you've got the drill under control - very good!!! Enjoy your time at home!
 
Bounces should be less with lev - and the right dose. I am always inclined to think that bouncing means too much insulin - even if by a tiny amount.

Well, as far as humans and diabetes goes, it does not always work to apply that knowledge to cats. I am a little surprised that the old protocol was 50. I have always seen 70 as the lower end of the normal range, so would have expected that to be the deciding number for anti-hypo measures. My neighbor is diabetic and he woke up in the middle of the night feeling just awful and got up to take his BG and it was 45! Now that is scary for a human. Cats seem to tolerate lower numbers better. Both of mine have been in the 30s with no symptoms. Beau once got into the 20s and started acting odd - trying to eat from an empty bowl when a full one was a few feet away. I was laughing at him when I suddenly though, "OMG, I better test him!" I just never worry about 50s, unless they happen at +2 or something, then I know I need to get food into them and keep testing.
 
Boo is doing very well. I know about working long hours and on your feet all day. More power to you! I won't do 12 hour days anymore unless I have no other choice.

Levemir is somewhat notorious for throwing those kind of lows at +3 or +4. We used to call it previous dose sign-off. As you saw they can hold themselves pretty well, especially as Sheila mentioned, if the dose is about right. Since you're off for a while you can test the 1.25U dose more often and see how it goes.

Get some rest. @-)
 
I GOT CALLED IN YESTERDAY!!! :shock: :shock: So I am NOW officially off until Monday~

by Sheila & Beau & Jeddie
I am a little surprised that the old protocol was 50. I have always seen 70 as the lower end of the normal range, so would have expected that to be the deciding number for anti-hypo measures.
Click to expand...

Our hospital does use 70-130 as normal pre-meal range. "Normal Range #s usually have a treatment point that is outside of the "normal". For example, we don't treat hyperglycemia until 150, and as mentioned hypo used to be 50. The other vital signs are similar (normal heart rate is 60-100, we treat tachycardia at 130 and bradycardia at below 50 (of if symptomatic above 50). Blood pressure systolic normal range is between 100 - 120. We treat acute hypertension (outside of person's normal blood pressure regimen) at >150 and hypotension at <85.

I think the other interesting thing we see is how human meters read feline blood sugars. These meters most of us use are calibrated for human blood and in every single case where I've run checks with a human meter against the vets species specific calibrated meter, or through an Alpha Trak; the human meters always run lower by an average of 30 points....(much much more with the Freestyle as many of us unfortunately know). This says to me that the numbers that are laid out in these protocols as "break out the karo and high carb food" numbers, are within normal range and are probably very, very often, unnecessarily treated when they are in fact just normal numbers. I saw this everyday with TR. It makes sense again, with this reasoning, why Beau was asymptomatic in the 30's but got a little wacky at 20 (that 20 was probably more like 50).

.....I need to add a disclaimer here that I am not advocating anyone to change their reaction to low numbers - it's simply my opinion and we all know ECID ;-)

by Vicky & Gandalf (GA) & Murrlin » Wed Jun 27, 2012 9:51 am
Levemir is somewhat notorious for throwing those kind of lows at +3 or +4. We used to call it previous dose sign-off. As you saw they can hold themselves pretty well, especially as Sheila mentioned, if the dose is about right. Since you're off for a while you can test the 1.25U dose more often and see how it goes.
Click to expand...

I'm keeping my fingers crossed that we are at about the right dose and that he just needs some extra time to settle in. He definitely can hold a nice cycle (look at last night), but that usually results in an ugly following day. Perhaps he just needs to get used to being green :mrgreen: I do see a pattern of a preshot in the lower 200's or upper 100's lends to a beauty of a cycle.

Testing I shall do!
 
That sure was a purty cycle last night! To bad Boo's body bounced so far.

Do you have a picture of a cat with sparkly GREEN eyes like you did with the blue for me? I saved the picture it was so pretty!
 
Status
Not open for further replies.
Back
Top