First shot need advice.........

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Robin&BB said:
Good. I'm glad you gave him some food, Kevin. That 1/2 can certainly did the trick - and great job in getting that test! :)
(How did Bandit react this time around?)
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Better. I put a flashlight under his ear, so I could see the vein better and just pressed the lance against it, till I heard a faint snap of the skin. Small bloodlet this time, but enough for the meter.

So 218 isn't too high? Or normal for right after a meal when not accompanied by a dose of insulin?
 
Bandit said:
Better. I put a flashlight under his ear, so I could see the vein better and just pressed the lance against it, till I heard a faint snap of the skin. Small bloodlet this time, but enough for the meter.

So 218 isn't too high? Or normal for right after a meal when not accompanied by a dose of insulin?
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No, 218 is not too high. It isn't even drastically "above normal" on the meter you are using. Some, but not a lot.

The 66 that you saw an hour after shooting and feeding this morning - that number was most likely NOT due to the shot you gave an hour beforehand. That is what caught my attention when I saw it. It usually takes 2-3 hours before the shot really starts bringing the numbers down ("Onset" is what we call it). And then it will continue to cause the number to fall for several hours after that. 5-7 hours after the shot is what you would expect as far as when the insulin is reaching its "peak effect".

I am guessing that if you had been able to get a test before that shot this morning, his BG would not have been too much higher than the 66, and we probably would have suggested that you not give insulin on a number that low. Which is why the people who saw this earlier hopped onto the thread, so you would be aware of the situation and possible "emergency" that could take place.
 
OK, I think I'm getting it.

Even though the shot should drive the number down, it wouldn't likely do it that quickly (2hr after shot), so the pre-shot number was probably low to begin with. The 1/2 can probably boosted the number, but the only real way to tell is by confirming a pre-shot BG level.

I'm filling out the Spread Sheet. I suppose the pre-shot should go in the +11 column in that it is 11 hours after the AM shot, and 1 hour before the PM shot?
 
Am I correct in assuming that Bandit will get his preshot BG test in about 2.75 hours from now?
(You'll let us know what that # is before you shoot any insulin, right?;))
 
Bandit said:
OK, I think I'm getting it.

Even though the shot should drive the number down, it wouldn't likely do it that quickly (2hr after shot), so the pre-shot number was probably low to begin with. The 1/2 can probably boosted the number, but the only real way to tell is by confirming a pre-shot BG level.

I'm filling out the Spread Sheet. I suppose the pre-shot should go in the +11 column in that it is 11 hours after the AM shot, and 1 hour before the PM shot?
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The "preshot" number would go in the columns marked AMPS and PMPS. Most people will test the BG, then feed, then give the shot (assuming the BG number is high enough to warrant giving a shot). A 5-10 minute sequence of events.

Yes, the shot will drive the number down, but usually not until "onset" happens, usually 2-3 hours after the shot.

Here is what you would see in a "normal" 12 hour cycle:

AMPS/PMPS - the number would normally be "free from food", in that food shouldn't be given in the two hours prior to getting a preshot test. That way you know that carbs from the food aren't influencing the number
+1 to +2 - The number might rise during this period. Because the food will be pushing the number up before the insulin starts to push it down
+2 to _+3 - Prozinc should be reaching the onset point, where it will start pushing the number down
+5 to +7 - The insulin should be having its biggest effect, and the BG should go as low as it will likely go that cycle and reach "nadir".
+8 to +12 - The BG is most likely coming up because the insulin should start to wear off.
+12 - that would be AMPS or PMPS, when it's time for the next scheduled shot.

Of course, lots of things can change, it wouldn't always look this simple. Food given during the cycle can affect the numbers. Sometimes onset and nadir will happen earlier or later than expected. Duration might be longer or shorter than 12 hours. But in a perfect world, that's what a PZI/Prozinc cycle should look like.
 
So, Kevin, we probably expect a high number tonight (could be in the 300 range?). But it is most likely a bounce from the low numbers today. A bounce is when the body perceives a lower number than it is used to and releases extra glucose, making the number bounce up.

Regardless I would reduce the dose. Did the vet suggest reducing the dose?
 
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Sue and Oliver (GA) said:
So, Kevin, we probably expect a high number tonight (could be in the 300 range?). But it is most likely a bounce from the low numbers today. A bounce is when the body perceives a lower number than it is used to and releases extra glucose, making the number bounce up.

Regardless I would reduce the dose. Did the vet suggest reducing the dose?
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66 was a couple of hours after the AM shot.

He was a 154 at 7:00pm PMPS.
 
So he dropped from the number earlier this afternoon? I would skip tonight. It is unusual for the numbers not to climb after a low like today and he is still lower than we would suggest a new diabetic to get insulin.

Tomorrow he probably will be high, if you skip tonight. I think I would still reduce the dose to one unit. Then, you can raise slowly and carefully based on your numbers at home.

What do you think?
 
Hey, that 154 is a very good blue number. But you will want to monitor him tonight, given that we really didn't know what his preshot # was before you gave him the dose this morning.

Is that correct, what I'm seeing in his SS: Did you just give him 2 units tonight?
 
Crap the wife just gave him his shot, and feed him.

What should we do? I'll test him in a few hours and make sure it's not too low. Wife held him this time around and it was a lot easier.
 
Ok. For future reference - as mentioned earlier - we don't recommend shooting at below 200 when you're new at this - but it's okay, Kevin.
I'd like to see you test him at +2, and then we'll go from there when we see that BG#. (If his # is rising, that's a good sign.) But this cycle we will still need to make sure he doesn't drop too low later overnight, either.

Don't worry, we'll hang out with you on this.
 
How much? 2 units? You are going to test every hour or so, monitoring carefully. If he drops lower than 80, I'd start giving him some gravy off the high carb gravy food. (Normally you could wait until the 70s, but he is likely to be sensitive to insulin and may drop faster than usual.). You want to give him little bits of gravy so he will eat when you need him to bring up his numbers, not a big meal.

Do you have gravy food? Karo syrup or honey? If not, I'd go get some.
 
Sorry, Sue's right - you probably want to start checking earlier than that, given the situation you ran into earier today - like test him around +1 or so (just to be really on the safest side here).
 
Hi Kevin! It's been a rough day, I'm sure, but I'm with everyone else. I'd get some tests in and make sure that you have karo or honey as well as gravy food in case you need to steer.
 
That's great that you've got syrup handy. We'll see what the #s tell you to do ...
(Looks like you'll be getting in some good testing practice tonight.;))
 
I just got home. Looks like you've got plenty of help but I'll watch silently from the peanut gallery ;)
 
Glad to hear you got a test. It isn't super low but there isn't a whole lot of room to drop in the next couple hours. Did you give him a little something to eat?
 
I see that Bandit is at 69. Did you just test him? Have you started giving him gravy food or karo syrup? He cannot go any lower at all. Since you took this at +4, Bandit could still go lower in the next couple of hours. You will need to give him gravy food now (about a teaspoon) or karo syrup now. Test in 20 minutes and get back to us. Karo syrup is only a short term solution and does not keep the BG up for very long.
 
OK, so this is what we have...

PMPS ~ 154
+ 3 ~ 97
+4 ~ 69

He ate a full can of food at PMPS. And then a 1/2 can at +3 or so?
 
I agree, gravy would be good about now. 69 is low enough. One thing though. You don't want to "fill him up" with the food. The gravy style would have more carbs, so you get more bang for your buck in terms of carbs boosting up the numbers. But you don't want his belly full in case you have to feed him again in 20-30 minutes either. So maybe 1/4 can?
 
lol, I'm sure that feels great for him! It'll take 20-30 minutes for the karo to show up on your meter
 
Is he acting okay? No spacey looking eyes or walking like he's dizzy?
 
ok good. test by midnight?
Just noticed you're in Lowell, MA. Any snow yet? I grew up and lived in a town toward Worcester called Grafton.
 
Cindi,
I'm good for another couple of hours if need be.
 
He's kneading a blanket. Which is rare for him. Now sleeping on it. How long does the insulin push the BG down? Is it like half the 12 hour interval? If he's on the rise this next test are we out of the woods?
 
Bandit said:
He's kneading a blanket. Which is rare for him. Now sleeping on it. How long does the insulin push the BG down? Is it like half the 12 hour interval? If he's on the rise this next test are we out of the woods?
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Theoretically? 5-7 hours after the shot is when nadir is supposed to happen.
"Kneading dough! It's what I do!" That's awesome. Cats don't care what the meter says!
 
The nadir can and does vary; with ProZinc, we've seen it go later when the dose was too high.
You want the glucose to be rising, at a safe level, and past the nadir before relaxing.

For reference: How To Handle A Hypo.

You can give him a couple teaspoons of regular food at this point. Snag another test in 30 minutes to see if his glucose is holding steady.
 
Great!
So, you're at +5.5 with a rising number from food given an hour ago.

My opinion, others may differ...
I think you could give him a 1/4 can of food, make sure he munches it. Then leave a little out for later.

Going forward. On a preshot as low as a 154 on an AT meter, a 2u dose is too much. Many people might not even shoot at a number that low. At most, I think 1u max, if you can be around to keep an eye on Bandit's numbers. 154 on an AT is just about the top end on the "normal range" of BG as I understand it. As you saw twice today, there isn't much wiggle room when the bottom is about a 68.
 
Well 100 is much better. Isn't this a +5 test instead of +6? If it is a +5 test, I would check him one more time say in about 30 minutes. Sometimes the Karo will wear off and the insulin could take him down again. If it is a +6, he probably will be ok for the night but if you want to know for sure, just test him again in 30 minutes. We want it now to rise above 100 instead of drop again. I would leave food out for him tonight.

Now for tomorrow morning, it usually is going to be high. You probably will not want to give your usual dose because this number is considered a bounce for going down too low. I believe Sue mentioned 1u but I would jump on this forum and ask for advice before you shoot.
 
When I was posting the 154 preshot number my wife called to me from the kitchen and said "you want me to give him his shot". I just reacted to the question with an affirmative. Next time I'll pay closer attention to the numbers. I wasn't thinking the 154 was at the end of the insulin's effectiveness.

I'm going to sleep, my wife will wake me when she gets up for work in a few hours. I'll leave another 1/4 can down for him in the interim.

All in all, I'm encouraged.

Thanks so much to everyone tonight.
 
Also, from going pretty low, it is possible he could be more sensitive to insulin and reuire less than before.
 
BJM said:
Also, from going pretty low, it is possible he could be more sensitive to insulin and reuire less than before.
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The Dr. felt another brand of insulin might be in order, but it's awfully expensive. I forget the name.
 
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