Lily PMPS 138

Looks like Lily’s BG is lower than usual today. I will hold on her dinner and retest in 20 min. And see where we are then.

 

Your girl's full of surprises today, Sally! Will keep an eye on this thread for your post-stall test result.


Mogs
.

 

Thanks Mogs, she is 146 now. Should I check in another 20 min?

 

Meter variance would account for the different in those two readings. Essentially Lily hasn't budged. You could try stalling another 20 minutes and testing again. I'll stay online until I see where she's at by then.


Mogs
.

 

Thanks for hanging with us Mogs. She is now 171.

 

Seen it. Looking at SS. BRB...


.

 

Back to you, Sally.

Just to double-check, am I correct that Lily has no history of testing positive for ketones or DKA episodes?


Mogs
.

 

The vet has not mentioned that at all.

 

Thanks for the info. If Sally had had a DKA episode, you'd know (requires hospital treatment).

OK, according to the FDMB guide, Lily's dose should be reduced by 0.25IU because she dipped below 90 today at nadir. Tricky situation.

Considerations:

1. Much lower numbers today with no change in daily routine/feeding, etc.
2. Dose reduction of 0.25IU earned by dropping below 90 at nadir.
3. Much lower PMPS. (Even though now rising, the first PMPS reading goes to extra-long duration of this morning's dose which is not normal pattern).
4. Based on my own experience of using Vetsulin I am concerned that even a drop dose tonight could potentially drop Lily right back down to the lower numbers she saw on today's AM cycle.
5. No history of positive ketone tests or DKA.
6. It's a night time cycle.

Based on the above, I'd suggest skipping tonight. I'm not sure what to suggest for the morning (especially because of the 0.25IU dose reduction earned). Something to mull over for the evening: would you consider a switch to a different insulin, because you've come up against what I refer to as the Vetsulin dosing wall (Lily still needing insulin, Vetsulin dropping BG into lower numbers, nowhere to go with dose reduction).

What do you think, Sally?


Mogs
.

 

Think about what to do tonight, that is.


.

 

I think it’s a good idea to skip tonight. I need to feed her since it has been 13 1/2 hours since she has eaten. Do you think she needs to have a snack sometime in the mid afternoon? Maybe that would help.

 

Sorry for delay in reply - was checking Lúnasa's blood pressure.

Altering the feeding pattern might slow the drop and bump up the nadir a bit, especially if you've not been giving her any food mid-cycle up to now, but there's no guarantee. You'd need to monitor closely to see how a change in the feeding pattern might affect numbers and, after today's surprises, to make sure Lily doesn't drop too low.

Couple of suggestions:

1. Would you be able to test at one hour and two hours after Lily finishes this evening's feed to see how her BG levels go after food (looking to see whether she might bring the numbers down a bit on her own - a check to see whether her pancreas might be starting to sputter).

2. I'd suggest testing half an hour before your normal AMPS time in the morning and posting a new thread with the reading and ask for dosing input. That'll give a little time to see the post and come up with a plan of attack for tomorrow's AM cycle.


Mogs
.

 

Yes I will check at +1 and at +2 tonight and get up a little earlier in the morning. Sounds great, thanks for your help!

 

Wishing you both a safe and restful night. Catch you on the morrow.




Mogs
.