Nadir Higher than Pre Shot?

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BaileyUK

BaileyUK

Member Since 2013
Hi

We're struggling to make sense of why in the last week we have had a couple of very high nadir readings that are in fact higher than the pre shot reading some 6 hours earlier.

Is anyone able to take a look at Bailey's chart and let us know if this could be a bounce? Or anything else that might be causing this? We only just changed onto a new bottle of Lantus so cannot / should not be this.

We know we need to test more often but for reasons explained previously we're struggling so please forgive us for not presenting as much data as I know most of you would like.

The fact is Bailey is becoming dehydrated and his levels are really high two lots of pink readings yesterday and his nadir is 15 again today - it was 15 at pre shot this morning 6 hours ago so we really don't know what's going on and are really worried.

Thanks in advance for any help anyone can offer.

Barnes and Bailey
 
Hiya Barnes

First off congrats on getting those extra tests in it really helps to make sense of his readings.

Okay yes number wise his nadirs on a couple days appear higher but if you figure in that all meters have a +/- 20% Bailey is in reality running very flat.

There could be a couple causes for that. If he's dehydrated then he isn't able to properly absorb the insulin. I know he is a pain to test but if he will let you, you could have your vet show you how to give sub-q fluids at home. If not then see about having a vet give him some that will help with both his pancreantitis as well as the insulin absorption.

But honestly I don't think that is the whole issue as much as it just plain isn't enough insulin to start with. Yes you are seeing blue but no green at all.

So if he was my Autumn here would be my course of action. Up the dose to 4u and get sub-q fluids in him either at home or by a vetand see where he goes from there.

Mel, Maxwell, Autumn and The Fur Gang
 
Hi Mel

Thank you so much - we have booked him in for some fluids this afternoon and shall raise his dose to 4U - you think twice a day or just give him a slightly higher dose for the AM shot? So 3.75U PM and 4U AM - do you think that may be safer?

Thanks so much we're so worried it's a constant battle but your advice and support is so very much appreciated more than you may ever know!

We shall keep you updated.

Thanks again

B&B
 
With Lantus you want the dose the same a.m. and p.m. Because each shot builds on the next one...Think of it like filling an uncorked funnel. If you fill to much to fast it over flows (hypo) but if you don't fill fast enough or don't add enough the level at the top of the funnel drops (high BGs) but regardless the water flowing out of the bottom of the funnel isn't what just went in, its what has been there and is now being replaced by what your pouring in at the top. That's how Lantus works its not the shot given that effects the BGs its the one that was given a cycle or two ago that you are now making available to do its job because it has been replaced by what you just gave.

Mel, Maxwell, Autumn and The Fur Gang
 
Thanks Mel

Understood, it helps to understand how the Lantus is absorbed we knew there was the shed effect but not that each daily dose needed to be the same - we shall up him to 4U both ends and see how we fare.

We have just got back from the vets. They gave him fluids and said his tummy does seem very tender (which it isn't normally) they think this is likely another p'titis flare up that is knocking his BG's up.

If things don't improve in the next few days then the vet thinks we should try him on Budesonide to see if this will help with the p'titis but we're well aware that this will do bad things to his BG's so it's catch 22.

So it's upto 4U and fingers crossed!

Thanks again Mel we are so very grateful for your support.

B&B
 
No problem hon. Give Mr Handsome some scritches for me.

I think the shed is the hardest part to wrap the head around at least it was for me until someone gave me the funnel comparison then it finally clicked.

Mel, Maxwell, Autumn and The Fur Gang
 
Quick update. He's down to 10 tonight so we've given him his usual 3.75 units - fluid must have helped - don't want him going hypo overnight so we're going to give him 4U in the AM subject to his AM reading!

Thank you again much appreciated :)
 
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