? Pre-AM shot: 108? Should I give shot?

[Natalie and Ziggy]

Hi, everyone! Just a quick question. Ziggy’s currently on a dose of 4U and his pre-shot numbers have been extremely high lately. I just started him on a new vial of Vetsulin last night and his AM numbers are 108.

I know that if I give him a shot now, he would likely be in hypo city later. But if I don’t, he’ll definitely be up in the 500s in a couple of hours.

Should I give a reduced dose? If so, any thoughts on how much?

He increased to 127 after 20 minutes with no feeding.

 

[Natalie and Ziggy]

I took another test 20 minutes after he started eating and he was at 145. I decided to give him a dose of 1.5U. I was too afraid to give him anything near his normal dose, considering how sharp his drops have been.

I’ve given him 1U when his numbers were almost this low before, and it was never effective, so we will see what this does.

 

[Kris & Teasel]

Good call reducing. You can always increase if necessary. That lime green a few nights ago was a sign of too high a dose so you reduced a little but went back to 4 u. I think he's telling you that 4 u is too high a dose overall for now.

How much to reduce on a low PS is always a tough call. Trial and error is how you learn what works. It's possible a drop to 3 u would have worked but who knows? Those black PSs could be a sign of him dropping too low/too fast on the current dose range. Vetsulin curves are deep-ish by nature but reducing some of the big difference between PSs and middle cycle numbers might be a good thing to try. PSs are good for determining if a planned dose is safe - ie., high enough to give the usual dose of insulin. They aren't very useful for evaluating the effectiveness of a dose. The middle cycle/nadir numbers are the ones to look at for that. The goal range for those numbers with Vetsulin is around high 90s to low 100s.

Maybe try 3 u tonight and tomorrow and increase to 3.25 u after if the lows are too high. Don't jump right up to 4 u again. Go to 3.5 u for 3-4 cycles, evalutate, then 3.75 u for 3-4 cycles, etc. His good range might be somewhere between 3 and 4 u right now.