Sam - the good news, the bad news

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KristenP&Sam

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The good news - no ketones!
The bad news - +6 was 245.

I'm seriously thinking about giving him a full 1 unit tomorrow to push for some good numbers. Thoughts?
 
The BAM dose really worked for us to get things moving/changing, but now we’re having these late nadirs.

This sounds like a Joanna question. She really called it this time with Asher.
 
It's important to not lose sight of the good things we have, so yeah for no ketones!!! I don't have the experience to advise on dose, but the BAM did seem to help Asher and Sam seems to have been less bouncy this past week. Let us know what you decide.
 
If you'll be home to test I would go for the bam dose i unit.

You know what to do if he starts to go low. Feed low carb, test, test, feed med carb, test, test.
 
I will be home with him tomorrow. I'm going to do the 1 unit and monitor him closely. His PMPS was 423. I am SO tired of these high numbers. Next week I'm getting him in to the vet for a dental if at all possible, too.
 
Yay no ketones :-D boo yellows pinks and reds! :evil: I'd say go for it with more insulin if you are home to test. If you look at some of your earlier #s you have quite a bit of room to raise the dose w/o being overly afraid of hypo. Make sure you have a hypo toolkit handy and know what to do if needed, and then test at +2 and +4 to check for unexpected lows. I wouldn't even worry really at 1u, just a spot check by +4 to be sure. Jojo had suggested some insulin resistance has probably built up, so if that is correct, you will need more insulin to get a breakthrough. You can do something like 1u and see if you get a better response by cycle 3 or 4, or you can do something like 1.2 for one shot (with extra spot testing) to jump start things, and then maybe pull back to 1u for a couple shots after that. PZI's flexibility can really be handy on stuff like this. As long as you know your risks and are prepared to monitor and treat low #s if you get them, you can be more aggressive with the doses if you want. Also if you want extra guidance or are feeling uncertain, I would go ahead and PM some of those who had posted earlier to suggest more insulin. I know Jojo has a TON of experience (way way more than I do!), and maybe some of the others as well, I'm not sure.
 
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