Sneakers 4-5- time to change dose?

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hmjohnston

hmjohnston

Member Since 2011
Hello everybody. Not been on in a few days, I myself have been feeling lethargic and have put all of the energy I had into school work. Too much yard working and not enough calories in to cover it. Medically supervised diets to tend to suck in that respect.

I have updated Sneakers chart- doing good except for a strange 400 level yesterday at her +3AM. I tested twice just to make sure it was a correct reading. She could have been eating before the test- I came home early from work and was able to get the testing in. I didn't think I did a fur shot- no wetness on the fur but that 424 made me wonder- but the rest of her numbers were in line.

Tonight is my school night so she will be getting her PM shot late. I'll be able to give shots later in the morning 7am the latest. Will I give her normal shot tonight but decrease the shot tomorrow? Or should i keep the same 2u and do the PM shot a little more? I think it is time to increase by .25u as her numbers, while not usually so extreme as they were before, are still high enough that her dose does need to change. I was going to start that on the weekend but maybe Thursday is a good day so I could get a curve in on Sunday to see how the new dose settled.

Her ketone levels have started to come down, which is good. She never got over the small- nearly up to it, but not over it. Now they are between negative and a trace again- completely due to insulin I am sure. She is eating well with plenty of added water.
 
What are the exact times you are shooting today and tomorrow - or can shoot? How late will it be tonight (how many + hours) and do you have to shoot at 7am again tomorrow and how many + hours will that be?
 
In case I don't get your replay - basically here's how you handle a time change:

You could have split her morning shot at something like 7a/9a IF you can be around to give the second half. Then tonight's dose, which should be reduced if you are shooting at 7a tomorrow (which is a +10), can be at 9pm and will be 12 hours after the last half of the morning dose. Are you with me so far?

Since I am assuming you didn't split this morning's dose, then tonight's will just have to be late by however many hours it has to be.

Then the next day, if you have to move the shot back to 7a, that is +10 so you HAVE to reduce it. Usually you reduce the shot before AND the early shot by about 10-15%. If you can shoot tomorrow morning at +12, and can slowly move the time back over the weekend to 7a, then you don't need to reduce the shots. Just don't shoot any cycle earlier than about +11.5.

Since you are planning on a dose increase, then I think you are probably safe to shoot 2u tonight (late) and 2u tomorrow at 7 am, then if tomorrow night's shot is at +12 (7pm), that one can be raised to 2.25u. That essentially means you increased starting with tonight's dose because 2.25u less 10% is 2u.

If you do not have to shoot at +10 tomorrow am, and can move the shots slowly back to 7a/7p, then you can start with 2.25u tonight on the late shot - again, move the shot back over the weekend to 7a/p slowly.
 
Thanks for the advice-

Her am shot was at 6 and her pm shot will most likely be around 8- a +14 (it depends on when the teacher decides he's finished- usually 7:30 or so). Tomorrows am shot would be at 7- a +11 from the pm shot and the PM shot can be at +12 or 15 minutes shorter than +12 to start moving it back down to her normal 6/6 schedule- knowing it will jump back up next Thursday, and the next, and the next. But, if I have to increase that would be the perfect time to do it since Sundays are usually the only day I can get the nadir at all.

I only have one more month of school and no other really late nights besides that- I lead a pretty dull life- school, work, church :lol: . I've decided to not take a summer course so I can focus more on Sneakers.

so- 2u tonight's pm, 2u tomorrow am at +11, and 2.25u tomorrow pm
 
Sorry to get back to you so late - you are at school now, probably. That looks right and I am glad you understood my pre-coffee ramblings! :roll:

That plan sounds good.

Also, you should know and be prepared for some numbers wobble as you make these schedule changes. There is really no way to avoid it with a +14 shot and then and early, reduced shot. I suspect that she will get into a rhythm with it just about the time you are down with the late class.
 
I think you should consider increasing the dose to 2.5U. My reasons are from Tilly -
if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose).
Click to expand...

A lower dose would be 1U. I consider 2U a higher dose on Levemir because generally here we've seen cats need less than 2U. I also am suggesting the higher increase so we keep those nasty ketones away.

Although it's probably fine to increase by .25U, just keep in mind the 2-3 day timeline according to the above criteria.
 
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