Snowflake, day 2 after double dose mistake

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+1 251
+2 249
+2.5 221
+3.5 178
+4 166
+6 107
+11 102
+12.5 147
fed
+13 193

So now I wait? Since I'm already working from home, I think I'll test every 1/2 hour.
 
Well its good she's holding, I'd go ahead and shoot if it doesn't mess up your schedule, try something around .3 in my opinion. impressive that is all she rose with food, keep trying it every chance you get!
 
She still seems to be holding almost exactly where she was. I'm trying to stretch out the shots now since in a few days she'll only get one a day, so I think I'll wait until it rises more then 20 to shoot. At least she's out of the 300's :)
 
Well, at +15 she was 234 :( , so I just shot 0.3. She was sleeping during the last 4 or 5 tests, so the 35 jump came totally out of nowhere, which is why I shot.
 
Good decision to shoot when you did. That should stop her from going too high, and should get her to come down in an hour or two.

Carl
 
oh no. I wonder if i should've waited another hour or two? I hope she doesn't crash...

PS: 236
+0.5 266
+1.5 175
+2 169
+2.6 125
+3 130
+4 107
+5 105
+6 134
+7 181
+8 166

Does this look like her P kicked in and dropped it the almost 100 points or is this probably the insulin?
 
I think that's the insulin with maybe a little bit of help from Snowflake. :smile: It looks good so far, IMO.
Maybe a +3 will tell you more?

Carl
 
Don't worry too much, you've seen really low numbers before with no ill effect, you've got over 100 pints to go! Plus once we are under the half unit dose I don't worry so much, .3 is so little that a healthy cat will be fine. Looks good to me!
 
Okay, I updated it above and now at a little over 2.5, she's at 125. you're right that I've shot more than this into lower than that and she's been fine. I guess I'm just hyper aware of it now after last week.
 
You're good, things are different with your cat just because you have so much data for how she handles doses and low numbers. I think the.4 was a bit much, but hopefully this one will take her no lower than the 50s. If she gets really low she will get hungry and since you free feed she should take care of it herself, just stay with her normal food.
 
it was somewhere between 0.3 and 0.35, so for the sake of rounding I just said 0.3. At 3 she was 130. I'm going to skip testing 3.5 but I'll post what she is at +4.
 
at +4, she's back down to 107 :)

So now, I have the petsitter coming over tonight (in an hour and a half) to meet to discuss all of the details. I'm thinking I need to give her specific guidelines about what to shoot or not shoot or if I need to switch it and ask her to start coming twice a day.

I'm thinking that if she comes and she's 300-400, shoot 0.6, if she's 200 or less don't shoot, and if she's 200-300 shoot 0.4? I was thinking maybe 0.2 if she's 150-200, but that didn't seem to do anything, and 0.4 into 200 was too much. If she comes and she's above 400 two days in a row, then she needs to start coming twice a day to get things back down, in which case 0.4 twice a day, still with 200 as the no shoot? How does that sound to you guys?
 
Given what .3ish did tonight, I'd put the line at 250 for .4
< 200 no shot
200-250 .2
251-300 .4
300+ .6 ?

And yes, if she sees highs for 2 days in a row, twice a day would be a good idea. I'd keep the scale for the two-a-days also.
What's everyone else think?

How are the meals going to be dealt with? Is the sitter going to be putting out food twice a day? (probably already discussed in another thread...)

Carl
 
First of all, 105 at +5 so that's good, though I wish it would be a little lower.

My roommate will still be here, so she'll be feeding twice a day and the pet sitter is just coming to do the shot and scoop the poop. I'm going to train her on how to do blood tests, so she'll test then shoot, and she'll write down what she does in the notebook, and my roommate will email it to me.
 
Can your roommate post here if there's a crisis of some sort?

Carl
 
As much as I wish she were open to learning how to do the blood tests, she isn't. I just finished meeting with the pet sitter and I feel pretty confident that she'll do a good job. She's on the older side though, and doesn't do email, so I've asked her to write any notes in a notebook, and my roommate will email them to me, along with the blood sugar numbers and what she shot. She seemed agreeable to doing 2 shots per day if the numbers go up, and seemed to fully buy into the idea that testing is safer.

Also, at +6 she was 134, and now at +7 she's 181. However, the petsitter just left so that might have been an "excitement". I'm thinking the 0.3 may not have been quite enough since she never got lower than 105 during the day.
 
Probably could have gone .4 today, I'd try closer to.3 into a 200 but agree that higher in the mid yellows and rising needs more. Of course, this is still a nice cycle.your sensitivity earlier in the week may have been due to the double dose and you may be okay shooting like you used to, the thing is you don't know until you try.
 
Thanks for the advice about the pet sitter. I think that when I'm doing the shots, I'm going to nix the 0.3's and do a min of 0.4.

Here's an update to the day:
PS: 236
+0.5 266
+1.5 175
+2 169
+2.6 125
+3 130
+4 107
+5 105
+6 134
+7 181
+8 166
+9 179
+10 295--shooting 0.6 now
 
If you are just shooting once a day, probably okay. I would prefill syringes and leave them facing down in a glass in the fridge so there are no dosing errors while you are gone.
 
I like Carl's scale because it is safe, I would probably do a .3 at the bottom range but .2 is safer if you're concerned, I just don't know how much action you'll get out of it. While you're here though, I like the .3 for 200 just until we see if those couple of 30's from that dose were a fluke. I like the 0.6 into the 244, we'll see what it gives your for pmps tonight for basically a 300. 0.3 and 0.6 do leave you with a big spread in between, if it ends up that 0.3 into 200 isn't giving you the crazy drop anymore and 0.4 looks good again, that gives you a better scale. I would probably shoot the 0.4 into anything up to 240ish and then switch to the 0.6.
 
That is a fantastic idea about pre-filling the syringes. How far in advance can you do that? The lady is very nice and seems capable but is a bit on the older side, so I would strongly prefer that I do the needles in advance. I'll be gone for 9 days though--is that too far out to fill them? Do I just tell her to roll the needled around to "activate" the insulin?
 
Also, this morning at +10, she was 150. I was running late and had to go to work, so I didn't post or give her a shot, but I'll post what she is when I get home tonight at +21 (hopefully it isn't too crazy)
 
Do them whenever you need to, the rolling is to make sure the insulin in the vial is mixed and remains the same strength throughout it's usage. Once a dose is drawn you don't need to remix it while in the syringe because you will be shooting the whole amount.

I hope you get a nice surprise when you get home....
 
Well, I've just confirmed that the one shot a day will most certainly not work :\ Came home at +21.5 and she was 480, and they still hadn't eaten their breakfast (guess they've firmly told me they do NOT like EVO venison, sigh). I wonder if she went super low and then bounced due to not eating all day? Either way, once a day's not gonna fly :( So I fed and then gave her 0.6. I'm teaching my roommate how to do the blood test--it seems she's okay with learning how to do that, she's just really nervous about screwing up the shot. So that's one step better. Tonight I'm going to make up a bunch of 0.6 and 0.4 pre-filled needles, labeled carefully. So much to do and I still haven't packed!!
 
That is awesome! Well, not the number but the roomate! I was worried about trying to go 24, I mean I think you could get her where she had something below 350 after 24 but you'd have to shoot really heavy when you did shoot and I wouldn't recommend that with you not being there. Teach her how to post and we'll watch for her while you're gone!
 
Woke up to +11 450 so I immediately gave 0.6. I pre filled 18 needles at 0.4 and 9 at 0.6. I've been thinking about it, and if she (the petsitter) can't get a reading, I think I want to instruct her to feed and give 0.4. I think Snowflake's P has backed off a bit, and maybe some more regular 12/12 at 0.4 will be a good thing for it. Off to work now, but will be back home really quickly before leaving for the airport so if either of you have any last minute words of advice or actions to take, now's the time :)
 
Also, unfortunately I don't think my roommate will post here--she's quite busy with work and studying for the LSATs, however, she'll be emailing me with updates with the notes that the catsitter will leave, so I can still go on here and post any updates (oh the joys of technology).
 
If you get another red I would seriously think about shooting a 1u at it, see no reason for the high numbers, no bounce and it doesn't look like she went under 300 the last cycle. Hope she comes back down though.
 
yeah I just came home to test and she was 334 :( Looks like the 0.6 wasn't very effective. Think I'll add to the instructions that if she's above 400 to shoot 0.8. sigh.
 
Here's my take...

Snowflake got .6 on a 244 on the PMBG +10 4/23. Somewhere in the middle she saw "green" between that 107 and 102. The cycle ran a tad long, and you shot .35 the following night into basically the same number. She almost went green again, but shot up over 100 points in an hour before the 12 hours was up, right? That was the beginning of a bounce, from two green or almost green cycles in a row.
Now at the end of that cycle, seeing the 295, we figured "heck, .6 worked on the 244 a couple nights ago, how can it not work this time? The difference is, that you were probably shooting into a bounce rather than a "normal" BG rise.
The result was a super long cycle, and I'd bet the farm she saw green, maybe low green, in between the 150 and the ugly 480. I think the 480 was an additional bounce because the .6 was too much the night +11 before.
Today, high and flat, which also is symptomatic of a bounce that hasn't cleared yet.
The very good thing is that you have not shot more than .6 into either of the red numbers. Because if you did, you would be "shooting a bounce", and you would most likely just keep getting "repeat performances".

A "too high dose" can do one of three things. It can go normal duration, with a quick or really deep drop, causing liver panic and a follow up high PS. It can also have a "normal" drop, but the cycle can run really long before the climb to a high number all of a sudden. Or, it can do both at the same time. Too low and too long.

I think the .6 was too much into the 295 because the 295 was the start of a bounce. Also, the difference between .35 and .6 might seem like just a tiny amount, but it is almost twice as much insulin into a number that was only 25% higher than the number the .35 was shot into.

My advice, I guess, would be not to increase the dose due to the higher PS numbers. Let the bounces clear on their own. And I'd say shoot .4 into a 300, not anything more than .4. When the bouncing clears, you aren't likely to see many pink PS's, and I don't think you'll have to fret about 400s either.
I would prefill my syringes as follows:

.2 for a number between 225 and 300 (maybe 18 of them)
.4 for a number betwwen 301 and 399 (maybe 8 of them?)
.6 for a number over 400 (no more than 2 of them) If the sitter sees more than 2 PS's over 400, she can shoot a .2 and a .4 at the same time. I personally don't think it will come to that.

That's my thinking anyway.
Anybody else?

Carl
 
Even though the 0.2's seemed to do almost nothing??

In retrospect, maybe the 0.6 was too much--earlier on when I was initially figuring things out, I tried going as high as 0.8 and it only resulted in her getting higher numbers (as seen in the freestyle ss). Now I'll rush home and re-do the syringes, since I currently have 18 at 0.4, 9 at 0.6 and none anywhere lower.

I'm worried that she won't be able to figure out the blood testing, though, and I'll have to "pick" a number to just have her shoot every 12 hours.
 
okay, I didn't have time do make up a bunch more needles, but I changed the instructions. I have it as less than 200 no shoot, 200-350 0.4, and 350+ 0.6. When I got home today at +16 she was 145, so she's coming back to normal. blah, what a mess this all is. Thank you so much for all of the help.
 
The reason I went as low as .2 was that I was thinking "in your shoes" I guess. Just so you can enjoy your trip and not be worried every day/night about BG. I was thinking .2 might not do much, but it's better than nothing, and won't cause stress and worry half way around the world. :-D

Carl
 
equine99 said:
okay, I didn't have time do make up a bunch more needles, but I changed the instructions. I have it as less than 200 no shoot, 200-350 0.4, and 350+ 0.6. When I got home today at +16 she was 145, so she's coming back to normal. blah, what a mess this all is. Thank you so much for all of the help.
Click to expand...

But her last shot was at +8, right? So it's only 8 hours after her last dose? In that case, a 145 is great. It does indicate a late nadir, since she was at 334 just two hours ago by your SS. So in 4 more hours, she isn't likely to be too high.

Carl
 
Wait, I'm missing something...did you get a 300+ at +12 and not shoot and now she's 140ish at +16? If this is the case keep feeding and test, Mr. P may have come back.
 
Cathy,
The way I am reading it on the SS, the shot came at +8 today. The 330ish was 5 hours later, and the blue was at +8 from that last shot, so she should have 4 hours (from the time that was posted) till the next "shot time".

Carl
 
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