Too low dose last night?

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Puddensmom

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Last night Pudden's PMPS was in the low 200s so I gave her .75 units instead of 1 unit. She stayed pretty flat all night and then shot up to 516 this morning. Should I have given the 1 unit last night? I am trying to get a feel for all of this. Hopefully I will get it soon!
 
I can understand your hesitation. I would have done the same thing, going into overnight It does look like the dose was low. That's what gathering data is about - next time you can try one unit . Nice pmps!
 
Thank you Sue! It was so exciting to see such a good number last night. It looks like we are finally getting some movement! Hopefully pretty soon I can get her to stay lower. I can't wait to see some blues!
 
You might look at a sliding scale, so giving less insulin at the lower ranges and more insulin at the higher ones. (This is an option for ProZinc) Let me see of Cindi @Merlin if she'd look at your SS and maybe give you a few parameters to start with. She is our math whiz and is great at sliding scales.

She may want some more data, especially overnight. If you could get a number before bed and then set the alarm for a nadir overnight (or if you are of a certain age, get a test when you are up anyway), that would be helpful.
 
Hello. Took a quick look at your SS before I have to leave today. We could probably start with something pretty general and small. I would have like to have seen lower nadirs but we can add a little more insulin to the scale. Overall, it does appear that you need to increase. Can you start doing that? Maybe a starting increase of 0.25u. As you collect more data i.e. your scale will need to be adjusted. First I have a few questions.

Is Pudden on PZI or Prozinc?

I am possibly seeing you stall when you get numbers like 223, 295 & 296 on 11/21, 11/23 & 11/14, respectively? Is this because you tested prior to your 12 hour schedule or you didn't want to shoot in the 200's? Let's not stall and go ahead and shoot when the number is above 200 and keep to a 12 hour schedule. At first, we do not want to have you start shooting under 200. This is the time when you want to stall, with no food and test again in 20-30 minutes. Then hopefully, you have a number at 200 or more, and you can feed and shoot.

On a positive note, it does look like Pudden is responding nicely to the insulin i.e. he is dropping very nicely to mid-cycle. Since we don't have any low pre-shot numbers to calculate, I am going to give you a starting dose. We don't know how he is going to respond but we need to see what he will do. So let's start with a small amount just to see how much he will drop. At the same time, when he is higher, I do believe he needs more insulin.

Are you able to test whenever you try out a new dose with a new number? With Prozinc, it is important to know the pre-shot AND nadir (mid-cycle) number. That is the only way we know if that dose is working.
 
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I was thinking Pudden may benefit from a sliding scale, but I had no idea how to do it. Some help with that would be wonderful! She was 200 at the vet today at 7+. I got a blue last night and was so excited! She is off the steroid now so I am going to be watching her numbers closely. Pudden is very stressed out lately and is suffering from stress induced bladder inflammation. I hope that isn't messing up her numbers at all. I am going to try wellness since it doesn't contain any fish. But she was never a fan of wellness before so we'll see how it goes.
 
Oops just posted at the same time! Pudden is on Prozinc. I was stalling since the pmps numbers were lower than the last tested number. I just wanted to make sure she wasn't still going down since she seems to go lower sometimes very late in the cycle. I work from home so I can always test on a new dose for sure.
 
I gave Pudden the 1.25 dose yesterday morning. She was at 465 and dropped down to 174 in 3 hours. She stayed in those blues a few more hours then started to go up.

Was that too fast of a drop? She has been in the 300s so I have been playing it safe and giving 1 unit again until I got a chance to ask what you guys think.

Edit: Also wanted to add today is exactly 1 week since Pudden has stopped oral steroids. It should be completely leaving her system now. I wish those amps and pmps numbers would go down some soon!

I hope everyone had a wonderful holiday!
 
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It was a big drop - we usually figure 50% is a nice average- but she didn't bounce super high from it, she didn't drop too low (she has room to be lower at nadir) so I think I'd continue with the 1.25 for the Reds. She could start dropping a little lower on her own with the steroids out of her system or you may want to increase the dose a smidge in a few cycles. I'd see how things look.
 
So maybe only give 1.25 if she is in the reds and 1.15 if she is in the purples? It does seem like she needs some kind of an increase since she keeps hanging on to those pre shot purples. Maybe 1.15 is the answer?
 
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