Patty's Ali - my precious, beautiful angel

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Ali has had another 'low' day all day today. She's had snacks and honey both several times today. Her lowest was in the 80s and dropping. This morning she went from 232 to 105 in 3.5 hours and her next meal is usually at 4 hours. She seemed to have a lot more overlap going on. I've been giving her just over 7 1/2u (like 7 5/8).

I don't know if this trend is due to our food change or what. I finally spiked her tonight to 297. Normally I'd grumble I gave her too much, but it's nice to have her in a 'safe' zone and not dropping. I'll check her again before her shot and IF she's not dropping again I'm going to assume we don't have much overlap going on.

I don't like switching insulins at night without vet open, having to stay up to check her, etc. But I think I'm going to take advantage of her being higher and without as much overlap (hopefully) and switch her back to NPH tonight.

Because her insulin needs have been decreasing, I'm thinking of starting her at 6.5u instead of 7 units.

I have to say I'm a bit nervous. After the seizure she had in Aug, and my husband was here for backup when we switched to Lantus, I'm nervous this time around. Mainly because she's so unpredictable. And I don't know how this food will match up for her 2nd meal.

We'll find out. I supposed I'm as prepared as I can be.
Praying she doesn't drop before her shot time and it all goes well
Patty

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Well, she went from 157 at 3:30 to 297 at 5:00p to 281 at 6:20p. So I'd say we eliminated any overlap!

Because she's so high, I started with the 7u. I was mainly worried about overlap and starting so close to her Lantus dose.

[ladysmom06]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Hi Patty,

Sorry I don't have any advise for you but sending postive thoughts that you get it all sorted out. Hugs to you and Ali.

[ravenecw]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

I'm not sure what to say either other than I totally understand. I do hope you get it worked out, i'll be checking in on you.

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Well, on 7 units, Ali is returning to her preshot value 3 hours later (despite one scary morning drop), which is what she used to do most of the time prior to Lantus on 8-ish units. But she's been running higher in the 200-300s sometimes 400 because I'm tweaking the amount of lentils yet.

So this morning I bumped her up to 7 1/4u and she was 165 a half hour after her 2nd meal (4 1/2 hours later from 302 preshot). That's great but I have to laugh because I need to recondition myself not to get nervous with 'good numbers' again and not add anything. On the Lantus she just didn't stay there without continually feeding her.

I am testing her less than on the Lantus, which she and I both love.

[k9diabetes]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Maybe you can sleep through the night!

[CarolW]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

I'd be making an effort to determine the approximate peak times on NPH insulin, which, of course, would require a curve.

With Kumbi, who has been on Novolin NPH from the start, over 3 years ago, I omitted to read the package insert for some time! Not the greatest idea for omissions!

I found the kick-in time for Kumbi was much as indicated on the package insert - around 1.5 hours after injection. Peak time for the insulin seems to vary with the individual dog, and with Kumbi, it varies with him as well - but I attribute that to other daily events that affect BG levels, too.

In the end, after many curves, I found I could expect peak-time to be sometime from early afternoon (after a 7 a.m. injection) to just before Kumbi's supper (I feed at 6:30 a.m. and p.m.)

Somebody, I think you, Patti, mentioned the joys of less testing. I also think that using NPH insulin, providing the dog tolerates it well and derives benefit, seems to require less testing than if I were using Caninsulin (Vetsulin), where I'd probably be monitoring both fastings, maybe daily, and also sometime around Caninsulin's advertised peak-time - about 4 to 6 hours after injection.

Good luck on this change. It's obviously not easy, when you ARE tweaking the food at the same time!

I agree with Natalie - maybe you can sleep through the night.

Fri, 20 Nov 2009 00:17:52 (PST)

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Thanks Carol. The big benefit we have is having been on NPH before and knowing a little bit about how she uses it. Ali is a bit unpredictable and surprises me when I'm least expecting it. In the past her nadir has been around 7-8 hours post shot...but curves change with food changes.

I've been pleasantly surprised at how steady she's been in the afternoons. The lentils are really giving her the fiber I think she needs to carry her through. In the past she'd start dropping until shot time after several days of a new food.

Some of our numbers since figuring out the lentils. I'm giving her 3T with her 2nd meal during the day and 2T with 2nd meal at night (but weigh them so they come out the same each time):
11/15
301 - 6:22p fed 7 1/4u
304 - 9:30p
fed - 10:30p

11/16
302 - 6:40a fed 7 1/4 u
289 - 9:32a
177 - 10:40a fed
165 - 11:35a spot checking for nadir
191 - 2:44p
255 - 5:05p check after ride in car to post office

305 - 6:30p fed 7 1/4u
fed - 10:30p

11/17
284 - 6:40a fed 7 1/4u changed to a probiotic powder instead of capsule here
362 - 9:00a got a big rise
fed - 10:30a
268 - 11:00a

271 - 6:30p fed 7 1/4u
231 - 9:30p checked - stomach noises
fed - 10:30p
223 - 11:45p

11/18
247 - 6:30a fed 7 1/4u same probiotic powder
379 - 9:25a restless another big rise
11:00a fed a little later

316 - 6:20p fed 7 1/4u
226 - 10:08p
fed - 10:30p

11/19
293 - 6:40a fed 7 1/4u changed timing of probiotic powder to 2nd meal instead
202 - 10:40a fed didn't get big rise taking probiotic out of 1st meal, put probiotic powder here instead
198 - 12:30p checking for rise from probiotic
226 - 2:34p ride in car 3-4:30p

242 - 6:30p fed 7 1/4u
287 - 10:30p fed

11/20
379 - 6:15a fed increase insulin to a hair under 7 1/2
79 - 8:20a moving head around a bit, gave 2 larger drops honey, fed 2nd meal early
99 - 9:20a
179 - 10:20a
203 - 11:00a

I was surprised I didn't hear her stomach gurgling this morning. It usually does when she's dropping fast. 379 to 79 in 2 hours sets her up for rebound. On 11/13 she went from 347 at 6:40a to 84 at 10:30a on 7u. She wound up 446 that night. Today's cold and rainy here...she just wants to sleep...can't blame her

I've been thinking about adding a teaspoon of lentils to her morning meal or at least even an hour after her shot to try to stabilize her mornings.

I know it still looks like a lot of testing. Believe it or not we were having to test more on the Lantus because of late drops and overlap times. My goal is to get her down to 3-4x a day and reduce from there if she's doing well. I am sleeping better at night though! No more 2am meals. And she has free access to her dog door when I'm home from her 2nd meal until evening shot time and is staying steady now.
Patty

[k9diabetes]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

I need to get back and look at this in more detail but at quick glance it looks pretty good!

With a dog like Ali, three or four tests a day may need to be the norm. We tested Chris on average three times a day since he got four injections a day and then any other time we had reason for concern. The 4am feeding I was usually pretty willing to skip testing his blood sugar!

We tested him a minimum of three times a day every day for more almost four years and it never bothered him. When you have a dog who throws you low curve balls without warning or a dog who needs four injections a day, you do what you have to!

I only worry when a dog is pretty stable, at least not getting into dangerous low blood sugar, and is still being tested five or six times a day. At some point, there's no real useful information being generated.

But that's not Ali!

Natalie

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Thanks Natalie. We are going through a rough patch right now after that insulin increase and big drop.

11/20
379 - 6:15a fed increase insulin to a hair under 7 1/2
79 - 8:20a moving head around a bit, gave 2 larger drops honey, fed 2nd meal early
99 - 9:20a
179 - 10:20a
203 - 11:00a
430 - 5:00p

fed and 7 1/2u - early at 6:00p
450 - 8:30p
379 - 8:30p
293 - 9:44p
fed - 10:00p
379 - 2:46a out to potty, lip smacking

11/21
359 - 7:22a (I overslept! ugh) fed and 7 1/2u -
418 - 8:30a
410 - 10:20a

She's really sluggish and not feeling well.

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Ali is developing a nice pattern I'm happy to say. No big bg surprises in a while. I have increased her another 1/8u since she's been running in the 200s to low 300s the last week. May need to increase a bit more but I'm being cautious and going slow.

Last night we had our first real snow of the year and she was happy to play in it this morning.

Thought this action photo trying to catch her rope ball was funny (see Patty's Album)

[Margaret Boyle]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Ali is developing a nice pattern I'm happy to say. No big bg surprises in a while. I have increased her another 1/8u since she's been running in the 200s to low 300s the last week. May need to increase a bit more but I'm being cautious and going slow.

Last night we had our first real snow of the year and she was happy to play in it this morning.

Thought this action photo trying to catch her rope ball was funny (see Patty's Album)

Hi Patty,

Glad to hear you are having a good pattern with Ali, well done.

As we say a small step at a time.

Hugs

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

I did a full curve on Ali yesterday. Here are our results:

229 - 6:50am Fed 4.5oz Pheasant formula 7 1/2u
265 - 9:00
176 - 10:50 Fed 5.75oz Chicken formula
180 - 12:00p
209 - 1:00p
223 - 3:00p
219 - 5:00p

214 - 6:30p Fed 4.5oz 7 1/2u
202 - 8:30p
165 - 10:30 Fed 5.75oz
167 - 11:30
205 - 12:30a
267 - 3:30a

318 - 6:30am Fed 4.5oz 7 1/2u
336 - 9:02am out to play
273 - 10:50am Fed 5.75oz

She's rising quite a bit at night. From 165 to 318. She started well yesterday because she'd had some more activity the night before.

I was thinking since she didn't get the same rise in the evening as she did in the morning the first 4 hours, maybe I could shift 1/4 to 1/2oz of her food to the 1st meal. See how that looks, then maybe increase her insulin slightly.

I had to take out the lentils completely. She was getting almost 1/4cup during the day when we switched back and that was on 7 - 7 1/4u. Now she's not needing it. Could be the weather and less activity when it's cold and blustery out. Her weight is holding steady without them.

The chicken formula seems to have really helped though. She's turning back upward instead of falling or needing honey until next shot.

Patty

[ravenecw]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

I did a full curve on Ali yesterday. Here are our results:

229 - 6:50am Fed 4.5oz Pheasant formula 7 1/2u
265 - 9:00
176 - 10:50 Fed 5.75oz Chicken formula
180 - 12:00p
209 - 1:00p
223 - 3:00p
219 - 5:00p

214 - 6:30p Fed 4.5oz 7 1/2u
202 - 8:30p
165 - 10:30 Fed 5.75oz
167 - 11:30
205 - 12:30a
267 - 3:30a

318 - 6:30am Fed 4.5oz 7 1/2u
336 - 9:02am out to play
273 - 10:50am Fed 5.75oz

She's rising quite a bit at night. From 165 to 318. She started well yesterday because she'd had some more activity the night before.

I was thinking since she didn't get the same rise in the evening as she did in the morning the first 4 hours, maybe I could shift 1/4 to 1/2oz of her food to the 1st meal. See how that looks, then maybe increase her insulin slightly.

I had to take out the lentils completely. She was getting almost 1/4cup during the day when we switched back and that was on 7 - 7 1/4u. Now she's not needing it. Could be the weather and less activity when it's cold and blustery out. Her weight is holding steady without them.

The chicken formula seems to have really helped though. She's turning back upward instead of falling or needing honey until next shot.

Patty

I think these numbers look very good. It's nice to see numbers with some consistancy (trust me I know how that is ). Awesome Patty!

[Patty]

Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

I think these numbers look very good. It's nice to see numbers with some consistancy (trust me I know how that is ). Awesome Patty!

Thanks Eric. Love it when we get some consistancy!