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  #131  
Old 10-11-2018, 01:37 PM
robl45 robl45 is offline
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Default Re: New member Snowball

Quote:
Originally Posted by RowansRys View Post
Posting from my car, so only time for the vet curve with the shot at the office- I think they told you to drop back after that because while the numbers “leveled off”, that first plunge down the hill was very long and very fast. 300 points in 2 hours is pretty insane. I would think that the leveling off after that was probably a combination of meal timing and protective measures from the body.
On the last curve at the office, she ate before going, there was no meal at the office.
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  #132  
Old 10-11-2018, 02:15 PM
robl45 robl45 is offline
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Default Re: New member Snowball

578 at 4pm.

so
630 314
10 197
12 401
2 489
4 578

Dog has had no treats today. She ate her one meal at 6:30 to 7am. I feel like a failure.
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  #133  
Old 10-11-2018, 02:45 PM
RowansRys RowansRys is offline
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Default Re: New member Snowball

I meant by meal timing that she was digesting enough at that point to have enough sugar going into her blood to balance the insulin so that’s why it evened out instead of dropping.

Though you don’t think so, today is probably our best data yet to base decisions on!! Getting her meals regular is so very important so that we can see what’s going on more clearly! I know how hard it is when you want to be able to give them treats and not feel so regimented, so you’redoing REALLY well (for reference, I’ve been a pet sitter for 19 years, so I’ve seen a lot of pet parents at not so fun moments. Deep breath, you’re doing much better than it feels.

Today’s numbers look to me like the best argument yet that she’s past her optimal dose and needs to have her insulin reduced, if you look how it dipped over the 3.5 hours (and we don’t know from that how low exactly), and then shot up past where it started. I would love to have someone weigh in who’s had the same issue to work with for the “now how do we fix it” part...

I may be able to do more research once I get fuel and get home and changed, I’m soaked to the skin with the hurricane remains hitting New England.
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  #134  
Old 10-11-2018, 05:43 PM
RowansRys RowansRys is offline
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Default Re: New member Snowball

Ok, I was reading around quickly and from the caninsulin uk site:
Hyperglycaemia due to a Somogyi effect can sometimes persist for as long as 3 days after a single hypoglycaemic episode. As a result blood glucose concentrations do not always normalise within a few days of lowering the insulin dose.
If the Somogyi effect is suspected, an alternative approach is to decrease the dose by 20% and closely observe the clinical signs. If signs of polyuria or polydipsia worsen a few days following the dose adjustment, it is unlikely that the Somogyi effect was the cause of the regulation problems. Conversely, if the polyuria and polydipsia disappear within a few days it is probable that the Somogyi effect was the cause.
Either of the following blood glucose curves indicate Somogyi effect:
  • Hypoglycaemia (low nadir) followed by rebound hyperglycaemia. [or BG dropped into actual hypoglycemic range, and then shot up high]
  • A rapid decrease in glycaemia with an adequte nadir followed by rebound hyperglycaemia. [Snowball's version- drops down quickly but to what looks like a "good" number, and then shoots way up again]
In this case, going from either the 3 units or 2.5 units you end up roughly at 2 units, so I would feel safe trying that amount if it were my kiddo. I do not know if it would be better to drop back to the 1.5 or not, but I would think 2 would be better than not changing. Please note above that her numbers WILL NOT immediately look perfect, or possibly very nice at all (I have looked many times at the tester screen with numbers in the 400's and 500's while we were figuring out Bean's dosage). But in this case, we need to get her to stop having large drops and then rebounding, before it turns into an all out hypoglycemic crisis. High sugar while being treated with insulin is far less dangerous than messing with hypoglycemia. So I think the only thing to do is grit your teeth through it, and do a full week at a lower number and see where she stabilizes with that, and then do a full curve and see what's going on before deciding to change anything at all.

That's my .05 (inflation, you know)
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  #135  
Old 10-12-2018, 04:36 AM
robl45 robl45 is offline
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Default Re: New member Snowball

At 6pm last night she was at 404.

This morning at 630am she is at 264 with 2 units given last night
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  #136  
Old 10-12-2018, 05:54 AM
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MikeMurphy MikeMurphy is offline
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Default Re: New member Snowball

Please remain at 2 units for 5 - 7 days so that her body can adjust to the change. Then you can do a 12 hour curve and evaluate the results. Depending on the results, you may need to drop another .5 units.

In the meantime, it would be good to spot test at fasting and possibly mid day.
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Lily is a 62 lb English Setter, born 07-27-2007.
Diabetes: Aug 2013 - Hypothyroid: Dec 2013 - Cataract Surgery: Feb 2014
Insulin: Novolin R/N mix - Meter: ReliOn Prime
Nulo Adult Trim Cod & Lentils, Pumpkin, FortiFlora, Dasuquin, Thyroxine

Last edited by MikeMurphy; 10-12-2018 at 06:09 AM.
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  #137  
Old 10-12-2018, 07:06 AM
robl45 robl45 is offline
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Default Re: New member Snowball

now 300 at 9am, still on 2 units.
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  #138  
Old 10-12-2018, 08:10 AM
RowansRys RowansRys is offline
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Default Re: New member Snowball

Excellent! The waiting is the hard part, doing something by carefully doing pretty much nothing....

This is looking very hopeful. If you compare it to 10/9, where she started in a similar place but had dropped down at 9am, and then went way up, it's much better looking that she's gone up very gently and doesn't appear to have triggered a rebound. Fingers crossed! First we wait for the curve to turn from mountains and valleys into gently rolling hills, and then see if the overall range needs to be adjusted at all in a week or so. Stay strong!
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  #139  
Old 10-12-2018, 09:26 AM
robl45 robl45 is offline
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Default Re: New member Snowball

337 at 11:25am
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  #140  
Old 10-12-2018, 11:17 AM
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jesse girl jesse girl is offline
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Default Re: New member Snowball

How is snowball feeling at these levels without it appears any big swings up or down

I try to correlate physical symptoms with specific levels i see with jesse at specific times . when she drops or spikes she gets a bit lethargic . Usually stable sugar without allot of movement she feels good and she doesnt have to be in the 100s . Just the other day she was acting like a puppy being very playful i went to test her thinking her numbers had to be very good and she was at 313

So you look for where snowball does better physically and try to correlate that to blood sugar and see if there is some kind of pattern . Sometimes you have to dig to see the pattern
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jesse-26 lbs - 14 years old - 8 years diabetic - one meal a day homemade and a vitabone snack - 3 shots of novolin a day sometimes novolog or r as a correction to higher sugar . total insulin for a 24 hour period is between 6 and 8 units of nph insulin depending on her fasting number
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