Angel Piper.... October 31, 2015

[ceruleanblue]

Re: Piper

We did decide to go ahead and do a curve today. I will post the results later tonight (I would like to go longer than 12 hours just to see how she does during the evening), but so far, the numbers are pretty good. Still slightly high, but not too bad. I will call my vet tomorrow with the results and discuss adjusting her insulin dose.

[ceruleanblue]

Re: Piper

Here are the results of Piper's curve today:



Forgot to add in the image that our meter is the AT2. When we compared it with the vet's last time, it was very close to theirs.

I'm glad that I didn't go up to 18 units like the vet had said before. I think that that would have been a little too much. I think it would probably be okay to go up to 17.5, but I will call the vet tomorrow and discuss it with her. What do you guys think?

[Rubytuesday]

Re: Piper

You go girl! Look at that.

Not sure when you did the increase, but when you are getting this close it is good to let the dose settle in a bit longer. I probably wouldn't do an increase for about 2 weeks from the last increase too be sure you were catching it's full impact.

When you do increase you might even try doing a 1/4 unit increase.

Nicely done.

Tara

[ceruleanblue]

Re: Piper

She's been at 17 for a month, so the dose has had plenty of time to settle. How do you measure 1/4 units?

[Rubytuesday]

Re: Piper

When measuring such small amounts the most important thing is that whatever you do it is repeatable.

I use syringes that have a 1/2 unit markings. For a 17 1/4 dose I would look at the distance between the top of the 17 unit mark and the bottom of the 1/2 unit mark and put the bottom of the plunger equally between the two.....with a bright light and possibly a magnifying glass.

All you are really trying to do is ease her into a 17 1/2 a little slower just incase it is too much for her. So if you don't have 1/2 unit markings I would just measure up some water to practice. Then find a place on the syringe that is repeatable for you and isn't quite 17 1/2 and work with that.

Tara

[ceruleanblue]

Re: Piper

My syringes do have 1/2 unit marks. I knew (well, felt like) we were getting close to her right dose, so last time I ordered syringes, I got the 1/2 unit ones so we could increase in smaller increments, if needed. It looks like I'll definitely need a magnifying glass to measure 1/4 unit. I was surprised at how close the 1/2 and whole unit marks are!

I didn't change her dose this morning, and I'm waiting for the vet to call me back before I do.

[Rubytuesday]

Re: Piper

At one point Ruby was on levemir (4 x more potent then NPH) and she only gets one meal a day. Her non- meal insulin dose was .2,. I don't miss that stress!

Tara

[ceruleanblue]

Re: Piper

Wow! I'm kind of glad that Piper is a big dog, because those itty bitty doses I've seen some of you give would really stress me out!

[ceruleanblue]

Re: Piper

I just got off the phone with the vet. She wants us to go up to 18. She wants Piper in the 100-200 BG range, and said that even if her lowest number of the day were cut in half by the 1 unit increase, it'd still be 80, so it's probably safe. The thing is, compared to her last curve, it seems her numbers have come down by about 100 with the increase from 16 to 17. I'm not sure I'm comfortable with that yet. I still want to increase more slowly, and when I mentioned that, she suggested we just increase to 18 in the morning and still do 17 at night. I'm still not sure I like that idea, so I don't know what to do. We're also almost out of strips for the meter, so we'll have to wait til we can re-order them to do another curve. I don't have many left to last me the week, so I even have to be conservative with the spot checks. :-/

[Soaphie & Sydney's Mom]

Re: Piper

Hi!

Going to 18 would scare me as well. I think perhaps consider going up just 1/4 unit...you would have to eyeball it since the syringes don't have that marking - but I think it would be much safer.

The numbers you posted below are really quite good (yes - I'm jealous ).

Tami, Soaphie, Sydney

[ceruleanblue]

Re: Piper

I kinda feel bad about throwing out my vet's advice, and Piper may do okay on 18 units, but I'm just more comfortable with smaller increases at this point. I'm just going to go up 1/4. I only have 4 test strips left, but we should be able to order more on Friday. Her PM fasting seems to be the low point of the day, so would spot checking at that time be okay?

[Rubytuesday]

Re: Piper

Glad you will take it slow and trust your instincts. The numbers you posted aren't bad so there is time to take the safer route.

I would not be comfortable with a dog running an 80 at nadir. It doesn't leave enough of a cushion.

Yes, the PM fasting would be good to check.

Tara

[ceruleanblue]

Re: Piper

I would not be comfortable with it running that low either, and it could be even lower, considering the other night she tested at 140.

I got out the magnifying glass and tried I give myself a quarter unit mark for her dose in the morning. I guess I'll be aiming to have the plunger on that little orange spot.

[Rubytuesday]

Re: Piper

I use the absolute bottom of the plunger as my dose marker. So that would be where the bottom of the plunger meets the white of the insulin.
If you look at it that way you will probably have just a little bit of white (maybe the width of a thread) between the 17 mark and the bottom of the plunger. Like wise you will have about that much of the black from the plunger before it meets with the black of the 17 1/2 mark.

Remember though, you are in the ballpark. Just remember where you do it and do it the same each time.....and be sure the zero mark sits at the bottom of the syringe and not up a bit. Why isn't this better regulated is beyond me.

Tara

[Patty]

Re: Piper

Well, I was trying to edit your pic to show how I measure and the photo turned out smaller than I wanted:

Using this picture - When I measured 1/4u, I placed the top of the plunger between the 2 and 2 1/2u lines where the white arrow is. (As a guideline, the bottom of the plunger would just touch the 3u line and the center of the plunger would sit at the 2 1/2u line if that makes sense).

As Tara said though, you just want to find landmarks that make it repeatable for you.