Re: Sissy's Mom
 

Re: Sissy's Mom
 

congratulations on a job well done

never thought you would be able to do it i was amazed when i was able to test anytime we needed to so uplifting and you are able to work on figuring things out and keeping your baby safe

curve looks good you got a spike at the end which is very common whether that is food and or insulin running out or a response from the body or insulin being overwhelmed that where you have to put the work in to figure

it does look like she is already rising into food and shot
the half hour later dose may contribute to that maybe from 50 to a 100 point additional rise but it might be helping with the second fasting that is much lower do to it being later and having more insulin in the system late to work with

i understand about giving a full dose at mealtime and if your baby is prone to throwing up that can be a problem but if not you could try the shot at mealtime it appears sissy is already on the rise at that time possibly indicating insulin is wearing out or overwhelmed before that 12 hour mark as you see from the spike which is very common it may lower the high fasting and may raise the lower fasting making it more even

Re: Sissy's Mom
 

Jesse,
Not quite understanding all u said, but will keep reading. I assume I should give regular dose tonite.I don't understand why she lowered at 6:00 test,just before supper. I'm sorry I'm such a dummy figuring this all out.:):)

Re: Sissy's Mom
 

She was just 349 after food. Gave her usual 6 1/2 u

Re: Sissy's Mom
 

So,should I expect Sissy to drop sooner tonite????

Re: Sissy's Mom
 

Not qualified to give advice or interpretation of curve but just wanted to congratulate you on managing to do a curve.

Yay;):D:cool:

Louise

Re: Sissy's Mom
 

Wow, lol,stressful day for both of us. Now,I'm more confused than before!!!!

Re: Sissy's Mom
 

giving the dose a half hour later after meal means you have that insulin working a half hour later into next fasting (before insulin is given ) possibly giving those lower numbers in the evening

giving the shot at mealtime may not completely fix things just lower things a bit at fasting and hopefully over time things will even out a bit more

my jesse always rose into fasting and still dose but not nearly as dramatic as she used to

now that you can do your own curves you can do more and compare and see how you want to proceed

Re: Sissy's Mom
 

Do you mean why is the 249 lower then the 318? Or do you mean she usually is higher at this time of day and the 249 is lower then she usually is at this time?

Re: Sissy's Mom
 

you would think she would run a bit lower tonight but this disease can give curve balls

i think if you can keep the numbers for the high in the 350s or lower that would be a big improvement and that may show giving the shot at mealtime maybe the best approach and the curve you posted it is appropriate to give at that time

now you can look at the curve you just did and just do a few checks for the next couple days maybe at fasting which most of us do on a daily basis and maybe that couple hours later to see how high sissy gets to see if there is an improvement dont expect it to be perfect you just looking for a bit of improvement

Re: Sissy's Mom
 

Why is it (249) lower than the 318 and yes, the 349 after food,before insulin is lower than she usually is after food.

Re: Sissy's Mom
 

It would be nice if you could get a flatter curve, but that depends on so many things. The two big ones are:
* How the dog uses the insulin, not all dogs process it the same
* What type of food is being fed

More insulin would probably lower the numbers overall. It might affect the overall curve, but probably not.

This being the first curve more will become apparent on future curves as you learn her trends.

My dog goes quite high after food due to RX enzymes for another condition. Due to that I use a fast acting insulin to take care of the food rise. Doing that takes a fair amount of testing, but that would be one way to even out the numbers if the trend turns out to be consistent.

For right now....if I were you;)....I would do an increase of 1/2 unit as I think the nadir has enough cushion for it. It is a good idea if possible to test the probable nadir after increases to see how low the dog is going during the nadir. Then I would curve again in 3 days.

Tara

Re: Sissy's Mom
 

Way to go on surviving your first curve! :)

Re: Sissy's Mom
 

1) think back over your day and see if she did anything at those times (exercise/excitement),that might have risen or lowered the numbers. In theory it could have gone like this:
* walk or visitor at the 349 raising the numbers
or
*walk or visitor at the 249 lowering the numbers

Hah, if you thought you were confused before:p
It can be fairly easy to figure out though as the trends and curves stack up.

If you can point to something like that happening around those times, particularly a walk, you could duplicate it, testing before the walk and after to see if she consistenlt raises or lowers with exercise/excitement.

2) the food rise isn't always consistent and this would be important to determine if you ever wanted to work with a fast acting insulin ( as referred to in earlier post). Do you weigh her food amounts? There are so many things that could be the cause for it being a bit lower, not to mention the inconsistent nature of the disease itself.

Tara

Re: Sissy's Mom
 

The 249 was lower than usual before food.the 349 was lower than usual after food!!!! We had a quiet day.I do not walk her,she just has a 30x 20 side yard.she doesnt run or play!! Lol never has,she is a pretty quiet girl:):) I will keep an eye on her tonite.would u continue with insulin 30 minutes after food??

Re: Sissy's Mom
 

Answers above in pretty blue color.:D

Re: Sissy's Mom
 

Lolol,this disease is like a puzzle missing a piece!!!! And we have to find the piece...;);) thank all of u for all ur knowledge. My comfort is that all of u were probably where I am,and with any luck,I will get to where u r :):):):):)

Re: Sissy's Mom
 

Think of the food and insulin like two racehorses at a starting gate. If you feed and wait to give the insulin it would be like allowing one horse to run but holding the other one back. The food will start to be processed and the insulin doesn't have time to catch up and the numbers go higher. But then, the food horse runs out of steam and then the insulin horse catches up later in the race, creating some lower numbers.

That 171 is not too low. Nothing in your curve would lead me to lower any dose. The change I would make is to give insulin immediately after food is consumed, and keep that consistent for 3-4 days then do another curve. If that curve still has higher numbers I would consult with the vet and raise the dose from 6.5 to 7, but only with vet approval.

Re: Sissy's Mom
 

Thank u all,lots of good helpful info. I know Sissy has room to go lower.I am processing sissys past and recent info!!!I need to focus on figuring her out. Hope we r getting closer!!:) more and more is making sense to me.!!

Re: Sissy's Mom
 

What does it mean when the glucose number goes lower the hour before food.is that because the insulin is done working or still working but food is gone????

Re: Sissy's Mom
 

Could still be some insulin in the system, and it doesn't have to be very much insulin if the meal stopped generating sugar quite a while ago.

Other things can drop blood sugar as well, such as activity, anxiety, excitement in a dog whose blood sugar system is very sensitive. Our dog's blood sugar used to drop like a rock any time he went to the vet even though he wasn't particularly stressed by vet visits.

There is also the mechanism in the liver that generates "basal" blood sugar - the sugar supplied to the body when the stomach is empty. If that's not functioning perfectly, the glucose level could go down.

All of which tells you to try not to lose sight of the forest among the trees. Trends and patterns are the important thing when making decisions about how to manage the blood sugar.

Quirky stuff happens all the time, in diabetics and in nondiabetics. The system in the body that produces insulin is exquisitely finetuned to deliver just the amount needed as needed. We try to replace that system with a couple of shots and consistent amounts of food. It's almost laughable, if you sit back and think about it practically, that it even has a prayer of working. And yet it does work, well enough that dogs can have a long healthy life with that basic replacement.

Natalie

Re: Sissy's Mom
 

Not necessarily. It is how your dog may use the insulin and the balance between insulin and food.

For example, the lowest number could be the fasting number (the number in which you get prior to food). After food, the BG levels could raise, and look more like a mountain shape curve, than a bowl shaped curve.

I would suspect that if the insulin was not working any longer, then the number would increase.

Barb

Re: Sissy's Mom
 

Remember we theorized that your dog is digesting more quickly? so that dip might be the Food racehorse giving out, while the insulin horse is still going, and this would be especially true if you're still delaying the shot.

My opinion (and it's only my opinion) is that you should be very precise about feeding and giving the shot right after food, then do another curve. I think taking out any delay variable will tell you how your dog processes both the food and insulin and will give you the best information to share with your vet before changing the dose.

Re: Sissy's Mom
 

It seems like Sissy is settling in with the novolin.with humilin she was always higher before food.now she is lower the last hr or so. Vet wants to bump her up to 7 units,and see if that brings down those 400"s. Then they want another curve next week. I talked about moving I.ailing time and using R. Not quite sure how R works,but they want me to try 7 units. If I backed up Insulin time, did u lower dose or leave the same?

Re: Sissy's Mom
 

Basal Bg is different from nadir????

Re: Sissy's Mom
 

Yes.

Nadir is the lowest blood sugar between meals and injections and is a function of how the dog's body processes the food and insulin. It can vary significantly from dog to dog.

Basal blood sugar is the blood sugar level maintained in the body 24 hours a day regardless of the food consumed.

The brain requires energy constantly. When the stomach is empty and isn't providing any sugar, stored sugar is released by the liver to maintain that "basal" blood sugar.

When you go to the doctor and have a fasting blood test, they are checking your basal blood sugar level.

Human diabetics typically use two types of insulins - a long acting insulin for that "basal" blood sugar. And the dosage of their long acting basal insulin varies rarely as it is affected by overall health, metabolism, etc.

Then they use a fast or faster acting insulin to cover sugar from meals and that dose is varied sometimes constantly based on what they are eating, how much they will eat at a meal, their activity level...

In dogs. we don't often use basal and "bolus" (meal) insulin because dogs process intermediate insulins like NPH fast enough that they often don't need faster acting insulin to cover their meals. Sometimes NPH alone can drop their blood sugar sharply within an hour of a meal and injection.

Consequently, it's generally not useful to constantly vary a dog's dose of insulin if they are NPH only. Because that one insulin is supplying a generally stable basal need plus a meal need.

Natalie

Re: Sissy's Mom
 

Lol,thank u. Makes sense:):)

Re: Sissy's Mom
 

What do you mean, if you backed up insulin time - meaning giving it with the food? If that's what you meant, then no, I would not lower the dose. I agree with your vet that you should try 7 units.

Re: Sissy's Mom
 

Yes,will start 7 units wed a.m. she has been getting lower every day. Today 200 or below since 11:30 this a.m. will see what she does tomarrow :). Still 400. 1-1 1/2 hrs after food!

Re: Sissy's Mom
 

Is there a adjustment period when u change insulin??? Every 12 hr period sissys #'s r going lower. Now she is in the mid (140) 100's.I'm going to wait to up her units until I see what she is doing!! She has been on novolin 8 days.

Re: Sissy's Mom
 

Yeah, sure. There can be an adjustment period. If she is throwing a lot of mid 100s, then your instinct to hold is good. When can you do another curve?

Can you post all the readings you're getting and the times?

Re: Sissy's Mom
 

How do u know I'd u have overlapping insulin and what do u do??? Sorry,stupid question!!!! #'s at food and insulin would be low right??:)

Re: Sissy's Mom
 

Not a lot of mid 100's,not that flat,but overall about 30 points lower each 12 hr period.last one was 195,206,218,140,200. Overall,coming down. Will see how she does today.

Re: Sissy's Mom
 

Yes, low at the time of the next food and shot may indicate some overlapping. But remember, your going to feed again right at that moment and if your dog metabolizes food quickly, the same dose of insulin may still be needed.

Are you giving the shot without delay now? :)

Btw, those numbers are pretty good. :)

Re: Sissy's Mom
 

I was concerned, with her numbers changing so the last few days,that if she went lower yet I might get in trouble,so have stayed with time.

Re: Sissy's Mom
 

some dogs it takes longer to see a long term response to insulin thats why we do not progress to quickly because you can easily pass the maintenance dose and create some real problems and its hard to get back to where you were at

so seeing the better level i would not raise the dose and do some additional testing to see if this is a true trend keeping in the back of your mind if you do see lower numbers you may have to reduce a bit

Re: Sissy's Mom
 

Thank u,thank u so much.I am going to wait a few more days where we r. If her numbers keep dropping hr 4-12, then how do u fix the food spike?? If need be and she keeps falling, I can always cut back.

Re: Sissy's Mom
 

You are the one with your dog, so you are in the best position to monitor and know what's going on.

My recommendation to close the gap between feeding and shot stands, however. Just based on the information you've posted, it's my view that the lower number before feeding is a direct result of the delay in the shot, as is the food spike after shot.

My opinions notwithstanding, you have good instincts and you are being very careful. So, trust yourself and do what you feel is best. :)

Re: Sissy's Mom
 

Thank u!!! I know I am cautious!! I am also emotionally tired.there is not a break and I don't want to make any mistakes . Sissy is so important to me. She owns a piece of my heart....lol,as all our pups do:):) I am checking at key points during day.will do another curve as soon as I see her settle a little????

Re: Sissy's Mom
 

sometimes it just takes time for things to settle your seeing some good numbers sissy isnt high all day and down the road a bit if the spike is consistent day in day out there maybe a couple things to reduce it you may not want to remove it entirely because it maybe needed my jesse spikes a bit after dinner and i am ok with that just so she does not stay high from it for the rest of the day it use to be the opposite so as you can see when you decide to do something you want to be sure you have good information before you do it

as cebe said you do have good instincts you can just tell from reading your post