1/23 Yum PMPS+11 540 .25uR AMPS 588 9uL +2 506 +3 523 +5 486+8.5 573 PMPS587 9.5uL+3 477+5 411+7 412

Previous condo: http://www.felinediabetes.com/FDMB/...d-i-try-for-pinks-with-r.190020/#post-2116988

All black

 

Hang in there

Patience, perseverance and persistence will prevail.

 

Hugs

 

Lots of hugs from over this way too.

I’m so glad you were able to get the acro/IAA testing done and I hope it gives you some insight to sort Yum out.

 

It is frustrating to be stuck in blacks, we were in that same boat. One thing that really helped was looking at other high-dose kitty spreadsheets and seeing how they improved over time as you get closer and closer to the right dose. Take a peek at Black Kitty's SS if you haven't done so already, it really gave me peace of mind that better days are ahead.

 

When do you expect you might finish your current vial of Lantus and start a fresh one?

 

You think I should replace it? Because (a) it is bad or (b) because I should switch to Levemir?
(a) I do have the previous vial that I opened in October. Or I could just go out and get a new one.
(b) I worry about the late nadirs with Levemir, and learning a whole new pattern.

She did seem to respond to the increase to 9uL, but now the response might be fading.

 

Do you see any hint of "floaties"/"tiny particles"?
Is the insulin cloudy or discolored?
Is rubber stopper cracked?
Was it ever frozen? (this can happen if it’s touching the inside wall of your fridge).

If the answer to any of those questions is yes it’s time for a new vial. Otherwise carry on with the current one.
And no I don’t think you should switch to Lev at this time, unless Lantus is stinging Yum.

Sometimes a fresh vial has a bit more oomph - it’s just (one more) something to be mindful of when the time comes.

 

Finally a red.

If her current vial is bad, it must have been bad when I purchased it. I guess that is possible.
I worry if I buy a new one or go back to the old one and the current vial is bad, I will overdose her. Maybe I would have to take her back to 5 units.

 

Her current vial looks perfect. I do worry about them freezing. But the old ones pushed to the back aren't frozen. And they are always in a box or when in use in a box and a teacup. They never touch the wall completely.
I would run out immediately and get another vial except for the worry about overdosing her. I guess that's a stupid argument.

 

The old vial looks perfect too, but I don't know how they handled it at the vet.

 

Does it fit any of the criteria in my previous post? If not it’s likely fine.

When it comes close to time for you to start a new vial make sure and let us know. Depending when that is (which by the way you have not told me) a lot can change between now and then.

Stay focused on the here and now. One shot at a time, until the test results are back. You have some very experienced eyes and minds following Yum. We all want to see her safely arrive into better numbers.

 

Because her numbers started up before you changed vials, I don’t believe it is the insulin unless you can answer yes to some of Sandy’s questions about the vial/insulin.

I do think it is worth a discussion about switching to Levemir when you get closer to finishing with this vial; maybe a couple weeks out to give you time to ask questions and get the Lev if you decide to switch. I also worried about switching to Levemir based on the different curves (and I was working) but I was so glad I did. In fact, I wish I had started with Levemir and Gracie was always a very low dose kitty.

 

None of the criteria fit. I have a rule of 4 months for keeping a vial. However I never go that long because I usually rush out and get a new one the minute her BG rises. I only used her previous vial 2.5 months. This vial will probably run out in 30 days or less, if she continues to need 20 units or more a day. I wish I had alternated it with the old vial a few times before she shot up to all blacks and reds.

Thank you! As discussed yesterday, I am stopping the R for two cycles beginning tonight and increasing her tonight to 9.5uL. 10uL is very tempting of course, but it will be 9.5uL.

 

Now I think I will use her old vial tomorrow morning. The vet is just 15 minutes away. I can't stand wondering if I have a completely defective bottle. The old vial does have an expiration date of 2/18. That made me wonder if CVS was dumping old stock on my cat. The new bottle expires in 2019. I checked it before leaving the pharmacy.

 

Dose increase to 9.5uL and a red 477 at +3. Surprise.

 

And down to 411 without R! Good luck with the increase.

 

And still down at 412 at +7!!!
I won't try the old vial. This is a clear response to the increase!!!

 

Yay Yum!!! Congratulations! I am so happy she is seeing reds! Keep it up!!

 

it just goes to show you never can tell.