11/8 Ming PMPS = 448, +2 = 356, +4 = 239

Discussion in 'Lantus / Levemir / Biosimilars' started by Crista & Ming, Nov 8, 2018.

  1. Crista & Ming

    Crista & Ming Well-Known Member

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    Last edited: Nov 8, 2018
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  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    All I see over 7 cycles on this dose is one brief foray into mid upper blues and a whole lot of pink/red/worse. That tells me this 5,5 dose is too low. The goal should be a lot more blue and some green, ideally the majority of time under renal threshold. I would still think about that increase.

    How is Ming feeling today?
     
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  3. Crista & Ming

    Crista & Ming Well-Known Member

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    True. I was thinking at least holding the 5.5 u today since I really don’t want to bring him into work to monitor and going with the original plan to increase on Friday. Sandy suggested 0.25 u increase. What do you think?

    He’s much more energetic this morning. Ran downstairs to greet me and went out to the yard to walk around and survey his domain. Ate everything from last night and ate well this morning. He’s now lounging from this morning’s activities.
     
  4. Crista & Ming

    Crista & Ming Well-Known Member

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    And oops. I misremembered that last night’s cycle was actually #7 and not #6

    Also Wendy, still working on cleaning up Ming’s SS! Sorry about the delay.
     
    Last edited: Nov 8, 2018
  5. Olive & Paula

    Olive & Paula Well-Known Member

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  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    No worries about the SS, already easier to see. It’s just the last couple weeks that are the most important.

    It’s Ok per TR to hold a dose with blue for 8 cycles. And if it makes sense to do when you can monitor, all the better. Though not all cats respond to the first cycle of an increase.
     
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  7. Crista & Ming

    Crista & Ming Well-Known Member

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    I’ll see how this AM goes and if my sister will be home tonight. Mom can only stay up so long lol. If he’s bouncing then I don’t want to put him through another cycle of high numbers and will probably increase.

    0.25 u increase doesn’t sound “too much” so it does give me a bit more confidence with increasing even though it’s my sister monitoring. She’s doing a good job though. I was pleasantly surprised! When we got the blue number she said herself that she’ll test in an hour and wake up sometime later and test again.
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    I would save 0.25 unit increases for when you are just trying to fine tune a dose that is already seeing green. For Ming’s size of dose, over 5 units, and just seeing higher blues, I would go with a 0.5 unit increase.

    Good to see the backup tester, sis, is getting good instincts.
     
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  9. Crista & Ming

    Crista & Ming Well-Known Member

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    Ok! 0.5 units makes it easier to draw at least.
     
  10. Crista & Ming

    Crista & Ming Well-Known Member

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    Oh my lord.... I was just looking at the syringe... we’ve been giving Ming 6 units this whole time!! Jesus Christ... I’m glad I didn’t make this mistake at work with a patient. Both my mom and I gave 6 units. So the dose was consistent. She sent me a photo last night asking if it was 5.5 units and it was at the 6 mark now that I look at it.

    I feel so stupid. :banghead::banghead::banghead: I completely disregarded the other markings on the other side of the syringe and I didn’t think to count.
     
  11. Crista & Ming

    Crista & Ming Well-Known Member

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  12. Crista & Ming

    Crista & Ming Well-Known Member

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    Nevermind, my mom gave 5.5 units last night. I’ve been giving 6.

    WELL IVE SCREWED THIS UP MAJORLY

    Sigh... would it still be okay to increase to 6.5?

    I’m also starting to doubt myself if I gave 5.5 or 6. I’m pretty sure I gave 6. :banghead::banghead::mad::mad:

    Edit: ok I’m positive I gave 6. We wouldn’t be “starting over” if we count last night’s dose as 5.5, would we?
     
    Last edited: Nov 8, 2018
  13. Crista & Ming

    Crista & Ming Well-Known Member

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    +2 = 320. Is this bouncing? Or could the last (reduced) dose just be wearing off?

    I most likely will keep with 6 units tonight because of my screw up. :( Thoughts?
     
  14. Bellasmom

    Bellasmom Well-Known Member

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    Get out of the trees Ming:bighug::bighug: beach is much more fun
     
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  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Could you update the SS to reflect what you think was really done?
     
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  16. Crista & Ming

    Crista & Ming Well-Known Member

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    Yes I have done that.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Looks like it was just a one time 5.5 in there, but you did get six cycles in a row at 6.0 and that only got you to blue. Last night's cycle was influenced by the 6 unit depot. And still only blues.

    When are you off again? Just wondering if that's a factor in when to increase to 6.5 units.

    BTW, with multiple people giving a dose, there are a couple of tricks that can help with consistency. One is to take used syringe and fill it with coloured liquid such as tea or juice, and set it to the correct dose. That is the reference syringe that you check against before shooting. Also a good trick when you have strangers such as petsitters doing the shot. The second method is using digital calipers. More a technique for smaller doses, but I found it helpful with DH also dosing.
     
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  18. Crista & Ming

    Crista & Ming Well-Known Member

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    I’m off tomorrow morning. So I have a shift tonight but when I come home on Friday AM, I can monitor the increase.

    And oooo I like the tea/coloured liquid idea.
     
  19. Crista & Ming

    Crista & Ming Well-Known Member

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    spec fPL came back normal at 2.5. He was at 1 two weeks ago. I have to look at this blood again in better light, but I think it looks less pink. It might actually have been from the HC feast that his blood was so fatty... maybe?

    +8.5 = 563!!!!

    I gave him 100 mL SQ fluids. Missed his pee again. He's eating well but sleeping the whole day - probably from going high.

    My sister hasn't replied yet if she can monitor him
     
  20. Crista & Ming

    Crista & Ming Well-Known Member

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    My sister can’t monitor tonight. The most my mom can do is a +2. I’ll stick to increasing tomorrow AM unless someone has thoughts that make me feel ok with an increase tonight :smuggrin:

    I do hope he repeats what happened last night though.
     
  21. Crista & Ming

    Crista & Ming Well-Known Member

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    He woke up when I woke up and started following me around while I got ready for work. Then we played and he asked for food. He’s acting good and normal. I guess he just wanted to stay in bed with me this whole morning and afternoon.

    Edit: oh yaaaa his blood is back to normal colour!
     
    Last edited: Nov 8, 2018
  22. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    It’s fine to wait another cycle for the increase. And a big YES for normal blood. Never seen that before, very odd.

    Down Ming, easy now.
     
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  23. Crista & Ming

    Crista & Ming Well-Known Member

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    PMPS = 448 and +2 = 356

    Don't think anyone can stay up tonight with him. So we're putting down his regular FF LC with a tsp of gravy.
     
  24. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    +4 = 239

    We decided not to add gravy and just give him his regular food. :)
     

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