Pm dose: 18u lantus and 0.25u R. Did my best to eyeball 0.25... looked and felt like nothing.
Shots given at 3:20pm. There was a knock at the door and the dog went nuts. Chuck hid where I can't reach him. I'm still limited on bending and twisting for 3 more weeks.
I don't expect 0.25 units R to do much at all. Comparing it to his lantus dose, just seems like it won't help.
BUT I've seen him go crazy with an extra drop of lantus so fingers crossed!
Do be careful with your back, Steph! You've been through enough with that already!
Was the 380 before he went into hiding? Or after he came back out again? Hopefully he'll stay nearby for a couple of hours now to make things easier on you.
+1 380 was after he came out from hiding. He hid for 15 mins after he ate for 5 minutes.
Must have been a sight for the fed ex guy. Seeing me walk to the door with two syringes in hand. I felt the need to explain it's only insulin for my cat. Heroin use runs rampant in my little town.
His +2 is 368 so he seems to be trying to surf which I'm happy to see.
I would get a +5 test to see if he's done working the R. Neko's R onset was later and it lasted later than +4. Let's see how the rest of the cycle goes before deciding any R dose changes.
I would skip R on the next cycle too. Some cats show an effect on the cycle following the one you use R.
While I'm at it, a few more guidelines for using/not using R:
Don't use R on a bounce breaking cycle.
Don't give R on the same cycle you do a L increase (some cats have a strong reaction in the first cycle of an increase).
Make sure you have a system in place to clearly separate the L and R insulins. Whether it's sticky notes, using R in vial and L in pens, tactile feel of the R container (rubber band), storing in different place in the fridge, etc.) There have been too many cases of people mixing up the doses. You DON'T want to shoot 18U or R. Double check each time you load the syringes.
Have a clear understanding of the R cycle timing and how it lays on top of the L cycle so you can avoid fast drops which cause yet another bounce. Once you've done that, then you can experiment with changing the dose.
Eventually you will want to build an R scale which tells you how much R to give based on BG test and time given in the cycle.
I'm keeping the R in the box it came in. DH doesn't really want to give R so skipping the next cycle works out for now.
Do I want to skip every other cycle, always? Or just until we get an idea of how he works it?
Can I shoot the R in the same area as lantus? Today I shot on the other side but in the same area I shoot lantus on that side.
Keeping R doses on pm cycle works best for now but eventually he will need it on the AM cycle too. That is usually hours higher cycle anyways.
I'm excited to see where he can go with R.
Impatient and greedy to keep him under 200 and not to increase lantus.
One vial only lasts 27 days at this point!
You want to shoot it in another area than the Lantus if I am remembering correctly. Good luck with the R. Sometimes the first time used you see little to no movement. Don't be discouraged.
Too funny about the FedEx guy and you with two syringes in hand at the door. I can just see you stammering trying to explain.
Thanks for the support and encouragement! Hopefully we will see his food spikes disappear least.
Trying to go to convince him to come out from under the chair now. He's on to my evil plan... Poke poke poke! Plenty of treats too. Not enough to change BG.
You don't have to use R every other cycle, just until you have a good idea of whether he's one of those that likes to show a reaction in the subsequent cycle. Sometimes that reaction is just from R lowering the numbers to a level that Lantus can do something with. Remember that if in doubt with R, just don't use it. That's never a wrong choice.
R should be shot in the scruff. I shot on the opposide side from the Lev.
As far as the poking goes, once you've done every hour the first few times, enough so that you can characterize the R onset and nadir, then you can ease off.
Out of curiosity, have you ever considered switching the Levemir? A lot of cats go flatter on Lev. And at larger doses of Lantus, it's acid base can sting. Though Stacy just found out Asia was noticing the sting at 1.25 units. ECID of course.
I shot the R in his shoulder area. I'll try the scruff next time. It's been so long it will be awkward!
That is really my plan with R. Get the numbers to stay near a number that the lantus can work it's magic on.
He's hit blue tonight! So I think the R will probably be a tool to keep him from spiking from food. If it works on one cycle... It might make the lantus last a little longer and have enough strength to hold down the next cycles food spike.
Makes sense in my head but he is a cat and he will cat how he sees fit!
So just from this cycle, it looks like 0.25R is enough to hold him steady around his preshot level if it's in the 300s. Then the lantus takes over at +5 or more likely +6 if comparing numbers to his preshot only. From hour to hour it looks more like a surf. He's under 200 and I'm very happy to see that even though you could argue that it very likely could be meter variance. I'm taking this as a win!
He didn't go down 100 points from R on this dose, but it might be a good start for a BG of 300. If you see a 350+, maybe you could try a .5U next time.
The fun thing about R is that sometimes it dosen't seem to do anything. But even preventing Chuck from going higher can be a win. But let's see what he does next cycle first.
He didn't go down 100 points from R on this dose, but it might be a good start for a BG of 300. If you see a 350+, maybe you could try a .5U next time.
Sounds like a good plan.
His +10 was 179.
We are skipping the R this morning and will try again tomorrow on his pm cycle.
If he's above 200 can I give R? I'll be home to monitor and steer if necessary.
Sorry I never answered this question. I have thought about Lev but at this point I get my lantus at a great price from a friend that is on it. Well I have been but recently their Dr changed their rx so they are getting less vials and Chuck's going through a vial in 27 days.
So if I need to start buying from Canada, I might see if my vet will prescribe lev. It will be a year on lantus on April 7th.
I want to give R a chance to see if it helps him breakthrough.
I'm taking this as a win! 
