? 2.25 Rufus AMPS 85, Half Dose, +1.5 98, +3 74, +7 109, PMPS 152, +2 111, +3.5 76, +4.5 115

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Sean & Rufus, Feb 25, 2018.

  1. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    Last edited: Feb 25, 2018
  2. Nan & Amber

    Nan & Amber Well-Known Member

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    Wow, what a wild ride you are having!!!

    When is your usual shot time by the clock?

    I think Sandy and Wendy mentioned the possibility of "draining the depot" with a reduced dose if it seems necessary. Throwing that out there now for consideration this morning, depending on where Rufus goes from here. Hoping others who have more experience in this kind of thing than I do will be around soon to discuss.

    He is looking amazing!
     
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  3. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Usually shoot 7:15ish. Gonna go retest him in a few min. If he's under 90. I'll skip right? But have to make a decision soon, because I have to do earlier shoots tonight and tomorrow am. Tomorrow have to give shot early and then leave and be gone for almost 12 hours :(
     
  4. Nan & Amber

    Nan & Amber Well-Known Member

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    How much do you have to shift the shots by tonight and tomorrow? Wondering if a full skip might be best in this case-- drains the depot and lets you get onto the schedule you want in one go.

    Can anyone check in on him while you're gone?
     
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  5. Nan & Amber

    Nan & Amber Well-Known Member

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    Any possibility of delaying your trip?
     
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  6. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ok, so did 2 retests. 85 and 83. And he won't eat his food. So, I guess no shot.

    I was going to shoot 7:15am, 7pm, and then 6:30am tomorrow. I can push the trip til tues or wed. Just am going to canada for insulin.
     
  7. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I hope this no shot doesn't cause his numbers to go high :nailbiting::nailbiting::nailbiting:
     
  8. Nan & Amber

    Nan & Amber Well-Known Member

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    He's still got the depot in play, that will help keep his numbers down (we hope! Rufus, I hope you are listening!).

    I'm a little concerned that he won't eat his food this morning. He has no history of ketones, correct? The last thing we want to do here is to trigger an episode of that by skipping a dose.
     
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  9. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ok. He ate a little deli turkey. Wonder if I should give him a half shot? Can it be later in the AM and then stick to my schedule??
     
  10. Sean & Rufus

    Sean & Rufus Well-Known Member

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    No, never ketones. Whenever I test the strip isn't clear though. Always looks between neg and trace. He did just eat a little turkey.
     
  11. Nan & Amber

    Nan & Amber Well-Known Member

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    If you are confident that he's going to eat (eventually), you could do the half shot. By the evening, time zones will be in your favor and some of the folks with more experience can advise you on the next steps. Rufus's rapid journey is a bit out of my league, I confess!

    The thing about changing shot times that you have to keep in mind is that shooting early can sometimes act like a dose increase (and shooting late a decrease). That's why we try to keep time changes to a minimum. That said, he'll have a wonky depot no matter what with the dose changes over the last few days-- this is kind of an unusual case.
     
  12. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ok, made him some new food. He's going to town on it. I think the new routine might have bothered him. Used to feed, then test. Today tested, 10 pokes. Waited 20 minutes, 10 pokes, and then feed. He might have just been showing his displeasure at the new sequence of events :)
     
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  13. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I know. I try to keep it around 7:15, but have gone 15 min early or late more then a few times. Hopefully it doesn't screw too much up.

    I think I'll give him 2.5u now
     
  14. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Up to 98
     
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  15. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Seriously, this is great numbers but what is going on? He had a 1/2 dose?! I suppose it depends on what the rest of the day goes like, but would I stick to the 4.5 tonight?
     
  16. Nan & Amber

    Nan & Amber Well-Known Member

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    Still could be depot talking, but wow! Rufus isn't slowing down! So amazing, the change in the numbers over just a few days.

    I don't know about the dose tonight, but it's sure looking to me as if the best move for your trip will probably be a no-shot-- with the way he's going, I wouldn't want to leave him for 12 hrs with new insulin on board.

    Let's see what the experts have to say about dose tonight, but depending on what he does the rest of the day I'd be inclined to go down again (testing ketones daily) if he were my cat.
     
  17. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Sounds good. I might drop him off at my parents house, but I don't know if my Dad would even recongize signs of hypo. And he won't test.
     
  18. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Well saw something out of Rufus that I haven't seen in many many many months today. Whenever I change my bed sheets and put the new ones on, Rufus would jump (or walk up the stairs) on the bed and go around in circles and jump around and bat around at my hands underneath the sheets and then he would be on his back and i'd tickle him. Did that today, so he must be feeling a little better :)
     
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  19. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Hi there :cool:

    Good call on the BCS this morning. Remember Lantus is slow acting - and you have the depot in play - the gift that keeps on giving. So you won’t see the effects of the reduced dose immediately.

    Let’s see how this cycle unfolds. That will help you determine the best strategy for when you are away.

    Go team Rufus!
     
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  20. Stacy & Asia

    Stacy & Asia Well-Known Member

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    How soon are you to run out of insulin? Any chance to postpone the trip? Between switching from kibble to low carb wet food and the dental...

    I don't want to get your hopes too high, but at the least he's looking like he won't be going through insulin as quickly as he was and he may just not need it much longer (anti-jinx)!
     
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  21. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Well he's still eating kibble, but it is low carb. I have a friend that lives in Canada and he already bought me 2 vials. I'm going to meet him just on our side of the border.

    That would be awesome if the 2 vials is too much, but too late now!
     
  22. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Negative ketones, didn't eat lunch. Gave him some turkey (his fav) and only ate some of it, did eat 4 treats though. I think it's the nausea still unfortunetley.
     
  23. Sean & Rufus

    Sean & Rufus Well-Known Member

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  24. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Looking great! That dental has done wonders for Rufus!
     
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  25. Sean & Rufus

    Sean & Rufus Well-Known Member

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    It really has! Numbers wise huge, but still working on other issues :)
     
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  26. Wendy&Neko

    Wendy&Neko Well-Known Member

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    That's the depot keeping the numbers down today. Chances are he'll keep going up until PMPS. One option is to shoot a lower dose tonight and tomorrow morning, that you know will keep him safe tomorrow. According to SLGS, his new official dose should be 4.25 units, even if the depot was in play last night. So you could try something like 3.5 tonight and tomorrow. He may run a little higher, but at least you know you'll be OK to go for your trip.
     
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  27. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Sounds good! Thank you! This .25 dosing is going to kill me, even on the half mark syringes it's hard for me to get at the half
     
  28. Sean & Rufus

    Sean & Rufus Well-Known Member

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    So I'm not trying to get ahead of myself and I'm going to knock on wood, but what are the chances of him ever going into remission do you think? Pancreatitis, dental, and steroids brought us here. He did have all the prerequisites for diabetes being male, overweight, neutered, and older. I know things can happen quickly, but when he was not eating well and we tried all these things to getting him feeling better he developed the diabetes in the process. He's obviously on a still high dose and who knows when are where the dosing will takes us but at this point I think he's still getting too much juice by the way he acts. Any stats out there that I am missing on remission rates?
     
  29. Wendy&Neko

    Wendy&Neko Well-Known Member

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    I don't predict remission. Regulation is the first step and a prerequisite. Focus on that first. Getting to regulation early on after the diagnosis does help.

    Acromegalic cats are usually male and short haired. My girl had long hair. ECID.
     
  30. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Sorry if this is dumb, but at what point do you consider regulated? When there are in blues and greens for a set amount of time without increases/decreases?
     
  31. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Tightly regulated is mostly below 100, but since you are following SLGS, that's not possible. There are varying definitions of regulated, but being mostly between 90 and 150 would be good for SLGS. And yes, on the same dose and for a week. If he keeps throwing you low numbers, then obviously you can't stay on the same dose. But a well regulated cat can still handle the odd low number and not bounce much at all.
     
  32. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ok. So it appears that we are close to being regulated hopefully. In regards to the 3.5 tonight and tomorrow am, do think there is a chance that this could throw him all off and there would be a chance it could take some time to get back to better numbers? I don't want to jeopardize the progress, but really need to go tomorrow, Tues, or Wed at the latest.

    Thanks again for all of your insight and help :)
     
  33. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ok nearing shot time and a little worried that if I give him 3 reduced shots I'll screw up his progress. I'm going to give 4.25u and see where that takes us in the am. If the numbers are above 100 I'll feel safe to give him full dose and go on trip.
     
  34. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Hi all-

    Sorry this is not in my condo...delete if need be :)

    I know someone showed a pic of .25 vs .5 in a syringe, I cannot find it now. Anyways, it's like a thin, thin line between the 2 on a syringe. How in the heck can you get an accurate .25? Also, these syringes I am using now that have .5 markings are acting weird. After I pull the plunger back while in the vial and fill to what I believe is what I need, I let go and the plunges pushes itself forward, to a little less then what I had pulled it to. Know what I mean?

    Any advice is appreciated :)
     
  35. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Eyeballing those tiny doses is tough. Many of us use calipers. See Marje's excellent discussion of using calipers to measure the dose: http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/

    It is always advisable to draw out a little more insulin into the syringe than you need. Then, pull the needle out of the vial and slowly twist the plunger until you reach your dose.
    Insulin syringes are often inaccurate: the zero line does not line up with the plastic disk at the top of the syringe; lines are crooked, etc. We all just have to try to be as consistent as we can. Total accuracy is almost impossible to achieve!

    The pictures you are looking for are in the "Sticky" Lantus and Levemir at the top of the forum:
    http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/

    Good luck!
     
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  36. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Thanks! I was shown an actual pic of syringe filled to a .25, so it wasn't those pics in the sticky. That .25 is so miniscule in the syringe, it is tough! I'll try our your tip for the slow twist tomorrow am :)
     
  37. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Keep in mind, too, that you cannot compare the dose lines on your syringes with the lines in the pictures unless they are the same brand as the one in the pictures. This is because some brands have a much skinnier barrel than others. A skinny barrel will be easier to eyeball because the lines are further apart. What brand of syringe are you using? Are you using U-100, 0.3mL syringes (for doses of 30 Units and lower)? Syringes for doses above 30 Units will have the lines impossibly close together.
     
  38. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Better safe than sorry. Due to the effects of the depot, it is better to start the reduction before the cycle you need him to be safe. Wore case, skip tomorrow morning. He will get back on track, no matter what you do.:bighug:
     
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  39. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Yes I am using U100, .3ml syringes. My half mark ones are carepoint vet brand. I really don't care for them. They are the ones that I have the plunger issue with. My full mark ones are Ulticare, I much prefer these ones and can get half dosing pretty good on these. Tonight was the first time doing a 4.25u dose.
     
  40. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Sorry I know that there isn't a for sure answer/number to this question....but if he is above 100 is a full dose ok? Or what number do you think is safe for a full dose. Sorry this is all kind of confusing, but I really am starting to understand it more and more each day. Sorry I didn't heed your advice from earlier. Just got worried after reading about someone else on here having big issues after a reduction and didn't wnat to screw things up.
     
  41. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    .25 unit.PNG

    It's not so important that you get an exact .25....just that you get what you think .25 is as consistently as possible
     
  42. Sean & Rufus

    Sean & Rufus Well-Known Member

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    That statement makes sense total sense!
     
  43. Wendy&Neko

    Wendy&Neko Well-Known Member

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    If following SLGS, the suggestion is not to shoot below 90, and you only do that when you have the data, are comfortable doing so and can monitor.

    No worries about giving the higher dose. You just might not get as much sleep tonight.
     
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  44. Sean & Rufus

    Sean & Rufus Well-Known Member

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    OK. So hypothetically if he is above 100 tomorrow morning and you were me you would.....
     
  45. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Depends what he does tonight. If you are worried, get a +11 and post for help
     
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  46. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Today's threads have been merged. :)
     
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  47. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Jan 10, 2018
    +3.5 76. So he's earned another reduction? He had a half shot this am, multiple reductions last few days! This is crazy.
     
  48. Wendy&Neko

    Wendy&Neko Well-Known Member

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    To answer your earlier question, I would skip tomorrow morning since you will be away and he's being unpredictable. You need to drain that depot more.

    Up Rufus!:eek:
     
  49. Sean & Rufus

    Sean & Rufus Well-Known Member

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    + 4.5. 115. I fed him at 3.5 and gave him 8 treats to get numbers up. Guess that worked!
     

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