? 5/1 Asia AMPS 407,+5 212, +9 130, PMPS 321 R question

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Stacy & Asia

Stacy & Asia

Member Since 2017
http://www.felinediabetes.com/FDMB/threads/4-29-asia-amps-128-3-92-4-60.194856/

Still on the crazy bounce train, really getting distressed over these super high am numbers, I just don’t know what to do differently. I’ve thought about trying R, but it scares me because from what I’ve seen, the dose is so much smaller in relation to the L dose and considering how small a dose of Lev Asia is on right now, I can only assume even a drop of R would be way too much? She needs something, sometimes to carry her through PMPS +9ish until a couple hours post AMPS. I just don’t know what to do, that’s how humans clear their spikes (but they aren’t dealing in microdosing for the most part) and cat info outside of FDMB is so sparse, I can’t figure anything I haven’t tried to stop this from happening! ...and I know a lot of her middle numbers look good, but nobody can tell me it’s not hurting her to have hours of pinks/reds even black most days these days. :(

I’m trying to be patient with the antibiotics and getting through this heart echo and perhaps heart meds and see if that changes anything. Once the dust settles from all that, I may bite the bullet and try TID, likely very briefly, just to see if it makes much of a difference. The SSs I’ve seen already haven’t inspired me much to think it will look much different and the payoff would need to be significant to put in the amount of effort required to keep up with that schedule. If it works for her, fabulous, I will do it, I will figure something out, but it really would need to work and for that I am not very hopeful.

So tomorrow is the heart echo. Asia gets to have a train ride over to the clinic that will allow me to be in the room with her. Thanks again and always @Love-Paula aka Woodsywife this wouldn’t be happening without you! I’m not nervous, I’m just focused on getting her there and having it done. I’m sure I will have a good cry over the results after what needs to happen happens, but I’m pretty cool about everything until my brain says I can relax. I liked @Tasha & Darwin ’s results, if in name only, something called “subclinical” seems like a fair enough diagnosis to hope for since I’m almost certain “her heart looks perfect” is not going to be the finding. ;)
 
Stacy & Asia said:
I’ve thought about trying R, but it scares me because from what I’ve seen, the dose is so much smaller in relation to the L dose and considering how small a dose of Lev Asia is on right now, I can only assume even a drop of R would be way too much?
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Hmm, the R dose is not relative to the size of the L dose. The size of the L dose shouldn't matter. Perhaps your conclusion is based on the fact that many/most using R in this forum have kitties with high dose conditions??? FWIW, I've administered 0.1u R when Alex's Lev dose was small as 0.25 unit... no high dose condition.
Stacy & Asia said:
I may bite the bullet and try TID, likely very briefly, just to see if it makes much of a difference.
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If you don't try it at some point, you'll always wonder...
Stacy & Asia said:
So tomorrow is the heart echo.
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I'll be thinking of you and wishing for the best possible outcome.
:bighug: :bighug: :bighug:
 
Jill & Alex (GA) said:
Hmm, the R dose is not relative to the size of the L dose. The size of the L dose shouldn't matter. Perhaps your conclusion is based on the fact that many/most using R in this forum have kitties with high dose conditions??? FWIW, I've administered 0.1u R when Alex's Lev dose was small as 0.25 unit... no high dose condition.
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That is exactly why I thought that, so it’s not relative to the dose of L at all? Next question, it often creates more bouncing? Or not so? Is this because if you have a bouncy cat or because the drop happens too fast and causes another bounce?

Jill & Alex (GA) said:
If you don't try it at some point, you'll always wonder...
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My husband is an engineer, and he said the same thing or rather he said “just do it, she’s not those other cats”, after I gave a long list of reasons why, in theory, it probably won’t work. :p He seems to think it should work, but I thought the same way he did until I looked at other TID SSs. But he also didn’t understand that I couldn’t shoot the 12 hour dose every 8 even if I wanted to and if the dose was lower, so likely would the duration be (for Asia). I told him you just can’t give too much, it doesn’t work like that, you can give a little more than enough, but that’s about it.

Jill & Alex (GA) said:
I'll be thinking of you and wishing for the best possible outcome.
:bighug: :bighug: :bighug:
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Thanks! :) :bighug:
 
Bobbie And Bubba said:
Good luck tomorrow with the heart echo, Stacy, and keep us posted.

Maybe some NDW tonight since you raised him a bit last night.
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Very much so, but it’s been a new trend that she bounces high and regularly for one reason or another. She was bouncing in the high blues or low yellows, just a short time back. I don’t understand it. :blackeye:
 
Stacy & Asia said:
Very much so, but it’s been a new trend that she bounces high and regularly for one reason or another. She was bouncing in the high blues or low yellows, just a short time back. I don’t understand it. :blackeye:
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Maybe she is picking up on Momma's stress about the cardio visit tomorrow? My guys are like super sleuths with that sort of thing.
 
Bobbie And Bubba said:
Maybe she is picking up on Momma's stress about the cardio visit tomorrow? My guys are like super sleuths with that sort of thing.
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Nah, I’m seriously not stressed about it at all. I was stressed about finding a way to get it done and have me be in the room, but the meltdowns and stress come after the results and hard work is done! ;)
 
Stacy & Asia said:
Nah, I’m seriously not stressed about it at all. I was stressed about finding a way to get it done and have me be in the room, but the meltdowns and stress come after the results and hard work is done! ;)
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I am so glad. I wish I could be a cool cucumber like you.

Another thought other than NDW, is that 2 days ago, she spent the most time she has in greens since the 25th. Maybe a bit more of liver panic?
 
Stacy & Asia said:
That is exactly why I thought that, so it’s not relative to the dose of L at all?
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Nope.
Stacy & Asia said:
Next question, it often creates more bouncing? Or not so? Is this because if you have a bouncy cat or because the drop happens too fast and causes another bounce?
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It can create more bouncing if the R dose is too high. You'll be looking for a 100 point drop maximum from the R so you don't create another bounce. You can also create a bounce if the R dose is administered at the wrong time. You definitely don't want the R and L to nadir at the same time. That could cause kitty to drop hard and fast.

Basically at the beginning of the cycle, I would try to have the R cycle wearing off as the L cycle kicked in . I gave R after nadir as soon as I saw the rise (bounce). In the latter, I would make sure I gave R in plenty of time to have it waning by the onset of the next shot.

When numbers are very high and flat (> 300), R can be given just about any time during the cycle without worrying about creating another bounce UNLESS the bounce is due to clear that cycle.
 
Best Of Luck tomorrow for the echo. I remember the cardiologist saying to me "If I had a 20 year old cat with that heart, I would be a happy man." I wish you the same.
I used to give J.D. micro doses of R. It was super tricky. Sometimes it worked and sometimes it seemed to not. Just remember the cycle after the dose of R might be affected.
 
Dyana said:
Best Of Luck tomorrow for the echo. I remember the cardiologist saying to me "If I had a 20 year old cat with that heart, I would be a happy man." I wish you the same.
I used to give J.D. micro doses of R. It was super tricky. Sometimes it worked and sometimes it seemed to not. Just remember the cycle after the dose of R might be affected.
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That would be great news to hear! I can only expect so much at her age, but it’s all hit me hard because outside of a UTI last year, arthritis, and her previously very stable CKD, she has been right as rain up until the diabetes diagnosis, then everything seemed to start crashing down. Which is why I’m such a freak about these higher numbers, she doesn’t need help falling apart and I think diabetes majorly contributed, if not directly caused most of damage that has been done since September. :(

I’m super afraid of R, but I was super afraid of the L’s too before I used them and understood them better. Just another thing I’m mulling as possibility if this keeps up. Did you find it helpful when it was all said and done, or do you think it was more trouble than it was worth?
 
We used R too when Bubba was throwing ketones. He was at 3.5 dose on 12.13.15 when we started the R. I don't know if we could have ever gotten him lower with out it. It d0es require peeps to understand when and how much to give. Get through tomorrow and see what happens.

Fingers and Paws crossed. :bighug::bighug::bighug::bighug:
 
Bobbie And Bubba said:
We used R too when Bubba was throwing ketones. He was at 3.5 dose on 12.13.15 when we started the R. I don't know if we could have ever gotten him lower with out it. It d0es require peeps to understand when and how much to give. Get through tomorrow and see what happens.

Fingers and Paws crossed. :bighug::bighug::bighug::bighug:
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Yeah, believe me, I’m not looking forward to trying any of these things, I just want to help her. There are things diabetes can do to humans that requires years of euglycemic numbers to undo, I couldn’t even dream for that, I just want to stop the leak, so to speak. I wish Asia would just read the TR protocol and do what it says she should do! :rolleyes:
 
Interesting discussion today on R.

I also administered tiny bits of R when Neko's Lev dose was as small as 0.25 units. Not exactly sure what the L dose was - it was under the zero lines on the BD's but I called it something more. The name didn't matter - I used calipers. But Neko did have a high dose condition, actually 2 of them. However, that tiny bits of R ( 2 drops) would have done nothing when she was at a higher dose. Neko's R scale came down as her Lev dose came down. Over 5 units Lev she needed 0.5 units R to do the same job that 2 drops did at her smallest dose.

A lot about R is ECID. That's why we get people to start low doses of R, with an experienced R person around at the time, and test a lot to gather data. The amount of R one cat needs can be completely different from what another needs, even if two cats were on the same L dose.
Stacy & Asia said:
Did you find it helpful when it was all said and done, or do you think it was more trouble than it was worth?
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Absolutely helpful. Even though the IM vet said not to worry about high numbers and her kidneys, as long as it wasn't prolonged high numbers, I worried. Which reminds of the most important part of using R, learning when not to use it. You do have to be very careful with cats that get over bounces quickly. Big drops (compounded if using R at the wrong time) can sometimes make worse bounces that those from lower numbers. When in doubt, skip the R.

You and Asia will be in my thoughts tomorrow. :bighug: I was relieved when the echo was done. Knowing what or not you are dealing with was a relief.
 
Sending vines for you and Asia for tomorrow!! :bighug::bighug::bighug: I only gave Phoebe 3 doses of R before we started going back down the ladder. From 24 to 3units, smh in amazement.
 
Sending you heaps and heaps of vines for Asia's echo tomorrow - I have continued to have you in my thoughts, and crossing all limbs that you get some answers that are helpful, but not too difficult to hear! Lots of hugs :bighug::bighug::bighug:
 
Wendy&Neko said:
Absolutely helpful. Even though the IM vet said not to worry about high numbers and her kidneys, as long as it wasn't prolonged high numbers, I worried. Which reminds of the most important part of using R, learning when not to use it. You do have to be very careful with cats that get over bounces quickly. Big drops (compounded if using R at the wrong time) can sometimes make worse bounces that those from lower numbers. When in doubt, skip the R.
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I worry about that too, I look at it like drops in a bucket, sure the bucket will fill up faster if you have a lot to put in it at once, but a couple scoops a day will eventually fill it too. Nobody knows the tipping point and I do not think it has to be prolonged to do damage. Slow boil or fast boil, if the water is boiling it’s the exact same temperature however you got there. It would be like saying if you only smoke 2 cigarettes a day as opposed to 20 you won’t get lung cancer.

I think I would mostly want to use it around +9/+10/+11 in the pm or occasionally am cycle, only if necessary. I don’t think I’d ever give the same time as Lev, she is very good at slamming down quickly from a high number when she wants to...or not. Also, her onset and nadir can vary depending if it’s a jump in to lime green or a slow, smooth cycle. Way too unpredictable to use there. A lot of the SS I am seeing with R are at the beginning of a cycle leading up to onset or on a big bounce cycle. Do you know of any SSs I can look at where it is used to bridge the gap of one cycle to the next or to stave off dawn phenomenon or whatever it is Asia is dealing with that gives these black eyes in the AMPS?

Does it seem to work differently depending on where you give it in the L cycle? Like if the numbers are rising at the end of the cycle, maybe they keep doing so but don’t get as high as they would, as opposed to it actually bringing the numbers down like perhaps at the beginning of a cycle? Or is it just fairly unpredictable? Is onset and duration fairly consistent and/or loosely related to how large or small the R dose is?

Thanks for your well wishes, and it will be a relief to know vs not knowing. It’s going to be a long day, I’m assuming roughly an hour there door to door, waiting once we get there, an echo, a vet visit, and then an hour back. My biggest concern actually is if she has to use the bathroom. She will hold it in without a litter box because she quite dignified that way and I don’t want her to hurt herself doing that.
 
I just looked at Asia's SS: wow! What a colour wheel she's using there. Oh Stacy, this must be so frustrating for you. I know that the people here will help you find some way through this, though.

I love that Asia is such a dignified lady! Could the vet give you a litterbox and some private space so she could try to use it before you head home at least? :rolleyes: What a sweetheart she is...
 
Girlie's mom said:
I just looked at Asia's SS: wow! What a colour wheel she's using there. Oh Stacy, this must be so frustrating for you. I know that the people here will help you find some way through this, though.

I love that Asia is such a dignified lady! Could the vet give you a litterbox and some private space so she could try to use it before you head home at least? :rolleyes: What a sweetheart she is...
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Yes, I don’t know what is happening, she just turned on a dime and started doing this skittles advert some weeks ago. :rolleyes: It could be related to this UTI/antibiotics, her heart, who knows what, but I don’t need to know exactly why, I just need to do something about it to support the rest of her parts in the meantime. I know you’ve been there with Girlie. It isn’t fun to feel so powerless.

I’m hoping they have a litter tray she can use, I’m certainly going to ask. That’s why her pee pee pants episodes were so concerning, if she could at all help herself...she would never do that on purpose.
 
Salut @Stacy & Asia! Désolée de te répondre en français, j’allais me coucher et je suis vraiment trop fatiguée pour traduire correctement.
R a un nadir entre 1 3h PS, et une action maximale de 5h.
Je l’ai utilisée en cas de rebond pour Dagobah, mais aussi pour Nikita. Généralement 0,1u suffisaient pour abaisser leur glycémie en attendant que L prenne le relai. Je pense que ponctuellement avec une surveillance un peu plus poussée que d’habitude ça devrait se passer sans souci!
J’espère avoir pu t’aider à prendre une décision, et je te souhaite bon courage (et un p’tit câlin pour Asia ;-) )

(@Stephanie & Quintus, si tu a si le temps de traduire c’est super, sinon je m’en occupe après voir récupéré un peu)
 
Marie Dagobah&Nikita said:
Salut @Stacy & Asia! Désolée de te répondre en français, j’allais me coucher et je suis vraiment trop fatiguée pour traduire correctement.
R a un nadir entre 1 3h PS, et une action maximale de 5h.
Je l’ai utilisée en cas de rebond pour Dagobah, mais aussi pour Nikita. Généralement 0,1u suffisaient pour abaisser leur glycémie en attendant que L prenne le relai. Je pense que ponctuellement avec une surveillance un peu plus poussée que d’habitude ça devrait se passer sans souci!
J’espère avoir pu t’aider à prendre une décision, et je te souhaite bon courage (et un p’tit câlin pour Asia ;-) )

(@Stephanie & Quintus, si tu a si le temps de traduire c’est super, sinon je m’en occupe après voir récupéré un peu)
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Translating and summarising, Marie was too tired to translate correctly. When she used R, she noted a nadir between +1 and +3, and maximum action of 5 hours. She used it when Dagobah was bouncing, and also Nikita. Usually 0.1ui were enough to keep them down until L kicked in. She says that with good monitoring it should not be a problem, and hopes this info can contribute to helping you make a decision. She sends courage and scritches to Asia.
 
I hope it is all good news with the Echo. Thinking of both of you. You've gotten some great advice on R insulin. I used it as well and it was a great tool to have in the toolkit. Like Wendy mentioned, learning when not to use it can be more important then when to use it.

I was taught that the R insulin is better at lowering numbers while the Lev is better at keeping the numbers down. It made for a good combination but it did make the FD dance a bit more challenging. Given that, I would use it again without hesitation. Sandy helped a lot when I dipped my toes in the R waters and due to the experience from the group it was completely uneventful. Just like L insulins, you slowly increase the dose until you get the action you want.

Having a set date to start lets some of the R veterans keep an eye on Asia to make sure she has an overall good reaction to it with no major surprises. As long as you can be around to monitor I think giving it a shot (lol) is a good experiment.

Paws crossed for good test results.
 
saltycat said:
I hope it is all good news with the Echo. Thinking of both of you. You've gotten some great advice on R insulin. I used it as well and it was a great tool to have in the toolkit. Like Wendy mentioned, learning when not to use it can be more important then when to use it.

I was taught that the R insulin is better at lowering numbers while the Lev is better at keeping the numbers down. It made for a good combination but it did make the FD dance a bit more challenging. Given that, I would use it again without hesitation. Sandy helped a lot when I dipped my toes in the R waters and due to the experience from the group it was completely uneventful. Just like L insulins, you slowly increase the dose until you get the action you want.

Having a set date to start lets some of the R veterans keep an eye on Asia to make sure she has an overall good reaction to it with no major surprises. As long as you can be around to monitor I think giving it a shot (lol) is a good experiment.

Paws crossed for good test results.
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Thank you, Wes. It’s nice to see you, hope are doing okay. :bighug:

Yes, adding another layer of complication and trickiness to something that is already so. I would absolutely get some hand holding should I decide to go for it. Just as often as I see it bringing numbers down, I see that sometimes they remain high but perhaps not go higher than they would without it? It still doesn’t seem like a Silver bullet, I’m beginning to realize there is no such thing. Still, it would be nice to have some recourse over seeing those ugly bits on the SS and watching her sleep the day away when her numbers are high because she probably feels like crap.
 
Thanks Stacy... I'm just keep on keeping on the best I can:)

Stacy & Asia said:
adding another layer of complication
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I always thought about it as just another variable in tracking numbers, never a complication. The 2 hardest parts were learning how to read the SS again to see the pattern of when to or not to give R. If I suspected a bounce, I didn't give R to keep him from diving too fast. You are right that it can be a good tool to flatten out rising numbers. Interestingly, R can also affect the next cycle to help keep numbers in check.

There are some good threads around on R. Suki & Crystal, Sandy & Black Kitty, Wendy, Marje, Jill & Alex, some of my old threads... The list goes on and I learned a lot going back and reading through them.

You will need to experiment a bit to find the best times to give R. I found a few different time slots that typically worked well to not overlap with the Lev onset. It seemed a lot of R users had preferred times based on their cats response.

Paws still crossed for your girl.
 
saltycat said:
Thanks Stacy... I'm just keep on keeping on the best I can:)


I always thought about it as just another variable in tracking numbers, never a complication. The 2 hardest parts were learning how to read the SS again to see the pattern of when to or not to give R. If I suspected a bounce, I didn't give R to keep him from diving too fast. You are right that it can be a good tool to flatten out rising numbers. Interestingly, R can also affect the next cycle to help keep numbers in check.

There are some good threads around on R. Suki & Crystal, Sandy & Black Kitty, Wendy, Marje, Jill & Alex, some of my old threads... The list goes on and I learned a lot going back and reading through them.

You will need to experiment a bit to find the best times to give R. I found a few different time slots that typically worked well to not overlap with the Lev onset. It seemed a lot of R users had preferred times based on their cats response.

Paws still crossed for your girl.
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Thank you, yes, I’ve been reading old threads and reviewing SSs. This is helpful to point me to some more though, never too much information as far as I’m concerned. :)
 
Hi. Here's some vines for everything: healing vines.jpg
 
Stacy & Asia said:
Yes, I don’t know what is happening, she just turned on a dime and started doing this skittles advert some weeks ago. :rolleyes: It could be related to this UTI/antibiotics, her heart, who knows what, but I don’t need to know exactly why, I just need to do something about it to support the rest of her parts in the meantime. I know you’ve been there with Girlie. It isn’t fun to feel so powerless.

I’m hoping they have a litter tray she can use, I’m certainly going to ask. That’s why her pee pee pants episodes were so concerning, if she could at all help herself...she would never do that on purpose.
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So true, so true: it's awful. I pretty much drove myself to a physical breakdown with the stress of doing what I did to monitor her all on my own. I am just very, very grateful that she responded so well to the Levemir. I honestly don't know where we'd both be if she hadn't. Probably on a higher dose with higher carbs to keep her safe.

Anyway! My concern is you. I really hope you two are okay. :bighug:
 
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