? 7/27 Jimmy's R insulin dosing help needed

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Susan G & Jimmy G

Susan G & Jimmy G

Member Since 2017
Is anyone available to give me a run down of how, when, etc to adjusted Novolin R for Jimmy today? I just picked it up and would like to get started. TIA.
 
Hi there :cool:

Please update the ss with this past weeks data so we know where Jimmy stands BG and dose wise.

I'm busy today but will check in later this afternoon and provide you with important information you need to know before you start adding R to the picture.

Hang in there :cool:
 
Sandy and Black Kitty said:
Hi there :cool:

Please update the ss with this past weeks data so we know where Jimmy stands BG and dose wise.

I'm busy today but will check in later this afternoon and provide you with important information you need to know before you start adding R to the picture.

Hang in there :cool:
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Are this weeks numbers not showing up?? I tested a +4 just this morning.
 
First off, what time zone are you in and when is preshot time? We like to have someone "sit" with you the first couple of times. Usually we start with dosing 0.25 units of R, so go ahead and practice getting 0.25 units consistently with coloured liquid and a used syringe.

When we start out with R, we test hourly for at least four hours after the shot. Typical R onset is +2 and lasts until+4. Of course Neko never liked to be typical about anything. :rolleyes: You never want the R nadir and the L nadir to be at the same time. What is Jimmy's onset and nadir with Lantus? You want to know the L action really well as you layer the R action on top. You never want the R to drop things more than 100 points as you can set up a bounce from that. And sometimes you'll see more action the cycle after using R, so you have to be able to monitor the following cycle too. Knowing whether he was IAA or not would be helpful, as the antibodies can play games with the R insulin too. That's it for now.
 
Wendy&Neko said:
First off, what time zone are you in and when is preshot time? We like to have someone "sit" with you the first couple of times. Usually we start with dosing 0.25 units of R, so go ahead and practice getting 0.25 units consistently with coloured liquid and a used syringe.

When we start out with R, we test hourly for at least four hours after the shot. Typical R onset is +2 and lasts until+4. Of course Neko never liked to be typical about anything. :rolleyes: You never want the R nadir and the L nadir to be at the same time. What is Jimmy's onset and nadir with Lantus? You want to know the L action really well as you layer the R action on top. You never want the R to drop things more than 100 points as you can set up a bounce from that. And sometimes you'll see more action the cycle after using R, so you have to be able to monitor the following cycle too. Knowing whether he was IAA or not would be helpful, as the antibodies can play games with the R insulin too. That's it for now.
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Thanks Wendy. Will do. We are EST (Boston). Preshot is at 5-5:15. His onset is typically +3 and his nadir between +5 and +7.

Is there a DNS number for R? Or will that be uncovered once we find out how he reacts to R?

I'm going to call MSU tomorrow to find out about the IAA tests.
 
People will generally build an R scale for their kitty. Usually you don't shoot below a certain number. And it really is ECID. Take a look at Sandy's Black Kitty spreadsheet for a good example. Mine was much more simple. You will note that people generally start using R at preshot time, but that can move as you learn how R works in your kitty. And your R scale at different times of the cycle can also change. Neko's R dose went down a lot as her Lev dose went down. It never got higher than 0.5 units. And because she was a late onset/nadir R kitty, I liked shooting a couple hours before preshot if she was on her way up. The R action would be out of the way before her Lev onset of +5.
 
Hi there :cool:

The IAA results will be good to know as IAA has it's own quirks to add to the mix. I recommend that you stick with 13u Lantus while you do your first trial as increasing will just add another moving part to the picture. Like Wendy said, you will want to start your first trial at preshot time and test every hour for at least 4 hours. The idea is to arrive at Lantus onset with a lower number, so that the Lantus has an easier time for the balance of the cycle. Then you evaluate and proceed from there with further trials. It takes time and patience; luckily you have the luxury of not being in a crisis situation.

Please note - when you are drawing and shooting 2 different insulins at once you must be fully present in the moment. Extreme care must be taken so that you don't fall into 'autopilot' mode. No multitasking. The last thing you want to do is get twisted around and later realize you shot 13u R and .25u Lantus instead of the other way around. It has happened more than once in the years I've been here. Develop a cross-check system of some sort before you shoot.

As always have plenty of supplies for testing and guiding numbers up on hand.

So, you shoot at 5:00-515 am/pm eastern?
 
I think I may start tomorrow morning if his AMPS is above 350. I am around to test monitor etc and have supplies on hand should things get wild.
Sandy and Black Kitty said:
Hi there :cool:

The IAA results will be good to know as IAA has it's own quirks to add to the mix. I recommend that you stick with 13u Lantus while you do your first trial as increasing will just add another moving part to the picture. Like Wendy said, you will want to start your first trial at preshot time and test every hour for at least 4 hours. The idea is to arrive at Lantus onset with a lower number, so that the Lantus has an easier time for the balance of the cycle. Then you evaluate and proceed from there with further trials. It takes time and patience; luckily you have the luxury of not being in a crisis situation.

Please note - when you are drawing and shooting 2 different insulins at once you must be fully present in the moment. Extreme care must be taken so that you don't fall into 'autopilot' mode. No multitasking. The last thing you want to do is get twisted around and later realize you shot 13u R and .25u Lantus instead of the other way around. It has happened more than once in the years I've been here. Develop a cross-check system of some sort before you shoot.

As always have plenty of supplies for testing and guiding numbers up on hand.

So, you shoot at 5:00-515 am/pm eastern?
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Yes. EST I know it's early - should I look for a certain number tomorrow morning? Anything above 300 or 350? To use the R?

...and thank you very much for the cross check idea. 5am is early...
 
I'm trying to stay confident. I'm not working with a vet on trying to manage his diabetes. I've talked with three different ones....I'd still be at 2 u twice a day if I were. Plus none of them believed 6.5 was a high dose when I asked about the Acro/IAA tests. Sooo...:nailbiting::nailbiting:
 
I am on the west coast. I hope to be sound asleep at your AMPS. Let's see if Sandy will be up. Anything above 300 should be OK for the experiment.

I had Lev in cartridges and R in a vial. The R was in a different part of the fridge well behind the Lev so I had to dig to get it out. I always drew the Lev first (if I was giving it at shot time) and R second.

I stopped asking my vet for dosing advice after about 2.5 units. I just handed her the protocol and periodically gave her the spreadsheet. After a while I stopped that and she would just ask me Neko's dose when I saw her.
 
Susan, just wanted to stop in and say good luck with the R. It really helped Bubba a lot and with out Jill et al., helping me, I couldn't have done it. We will all be looking in with much cheering for you and Jimmy. :):cat::bighug:
 
Wendy&Neko said:
I am on the west coast. I hope to be sound asleep at your AMPS. Let's see if Sandy will be up. Anything above 300 should be OK for the experiment.

I had Lev in cartridges and R in a vial. The R was in a different part of the fridge well behind the Lev so I had to dig to get it out. I always drew the Lev first (if I was giving it at shot time) and R second.

I stopped asking my vet for dosing advice after about 2.5 units. I just handed her the protocol and periodically gave her the spreadsheet. After a while I stopped that and she would just ask me Neko's dose when I saw her.
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Lol. I hope you'll be sound asleep too!! I'll be OK. I have the R in the vial as well and the Lantus in the pen. My husband usually is up with me...so I'll have someone to talk it through with. He seemed to perk up tonight...was playing and seemed more alert. I tested him and he is at 264. Very good for him at this hour. This is going to be a long road...grateful for all your support.
 
So then, if his AMPS is 300 or higher, after you shoot your Lantus, shoot 0.25u R. Test at +1, +2, +3 and +4. If at any point it looks like he is dropping too fast, intervene with food.
I'll look in at some point. :cool:

Susan G & Jimmy G said:
I'm trying to stay confident. I'm not working with a vet on trying to manage his diabetes. I've talked with three different ones....I'd still be at 2 u twice a day if I were. Plus none of them believed 6.5 was a high dose when I asked about the Acro/IAA tests. Sooo...:nailbiting::nailbiting:
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BKs vet (#3) looked at my ss, saw that I was shooting 13u Lantus with anywhere from 1-5u R every 6 hours and and flipped out. She threatened to not renew his Lantus rx. Fortunately his rx lasted long enough for the IAA to break. By that time she figured out I knew my cat and what I was doing.

 
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