9/15 Chino|AMPS=291|+8=391|PMPS=384|+2.5=348|+4=258|+6=229

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Adrian and Chino

Member Since 2016
Last post: 9/09

My computer charger broke and with delays due to hurricane aftermath, it took longer than expected to get the replacement.

As I had feared/expected, the reduction that we took after R got him to his last green didn't hold. We went back up to 14.5 units, then went up to 15 this morning.

I started tapering Chino off cabergoline on the 26th day (2 days ago).

There's enough Lantus left to keep giving it through Thursday of next week, but Thursday and Friday are religious holidays, which means I won't be able to monitor for most of the morning or evening while I'm in services. So I'm probably going to start the switch to Levemir at 10.5 units next Tuesday. That gives me 2 days to try to learn his new onset/peak/duration before the 2 days when I won't be able to test as often.
 
My main concern with Levemir is that it might change the onset/peak in a way that it makes monitoring difficult. His Lantus nadir falls around +8 (or +4 during a bounce), which is ideal because I wake up every night at +8 to take my 2nd dose. Daytime onset is around +4 and evening onset is around +2.

I'm not very functional/coherent for the first 2 hours after taking this medication. It makes my hands twitch, which makes testing/injecting difficult/dangerous. If his Levemir nadir falls around +12, onset around +4 or +6, I can manage that... If it falls around +9 or +10, it will be much more difficult.

My priority is getting the PM tests at the right time so I can catch him if he's falling too low/too quickly. If necessary, I could move the shot back 4 hours and shoot the AM dose when I get up at 0300. Then I'd certainly be awake for the onset in the evening. But I'm not sure how circadian rhythms will affect his cycles of I do that. Most (non-obese) humans are more insulin resistant in the evening. It appears to be the opposite with Chino. Giving the AM dose that early might mean he starts going lower during the day.

All I can really do is wait and see what the data shows after we switch, then try to adjust accordingly.
 
I'm in a doctor's office right now, an hour late for the appt and 30 mins late for the 2nd BG check/meal. If I'm not back by +5, my dad will feed the cats without testing. (If I wait until +6 to test/feed, the food will have been unrefrigerated for 3 hours.) I hope he's still bouncing from last night...
 
Good to hear from you again Adrian. I hope you survived Irma Ok.

When I get my act together, I am going to post a paper I just found of a study of the use of cabergoline in acrocats by a group in Argentina. The study went on for six months, and there were improvements in dose from months three to six. I am not sure 26 days is enough. I might hold off the tapering until we hear the results from RVC which should be in the next week.

You may end up moving preshot times for Lev. I found that most of the time I could go back to bed after preshot time. Neko nadired most of the time between +9 and +12.
 
The study went on for six months, and there were improvements in dose from months three to six. I am not sure 26 days is enough. I might hold off the tapering until we hear the results from RVC which should be in the next week.

If the results show a significant improvement in the majority of subjects, I might decide to resume it after the switch to Levemir, but $100/month is a lot for something that didn't appear to help.
 
I hate the thought of wasting 120 units (4 days) of Lantus, but I might switch Sunday or Monday instead. That way, I'll be able to monitor closely for a full 6 cycles before making the next dosing decision, and I'll know when I need to come back and test on the days that I'll be out for an extended period of time.
 
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