? Buddy 9/7 AMPS 268, PMPS 376 - Dosing question and Lantus vial question

I'm a bit surprised and disappointed that Buddy seems to have gone higher over the past week. When he was previously on his this dose and slightly higher carb foods, I was seeing more blue. Lately, it seems like I'm getting more readings in the 300s and nothing in the low 100s. I was so excited to see his reading of 138 last night and hoped maybe we were turning a corner but, alas, I came home today to a 1/2 empty water bowl (and it's a good sized water bowl) and lots of pee. He's gone from water bowl to water bowl since I've been home. Other than a possible piece of dog food he swiped a few nights ago, I am confident he hasn't found any other contraband.

So, I have two questions for my fellow FD warriors and I wished I had asked earlier today but I didn't have a chance to get to a computer to do so.

1) I contemplated increasing his dose from .25 to .5 but he has been so unpredictable with dropping low that I was afraid to double his dose. Instead, I bumped up to .3. Was this a mistake? Should I have gone with the higher dose?

2) When trying to get his syringe ready, I must have had a funky syringe because I tried two times and both times I could not get the correct amount. I grabbed a second syringe and forgot to move the plunger a few times and push the plunger flush with the end before inserting. . As I inserted thy syringe, the pressure caused the plunger to push air into they syringe (which is when I realized what I'd done). I know this is a big no-no and I saw the little white desk on the inside pop up. I know I need to get another vial now (which kills me) but can I get any more use out of this vial of Lantus? Can I at least use it for one more shot in case I can't replace it before tomorrow morning?

When it rains...it pours. Maybe if the rain (and my tears) create enough water, my Buddy will take a swim this weekend.

 

How many air bubbles. I’ve had a few in my vials without issue.

 

One biggish bubble as you can see in the picture.

Do you know why the air bubbles are such an issue if we are syringing? I can understand why the pressure is important when using the actual pen but I can't figure out the issue when drawing with a syringe. Not doubting what I've read, just curious.

 

I have had bubbles in my pen before and they actually dissipated.

Can you get a curve in this weekend? It looks like he could use more juice than just .3 and a curve will help you know.

 

@Bobbie And Bubba, should I just use the pen for now? At what point do I know the vial is no longer good?

Yes, I will be able to get data all weekend. I'm afraid you might be right about needing a higher dose; do you think I should stay with the .3 for the next week, even if I don't see a decent jump?

 

I think the pen would be okay unless it becomes cloudy.

I would see what the curve shows and then adjust the dose up to .5 if you aren't seeing a green number.

 

I'm just finishing up my first vial of insulin - and already have a stock of Lantus 'pens'. Why is it a 'no no' to have an air bubble? Can you direct me to where you're reading about using a pen and this question of an air bubble? I understand with the pens, unlike the vials I am not supposed to displace the insulin with air - but had no idea an air bubble would ruin the Lantus in a pen.

Thanks for directing me to what I need to know!

 

I don’t believe the air bubble doesn’t anything to the insulin. I also would not attempt to get all bubbles out of the syringesince I wasn’t successful.

 

Sue, I could be mistaken but I actually thought I saw it in the video made by the lady who explains how to withdraw from a pen to microdose cats but now I can't find that video. I did hop back out on the web and do some more reading and I think the bubble is only an issue if you plan to ever use the Lantus vial with the pen needles (since that mechanism is based on pressure). That makes perfect sense.

As long as my insulin stays clear, I plan to continue using it.

 

@Bobbie And Bubba - certainly doesn't look like Buddy will see any greens today. I suspect he won't see much blue either (and no blues last night). Assuming Buddy doesn't miraculously drop into greens in the next 2 hours, do you think I should go ahead and increase to the .5 tonight? Or should I hold longer? I just worry about doing dose increases when I go back to work. Jobs really have a way of getting in the way of life, LOL

 

I would finish the curve today to see if he does drop any lower, but looking like he needs the .5 dose. I understand your concern while you are at work. Are you able to get a +2 before you leave to get an idea of how the cycle could play out ? Then you could leave him some food while you are gone.

 

I could get a +1.75 most days but the +2 will be iffy. I'm already surviving on 5-6 hours of sleep with 10-12 hour days of work so I hate set my alarm any earlier. I've lost more sleep since this diagnosis than I have in the past 5 years and I have the black circles under my eyes to show for it, LOL. It seems like he has almost no drop at +2 so I worry about it being a bit deceptive. Maybe the higher dose will change that.

I feed a can off FF (2 carb) when I inject and then split another can into two timer-released feedings at +3-4 and +6. Do you think that food with such low carbs are sufficient? If I have any reservations, do you think mixing 1/2 FF and 1/2 Friskies (5 carb) would be advisable?

Sorry to ask so many questions. I just know Monday morning is just around the corner and I want to have a plan B an plan C so I don't panic and take two steps back. I greatly appreciate all you help.

 

If the +1.75 number is lower than the AMPS , or if he is starting off in a high blue number, I would do the mix of 1/2 FF and 1/2 Friskies since it seems that the Friskies raises him up some. He could be one of those cats like Bubba that is super sensitive to carbs. When Bubba drops, I can bring him up by feeding raw pure protein with 0 carbs.

It's always good to have a plan A and plan B.

 

And now Buddy just threw up and it had bright red blood in it. He is acting fine and still wanting to eat but I am definitely concerned. This poor cat can't catch a break!! I've texted my vet and waiting to hear back from her.

 

Oh no! I hope it's nothing! Keep us posted.