? IS RAFFY OVERDOSED?

Good Morning to all. Things are getting more strange and tedious. Step by step we ve reached 20U , however i have not seen any significant BG decrease yet. Even with lower dose , i was able to see blues and greens.
Is that situation can be result of an unnecessary high dose? I need your adviceses, ...

 

I don't think Raffy is overdosed. Instead, I think it's likely he has acromegaly, and the tumour is pulsing, causing a need for more insulin. When that happens, you have to keep increasing to catch up. Dose changes at this size of total dose are usually done in larger amounts, 1 unit or more, instead of 0.5 unit changes.

 

So do i have to wait 6 cycles again for dose increase?

 

It looks like you're doing everything right when it comes to dosing, so I agree with Wendy that it's not likely that he's getting too much insulin.

@Wendy&Neko - What's the likelihood that IAA is in play based on how the spreadsheet looks and the relative newness of the diabetes diagnosis?

Also, for numbers like this, under what circumstances might Raffy's beans consider adding something like a fast-acting insulin to the mix?

 

You only need to wait a total of six cycles, so two more, before increasing.

 

Thx Wendy..

 

As for IAA or not, Gurkan has no way of testing for that, much less acromegaly. If there is IAA, it would likely be in combo with acromegaly, as Neko had.

Let me ask a few others what they think about a bolus insulin. Gurkan , do you know if Regular or Humulin R would be available in your country for you to give to Raffy. It's something vet's would use in their clinics, but not sure about home use.

 

@Wendy&Neko - Oh my, I completely missed the country listed in the signature line. How embarrassing.

 

I can get both Humalin R and N from a pharmacy at Istanbul.
And if i am going to use both Humalin and Levemir, how will i use them? Dosage , timing etc...

 

.

 

Hello Gurkan, we did not get Titan checked for IAA, it was a vet issue. With his high numbers we had I just assumed he had it and dosed to break the black and red numbers. I was told that IAA could be over come and the antibodies will just give up eventually and not fight the insulin. That certainly happened for us at the 12ish unit mark as you can see on Titans SS we have come all the way back down to 6.5 units dealing with the acromegaly alone. Good luck sending healing vines for Raffy .

 

Sending best wishes to you and sweet Raffy in Istanbul/Turkey that those numbers start to change to prettier colors really soon!

 

If you start R, we suggest waiting until one of the expeerienced R users "sit" with you the first couple of times. If does require more monitoring with hourly testing for at least four hours, at least at the start. And you should know Raffy's onset, nadir, and duration on Levemir before starting. What time in GNT is your shot time?

 

AM Shot at 01:30 GMT.
But this week, until Sunday evening , my flights will not allow me to make this Humalin operation .

 

I ll get Humalin the day after tomarrow, so we can arrange a suitable time .

 

Hello Ed, nice to see Mr. Titan at seaside with such a good dose.
I wish u and your family a happy new year without insulin

 

The goal of using R is to take the blood sugar numbers down a bit, no more than 100 points. That will give the Levemir a lower number to work on. When you start the R experiment, I would suggest starting with a 0.25 unit dose. So you might want to practise those tiny doses. Let me know what you schedule is like and we'll schedule a time I can be around and help the first time.

 

Dear Wendy, i am ready for Humalin R operation.
Right now we r on 22U .
As u told before, i am going to start with 0,25U R,.
I just want to know, am i going to give both R and Levemir at the same time?
And will i keep 22U?

 

I don't know the answer to your question, I'll put out a message to some folk with R experience.

I have seen folk use it at the same time as Lev, but also at different points in the cycle. I don't know what would be best in Raffy's case.

As @Wendy&Neko is in west coast canada, she is likely sleeping now.

 

Thanks Gurkan and a happy new year to you! Titan will never be off the juice, he is an Acro cat like Raffy but we are enjoying these lower doses until............

 

Hoping Raffy gets on the right track! Regular diabetes is bad enough.

 

Could I ask you to start a new post when you want to start the R experiment? That way people can see that this is something new happening.

A few cautions first with R.
- To start, you will shoot R and Levemir at the same time. You don't want the R and L nadir to conicide and shooting at the same time is a good place to start with Levemir. As you gain more experience, you may find you can shoot R after nadir if the blood sugars are on their way up.
- Be very careful to keep track of which you are drawing and shooting. We have had people mix up the R and Lev doses and you don't want to shoot 22 units R! I used cartridges for Lev and a vial for R, so that helped distinguish the two of them. Some people put down different coloured sticky notes, one with R on it, one with L and lay the syringes with insulin on those sticky notes before shooting. Some always shoot the Lev first and R second. Try to come up with something that will help you to not mix them up.
- R you should shoot in the scruff. Levemir can shoot elsewhere.
- Don't change the Levemir dose when you are doing an R experiement and don't change the R and Lev doses at the same time.
- Maybe sure you aren't giving R on a cycle where the bounce is about to break. The goal with R is to lower the blood sugar about 100 points, to give the Levemir a lower number to work with. If it's a bounce breaking cycle, the extra momentum of R plus the bounce breaking could be a steeper drop and cause yet another bounce.
- As you can see, learning when not to use R is equally as important as learning when to use R, which is why it helps to have someone "sit" with you the first couple of times.

I see a PMPS listed on the spreadsheet - have you shot the Lev yet? If it's too late now, could we start the experiment in the morning for you (my afternoon). Not sure I have figured out exactly when your shot time is yet so I can be around. What is your shot time in Istanbul time. I can always Google when that is.

When you shoot R, you want to test every hour after that for 4-5 hours. You need to figure out R's onset, nadir and duration. Typically onset is +2 and it lasts for 4 hours. Neko wasn't typical and everything was later. Once you figure out what the R cycles look like with a couple of experiments, you can lay the curve on top of the Lev curve to see other times it might be safe to give R.

Over time you'll build an R scale - basically it tells you what dose to give based on the blood sugar values at the time. Sandy had a great R scale in Black Kitties spreadsheet. Note that it changed over time and she was using Lantus.

 

First of all, thank u very much for your unlimited support.
I give the shots 04:30am/pm local time (01:30Z)
Right now it is 20:30 pm, so i ll start R tomarrow morning.
And starting dose of R , something between 0,5-1U?

 

Start R at 0.25 units. He may have to go up in dose, but some cats react to just small amounts of R so you should start low.

You are 11 hours ahead of me. "See" you in 8 hours.