12/1 Tommy +2 396 Starting R boosters

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Good luck. Just make sure that you time it correctly and it doesn't peak at the same time as the Lantus....but I'm sure you know that :razz:
I use it when needed and find it to be a very helpful tool but just like everything else...there can be too much of a good thing. Tommy's numbers are high, for sure..but I would have waited until +6 or after for the second booster. Reason: you need to see how it works on Tommy before you start giving him too much.

I hope you don't mind the advice...this is just from my own experience.
 
Nora:

Are you using R per the instructions from Steve that you posted in your condo earlier this week or per Sharyn? They are very different in the way they approach the use of R. If you are using Steve's approach, you will need to make sure he's watching your back. We do not use that approach since he developed it in 2006 -- a time when tight regulation was at a different stage of development. I believe Jill mentioned this to you on Monday. None of us are familiar with the way Steve uses R and it is an approach that he cautions should not be used by someone new at managing feline diabetes. Please ask Steve for his help if you are using the method he developed.
 
Hey there,

I'm not familiar with Steve's approach, but what Sharyn posted is pretty similar to what jojo had me do with my acro-cat. R can be a great tool, but do be very careful - it's generally used with acrocats and IAA cats; some ketone-prone cats also use it. Definitely don't base your doses on what you see acro & IAA cats use - those doses could kill a regular cat.

For whatever reason, it's use is quite controversial around here, so don't get upset if you don't get much feedback (or if the feedback "stings" a bit).

(Irrelevant personal comment removed by Rebecca)

Good luck.

Heather
 
When just starting out, it may be a good idea to post what you are planning to shoot beforehand and see about feedback.

Start low, real low, like .1u, and have your hypo supplies all ready. Some kitties respond like dropping off a cliff, so please be very careful.
 
One more thing to add:
be sure to test hourly after the R shot - testing the 4 hours after the shot will tell you how Tommy is reacting to R.
I looked at your ss and did see the .1u dose but I can't see at what time you shot R in relation to regular shot.
 
Gayle and Shadoe said:
One more thing to add:
be sure to test hourly after the R shot - testing the 4 hours after the shot will tell you how Tommy is reacting to R.
I looked at your ss and did see the .1u dose but I can't see at what time you shot R in relation to regular shot.
Click to expand...

looks like Nora shot .1@PS, .25@+4 and .03@+8
 
Nora,
Did you give 3 shots of R on this cycle?
Also, what were the BG tests to show how Tommy is reacting to the R or you are just doing double lines on your ss, yes?
 
Thanks to all for the good wishes and advice. And advice/pushback is always welcome. So...

hypo kit at the ready..........................check
in contact with veterans......................check (Steve, Sharyn, and Dr. Lisa)
watching bg's and behavior like a hawk.....check
starting with tiny doses.......................check
raising doses slowly............................check

As to the R nadir coinciding with the Lantus nadir: there has never been any discernable correlation between Tommy's bg and the action of the Lantus. For a while he had nadirs 24-36 hours apart. Recently he has been flat and high. Today's experience with R is the first time that insulin action has been visible in his bg's. For the first two doses, you can actually see a little dip, with the cycle lasting about 4 hours, just as predicted. It's encouraging.

The +8 dose probably should have been a touch higher, since even though the Lantus action is typically invisible with Tommy, Lantus at +10 is probably losing its punch. Thoughts?

As to re-shooting at +4, this was done a) with consultation, b) after a rise, c) into a high number, d) at a low dose, and e) 4 hours is recommended by Steve and others. Sharyn recommended waiting 6 hours at first until a pattern was observed, but in this case the pattern seemed to be there at +4, and the drop in bg was relatively small.

Sharyn's and Steve's instructions seem to be fairly close, and we've gotten good guidance from both. And we've printed out everything we could find dealing with this technique.

The bottom line is a) his bg has been too high for too long, and b) we don't want to increase the Lantus too quickly and skip over an appropriate dose. Carefully using R boosters seems like a good approach.

Gayle, the 0.1 was shot at 6:00 am immediately after the Lantus. Yes, 3 shots of R this cycle. The light green row is for R shots, and the testing is shown in the row directly above.

And good suggestion about posting prior to a dose increase. We have been getting advice, but if there's ever a question, we'll post it.

Caryl, it's John actually :-D , and +8 was 0.3 (not 0.03).

Again, thanks for the interaction. This board has been tremendously helpful. We'll keep things updated.
 
Nora & John & Tommy said:
Thanks to all for the good wishes and advice. And advice/pushback is always welcome. So...

hypo kit at the ready..........................check
in contact with veterans......................check (Steve, Sharyn, and Dr. Lisa)
watching bg's and behavior like a hawk.....check
starting with tiny doses.......................check
raising doses slowly............................check

As to the R nadir coinciding with the Lantus nadir: there has never been any discernable correlation between Tommy's bg and the action of the Lantus. For a while he had nadirs 24-36 hours apart. Recently he has been flat and high. Today's experience with R is the first time that insulin action has been visible in his bg's. For the first two doses, you can actually see a little dip, with the cycle lasting about 4 hours, just as predicted. It's encouraging.

The +8 dose probably should have been a touch higher, since even though the Lantus action is typically invisible with Tommy, Lantus at +10 is probably losing its punch. Thoughts?

As to re-shooting at +4, this was done a) with consultation, b) after a rise, c) into a high number, d) at a low dose, and e) 4 hours is recommended by Steve and others. Sharyn recommended waiting 6 hours at first until a pattern was observed, but in this case the pattern seemed to be there at +4, and the drop in bg was relatively small.

Sharyn's and Steve's instructions seem to be fairly close, and we've gotten good guidance from both. And we've printed out everything we could find dealing with this technique.

The bottom line is a) his bg has been too high for too long, and b) we don't want to increase the Lantus too quickly and skip over an appropriate dose. Carefully using R boosters seems like a good approach.

Gayle, the 0.1 was shot at 6:00 am immediately after the Lantus. Yes, 3 shots of R this cycle. The light green row is for R shots, and the testing is shown in the row directly above.

And good suggestion about posting prior to a dose increase. We have been getting advice, but if there's ever a question, we'll post it.

Caryl, it's John actually :-D , and +8 was 0.3 (not 0.03).

Again, thanks for the interaction. This board has been tremendously helpful. We'll keep things updated.
Click to expand...

Well Nora..sounds like you have your bases covered :lol:
(don't mind me with the decimal points..I'm bad at that but I knew what you meant).

I know too well what it feels like to see those high numbers... only with my kitty ketones come with those numbers 9 out of 10 times....I really do find R to be a good tool if used carefully to bring the bg down to a place where the Lantus/Levemir has a chance of working more efficiently. :razz:
 
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