9/9 Kirby AMPS 350 +4 534; +6 515 +9 609 PMPS 605(+Alphatrak)

https://www.felinediabetes.com/FDMB...69-7-75-9-5-182-pmps-311.234934/#post-2630422

After yesterday's progress, Kirby is back to high numbers again. I suspect the reason might be that I started feeding him some higher carb food (about half LC, half his HC previous food), since we wanted to try to keep him out of the low dangerous zone. Or he is bouncing from yesterday's low numbers. Any thoughts?

Ketones are also up today, to 1.1 from yesterday's .3... clearly from his elevated bg levels. But he is eating and drinking well and seems to be feeling better than he has in quite some time.

thank you

 

My guess looks like a bounce from the numbers he isn’t used to yet...I’d keep an eye on the ketones, if you can. Seems like you are doing just that from your SS notes, so that’s good! Not sure if the HC was necessary this am after AMPS, but I’ll bet they were yummy

glad to hear he is feeling better! (Despite the high numbers)

 

you're right, the HC weren't necessary! He is gaining weight though. And he also ate more than usual this morning. I'm going to go back to the LC for now unless his numbers are dropping again.

 

He's definitely bouncing from yesterdays low. The good news is that his body's defence system against low blood sugar is working well!

Good news on the appetite!

By the way, next time the vet suggests you use R, post on this forum. There are a few people here with R experience who can help. 1 unit is a REALLY high dose of R. Neko got up to 7 units of Levemir, but she never needed more than 0.5 units of R. Typically we start people off at 0.1 or 0.25 units of R. When Neko was on smaller doses, a drop was often enough. Another thing, sometimes the cycle after the one you give R is an active, which is what it looks like happened to Kirby and you.

 

wow! I am surprised about the Humulin R being so potent. I have given Kirby multiple units at a time before, at the vet's direction. Are you sure we are referring to the same "units"? I am using U-100 syringes.

 

Yes, same units and u-100 syringes. I shudder to think what might have happened with multiple units. If I look at the spreadsheet, and keep in mind that the cycle after can also be very active, I see a lot of that happening. Followed by huge bounces. Thankfully most of the large R doses were when you were shooting Humulin N. With a depot it would have been way worse. When we shoot R, we don't want the numbers coming down much more than 100 points. Otherwise the steep fast drops will set up huge bounces.

I remember talking to Neko's internal medicine vet about R, and that clinic used to dilute to even smaller doses. Of course, I don't think they thought shooting 0.1 units was possible.

 

wow!

 

vet suggesting shooting R because Kirby is at 692. Wanting to get him lower because of ketones.

 

What dose is the vet suggesting? I agree R might be useful. There are a couple other considerations - you don't want the R nadir and the Lantus nadir to happen at the same time. You want to make sure you can monitor tonight. When people start using R, we suggest testing hourly for the first 4 hours, so you can get an idea of what the R curve looks like. And it allows you to intervene early if you need to. If you do want to shoot R, I wouldn't go above 0.25 units.

 

She suggests 1.5 units. I am going to wait and test again to see if he starts going down on his own without it. A bit nervous to shoot R at night before I go to bed. I'm still trying to recover from the last night he kept me up most of the night.

 

Good news. Kirby dropped to 563 on his own. No R for tonight.

 

Good call. That was a big enough drop without the R adding to it. The best time to do R when you start, is at preshot time. And we always recommend an experienced R user be around to help.

 

https://www.felinediabetes.com/FDMB/threads/9-10-kirby-amps-593-alphatrak.235039/