10/13 Jack AMPS 308: Nano-Dosing Trial

Link to Yesterday's Condo
Link to scroll down to my first nano-dosing trial

Yoshi here. Jack was negative for ketones yesterday. Not much advice/feedback on the No Insulin Experiment - (Libby, you around?) - so I'll be pushing forward by starting Jack out with the smallest dose possible of insulin - and we'll see if it does anything. The syringe we have can accurately measure out 0.01u - and since Jose & I won't be home after +3 AMPS today - starting out smaller is better, because hyper numbers are a lot less worrisome then hypo numbers.

 

Re: 10/13 Jack: nano-dosing

Wishing you well now, with this small dose. It will be interesting to see how Jack does with it.
You guys have done so much for Jack...and are so very thorough in your approach to this whole thing.
I do hope things get better for you all. :thumbup :thumbup :thumbup
How is jack acting...LB action is okay and he has all Ps in place? (purring, preening, pooping, peeing, playing?)

 

Re: 10/13 Jack: nano-dosing

Libby usually isn't around in the mornings.

If you shot the 0.01u, could you note it on your SS. Good luck with the microdose.

 

Re: 10/13 Jack: nano-dosing

Wishing you good luck and good #'s today.

 

Re: 10/13 Jack: nano-dosing

I think everything less than 0.1u is not a micro-injection anymore - but a "Nano-Injection!" He actually got the shot 30 minutes late (noted by +0.5 in my SS), because it took me a while to try out the 10 uL glass syringe. (Too bad I didn't think about practicing with it earlier). Silly me, I was too hopeful in thinking that using the new syringe would be similar to the disposables. So here's what I ended up doing:
1. Secured the disposable needle to the glass syringe
2. Took off the cap of the disposable needle (<this was a puzzle - will ask my vet if there's some trick to pulling it off - it's probably like trying to open a child proof cap to a medicine bottle - once you know the right way to pull it off, it won't be such a puzzle)
3. Filling the syringe: the first obstacle was that the needle tip itself holds a few drops of insulin, so drawing in to the 0.01u marker only sucks insulin into the needle cap - even drawing in 0.2u still didn't show insulin yet. I even tried taking the needle cap off - and "filling" the glass syringe using a little insulin from a disposable syringe (putting the needle of the disposable syringe into the head of the glass syringe, and injection insulin into the glass syringe until it filled up - then replacing the disposable cap on the glass syringe. Unfortunately, when I replace the disposable cap onto the "filled" glass syringe with 0.1u in it - after depressing the plunger to 0.0u, the insulin simply moved from the glass syringe into the needle tip, but it's such a small amount - it didn't reach the end of the 1/2" needle! lol) - so... I drew in 0.7u
4. Finding the dose: As the air bubbles in such a small tube cannot be "shaken" to the top - I played around with pushing the insulin in and out of the syringe. Even when you fill up the entire syringe - it's 1u - so there's no worries of "squirting" the insulin everywhere - it's such a small amount. When I depressed 0.7u in the air - the insulin formed in a bubble at the tip of the needle. So I could push in and out, and watch the bubble get bigger/smaller as it was sucked in and out of the needle tip. My goal was to measure out 0.01u - but that amount is so small, I could just as easily be injecting nothing. For example, there was an air bubble between 0.2u and 0.1u - so even though I push the air bubble out of the syringe, it could still be lingering in the needle tip. So after pushing the insulin bubble in and out of the plunger a few times - I was looking for what section of the tube was most likely to not have air. I pushed in 0.7 to 0.6 and nothing came out. Then I pushed in 0.6 to 0.5 and a small bubble began to form at the needle tip. After some adjusting - I had the plunger set to 0.45u and pushed it to 0.35u to see a small bubble of insulin form on the needle tip, and decided that was the best "section" of my draw that formed a consistent bubble.
5. Injecting the dose: Resetting the plunger to 0.45u - I poked Jack, and depressed the plunger to 0.35u and took out the needle. Being careful to not let the plunger move, so no insulin would be sucked back into the tube as I was pulling out the needle.

So Jack got somewhere between 0.01u and 0.1u - I'm more certain it was 0.1u in the glass syringe than injecting 0.1u in the disposable syringe - but this method is still not completely accurate.

Next step: I'm going to my vet to hopefully get them to "train" me in how to use this syringe. If they make a syringe like this - there's got to be an accurate way to actually use it, right!? But like any syringe, the ability to accurately dose 10% of the syringes volume becomes harder. If this syringe doesn't get easier to use - the only way to get accurate nano-doses will probably only be possible with a zero dead volume syringe (a syringe that has a plunger that depresses all the way through the needle tip to push out every last drop).

~Yoshi

p.s. - Libby: Lookin' forward to hearing your input on the past 4 days, (here's a link to a little of my newbie assessment from yesterday's condo).

 

Whew...I am totally exhausted and I was only reading about this...what a procedure! Glad you were up earlier. Sounds like something that needs some practice. Good luck with it. I just got to using the regular 29 gauge syringe, and could express the one drop and then suck it back into the needle.
Hope your vet office will give a good demo...can't wait to see his numbers today! Great job! :thumbup

ETA: Libby is at work now...I am sure she will touch base with you tonight when she gets home....

 

Wow...Yoshi....that is some kind of trial and error and I really, really hope it works for Jack...you guys have been so diligent with this.

As far as pulling the caps off disposable needles, just pull off straight....don't turn. I think the tendency is always to turn the cap and pull but if you secure the needle onto the syringe tightly then just pull the cap straight off.....at least that's how the Terumo needles I use for squids work. Oh...and your hands MUST be dry :lol: Can't wait to see what happens next with Jack's numbers!

 

Re: 10/13 Jack: nano-dosing

very quick comment since I'm running off to an appt....

I have used these glass microsyringes for chemical analysis injections at work. What we do is place an "air gap" on either side of the liquid sample; for instance, if we want to inject 1 uL, we'll suck up 1 uL air, then 1 uL liquid, then 1 uL air again. In particular the air gap before the liquid sample helps to push all of it out when the plunger is depressed fully.

MJ&Donovan

 

I'm glad you shot today. Jack settled down better than I expected with no insulin, but it is obvious that he still does need the juice. I hope now you can find a dose small enough to not send him bouncing again.

 

Nano-Dosing Trial

The micro glass syringe was clogging after one use. There are also trace gray smudges starting to build up inside the tube. Too many factors to figure out what to change or adapt - MJ, thanks for the tip on how to better use the glass syringe. For those that have been following this condo interested in the functionality of micro-glass syringes - I would currently recommend: If you don't have previous experience with a glass syringe - or have someone that can step you through it - trying to figure it out by trail and error won't work out well - a 10 uL (1u) syringe is just too delicate to 'experiment' with.

Burned out: I will be taking a break from the board for a while. I've been neglecting important parts of my life that need my attention - and I can't recenter myself without disappearing from the forum. I'll be back, but can't say when right now. Jose is swamped with law school and will be checking in infrequently, but not posting a lot. We'll be focusing on diet control at this point, as Jack's numbers are showing signs of edging down. If we see his glucose daily average starting to trend up over a few days- we'll talk about adding insulin. I know it's not what most would recommend (not shooting with high numbers).

But in any case, thank you for all your help and support.
~Yoshi

 

Like you, I hope Jack will trend down on his own with the diet control. But he may need a hint of insulin... at some point.
He is does do some wild swings in his BG numbers, that's for sure.

With all you have going on, life is stressful and we understand. Stay strong!
Take care, you guys and come back very soon.

 

You both have put a valiant effort into this recently and I do understand how time consuming it is. I am sorry that we will not see yo daily and will be thinking of Jack while you are away. Wishing you all the very best...
And remember that we are here if you need us, okay? Keep checking for ketones and keeping if the SS if you can. That's just my own personal suggestion to you all since the numbers are high and ketones are always a concern at that point, okay?
Hope to see you again one day....sending scritches to Jack! cat_pet_icon