4/17 Gus PMPS 600+ Humulin R

Gus started out with some promise today but I see by his #s that he going to be high again today. My question is: Is this still the bounce or is he returning to high #s as he usually does after a few cycles on a higher dose? He's in the middle of the 8thy cycle on 4U. Don't want to increase if this still the bounce. Thanks.

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

I think Champ is having the same problem. I'm pretty sure I'll be increasing no later than tomorrow morning. If his numbers are high going into his PMPS, I'm wondering if I should increase it at his 6 pm shot.

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

did you consult gus' instruction manual? :lol: just kidding, of course, don't we all wish we had one that would say exactly what to do to get the results we want.

i increased punkin's, but maybe it was too soon. Roni said she'd have waited a bit longer but i'd already done it by the time i saw her comment.

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

Morning Bev!!! Bounces can take up to 72 hours (6 cycles) to clear. I've asked Jill before how to tell the difference between bounces and high numbers and she said it is difficult and so I've had to learn to be patient (even though Gracie generally clears her bounces fast). Since this is Gus's first bounce, you have no idea how long it will take. You have to be careful about increasing the dose before the bounce can clear because the two combined *might* cause you to really be working the numbers. So.....IMHO, I'd wait the six cycles but perhaps others will come along that can offer their thoughts as well. Have a great day.

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

We've been taking our time in order to get it 'right', so I'm not gonna screw it up at this point by increasing before it's time. I'll count out 6 cycles from the initial bounce and see. I think we should all petition for the mandatory issuing of instruction manuals with each FD kitty! Gus likes to hang out in the 500-600 range, as his SS shows. My instinct tells me he's doing exactly that. But, each test is a potential surprise and so, Gus' beans waits. I've got a whole lot of new grey hairs with Gus' name on them. It's got to be love! Thanks for the guidance and for reminding me to be patient.

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

Hi Bev,
I agree with the consensus that you should wait the full time. It's Gus' dance and you are just along to listen to the music. It will be interesting to see what he does today.
Hang in there!

Ella & Rusty

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

Just with the advice you're getting, I think I may wait one more day also. I'll see how he does tonight and make my decision with tomorrow's AMPS. I hope Gus gets out of the nosebleed section soon!!

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

Hi Bev, I'm just popping in to see if you have thought any more about using Humulin R with Gus? I can help you, if you want. It could really help him in these cycles when he is bouncing and is so high, but you have to wait before you can increase his dose. I'm not thinking of anything drastic. What if we just set an initial goal of using it in tiny amounts just to try to nudge him out of the 500-600's?

When I have used R, my goal has never been to set up big fast drops, but just to take the edge off of higher numbers and to prevent bounces from going so high.

You have availability to test during the day, so IMHO that makes Gus a perfect candidate to use R and bring him down into a more reasonable range.

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

Hi Gus and Bev. Sorry I have no dosing advice but Choco and I just wanted to stop by to wish you guys a Happy Sunday! :mrgreen:

Re: 4/17 Gus AMPS 370;+4=549 Dose ???

I'd encourage you to give Libby's offer serious consideration. As much as I'd love to see Gus out of these high numbers, I bet you'd love it more.

Re: 4/17 Gus AMPS 370

Hi Bev,

Yes patience is a virture in this sugar dance. I always say if it's Sara's sugar dance why am i always doing the dancing?

Have a nice night and hope Gus clears his bounce soon.

jan and sara

Just popping to say good evening! Hope you had a good day, Bev... Gus' numbers notwithstanding!!

Libby, I've thought about it and if you think that this insulin will help Gus, I'll do it. I have an appointment to interview a new vet tomorrow. Any ideas as to how to go about getting a script for Humulin R.

Bev, I'm pretty sure R is OTC... no script needed.

I've also read that you don't need a prescription for Humulin R. Good luck with this. You're in good hands with Libby.

Ella

Shows you how much I know!! Well, that;s a relief anyhow. I was trying to figure out a way to introduce myself, show the spreadsheet, tell him about the website and all of you, And then........ask him for a med! Whew, I can get it myself. I have come to trust the people of FDMB and know that Gus' best interest is at heart.

If you decide to use Humulin R, I'm going to be watching Gus' SS with an eagle eye to see what happens. Anything has to be better than the 500-600's the poor thing is hitting now.

I'm guessing that the poor guy was a high flyin' diabetic for quite a while before showing me any symptoms. His system is so intent on maintaining those high numbers, it thinks that's what normal. Poor thing, walking around with maple syrup in his veins.

all you have to do is ask the pharmacist and they will give it to you. That seemed weird to me, but it worked! I think I paid around $50 for the vial, but I have seen others post that they got it for less so I might have overpaid. :lol: You use such tiny amounts that it lasts forever.

If you don't already have syringes with half unit markings you'll want to get those too. And make sure you have plenty of test strips because the first few times you shoot R I'll ask you to test at +1, +2, +3 and maybe +4 to collect data and see how he is responding. It's not hard and it's not that scary once you do it, because you'll collect data carefully and then use that data to make decisions.

For people who may be reading this, we don't usually suggest R except for cats with high dose conditions or occasionally for cats with ketones present. I'm only suggesting it because Gus has been so very high for such a long time that I think we can give his body some relief from the 600s while we work on getting him to a Lantus dose that will work for him. Even if he decides to hang out in the 400s, that will be an improvement. Once he finds his good Lantus dose, he probably won't need the R anymore. We just want to give him some help.

Libby, I have the appropriate syringes and plenty of test strips. I'll buy the R tomorrow. Gus is due for a dose increase of .5U tomorrow PM. He'll respond to the new dose within 24-36 hours and then shoot right back up to 600+. Will you be watching his response and subsequent bounce? I guess I'll just wait for you to get in contact with me when you feel the time is right. Thanks.

Hi guys - just a quick drop by to say HI! Good luck with the dew dose, and the addition of R. I can't help with any of that, never had to sue it, You're in good hands with those that will help you. I wish you good fortune - I think you've got a great attitude towards it all and a commitment to helping Gus.

Gus will be so happy to be posting better numbers.

I'll be around to watch and I am sure others with R experience will be around, so you won't be alone.
With such high numbers, it will be good to give a good pull down on those 600s and give your insulin a chance to work.

I'm so excited for you, Bev! This could be such a blessing, for Gus and you. I'm going to keep watching Gus' SS to see how this plays out. Good luck!!!

Thanks to everyone for your continued help and support. Thanking all those who will be helping me with R, in advance. Gus really does need relief. Now, I think I'm done with this day. I've had better and I've had worse. So, as long as we're somewhere in the middle, it's all good. Good night, that is. Have a nice sleep all. Thanks for not giving up on us, Libby.

it won't hurt to send me a PM when you get the R, since I'm not here every day. That way I'll be sure to check in on you.

What we'll want to do is hit him with R at the *beginning* of a bounce. See how when he went to blue, he was already 312 at the next PS and then went straight up from there? You could use 0.1 units of R at the first sign of a bounce (which in this case was the 312) and see if that keeps him from going as high. Usually R is in and out of the system in 4 hours, so we would start with 0.1 units of R and do an "R curve" - test at +1, +2, +3 and +4 to see what the onset/nadir/duration of R are for Gus at that dose. If the numbers are still high, you can give another 0.1 units of R after nadir. What you don't want to do is give R at a time when a bounce might be clearing, and you don't want to give it at a time when the R and Lantus might nadir at the same time. That's why we give R only at preshot and *after* nadir, and why we give it at the beginning of a bounce and not just in any cycle.

0.1 units may or may not do anything, but just like with Lantus you have to start low so you can be sure. For some cats 0.1 is all they need. Even for my Jazzy, that dose can pack a punch. After a couple of cycles of 0.1, if that isn't doing much then we try 0.25 units and do the same R curve. The goal is to find out what his R curve looks like, and also about how many points of drop he gets from each dose. Once we have some good data, we'll be able to figure out a good strategy for when and how to use R for Gus. It will make more sense once you're doing it. :smile:

Depending on what his numbers do tomorrow, we can either increase his Lantus dose as planned, OR keep the Lantus dose the same and spend a few cycles working with R. I wouldn't increase the dose and start R at the same time because then if his numbers get better we won't know what is working.

bev, i just want to cheer you and gus on in this new effort to get him in better numbers! So glad Libby, Gayle & others have the experience to help you through this.