Elmo PMPS 133.....

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Beth 73

Beth 73

Member Since 2016
Good morning from the Ozarks....just took Elmo's BG...141 after no insulin last night...fed him small amount before bed last night( about 6 hours ago).... please advise .....
 
Will be feeding in15 minutes and shot 30 minutes after that...he is more alert and yeowing to be fed...will be watching behavior as vetsulin has made him sleepy and lethargic most days...
 
Elmo held his numbers very well overnight. Do you feel comfortable with the same drill as yesterday's AM cycle?


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Critter Mom said:
Elmo held his numbers very well overnight. Do you feel comfortable with the same drill as yesterday's AM cycle?


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Yes if that is what he needs....yesterday summary was : give 0.25 minus one drop...test at +1.5 , +2, +2.5, +3, +3.5, + 4 , + 6.5 and +11.... monitor and feed at each as necessary
 
Your boy's pancreas is definitely doing something. It's his best AMPS for a good while - and it's down from last night's PM+2.

It's great that you got the PM+2 test; it shows a food rise from the PMPS test and gives us more info about what may be happening with Elmo's pancreas function.

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Thank you, Mogs, for " holding my hand" thru all of this....so I am to give him 0.25 minus one drop and monitor thru out as yesterday???
 
Both a pleasure and privilege, Beth. :bighug:

As long as you're able to test and feed then based on Elmo's numbers I think you should be OK with the same dose as yesterday morning.

Be sure to do the first test at +1.5 to make sure Elmo's safe and to see where the cycle's heading UNLESS he starts asking for food earlier (in which case test straight away in case he needs some carbs).


Mogs
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Critter Mom said:
Both a pleasure and privilege, Beth. :bighug:

As long as you're able to test and feed then based on Elmo's numbers I think you should be OK with the same dose as yesterday morning.

Be sure to do the first test at +1.5 to make sure Elmo's safe and to see where the cycle's heading UNLESS he starts asking for food earlier (in which case test straight away in case he needs some carbs).


Mogs
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A million thank you's.....going to ask a silly question...when I minus the one drop do I do it when drop first shows or wait til bigger?
 
Beth 73 said:
A million thank you's.....going to ask a silly question...when I minus the one drop do I do it when drop first shows or wait til bigger?
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That's a good question, Beth, because the size of drop can significantly affect the dose at these micro levels. Do you recall what you did yesterday? Try to mimic that as well as you can.
 
Kris & Teasel said:
Winter here has its charms and can be beautiful ...
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... but those charms can wear off pretty darn pronto when one ends up snowed-in with no food in the house.

My love affair with snow ended when I had to do a lot of driving in the course of my work. We're not geared up for it properly on this side of the pond and it makes road travel a complete mare.


Mogs
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Yes I do LOVE snow , although ours does not come often or stay for very long:(....going to call vet in a bit to at least get the u100s approved and hopefully gotten today..hoping he will consider changing insulins without seeing Elmo. Oh, how he ate the hour long round trip and not fond of the visit itself..has taken to biting if gets the chance.
 
Critter Mom said:
... but those charms can wear off pretty darn pronto when one ends up snowed-in with no food in the house.

My love affair with snow ended when I had to do a lot of driving in the course of my work. We're not geared up for it properly on this side of the pond and it makes road travel a complete mare.


Mogs
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I can well imagine. Mogs. At least here it's in our DNA and we put snow tires on our cars and there are huge fleets of vehicles out to plough/salt roads.
 
Be sure to let us know how things go with the vetty bean, Beth. Sending wishes for a productive and helpful consult.

:bighug:

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Beth 73 said:
Yes I do LOVE snow , although ours does not come often or stay for very long:(....going to call vet in a bit to at least get the u100s approved and hopefully gotten today..hoping he will consider changing insulins without seeing Elmo. Oh, how he ate the hour long round trip and not fond of the visit itself..has taken to biting if gets the chance.
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What? Biting? Not Elmo, the Buddha!
 
Kris, when u have a minute, please explain U100s to me and how if there r no extra markings it is easier to give these micro doses..I want to call vet well armed and sound like I know what I am talking about. I figure if I take baby steps, today requesting u 100 and then the request to change insulins I can ease vet into my brave, new world:)
 
Also, if u were me, what would need to be said to let vet know why I want first the needles and then the insulin change.Wanting to go in armed and informed.
 
Good morning all! Glad to see Elmo is holding great numbers despite no shot last night. I too will be around today between snow shoveling sojourns so I'll keep an eye on Elmo too. I love snow and prefer it over rain but I do wish Mother Nature had seen fit not to bless us with this huge dump all at once. Already did one clean up of what looked to be 3 to 4 inches last night and I'm guessing there is another 4-6 inches of it out there now.
Here's a picture for you Beth so you can enjoy it vicariously!

IMG_20161212_093831885.jpg

This is my front window view this AM! Not sure what's up with the sidewalk plow leavings. Looks like some ancient art site out there right now! :woot: And the neighbourhood dog walker with her 3 tiny charges is having a hard time getting them onto the road from the sidewalk at the corner. Poor babies!
 
MrWorfMen's Mom said:
Good morning all! Glad to see Elmo is holding great numbers despite no shot last night. I too will be around today between snow shoveling sojourns so I'll keep an eye on Elmo too. I love snow and prefer it over rain but I do wish Mother Nature had seen fit not to bless us with this huge dump all at once. Already did one clean up of what looked to be 3 to 4 inches last night and I'm guessing there is another 4-6 inches of it out there now.
Here's a picture for you Beth so you can enjoy it vicariously!

View attachment 24808
This is my front window view this AM! Not sure what's up with the sidewalk plow leavings. Looks like some ancient art site out there right now! :woot: And the neighbourhood dog walker with her 3 tiny charges is having a hard time getting them onto the road from the sidewalk at the corner. Poor babies!
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Ohhhhhhhhh.....makes my heart glad !! Thank u , Linda, for sharing that snowy photo! How absolutely gorgeous! What can I say, I'm an autumn and winter girl !!!
 
As for explaining the need for 100U syringes to the vet, I'd take a copy of the conversion chart with you to show how you'd be able to draw up 0.2u of Vetsulin using the first line on the syringe barrel and point out that you'd be able to draw up even less if need be, by drawing up between the top (needle end) of the barrel and the first marking. Elmo definitely needs very small doses now and this is the only way to be able to do it with Vetsulin.

On the long acting insulin side, I'd simply point out how quickly Elmo's BG is dropping and how much in the cycle and mention all the sleep derivation that has ensued because of the monitoring/steering that requires. The treatment plan has to work for both you and Elmo and right now using the Vetsulin even at tiny doses is time intensive and can be downright scary (don't be afraid to be dramatic to get your point across if there is any pushback!). It's also making it necessary to skip shots from time to time which you prefer not to do with a ketone prone cat. Longer acting insulins take longer to start working and will give Elmo a smoother cycle with a slower drop, easier to catch and steer if need be and will last through the 12 hour cycle which Vetsulin does not.
 
Beth 73 said:
how if there r no extra markings it is easier to give these micro doses..
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Not sure what this means, Beth, so I'll proceed:

Beth 73 said:
please explain U100s to me
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  • U40 insulin has 40 units (active amounts) of insulin in each mL of insulin solution. U100 insulin is more concentrated and has 100 units (active units) of insulin in each mL of insulin solution. So - U100 insulin is 100 ÷ 40 = 2.5 times more concentrated than U40 insulin.
  • Regardless of how concentrated the insulin solution is, a unit of insulin is a unit of insulin. It just takes more (a larger volume) of the U40 solution to get a dose than it takes of U100 solution. So if the dose you want is, say, 1 unit you'll have more insulin solution liquid in your U40 dose than the amount of liquid in your U100 dose. Make sense?
  • U40 syringes and U100 syringes are made to accommodate the difference in concentration. U40s are wider in diameter with a little more distance between the marks. U100s are smaller in diameter and there's less space between marks. The distance between full unit marks is still one unit on each type of syringe. It just takes LESS of the U100 insulin to get that unit.
  • One drawback of U100 insulin and the accompanying syringes is that it's harder to give tiny fractions of doses because the stuff is so concentrated. You can measure out full and half units using the marks and can learn to eyeball 0.25 u but that's it. The marks on the barrel are so close together that you can't dose any finer than that.
  • Here's where using U100s to dose U40 insulin comes in: U4o insulin is more dilute so it takes more liquid insulin solution to have 1 unit of insulin, as a matter of fact, 2.5 times more. Recall that U100 insulin is 2.5 times more concentrated. Said another way, U40 insulin is 2.5 times more dilute.
  • If you want to draw up 1 unit of insulin in a U40 syringe, you fill it to the 1 unit mark. That volume has 1 unit of active insulin floating around in it. If you could transfer this amount of liquid magically into a U100 syringe, lo and behold, it would fill that skinnier syringe with its closer markings up to the 2.5 unit mark.
  • The conversion chart we use here was made up so you don't even need to think of all this but just follow the numbers: conversion chart.
Here's why using U100 syringes for U40 insulin works to your advantage:
2.5 on the U1oo syringe = 1 unit of U40 insulin
2.0 " " = 0.8 u
1.5 " " = 0.6 u
1.0 " " = 0.4 u
0.5 " " = 0.2 u
0.0 " " = 0.0 u.
You can also eyeball half way between the half unit marks on the U100 syringes to dose even finer - eg. 0.1, 0.3, 0.7 u.

Many vets don't want their clients using U100s for U40 insulin because they're afraid of dosing mistakes being made. If you're careful this isn't an issue. Even if the math is confusing, the chart does the work for you.

Sorry if this is too long ...
 
Beth 73 said:
today requesting u 100 and then the request to change insulins
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If you request a U100 insulin the only option is U1oo syringes so that shouldn't be an issue. It's requesting a prescription for U100 syringes to use with U40 insulin like your Vetsulin that might cause some head-scratching. Maybe go armed with the conversion chart and say you want to be able to try smaller doses than you can manage with the U40s.

If you're not quite ready to give up on the Vetsulin, you could try using U100s for a bit to see how he gets on with tiny doses. If that doesn't work and you want to go to a U100 insulin you'd already have the proper syringes,
 
Kris & Teasel said:
BG numbers update Beth?[/QUOTE. AMPS..141.....+1.5..123.......+2..119.....gave 1t 5 carb at +1.5. And 1t 1/2 5 and 1/2 8 carb at +2.....thanks for explanation also....just wanting to be armed and u and Linda did that. My only other question is what if he presses a trial OTJ just to see....Mogs warned me about that...
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MrWorfMen's Mom said:
As for explaining the need for 100U syringes to the vet, I'd take a copy of the conversion chart with you to show how you'd be able to draw up 0.2u of Vetsulin using the first line on the syringe barrel and point out that you'd be able to draw up even less if need be, by drawing up between the top (needle end) of the barrel and the first marking. Elmo definitely needs very small doses now and this is the only way to be able to do it with Vetsulin.

On the long acting insulin side, I'd simply point out how quickly Elmo's BG is dropping and how much in the cycle and mention all the sleep derivation that has ensued because of the monitoring/steering that requires. The treatment plan has to work for both you and Elmo and right now using the Vetsulin even at tiny doses is time intensive and can be downright scary (don't be afraid to be dramatic to get your point across if there is any pushback!). It's also making it necessary to skip shots from time to time which you prefer not to do with a ketone prone cat. Longer acting insulins take longer to start working and will give Elmo a smoother cycle with a slower drop, easier to catch and steer if need be and will last through the 12 hour cycle which Vetsulin does not.
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Thank you, thank you
MrWorfMen's Mom said:
As for explaining the need for 100U syringes to the vet, I'd take a copy of the conversion chart with you to show how you'd be able to draw up 0.2u of Vetsulin using the first line on the syringe barrel and point out that you'd be able to draw up even less if need be, by drawing up between the top (needle end) of the barrel and the first marking. Elmo definitely needs very small doses now and this is the only way to be able to do it with Vetsulin.

On the long acting insulin side, I'd simply point out how quickly Elmo's BG is dropping and how much in the cycle and mention all the sleep derivation that has ensued because of the monitoring/steering that requires. The treatment plan has to work for both you and Elmo and right now using the Vetsulin even at tiny doses is time intensive and can be downright scary (don't be afraid to be dramatic to get your point across if there is any pushback!). It's also making it necessary to skip shots from time to time which you prefer not to do with a ketone prone cat. Longer acting insulins take longer to start working and will give Elmo a smoother cycle with a slower drop, easier to catch and steer if need be and will last through the 12 hour cycle which Vetsulin does not.
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Thank you, thank you, Linda !!
 
Beth 73 said:
Also, if u were me, what would need to be said to let vet know why I want first the needles and then the insulin change.Wanting to go in armed and informed.
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If it were me I wouldn't fanny around with the Vetsulin/U100 + conversion chart stuff; I'd move straight to the request for the new insulin. (Ask me some time about when I reached this stage with Saoirse and forked out nearly £100(!!) for a Vetpen which only got used twice. :banghead: )


Mogs
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Yes the snow is beautiful to look at! I've been using that beauty as my excuse for procrastinating at cleaning it up this morning but alas I really need to go get my butt in gear! Right now I'd probably have a hard time getting out of my driveway even with four wheel drive and snow tires! :arghh:
 
Nice start to the day for Elmo.

Critter Mom said:
If it were me I wouldn't fanny around with the Vetsulin/U100 + conversion chart stuff; I'd move straight to the request for the new insulin. (Ask me some time about when I reached this stage with Saoirse and forked out nearly £100(!!) for a Vetpen which only got used twice. :banghead: )
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Good point Mogs! Maybe reverse the order and make the U100 insulin request first. If you get any pushback, then you have the request for the U100 syringes as a fallback position in the negotiation.
 
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