4/5 Floyd AMPS 361, +2 368, +4 199, +5 152, +7 110, +9 436, PMPS Hi

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Good morning Janine. It's nice to see Floyd out of the blacks and reds all ready.

Using some R with Floyd to help hold down his numbers as soon as the bounce starts is a great idea. He is one bouncy boy!
 
When I do need to use the R, I have somewhat of an idea, but can anyone direct me to the members with specific experience to tag?

I some experience using R to treat DKA, but obviously not in this situation.
 
Janine & Floyd said:
When I do need to use the R, I have somewhat of an idea, but can anyone direct me to the members with specific experience to tag?

I some experience using R to treat DKA, but obviously not in this situation.
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You'll be using it as the bounce begins. When Floyd drops into high greens and low blues he's not staying there long because the dang bounce starts. As soon as it starts is when you'll give it. And as Sandy said, it will need to be at a time that you are available for the next 4 hours as you will be testing him every hour on the hour to see how he responds.

@Sandy and Black Kitty is one of the R experts here and she will help you get started.

Floyd: This is a warning, Dude, the R team is going to give you some liver training. :cat:
 
Sorry, just got on. I would have held off using R just yet. Typically we get people to start at preshot. Or you can start late in the cycle when you know he's on his way up which in Floyd is more like +8. His SS looks like he's on his way down. For now, get a test every hour. Do you have high carb food/karo around?

More guidelines in the next post.
 
Wendy&Neko said:
Sorry, just got on. I would have held off using R just yet. Typically we get people to start at preshot. Or you can start late in the cycle when you know he's on his way up which in Floyd is more like +8. His SS looks like he's on his way down. For now, get a test every hour. Do you have high carb food/karo around?

More guidelines in the next post.
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No problem. Yes, I have all the supplies. I'll keep testing. Thank you!
 
To start, learning when to use R is probably easier than learning when not to use it at first. The main goal with R is that you want to add it at a time when you know it won't cause a fast drop. Fast drops cause bounces which defeats the purpose of using R. You have to consider the action of the L basal insulin (works with either Lantus or Lev) plus the action of the R on top. For today and the next few experiments, you want to learn the onset, nadir and duration of the R so you can safely lay the R action on top of the L action. As a general guideline, the R action shouldn't take more than 100 points off during it's duration. It can be helpful the first few times you use R to coordinate that time with an experienced R user, so they can help you decide if it's a good time to shoot R.

As Sandy said yesterday, you want to avoid the overlap of nadirs of the bolus and basal insulin. Since R typically onsets around +2 and nadirs around +4, we generally avoid shooting early mid cycle. Don't look at Neko's SS as an example of R use, she was non typical for both her R and L onsets and nadirs.

Develop a fail safe method of storing/using your R and L insulins. I used R in a vial and L in cartridges (pens for the US). If shooting at the same time, I always shot L first, then R. Be mindful and in the game. We've seen people mix up the insulins and shoot the L dose of R. :eek: Store them in different parts of the fridge.

Don't use R on the cycle when you increase (which you did today). Those cycles can sometimes have a little extra momentum - as you are seeing. Similarly, don't use R when the bounce is breaking, as those cycles can have extra downward momentum. Both those situations can cause fast drops (ie. more bouncing).

Using R can sometimes have an effect on the following cycle. That's because you've lowered the BG and given the L some good numbers to work with the next cycle. If you ever can't monitor the following cycle, hold off on using R, just in case. Being cautious with R is always a good thing.

You don't always see immediate results from using R. Or it could be that R is just preventing the numbers from getting worse. That's all good. Be patient.

Overtime you will develop an R scale. Take a look at Sandy's BK's spreadsheet for a great example. He had extreme insulin resistance due to antibodies, so don't let the numbers scare you. My dosing scale was much simpler and I never used more then 0.5 units for numbers over 350. When Neko's dose got lower, the most I gave was 0.1 units. You have to learn what works for Floyd. It's truly ECID.

And finally, using R may be a temporary thing. A cat's situation can change. You may need to just use it for a while until Floyd starts to get used to better numbers. His quick turnaround on the bounce is a good sign.
 
Soooo.....feeling like an idiot. Misread some of the info...... Should have known better. :banghead: Ready for lots of activity.. :( (My objective brain shuts off sometimes when dealing with my own pets.)
 
Wendy&Neko said:
Hey, at least you are there and testing.:bighug: Let's just keep Floyd safe and we can regroup for another experiment at a later date. It's still a chance for data gathering and learning. Will someone be home after +9 today? Worst case, you take him to work. Best case, this is a non event.
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Someone will be home the rest of the day except about a 15 min stretch. I leave at about +9.5, but my almost 16 year-old DD will be home with him, then I'm back by +10.5.

Thanks, everyone for all your help and encouragement!
 
(I am going to pose this question in my own thread later.... but I wonder if using R would have assisted Gordy in his bounces on Lantus.... never really thought of it, but the bounces are his main issue.)

I'll be following Floyd's R journey!
 
Out of curiosity, is the food and treats you are giving him zero carb? He seems pretty flat, you could go to 1 hour between tests now.
 
Wendy&Neko said:
Out of curiosity, is the food and treats you are giving him zero carb? He seems pretty flat, you could go to 1 hour between tests now.
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Yes. The food is his regular zero carb and the treats are just a tiny morsel of chicken breast.
These are the treats - really just giving those to reward for testing as a way to get to testing in the morning before feeding. (One packet lasts 3-4 tests)

Testing again at +9.
 
Yep, there it is, but to be safe........

Wendy&Neko said:
Using R can sometimes have an effect on the following cycle. That's because you've lowered the BG and given the L some good numbers to work with the next cycle. If you ever can't monitor the following cycle, hold off on using R, just in case. Being cautious with R is always a good thing
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Hi Janine. You are in good hands with Sandy & Wendy assisting you with R, they helped guide me at first and it was the catalyst in getting Bronx out of all reds & blacks. One thing they may not have mentioned is that even though R is an "in & out" insulin, it can have a cumulative effect: ECID of course, but sometimes Bronx would have no reaction to R during a cycle and I would shoot R again later in the cycle & still no immediate effect, but then he would drop way too low later on that 2nd cycle. So make sure you can test at all times, even on the following non-R cycle. Using R to chase a bounce that R initially caused can get you in a constant cycle you don't want Floyd to be in. Use just enough R to drop Floyd 100 or so at the nadir. And like Sandy & Wendy said which can't be stressed enough is you don't want to overlap the R & Lantus nadirs. Good luck!!!
 
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