5/6 Asia R experiment, +10/R1 153, +11/R2 92, +12/R3 68, PMPS 89, +1 230

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Asia was acting super hungry before her +5 meal so I tested her: 89 down from 246 just 90 minutes ago. Makes perfect sense. :facepalm:

Case in point why I wouldn’t want to use R at a preshot. For every 10 times she doesn’t do this, this can and does happen and there’s no rhyme or reason or way to predict it.
 
I am anticipating a huge spike today later in the cycle, perfect opportunity to try R. I seem to recall not using R on a dose increase cycle, but I have to ask if that’s anywhere in the cycle, or just the beginning? I could understand not increasing and shooting R at a preshot since you don’t know what the L is going to do on the increase, but I know already. Would it still apply here for say +10 or whenever she shoots up? If so, what is the reasoning?

@Wendy&Neko @Jill & Alex (GA) @Sandy and Black Kitty
 
:woot:Slow down Asia!! Hope she doesn't bounce to the moon

cat to moon.jpg

Good luck with the R should you give it a whirl;)
 
Stacy & Asia said:
I am anticipating a huge spike today later in the cycle, perfect opportunity to try R. I seem to recall not using R on a dose increase cycle, but I have to ask if that’s anywhere in the cycle, or just the beginning? I could understand not increasing and shooting R at a preshot since you don’t know what the L is going to do on the increase, but I know already. Would it still apply here for say +10 or whenever she shoots up? If so, what is the reasoning?
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You are right, Asia gave a perfect example of why you wouldn't have wanted to use R this morning with the increase. Some kitties like to really work the juice the first cycle. I think you'd be fine giving R a try late in the cycle. Are you thinking something like 0.1U?

Surfs up Asia, get away from the sharks!
 
Wendy&Neko said:
You are right, Asia gave a perfect example of why you wouldn't have wanted to use R this morning with the increase. Some kitties like to really work the juice the first cycle. I think you'd be fine giving R a try late in the cycle. Are you thinking something like 0.1U?

Surfs up Asia, get away from the sharks!
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She likes to be dramatic sometimes on the increase, this is what I would refer to as a jump start, I think she will now work the 1 unit. Paws crossed!

I was thinking .1 u, that's a pretty standard start amount?
 
Yes, the 0.1 is a good starting place. Test every hour for 5 hours after you shoot R. You need to gather onset and nadir timing data. Shoot R in the scruff. Make sure you have a good system in place to clearly differentiate the L and R insulins. Easier if you aren't shooting at the same time.
 
Wendy&Neko said:
Yes, the 0.1 is a good starting place. Test every hour for 5 hours after you shoot R. You need to gather onset and nadir timing data. Shoot R in the scruff. Make sure you have a good system in place to clearly differentiate the L and R insulins. Easier if you aren't shooting at the same time.
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I already wrapped the vial of R in spiky Velcro and I keep it far away from the Lev in the fridge. Usually shoot L in my bedroom, going to shoot R in the living room.

What’s the reasoning for shooting in the scruff? To not mix them up or does it play with the depot somehow if you shoot in the same area? I ask because I give several other injections in her scruff (b12, Adequan, Cerenia) so I try to stay away from that area with insulin these days.
 
+8 93, on her way up. I gave rice flour today instead of potato flakes, lower p, higher carbs, haven’t experimented much with it yet, maybe overdid it but I didn’t like that 33 in a place where I know she could drop further. Oh well.
 
Oh Asia! What a show off!

I can't add anything to what you and Wendy have discussed about the use of R. You'll want to figure out onset, nadir and duration of R just as you've done with Lantus then Levemir. They say R can last 6 - 8 hours in some cats, but I've only seen it last as long as 6 hours in Joan's Madison. R seems to be over and out in 4 hours with most cats... 5 max.

Good luck!
 
R +1 153

So I suspect it starts working in under an hour, because even at the 30 it had to fight the rising number and I’m sure it likely did.
 
Jill & Alex (GA) said:
Oh Asia! What a show off!

I can't add anything to what you and Wendy have discussed about the use of R. You'll want to figure out onset, nadir and duration of R just as you've done with Lantus then Levemir. They say R can last 6 - 8 hours in some cats, but I've only seen it last as long as 6 hours in Joan's Madison. R seems to be over and out in 4 hours with most cats... 5 max.

Good luck!
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I have a theory about this and will type more later, installing an AC unit in the girls room.
 
R+2 92

Looks like it will be a lower preshot and a falling number (what it actually looks like is hope). I think I should drop her L to .6 or .7 instead of 1 unit. My logic is that is the last L dose that gave her nadirs I liked without going too low and working with the R it just might do well, the problem is always that she never has the preshot to make any use of a proper L dose. Thoughts? @Wendy&Neko @Jill & Alex (GA)
 
Stacy & Asia said:
R+2 92

Looks like it will be a lower preshot and a falling number (what it actually looks like is hope). I think I should drop her L to .6 or .7 instead of 1 unit. My logic is that is the last L dose that gave her nadirs I liked without going too low and working with the R it just might do well, the problem is always that she never has the preshot to make any use of a proper L dose. Thoughts? @Wendy&Neko @Jill & Alex (GA)
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Your reasoning is sound. Try it.
This is a learning experience. In any case, better to keep Asia safe than be sorry anyway...
 
Stacy & Asia said:
If the R dose is more of a sliding scale, I’m thinking a drop would have sufficed here?
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Probably.

However, R doesn't always do the same thing every time. That's why we encourage monitoring carefully until the caregiver becomes reasonably certain how kitty will respond...
 
Jill & Alex (GA) said:
Oh Asia! What a show off!

I can't add anything to what you and Wendy have discussed about the use of R. You'll want to figure out onset, nadir and duration of R just as you've done with Lantus then Levemir. They say R can last 6 - 8 hours in some cats, but I've only seen it last as long as 6 hours in Joan's Madison. R seems to be over and out in 4 hours with most cats... 5 max.

Good luck!
Click to expand...

So my theory is this, based on how Asia’s past experiences have gone and what I know of humans and their insulin needs, I have no idea if this applies to other people’s cats or not. When they say something has a duration of insulin action (DIA) of say 6 hours, perhaps it only lowers (nadirs) at hour 3 and then you think it’s not working any longer because the numbers begin to rise, but some insulin is still in there, it’s just not powerful enough to fight the force of the rise by itself. I think it may not work any longer (to lower numbers) if left alone, but if more insulin is given before that time wears off (within the 6 hour DIA, but anytime after the 3 hour nadir when numbers are rising) it reinvigorates the previous insulin and they both work to continue to lower BG with some gusto. When Asia has had duration or overlap, it’s almost like the next shot sometimes works at hyper speed, even if I shot a rising number. Onset is the same, but the lowering effect is much greater.

When she doesn’t get enough duration, the number continues to rise past the next shot time and is usually high enough by onset (+2) that the lowering effect of the shot is greatly reduced and it could take hours to come back down. All of this is impacted of course by a great many things, exercise, postprandial response, other hormones, etc. Which explains why the results are somewhat inconsistent. But it would very much explain how R could affect the following cycle even though it’s “worn off” by then.

Humans get in trouble this way when they stack their bolus insulins too close together by having lunch and then say a snack 3 hours later and taking more bolus for that, even if a lot less than they would do for a meal. When it appears the last has worn off, if you give more it’s double trouble (this is also in addition to their basal insulin which marginally lowers their numbers from food although it isn’t designed for that, which is essentially 3 insulin doses teaming up).
 
R+3 68, the drop has slowed, I’m going to stall by an hour to see what comes next. If this R works out, I might want to make my shot times a little later anyway so I’m not waking up in the tiny window of sleep I get to give R in the pm cycle.
 
Stacy & Asia said:
So my theory is this, based on how Asia’s past experiences have gone and what I know of humans and their insulin needs, I have no idea if this applies to other people’s cats or not. When they say something has a duration of insulin action (DIA) of say 6 hours, perhaps it only lowers (nadirs) at hour 3 and then you think it’s not working any longer because the numbers begin to rise, but some insulin is still in there, it’s just not powerful enough to fight the force of the rise by itself. I think it may not work any longer (to lower numbers) if left alone, but if more insulin is given before that time wears off (within the 6 hour DIA, but anytime after the 3 hour nadir when numbers are rising) it reinvigorates the previous insulin and they both work to continue to lower BG with some gusto. When Asia has had duration or overlap, it’s almost like the next shot sometimes works at hyper speed, even if I shot a rising number. Onset is the same, but the lowering effect is much greater.

When she doesn’t get enough duration, the number continues to rise past the next shot time and is usually high enough by onset (+2) that the lowering effect of the shot is greatly reduced and it could take hours to come back down. All of this is impacted of course by a great many things, exercise, postprandial response, other hormones, etc. Which explains why the results are somewhat inconsistent. But it would very much explain how R could affect the following cycle even though it’s “worn off” by then.

Humans get in trouble this way when they stack their bolus insulins too close together by having lunch and then say a snack 3 hours later and taking more bolus for that, even if a lot less than they would do for a meal. When it appears the last has worn off, if you give more it’s double trouble (this is also in addition to their basal insulin which marginally lowers their numbers from food although it isn’t designed for that, which is essentially 3 insulin doses teaming up).
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Interesting theory. Not sure if it'll hold up in all instances, but overall your theory makes a lot of sense.

I've found the better one "knows thy cat"... kitty's response to insulin and food...as well as has a full understanding of how the insulin used works... the easier it is to regulate their cat because that knowledge opens up trying other options... options that may not be apparent when following usual guidelines by the book.
 
Stacy & Asia said:
R+3.5 72 :woot:
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Ok, a little scary because it's new, but really... the R is doing exactly what it's supposed to be doing. The tricky part is incorporating it's use to fit Asia's patterns/responses.

You're in control. If you have to you can even skip tonight's shot. This is all good info to know... maybe you'll find it necessary to set a certain number for using R. Something higher than 155... even if Asia is on the rise.
 
Jill & Alex (GA) said:
Ok, a little scary because it's new, but really... the R is doing exactly what it's supposed to be doing. The tricky part is incorporating it's use to fit Asia's patterns/responses.

You're in control. If you have to you can even skip tonight's shot. This is all good info to know... maybe you'll find it necessary to set a certain number for using R. Something higher than 155... even if Asia is on the rise.
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Not scary, that’s happy surprise face, she’s coming up instead of lower still. I think it did an excellent job. Bigger drop than I’d like in hour 1 and hour 2, but as an overall, it dropped her a 115 points which is spot on, right?
 
Oh wow! Go Asia! I am glad you are experimenting with R. I found it not that bad, but it seems to give you an extra tool that you can use to steer numbers a bit. I always felt a little more in control with it. However, I imagine is it far different with a normal dose kitty. I remember trying to pull out .25u and worrying it was overdrawn.. But, you are a master at your craft!
 
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