3/13 Max pmps 398 +1 379 +2 407 +3 374 +4 331 +5 311

Max & Lori

Max & Lori

Member Since 2021
I missed the +1 snack and test, but he did get a big +2 snack. Then he decides to be mischievous Max today and takes a big plunge down anyway. :D So we all know what happens later.
 
I know! I knew it would be bad. Yes I’m up for it. Tell me what to do. I think he’ll probably bounce all night and not dive again so I should go for it.
 
At preshot time, you give 0.1 U R as well as his L. Most important, make sure you have a routine so you clearly separate the two insulins and doses. You don't want to give the L dose of R! (it's been done). I used to take one insulin out of the fridge, load it, then put it back. R was in a vial in the back, L cartridge in a little plastic container mid shelf of the fridge. After that, test ever +hour for 4 hours. We want to see when R takes effect.

On the odd change he gets over this fast, I wouldn't do R tomorrow morning.
 
Okay. That sounds good. I wouldn’t do it by myself yet anyway. Only thing that makes me nervous is that he onsets early with Levemir and sometimes he bounces and changes his mind. I think he will be really high though at PMPS which is in about 20 mins so maybe he won’t dive again.
 
Wanted to get that out there first. A few more guideines.

With some cats (especially with IAA), you can see impacts of an R dose on the following cycle. We are hoping that the use of R will lower the number that L(Levemir) has to work with, so that can last a little longer. Plus the IAA effect - first time you use R could confuse antibodies if still active.

Once have a better idea when R onset is, and how long it lasts, you won't have to test every hour. We might also change to shooting R more like +10 or +11 with Max, depending on whether you are positive he's bouncing, and how long the R effect lasts.

You don't always see action with an R experiment, be patient. You may need a couple of the same tests to see what the effect of R is, and whether you need to increase the R dose.

We will start to build an R scale for you. An R scale basically tells you how much R to shoot at what time and in what circumstanes (including the R preshot). Here is an example of an R scale for Oberon.
 
We are also starting at 0.1 units R, which is a pretty small dose. However, I've seen cats need all different ranges of R. Neko didn't need much, I even dosed her with a drop when her L dose was smaller than Max's is. But I've also seen a cat on 30uL need just a tiny dose of R. And I've seen a cat getting 20 units R. It's really ECID. Start low, go slow.
 
Okay I like that, that’s a great thing to have. One question did you use calipers for these fine doses or just eyeball it? I’ve seen the pictures and read the sticky on fine dosing.
 
I used calipers, but my BD syringes were horribly marked. There was a lot of insulin below the zero line, as much as 1/3 unit. So it'll depend how confident you are on your particular brand of syringes. Can't remember if I told you the experiment to practice 0.1 units by seeing how many drops you could squeeze out (twist the plunger) and try to make it consistent each time.
 
Yes I did practice that. I just have problems with measuring something that small with calipers. I use Vet RX Ulticare and they are pretty consistent from what I can tell. I’ve only had a couple that looked off.
 
Okay @Wendy&Neko he's at 379 @ +1. I did feed him 9% at pmps, but I usually don't feed every hour up until +4 when he's bouncing, should I just do as I normally would for now? I only feed hourly up until +4 when he's bounce clearing so I can prevent diving.
 
I see +1 is down just a bit. Hard to say if that is Max with an early R onset, or what he'd do normally. Typical R onset is around +2, Neko was later. Max likes to onset Levemir early too.

Just feed him as you would normally, unless you have to intervene. I'd like to see what R does in normal circumstances.
 
Just his regular food? Well, let's see what +3 says. It could be several things. One positive outcome of R is to put a lid on bounces.
 
Well I did give him 9% tonight. I usually give him 4% or something like that when he bounces. I probably should have stuck with the 4% maybe.
 
I see he's coming down, but that could be the Levemir onset too. Your goal is to make sure that over the course of R's effect, or about 4 hours, he doesn't come down more than 100 points. Let's get a +4, and see what that says. I'm looking at 3/6 for comparison.
 
Yeah, it could have been a way worse bounce without the R too, even though it doesn’t look like it’s doing much. He’s a little constipated too. He only had a very small hard poo today. So I’m waiting on that. I looked at 3/6 which was high and flat so I see what you’re doing.
 
Down 67 points, that's a good amount, since around 100 or less is what you want. But also includes some of the Lev onset, so hard to say how much was actually R.

Would you be up for a +5? It's not strictly necessary, more from a point of view of data gathering. Compared to March 6th, it seems to have put a bit of a lid on the bounce. But this is just one data point. If you can't do +5, that's OK. Will be curious to see where he is in the AM.
 
You won't have to do it all the time, and over time you won't have to do hourly tests, so this is just in the beginning while we figure things out with Max and R.
 
R might have helped some. Morning AMPS will provide more info. Need another more test under similar circumstances, starting a bounce, and same dose, as long as over 300 at PS.
 
Okay got it. Thank you for guiding me through it and all of the helpful info you’ve given me. This has helped so much! Good night.:)
 
Sleep well, I just caught up on your adventure. Welcome to the R club. :) I haven't had to use it for a while but Wendy is sooo right saying you don't always see action and have to be patient. I liked to say the R was for roulette because sometimes it worked wonderfully and othertimes...not so much. Paws crossed for you and Max!
 
Thank you Liz! I excited about learning how to use R for Max. Max needs all the help he can get. He’s acro and IAA. Its always good to hear from others sharing their experiences, so thanks for commenting! If there’s one thing this whole journey is teaching me, it’s patience. Still working on that sometimes, but I’m grateful for all the support along the way.:)
 
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