1/7 Bubba,+3-196,+4-195,+7-214,+11-207,PMPS 207,+3-229, +4.25-269

[Libby and Lucy]

@Jill & Alex (GA) and @Libby and Lucy , just got a + 4.25 - 269. Since today's cycle he has gone steadily up. If he continues into the yellow into tomorrow morning, should I take back up to 5 units? Just thinking ahead as y'all won't be around when I shoot at 5:30 AM EST. Guess I will get a good night's sleep tonight.

sorry, I fell asleep in front of the TV.

I think I would give it at least one more cycle. This looks like he is in a bounce that might still have a chance to clear. I'm not good at patience, but 51 was the lowest he has been in a long time so it's normal for him to bounce from it. Just my opinion right this minute...

 

[granadilla]

Bobbie, I love the patch!!

 

[Jill & Alex (GA)]

Bobbie - I just want to say that you have done such an excellent job with Bubba. Last night, I stayed up to 2am reading your journey since the beginning of December. I kind of "checked out" in December so I had a lot to cover. Anyway, it is much better to read your posts than any popular murder/mystery novel and I couldn't wait to see what the next day would bring. I thought it was so interesting jump starting Lantus with the R. That was so amazing. I wonder if this procedure is somewhere in the medical books. If not or even if so, you should be used as an example. Maybe you and Bubba can even do guest appearances on something like the Dr. Oz show???? Anyway, just wanted to say "great job" to you, Bubba, Jill, Libby and all the others here that has helped you. I am so happy for you and Bubba.

Thank you, but Bobbie did all the work. None of this could have been accomplished to date (we're not done yet) without her persistence and dedication to helping Bubba feel better.

Interestingly enough, Bubba's circumstances were not like what we've ever seen when throwing moderate ketones. Usually when kitty is throwing moderate ketones they're very sick and in most cases, won't eat and hospitalizing them is a must to prevent kitty from developing DKA and/or HL or to save kitty's life.

Bubba didn't have the usual signs/symptoms of being in DKA:

• Drinking excessive amounts of water OR no water
• Excessive urination
• Diminished activity
• Not eating for over 12 hours
• Vomiting
• Lethargy and depression
• Weakness
• Breathing very fast
• Dehydration
• Ketone odor on breath (smells like nail-polish remover or fruit)

The basic recipe for developing ketones = an insufficient supply of insulin + inappetance + infection OR other systemic stresses.

In this case, blood tests looked good. There were no signs of infection. Appetite was good. And yet he was throwing ketones... and moderate at that! That left us knowing that we were dealing with an insufficient supply of insulin and had to increase it as quickly as we could. We didn't want to take the chance of anything else happening in the meantime (Bubba getting sick or refusing to eat) because that would increase his chances of going into DKA.

Unfortunately, when a cat is actively throwing ketones is usually not the best time to switch insulins... especially switching to a depot insulin since it takes awhile to build the depot at each dose increase. We were in unchartered territory, but we knew we had to incorporate the use of R as a bolus insulin to actively increase the insulin supply while we increased the Lantus dose as quickly and as safely as we could. Libby and I had to draw on our experience and knowledge of depot insulins, using R as a bolus, and give due consideration to the caregiver and cat. We lucked out with both Bobbie and Bubba! They're both troopers!

So no, this procedure is not in any medical books that I know of. We ran with what we knew and so far it's worked out pretty well.
Hats off to Bobbie and Bubba!

 

[Bobbie And Bubba]

Thank you, but Bobbie did all the work. None of this could have been accomplished to date (we're not done yet) without her persistence and dedication to helping Bubba feel better.

Interestingly enough, Bubba's circumstances were not like what we've ever seen when throwing moderate ketones. Usually when kitty is throwing moderate ketones they're very sick and in most cases, won't eat and hospitalizing them is a must to prevent kitty from developing DKA and/or HL or to save kitty's life.

Bubba didn't have the usual signs/symptoms of being in DKA:

• Drinking excessive amounts of water OR no water
• Excessive urination
• Diminished activity
• Not eating for over 12 hours
• Vomiting
• Lethargy and depression
• Weakness
• Breathing very fast
• Dehydration
• Ketone odor on breath (smells like nail-polish remover or fruit)

The basic recipe for developing ketones = an insufficient supply of insulin + inappetance + infection OR other systemic stresses.

In this case, blood tests looked good. There were no signs of infection. Appetite was good. And yet he was throwing ketones... and moderate at that! That left us knowing that we were dealing with an insufficient supply of insulin and had to increase it as quickly as we could. We didn't want to take the chance of anything else happening in the meantime (Bubba getting sick or refusing to eat) because that would increase his chances of going into DKA.

Unfortunately, when a cat is actively throwing ketones is usually not the best time to switch insulins... especially switching to a depot insulin since it takes awhile to build the depot at each dose increase. We were in unchartered territory, but we knew we had to incorporate the use of R as a bolus insulin to actively increase the insulin supply while we increased the Lantus dose as quickly and as safely as we could. Libby and I had to draw on our experience and knowledge of depot insulins, using R as a bolus, and give due consideration to the caregiver and cat. We lucked out with both Bobbie and Bubba! They're both troopers!

So no, this procedure is not in any medical books that I know of. We ran with what we knew and so far it's worked out pretty well.
Hats off to Bobbie and Bubba!

Thanks for the compliment, Jill but, I could not have done this without yours and Libby's knowledge and experience of Lantus AND working with Novolin R as a bolus. Let's just say that we were a good team!