10/08 Jack The Night Before Resetting the Juice

Status
Not open for further replies.
Re: 10/08 Jack AMPS 341

I don't know if you saw Libby's post from last night:

Libby said:
Do you think you can consistently measure a dose smaller than 0.1? We'll need to talk about that and/or food manipulation to try to get Jack past this bounciness. We can't have him hitting 30's all the time.
Click to expand...
 
Re: 10/08 Jack AMPS 341

Here's a link to what 0.1u looks like when I load it:

http://jacksdads.shutterfly.com/pictures/9

And to answer Libby's question - no. It's not easy to be consistent about such a small dose in the U-100 needles. I think we're pretty close each time - but there's also two of us - and each person is always a little different. I'm ordering a 10 uL Nano Shot today.
 
Re: 10/08 Jack AMPS 341

01unit-1.jpg



that is taken from the Sticky at the top of the page "New to the Group"
Looks just like your picture, right?
 
Re: 10/08 Jack AMPS 341

I have a few thoughts about Jack's spreadsheet, so I'm going to share them and see if we can come up with a way to help him better.

Obviously 0.1 units BID is too much insulin for Jack. We don't want him hitting the 30's so often. There are a few things I can think of to try:

  • occasionally we'll see cats who bounce off the insulin itself, not necessarily just off of low numbers. If that is what is happening, what might help is to just stop shooting. Stop shooting and see what happens. The hard part about doing that is that you have to sit on your hands for up to 72 hours, and with a cat like Jack you will see horrible numbers and not shoot them. It's really hard not to shoot when you see 400's. The idea is that after a few days, if the insulin was causing the bounce then the bounce will clear and he'll settle into a nice life OTJ.
  • or you try a dose reduction to 0.05 or "some" insulin or whatever you like to call it, but less than your 0.1
  • or try 0.1 unit SID. Sometimes they drop just as low on SID as on BID, but sometimes the fact that the shed is a little emptier (due to skipping every other shot) sometimes that helps hold the numbers up better.
  • another option, which isn't a good idea long term but can help some cats get past the hump, is to feed a higher carb food so you can keep shooting insulin.

Jack gets a LOT of response from a small amount of insulin, so whatever you try will require lots of monitoring. I hope that we can get him flattened out and OTJ because it seems like that's where he wants to go. Thoughts?
 
Hitting the Reset Button

Yoshi here. Libby, thanks so much for your input and brainstorming. After "the weird 10/07 day" - it's really helpful to see what options are there - especially since our vet (who's been out of town for a month - perfect timing, right?) Gets back this week and we have an appointment scheduled for Jack on Friday, 10/15. I think we're going to do just a urine analysis (the vet recommended a urine analysis to see if there's something else going on to cause Jack to go in the greens) - maybe blood work, I have to call the vet tomorrow to see when his last labs were done.

Emotional Soap Box
Before I get to Libby's ideas about where to go from here posted above in this condo - let me first say that it's been really tough for me (and somewhat for Jose - but a lot more for me) to deal with how imprecise measurements less than 0.5u can be. I mean, jeez, we're no longer going by the markings on the actual syringe, but trying to eye-ball and match the measurement to a picture we're viewing on our computer (which were very helpful, btw, thanks to those, like Pat, who've re-posted those micro measurements ) - is still not so accurate--- especially for guys like us, who prior to Jack getting insulin shots starting mid-August, have never used a syringe before.

Jose thinks that the micro-doses are probably still too much insulin. I'm a little more skeptical about micro dosing - but that's probably because I don't completely understand the Somogyi rebound, and I say the "what if's" a lot (What if the insulin simply just didn't get absorbed all the way? What if Jack's just a freak of nature cat? What if it's not just diabetes? What if Jack is lowering his glucose on purpose so that he could get more food? << ok, ok - so "the what if's" can lead to complete irrational stress... :shock: It's nice to vent though :cool:

Our Planned Direction: Starting Over - Hit the Reset Button
Jose says, "The pattern that Jack falls into right now is: What happens when a cat gets too much insulin and is having a rebound."
So - based on the ideas Libby suggested - we're going to stop giving Jack insulin so that we can truly understand:
1. The effect the micro-doses are having on Jack
2. "Flush" his body from reactions to insulin in his shed or the Somogyi Phenomena
3. Completely starting from the ground up (Back in August, Jack was started on 3.0u)

Technical Question
If we're not giving him insulin - what should the title of our condos be over the next 3 to 4 days? I don't think I would put OTJ... this is different, this is more RTJ ("Resetting the Juice").

So maybe put:
10/09 Jack AMBG (#): DAY 1: Resetting the Juice <OR>
10/09 Jack AMBG (#): DAY 1: OTJ
10/09 Jack AMBG (#): DAY 1 of 4: Juice Reset
 
Re: 10/08 Jack AMPS 341 PMPS 306

I dont' have an answer for your question, but I think this is a good idea. And I love experiments! Good luck to you all!
 
Re: 10/08 Jack AMPS 341 PMPS 306

I'll be interested to see what the experienced folks think - I suppose we'll see by day 2 or 3 how long it takes to empty Jack's shed. He certainly did have a bizarro day yesterday and I can so see how that would lead to an emotional rollercoaster for you both. We will all learn from Jack's experiment. Good luck guys.
 
Re: 10/08 Jack AMPS 341

JacksDads said:
It's not easy to be consistent about such a small dose in the U-100 needles. I think we're pretty close each time - but there's also two of us - and each person is always a little different. I'm ordering a 10 uL Nano Shot today.
Click to expand...

Yoshi, you're a riot. I like your string of "if's." What I really want to know is, what is a Nano Shot, and why didn't I have one when I was so stressed out by microdoses, just as you describe?

We also had two people looking at the same syringe, emphatically sure that a) it was too much, b) it was too little, and c) it definitely didn't match what we gave the last time. :mrgreen:

You've thought through everything methodically. Sounds like a strategy worth a try. Looking forward to your AMBG tomorrow.
 
Thanks for the feedback late-nighters! (But What do I call tomorrow's condo?)

Kathy and Kitty said:
What I really want to know is, what is a Nano Shot, and why didn't I have one when I was so stressed out by microdoses, just as you describe?
Click to expand...

So in a few previous condos, I posted about hunting down a reusable syringe (also called non-sterile - because you have to re-sterilize it yourself) that actually has a marked measurement for 0.1 units of Insulin- (which is 1 microliter - or 1 uL). Keep in mind, using a reusable syringe and needle comes with a lot of maintenance (compared to the zero maintenance of disposable ones). In fact, I still haven't heard of anyone even trying it before (but it's hard to believe I'm really the first one to do this - if you're out there - please contact me :-) - So I don't know what type of learning curve I'm in for when my glass syringe arrives. I was ready to buy the NanoFil syringe made by the company WPI - but the sales rep actually talked me out of buying it earlier today because their product is designed for piercing the eyeball of lab rats and not the skin of a cat. So since the guy at WPI who was selling the $85 syringe that could only be paired with a 33 to 36 gauge needle that cost $80 for a 2 pack was convinced it would not work on a cat - it was a $200 investment that didn't have a high enough chance of working.

So I called around. I contacted Hamilton, Cadence Science (formerly Popper & Sons), BD, Walgreens Infusion Services, and even the AARP (who regretfully informed me that until Jack had medicare coverage, they couldn't help me).

All this calling around actually turned out to have a better option than the NanoFil from WPI...

A Possible Alternative to Micro Dosing with U-100 Disposable Syringes
So Hamilton produces a glass syringe with a luer tip. They also sell a 6 pack of reusable needles for this syringe - but those cost at least $70. This would have put the economic viability of Hamilton's micro-syringe in the same league of the WPI one - but then I discovered a difference that makes the Hamilton Luer Syringe more attractive: BD makes a disposable luer tip needle that fits the Hamilton Luer Syringe :-D

So the $32 10 uL Hamilton Micro Syringe (with 0.1u markings) I had shipped out to me today - and the BD 30 gauge 1/2" (they don't have 5/16") luer tip needles are available at my local pharmacy. ($33 for 100). Which would mean if I use 2 needles a day, then I will spend about $15 more ever 3 months for the luer tipped needles as compared to the U-100 disposable needle/syringes that everyone uses.

So we'll see if having a syringe that has marked measurements for 0.1u of insulin is worth the trade off of:
1. Paying $5 more per month on needles. (and $32 for the glass syringe and I think $20 to $30 for long-lasting cleaning supplies).
2. Having to worry about syringe maintenance (There's a cleaning process for the glass syringe that I haven't read up on yet...) But that's our next venture - when Jack finishes this no-insulin experiment that we're starting in the AM - we'll have the ability to give him precise and accurate micro measurements using the Hamilton Product #80301 micro luer-syringe.

~Yoshi
 
Your research into the syringes is impressive!! I just hope you didn't go to all of the trouble and expense and Jack is then OTJ. (Of course, because he's a cat, you know that's what is likely to happen but then it's a win-win, sort of!!)
 
yoshi...you are an absolute riot... with the amount of research you have done and the fascinating way you present it, you should be on a lecture tour... your audience wouldnt even leave the auditorium for coffee. meanwhile, back at the ranch, the rest of us should be creating and filing for a patent on the micro-500 disposable syringe...which should put all of us in clover for the rest of our days!

good luck with the experiment you three!

celi & binks
 
Status
Not open for further replies.
Back
Top