10/20 Sarge AMPS 334 +2 414 +5.75 350 +10.5 328

[Alison & Sarge]

Well, I can't explain it but for the third time now a new pen has made a difference for Sarge. He seems to be getting back to actually having a cycle and he hit blue last night. I am seeing a significant enough change I am treating the new pen like a dose increase (complete with NDW!) and giving it 6-10 cycles before I potentially raise the dose. I am also doing to some investigating into what is causing his pens to poop out early. We shall see from here... Paws crossed Happy Monday all!

Last Night
PMPS 336
+5.25 169 (Yeah blue!)
+7 195

10/17
viewtopic.php?f=9&t=127090

 

[Wendy&Neko]

Re: 10/20 Sarge AMPS 334 +2 414 +5.75 350

Are you counting today as cycle 6? It's been that many cycles since the new pen. I'd increase tonight if you can. 6 cycles is enough to know what that dose can do, with that pen. It's been a while since Sarge's body has seen green, and it looks like he's even bouncing from that high blue yesterday. The goal is to get Sarge into numbers from 50-120 as much as possible and he's going to need more juice to do it. The longer kitty is in higher numbers, then you may need more insulin to overcome glucose toxicity.

Bummer on the pens going bad. Are you keeping them in the same spot in the fridge, away from the door? I also try to make sure I don't put anything frozen or hot on the shelf near my box of cartridges. I once lot half a box of cartridges due to something frozen being placed too close. :evil: I've also seen some people put thermometers beside the pen so they know what's happening there.

 

[Alison & Sarge]

Re: 10/20 Sarge AMPS 334 +2 414 +5.75 350 +10.25 +10.5 328

Yes, I am counting today as cycle 6. Does that blue yesterday mean I have to wait until 10 cycles for an increase (for a nadir under 200) or because that nadir was more the exception than the rule can I go ahead and increase tonight? I definitely want to head off the glucose toxicity that seems to be looming so I don't want to mess around but I don't want to set him up for a hypo either. I am trying to figure out what to do when you get a bunch of 200+ cycles and then a random blue nadir.

After the first pen went bad early I started keeping them in the fridge drawer figuring it would provide a more constant environment. On the shelf above is the pretty much constant cast of condiments so no risk of frozen or hot stuff. This hasn't helped the last two pens. After talking to the pharmacy I am trying gently mixing this pen to see if that helps. If that doesn't work I have another fridge lined up to try. Bummer the frozen food nuked your pens Wendy!! Thanks for the heads up on that one. So sad to lose a box of pens!

 

[Wendy&Neko]

Re: 10/20 Sarge AMPS 334 +2 414 +5.75 350

The one blue nadir does not mean you need to hold for a total of 10 cycles. From the protocol:

Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

Sarge is no longer new to numbers under 200 so waiting 6 cycles is OK. Especially since it was just one cycle of blue.

Fortunately insulin is cheaper in Canada than the US and it wasn't an entire box I lost. You aren't supposed to shake the Lantus. From the sticky on Info on Handling and Storage of Lantus/Levemir:

Never shake or roll your vial, cartridge, or pen.