! 10/8 Copernicus AMPS=518 +4=560 +10=718 !

His shots are currently a mess and Lantus takes time to build the depot back up. The partial dose last night would have drained a good part of the depot, which hadn't even built up yet from the 18 units dose he was getting. No use regretting what was, but instead let's figure out how to deal with what you have.

Are you around and able to monitor him for 4 hours starting at shot time tonight? I'd try 0.25 units of Novolin R just after giving him his Lantus. With R you need to start low dose and work your way up. I've seen cats on around his dose need several units of R, and one on over 30 who maxed out at 0.5 units. Normally I'd start at 0.1 units of R, but I think we could go to 0.25 units, based on his size of dose.

What we want to do is to test every hour after his shot, for 4 hours and post here so I can watch. Meaning a PS, +1, +2, +3, and +4. You are trying to figure out his onset and duration with R. The more frequent testing can be reduced once you have figured how he uses R. You have a few goals with R besides lowering his dose. You actually don't want to lower his dose a lot, cause that can cause a bounce and even higher numbers. R is used to lower the numbers less than 100 points, over the 4 hours. Giving Lantus a lower number to work with is what you want. You also do not want the combination of R and Lantus action to lower his numbers too much. So you are looking at how his insulin action of Lantus + R stack up. You don't want the nadirs of both insulins to happen at the same time.

You can use R strategically to handle fur shots too, which is what we'd be doing in this case. In the fur shot situation, you are trying to put a lid on the numbers so they don't go too high. Hopefully it'll still tell us something about how he uses R.

Note, there are a lot of things to learn about giving R, and even more about when not to use it. As you experiment with it, I can explain more.

For anyone else reading, anything I'm saying here is for Krista only. R is an advanced technique, used in the case of ketones and for high dose kitties.
 
Wendy&Neko said:
His shots are currently a mess and Lantus takes time to build the depot back up. The partial dose last night would have drained a good part of the depot, which hadn't even built up yet from the 18 units dose he was getting. No use regretting what was, but instead let's figure out how to deal with what you have.

Are you around and able to monitor him for 4 hours starting at shot time tonight? I'd try 0.25 units of Novolin R just after giving him his Lantus. With R you need to start low dose and work your way up. I've seen cats on around his dose need several units of R, and one on over 30 who maxed out at 0.5 units. Normally I'd start at 0.1 units of R, but I think we could go to 0.25 units, based on his size of dose.

What we want to do is to test every hour after his shot, for 4 hours and post here so I can watch. Meaning a PS, +1, +2, +3, and +4. You are trying to figure out his onset and duration with R. The more frequent testing can be reduced once you have figured how he uses R. You have a few goals with R besides lowering his dose. You actually don't want to lower his dose a lot, cause that can cause a bounce and even higher numbers. R is used to lower the numbers less than 100 points, over the 4 hours. Giving Lantus a lower number to work with is what you want. You also do not want the combination of R and Lantus action to lower his numbers too much. So you are looking at how his insulin action of Lantus + R stack up. You don't want the nadirs of both insulins to happen at the same time.

You can use R strategically to handle fur shots too, which is what we'd be doing in this case. In the fur shot situation, you are trying to put a lid on the numbers so they don't go too high. Hopefully it'll still tell us something about how he uses R.

Note, there are a lot of things to learn about giving R, and even more about when not to use it. As you experiment with it, I can explain more.

For anyone else reading, anything I'm saying here is for Krista only. R is an advanced technique, used in the case of ketones and for high dose kitties.
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Do I use the u-100 needle?
 
The U-100 syringes have half unit markings. You eyeball half of that to get the 0.25 unit dose, half way between the zero line and the first 0.5 line.
 
Hi Krista, here is a picture of .25u.

1791505665135.jpeg


Hope this helps. Good luck with the R.
 
Good job entering it on the spreadsheet. For short hand, you could replace the Novolin with just "R" which is the generic term.

See you at +1.
 
Wendy&Neko said:
I see +1 697 +2 607 +3 616, looks like he's stalled out.
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If I google it, I read it peaks 2-4 hours. And then lasts in body 5-8 hours. So would I do it again or do it more tonight?

My gut just tells something else is going on. Hes skipped before and hasn't taken this long to recover or his skip hasn't gone this high or resistant. I hope it's not worsening kidney failure or acidosis without ketones or other.
 
Did he finally poop? I always saw unusually high numbers when Tubby was backed up.

Wasn’t Copernicus diagnosed with pancreatitis at the hospital? That could be part of the higher numbers too. Remind me … is he on anti nausea and pain meds? Pancreatitis doesn’t usually go away overnight so ongoing support is often needed for awhile.
 
JL and Chip said:
Did he finally poop? I always saw unusually high numbers when Tubby was backed up.

Wasn’t Copernicus diagnosed with pancreatitis at the hospital? That could be part of the higher numbers too. Remind me … is he on anti nausea and pain meds? Pancreatitis doesn’t usually go away overnight so ongoing support is often needed for awhile.
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So I got his records and he had elevated amylase and lipase (could also be from kidney disease) and the vet said that was pancreatitis. But they didn't actually do a fPLI. He's had pancreatitis before and I didnt see numbers like this.

He pooped immediately bringing him home and once again after that so maybe EOD.

He's on zofran and transdermal Cerenia. No pain meds.

Do you know anything about this. I noticed they gave him NaCl in addition to LR. His sodium and chloride weren't unbalanced. Would that additional sodium tax the kidneys and worsens kidney values?
 
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Lactated ringers contains sodium and chloride. Not uncommon to try to rehydrate a cat.
Krista & Copernicus said:
If I google it, I read it peaks 2-4 hours. And then lasts in body 5-8 hours. So would I do it again or do it more tonight?
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That's the stats for people, not cats. It lasts more like 4 hours in cats. Though Neko onset late with it and thus it went longer. Not common behaviour. For most cats it's in and out in 4 hours.

It's late, he's coming down. I'd get some sleep. Plus if you give it later, you risk having the R and L nadirs coincide, which you don't want. Let's stick to experiments at preshot for the moment. Once you've got a good handle on that and how it reacts in him, you can think about adding it later in the cycle, like after nadir.

One of the goals in using R is to try to build an R scale. It might be something like if BG >500 give X, if BG between 400 and 500 give Y, between 300 and 400 give Z. That's just an idea of what you might do. It takes experiment to see what works. I'm guessing that if you give it over 500, next time I'd try 0.5 units.
 
Wendy&Neko said:
Lactated ringers contains sodium and chloride. Not uncommon to try to rehydrate a cat.

That's the stats for people, not cats. It lasts more like 4 hours in cats. Though Neko onset late with it and thus it went longer. Not common behaviour. For most cats it's in and out in 4 hours.

It's late, he's coming down. I'd get some sleep. Plus if you give it later, you risk having the R and L nadirs coincide, which you don't want. Let's stick to experiments at preshot for the moment. Once you've got a good handle on that and how it reacts in him, you can think about adding it later in the cycle, like after nadir.

One of the goals in using R is to try to build an R scale. It might be something like if BG >500 give X, if BG between 400 and 500 give Y, between 300 and 400 give Z. That's just an idea of what you might do. It takes experiment to see what works. I'm guessing that if you give it over 500, next time I'd try 0.5 units.
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I see. Thank you very much. Goodnight.
 
Wendy&Neko said:
Lactated ringers contains sodium and chloride. Not uncommon to try to rehydrate a cat.

That's the stats for people, not cats. It lasts more like 4 hours in cats. Though Neko onset late with it and thus it went longer. Not common behaviour. For most cats it's in and out in 4 hours.

It's late, he's coming down. I'd get some sleep. Plus if you give it later, you risk having the R and L nadirs coincide, which you don't want. Let's stick to experiments at preshot for the moment. Once you've got a good handle on that and how it reacts in him, you can think about adding it later in the cycle, like after nadir.

One of the goals in using R is to try to build an R scale. It might be something like if BG >500 give X, if BG between 400 and 500 give Y, between 300 and 400 give Z. That's just an idea of what you might do. It takes experiment to see what works. I'm guessing that if you give it over 500, next time I'd try .5
Click to expand...

Wendy&Neko said:
Lactated ringers contains sodium and chloride. Not uncommon to try to rehydrate a cat.

That's the stats for people, not cats. It lasts more like 4 hours in cats. Though Neko onset late with it and thus it went longer. Not common behaviour. For most cats it's in and out in 4 hours.

It's late, he's coming down. I'd get some sleep. Plus if you give it later, you risk having the R and L nadirs coincide, which you don't want. Let's stick to experiments at preshot for the moment. Once you've got a good handle on that and how it reacts in him, you can think about adding it later in the cycle, like after nadir.

One of the goals in using R is to try to build an R scale. It might be something like if BG >500 give X, if BG between 400 and 500 give Y, between 300 and 400 give Z. That's just an idea of what you might do. It takes experiment to see what works. I'm guessing that if you give it over 500, next time I'd try 0.5 units.
Click to expand...
So shoukd this be part of daily considerations? So his AMPS is 427, should I try the .25 again this morning. I understand we are trying to establish the suggested goals above, but you mentioned not dropping him too quickly. His +4 ended up being 200 point change from baseline if I'm doing the math correctly. ?
 
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