11/14 B the C PMPS:HI +3:225 +4:209 +7:398

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kotek

Member Since 2011
Well, B the C still has no ketones and has been eating great at the vet. And they started having to wear protective gloves to test her BG...always a great sign with her. :-D

And so, the vet deems her to be doing well and we are going to see if we can't get her back on track at home on a 1 unit dose...keeping a close eye on her eating and those pesky ketones.

Her BG was "HI" tonight -- as it was this morning, but she successfully came down a bit from it today, even while at the vet, and for tonight she got 1 unit of Humulin to give us an extra downward push. Now I'm supposed to be patient, even if she runs a bit high for a few days, and let her body come back down again. Hmph, there's that damn "P" word again! :-x

Meanwhile, she's on my lap, which is lovely...

OOOPS: Here's yesterday: B's condo from 11/13
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

Kotek,
Just so I understand, tonight she got Humulin instead of Lantus?

Carl
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

Or, did she get Humulin + Lantus.

What kind of Humulin did she get? There's Humulin N and Humulin R.
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

1 unit of Humulin + 1 unit of Lantus. Same as yesterday, although she started off higher today.

Don't know about N vs R and never thought to ask. I don't know the difference -- can you tell me, so I can clarify with them next time/tomorrow?

If it helps, they call it Toronto/"regular"/humulin/fast-acting, and it is given intra-muscularly.
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

1 unit of Humulin + 1 unit of Lantus. Same as yesterday, although she started off higher today.

Don't know about N vs R and never thought to ask. I don't know the difference -- can you tell me, so I can clarify with them next time/tomorrow?

If it helps, they call it Toronto/"regular"/humulin/fast-acting, and it is given intra-muscularly.
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

Then it is most likely Humulin R, which is a short duration fast acting insulin. "N" would be considered to act more slowly and last a little longer.

Did they tell you to check her BG during the first part of her cycle to see how the R is working?

Carl
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

Toronto insulin or "regular" insulin is what we call "R" -- it's Humulin R.

Please monitor B carefully. That's a lot of R and it's VERY, VERY potent insulin. What I would suggest is that you curve the R. Start getting tests every hour for the 4 hours after you shot the R. Like Carl said, it's a short duration insulin who's effect lasts approximately 4 hours. But, like Lantus, it's duration can vary. (Oh, did I say it was potent?)

One word of caution. You do not want the nadir on the R to coincide with the nadir of Lantus.

I'm going to ask Libby/Lucy to stop by (if she's still awake). She's experienced with R and can guide you with it's use. BTW, I've never heard of it's being given as an IM injection.
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

I could also be getting some of the details wrong -- please don't rule that out!

As I mentioned, this has been the approach for her for the last few days at the vet. I will definitely be testing her, though!

Her +2 was a big drop, but I'm guessing she's going to even out. She had Toronto a little earlier yesterday when I took her home, and you can see how she raised dramatically when it wore off.

Very glad to hear Libby's thoughts -- and always glad for your watchful and experienced eyes!
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

There are a number of people here who have used R in addition to Lantus with a ketone-prone cat or with some of the high dose cats. It's an effective tool. You just need to have a healthy respect for the insulin and know how it works for your cat.
 
Re: 11/14 B the C PMPS:HI home now, hopefully?

As I said, she's been recovering from her ketones this is how she's been managed at the vet. Seems to be working pretty well. They know how close an eye I keep on her...the vet now has her spreadsheet link! :-D

Much less dramatic drop for +3...at 225 now. I'll be glad if she stays around this level. Honestly, I'm more expecting her to go up and sit in the 20s than to go low, like she did last night...but that's why we watch!

I should also mention she got the Toronto probably about half an hour before the Lantus...

CLARIFICATION: +3 for the Lantus, probably more like +3.5 for the Humulin.
 
Re: 11/14 B the C PMPS:HI +3:225 home now, hopefully?

It's very important that if you're using R that you have food on board. It may be best if you give each insulin around the same time. If you get your pre-shot number, you can choose which insulin to shoot first. I'd probably shoot the Lantus, feed, then shoot the R. Lantus is more forgiving with regard to food. Since onset can be in 1 - 2 hours, you've got time to make sure B is eating. With R, you don't have that luxury. It's onset is very quick.
 
Re: 11/14 B the C PMPS:HI +3:225 +4:209

Thanks, Sienne! I'm hoping we won't have to use it too much...and she'll only get it from the vet at this point. Certainly nothing I'd give her myself without a *lot* more information. They were watching her really closely at the vet...she's definitely been eating very well -- and since she got home, too.

Not much movement to +4 at 209...guessing the Humulin has done it's thing. If Lantus can keep her here...or drop her into the green a bit...I'd be super happy!

Trying to prepare for a spike again tonight/tomorrow AMPS...stresses me out still, although I understand it can take them a bit to recover from the high BG/ketone place... :YMSIGH:
 
Re: 11/14 B the C PMPS:HI +3:225 +4:209 home now, hopefully?

The R works to lower the BG so the Lantus can "grab on" and bring numbers into a better place. Lantus is a less potent insulin but what you don't get in potency, you gain in duration.
 
Re: 11/14 B the C PMPS:HI +3:225 +4:209 +5:225

+5:255...flat and yellow...I'll take it! :smile:

Back for a +8, I think...maybe sooner...
 
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