11/26 Gus, AMPS 265 +2 322, +4 223, +6 304, +8 320 PMPS 319, +9.25 261

We are having a bad day.. so many pinks.. so weird, not sure what’s going on. No fur shots to my knowledge… I check with my hand and usually give his injection spot a little kiss after (no insulin smell).

I’m thinking it might be time for a new vial (also looking into pens). I’ve sent an email out to my vet
 

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Gus the Furminator said:
We are having a bad day.. so many pinks.. so weird, not sure what’s going on. No fur shots to my knowledge… I check with my hand and usually give his injection spot a little kiss after (no insulin smell).
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lol! Not sure how that emoji attachment made into my post!!! I’m definitely not laughing at that post! I am now though.

And now y’all know what I look like in emoji form :)
 
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Hang in, Kim. It seems that not too many people are on the site today. Gus is high but safe. I think he needs an increase but strongly suggest you wait to get advice tomorrow. Hopefully, more folks will be on site to advise tomorrow and, if not, don't make any changes in his dose until after the weekend. Holiday weekends are sparse for advice.
 
Summer and Susie (GA) said:
Hang in, Kim. It seems that not too many people are on the site today. Gus is high but safe. I think he needs an increase but strongly suggest you wait to get advice tomorrow. Hopefully, more folks will be on site to advise tomorrow and, if not, don't make any changes in his dose until after the weekend. Holiday weekends are sparse for advice.
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Thanks Summer, Carla popped in a few hours ago thinking he might need an increase without seeing his curve. I think he does too from what the week has been telling me. I’m still a little unsure of who to take dosing advise from here unless they have a ‘moderator’ badge (I don’t see many ‘mod’ badges in my threads though’ but I’ve been looking at their years of being here and going with that :)

I might cross post on Facebook and see if any of the admins can pop over and help me out.
 
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Hi Kim. Looks like you are following SLGS [as I am]. This is from the sticky on dose adjustments:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

Have you determined when Gus typically nadirs?
 
Bama Kitty Mom said:
Hi Kim. Looks like you are following SLGS [as I am]. This is from the sticky on dose adjustments:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

Have you determined when Gus typically nadirs?
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Ya. With following the protocol, he’s definitely due for an increase.

Gus’ nadirs are honestly all over the place! I have not been able to pin point it. His lows are generally at PS or between +4 to +8

I wish it was more consistent.

I’m home tonight and will be home most of the day tomorrow. I think I’m going to follow the protocol and increase .25 tonight…
 
Gus the Furminator said:
Ya. With following the protocol, he’s definitely due for an increase.

Gus’ nadirs are honestly all over the place! I have not been able to pin point it. His lows are generally at PS or between +4 to +8

I wish it was more consistent.

I’m home tonight and will be home most of the day tomorrow. I think I’m going to follow the protocol and increase .25 tonight…
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Bama's are a lot like that. Loves to nadir at PS. Looks like I'll be up tonight. Pop on over if you want and check out the action. :cat:
 
Hey Kim! How old is Gus's insulin?

I don't have a good reason for the sudden pinks but yes, you should have increased.

You test enough to do TR....Is there a reason you don't want to do it? As long as he's eating canned food (no dry), TR would allow you to increase as often as every 3 days instead of holding a dose that's not working for a full 7 days.
 
Chris & China (GA) said:
Hey Kim! How old is Gus's insulin?

I don't have a good reason for the sudden pinks but yes, you should have increased.

You test enough to do TR....Is there a reason you don't want to do it? As long as he's eating canned food (no dry), TR would allow you to increase as often as every 3 days instead of holding a dose that's not working for a full 7 days.
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We opened the 10ml vial of insulin on July 25 I believe. I think I’m gonna head to Costco tomorrow and grab some pens. I feel like the pens will stay effective to the last drop and honestly with the amount I’m throwing out in the vial, I think cost wise it makes most sense.

I’ve been thinking of switching to TR a lot recently. I think, honestly I’m just nervous with the higher doses. Maybe I can try this week.

He’s on a complete wet diet but on the off days, maybe once a week or once every two week if he doesn’t want to eat his wet, I might give him literally 4 kibbles beside his dish (Dr. Elseys chicken), which he will eat one then start eating his wet then eat another and so on… I’ve been told that little won’t be an issues though.

My main concern was that with the holidays coming up, I’ll be out of the house more often then I am now. I guess I could potentially hold a dose we are comfortable with on the days id be out but that time… would that be an option?
 
Gus the Furminator said:
I guess I could potentially hold a dose we are comfortable with on the days id be out but that time… would that be an option?
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Absolutely....you can also switch back to SLGS if you really find that TR isn't for you. Just because you can increase as often as every 3 days doesn't necessarily mean you have to (or even should...there are times you'll want to hold it more than 3 days but we'll get into that later)

Gus the Furminator said:
We opened the 10ml vial of insulin on July 25 I believe.
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yeah it could be starting to lose efficacy but we don't usually see it happen that quickly. It's more of a gradual increase in numbers but I'd get some new soon. The pens are definitely the better choice!
 
Chris & China (GA) said:
Absolutely....you can also switch back to SLGS if you really find that TR isn't for you. Just because you can increase as often as every 3 days doesn't necessarily mean you have to (or even should...there are times you'll want to hold it more than 3 days but we'll get into that later)



yeah it could be starting to lose efficacy but we don't usually see it happen that quickly. It's more of a gradual increase in numbers but I'd get some new soon. The pens are definitely the better choice!
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Thanks Chris!

Now that I think of it… really I’m going to need to get to that right dose anyway… I’m just prolonging it with SLGS. But I guess I’m also thinking about the depot and how that builds over time
 
Gus the Furminator said:
But I guess I’m also thinking about the depot and how that builds over time
Click to expand...

Read over the TR protocol again....when you start to see blue nadirs, you hold the dose a little longer than 3 days (8-10 cycles) and then when they hit green, you hold for at least 10 cycles ...as you gain more data and experience, you can increase sooner but for now, you're over-thinking it.
 
Chris & China (GA) said:
Read over the TR protocol again....when you start to see blue nadirs, you hold the dose a little longer than 3 days (8-10 cycles) and then when they hit green, you hold for at least 10 cycles ...as you gain more data and experience, you can increase sooner but for now, you're over-thinking it.
Click to expand...

You are probably not wrong - I over think sometimes. I love how straight forward you are… appreciate your help. I will reread the TR protocol tonight or tomorrow and take the next day to think about the switch. I think I’m going to make the move!
 
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