12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412 +9:328

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Re: 12/02/11 Marilyn AMPS:461 +2:481 PMPS:524 +2:480 +4:445

Hmmm
Still not pretty.
Anyone, are the ketones sn issue or is that still "trace"?
Carl
 
Re: 12/02/11 Marilyn AMPS:461 +2:481 PMPS:524 +2:480 +4:445

Hi Carl,

You actually asked this question on my 11/28 condo too. I don't think anyone replied, and I apologize...it was on my "to do" list, which I should rename my "things I will never find time to do" list. I received some awesome info from Heather on the Health board. She dug it up from an old post. She also provided me with the "eBay tip" for purchasing ketone strips. Six boxes of 10 strips arrived today...for the price of 1-box of 10 strips!

The link below is my original Health post. You'll notice that Heather also provided a link to the full post where she pulled the "quote" from....good stuff.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=57008

Thanks for your concern Carl...and for your diligence!

Deb
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Hi All,

Anyone think I should bump Marilyn up another 0.25 Units; for a total of 1.5 Units BID? I've only given the 1.25 Units (which reflects a 0.25u increase) for 2 days (or 4 cycles). Is it too soon for another quarter unit increase? Her vet said to give her 2 Units for PM, and 1.5 Units for AM, since her PM numbers are highest...but I'm thinking different doses, so soon, might confuse her body even more. Thoughts please? Deb
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Hi Deb;

Here is the info on 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.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

If you can continue to monitor like you have, I'd give her two more cycles and see what she does. If she continues these high numbers, I'd increase by .5u. If she starts getting lower nadirs (200-300), I'd increase by .25u. I very respectfully disagree with your vet; you never want to give one dose in the a.m. and another in the p.m. Some cats just run higher one cycle over the other.

I know you are really swamped with all your babies but I don't think giving "R" will put a huge extra burden on you as you are already doing alot of monitoring and the people who are experienced will walk you through every single step telling you when to give it, how much to give, when to test, etc. .....and if they can't, they won't suggest you give it. I hope you will just think about sending one of them a PM and just getting the info.....they are great about helping folks with it but it can only be given under their supervision.

Sending you hugs and wishes for Miss Marilyn to come down!
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Hi Marje,

It's a shame I didn't bump her up a half unit, as opposed to the quarter unit, to begin with. I can certainly PM the people you suggested...I just don't know how I'll know what the Lantus is doing, if I introduce R this early in the game. Do you know the answer to this...or is it a question for the "R experts"?
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

They use "R" to work in conjunction with the lantus to bring the overall numbers down. It has to be given at certain times so that is does not interfere with the nadir of lantus. They are able to look at your SS and tell
you exactly when to give it. It does not require a prescription and it is relatively inexpensive. I hope you will at least let them answer your detailed questions because I don't know any more specifics than that. Sandy tends to
be around more than Libby and so she might see the post sooner. The "R" really did wonders for Black Kitty...he was insulin resistant...and he went OTJ......

Although she doesn't post much anymore, you could look under "Members" for Bev and Gus and look at his SS or also at Garland's SS as Violet had to use "R" to bring Garland's numbers down. AND at the same time, she was nursing Garland through DKA and hepatic lipidosis.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Personally, I think Marilyn is under dose. I would encourage you to increase her dose every 4 cycles for now until you start seeing more movement. You were seeing lower nadirs when she was at 2.0u of N. You might not see any action until she's closer to that dose of Lantus.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

I'm glad Sienne checked in. I didn't want to stray from the protocol without someone with alot of experience suggesting it. I would most definitely take her advice and increase tomorrow morning as I believe tonight is her fourth cycle at this dose.

Good luck!!
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Just so you don't think I'm making this up, the German counterpart of LL uses a modified version of the TR protocol. The Tilly version specifies that you can increase the dose in 4 - 6 cycles.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

just sending hopes that she comes down for you...

celi
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

What to do in this situation? Coin toss? Her next cycle starts in a couple hours.

1. Wait for 3rd cycle from now to increase to 1.75 Units BID
2. Increase next cycle to 1.5 Units BID

Oh, wait, good thing I just looked below to see your new post Marje. Marilyn is on her 4th cycle now. A new cycle (would be her 5th on 1.25u) starts in a couple hours. So I should increase another 0.25u, totaling 1.5 Units, this AM...which would be option number 2?

Thanks for the "eyes" Sienne. I have no idea "who is who" in LantusLand.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Boy-O-Boy...a lot goes on when you walk away from the computer in the middle of a post. Thanks everyone...still need clarification on the 1.50 Units total, starting in a couple hours.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

The next cycle would be your AM cycle on 12/3. Yes, you could increase the dose to 1.5u then.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

Sienne,

I operate backwards from most...so, yes, her 12/03 AM cycle starts in a couple hours. Thank you kindly for the clarification.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412

I didn't want to stray from the protocol without someone with alot of experience suggesting it.
Click to expand...

I forgot Marilyn was on humulin before :oops: :oops: I know it is on her SS but I was focused on the numbers. The Tilly protocol does state that cats on a previous insulin can increase sooner so Sienne was following protocol. I did this when I moved Gracie from lantus to levemir.

Good luck.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412 +9

Thanks All. Of course she came down a bit...just to mess with me. It could've been the SQ fluids. I'll proceed as planned, unless someone posts otherwise.
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412 +9

HI there,

I agree with Sienne that Marilyn is probably under dose right now and needs to be on the faster track.

What is the ketone situation? Why is s he getting SQs?
 
Re: 12/02/11 Marilyn PMPS:524 +2:480 +4:445 +5:479 +6:412 +9

Hi Sandy,

Thanks for looking in. I'm not sure what you mean by "what's the ketone situation", unless you are wondering what her readings have been. Her last blood ketone reading was only 0.2, but she's gone as high as 0.7; I don't know if she's ever gone higher. She getting SQs for dehydration.
 
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