12/12 Howie AMPS=244 +1=295 +2=301 +3=199 +4=279 +5=296 PMPS=327 +1=315 +2=345

Howiesmom

Howiesmom

Member Since 2020
Starting him on R for the first time along with 19 units levemir. Wish me luck! Not sure how much he really got as I am not skilled in drawing .25 units!
 
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:cool:Good morning :coffee:
Here’s a link to your previous thread so folks can quickly go back in time. Please provide a link to your previous thread with each new daily thread.

We want to also see how much R you shot and when. Here’s an example of documenting R used with L

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See you at +1:cool:
 

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Also, his ear infection did not clear up so he is back on 7 days of Tresaderm. This will raise his BG again.
 
The idea behind shooting R with the AMPS or PMPS is that the R, being fast acting, reaches nadir just as L onsets, so the L has a better starting point.

That’s some drop though; 301 to 199 in 1 hour...
 
The goal is to find an R dose that takes the numbers down around 100 points, and no more. You do a couple experiments at a dose and see what happens. Today's +3 looks odd in comparison to the rest of the cycle, so this experiment needs to be repeated. You don't always get the same reaction with the same dose anyway, based on whether kitty is bouncing, and a host of other factors. You also need to experiment with amounts of R based on the BG at the time of the shot. That's what gets you the R scale.
 
Wendy&Neko said:
The goal is to find an R dose that takes the numbers down around 100 points, and no more. You do a couple experiments at a dose and see what happens. Today's +3 looks odd in comparison to the rest of the cycle, so this experiment needs to be repeated. You don't always get the same reaction with the same dose anyway, based on whether kitty is bouncing, and a host of other factors. You also need to experiment with amounts of R based on the BG at the time of the shot. That's what gets you the R scale.
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I will let you lead me in the right direction! His numbers are all over the place right now. Going back on Tresaderm for 7 days for his ear infection is not going to help either! PM +1 is at 315.
 
Howiesmom said:
@Wendy&Neko , @Sandy and Black Kitty
Just for my future reference, what precipitates a dose increase of R? I'm just curious! THANKS!
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Unlike the Ls, R is fast acting, with no depot. There is also no protocol, however we have accumulated a good deal of tribal knowledge and developed best practices for using R safely. its used around here for a few situations

Ketones- I first learned to use R when faced with a ketone crisis, our second one in a months time. One day after checking his urine (using ketostix) for the presence of ketones (this was the time before meters that checked the blood) I found BKs results had gone from "negative" to "large" in exactly 24 hours. :eek: Back to the ER we went
Part of the recipe for development of ketones is not enough insulin, so in these cases using R helps get extra needed insulin into the bloodstream quick to help disrupt the formation of ketones

Acro- The pituitary hormone responsible for raising BG in kitties with Acro is unpreditable. Output can sometimes ramp up and also wane faster than an approriate dose change to the Ls can keep pace with. Depots take time to make adjustments - like turning a cruise ship around. Using R in these cases allows tighter control for those fluctuations.

IAA- when BKs IAA broke I was using 13.5uL and upto 10u R each cycle, depending on the numbers. that made it possible to reduce his overall insulin dose by 10u instantly...with no worries about depot action. That was not a strategy we planned-That was dumb luck - and a lesson to be learned. Being that BK was the first, we had no ones sleeve to tug on for sharing of experience - we were flying by the seat of our pants.


It is very ECID. As with all things FD its very important to "Know Thy Cat" learn how your cat responds to R- Onset, Nadir, duration and with IAA possible carryover. That way as you accumulate data you make the best dosing decisions as the picture changes. Along with the science, there is a good bit of art to using it.
 
Sandy and Black Kitty said:
Unlike the Ls, R is fast acting, with no depot. There is also no protocol, however we have accumulated a good deal of tribal knowledge and developed best practices for using R safely. its used around here for a few situations

Ketones- I first learned to use R when faced with a ketone crisis, our second one in a months time. One day after checking his urine (using ketostix) for the presence of ketones (this was the time before meters that checked the blood) I found BKs results had gone from "negative" to "large" in exactly 24 hours. :eek: Back to the ER we went
Part of the recipe for development of ketones is not enough insulin, so in these cases using R helps get extra needed insulin into the bloodstream quick to help disrupt the formation of ketones

Acro- The pituitary hormone responsible for raising BG in kitties with Acro is unpreditable. Output can sometimes ramp up and also wane faster than an approriate dose change to the Ls can keep pace with. Depots take time to make adjustments - like turning a cruise ship around. Using R in these cases allows tighter control for those fluctuations.

IAA- when BKs IAA broke I was using 13.5uL and upto 10u R each cycle, depending on the numbers. that made it possible to reduce his overall insulin dose by 10u instantly...with no worries about depot action. That was not a strategy we planned-That was dumb luck - and a lesson to be learned. Being that BK was the first, we had no ones sleeve to tug on for sharing of experience - we were flying by the seat of our pants.


It is very ECID. As with all things FD its very important to "Know Thy Cat" learn how your cat responds to R- Onset, Nadir, duration and with IAA possible carryover. That way as you accumulate data you make the best dosing decisions as the picture changes. Along with the science, there is a good bit of art to using it.
Click to expand...
This is very helpful information. How/when should I determine if he should go up to .5? I realize this is only day 1, but I just don’t want to sit on a dose too long or keep him at a small dose when his BG is higher. I really appreciate everyone’s expertise!
 
Howiesmom said:
This is very helpful information wee as. How/when should I determine if he should go up to .5? I realize this is only day 1, but I just don’t want to sit on a dose Itoo long or keep him at a small dose when his BG is higher. I really appreciate everyone’s expertise!
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As long as you have plenty of supplies-strips, high carb wet food as well as karo or honey, if your AMPS is yellow or higher I think you can try 0.5u R with your AM Lev shot. If high blue (175-199) then try 0.25. In either case you must test +1-+4.

eta-if you get a number that seems way out of context, like the AMPS+3. 100 point drop immediately re-test. Could have been a bad strip.
 
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Sandy and Black Kitty said:
As long as you have plenty of supplies-strips, high carb wet food as well as karo or honey, if your AMPS is yellow or higher I think you can try 0.5u R with your AM Lev shot. If high blue (175-199) then try 0.25. In either case you must test +1-+4.

eta-if you get a number that seems way out of context, like the AMPS+3. 100 point drop immediately re-test. Could have been a bad strip.
Click to expand...
If he is ever below 175, I’m assuming no R? Thanks for this guidance! Very helpful!
 
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