12/30 Champ AMPS 445, +3 502, +6 434, +10 469, PMPS 439, +1 473, +2 440, +3 454

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Patty & Champ

Patty & Champ

Member Since 2011
Hey everyone. Champ is one of the last old timers. He had been doing so well that I almost forgot he’s an old man with diabetes. Then the diagnosis of CKD in November comes along. The quality of vets in this little Texas town I moved to a couple years ago leaves a lot to be desired. They all seem to have very old fashioned ideas of veterinary medicine and I don’t trust any of the four vet clinics I’ve already tried. Thank goodness for Marje and the rest of the resident “experts” to help me through this crisis. Champ’s numbers have always been pretty good. Two days ago, they catapulted sky high. He actually had his very first 500 today. I took him to the vet yesterday and was given antibiotics. The vet didn’t do half of what should have been done and Champ has only gotten worse. I’m going to start him on R tonight. So, Champ is getting 1.5 units (increased to that dose last night) and I’ll give him 0.1 of the R. Do I feed him first? I have to syringe feed him because he’s not eating on his own. Let me know if I should feed before I shoot and how much do I try to get in him. I’m going to feed the feral cats I take care of and then come back for the answer, in about 15 minutes. Thanks for helping me with this!!!
 
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Patty

Glad to see you and Champ back but I’m sorry he’s not well. His SS link is not working so we need to get that up and running ASAP. I’m assuming he’s been high and flat since he’s been sick and today is “typical” or has he been coming down and then bouncing?

Yes, you’ll want to feed him because R will onset pretty quickly. It’s not like Lantus where you’ve got some time. He needs to have “some” food on board. Since I can’t see his SS, I don’t know if you are feeding him minimeals. If you are, I’d continue with that.

R generally onsets pretty quickly so by +1 you are seeing some activity; by +2 and +3 you’ll see more and likely the nadir, and by +4 the BG will start to flatten out or rise. But remember...ECID. The goal with R is to see a drop between 100-150 mg/dL over the four hours with 100 being optimum. What you don’t want to do is start an R dive/bounce pattern which can happen when giving too much R or giving it in the wrong time of the cycle.

He’s pretty flat from +10. You can try the R but I would suggest you do not shoot more than 0.1u. You’ll need to test at +1, +2, +3, +4. Be sure you have plenty of HC food, karo, test strips, etc and that you will be able to get food in him. Many times, we don’t see much action on the first go round with R but just in case he reads this and decides to “show us”, you’ll want to be sure you can control quickly dropping numbers.

When we use R, we want to be sure the R and L nadirs do not overlap. In other words, don’t give R four hours before he nadirs with L as you risk overlapping the nadirs. We don’t want to give R on a bounce clearing cycle. It’s often best to give it as numbers head up.

I’ll be on the board tonight so please tag me once you’ve shot the R.
 
Go to his SS and in the upper left corner click on “file” and then “publish to the web”. Click on “start publishing” and it will generate a link that you want to copy and paste into your signature block.
 
The SS link should be working now. It said my signature was 2 lines too long, even though it was the same as before, so I just took out his profile line since it's out of date anyway and combined his date of birth and diagnosis, etc., onto one line. I found trying to edit stuff on my ipad a pain in the tookus so I went into my office. Guess who just walked in? Champers!!! I'm using a 12 mL syringe to feed him and was able to get two full ones into him so he's had 24 mL of food so far. I'm going to feed him some more in about 15 minutes or so.
 
It says "You need permission". So, something is still not set up for us to see it.
I hope he's feeling better.
 
I shot him with the R, it's been a bit over an hour, I just tested him and, yuck, it's worse at 473. I can't remember how to change my status line to update his numbers
 
Hi Patty, sorry Champ isn't well. I can see your SS now. :)

To change your subject line, go to the first post of the day and edit it. To the right is a small drop down that allows you to edit the title.
 
So, he's come down a bit!! Also, I gave him another 12 mL of liquid food and then decided to offer him his bowl with his normal food in it or another syringe of food...he chose the bowl!! He ate about 1 oz so I'm pleased.
 
I don’t know when you are headed to bed but it doesn’t look like you need to test again tonight. If you are up a while, you could get a before bed test.

The goal with using R is to get the BG down gradually over several cycles so when the L insulin starts to work, the overall curve is gradually lower. Then, hopefully, it will set you up for a better PS.

Another good time to give R if he is flat and not dropping at +10. That way, the R can be waning while the L is kicking in at onset at +2.

Finally, some of us have found that the cycle or after so using R can produce good numbers. ECID. I’d keep an eye on it to see if he develops patterns on the R.

If he’s high in the morning and you want to try it again, there might be some experienced R users on.
 
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I’ll check him one last time and give him another syringe or two of food before I head to bed in a few minutes. I am going to want to give him R in the morning. Do I give him 0.01 again and check at +1 thru +4?
 
Patty & Champ said:
I’ll check him one last time and give him another syringe or two of food before I head to bed in a few minutes. I am going to want to give him R in the morning. Do I give him 0.01 again and check at +1 thru +4?
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As long as he’s not dropping and you can give food, then, yes, 0.1u (not 0.01u) is what I’d suggest. Correct....testing at +1, +2, +3, and perhaps at +4 is appropriate.

I hope tomorrow is a better day for him.

Night, Patty!
 
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