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2/28 Chino|AMPS=504|+4=441|+8=426|PMPS=313|+2=295|+4=197
- Thread starter Adrian and Chino
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Ugh Chino, no need to be so dramatic with the bounce. 
You asked about using R recently. There isn't really a bad time to start it. My main suggestion would be to time your first couple of experiments so that someone experienced in R can be on with you. One use of R is cutting the knees off ugly bounces, but for acros it's also used to give the L insulins a lower number to work with.
You asked about using R recently. There isn't really a bad time to start it. My main suggestion would be to time your first couple of experiments so that someone experienced in R can be on with you. One use of R is cutting the knees off ugly bounces, but for acros it's also used to give the L insulins a lower number to work with.
Adrian and Chino
Member Since 2016
Almost every daytime cycle has been flat pink/red. Chino also tends to have a reliable nadir between +7 and +9. Would this be a sensible plan for starting R?
If AMPS is 350 or above, give 0.25 units R at AMPS or at +1
Test hourly for the first 4 hours
Goal 1: Get him below 300 for at least part of the daytime cycle
Goal 2 (if the above isn't practical): Lower his PMPS to keep him in better numbers overnight
Goal 3: Limit the extent of the inevitable bounce when he sees blues/greens
While it might be more effective to give R near the end of the PM cycle so he can start the day with a lower number, I can't wake up early to give him high-risk meds before my own medication has worn off.
The overall goal of using R is to lower the numbers no more than 100 points. If you do more than that, then the drop can set off a bounce and start the whole bounce cycle all over again. The R cycle is "typically" onset around +2 and it lasts around 4 hours. Neko didn't like to be typical. She was a little later to onset and it lasted later. But when she was on smaller doses, the R behaviour change to be more "typical".
You want to try to time the R use to avoid the big drops, which mean the nadirs of the L and R insulins don't happen at the same time, nor the onsets. You do typically start with a small dose, maybe even as small as 0.1 unit, to see what the impact is. Some acrocats respond to a small amount of R, some need larger doses. Another one of those ECID things. The first couple of times it's good to get tests every four hours to try to find that onset/nadir/duration of R. Of course, if kitty like to be later, the monitoring might go on a little longer.
If you are interested in starting R, let me know the time frame and I'll see if I can find someone experienced to hang out the first time or two. What time is your preshot? (and time zone). The goals as stated above look mostly good, though we might start a smaller R dose.
She was a little later to onset and it lasted later. But when she was on smaller doses, the R behaviour change to be more "typical". You want to try to time the R use to avoid the big drops, which mean the nadirs of the L and R insulins don't happen at the same time, nor the onsets. You do typically start with a small dose, maybe even as small as 0.1 unit, to see what the impact is. Some acrocats respond to a small amount of R, some need larger doses. Another one of those ECID things. The first couple of times it's good to get tests every four hours to try to find that onset/nadir/duration of R. Of course, if kitty like to be later, the monitoring might go on a little longer.
If you are interested in starting R, let me know the time frame and I'll see if I can find someone experienced to hang out the first time or two. What time is your preshot? (and time zone). The goals as stated above look mostly good, though we might start a smaller R dose.
Adrian and Chino
Member Since 2016
I love when he's breaking a bounce! He's already breaking the one that started this morning, and I'm hoping to see green tonight! 
I can't keep skipping meds... this was the 2nd morning in a row that I slept through the first 20 minutes of my alarm. So I'll get a +5, give a half can of LC or MC (depending on how low it is and how fast it's going down), then try for 3 hours of sleep before getting a +8.
Thanks! I test around 0650 EST with a goal of shooting right around 7.
I can't keep skipping meds... this was the 2nd morning in a row that I slept through the first 20 minutes of my alarm. So I'll get a +5, give a half can of LC or MC (depending on how low it is and how fast it's going down), then try for 3 hours of sleep before getting a +8.Thanks! I test around 0650 EST with a goal of shooting right around 7.
Woohoo on the bounce breaking! Timing is a little off.
Ozzy Pawzbourne
Member Since 2016
Check out Mr Chino in the blues tonight! Good luck with the new R dosing! 
Sandy and Black Kitty
Member Since 2009
Hi there Adrian 
I'm experienced with the use of R, on the east coast and happy to help guide you.
I'll look for you in the morning.
Here's my $0.02:
Because Chino is so bouncy, I'm thinking a light hand is best.
I would start with 0.1u R if AMPS is above 350.
What you want to be careful about is getting stuck in a continuous loop of seeing a high number, shooting it too far down with R and triggering a bounce to high numbers.
I also recommend holding the Lantus dose while you are figuring out his response to R. It will make it easier to determine R onset, nadir and duration.
What do you think?
I'm experienced with the use of R, on the east coast and happy to help guide you.
I'll look for you in the morning.
Here's my $0.02:
He does not appear to be insulin resistant - he is seeing green on a pretty regular basis.
Because Chino is so bouncy, I'm thinking a light hand is best.
I would start with 0.1u R if AMPS is above 350.
Yes.
Yes. A few nice runs of yellow would be good for starters.
Based on the recent overnight numbers and your need for sleep, I would not use R on the PMPS since currently the swing from 384 to 187 (and possibly lower) has him bounce to black by AMPS.
R is good for taking the edge off a bounce. He seems to clear bounces fairly fast, another reason I think a light touch is in order.
What you want to be careful about is getting stuck in a continuous loop of seeing a high number, shooting it too far down with R and triggering a bounce to high numbers.
I also recommend holding the Lantus dose while you are figuring out his response to R. It will make it easier to determine R onset, nadir and duration.
What do you think?
Adrian and Chino
Member Since 2016
Thanks! Until recently, it was taking him a full 6 cycles to clear a bounce. Hold the dose = keep the same dose? (Just making sure - when I worked in direct patient care, "hold" meant "don't give.")
I don't have the insulin yet so I can't start it today, but I intend to get it this evening, if I can't take a mid-day break from work. Will you be available tomorrow morning?
We've seen green just 3 times in the 3 months that he's been on insulin, and it generally only happens when he's coming down from a bounce, where there was no nadir on the previous cycle but a continuous downward trend. I would like to see green that doesn't rely on the momentum of a bounce breaking, but I know that will have to be a long-term goal.
0.1 means pressing the plunger before entering the vial, then giving what is drawn up when the plunger is released? Thanks, I appreciate your help with this!
Doodles & Karen
Member Since 2015
Adrian and Chino
Member Since 2016
That's helpful, thank you!
Sandy and Black Kitty
Member Since 2009
Good morning
Yea I can be available tomorrow morning.
And yes, I did not mean to suggest you withhold his Lantus but rather 'hold' the Lantus dose at the current 6.5u while trying to see the effects of R on your kitty's BG. That way you are only introducing one variable, the R, to the insulin picture.
Although you have caught green 'just' 3 times in 3 months, I suspect he has seen green more often. ( I would have given my eye teeth for Black Kitty to have seen green 'just' 3 times in his first 3 months on insulin. It was 6 months before he saw green. It lasted 3 hours and didn't return for another 6 weeks)
Note that green is not caused by nor dependent upon the momentum of a bounce breaking Green means the dose is bringing BG into the normal range. Unfortunately having become accustomed to higher BG his body for the time being may perceive green as dangerous. The resulting bounce is an attempt to bring BG back up to what has become the norm. The goal is to try and get his body accustomed to truly normal BGs once again.
Gotta run. BBL
Yea I can be available tomorrow morning.
And yes, I did not mean to suggest you withhold his Lantus but rather 'hold' the Lantus dose at the current 6.5u while trying to see the effects of R on your kitty's BG. That way you are only introducing one variable, the R, to the insulin picture.
Although you have caught green 'just' 3 times in 3 months, I suspect he has seen green more often. ( I would have given my eye teeth for Black Kitty to have seen green 'just' 3 times in his first 3 months on insulin. It was 6 months before he saw green. It lasted 3 hours and didn't return for another 6 weeks
)Note that green is not caused by nor dependent upon the momentum of a bounce breaking Green means the dose is bringing BG into the normal range. Unfortunately having become accustomed to higher BG his body for the time being may perceive green as dangerous. The resulting bounce is an attempt to bring BG back up to what has become the norm. The goal is to try and get his body accustomed to truly normal BGs once again.
Gotta run. BBL
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