2/5 George AMPS 456 +2 479 +9 400 PMPS 79 +1 385 +5 349

Gill & George

Gill & George

Member Since 2015
Yesterdays dose Ponderings
Afternoon All,
prayers and vines for those kitties in need.

Late posting today, one thing and another.
BFG still in red this morning decided on 1u after I got a pink yesterday, thought that the drop back into pink might be a sign of steroid waning.
He's stayed red all morning +9 was 400 (so nearly pink). I'll be sticking with this new dose for at least 4 cycles and reassess.
Still eating, peeing and pooping fine, is cuddly and purry, interestingly pee output seems normal, his tummy doesn't feel swollen now either.

I want to thank
@Jill & Alex (GA)
@Marje and Gracie
@Wendy&Neko
@Bobbie And Bubba
for sharing your thoughts on dosing on yesterdays condo and helping me come to a decision

Surf safely kittens.
 
I hope you'll see those reds disappear ASAP. It is very disheartening ,but so glad he is feeling well and eating well. Sending lots of :bighug::bighug::bighug:
 
My suggestion to increase by 0.25u after every 4 cycles was an attempt to be aggressive without building as big of an insulin depot as would be built when fast-tracking with 0.5u increases in light of the possibility of the steroid suddenly wearing off. I still think that's a good idea, but seeing those high numbers is hard to take... especially given that you're an experienced caregiver, it's not your first rodeo, and you're able and available to test as often as necessary.

Gill, is R or the equivalent available there?

Brainstorming here...
I think using R is the route I would take temporarily... or at least until I felt like there's no way the steroid would suddenly wear off. The benefit to incorporating R into the program is R is in and out... no depot. If the steroid suddenly causes his BG numbers to plummet, the R will wear off after a few hours... unlike the possibility of having to battle the effects of a depot for hours or more than one cycle.

This suggestion is unusual, but given the circumstances, I think it would be my choice if George were mine. Caregivers with cats on higher doses of insulin will often incorporate this technique, but because the plan is somewhat unusual for a low dose cat, I'd really like to hear your thoughts as well as those from @Wendy&Neko and @Marje and Gracie and @Bobbie And Bubba .
 
Bobbie And Bubba said:
I hope you'll see those reds disappear ASAP. It is very disheartening ,but so glad he is feeling well and eating well. Sending lots of :bighug::bighug::bighug:
Click to expand...

He's been in pink since PMPS, 375 down to 349@ +5.
Let's not kid ourselves it's high but going in the right direction, and seemingly coinciding with the steroid action drawing to a close.
 
If R or similar is available in Spain, if BFG was mine, I would go for it. It pains me for you Gill to see him hanging in these numbers. With in being an in/out insulin, you will have more control for sure.

Not sure what the dose would be with a lower dose basal insulin.
 
Jill & Alex (GA) said:
Gill, is R or the equivalent available there?
Click to expand...
I'm sure it's available, but I think I would need an Rx and that's tricky, long story, bit I am friendly with my local pharmacist, so I will ask even if I don't use it now, it will be good to know.

How do I feel about it??
Well, it makes me nervous, I have hand held a couple of CG using it for the first time when others haven't been available due to time zones, but always with a lot of coaching from those that have used R.

My understanding is that the steroid causes insulin resistance, to both exogenous and endogenous insulin, so I worry about being able to determine an adequate R scale. If he doesn't respond to R because of the steroid, any scale I develop while the steroid is still influencing the insulin resistance, would be an over estimation, and that may then lead to him bottoming out, having seen the 'power' of a teensy drop of R on high dose kitties, that is a worry, especially as I haven't got access
to an er vet or hospital.

I feel that it is an option that I would consider once the 7-10 days have passed and if I'm not seeing any improvement.

I am encouraged by his drop into pink tonight, imagining a 7 day curve of steroid action there does seem to be a certain symmetry in the numbers. I might be completely wrong, but I imagine that in the same way that it took 30+ hrs to see the full action of the steroid it may be similar as it wears of. Rather than just jumping of a cliff so to speak.
 
Gill & George said:
My understanding is that the steroid causes insulin resistance, to both exogenous and endogenous insulin, so I worry about being able to determine an adequate R scale. If he doesn't respond to R because of the steroid, any scale I develop while the steroid is still influencing the insulin resistance, would be an over estimation, and that may then lead to him bottoming out, having seen the 'power' of a teensy drop of R on high dose kitties, that is a worry, especially as I haven't got access
to an er vet or hospital.
Click to expand...
Valid points!
My gut feeling is you wouldn't have to develop an R scale. I think you would use it more like I did with Alex and Marje did with Gracie... both low dose kitties (teensy-tiny doses), but there's no way to know for sure without trying.
Gill & George said:
I feel that it is an option that I would consider once the 7-10 days have passed and if I'm not seeing any improvement.
Click to expand...
Sounds good.
Gill & George said:
I am encouraged by his drop into pink tonight, imagining a 7 day curve of steroid action there does seem to be a certain symmetry in the numbers. I might be completely wrong, but I imagine that in the same way that it took 30+ hrs to see the full action of the steroid it may be similar as it wears of. Rather than just jumping of a cliff so to speak.
Click to expand...
That drop into pink is encouraging! Let's see how things go!
 
Gill & George said:
but I imagine that in the same way that it took 30+ hrs to see the full action of the steroid it may be similar as it wears of. Rather than just jumping of a cliff so to speak.
Click to expand...
I was wondering the same thing. The other day when a member weighed in about her kitty being on a fast acting steroid it was in and done in 2days.
 
Liking like typo for PMPS, seriously though, the trend down is good,

I “micro dosed” R to Neko when she was a small dose cat, as well as on higher doses. At that point, scale consisted on a drop vs. a 0.1 unit dose. Keep in mind the goal of using R is to lower the BG no more than 100 points. One of the key considerations for using R is making sure you have an R mentor around the first few times you start it. The time zone difference may make a difference. Plus, as you know, I won’t be around much, if at all, the next week and a bit, so that is one less R helper.
 
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I will do whatever I can to help you. As Jill said, I shot small doses of R with small doses of L. You start small. Just let me know how I can help. The R insulin Suki used in France was ACTRAPID R. It is equivalent to Humulin/Normalin R.
 
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