Hi Folks:
Well it was not as long a night as I anticipated as I fell asleep . While I was sleeping wonderful Marje set up Jacks SS and even linked it for me. Thank you Marje!
Jack - I don't know what happened between +4 - +11. So the curve starts today instead. Perhaps this will yield some green already. I have a kit ready if he slips low.
Scooter - still not on insulin but seems to be stable in the yellows. He is on clavamox hopefully to kill a big infection and help. He is also on Neomycin and polymyxin B sulfates, Bacitracin zinc and hydrocortisone cream for his eye bid. . It is also a bit swollen, part of the big infection. The cream has a steroid in it which may also be pushing Scooters numbers up I think. I am holding my breath a little because we are hoping it is not cancer. More will be revealed.
That's quite a change for Jack. Maybe a trip to the lagoon later? Sorry to hear that Scooter has a massive infection and hope that the meds will clear it up fast. Lots of vines for him today!
The Northern Lights were indeed gorgeous. I'm glad that you got to see them too.
Poor Scooter. No wonder his BGs are up! Hopefully, once the infection is gone and he's off the ABs, he'll get back to business and you won't even have to think about juice for him. Sending lots more healing vine.
Jack, blue looks good on you! May we see some more, please?
Whoa I am shocked by these numbers on day one of insulin. I am doing the TR protocol using weight but maybe I am giving him to much to start. Any guidance or suggestions?
I am going to check again in an hour to make sure he doesn't go hypo. I forgot to mention he threw up his breakfast at +5.
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
How much does he weigh?
A couple of thoughts:
- if he got to 60 on day 1, as the depot builds, this dose may be too much
- getting him back in greens asap is a worthwhile goal if you want to get him into remission
- vomiting up his food may cause his BGs to go down because there are no carbs to counter the insulin's effects.
He weights 16.4 pds and I used the kgs calculator to 7.4 kg so his dose became 1.75U.
Ok so getting him into the green today is good news for possible remission. I forgot about the throwing up affecting his carb level thanks for the reminder. In a couple hours I will have to shoot him again. I guess I should keep him on the same dose or what would you all recommend for tonight?
In 20 minutes he will have his evening meal. I will be up tonight if I have to.
I followed the TRP because it worked for Scooter but perhaps since Jack has never had Levemir I should have done the low and slow. I am puzzled but really don't know what to do tonight.
What worked for a cat last time can be quite different when they come out of remission.
There is a good chance Jack will go low tonight, given his depot is still building. If you can monitor you can shoot he same dose and see if he goes under 50. If you think you might fall asleep, I'd take the dose down, maybe to 1.5, but you still might have to monitor that.
Most of us do test, feed, then shoot at preshot time. How far before preshot is Jack's evening meal? Keep in mind you don't want to feed for two hours before shot time in case you end up with a food inflated test, especially if he's in lower numbers.
ETA: there are other options for tonight. Let's see where he is closer to shot time.
Thanks Wendy! Well he is eating at 7 then pmps is at 9. The reason is because of the other kitties and having them all on a schedule. Its been a long while since I have had to deal with Diabetes so I am not as sharp as I once was. I am thinking Jack and Scooter may have to change their schedule since they eat together. Also I can change the shot time as well. If I remember right I could back it 1/2 hour at a time till I get everyone at an 8 pm schedule instead. Is that right?
You remember correctly. You can change your shot schedule 1/2 hour once a day, or 15 minutes per cycle.
With Levemir's later nadir, there is some merit to thinking about when preshot is and when the nadir will land. With limited data, it looks like Jack might nadir around +9. Although if that +11 is with food in his tummy, it might be later. With shot time at 9, that means a +9 nadir around 6AM if you need to do spot checks. Moving it earlier means an earlier time to get up if you think you need to test the nadir time. Neko nadirs most often between +9 and +12, and during rowing season I'm up several days at 4:30, hence PS time is 7:30. The complicating factor for you is that if Scooter goes back on insulin (praying hard that isn't so), then he might not nadir at the same time.
Now the shot time may work better for me if it is midnight and noon. Giving shots and getting everyone out the door and dispatched to jobs as well as answering phones can be stressful first thing. I can move the feeding time to so he is getting fed after shots instead of 2 hrs before (which he is right now). So his nadirs would be between 9-11 am and pm each day. Those times are much better for me since I am usually alone and can concentrate on Jack. I do remember my master course and the concentration it took.
Whatever you do as far as shot time, remember you can change your mind and adjust it earlier or later if you decide it doesn't work for you.
With a low preshot, you're just going to have to keep monitoring. You do have the option of dropping the dose down farther if you want.
Also, just edit out some of the numbers. I usually left in the preshots and whatever I thought was significant. He's been surfing so you don' tneed to show every test. But the current test is the most important, so i'd make sure it gets in there.
Okay well will go with Wendys suggestion of 1.5 and see if that will be okay. I think it will be a long night. Of course that is if his number is still low. Going to go get his number now.
Okay he is at PMPS 107 and I will roll him 15 minutes and then give him 1.5U.
. While I was sleeping wonderful Marje set up Jacks SS and even linked it for me. Thank you Marje! 
