4/2 Doodles AMPS 375 PMPS 440 +1 396 +2 373 +4 481

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Glad his appy is good. Hope you had a good time with DH last night. I really related to you saying on your thread yesterday and if you wanted to stay married you better go out. My DH is sick to death of hearing about Bubba, well all the animals really. It's hard to separate isn't it?
 
Glad to hear he's eating well and enjoying his day so far. Stomps and the dogs have also been sneezing a little too the last few days, I wonder if it's the time of year.

Hope you had a nice evening out! :bighug:
 
Happy to hear that Doodles' appy is good! Hope you had a good time last night!

My DH understands (I think) hearing about Boomer all the time and that our freedom each day depends on what Boomer is doing. That being said, my idea of monitoring Boomer is different than the DH's.
 
Hi Karen
Glad Doodles is eating - that's such a big part of the battle for these IBD kitties
here's to things starting in the right direction today
 
Hi there:cool:

Putting together an R scale helped me, especially since I was not the only one shooting. Below are some examples:
image.png
An R scale is dynamic- it evolves and changes. Carefully and methodically,
with close observation.
You'll get there.
 
I'm sorry Karen. I know how frustrated I get and I'm not even close to dealing with what you deal with every day. I know it doesn't seem very helpful right now but hang in there. We are all here for you 150% :bighug:
 
Sandy and Black Kitty said:
Hi there:cool:

Putting together an R scale helped me, especially since I was not the only one shooting. Below are some examples:
View attachment 19538
An R scale is dynamic- it evolves and changes. Carefully and methodically,
with close observation.
You'll get there.
Click to expand...

I've looked at your R scale. How do I even go about putting one together? How many shots a day his he going to have! Last 2 days he's had 7 shots. I'm going to ask the vet on Monday what other form Lasix is available in besides injection. Maybe if it can be compounded it will be slower release and decrease the hideous spikes.
 
Karen, I am glad that Doodles is eating today. I so wish for you that the R would start to kick in and the new plan will work.
 
Lasix comes in liquid form. I had to give it to one of my cats in the past and she got liquid every 12 hours. Sending prayers. :bighug::bighug::bighug:
 
I think trying to get the lasix compounded is a good idea. We've had a couple kitties here who took lasix in either pill or compounded form and it didn't have this effect. This is what is befuddling me: you said you test the +2 before lasix so some of the time, the R drops him even with lasix and some of the time it doesn't. I'm pretty sure that you are consistent with always testing before lasix, right?

That would have me think that the +2 is sometimes a food spike and I do remember commenting before that even when he was blue/green, he often got a pretty good +2 food spike. He clearly needs more R especially in the morning. He doesn't always go quite so high at night.

Here is what I'm wondering and I would like @Sandy and Black Kitty and @Jill & Alex (GA) to comment because I'm just trying to come up with a different approach. If you test him at R+4 and he's headed up, what if we give another shot of R then instead of waiting until +7 or +10? Maybe it would nip anymore rise and then the lasix would also start to wear off from, hopefully, a lower number. And maybe try a bit more R...1.25u? And this is only if he heads back up today.

I think an R scale is a great idea. We also need to find that dose of R that is doing something for him and I think that will help with the scale. He went from 382 to 327 last night and perhaps dropped a bit more but not likely much based on his +5.15 test. That small drop is within meter variance so I'm not sure how much is really R action.

I know it's really hard to see that 1u of R is still not bringing those food and lasix spikes down. Try not to give up hope....you can see how much R it took BK to come down. We want the numbers down (but not precipitously) but it's important to focus on how he's doing and I know you are watching him closely.

I hope your dinner was really lovely and you could talk about something other than Doodles. Mike was as fanatical about talking about Gracie as I was the first couple of years and then we just decided when we went out for dinner and had "our" time, we had to talk about something else. We talked about her all the rest of the time.
 
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The other thought then is to not give R at PS but to delay it until you give the lasix so the +4 is not so high....hopefully. If you give it at +2 with the lasix, and it onsets at +4 when the lasix kicks in, then it might help.
 
He does start to come back down a bit on his own later in the cycle as the lasix is waning. I would say to try 1u but he really got a bump today for some reason. What I don't want to do is give him 1.25u and have him drop like a rocket as the lasix wears off.

Maybe we should just try 1u since this is a new time to give it and we are experimenting? What do you think?

Sweet picture!
 
Let's see what it does today, ok? This is just an experiment.

It's probably a good idea to watch the numbers.....we want to see when the R onsets and what it does. I know how hard it is to poke him when he's high....I really understand...but we need to know how giving it now affects him.

Even if he goes up after R+4 this time, I would not give it the rest of this cycle since you are giving it now.
 
You're welcome. I'm working today from home but are watching your thread so I'll check in when you post.

Come on McDoodles!!!!!! Nice and easy but let's see some progress.
 
I just saw the R+1 ...ha! Is it the R working or how long does it take the lasix effect to start waning a bit? I think it is the R because he hasn't dropped that much before during this timeframe. I think that's the most significant drop we've seen.

When you add a number to the subject line alone, it doesn't act as a post so I didn't get a notification but that's ok...I'll just drop back in in a little bit.
 
I'd grab a test at R+4 or so to let us see how fast he goes back up.

Guess we could have done a bit more R but we were just trying it out and he got a good initial response. I would not want to overdo the R the first time we tried this and have him spiral downhill fast.

Just a note: normally, we would be cautious about overlapping nadirs of R and L or even a big onset from R as L nadirs but with him being where he is with no big movement from the L increases yet, we have a bit more leeway. As his numbers improve, we will have to be more cognizant of onsets and nadirs.

What is interesting is that his nighttime cycles are different. Sometimes he gets a +2 spike, sometimes not, sometimes a bit. His lasix spikes don't seem to be as high either.

Let's see where he is at PMPS. What do you think about testing at +11.5 so we have time to see where he is and make a plan? He, hopefully, will come down more on his own as the lasix dwindles.
 
I honestly don't think that drop caused a bounce. He's not that much higher than he was two hours ago. He started much higher today when you gave him R and when it wears off, the numbers can go up.

Some days...there is no "getting it". Some days, we don't know. He's had other cycles where he went up when the R wore off.
 
Are you comfortable with that at night? So you are talking now about giving it t PMPS and not +2 right? I think if you want to try 1.5u, it's best to do it at PMPS; keep in mind he doesn't always go up as much at night at +2 but I agree he's likely to be higher at PMPS tonight.

What do you think the sneezing is a out...allergies? It's very windy here so you might also have a lot of wind. I wouldn't think it was related to the HCM or CHF but never say never.
 
Remember
  • Injected insulin first gets bound to the antibodies. Any insulin that does not get bound goes toward metabolizing sugars. How much goes to antibodies and how much goes to metabolizing sugars is anybody’s guess and a moving target
  • IAA can retard the initial rise of available insulin after an injection.
Doodles & Karen said:
I've looked at your R scale. How do I even go about putting one together?
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experimentation and close observation. With experience in time you will develop a sense of the ebb and flow of it all . The scale serves as a guide. There will be times when your gut tells you to stray one way or the other from the scale.

I wish I could give some slick formula but the truth of the matter is we were flying by the seat of our pants

Regarding shots, once BKs dose got over 7u L I was plagued by fur shots due to a sever tremor in my right arm/hand so I split the L dose into 2 syringes. For quite some time I gave BK R at PS and +6 - around the clock. So 8 shots a day was the norm for us.

Doodles & Karen said:
R+4 and we're back to 483....I don't get this:arghh: Did the larger drop create a higher bounce?
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Personally I don't think it's a bounce. If he had seen blue or low yellow I would think it was a bounce.
Using R on top of L with IAA is extremely situational and nuanced and will never be perfect or static.

I'll admit that while in the thick of it I didn't concern myself with nadirs or bounces - because I could see no evidence of either. No matter how hard I pounded on the BGs he pretty much remained high and flat -- a relentless sea of pink and red.

One final thing you may have already been advised of but it bears repeating - when administering L and R at PS it's critically important that you remain mindful of the task at hand. The last thing you want is to pull and shoot 6uR and 1uL instead of 6uL and 1uR.

Hang in there and hang in here.:cool:
 
Great post, Sandy.

Sandy and Black Kitty said:
One final thing you may have already been advised of but it bears repeating - when administering L and R at PS it's critically important that you remain mindful of the task at hand. The last thing you want is to pull and shoot 6uR and 1uL instead of 6uL and 1uR.
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And great reminder because it has happened here more than once. I only took one insulin out of the frig at a time. I always drew my lev dose, put the lev syringe on my left, Put the lev back, took out the R, drew the dose, put the R syringe on my right, put the R back. Checked the syringes again and then once again before I shot so I gave the R in the scruff. Developing a defined routine will help. I thought of it as my L and R dosing dance.
smiley-dance007.gif
 
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Wise words indeed by Sandy. Try not to analyze the why in each cycle (says the one who did the same:oops:). Figuring out what's happening with IAA in the picture can drive you crazy. Either the dose works, or it doesn't.

Good to see Doodles up and about. :bighug:
 
Marje and Gracie said:
So you are talking now about giving it t PMPS and not +2 right? I think if you want to try 1.5u, it's best to do it at PMPS
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Yes, if I do it would be at PMPS not +2 :)

Marje and Gracie said:
Developing a defined routine will help
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Yep, I already draw R first put it back and then bring out L....any questions and I dump the syringes and start over.

Sorry for not responding earlier....took a nap!
 
Sandy and Black Kitty said:
I wish I could give some slick formula but the truth of the matter is we were flying by the seat of our pants
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Thanks Sandy. Sure wish you had the magic scale.
Sandy and Black Kitty said:
Personally I don't think it's a bounce. If he had seen blue or low yellow I would think it was a bounce.
Using R on top of L with IAA is extremely situational and nuanced and will never be perfect or static.
Click to expand...
I didn't think it was a bounce really...today has been another rough one.
 
Wendy&Neko said:
Try not to analyze the why in each cycle (says the one who did the same:oops:). Figuring out what's happening with IAA in the picture can drive you crazy.
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It's like the 4 year old that discovers the word "why".....just really stinks. But yes, he was out quite a bit today thankfully...my poor baby.
 
Doodles & Karen said:
It's like the 4 year old that discovers the word "why".....just really stinks. But yes, he was out quite a bit today thankfully...my poor baby.
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Yes that's true. But I think it applies to FD all the way around. That's when I drove Mike crazy in the early days....when I wanted to know why the numbers were what they were (actually, I also drove @Sienne and Gabby (GA) beserk too...shhhhh.....don't remind her ;)). Somewhere along the way, I learned it just was what it was. Either she needed more insulin or she didn't.
 
Marje and Gracie said:
Yes that's true. But I think it applies to FD all the way around. That's when I drove Mike crazy in the early days....when I wanted to know why the numbers were what they were (actually, I also drove @Sienne and Gabby (GA) beserk too...shhhhh.....don't remind her ;)). Somewhere along the way, I learned it just was what it was. Either she needed more insulin or she didn't.
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A lesson of mine too and I am still a student learning, forgetting, and relearning. :banghead:
 
I'm liking that +2!!!! A little more big guy.....lets see you down in the low 300s.

I think it will be a bit easier to do an R scale when we can tell how much starts to affect him. If no matter what you give, he barely moves, than we need to go up. Once we see a little more progress, then you can make the scale both ways.

I also had one but it was pretty simple so I'm glad Sandy gave you a really good example.
 
Love the pic of him drinking from your glass! In all of this, it's always a good perspective to keep his quirks, sweet personality and the things you love about him in front of you. When a kitty is having a hard time, it's so easy for that to become everything. Been there, done that - it's hard not to. No matter what his numbers are or how resistant his BGs are, he's still the same sweet kitter you've loved for a long time.

I don't want to jump in the middle of your conversations on the R dose, so will let Marje or Sandy answer your question about the R scale for morning. It looks reasonable to me, but I haven't been working on this with you like they have, so it's better to let her or Sandy answer. While that 481 tonight looks grim, there is always the question of how much higher he might have been without the 1.5u R tonight.

We gave punkin bupe injections twice a day as well, so he often got 2 L shots, 2 Bupe shots and 1-2 R shots in a day. Oh yeah, and he got Adequan as well, but that wasn't daily. He also got injectible vit B, but if it was a fluid day, the Adequan and Vit B went in with the port in the fluid tubing. Not ideal, but he needed all of those things and he tolerated all the shots and pokes without complaining. I always told him it was to help him feel better. He may not have understood, but he trusted me implicitly, so I'd like to think that he knew it was for his benefit.

:bighug::bighug: One for you, one for Doodles!
 
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