4/27 CRYSTAL PMPS 284 + 7.5 192 - gave "R" | Feline Diabetes Message Board - FDMB

4/27 CRYSTAL PMPS 284 + 7.5 192 - gave "R"

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suki & crystal (GA)

suki & crystal (GA)

Member since 2014
yesterday's R trial

Recap
315 AMPS
283 +2.5
234 +4
242 +5.5
241 +7
265 +8.75
288 PMPS
252 +3
261 +5
265 +6.5


Morning all,

Not sure what to make of Crystal's R session yesterday. It didn't bring her down into blue at all, but as Marilyn pointed out, where would she have gone without it? So today I'm giving her a pokey rest and didn't give any R just to see if there is any delayed reaction like there was on the 22/23 April when she had nearly 24 hours in blue, without the intervention of R .... at the moment, it doesn't look like we will get a repeat performance.

Crystal was very cuddly and affectionate last night and followed us up to bed and slept the whole night tucked into my legs, first time for ages that she has done that :) and after T/F/S we both went back to bed as we had a late night with friends. Perhaps she was a little stressed as friends brought puppy Vincent and although Crystal was shut safely away in the downstairs bedroom and didn't see him, I'm sure she was able to smell his presence after they had left, especially as he peed himself with excitment on the kitchen floor :(..... one for DH to deal with.

Not cat weather today as very windy so all are safely asleep in their favorite indoor beds, wish I could join them.
 
We have showers here today too. Bet Crystal will enjoy the break. Nice to be a cat to just be able to curl up and take a nap on a rainy day. No cares in the world. Have a good day Suki.
 
Sorry to hear the R is confusing you at the moment. Nothing is straight forward with cats is it?:rolleyes:
You must get through a lot of insulin giving such a big dose. Are you able to get it a bit cheaper?
Am glad Crystal is well, even though she was a bit stressed by the dog's visit. I am sure she would have been able to smell him, even if she didn't see him. I have seen Sheba suddenly start to sniff the floor looking for something and she always finds it...even when it is not close. So they do have a great sense of smell.
It will be interesting to see if Crystal comes down on her own a bit today.
 
A few brief thoughts...

I think, if you're comfortable, you should start using R more regularly. Looking at the last few times you've given, I would be tempted to bump up your dose to 3.5uR if she is over 350, 3uR if Crystal is 300-350, 2.5uR for 250-300, and 2uR for 200-250.

Remember, you can give R at both preshots.

One thing you might try today if Crystal is still above 300 in the second half of the cycle is to give some R in the midcycle. That might bring her down for her evening preshot.
 
@ Peg, Marilyn, Bron & Tina, thanks for looking in on us, not much else to report other than she continues high, so frustrating. Yes Bron, the insulin is costing a small fortune, she goes through a complete box of 5 pens in 15 days .....$$$$
@Suzanne & Cobb(GA) , sorry Suzanne, I didn't read your reply until +10 so I've missed the mid cycle for giving her some R (have been a bit lax in updating her SS today, all done now). If I had given R then, on your recommendation it would be 3uR on her +6 of 328 or a reduced dose? Sorry I'm a bit confused here as I'm sure I remember reading previously, maybe from Sandy/Marje or Lu-Ann ? about the importance of not having the two insulins at nadir at the same time, I think I may have asked you about it in an earlier post as I was querying the Lev onset for Crystal, so for that reason I would be a bit reluctant to do a mid cycle as I can't yet interpret the data correctly. I know I'm pretty safe to do the R at preshots and I'm okay with this, but you think it's okay to do both the AM and PM with the R so in effect she could be getting 6uR+ during the 2 cycles?
Just need to get this clear in my head, I agree with you though that I probably need to up the R dose.
 
Good luck with the switch to two R cycles a day - now that you've gained some experience with R. I've seen a number of acro SS's where people give it at every preshot, especially with Lev when you've still got several hours until onset and the R action will be mostly gone by then.

The alternative Susanne was talking about later in the cycle was to use R when you see the numbers are starting to rise at the end of the Lev cycle but before preshot. So it would be after the Levemir nadir and the two nadirs wouldn't coincide. Today it wouldn't have worked because Crystal's nadir was at +12, but yesterday her AM nadir was earlier and her numbers were rising by +9.

OK Crystal - think blue!
 
Hi Wendy, It's easy to see after the event but catching her at the right time is a bit more difficult for me, if only Crystal was more consistent in her nadirs. She obviously doesn't think much of blue at the moment.
 
Yes, giving midcycle would be, as Wendy said, if Crystal was rising. She didn't do that today, so it wouldn't be the right time to give midcycle.

I think it is fine to give it at every preshot. Again, like Wendy mentioned, with Lev you have several hours until onset and the R action will be mostly gone by that onset.

One would hope that you aren't seeing 300+ BGs on both morning and evening preshots, but it is always possible. There were times I gave Cobb R morning, mid, and evening -- I decided that when I had to do that, my R scale wasn't quite right and refigured it a bit.

I did get a suggestion once that you could give your regular dose of R at preshot and if there wasn't any movement, 1/2 of that dose at midcycle, and then the full dose again at the next preshot. It never worked for me -- and I think I only tried it one or two times. I'd have to refer back to Cobb's spreadsheet to be sure. It's a technique that some high dosers have used. Perhaps @Grayson & Lu could speak to it. I don't know if LuAnn used it for Grayson or not. I also don't know if there is any evidence to back up that technique. Just offering it up as something that was once suggested to me.

Another thing that suggests IAA to me is Crystal's inconsistent nadirs. With IAA, those nadirs can jump around -- and they can be hard to track. Sometimes Cobb would nadir at +7, sometimes he'd nadir at +12. It's that irritating part of IAA (well, one of the irritating parts) that just keeps you guessing. Again, something that comes with practice.

The silver lining for today? Crystal didn't go TOO high without any R. :)
 
@Suzanne & Cobb(GA) Thanks for answering my queries Suzanne, I appreciate you taking the time to explain, I was just getting a bit confused. A "crystal ball" for Crystal would certainly come in very handy at the moment! Hope Lu-Ann chimes in and perhaps @Sandy and Black Kitty with their thoughts as experienced R users also. For the moment I think I'll stick with R just at preshots until I've gained more experience, it really is all trial and error. I think you are probably right about the IAA affecting Crystal's nadirs, it seems the most likely reason. Time for another pokey ear Crystal ....
 
151 at AMPS :cool: so didn't give her any R this morning. She seems to like the PM cycle better for some reason, typical cat, can't cooperate in daylight hours! Btb for an hour or so.
 
Sandy gave R at both preshots and at +6 for a long period of time. The difference is that the Lev cycle all runs a bit later - later onset, later nadirs, so even though you are routinely shooting R at preshot with the Lev, that's not really the same as shooting R with the Lantus preshot.

However, what you're doing is working, so I'd just keep going with it until reading her Lev cycle becomes easier for you. Keep asking questions, Suki, because I'm sure it will get easier to see the patterns as you get practice looking back as people explain things.
 
I gave Grayson R at preshots - rarely mid-cycle. Most of the time he nadired late - +9 or +10; so anything mid-cycle might have wound up w/ simultaneous nadirs instead of a jumpstart at his base line.

He was resistant to responding to it until we reached 3u. Even at CSU - they gave him 1uR (no effect) and gave Tracy's Leo a glucose drip! Our boys couldn't have been more different if they tried!

I see she's playing with your sleep patterns. Those are the nights when I didn't give R, and took an Excedrin PM so I could try to get a solid block of sleep. Sometimes, that's the price to pay for all their slumber parties!
 
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