4/30 Gus PMPS 476; R.25; +2R=402; +4R=383

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bev5477

bev5477

Member Since 2011
Just another spin on the Lantus dance floor. So thankful I have R to bring him back down.
 
Re: 4/30 Gus AMPS HI;+2R=HI;Can I Give More??

Should I wait until +3 and if he's not lower, give him R.5?
 
Re: 4/30 Gus AMPS HI;+2R=HI;Can I Give More??

Hi guys .. no advice on the R here, but I will say I hope Gus comes down soon .. he was looking so good in yellow the other day .. hang in there guys .. have a great day!
 
Re: 4/30 Gus AMPS HI;+2R=HI;Can I Give More??

Here's my thinking: I'll give R.5 at +3R if Gus isn't lower because the 1st R will be washing out . I'll still have 3 hours for the 2nd R to wash out so that it won't be a strong pull on his Lantus 'nadir'. So, if someone with advice comes along after 30 minutes from now, that's what I've gone and done. I think I'm OK because his bounce has been a big one and I don't think there's much chance of him crashing. Advice and/or feedback appreciated. Thanks
 
Re: 4/30 Gus AMPS HI;+2R=HI;+3R=230

Well, that answers my question!! :shock: :shock: No more R for you!
 
Re: 4/30 Gus AMPS HI;+2R=HI;+3R=230

Bev, Nice job with the R... :-D . Had to give a bit of that myself this a.m.
I can only hope Tommy responds as well as Gus did.
I'll check back in a while to see if Gus continues to hang out in the sun..
Have a great day Bev,
Squirrel & Tommy ;-)
 
Re: 4/30 Gus AMPS HI;+2R=HI;+3R=230

That's an awful big drop; you may want to ease up with the R.
The harder/faster he comes down, the higher he is going to bounce.
 
Re: 4/30 Gus AMPS HI;+2R=HI;+3R=230

wow, that sure brought him down! 230 is looking great - good job on managing him, bev. feeling like an expert yet?!? :-D
 
Re: 4/30 Gus AMPS HI;+2R=HI;+3R=230

Gayle and Shadoe said:
That's an awful big drop; you may want to ease up with the R.
The harder/faster he comes down, the higher he is going to bounce.
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I agree with Gayle. If he came down 330 points in 3 hours, that's a lot and fast.
As far as I know, bounces often happen because of a big drop or a fast drop, and Gus just had both.
When I give R (and I might use it differently than you), I hope for a slow easy drop of about 150 to 200 points in about 4 hours.
 
Re: 4/30 Gus AMPS HI;+3R=230;+5=538

No Julie, I really don't feel like an expert. I had no advice on this last R dose, but plenty after. Thanks for looking in on us.
 
Re: 4/30 Gus AMPS HI;+3R=230;+5=538/R.25

Smokey said:
What is, "R"?
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R is Regular insulin. It is what vets often use when a cat is in DKA. It is very potent stuff, and can be very dangerous if given incorrectly, so close supervision and monitoring is necessary. We don't recommend using R here, unless you have someone experienced mentoring or guiding you.
 
Re: 4/30 Gus AMPS HI;+3R=230;+5=538/R.25

Bev, you ARE doing a good job with Gus. Sometimes we just have to do what we think is right, see what happens, and then adjust from there. I think you're AWESOME and doing an awesome job!! :-D
 
Re: 4/30 Gus AMPS HI;+3R=230;+5=538/R.25

i think so too - and am glad Gayle & Dyana were here today to advise on it. in another month or so, bev, you're going to be helping someone else to learn what you have learned. Just think, there was some point both of them were learning what you are learning now with their own similar kitties.

You're a champ! Be encouraged!
 
Re: 4/30 Gus AMPS HI;+3R=230;+5=538/R.25

Trying to get Gus to a lower BG has been tough but, Libby has been a great teacher. Basically, when R is used, you're working with 2 curves and trying to get the basal insulin to work better. Gus threw me a real curve this AM. He's never reacted to R like that before. The 230 had to be the overlap of R nadir and the early beginnings of Lantus' nadir. I'm staying away from R.5s at the beginning of a cycle from now on.
 
Re: 4/30 Gus AMPS HI; R.25; +2R(+11 Lantus)=516 Advice Pleas

Gus is one hour away from his PM Lantus dose. He's at 516. Should I give R.25 now? Should I give R.25 with Lantus? Or should I not use R and see what his Lantus dose does?
 
Re: 4/30 Gus AMPS HI; R.25; +2R(+11 Lantus)=516 Advice Pleas

Oh Bev, I'm so sorry, I wish i had an answer for you.. Expert eyes heading your way, soon I hope.
I wish you luck with Gus tonight.. ;-)
Squirrel
 
Re: 4/30 Gus AMPS HI; R.25; +2R(+11 Lantus)=516 Advice Pleas

I wish you had an answer for me too, Squirrel. Do you ever feel so weary with this experience? And now, I don't have any confidence after what happened this AM with Gus' huge fall. I wouldn't ever forgive myself if I gave a dose that hurt (or worse) him. What a *%^$#@ day. Pray someone comes along soon.
 
Re: 4/30 Gus AMPS HI; R.25; +2R(+11 Lantus)=516 Advice Pleas

:YMHUG: Don't worry, you're doing fine. Yes it was a big drop but you caught it. I think you're right, it looks like he may not need 0.5s at the beginning of a cycle. I'm glad you tried, though. I was wondering if it would be smart to try a higher dose when he is HI at preshot. Looks like it is better to reserve that dose for when he is HI after nadir. Good information to have. I'm also impressed that you have so far held his bounce under 600 (anti-jinx).

If you look back at your data, several times he has been HI at preshot and 0.25 has brought him to the 400s. That seems like a good rate of drop to me, so I would be comfortable with that. If you're not, then 0.1 should give him enough to help cover his food spike and maybe keep him from bouncing to the moon.

You're doing fine, really.
 
Re: 4/30 Gus AMPS HI; R.25; +2R(+11 Lantus)=516 Advice Pleas

bev5477 said:
I wish you had an answer for me too, Squirrel. Do you ever feel so weary with this experience? And now, I don't have any confidence after what happened this AM with Gus' huge fall. I wouldn't ever forgive myself if I gave a dose that hurt (or worse) him. What a *%^$#@ day. Pray someone comes along soon.
Click to expand...
Yes I do, I have felt like i have let Tommy down a few times in the past few weeks. I think all of us have felt that at one time or another.
You haven't! Gus knows that you are doing your very best to help make him better. It is very much a learning process and there are going to be bumps and bruises along the way ( not for the kitties but for us :lol: ), but we'll get through this. Both of us are still pretty new to this journey, you more than me, but i think like Libby said, you are doing a wonderful job. Damn woman, it's so obvious that you adore that boy and we know that you would never do anything to intentionally hurt him.. The good thing about this morning, He was soooo hi that the dose didn't bring him to an unsafe level, Just too fast for him is all.. slower is much better all around..I'm gonna have to make a decision here in a few hours as to whether or not to give just a little R to Tommy or see if this bounce can clear on it's own.
I just knew Libby would come... LL prayers at work for Bev and Gus.. ;-) ;-)
I'll check back to see what the boy is up to.. I must work out now..
Squirrel & Tommy!
 
Re: 4/30 Gus PMPS 476; Lantus & R.25

Libby, thanks for the encouragement. I feel better hearing from you. I think I can give Gus .25 without any drama. I'm comfortable with it. Thanks again. You too Squirrel.
 
Re: 4/30 Gus PMPS 476; R.25; +2R=402

Gus is on the lower level of the clouds, so I'm happy with that for today. His Lantus nadir has yet to hit, so he'll theoretically go lower in a couple of hours. I've learned NOT to plan anything!
 
Re: 4/30 Gus PMPS 476; R.25; +2R=402

wow Bev, what a day for you. Sorry I missed it all, though I probably couldn't have helped anyways - I know nothing on R. This sure looks like the making of a great PM cycle, especially after the morning. Good luck - it is nice to see Gus improving.
 
Re: 4/30 Gus PMPS 476; R.25; +2R=402

After today, I really am happy with this! I'll get another look at his BG at about +5 and call it a day then. He'll probably have a beautiful day tomorrow (while I eat a bottle of Tums!!). If he does start the day off in OK #s, I'll let the Lantus do the work (please God). Tomorrow AM will be cycle #5. Libby, does this mean another increase is due soon?
 
Re: 4/30 Gus PMPS 476; R.25; +2R=402; ??

:YMHUG: a little hug to help you through this - you're doing great. i'm guessing you surely must've had times like this when you were a new nurse, didn't you?
 
Re: 4/30 Gus PMPS 476; R.25; +2R=402

You can increase his Lantus dose if you want to. Usually we suggest waiting 6 cycles, but 4 cycles is ok when they are high and flat. Gus would be flatter if you weren't helping him.

I have to say, given the rest of today's numbers, I'm wondering if the 230 might have been a bad test. It seems like Gus would have bounced higher by now if he really dropped that fast. You've given him lots of R to fend off the bounce, but usually he can outfox the R anyway. :lol: We'll find out soon enough - if he does it again, we'll know it was for real. Not really a big deal either way, just thinking.
 
Re: 4/30 Gus PMPS 476; R.25; +2R=402; ??

You could have a point , Libby. A thought to keep off to the side for the future. As for having times like this at work, it was different. Anyone who survives in medicine has to have a loving heart and a very strong wall around it...or you wouldn't survive. It was completely different when my daughter was the patient. Sometimes my knowledge would be clouded by my heart. It's just the way it is, with most in the field. It's the emotional involvement that makes all the difference. Hey, I've got an idea. Let's all get back here tomorrow and do this again! :lol:
 
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