5/13 Guinness MORE HUMULIN R QUESTIONS!

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linda and guinness

linda and guinness

Member Since 2009
Happy Friday the 13th! It's a perfect day for a certain black cat to start responding to his insulin!

Questions/Comments:
I will be increasing his dose to 5.0u this PM, unless I am told otherwise. I would have done it this am, but feel uncomfortable increasing his dose when no one is home to monitor his reactions.

Dosing Experts: Do you think I should utilize the Humulin R at this point (this point being tomorrow morning when I can get numerous tests in the early part of his cycle)? Or, should I wait to see his response to the 5.0u and then consider it? Will someone be able to walk me through the process this today in a post here? I'm a little nervous about adding it at this point.

Anyone: Where on your cat do you administer your shot? I used to shoot him behind the shoulders, in the scruff area, but then came across something that said the stomach or side of the body nearer to the stomach was best. I'm finding this stomach/side shot challenging because he is so furry and chubby there. I know the insulin is going in him because I always check for wet fur after his shot, and when shooting 4.5u, there would definitely be wet fur if it didn't go in. I'm just not feeling as confident in this shot area as between his shoulder blades. Plus, I see no difference in response with either area.

Link to yesterday's condo:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=43194

Ok, that's it for my question/comment section. I'm so flippin' happy it's Friday. I'm looking forward to take-out Mexican food, margaritas and bed!
 
Re: 5/13 Guinness AMPS 374 Dosing/Humulin R Questions

Good luck with the dose increase Linda!! When Tarragon was first diagnosed, the vet shaved the back of his neck so I could see what I was doing since he is super hairy. The hair is finally growing back and I am being soooo careful to make sure to get the shot in. It would be almost impossible for me to do a tummy shot, plus he hates to have his stomach touched much.

Yummy take out Mexican and margaritas. I love love love Fridays! We hope you both have a wonderful day and weekend!!
 
Re: 5/13 Guinness AMPS 374 Dosing/Humulin R Questions

Good morning ... I can't really help with your dosing or R question .. but as far as shooting, we shot mocha on her left side, near her belly area .. we tried the scruff once and she let us know to never shoot her there again .. have a great weekend!
 
Re: 5/13 Guinness AMPS 374 Dosing/Humulin R Questions

i probably read the same info you did on the shot placement - but i do the scruff. i can get to it easily - i think the main thing is probably consistency. what i read said that if more than one person was giving the shot and they were giving it different locations, the absorption rate varied. i wear my handy-dandy-official-nerd miner's headlight so i can see his white skin through the white hair, and that has made it a million times easier to see.

i don't know the answer to your q on the insulins, but just my gut would be to not make 2 changes at once. how will you know guinness' response to the 5.0 units on its own if you're adding in R at the same time? just my 2 cents worth, but i would get an idea of how the 5.0 units is before tinkering more.

someone expert will no doubt be along to answer your question on it, though. i'll be curious to read their answer.
 
Re: 5/13 Guinness AMPS 374 Dosing/Humulin R Questions

I shoot on the side be it shoulder (side), tummy (side), or flank (side). I read somewhere that the scruff area has poor absorption due to there being so much extra skin or something like that. I will see if I can find it a little later for you. I also remember reading you DON'T want to shoot the same place over and over because it will build up scar tissue and become tough. I have noticed with Willy, the closer to his tummy that we shoot the quicker his BG drops so I try to utilize this when his pre-shot is high. Maybe I am crazy and this is totally NOT the case.

It might only make a big difference at lower doses maybe? Since there is less insulin going in you would need optimum absorption? At least that makes sense to me! :lol: And as we allll know sometimes things can take a few days to make a difference.

I know what you mean about being less confident on the sides. I shoot while Willy is still eating (atm) but when I was doing it 15 min after he was eating (vet advised) I would lay him gently on his side. This REALLY helped with gathering some extra skin. I try to spread his fur the best I can so I can see the needle go in and sometimes I can feel it pierce the skin (sometimes). When he was laying down it was a lot easier to see if I got him. I will also VERY VERY gently pull up to or to the side if I am having a hard time seeing/feeling it. If it doesn't move then I am pretty sure I got him (the next check was for fluid). I need to emphasize the VERY. It's barely anything at all and I don't think this would work on most cats because Willy honestly does not care at all about the shot. My only issue with shooting on the side is actually going THROUGH him and out the other side! I make sure this doesn't happen!

Marjorie is busy today but maybe you can send her a PM with this thread and ask her to look at it. She is really consistent and detailed with her shot sites, from what I have read in her condo's and on her SS. Maybe she can give insight/advice as to why she does it that way with her Gracie that would be helpful to you.

Have a great weekend!

Edit: Here is the link for shot information http://www.felinediabetes.com/injections.htm
another link: http://www.bd.com/us/diabetes/page.aspx ... 01&id=7374
one more! http://fdlibrary.yuku.com/topic/51/t/Sh ... erlap.html

***all links are stickied throughout the site. It seems the consensus is the flank has a better blood supply and absorbs better but is more prone to losing overlap. the scruff is more prone to building up granulomas.
 
Re: 5/13 Guinness AMPS 374|PMPS 330 Dosing/Humulin R Questio

I tested this am at +2.5 and got a 487!! I retested less than 5 minutes later and got a 395...now at PMPS I get a 330...man this cat is screwy! Shot 5.0u in his side by his belly. I hopefully can get some good tests in this evening to see how he is reacting. If you see me post something like a 65 or something you will know I had too many margaritas and tested my civvie by mistake! :o

Still not sure if I should attempt the Humulin R tomorrow. I will probably hold off until Sunday, but I need to get some clarification and understanding if that is the direction that people familiar with it feel we should be moving in.
 
Re: 5/13 Guinness AMPS 374|PMPS 330 Humulin R Questions

Hi Linda,

To sort of answer your question, if Guinness was mine, I would start using R because I would want to try to help him get out of pink. He might not need it for very long, but it can help get him into better numbers while we work on finding his good dose. Of course it is up to you. You'll need to be able to do a good bit of testing at first so we can see how Guinness responds to the insulin and figure out the best strategy for how to use it with him.

That's just my opinion...
 
Re: 5/13 Guinness AMPS 374|PMPS 330 MORE "R" QUESTIONS!!

Sorry to be overly "dense" about this, but I could really use some explanation about Humulin R. How much should I be giving him? Do I give two shots at AMPS, one Lantus at 5.0u and one Humulin or do I just put both insulins within the same syringe? Do I continue to give him the Humulin from now on or only for one cycle?

Is there a sticky about Humulin R and it's affect? Seriously, I don't even know what it is. Thank you in advance for your answers. BTW, who is the Humulin R expert out there?
 
Re: 5/13 Guinness AMPS 374|PMPS 330 Humulin R Questions

two separate syringes. So yes, his usual 5u of Lantus and 0.1u of R, to start.

The beauty of it is that it is quick in and quick out, no shed. You can give R in cycles when he is high and you're able to monitor, but if you can't give it then no big deal. If you're going out or if you don't feel well or if he doesn't feel well or vomits or doesn't eat or throws a lower than expected preshot or whatever, you just don't give R that cycle.

Before doing anything, please read through Gus's condos when I was helping Bev get started:

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=41404
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=41609
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=41810&p=446072#p446072
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=41888
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=41962

Since Guinness is not a high dose cat, most likely he won't need an R dose higher than 0.1 or maybe 0.25, but anything is possible. It's just meant to be a little nudge, not a bulldozer.

So the plan is to start whenever you are ready (and if you don't want to, then don't, no pressure whatsoever). The easiest thing to do is start on a cycle when he is pink after nadir, say at +6. Test, shoot 0.1 units of R, then get a +1, +2, and +3 after that. If +3 is still going down, then get a +4. That will show us whether he gets any response to 0.1, and if so it will give us an idea of how many points of drop he might get from that dose. We'll see how he does with 0.1 after nadir and go from there. It might not do anything, or it might do quite a bit. By starting with such a tiny dose, we can be sure he is safe because it is such a small amount of insulin that you'll be able to control it with food. Ok?
 
Libby, I just need to clarify. Am I giving him his first shot of after his +6 in that same cycle or am I waiting for the next cycle to start and then giving him his first shot at AMPS along with his Lantus and then monitoring +1,+2, +3,etc. or is the +1, +2, etc. that you are referring to after his +6 (like +6 and then +6 +1). Sorry to be so dense, but I am a very literal person and need to understand exactly what I am doing before I jump in.
 
what I am suggesting for your first shot of R is this:

AMPS: give 5 units of Lantus
+6: test and if still pink, give 0.1u of R
+7: test (this is +7 after Lantus and +1 after R)
+8: test (this is +8 after Lantus and +2 after R)
+9: test (this is +9 after Lantus and +3 after R)
+10: test (this is +10 after Lantus and +4 after R)
PMPS: give 5 units of Lantus and MAYBE 0.1u of R (we'll have to wait to see the tests above before deciding)

This is the easiest way to do your very first shot of R. Later you will use R at preshot too, but it's nice to do the first shot at a time when the Lantus is wearing off so you will know that if you see a drop in numbers, it is most likely attributable to the R and not the Lantus.

I will probably not be home tomorrow afternoon to walk you through testing, but if you decide to shoot R tomorrow, others here can help.
 
I believe what Libby is saying is that you want to shoot after a pink nadir. So, if Guinness' nadir is at +6, you would shoot 0.1u of R. You would then be testing so you can establish a curve for the use of the R. So, you would then test at +1R (or your +7 of the Lantus cycle), +2R (your +8), etc. Take a look at Bev's SS and/or condo.

As far as shooting, I shoot in the scruff/shoulder area. I tried flank shots. Gabby was not amused. Worse, I was not amused -- more fur shots.
 
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