? 5/2 Minnie PMPS 382 +2 377

Wendy&Neko said:
You can always do a little bit of R at mid cycle, if she's not diving down by then.
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@Wendy&Neko Mind reader! She is hounding me for food, ketones up to 0.9 @+2 and BG up to 388.

Do you think 0.25 or 0.5u R? Do you recommend waiting til mid-cycle or is it ok to give the R now? (I know that means we will be overlapping nadirs but the ketone increase has me panicking)

ETA I am leaning to 0.5u R just not sure on waiting (per previous recommendations here) or get it in (per vet suggestions / BG heading to 400 + ketones on the rise)

thanks
 
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Adding @Lisa & Oberon since you are more experienced with R than I am and don't know when Wendy will be back. Or anyone else with R experience using 'off cycle' ie not at PS or exactly midcycle.

I am itching to give her some R @+2 right now, she is eating up a storm and ketones up to 0.9 though I realize that will likely have the nadirs completely overlapping. I am afraid of waiting. Appetite is good and I can monitor and she is rising at 388. Looking for a second opinion.
 
I've only ever done R at shot time or midcycle (maybe an hour off from that one time, when I tested late). So I'm not sure. But I think a rise at +2 could be the previous Lantus wearing off before the current dose has kicked in, so maybe it would be better to wait and see what happens by midcycle? (I say that, but at the same time it seems like every time I've decided to hold off on R I later wish I hadn't...)
 
Lisa & Oberon said:
I've only ever done R at shot time or midcycle (maybe an hour off from that one time, when I tested late). So I'm not sure. But I think a rise at +2 could be the previous Lantus wearing off before the current dose has kicked in, so maybe it would be better to wait and see what happens by midcycle? (I say that, but at the same time it seems like every time I've decided to hold off on R I later wish I hadn't...)
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Thanks for the second set of eyes. You're right, last few days she has been up at +2. I acknowledge I am panicking because of the ketone rise so my brain is whizzing around with other ideas than what is prescribed here...0.25u then review in 4 hours which would be mid-cycle (and consistent with vet's suggestions previously).

Of course I look at her, and she is peacefully washing her tail oblivious to my concern. At least she has stopped begging for food.
 
Sorry to interrupt this thread but I have to ask. What is R and why is it needed to be added to insulin? I see constant references to people who add R to their kitties insulin routine.
 
R (Regular) insulin is a bolus insulin that can help some kitties, specifically those with ketone issues or conditions that can cause the need for higher doses. It is a short acting insulin, and the goal with its use is to take the numbers down a bit, to give the L insulins better numbers to work with.
 
Things to consider. She always seems to rise between the a.m. shot and +3 (when it appears that you frequently test) so nothing unusual there. Also, what kind of a drop have you achieved in the past when giving her .25 units R and .5 units R? I have used R at AMPS and mid-cycle or near mid-cycle. Hopefully, Minnie is more regular in her R drop than Darcy has been. I TOTALLY understand the rise in ketone panic. Consider that her eating a LOT of food is very good though (helpful with ketones, I mean).
 
Things to consider. She always seems to rise between the a.m. shot and +3 (when it appears that you frequently test) so nothing unusual there. Also, what kind of a drop have you achieved in the past when giving her .25 units R and .5 units R? I have used R at AMPS and mid-cycle or near mid-cycle. Hopefully, Minnie is more regular in her R drop than Darcy has been. I TOTALLY understand the rise in ketone panic. Consider that her eating a LOT of food is very good though (helpful with ketones, I mean).
Summer and Susie said:
Sorry to interrupt this thread but I have to ask. What is R and why is it needed to be added to insulin? I see constant references to people who add R to their kitties insulin routine.
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Where are you now in your cycle, Liz? I mean, what time did you shoot this morning. Are you at mid-cycle now? Or past it?

ETA: Nevermind, I see you shot at 8:45 a.m. You should be approaching mid-cycle in about 45 minutes from the time I am writing this.
 
I'm about to test her and see where the BG is I have a tab of R scales where I'm tracking all the R doses/responses but I've only given 0.25u once before and turns out that was when she was clearing a bounce. I'm not really able to see a consistent pattern myself but if anyone else can see one I'd love to have some input.

I'll make a decision on R dose amount depending on the BG reading I'm about to get plus any input I see in the meantime :)

PS Mr Darcy I will check in on you in a bit, hope you are still eating well

ETA - nearly at 400 so gave her 0.5u. Increasing the dose back to 5 tonight, so no R. Or - question for @Wendy&Neko - instead of that is there any reason to give R again tonight and hold off the increase til tomorrow?
 
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I see your scale says no R if below 300.

Are those all your R scales or somebody else's? I see some Black Kitty ones in there so I got confused.

I have used loads of R on Darcy, but in a different way than you. Being a high-dose kitty, I was using R as a supplemental insulin to the Lantus and later Levemir (because I was using more than a pen a week and just wasn't going to pay for any more.) So Darcy got a lot of R. Nowadays, thankfully, we aren't needing it much at all.
 
Suzanne & Darcy said:
I see your scale says no R if below 300.

Are those all your R scales or somebody else's? I see some Black Kitty ones in there so I got confused.

I have used loads of R on Darcy, but in a different way than you. Being a high-dose kitty, I was using R as a supplemental insulin to the Lantus and later Levemir (because I was using more than a pen a week and just wasn't going to pay for any more.) So Darcy got a lot of R. Nowadays, thankfully, we aren't needing it much at all.
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:) They are mine, except for the Black Kitty ones I included for reference when I set up the sheet. The 'no R below 300' was based on the vet's instructions, though she said it the other way round i.e. give R if over 300. It never really came up for debate before and she was doing so well on 5u that I didn't get the opportunity to fine tune the R dosing. With hindsight I kinda wish I'd ignored the 39 and kept her at 5u but at least I know now to pay a bit more attention to feeding the curve after we increase.
 
Liz & Minnie said:
:) They are mine, except for the Black Kitty ones I included for reference when I set up the sheet. The 'no R below 300' was based on the vet's instructions, though she said it the other way round i.e. give R if over 300. It never really came up for debate before and she was doing so well on 5u that I didn't get the opportunity to fine tune the R dosing. With hindsight I kinda wish I'd ignored the 39 and kept her at 5u but at least I know now to pay a bit more attention to feeding the curve after we increase.
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Wish there were a way to dose in between 4.75 and 5 and see how that worked.
 
Suzanne & Darcy said:
Wish there were a way to dose in between 4.75 and 5 and see how that worked.
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My eyes don't wish that though! I normally wear contacts but now need reading glasses so it's a bit of a circus at shot time while I figure out if I'm wearing my glasses and need to take them off, or wearing contacts and need to put ON the reading glasses! I live in dread of having to resort to callipers (which means I have probably just guaranteed that to happen in my future)

The day we got the 39 was the day I gave her 0.25uR at AMPS when (as it turned out) she was breaking a bounce. It's so much easier to look at numbers objectively when it's somebody else's cat, or it's in the past! When you're in the middle of it....ugh. :eek: I am trying to keep distracted now for the next 2h to see what the R does. Minnie is just hanging out looking fine after I had another minor panic when she refused some food (which I had "sneaked" some slippery elm into). Put a bowl of the same food sans slippery elm alongside and she scarfed that one. Maybe her other nickname is now Goldilocks.
 
Wendy&Neko said:
R (Regular) insulin is a bolus insulin that can help some kitties, specifically those with ketone issues or conditions that can cause the need for higher doses. It is a short acting insulin, and the goal with its use is to take the numbers down a bit, to give the L insulins better numbers to work with.
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Thanks, Wendy.
 
Okay, I was just looking to find out how much R you gave her (not on your SS) but I see you went for .5

Fortes Fortuna Juvat

(that's Latin for: Fortune Favors the Brave)!
 
Suzanne & Darcy said:
Okay, I was just looking to find out how much R you gave her (not on your SS) but I see you went for .5

Fortes Fortuna Juvat

(that's Latin for: Fortune Favors the Brave)!
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:joyful::nailbiting: brave/reckless....it's a fine line. But with nearly 400 I think I'm safe we aren't going to neon this afternoon. (anti jinx)

I just realized I checked 30min too early, looks like she's getting a gentle assist from the R though.
 
That R was too little, too late. Frustrating. I hope this doesn't turn into a relapse. Looks like I used up my quota of advice for today!
 
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