6/22 Tiger AMPS 249;+4=64;PMPS 201

[Tiger(GA) and Ruth]

Last condo: viewtopic.php?f=9&t=120394

OT: It's been awhile since our last post. I would go to make a post, then something would come up and it got pushed aside. DH had a good bill of health from his doctor; cleared to return to work full time, unless fatigue becomes a problem, he still needs regular naps but this is considered normal. He played tennis for the first time Saturday and felt pretty good or so he says. It's easier to sleep nights not having to worry about him so much anyways.

And now to my questions...Tiger's numbers were all over the place the past two days; one day she displayed all the colors of the rainbow except for black, thankfully! Is this just normal bouncing? She has managed to pull a few green numbers but I need to know if there is anything I should be doing, i.e. increasing or am I okay holding this dose? Another off topic, I'm a little frustrated, I made 3 trips to 3 different Walmarts looking for Relion 1/2 unit syringes and each one the pharmacist insisted they don't have them! Is there a better place to get a different brand? Thanks for any input.

Sending healing vines to all who need them and wow, congrats to all the OTJ trials!

 

[julie & punkin (ga)]

As far as syringes go, i just posted this today to Darin/Charlie

the relions have a bigger barrel than the terumos. i promise i don't get a commission, but i loved the Terumos. The plunger slides smoothly, the markings are more accurate than some of the syringes, and they are some of the cheapest syringes. Save a little money by registering first at http://www.mrrebates.com and go through their site to American Diabetes Wholesale. When you've got enough $ rebated, you can request a check. I've had checks of $35 even, all from diabetic supplies for punkin. These http://www.americandiabeteswholesale.com/product/terumo-thinpro-insulin-syringe_5891.htm syringes are awesome. The barrel is a little narrower, which makes the markings spread out a little farther, making it much easier to fine-tune a dose.

have you seen Marje's post on using the Calipers?

By the way, at the bottom of each page on FDMB is an option to "bookmark topic." If you click there, it will get saved for you. To find it again, you go to the User Control Panel. The first tab on the top is "overview." When that is clicked on the left side of the page you can click on "Manage Bookmarks." From there, just click on any bookmark you've made and you can see the post again.

It's a great way to save any discussions that you want to refer back to again.

For the dose question, I think i'd be tempted to increase the dose to 4.0 again. The TR protocol says

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

You're having pretty good nadirs. She's just clearing the bounce today from 3 days ago. One option is to just hang onto this dose and wait for the bouncing to stop. Most cats will eventually stop bouncing if they get used to being in greens. You've got far more than 10 cycles on this dose, though, and the goal of TR is to get all of the numbers in normal range (50-120). I'd probably increase by 0.25u.

If you do increase, you'll likely need to be prepared to use carbs to keep her nadirs above 50. Sometimes a little more insulin can help bring down the high numbers. If you want to do that, you'd watch the BGs, especially her +2 numbers and when they are significantly less than the preshot, i'd give a snack of a little higher carbs, say 8-10%. Sometimes doing that for a while can help flatten out the cycles.

 

[Wendy&Neko]

Nice cycle today for Tiger! I've heard others say that many Walmart pharmacists don't know that the 1/2 unit marked syringes exist. :roll: I know it's easier for me to just show the lid of my old box to the pharmacist for my BD syringes, then they know what to look for. I think a lot of people here like the Terumo's. Just be prepared that if you change syringes, you may have to change the dose because what is 4U on one syringe may not be 4U on another.

Good to hear that DH has a clean bill of health. I guess it was hard to hold him back from playing tennis again.

Regarding bouncing, some cats do take a long time to get used to green - Neko was one of them. She used to really like running the rainbow and it took over a year to convince her red shouldn't be a regular occurrence. Now I'm trying to banish pink, but weren't not there yet. :roll: With an acrocat it's a little harder to play the higher carb game Julie suggests. Max/Elise and Eddie/Jen are currently trying to experiment with higher carbs to reduce their kitties bouncing, if you want to look at how that works. Most food experiments do take a while so be prepared to be patient. ;-)

 

[Ella & Rusty & Stu(GA)]

Hi Ruth,
I have nothing to add to the Tiger discussion tonight, but just wanted to say how happy we are that your DH is able now to do everything again.

Have a good evening,

Ella & Rusty

p.s. we use Terumo syringes and measure the dose with calipers. Most syringes, including Terumos, are not particularly accurate, but Terumos are the easiest to work with. Calipers take all the guesswork out of measuring the dose. See Marje's posts that Julie references, above.

 

[Deanna & Billie]

Tiger and Billie had a similarly nice day and have matching PMPS numbers! :smile: Have a good night!

 

[tiffmaxee]

I'm glad your husband has recovered. I am using terumos now. I buy mine from ADW. They ship them really fast. The difference between them and the monojects I was using is the dose doesn't vary as much. I'm using calipers but even eyeballing them they are more accurate. The only negative is that I am flunking the get rid of bubbles test. Good luck on the increase if you decide to go that route.

 

[Chris & China (GA)]

I've had the same problem with my WalMart Ruth

They DO have them...you just have to tell them you want a box of 100 3/10cc, 30 or 31 gauge, 5/8" needle length Relion insulin syringes....open the box and look and you'll see they have the half unit markings

My box is white with a purple "band" around it with the actual syringe info printed on it.

A lot of people like the Terumo's from ADW here too, and the barrel is a little thinner so the lines are a little further apart, so sometimes they're easier to see but the plungers on them are VERY easy to push in, so you have to be careful not to bump the plunger until you're ready to give the shot (been there, done that...LOL)

They also have a tendency to be a little harder to get rid of the air bubbles, but with some practice, most people figure it out!

Glad to hear DH is better!