6/24 Henry's ongoing saga AMPS 317 +1.5 308 +2.25 313 +3 336

Hi John, I agree with what Sandy said about keeping the 2 insulins separate and being really careful when drawing up the doses.
I also have seen where the two insulin one were given the wrong way around.

I would get two different coloured plastic cups and mark them ‘Lantus’ and ‘R’ and when you draw up the dose of each, put each insulin bottle or vial into the cup with the syringe so that you can double check it just before you give it. That is how I did it when nursing.
I would also keep the R insulin well away from the lantus insulin in the fridge as it is very easy to pick up the wrong bottle mindlessly.
 
Bron and Sheba (GA) said:
Hi John, I agree with what Sandy said about keeping the 2 insulins separate and being really careful when drawing up the doses.
I also have seen where the two insulin one were given the wrong way around.

I would get two different coloured plastic cups and mark them ‘Lantus’ and ‘R’ and when you draw up the dose of each, put each insulin bottle or vial into the cup with the syringe so that you can double check it just before you give it. That is how I did it when nursing.
I would also keep the R insulin well away from the lantus insulin in the fridge as it is very easy to pick up the wrong bottle mindlessly.
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Good idea. Luckily the R is in a glass vial and the Lantus is a pen, so they'd be pretty hard to get mixed up, but I'm new to dosing 2 different types of insulin at the same time, so this warning is really useful. I'll be extra careful. So far i've dosed one, put the syrigine in the sharps container then do the next one, so I hope I wouldn't mix them up. Especially important to remember when running on little to no sleep I'm sure.
 
One more word of caution since I happened to wake up - R is not used on cycles where they're breaking a bounce. He has broken a bounce after one cycle before - 6/5 PM. More typically his bounces last a little longer than that. Trouble is, it's not exactly always clear when a bounce will break.

I saw the 355 populate as I was looking, glad he stayed a little lower
 
FrostD said:
One more word of caution since I happened to wake up - R is not used on cycles where they're breaking a bounce. He has broken a bounce after one cycle before - 6/5 PM. More typically his bounces last a little longer than that. Trouble is, it's not exactly always clear when a bounce will break.

I saw the 355 populate as I was looking, glad he stayed a little lower
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Yes, me too and glad the ketones haven't came up anymore. Bounce are usually 3 cycles or 6? or is it really cat dependent? I really hope to not be living in the reds on this next cycle. Too bad the libre couldn't tell me "Bounce breaking in 5 hours" :)

1 minute ago
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Another thing I am seeing is his L onset is definitely by +2 (L+2) - and it's a pretty big onset in terms.of how far he drops. Not a lot of +1 data, so it could be earlier.

Now, we saw tonight the R onset is by R+1, nadir R+2 ish. So, those can and will overlap as the bounce starts to let up a bit or he has a more normal cycle. Yet again, the problem is it's not always clear when the bounce will let up a bit. I'm also assuming the R patterns can shift a little from cycle to cycle as well.

Someone else is better to advise, but I personally would be using extreme caution when giving R at shot time for the reasons above (overlapping onsets and nadirs causing quite a potential drop).
 
FrostD said:
Another thing I am seeing is his L onset is definitely by +2 (L+2) - and it's a pretty big onset in terms.of how far he drops. Not a lot of +1 data, so it could be earlier.

Now, we saw tonight the R onset is by R+1, nadir R+2 ish. So, those can and will overlap as the bounce starts to let up a bit or he has a more normal cycle. Yet again, the problem is it's not always clear when the bounce will let up a bit. I'm also assuming the R patterns can shift a little from cycle to cycle as well.

Someone else is better to advise, but I personally would be using extreme caution when giving R at shot time for the reasons above (overlapping onsets and nadirs causing quite a potential drop).
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Noted. Not sure it can get too much crazier than last night (I'm sure it can), but I will be monitoring very closely. Henry is under 24/7 supervision. It would be great to get out of the 300s so the libre would start working again and give me alerts.
 
John & Henry said:
Yes, me too and glad the ketones haven't came up anymore. Bounce are usually 3 cycles or 6? or is it really cat dependent? I really hope to not be living in the reds on this next cycle. Too bad the libre couldn't tell me "Bounce breaking in 5 hours" :)
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They can last up to 6. Not a lot of runtime and there are gaps in data, but about the only trend I can pull from SS is the cycle before he breaks it seems to be characterized by a decent early drop + then back up by midcycle + stays nearly flat the back half of the cycle. Then the cycle after he tends to break it.

Now of course that would be a bit masked by R use but hopefully people like Wendy, Liz, and Sandy may be able to help you see through that.
 
Bron and Sheba (GA) said:
How are you feeling John?
How much sleep have you had?
Are you OK to monitor for the next 4 or 5 hours?
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Yes, I'll be watching closely. I've been setting my alarm to wake me up and getting 45 minute naps in between. The libre is great at making my phone beep very loudly when he goes low.

edit: Oh, I think I've only had about 2 or 3 hours in the last two days, but I've been closing my eyes for 45 minutes or so in between alarms.
 
Regarding keeping the R separate from the other insulin to make sure no dangerous mistakes are made, I always kept my insulin pen sitting upright in in a cup and my R in the original box. As you know Darcy was a super high dose kitty so I had to be extra careful. As to the temperature of the insulin in the fridge, I was so uptight that I had a large digital refrigerator thermometer hanging right over the spot where the insulins were kept.
 
Now, about giving sub-q fluids, be sure to warm the fluids by putting the bag in a bowl of hot water for a while. This will make the fluids more comfortable for Henry. I usually shoot for about 101 or so - close to cat body temperature (so it could be a little warmer or a little less but much warmer than room temperature.). Obviously keep the end of the bag where the ports are out of the water. Be sure to run out the cooler water from the line (you’ll probably need to get air bubbles out anyway) and run it out until you feel the warm water on the inside of your forearm - to make sure it doesn’t feel too hot. next up: needles:

Get yourself some Terumo thin wall needles. These needles are much sharper and will be much more comfortable for Henry. You should get Terumo 20 gauge or 19 gauge one inch needles. I keep boxes of both sizes on hand. Ditch the harpoon they gave you at the vet. I just ordered three boxes from Thriving Pets.
https://thrivingpets.com/products/t...1-inch-box-of-100?_pos=1&_sid=da74c5240&_ss=r
 
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