8/15 Mačka AMPS 667, +3 547, +6 506 what if vial is bad?

Penelope and Mačka

Penelope and Mačka

Member Since 2019
http://www.felinediabetes.com/FDMB/...-and-switch-to-tr-pmps-552-not-hungry.218052/

The whole time Macka was at 2.25, he stayed in the reds and blacks. It's pretty scary.
Like @Figaro's Liz I don't understand if it's a bounce or toxicity or whatnot? But with an increase the numbers should go down, shouldn't they? I understand insulin is a hormone and not a drug, but I don't understand Macka's needs at all :)
I was hoping for a bounce break yesterday, now hoping today, and will increase tomorrow anyway. I don't feel like increasing in the evening... But what if it's a bounce and it breaks on the day I increase? ahhhhh.

Edit: please tell me if I'm wrong, but I suspect 4% carb food is too much for him? I recently gave him Wellness, and other brands that were more around 4-5% carbs, and got those numbers. Could it be correlated or are 2% and 4% basically the same?
 
Since Lantus is a hormone, and with his numbers being so high, it shouldn't really matter if you increase in the morning or evening - it's not fast acting like some medications - the depot needs to build up. I think the food is ok...a few percent of carbs 2% vs 5% isn't going to make that big of a difference. You need to increase his insulin based on your protocol...hopefully he'll start to see better numbers soon. Some kitties just take longer and more insulin to get 'there' than others. Be sure to look at some other spreadsheets to see how other kitties are doing especially some that are on higher doses - they need what they need. :)
 
Sue and Luci said:
Since Lantus is a hormone, and with his numbers being so high, it shouldn't really matter if you increase in the morning or evening - it's not fast acting like some medications - the depot needs to build up.
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Thank you for reminding me! I still need to be reminded how Lantus works. I always research spreadsheets on the forum to understand how cats do, and my husband thinks I'm nuts and obsessed because he can't have a conversation with me anymore :) ! I feel like no one has had as high numbers as Macka though... The encouraging aspect of it is, almost all cats manage to find their dose, and so, so many go into remission at a point or another, unless they had some other condition. Can a cat with IBD go into remission?
 
Penelope and Mačka said:
Thank you for reminding me! I still need to be reminded how Lantus works. I always research spreadsheets on the forum to understand how cats do, and my husband thinks I'm nuts and obsessed because he can't have a conversation with me anymore :) ! I feel like no one has had as high numbers as Macka though... The encouraging aspect of it is, almost all cats manage to find their dose, and so, so many go into remission at a point or another, unless they had some other condition. Can a cat with IBD go into remission?
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Have you checked out Biscuits SS?
 
Tina Marie and Jan said:
Yes, I just read that after 6 cycles, you can increase by .5 if nadirs are above 300
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I could, but i'm very scared to do so!!

I have a question: what if the vial was not good anymore, thus explaining the high numbers even though I'm increasing? I've had it for two months and keep it in the fridge. No crystals, but is it a possibility?
 
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Penelope and Mačka said:
Thank you for reminding me! I still need to be reminded how Lantus works. I always research spreadsheets on the forum to understand how cats do, and my husband thinks I'm nuts and obsessed because he can't have a conversation with me anymore :) ! I feel like no one has had as high numbers as Macka though... The encouraging aspect of it is, almost all cats manage to find their dose, and so, so many go into remission at a point or another, unless they had some other condition. Can a cat with IBD go into remission?
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I was feeling like this with Figaro too, that he was in another league with his black and red and pink numbers. I think part of that for me was that I am comparing my Alphatrak spreadsheet to human meter spreadsheets.

Jill pointed out to me that if i was thinking about accelerating an already aggressive protocol, that following the requisites of the protocol was even more important. Very good advice.

So I have started testing with two meters to get a better idea of how different the numbers actually could be. I certainly knew in theory Figaro's numbers would look higher on the AT, but I didn't realize by how much. So far, with a relatively small number of tests, I have seen a big difference between meters in those higher numbers! Unfortunately Fig has not had any lower numbers for several days so I haven't been able to test that end yet :( I added a tab to Fig's SS with the comparison numbers.

But I bring this up because it's not an expensive experiment... I got the relion and strips for $20, and use the same blood drop each time so there's no extra pokes. And the value for me is that 1) I'm slightly less panicked about his high numbers being so outrageous, although they are still much too high and 2) I'm more confident in following the protocol as written going forward and 3) I understand better what other cats are doing and how Figaro's journey relates :)

Oh another thing.. I'm trying to remind myself all the time, this is a marathon, no sprinting here, patience pants :confused: it's very hard, don't I know!!
 
Hi Penelope. Macka definitely needs an increase. If you are following TR the increases can be every 3 days or 6 cycles if needed.

@Tina Marie and Jan , she is right on with increasing by .0.5 u with his nadirs being over 300. So , his new dose would be 2.75. ;)


Why are you scared to increase ? The threat of another DKA is much scarier. You test often so you are in control.


With a kitty with a previous DKA and still in the rear view mirror , we want to get him out of these high numbers ASAP.

Keep checking the ketones daily while he’s in these high numbers.

As far as the vial being bad, it’s doubtful since you have stored it properly. They can last for 6 months with proper storage.

We say low carb wet under 10% but some kitties ate very carb sensitive , so you could experiment with the lowest you can find.

Just keep following the protocol and increase when it’s time and don’t hold on to a dose too long when it’s not getting him anywhere.
 
Bobbie And Bubba said:
As far as the vial being bad, it’s doubtful since you have stored it properly. They can last for 6 months with proper storage.
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I read on one of your posts that the syringe should not be pushed back in the vial to adjust the dose. I should adjust it once it's out "like in tv shows".
I didn't know that and have been going up and down while in the vial, in order to dose accurately, twice a day. I've sent in many air bubbles too. That made me wonder if I damaged the vial by doing so?
 
Penelope and Mačka said:
I read on one of your posts that the syringe should not be pushed back in the vial to adjust the dose. I should adjust it once it's out "like in tv shows".
I didn't know that and have been going up and down while in the vial, in order to dose accurately, twice a day. I've sent in many air bubbles too. That made me wonder if I damaged the vial by doing so?
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You could try a new vial to see but I know one member who always shoots excess back into the vial or pen despite knowing it could be a contaminant and her cat is getting great numbers on a low dose.

But, even if you do start a new vial or pen, I would still increase.
 
Penelope and Mačka said:
I could, but i'm very scared to do so!!

I have a question: what if the vial was not good anymore, thus explaining the high numbers even though I'm increasing? I've had it for two months and keep it in the fridge. No crystals, but is it a possibility?
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The only time I ruined insulin was when I had it outside in the heat all day. Lantus doesn't need twirling to mix like some other insulins, it's quite stable too. A Lantus pen can be left inside at room temp for a month, and likely longer. And I have never seen crystals in Lantus, but would toss if I did. I take the pen out of fridge, draw dose and put it back up. I think that's what most people here do.
So . . . .tiny chance your insulin is bad.

I did not follow protocol when first starting insulin with Tina; I didn't know about it at the time. But, look at how much I had to raise the dose to cut out those reds and pinks. Before long I got to start decreasing.
 
Penelope and Mačka said:
I read on one of your posts that the syringe should not be pushed back in the vial to adjust the dose. I should adjust it once it's out "like in tv shows".
I didn't know that and have been going up and down while in the vial, in order to dose accurately, twice a day. I've sent in many air bubbles too. That made me wonder if I damaged the vial by doing so?
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I did this with my first Lantus pen and the pen continued to work. I don’t do it now... but it didn’t ruin the insulin. I had this same thought when I started raising Jackson’s dose.
Sometimes cats need more at first to heal. I was really reluctant to bring Jackson up to 3 units, because the vet said most cats don’t need so much, but he did, and maybe he still does! I don’t think I’ve ever heard of a hypo episode creeping up on someone who tests frequently. You know him now! Also, Macka will eat more if his blood sugar drops, so he will try to raise it too.
 
Penelope and Mačka said:
I read on one of your posts that the syringe should not be pushed back in the vial to adjust the dose. I should adjust it once it's out "like in tv shows".
I didn't know that and have been going up and down while in the vial, in order to dose accurately, twice a day. I've sent in many air bubbles too. That made me wonder if I damaged the vial by doing so?
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I injected air into the vial as I had been taught when drawing up other medicines until I read that you shouldn’t. I used the rest of the vial and it took longer than two months. Your insulin is very likely just fine.
 
So, I gave 2.75u this morning.
My heart is beating really fast, I hope I did not make a mistake even though I followed the protocol.
It seems like a huge increase to me. What if he breaks the bounce today and it does make a difference? What if it's just too strong? Am I exaggerating? He can go from 600s to 100s in a few hours...
Oh guys, I am SO scared of a hypo episode.
I'll be at home today and monitoring like crazy. Wish him + me luck!!
 
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Lantus insulin in the vial does last more than 2 months if kept in fridge -- I'm still using the vial I got from Mialia -- don't know if she was injecting air into vial before drawing it (I don't) -- but she started using it in early February until April -- I started using out of it in early July -- still getting good action from it in mid August -- so if they tell you it lasts 6 months .. it DOES

every so often I wonder, when I get a test result higher than I expect, then soldier on and it works in his system as it should ...

yes I know the feeling of holding breath and dreading a hypo -- but thank goodness this is Lantus and not Vetsulin -- and you are prepared and available -- it WILL be ok
 
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