Bubba's glucose numbers, ss..and Happy Holidays!

Status
Not open for further replies.
chubbabubba

chubbabubba

Member Since 2012
Hi Everyone,

Quick update.. Bubba has been eating better today. I tried to get as many tests in last night, but then I feel asleep :(
His lowest number that I got was after his pm shot at +6 153. He acted so much better last night.!

I am looking at his SS, and was wondering are his numbers really moving down as they should? Could this dose be a little low for him?
The only reason I am asking is he is on Humilin ( Right now- Ketones) and although short lasting, I thought fast acting.
I am a newbie in the sense, I never tested so much ( meaning every two, three etc)
So maybe the numbers are moving ( but he is starting at a high number to start with)

I was unable to get his urine sample yet today and did order the Nova Max and have the urine test strips as well to monitor keones on both ends. I am stalking him at the moment, so I will update asap.

It has only been 3 days since he is back on insulin, is that a factor?

Any feedback is much appreciated. I am going to continue to test every 2 or so.

Most important-------Happy Holidays--------------------!!
 
1n5w1dZJLR.gif

Merry Christmas!!!

Jackie

I'll try to get someone's eyes on his SS that is familiar with using "N". I'm not but his numbers do seem a little high. I would have also liked to have seen him start on lantus with "R" or "N" as a bolus...I think you'd be seeing better numbers. I'm glad he's eating.

It may be a little tough to find someone available today to look at his SS so hang in there.
 
What you're seeing is the effect of the N wearing off at about +8. I agree with Marje and I think I posted this previously. If you could talk to your vet, especially now that you have test data, and ask about starting Lantus. If Bubba's numbers are still on the high end and you're worried about ketones, I'd ask about using Humulin R as a bolus insulin. (FWIW, you don't need a prescription for R.) R is as potent as N but it has half of the duration. It can be used very effectively with Lantus.

I do think Bubba could benefit from more insulin. While I've used N, it's been quite some time. My suggestion would be to hold the dose and talk to your vet in the morning. However, if Bubba is testing positive for ketones, you could consider raising the dose.
 
Thank you. I am going to ask the vet on that combo. I know Sienna mentioned it as well.
How does that work? I give both ? Sorry I just want to understand so when speaking to him I understand
What I'm talking about ;)

I really want to incorporate Lantus already.
He's eating, but I notice that after his pm shot
He acts more " normal". I already took the first week of Jan off to be home with him
In hopes we will move to lantus by then or what you mentioned.

No worries on the ss, it will be there tomorrow.

Happy Holiday..
 
;) how cute!

I am going to ask the vet for sure.
Tomorrow sometime could you explain ' normally
How they both would be used?
If I'm understanding correctly, since N is not long lasting
By having both used Lantus will build up and take over where N stopped
Is it common to use two different insulins at once?
Thanks everyone. Just want to " get" the idea in order to present it to my vet
To see if he agrees that's what should be done.
Knowledge is power...;)
 
R is used in some very specific situations. For high dose cats (e.g., a cat with acromegaly or insulin resistance) it can help to bring down those high numbers since the highs can occur intermittently. For some cats that are prone to big bounces and the basal insulin (e.g., Lantus) hasn't always been effective in flattening out the curve, R can be helpful to reduce the impact of the bounce. (Dyana's J.D. is one of those cats.) For cats who are having medical issues and/or are prone to ketones, R can also be useful. Lantus doesn't yank numbers down. Both R and N do. Because Lantus is gentle, if numbers are high, it can be helpful to use a bolus insulin to help to lower the numbers and give the Lantus a way to "grab on" and begin to bring the numbers down.

What happens with R is that you first need to have a curve with Lantus. It's important to know when the Lantus nadir falls. The reason for this is that you don't want the Lantus nadir and the R nadir to coincide. This could end up dropping numbers in a less controlled manner. The first time you give R, you use a tiny amount -- 0.1u and you then test every hour for 4 hours. R is in and out of the system in 4 hours. This will give you baseline data. You can then begin to systematically raise the dose of either the Lantus or the R as you need to.

Libby or Dyana or some of the others who have used R are better able to give you more of the details but that's the overview.
 
I agree with Sienne 100%. I'd seriously talk to my vet about getting started on lantus with an R bolus. We've had good results here with many members doing that combination under the tutelage of experienced "R" users like Libby and Dyana.
 
I'll try to illustrate an example.

If your Lantus curve is like:
350 +12
370 +1 ----spike from food
345 +2 ----onset of Lantus
320 +3
295 +4
270 +5
240 +6 ----the nadir is the lowest point of the cycle
265 +7
280 +8
300 +9
310 +10
330 +11

If you use both Lantus and R at +12, your curve might be like:
350 +12 ---onset of R
305 +1 ----R is working but against food spike
250 +2 ----onset of Lantus
190 +3 ----when I use R, it's nadir is about +2.5 (you'll have to test to find yours) you don't want R and Lantus nadirs to happen at the same time.
150 +4 ----R is done with it's cycle, and just the Lantus can take over with the lower number
120 +5
100 +6 ----typical Lantus nadir
110 +7
130 +8
160 +9
200 +10
250 +11
if the next +12 is low enough, you may not need to give R

That's the best I could do at 5:00am :) Let us know if you have questions.
Hopefully, this illustrates how R can bring the numbers down to a level the Lantus can better work with.
 
Thank you Dyana,
Im still a little confused, not going to lie and act proud here
Bubba would really needed to be monitored during the onset of r and lantus
To make sure the lows don't come together. ? I know there is a different time in how long they last, but wouldn't want to leave him during the new introduction.

R is only about 4 hrs, lantus 12. I get the concept
It's wanting to be home to monitor how his numbers will be and how he's acting.
That won't happen until the weekend and a full week in Jan.

I'm just afraid . Bubba got weighed and he is 24 lbs not 22.
Big boy and should weigh no more then 18 w his size Dr said.
Ok, diet noted but for right this second without being to monitor I am wondering if
A small increase of N would help?
Like a half of a unit. ?? Dr wanted to start him on 4, I thought that's way to much to start him.
So he agreed to 2 to see where it takes him for now.


It looks like your in NJ as well, if its allowed maybe you can call me and I would better understand.
My vet is off today, so I wont be able to see him till tomorrow.
 
I have to go to work, today, and have to log off like now, to get ready for work.

I'll PM you my work number.
I can't advise you on dose over the phone, but I can try to answer your questions about R.
 
Hi Dyana,

Thank you for your above post. When my Vet comes in tomorrow I will try and discuss all of what was mentioned with him
I think thats best right now. I am sure he will be able to guide me on the proper dose for him. I still think its off.
Sometimes, it just gets so confusing with all the terms etc. Diabetic land is tricky , especially when you cant gather your thoughts.
Thats why I mentioned the phone, better yet I will just print this out or show it to him for advise.

I will update his ss later with the rest of the numbers.

Thanks again! Your Tux is a cutie! Just love them. They are dressed up 24/7 :-D
 
Just as an FYI....

The initial dose of Lantus can be calculated by a formula:
initial dose = 0.25 x ideal weight in kilograms

So, if Bubba is, ummmmm.... "fluffy", the calculation would still be based on his ideal weight of 18 lbs. The result would be 2.05u of Lantus.

To be honest, it's a lot easier on your nerves if you aren't chasing after the numbers because the dose is too high. That can lead to being frazzled because you're worrying about Bubba's numbers all the time. You have to weigh that against ketones. Having R gives you flexibility. If the Lantus dose is a little low, you can augment with a short acting insulin and then raise the Lantus dose every few days.

I would agree that getting started on an evening or the weekend will give you a greater sense of confidence. The other thing to keep in mind is that while you want to be giving Lantus twice a day, because R in short-acting and there's no insulin depot, you can use it one cycle and not use it the next cycle.
 
Thanks Sienna,

Haha, Fluffy! Boy if he understood that he would appreciate it! He gets obese and yes he is.
I know its not helping matters, but I have to focus on one thing at a time. Weight will be a factor, for sure.

My first step is to see if my vet has used this method before and see how comfortable he is with it.
If he is not, I will post and see what I should do at that time. ( suggestions)

I am hoping my Vet has used this method before so I could relax. :?

You're right! I am chasing the numbers and getting a bit crazy! Ketones are still a faint trace. I ordered the meter that was posted.
Ordered another 100 test strips. ( never going to be without) way to scary.

To your knowledge, do you know of anything online that would determine the amount of R that should be added?
I am sure its a case by case, but I have trust issues as I almost lost him yrs ago, so I like to read and ask a million questions. :(
 
Status
Not open for further replies.
Back
Top