? MARKIES HELP NEEDED. PMPS (443) 1.25 uLev 0.5 u R +9 (452)

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well, its 5.31 am. Im testing Markies and going to bed. At least he is resting and no more begging for food.

AND THANK YOU SO MUCH FOR ALL YOUR HELP!!!!

WHEN I WAKE UP I WILL OPEN A NEW THREAD.
 
Ahh - you're right. Your spreadsheet is set up a little differently as most of us don't include the time the shot was given. Yes - 1.25 looks like it was a good dose for him. That's about what you're giving him most of the time for Lev now too over the last few days? And he's on Baytril (enrofloxacin) at the moment? Or he's just finished a course? Do you have ketone strips so you can test for ketones over the next few days if you try him on just the Lev? It may be that you will have to increase his dose once you see how things settle for him without the R, but it would be good to see what pattern he can settle into. There is always the option to increase every 3 days if you're not seeing good numbers to get it all under control as quickly as possible for him too.

I hope you get some good sleep and I'll look out for your new thread tomorrow. :bighug:
 
Silvinia

I won't comment on the R since I have never used it and you have experienced people helping you. The one question that I have though is how old is the Levemir and has it been stored properly? Last night it appears that the R brought Markie down as to be expected, but when the Levemir should have been "kicking in" around +4 or so, the numbers started to go up. This would have been the time that the R was wearing off and if the Levemir was working correctly it should have brought the numbers down some or at least held them in the same range. Even if there was a bit of a bounce from the R, the Levemir should have held the numbers better than it did if is working properly. It almost appears that the Levemir has lost some/all of its effectiveness. This may not be the case however better to address all possibilities.

:bighug::bighug:
 
I have no experience at all with R insulin but I've been following this thread. April made a very good suggestion in Post #92 above: why not put the R insulin aside for now and work on using one of the L protocols very strictly? It would be a lot simpler in the long run, there'd be less panic about R dosing and you might be able to get your kitty doing better over time. As you know, there are no quick fixes in feline diabetes and good numbers can't be forced. I truly understand the fear of DKA because I've been there but a high enough Levemir dose along with proper use of food to steer as needed might well get you to a better place than trying to force BG down with R.

You've been through a lot of very difficult things in your life lately and simplifying Markies' routine would help you and him a lot. :bighug:
 
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Silvina

I'm so sorry for all you've been through and send you prayers.

There are a few reasons we use R:
--high dose cats
--cats post-DKA or who have a history of DKA where we need to get the numbers down quickly as we increase the L insulin per a specific approach
--bouncy cats

That doesn't mean we can't use it at other times but I think April has shared some good wisdom that I would try to focus on laying off the R for now and increasing the Levemir dose by 0.25u every four cycles until you are seeing more yellow and less red and pink as long as you can monitor him. If you can't monitor him during the day more than once or twice, I'd increase every six cycles.

If he were my kitty, if I felt like I absolutely had to use R, I would not use a diluted solution but would use a very tiny dose as April has suggested....start with 0.1u and see how he does. Using a diluted solution just allows too much margin for error if you are exhausted and the ratios get confusing.

Lastly, just as an informational thing, R can be predrawn. It's the L insulins that should not.

Sending many vines for Markies.

BTW, you are still using his original SS. If you'd like me to do a new one for 2017 him with the old one on it as well, I can. That way you won't have to scroll so far to add numbers. Please just send me a PM.
 
Tuxedo Mom said:
Silvinia

I won't comment on the R since I have never used it and you have experienced people helping you. The one question that I have though is how old is the Levemir and has it been stored properly? Last night it appears that the R brought Markie down as to be expected, but when the Levemir should have been "kicking in" around +4 or so, the numbers started to go up. This would have been the time that the R was wearing off and if the Levemir was working correctly it should have brought the numbers down some or at least held them in the same range. Even if there was a bit of a bounce from the R, the Levemir should have held the numbers better than it did if is working properly. It almost appears that the Levemir has lost some/all of its effectiveness. This may not be the case however better to address all possibilities.

:bighug::bighug:
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this is what I have been thinkign about all this last months about the previous pen I was using, that the Levemir is not really working. I was not even finding any nadir, seems no curve, like now effectiveness. So a friend of mine donated a new pen so Im almost sure is not the insuline. But could be other reasons. Im not finding new sopots to shoot. His shoulders skin are very thikened so I have to avoid that area but some times when Im in a rush and he fights me I have to shoot anywhere. I hope I could shooe in the other side of his body, which I never shoot. But he had a very bad sore there cause by baytril shot infeciont and is very sensitive area, and since Im right handed is difficult for me to locate a spot and position him.

It would be a good idea finding a new spot so start shooting. Could that be a possible reason, not absorbing properly due to thikened skin?

I will open a new thread now. If not I will be killed.

Fortunatelly today pmps was not so high!!! in the 300s!!!
 
Marje and Gracie said:
Silvina

I'm so sorry for all you've been through and send you prayers.

There are a few reasons we use R:
--high dose cats
--cats post-DKA or who have a history of DKA where we need to get the numbers down quickly as we increase the L insulin per a specific approach
--bouncy cats

That doesn't mean we can't use it at other times but I think April has shared some good wisdom that I would try to focus on laying off the R for now and increasing the Levemir dose by 0.25u every four cycles until you are seeing more yellow and less red and pink as long as you can monitor him. If you can't monitor him during the day more than once or twice, I'd increase every six cycles.

If he were my kitty, if I felt like I absolutely had to use R, I would not use a diluted solution but would use a very tiny dose as April has suggested....start with 0.1u and see how he does. Using a diluted solution just allows too much margin for error if you are exhausted and the ratios get confusing.

Lastly, just as an informational thing, R can be predrawn. It's the L insulins that should not.

Sending many vines for Markies.

BTW, you are still using his original SS. If you'd like me to do a new one for 2017 him with the old one on it as well, I can. That way you won't have to scroll so far to add numbers. Please just send me a PM.
Click to expand...


thank you for all your help!!! I gor out from bed very late so now Im rushing to do all I have to do and there are one word I couldnt find translation. What means this sentence "Lastly, just as an informational thing, R can be predrawn. It's the L insulins that should not. "

Yes please, I would love if you can do that for me, divide the 2017 page from the rest, I didn´t know how to do it. I don´t want to lose the rest. THANK YOU.

I will start using R without dilution. Im scared but also will try not to, and will try to avoid it by increasin L. Im ready to increase it since its been more than 6 cycles of 1.25 of L. But lets see how it works a little more in this dose without R.. may be he was bouncing?
 
Silvina said:
Lastly, just as an informational thing, R can be predrawn. It's the L insulins that should not.
Click to expand...
This means that having R insulin sit in the syringe is actually OK to do - I thought the rule about that applied to all insulins, but apparently it does not. @Marje and Gracie - thank you for the information on that. :)

I think you need to do at least 4 cycles with no R at all to be able to tell what the Levemir is really doing for Markies. It may be that he is ready for an increase, but I think it would make sense to let his numbers settle without the influence of R and possible bouncing before you decide whether to increase or wait. But so far, so good with those numbers today. :)
 
that was my plan Wendy but I was the whole day in bed and when I woke up i just started completing the ss and respondind messages and now two patients are coming.. then dinner with mom
so when Im back I will post a new thread which will probably already late and almost tomorrows thread.. but sorry.. I had a difficult day and I was in bed almost the entire day.. sorry sorry for that..
 
manxcat419 said:
This means that having R insulin sit in the syringe is actually OK to do - I thought the rule about that applied to all insulins, but apparently it does not. @Marje and Gracie - thank you for the information on that. :)

I think you need to do at least 4 cycles with no R at all to be able to tell what the Levemir is really doing for Markies. It may be that he is ready for an increase, but I think it would make sense to let his numbers settle without the influence of R and possible bouncing before you decide whether to increase or wait. But so far, so good with those numbers today. :)
Click to expand...
ok predrawn or sit down on th syringe means that you can do things on revers, instead of loading and shooting you load compleating and shoot substracting the units to the ammount in the syringe.. well its chineese to do that.. I will throw this mixx away and will have the BD syring eready for 0.1 dose.
 
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