Newbie: looking for tips on avoiding a hypo whilst home alone

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Bella's Mum

Member Since 2023
Hello everyone,

I joined this wonderful forum a few days ago after my 11 yr DSH, Bella, was diagnosed. Here's a quick little backstory. Bella has pemphigus and has been on prednisolone & dexamethasone eye drops (both steroids...) daily for the past 4 years or so. Little did I know these would eventually induce diabetes. Since the diagnosis, we've started tapering these drugs off and will eventually replace them with Cyclosporine. We've also changed her diet to Ziwi peak biscuits and royal canin diabetic wet morning.

We've only been on insulin (Toujeo) for 4 days and I've noticed some pretty sharp drops on the libre sensor graph (I assume it's because we're still just getting started?). It's just got me worried since my partner and I work full-time and Bella is left alone for up to 10 hours a day. I don't want her to go Hypo during the day whilst no one's home or during the night whilst we are both asleep. I got particularly worried last night as when I was about to sleep she got to the green for the first time (88) and was scared to death that she was going to keep going down as she was on a pretty sharp decline that entire day (spreadsheet here). Thankfully that didn't happen and the curve today seems a bit more flat.

So I guess what I am asking for is some tips on deciding when to shoot/when not to and what numbers/graph trends I should be looking out for to help make the decision.

Thank you so much!
 
WHen I click on the spreadsheet i n your signature I get a page with:
"Sorry, the file you have requested does not exist.
"Make sure that you have the correct URL and the file exists."

You need to provide BG value at various times for us to really help you. You can post screenshots of the Libre graphs. If you do please also say when you inject in order for the graph to be meaningful.
Also, you said
Bella's Mum said:
Ziwi peak biscuits and royal canin diabetic wet morning.
Click to expand...
When are you feeding the Ziwi peak biscuits?
Are the biscuits the freeze dried food?
Feeding different kinds of food, carbwise, morning and even makes it harder to find good dose.
Why are you using Toujeo? It is U300 glargine. Are you using the pens that dose in 1 unit increments? Many cats do best at non-unit increment doses. Some even need less than one unit.
 
Sorry not too sure what happened there! I've updated my signature and it appears to be working now. We leave small amounts of Ziwi peak dry (air dried) out throughout the day to graze (vet told me this is ok). The royal canin diabetic gets fed morning and night with the shots (roughly 7am/7pm). My vet provided me with Toujeo (U300 Glargine) I didn't really have an option and hadn't done much research into insulin at the time so I took their word. It is a pen so yes only 1u so not being able to go less than that does concern me however, it appears to be going ok for now.
 
Bella's Mum said:
Australia
Click to expand...
OK I'm going to tag a member that lives in Australia
Can you please add you live in Australia to your signature and Toujeo and Libre Sensor
That's the first things members will look at
Tap on your name up top, then tap signature add Australia then tap save
Bron will probably be on tonight
@Bella's Mum
 
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Here is some information that will be helpful
https://www.felinediabetes.com/FDMB...for-aussie-feline-diabetic-caregivers.217781/
There is lots of information here about everything you would need
When looking for foods that are medium and high carb foods in case you need to bring the BG numbers
Between 11% and 17% is medium carbs.

18% and over is high carb.
Tap on this blue link I see there is some information about Toujeo.
Just read through the posts.
I really haven't seen any cats on here that are on it now or recently
https://felinediabetes.com/FDMB/threads/addie-5-20.263563/#post-2952794

Go to the top where it says search and type in Toujeo and a lot of posts are there about Toujeo you will have to skim through them
 
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Do you prime the pen after each needle replacement?
Are you keeping the pen in the fridge between uses? The manufacture says you are NOT supposed to keep i -use pen in the fridge. One concern is that the expansion and contraction due to temperature change can result in getting air into the pen vial which results in inaccurate dosing. This would especially be a concern with dispensing only 1 unit of a U300 insulin since that is such a small volume.
 
Bella's Mum said:
We've only been on insulin (Toujeo) for 4 days and I've noticed some pretty sharp drops on the libre sensor graph (I assume it's because we're still just getting started?). It's just got me worried since my partner and I work full-time and Bella is left alone for up to 10 hours a day. I don't want her to go Hypo during the day whilst no one's home or during the night whilst we are both asleep. I got particularly worried last night as when I was about to sleep she got to the green for the first time (88) and was scared to death that she was going to keep going down as she was on a pretty sharp decline that entire day (spreadsheet here). Thankfully that didn't happen and
Click to expand...
You can get an automatic feeder to use when you both are at work and at night
You can set them to open at different times for Bella to eat
maybe @Bron and Sheba (GA) can suggest one to get
 
Hi @Bella's Mum, my name is Bron and I live in Sydney.
Welcome to the forum to you and Bella!.

Toujeo is not really a suitable insulin for cats. It is not recommended for children under 6 years and a cat is much smaller than that.
Toujeo is 300 Units of Glargine per ml whereas Lantus is 100 units of glargine per ml. So Toujeo is three times stronger than Lantus which is the insulin recommended for cats. Cats need small amounts of insulin and tiny increases. With toujeo you will not be able to do that.
The starting dose of Lantus for newly diagnosed cats is 1 unit. However with Toujeo, you are giving 1 unit but that is equivalents of 3 units of lantus which is too big a dose to start off with.
Also glargine is a depot insulin and the full effects of the dose is not felt for 5 to 7 days initially and then each time you increase, it takes 3 days for the depot to fill again.
If I were you, I would go back to the vet and ask to be swapped over to Lantus insulin and start at 1 unit. Don't let the vet put you off swapping to a more suitable insulin.
The brand name for glargine now in Australia is OPTISULIN. This is because lantus is no longer on the PBS and optisulin is......all very confusing I know. It might seem to be a waste to not use the insulin you have bought but honestly it will be much safer to get the lesser strength glargine insulin. Toujeo is meant for humans who need more than 20 units of insulin a day, not little cats.

After you have obtained the optisulin, I would also get some U100, 3/10ml, 30 or 31 gauge, 6 or 8 mm insulin syringes to use with the optisulin when you get it. It is NOT to be used with the TOUJEO
Here are the syringes I mean
https://petchemist.com.au/bd-ultra-fine-31g-insulin-syringes-0-3ml-100iu-ml-328822-100-pack/

Here are 2 auto feeders similar to the one i have used. You can put wet canned food in them and just wash out each day. That is what I did. Auto feeders are fantastic to have. Until you get the feeder, please leave food out foe her when you are not there.
https://www.petcircle.com.au/product/petsafe-eatwell-pet-feeder-5-meal/pfd11-13707
https://www.petcircle.com.au/product/prestige-pet-automatic-feeder-05/49-4448

How often are you feeding Bella?
As well as the two preshot meals, are you giving some snacks during the cycles. Looking at the spreadsheet, I would also give a snack at +3 and +5 every cycle (both am and pm) and see if that helps.
I think if you swap to a more suitable insulin, you will find things are better.
Do you have any higher carb foods at home in case off low numbers? Fancy Feast gravy lovers is high carb

Please ask as many questions as you like. We are here to help.
Bron
 
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Thanks so much Bron,

I will chat to them about Optisulin, I've heard many other cat owners on that here too. At the time she gave it to me I hadn't really researched different insulins. Bella is currently getting fed diabetic wet 7am/7pm with the shots but we leave Ziwi peak dry out during the day and throughout the night in case as me and my partner are both work so I thought that would be the better option but I will look into the feeders too. I didn't know you could put wet food in the feeders!
 
Larry and Kitties said:
Do you prime the pen after each needle replacement?
Are you keeping the pen in the fridge between uses? The manufacture says you are NOT supposed to keep i -use pen in the fridge. One concern is that the expansion and contraction due to temperature change can result in getting air into the pen vial which results in inaccurate dosing. This would especially be a concern with dispensing only 1 unit of a U300 insulin since that is such a small volume.
Click to expand...

Yes, I do keep it in fridge per vet and pharmacist instructions but now that you mention that that does concern me. Thanks for letting me know - all I was told is that we'd be able to keep it for a lot longer in the fridge. Luckily when I purchased it from the pharmacist they actually dispensed me extra pens for the price of one (as the pens typically sold as sets). So perhaps I ditch the current pen, and grab a new pen for tonights dose and leave it out of the fridge moving forward.
 
Diane Tyler's Mom said:
Here is some information that will be helpful
https://www.felinediabetes.com/FDMB...for-aussie-feline-diabetic-caregivers.217781/
There is lots of information here about everything you would need
When looking for foods that are medium and high carb foods in case you need to bring the BG numbers
Between 11% and 17% is medium carbs.

18% and over is high carb.
Tap on this blue link I see there is some information about Toujeo.
Just read through the posts.
I really haven't seen any cats on here that are on it now or recently
https://felinediabetes.com/FDMB/threads/addie-5-20.263563/#post-2952794

Go to the top where it says search and type in Toujeo and a lot of posts are there about Toujeo you will have to skim through them
Click to expand...
Thank you so much I will take a read through :)
 
For your hypo kit
med and high carb wet food and some honey, karo or maple syrup


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy
20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about themed and high carb foods
 
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@Bron and Sheba (GA) or anyone - I don't want to sidetrack this conversation, but want to ask very quickly... I noticed that there are numbers on Bella's spreadsheet that appear on the WORLD tab -- presumably where they are being entered from -- that do not appear on the US tab. Look at May 1 for AM+6 and PM+3. Just curious if this is a known issue that I've just never noticed, because in a critical situation this could be important. Thx.

Also @Bella's Mum I assume you meant April on your first 3 days of testing in your spreadsheet and not March? I can't believe it is actually MAY already! And Welcome :bighug:
 
Sandi&Maxine&Whispy(GA) said:
I don't want to sidetrack this conversation, but want to ask very quickly... I noticed that there are numbers on Bella's spreadsheet that appear on the WORLD tab -- presumably where they are being entered from -- that do not appear on the US tab. Look at May 1 for AM+6 and PM+3. Just curious if this is a known issue that I've just never noticed, because in a critical situation this could be important. Thx.
Click to expand...
I'm not sure why they are not appearing on the US SS. Ill ask @Bandit's Mom to have a look...would you mind Bhooma please?
 
Bron and Sheba (GA) said:
I'm not sure why they are not appearing on the US SS. Ill ask @Bandit's Mom to have a look...would you mind Bhooma please?
Click to expand...
I am able to see the numbers in the US tab. Maybe @Bella's Mum fixed the SS?

upload_2023-5-2_15-19-49.png
 

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Bron and Sheba (GA) said:
Did you hear back from the Vet about your query re swapping insulins?
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So they finally called me back just before closing time. Unfortunately, the nurse spoke to me on behalf of the vet so needed to check with vet again so won't hear until tomorrow but the vet apparently says shes quite happy with Bella's curves and that they appear quite normal? I tried to ask questions but they couldn't give me much of an answer.
 
We're looking a little less up & down thus far but still not ideal... Am not sure what the rest of the night will bring but will be onto her very frequently to check. Here's what I've got from the libre app (note the missing data is when my partner was scanning on his phone whilst I was at work)
 

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Also @Bella's Mum I assume you meant April on your first 3 days of testing in your spreadsheet and not March? I can't believe it is actually MAY already! And Welcome :bighug:[/QUOTE]

Yes, my bad! IKR! Also fixed missing data - yes must've accidently deleted the formula :)
 
this is as unscientific as it gets regarding hypos
Our first sugar cat was the perfect patient; his doses rarely changed, textbook curves and in all the time we had him only once did I rub a little honey on his gums. Noah was our second and he was a mess, I never got him anywhere near stable day to day numbers. He always had slightly high numbers but the mystery was if I increased his dose by just .25 his numbers would drop like a stone. Some people will get up at 1AM every night to check blood sugar, I just couldn't do that so Noah's PM dose was always about 2/3 of what I would normally give him.
The rule I was following was better a day too high than a minute too low. Noah was an anomaly, I'm not advising the 2/3 dose but in my case an older cat with a slow metabolism and other medical issues needed that to keep him from ever having a hypo episode.
 
Bella's Mum said:
So they finally called me back just before closing time. Unfortunately, the nurse spoke to me on behalf of the vet so needed to check with vet again so won't hear until tomorrow but the vet apparently says shes quite happy with Bella's curves and that they appear quite normal? I tried to ask questions but they couldn't give me much of an answer.
Click to expand...
I agree that the curves look quite good, but most cats that have just started insulin 4 days ago do not have green BGs. If they did we would most likely recommend reducing the dose a bit as the depot had not even completely filled initially by then, and the full effect of the dose would not have been felt.
My questions to the vet would be ..she has only been on insulin 4 days …how are you going to increase the dose when you can only go up in 1 unit increments of the Toujeo. I have removed further information from here as it was incorrect.
 
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Bron and Sheba (GA) said:
My questions to the vet would be ..she has only been on insulin 4 days …how are you going to increase the dose when you can only go up in 1 unit increments of the Toujeo (which is 3 units of the normal U100 glargine insulin.) and that would be dangerous.
And you can’t reduce the dose as there is no smaller dose than 1 unit if you are using a pen. On the forum we recommend going up in 1/4 unit increments of the U100 glargine insulin.
Increasing with the Toujeo by 1 unit would be 12 times stronger than what we recommend (ie 1/4 unit)
Click to expand...

Absolutely! Not leaving the vets until I get an answer on that one. Just as i thought we were looking relatively flat she's just shot down to 3.9 for her 2+. Giving her a snack and will call them call back tomorrow these numbers are getting too low at night for comfort.
 
Bron and Sheba (GA) said:
However with Toujeo, you are giving 1 unit but that is equivalents of 3 units of lantus which is too big a dose to start off with.
Click to expand...
Not true. The regular pen for Toujeo, SolaStar, doses in 1-unit increments. They do a Max SloStart that does in 2-unit increments and contains twice as many units in each pen. I unit of insulin is a unit of insulin irregradus of the concentration although the volume will change for a unit depending upn the concentration. The volume of one unit of Lantus is 0.01ml whas the volume on one unit of Toujeo is 0.0033333ml
https://www.toujeo.com/how-to-use-toujeo-insulin
 
Larry and Kitties said:
Not true. The regular pen for Toujeo, SolaStar, doses in 1-unit increments. They do a Max SloStart that does in 2-unit increments and contains twice as many units in each pen. I unit of insulin is a unit of insulin irregradus of the concentration although the volume will change for a unit depending upn the concentration. The volume of one unit of Lantus is 0.01ml whas the volume on one unit of Toujeo is 0.0033333ml
https://www.toujeo.com/how-to-use-toujeo-insulin
Click to expand...
Thanks Larry. We rarely have anyone here using Toujeo.
However it does not change the problem of smaller increments to increase or decrease. I read in the literature they say not to use a syringe with Toujeo. I would imagine that is because there is not a syringe that would draw up the correct dose as there is with the U 100 syringe/insulins.
So we are left with the issue of how to increase or decrease in safe amounts. And looking at Bellas SS, she is very close to needing a reduction in dose with the 54 at +5 last night.
 
I’ll answer your pm on here.
Skipping doses, as it sounds as if the vet is going to suggest, is not best practice with using depot insulins.
Each time a dose is skipped it empties the depot a bit and if it keeps happening, the depot will be all over the place. Glargine like consistent dosing. If the vet wants to skip the dose because the numbers are dropping too low, and you can’t shoot, then the dose needs to be reduced.
The answer is not to skip doses (Although that can happen from time to time if the preshot is too low, but then you look at the dose) but it’s not the answer when the answer is a reduced dose is needed….does that make sense.
Another question to ask is did Bella have any ketones at diagnosis.
WHAT IS A DEPOT
 
A
Bron and Sheba (GA) said:
I’ll answer your pm on here.
Skipping doses, as it sounds as if the vet is going to suggest, is not best practice with using depot insulins.
Each time a dose is skipped it empties the depot a bit and if it keeps happening, the depot will be all over the place. Glargine like consistent dosing. If the vet wants to skip the dose because the numbers are dropping too low, and you can’t shoot, then the dose needs to be reduced.
The answer is not to skip doses (Although that can happen from time to time if the preshot is too low, but then you look at the dose) but it’s not the answer when the answer is a reduced dose is needed….does that make sense.
Another question to ask is did Bella have any ketones at diagnosis.
WHAT IS A DEPOT
Click to expand...

All makes sense, thanks for that info learning a lot every day! Hopefully they’ll provide me with some insight on what we’ll do regards dosing moving forward.
 
If in doubt, you might need a new vet that has experience treating feline diabetes or just tell the vet to give you the Optisulin and you'll take care of the rest using this forum. We had to show our vet the Roomp & Rand protocol (linked in my sig. below) because our vets were not up on the scientific literature and didn't have any real idea how to treat feline diabetes. Our cat would have been dead 5 years ago if we had listened to the vet's advice (which was pretty much 0.5U of Lantus 2x a day forever).
 
Catacular said:
If in doubt, you might need a new vet that has experience treating feline diabetes or just tell the vet to give you the Optisulin and you'll take care of the rest using this forum. We had to show our vet the Roomp & Rand protocol (linked in my sig. below) because our vets were not up on the scientific literature and didn't have any real idea how to treat feline diabetes. Our cat would have been dead 5 years ago if we had listened to the vet's advice (which was pretty much 0.5U of Lantus 2x a day forever).
Click to expand...

My cat's specialist actually takes a lot of diabetes cases :( I have to go to an internal medicine specialist due to Bella's' other illness and there are only 2 internal clinics where I live. Nonetheless, I will hear them out on the rationale behind this one but yes I would like to be able to dose myself here with optisulum. Probably will end up cheaper in the long run too!
 
Here's an update on my situation after today's appointments. We saw both of her specialists. 1) Would like to start Atopica now - this is to replace her pred which we will continue tapering for the next 2 weeks. 2) Wants to reduce insulin dose to 0.5u but obviously, we can't. So according to her, the literature for toujeo has presented successful remission when tapering down the dose to eventually reach 1u per day, which is where we are at now. So I've agreed to trial this over the next week. If things go haywire we will switch to 100u glargine but for now we will trial her on the 1u per day instead of twice daily. Vet is positive that we will see remission eventually.
 
Bella's Mum said:
Here's an update on my situation after today's appointments. We saw both of her specialists. 1) Would like to start Atopica now - this is to replace her pred which we will continue tapering for the next 2 weeks. 2) Wants to reduce insulin dose to 0.5u but obviously, we can't. So according to her, the literature for toujeo has presented successful remission when tapering down the dose to eventually reach 1u per day, which is where we are at now. So I've agreed to trial this over the next week. If things go haywire we will switch to 100u glargine but for now we will trial her on the 1u per day instead of twice daily. Vet is positive that we will see remission eventually.
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OK. You have to do what you are comfortable with.
However only giving the dose once a day means that the other 12 hours Bella will be without insulin. We don't recommend doing once a day insulin.
Cats have a much faster metabolism that humans and need insulin twice a day. Also we have found that to get a strong remission, the cat need to be supported with some insulin for longer than just giving the 0.5 unit dose. We go down to 0.25, 0.1, and a drop dose twice a day. During that time the cat has to either earn a reduction to go down to the lower dose or be in normal numbers (50 to 120, but preferably 50-100) for a week. The once they have graduated off the drop dose, they go on a 2 week trial 'off the juice'.
Please keep posting and keeping up in the loop.:)
 
Bron and Sheba (GA) said:
OK. You have to do what you are comfortable with.
However only giving the dose once a day means that the other 12 hours Bella will be without insulin. We don't recommend doing once a day insulin.
Cats have a much faster metabolism that humans and need insulin twice a day. Also we have found that to get a strong remission, the cat need to be supported with some insulin for longer than just giving the 0.5 unit dose. We go down to 0.25, 0.1, and a drop dose twice a day. During that time the cat has to either earn a reduction to go down to the lower dose or be in normal numbers (50 to 120, but preferably 50-100) for a week. The once they have graduated off the drop dose, they go on a 2 week trial 'off the juice'.
Please keep posting and keeping up in the loop.:)
Click to expand...
Yes I was a bit sceptical about the 1 dose, but the vet seemed to be able to back up her claims so I am willing to trial. I've also spent thousands in the past few weeks due to her diabetes & automimmune disease so if we can utilise the insulin we've got safely then that would be ideal to save a bit of cash. However, If I'm not happy with her numbers after this week we are definitely switching.
 
Bella's Mum said:
Yes I was a bit sceptical about the 1 dose, but the vet seemed to be able to back up her claims so I am willing to trial. I've also spent thousands in the past few weeks due to her diabetes & automimmune disease so if we can utilise the insulin we've got safely then that would be ideal to save a bit of cash. However, If I'm not happy with her numbers after this week we are definitely switching.
Click to expand...
I can understand how you feel. It does cost a lot in the beginning.
I am just concerned Bella will not stay in remission which is what you want as it is hard to get them back into remission if they fall out of it.
She will need to be in green BGs and I doubt the vets will see it like that. They are happy to stop insulin when the BGs are quite a bit higher. I would be interested to see what she considers an acceptable BG to say she is in remission.
There is no reason why you can't do the week with the 0.5 once a day then continue with the lantus U100 and syringe to do the lower doses.
I used to be able to buy the Lantus (5 cartridges that are used for the pens) from the pharmacy with a script from the vet for around $100.
I don't want to stress you, I just want you to know the best options for Bella. It is much better to do the hard work now than later if/when she falls out of remission.
 
Ok I’ve decided I’m going to call them today. I’m not comfortable injecting in the low numbers with that insulin, espiciallyw when I’m not home all day to check. Hopefully they give me the prescription.
 
Bron and Sheba (GA) said:
Did you check again after the 52 at +4 last night?
Click to expand...

Yep so I set an alarm for 6+ and got up and she was fine at 6.2 so I must've just missed the dip. However, this is what I woke up to.... Which just confirmed my decision. It still only 9am here so couldn't get through when I called so I emailed.
 

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Bella's Mum said:
Yep so I set an alarm for 6+ and got up and she was fine at 6.2 so I must've just missed the dip. However, this is what I woke up to.... Which just confirmed my decision. It still only 9am here so couldn't get through when I called so I emailed.
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Can you pop the 5.1 and the 6.2 into the SS please so we can see the numbers? Thanks.
Have you taken the BG since giving the insulin? Or left out some food if you had to leave?
I would also think about getting a human meter and learning to hometest with it. It will be much cheaper than having to pay out for a libre every two weeks. I can help you with that if you decide to do that.
 
Yes I will do when I get to a computer. So I left the house at 8am and we got up to 6.2. So I was confident in seeing we were going up. I’ve left some food and made sure she ate a little bit more before I left too. Vet just called me she’s getting me to come in soon and we going to go to start using syringe annd reduce dose further to eventually taper. Will be home around +6 which is her typical low.
 
Bella's Mum said:
Yes I will do when I get to a computer. So I left the house at 8am and we got up to 6.2. So I was confident in seeing we were going up. I’ve left some food and made sure she ate a little bit more before I left too. Vet just called me she’s getting me to come in soon and we going to go to start using syringe annd reduce dose further to eventually taper. Will be home around +6 which is her typical low.
Click to expand...
Sorry should have clarified we're switching to a 100u glargine. She didn't specify which one but will find out shortly.
 
Hi!
Just answering your PM question about how to draw up smaller doses of the Lantus which the vet has swapped Bella to. .
It looks as if the vet has you on 0.5 units twice a day, looking at the SS.

First of all, I would get a magnifying glass to use when drawing up and make sure you do it in a good light.
Here is a picture on dosing 0.25 when it is needed
upload_2023-5-6_14-4-36.jpeg

What are the syringes you were given?. Were they like the ones in the picture below?
You need to have U100 3/10 ml, 30 or 31 gauge, 6 or 8 mm insulin syringes. So the syringe should be a 30 unit syringe.
upload_2023-5-6_14-7-16.jpeg


The syringe should have markings like the syringe on the right
upload_2023-5-6_14-8-41.jpeg
 

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Bron and Sheba (GA) said:
Hi!
Just answering your PM question about how to draw up smaller doses of the Lantus which the vet has swapped Bella to. .
It looks as if the vet has you on 0.5 units twice a day, looking at the SS.

First of all, I would get a magnifying glass to use when drawing up and make sure you do it in a good light.
Here is a picture on dosing 0.25 when it is needed
View attachment 66786
What are the syringes you were given?. Were they like the ones in the picture below?
You need to have U100 3/10 ml, 30 or 31 gauge, 6 or 8 mm insulin syringes. So the syringe should be a 30 unit syringe.
View attachment 66787

The syringe should have markings like the syringe on the right
View attachment 66788
Click to expand...

amazing thanks so much for that Bron, you have been a lifesaver!
 
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