Samantha PMPS 111 +4/68 +5/79

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Thebudster77

Thebudster77

Member Since 2014
Hello All,

Samantha has had a short trip to the 100's and at .5 u, there is not much wiggle room.

A week ago, I skipped because her AMPS was 83. I decided to let it go and then 2 days later she was PMPS 175, so I went back to the .5 u and have been trying to keep it up.

My question would be, at what point would I try another trial of no insulin? I was thinking of keeping the .5 up for a while and wanted to see her surf the greens for a little bit..thoughts? At what nadir would you stop giving insulin?

While I am not uncomfortable shooting low, the .5 barely gives any feed back when I give the shot, a .5 is just a drop (I tested it) and they don't make a syringe small enough to make accurate dosing under .5.In my opinion.

Any help would be greatly appreciated.

Thank you.
 
Re: Samantha AMPS 83 +3/96, +954/, +5/105 PMPS 111

A cat is ready for an OTJ trial when you are seeing mostly numbers that are below 100 (green). There may be an occasional number above 100 but those numbers should be in the normal BG range (i.e., below 120). In order to give the pancreas as much support as possible, you want to taper down the dose from 0.5 to 0.25 to 0.1u.

It looks like you've been tinkering with Samantha's dose (i.e., between 0.4 and 0.5u with an occasional 0.3). You will see better results if the dose is consistent. If you keep changing the dose, the insulin depot has to keep adjusting and you end up with wonky numbers.

At this point, if this were my cat, I'd be holding the dose at 0.5u until you either got a number that's under 50 or Samantha's numbers are below 120 for 7 days.
 
Re: Samantha AMPS 83 +3/96, +954/, +5/105 PMPS 111

i agree with what sienne said. the TR protocol is proven and we see cats work off of insulin all the time by following its guidelines. There are 2 cats on OTJ trials right now.
 
Re: Samantha AMPS 83 +3/96, +954/, +5/105 PMPS 111

Hi Julie and Sienne,

Thank you for the input.

Yes, I was tweaking a little. There is only so much plunge at that low a dose and was trying to come down a little without skipping.

I have a +4/68, so that is encouraging.

I am work from home so I intend on continuing the .5 tomorrow AM. So long as the nadir is not below? what 50? Then I would stall/skip. I would most likely skip.

I figure she will maybe go to 60 (+5) (in 10 minutes) but not lower tonight and I might expect a 102 tomorrow AMPS.

I am not really comfortable shooting below 100 unless I could be more comfortable that I could lower the dose below .5.

I just took another syringe and measured .5. It is literally just 1 drop. Not large at all. I use the .3 ml syringe and I have inquired but have not had any luck with finding a smaller one.

Input on the nadir tonight and dose tomorrow AM would be appreciated.

Thank you.
 
Hello All,

The +5/79 tells me what I need to know for now.

I will continue the .5 tomorrow AM and see what the +4 or +5 is then and will post with questions from there.

Thank you!
 
it sounds like you've got syringes with a wider barrel. These Terumos have a skinny barrel with 0.5u markings and are a little easier to tweak the dose. I'm guessing you may have a fairly large drop. For many syringes, 1u is 10 drops, so 0.5u is 5 drops.

If i were you, I'd get the Terumos. They are seriously great syringes and make fine-tuning so easy.

However, if you have a bazillion of your current syringes, then maybe see what you can do with what is usually our very smallest dose. You press the plunger in hard, insert the needle into the insulin and then release the plunger. That little bit of vacuum will draw in a very small drop. Usually that is just 0.1u - i don't know what that would be with your syringes, but you can play with it and see if that dose is less than the drop you are giving now.

of course, compared to the cost of ongoing insulin and supplies, $13 for a new box of needles is a small investment when going off of insulin is the potential pay-off!

I tried to help someone in person who was using either Relions or Monojects, i don't remember which at the moment, and i also couldn't get a tiny dose drawn up. The barrel was so wide that it was just hard to see anything small.

For those following Tight Reg and working towards remission, they'll shoot everything over 50ish once they have learned about their cat's response to insulin, providing they are able to monitor afterwards. You might want to work up to that. Gradually lower your no-shoot line to see how samantha responds to it. For many people that's a little easier than trying to go cold-turkey to shooting low. I think what you will find is that she stays fairly flat throughout the rest of the cycle.

There are pictures of small doses on the New to the Group Sticky.

We would also keep the dose steady until the cat goes under 50, and then reduce it by 0.25u. A second way we reduce the dose is if the cat stays completely under 120 and mostly under 100 for 7 days in a row on one dose - then you also can try to reduce the dose by 0.25u. Samantha's got 2 days towards that right now.

I'm not sure what to suggest if you can't measure less than 0.5u. Perhaps if you study those pictures carefully, looking at where the plunger line is in relation to the lines on the syringe, that might help. Or try that drawing in a small drop dose and compare that to what you've been giving. I'd keep working on it.
 
Hi Julie,

Thank you so much for the information it is helpful.

About the:
I'm guessing you may have a fairly large drop. For many syringes, 1u is 10 drops, so 0.5u is 5 drops.
Click to expand...

Are you talking about the drop at the end of the syringe? If so, ok a .5 would be about 5 of those. Squirting it on the counter, well it is just a drop and not large at all. This might be the key here.

I looked up the Terumos and looks/sounds like a plan. The $13 is not an issue. I am using the Walgreens Super Thin II now. and yeah have a bazillion (ok 120) left, but that is par for the course for me. I am sure I can find someone on here that can use them.

We would also keep the dose steady until the cat goes under 50, and then reduce it by 0.25u. A second way we reduce the dose is if the cat stays completely under 120 and mostly under 100 for 7 days in a row on one dose - then you also can try to reduce the dose by 0.25u. Samantha's got 2 days towards that right now.
Click to expand...

Very helpful information. I got it. Thank you so so much.

If you read this and get a chance to look at Jack's numbers, I think tomorrow might be time to announce that he is on day 11 OTJ. Please be aware, Jack uses an AlphaTrak and I snuck in 1 or 2 ReliOn readings just to make sure I was in the groups regular ball park.
 
Jack's looking great! I'd keep testing once a day for the entire 2 weeks. For the AT, you want to see everything under 165 (120 human), most of them under 130ish (100 human).

Once he goes 2 weeks without insulin, you want to switch to testing once a week - don't let that slide because cats do come out of remission, and the sooner you catch it and get them back on insulin, the greater the chance for a second remission.

congrats on how well Jack is doing! Samantha's doing great too.

the way to count drops is to point the needle to the ceiling and try to "screw" the plunger and work the drops out. The goal is to establish how much you are giving so that you can reduce the amount. Then one option when faced with a lower than usual preshot is to give a reduced dose shot.
 
Hi Julie,

Thank you for the information on the drops. It all fits and makes sense now.

The syringes that I use have .5u marking as well and I think that with the information you have kindly provided, that I am all set with these...

I will call ADW just to check to ensure they are both the 3/8" form factor (I assume width of the barrel).

Again, thank you so much for the information.
 
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