an idea......(long)
hey there. ;-)
carolyn and carolynn (lol) both asked me to stop by here to see if i can help here at all.
first i wanted to say something to the HD peeps..i have an idea i have been playing with for situations just exactly like this in my mind when 'to do a rebound check or not to do a rebound check' (said in best Shakespearean voice) is on the line....what about a reverse rebound check using R? credit lorna/GirlCat with the idea that time she shot GC with 7 units of R instead of 7 units of lantus by accident pre-acro dx and ran to ER while GC giggled. R being the powerful insulin it is, having the action it does, once GC's numbers did not move from that, the acro test results we were waiting for were just a formality, that incident gave all the answers right there.
no i'm not saying to shoot BB with 9 units of R, what i was thinking was a 2 part process ~in case this is an IAA cat can't shoot any real dose of R first time since you can have the kinda 'mismatched' insulin response like what jan/buddy (an IAA cat) to lantus vs. her R.
the first part would be to wait until after whatever little vetsulin nadir is happening here in a cycle and then give a teeny tiny touch of R, say 0.25 units. (and must have person get U-100 syringes, the usual 3/10cc with 1/2 unit markings). do an R curve from there (should be over before next PS easy). if nothing then next day give at the same point in cycle 1 unit of R and do another R curve. (of course making sure have well stocked hypo toolbox in house just in case). if still no response, then i think you have gotten pretty good hints as to the answers to a lot of questions about this cat and the current vetsulin dose. unless a cat has ketones **(joanne see below paragraph to you about this) which in and of themselves cause insulin resistance 1 unit of R should cause good movement of numbers, even through rebound hormones (when i first got settleD, i used R all the time to cut through rebound hormones, it does). hence a 'rebound check' has been done w/o letting ketones enter the picture and at same time clues as to what is really up with this cat have been given.
and if there ends up being a response to the first tiny test dose of R then it is a whole new ballgame and you've opened the door to suspect bad insulin, IAA or way over dose, in other words rebound check was positive, unless IAA cat(rare). (you can get an IAA test done easily in canada, and while waiting for results would get a new insulin (lev) and start over using regular tilly protocol)
this technique could only be used in very special circumstances like that is going on here. it is not something to be suggested in lieu of a real rebound check to a newbie on health when one is indicated there.
if the reverse rebound check is negative (no response to 1 unit R), this would also help decide what does of lev to start barnbuddy at if switching to lev is done, plus i would STRONGLY suggest having R in house anyways when doing the switch, while that first shed is building it is a very dangerous time for a HD cat, R greatly lessens the ketone dangers associated with that and is a safety net until real lev dose needed is worked up to through the start middle-ish dose and move really fast technique.
so what do you guys think? does this idea have merit?
i know i is kinda different than anything proposed before and i really wish i could do this in my own household first before throwing the idea out there but unless someone knocks on my door tomorrow with a BB like cat, it ain't happening. but like i said, i've used R plenty of times to cut through rebound on my own cat in past (and this was back when he was on doses around 5 units lev). i've had this reverse rebound check idea for long time, and when i was asked to look at BB's threads and saw 'let's do a rebound check' and 'cat has trace ketones' in same thread i had to throw this idea out there.
***joanne~ i read above that you believe you have 'between negative and trace' on urine ketone stick. can you take one of those test strips and wet them with water (or even use it on yourself) and then look at it under same light you have been? asking because even a trace on a urine ketone test strips "pops" when it is positive at all. like when you look at it you would have no doubt in mind that it was positive. you are timing the seconds when measuring it's color to chart on bottle right? this is important because if there really is trace ketones then things have to be played differently, and a rebound check of cutting insulin given down cannot be done. (nor does it need to be, too much insulin cannot cause ketones, only too little). and an insulin switch should not be attempted to long lasting insulin until the trace ketones are long gone.
well hope that helps....
~jojo
