Using R? Dr. Lisa's looking for info
- Thread starter Sheila & Beau GA & Jeddie GA
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Vicky & Gandalf (GA) & Murrlin
Member Since 2009
I saw that. I think there are special cases (acro and IAA diagnosed) which it helps tremendously, but the "average" diabetic cat would not benefit from it unless they are in serious trouble such as DKA. A university vet told me R would interfere with the action of the basal insulin. Although I understand the basic reasoning for using it (to bring down higher BGs so the basal insulin can manage them better) I also understand that means the basal insulin is working from an altered baseline, so how are you supposed to tell what the basal insulin is doing to dose accordingly?
Once I got a handle on more regular shots I saw that Levemir worked absolutely fine without the R, even on higher BGs. At one point we "assumed" Levemir couldn't handle higher BGs, that it had a hard time bringing them down. I no longer believe that to be the case. Look at other factors such as rebound, shot schedule, diet or just not enough insulin and manage that accordingly with the basal insulin.
Once I got a handle on more regular shots I saw that Levemir worked absolutely fine without the R, even on higher BGs. At one point we "assumed" Levemir couldn't handle higher BGs, that it had a hard time bringing them down. I no longer believe that to be the case. Look at other factors such as rebound, shot schedule, diet or just not enough insulin and manage that accordingly with the basal insulin.
Jessica & Boo Radley
Member Since 2011
I'll be interested to see if this turns into something. It was really, really hard for me when Boo was first diagnosed to consider not using R because it was completely different than what I'm used to. In the hospital, our protocol for NPO patients on continuous feed is to use a long acting insulin either just at night or on a 12/12 schedule and then a sliding scale of R every 6 hours, and for PO patients, the same long acting regimen, but a sliding scale of R before meals and at bedtime.
The physicians then make dosing decisions on the long acting once a week based on the data we pull throughout that week. I'd feel comfortable using the word "fantastic" to describe the glycemic control results they seem to get.
I've played around a bit with R for Boo on his high numbers. The R did a GREAT job of bring him down very quickly, but the dose was very difficult. Even 0.25 could cause a big swing, very quickly and with a bouncing cat...well you know what happens. As Vicky said too, it made it difficult to isolate a single factor to make decisions on. I think at least with the human protocol, there's enough data behind it to create a sliding scale. For cats....not so much.
Interesting none the less. :idea: :idea:
The physicians then make dosing decisions on the long acting once a week based on the data we pull throughout that week. I'd feel comfortable using the word "fantastic" to describe the glycemic control results they seem to get.
I've played around a bit with R for Boo on his high numbers. The R did a GREAT job of bring him down very quickly, but the dose was very difficult. Even 0.25 could cause a big swing, very quickly and with a bouncing cat...well you know what happens. As Vicky said too, it made it difficult to isolate a single factor to make decisions on. I think at least with the human protocol, there's enough data behind it to create a sliding scale. For cats....not so much.
Interesting none the less. :idea: :idea:
Sheila & Beau GA & Jeddie GA
Member Since 2009
Jessica, did you post in Dr. Lisa's thread? I was thinking of you when I saw her request.
Jessica & Boo Radley
Member Since 2011
I didn't because I'm not sure I have much info to offer in relation to cats.....I played around with R and still use it now from time to time, but don't really have any "hard data" written for when and why. I get the feeling that is what she's looking for.
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