Yoshi 2/2 amps 259 +6.5 79 +11 105

[Stressedcatmom]

Gave MC (12). He doesn’t particularly care for the shredded wurva fowl ball I’ve given him since yesterday, he leaves some of the shreads behind, so maybe he didn’t eat much today.

Glad I was home.

I’m contending w air bubbles since I switched to a vial. I tap the syringe and sometimes I get them out sometimes I don’t. Can I shoot levimir back into the vial? Ive also read to shoot air into the vial then draw?

Should I decrease dose? @Wendy&Neko

My vet advised that my no shoot number should be in the mid to high 100’s since we will never know what the tumor is doing.

 

[Wendy&Neko]

No, do not shoot insulin back into the vial. Syringes have a lubricant in them you don’t want in the vial. There is a video in the insulin care Sticky Note that shows how to draw insulin from a vial. As demoed by a Julie and handsome acrokitty Punkin.

My. ”no shoot” number on Lev was 50, and I was dealing with post radiation tumour changes. Tumour changes on their own aren’t that fast. Nadirs are often at preshot, you will need to shoot lower. I suspect your vet isn’t familiar with Levemir cycles.

To bad you gave MC, we suggest LC when you first see green. Now you don’t know if he would have gone lower.

 

[Judy and Freckles]

I’m contending w air bubbles since I switched to a vial.

I read on here someplace that once you withdraw the syringe of insulin from the vial to just draw in a bit of air. I've been doing that and it seems once I flick the syringe, the little air bubbles attach to the big air bubble at the top of the syringe and then I can push all of the air out at once. Seems to be working for me?.

 

[Stressedcatmom]

No, do not shoot insulin back into the vial. Syringes have a lubricant in them you don’t want in the vial. There is a video in the insulin care Sticky Note that shows how to draw insulin from a vial. As demoed by a Julie and handsome acrokitty Punkin.

My. ”no shoot” number on Lev was 50, and I was dealing with post radiation tumour changes. Tumour changes on their own aren’t that fast. Nadirs are often at preshot, you will need to shoot lower. I suspect your vet isn’t familiar with Levemir cycles.

To bad you gave MC, we suggest LC when you first see green. Now you don’t know if he would have gone lower.

Here is what my vet said:

Levemir tends to act a background insulin and is usually fairly peakless. I wouldn't normally worry about giving the Levemir if he is 100 and greater, *but* he's not a typical diabetic and his numbers are somewhat influenced by his pituitary. My inclination would be to play it safer at closer to upper 100s/200 for giving an injection- but you are doing the hard work of monitoring and you may be able to get a better sense of how long the average Levemir injection is lasting (I've seen it overlap with successive injections in some patients).

She is giving me agency, and giving me her best inclination. She got cab for me in a matter of a day even though she didn’t think it would help (I’m still too scared to fill the cab because of wk). She knows I’m gone all day most days. And I think my anxiety is evident. She is way better than my old vet who had me in tears constantly and broke up with us “because she couldn’t treat his diabetes anymore“ and ”I don’t listen to her”

I fed MC because I had to leave.

I asked her for advice on the preshot number because I know many feel uncomfortable to advise here because of his Acro and the ups and downs associated with it. And I use alpha track so 50 on a human meter doesn’t really help me much.

I’m going to use my best judgement, but with work, I don’t think I would be comfortable shooting below 120 or so. I’d be comfortable shooting a lower dose, but I don’t think any of us know what that dose would be. The days I’m off, sure. But Yoshi and I have gone too far for me to risk him being hypo while I’m away. The low greens aren’t worth it to me anymore. I would never be able to forgive myself. when he passes, I would like for it to be anything else but going hypo when I’m at work because I shot too much too low. I would be devastated. In my mind, it would be 100 percent my fault. And I’m not trying to do that to myself, or Yoshi.

My vet also told me that radiation was done on an acro of hers in Chicago. I was asking about price and she told me to call the facility that does it tomo. I am expecting it to be astronomical, but at least I would be able to set my mind at ease knowing the price and whether or not I can afford it. I’ll keep you all posted in the acro forum.

Also curious, when I look at the percentage of carbs in foods (like werva) do I pay attention to calories and metabolizable energy, as fed percentage or dry matter basis?

Thank you all! Blessings to you and your kitties.

 

[Stressedcatmom]

I read on here someplace that once you withdraw the syringe of insulin from the vial to just draw in a bit of air. I've been doing that and it seems once I flick the syringe, the little air bubbles attach to the big air bubble at the top of the syringe and then I can push all of the air out at once. Seems to be working for me?.

I’ll have to try that, thank you. So after you remove the needle, you pull the plunger back a bit and readjust for the dose? @Judy and Freckles

 

[Judy and Freckles]

I’ll have to try that, thank you. So after you remove the needle, you pull the plunger back a bit and readjust for the dose? @Judy and Freckles

Once you have the amount of insulin that you need, withdraw the needle from the vial. Pull back on the plunger to get a little bit of air in the syringe and then flick the syringe so the little bubbles join the air bubble you just created. Then gently push that air bubble out (I can see the air bubble moving it's way from the syringe into the needle).

Initially, I usually take in a bit more insulin that what I actually need so I can adjust the insulin to the amount I need. I end up wasting 1-2 drops of insulin to get the exact dose though

 

[Stressedcatmom]

Once you have the amount of insulin that you need, withdraw the needle from the vial. Pull back on the plunger to get a little bit of air in the syringe and then flick the syringe so the little bubbles join the air bubble you just created. Then gently push that air bubble out (I can see the air bubble moving it's way from the syringe into the needle).

Initially, I usually take in a bit more insulin that what I actually need so I can adjust the insulin to the amount I need. I end up wasting 1-2 drops of insulin to get the exact dose though

I just did it. Thank you!

 

[Judy and Freckles]

Glad it worked for you.

 

[Wendy&Neko]

Back from a day/night out, so a more detailed response now.

And I use alpha track so 50 on a human meter doesn’t really help me much.

We use 68 as the "don't shoot below" number if using the AT. No way I expect you to shoot near that and head out the door, especially since you don't have the data yet to do so. I am hoping he will give you the opportunity to see what happens when you shoot lower numbers, on a cycle when you can monitor. I am curious as to what happened tonight. Unfortunately the SS is not filled in, so I'll have to wait to find out. If you want to use 120 as a "don't shoot full dose" number for now until you gather more data, that's fine. Also remember that shooting a reduced dose is an option. I would start with a half dose and see what happens. The depot will help you a bit in keeping the numbers from going really high. Over time, and as you gather more data, you may feel more comfortable shooting full dose on lower numbers.

For me, I knew I could shoot in the 50's (human meter), because she got a 30-40 point bump from dinner, onset wasn't for another 5 hours and she would continue to go up until then. And yes, I did occasionally see the nadir of the previous shot go into the next cycle, or around +15. So I could delay a little at PS if I saw numbers in the 50's, to make sure she wasn't still dropping. The lesson, learn thy cat. Know the onset, nadir and duration, learn his reaction to food and various carbs. With him in nicer numbers now, get some +1 and +2 tests, to see what is happening in the early part of the cycle. Try to get at least a before bed test every night. Data is your friend and what keeps your cat safe.

As for dose, if you are nervous, you could always "skinny" the dose back to 7.25 units, and see what happens. Consider it an experiment. He didn't look very good at 7 units, but maybe half way would be good enough. I used "skinny/fat" doses to move the nadirs closer to where I wanted them to be. I expect you'd be happier with higher greens than the 70's. Somewhere you'll also find the sweet spot where you have nadirs you are comfortable with, and the high points are mostly under renal threshold. It will take experimenting to find what works best for Yoshi.

FWIW, I have looked at the spreadsheets of quite a few acro and non acros on Levemir and how they respond to the insulin isn't remarkably different.

 

[Stressedcatmom]

Well, I jinxed myself.

We had a very active morning. Yoshi kept dropping. I ran home via Uber on lunch to check on him. It was really scary. I am assuming he nadar-ed really late. I think this is what my vet was concerned about -- overlapping doses.

@Wendy&Neko

 

[Wendy&Neko]

Lovely blue cycle today. I don't think you had overlapping doses because AMPS was higher than the +6 the nigher before. It's possible he onsets from Levemir earlier than most. Would be good to see more +2 to +4 tests in the cycles he's not bouncing.