Micro dosing?

Ok so I'm really really happy with how things have been going. We have missed a lot of shots though. I'm Doing a full curve taking bg readings every 2 hours today to see what's going on. It's one and a half days since she's had insulin and we are sticking to blues for now.

I can see she is pretty flat today so far. I'm still awaiting my u100s but would like to give her something if it's safe to do so. I am off tomorrow so can do checks throughout the night tonight if necessary and will be here all day tomorrow.

I was considering doing the counting drops thing if the syringes aren't here today.

What's the number I should shoot at and not to? And what in your opinions would be a good amount to shoot?

Many thanks.

 

Let's see what others think - particularly AT users like @Carol & Murphy. I would think you could shoot at 2oo. You can monitor and know how to bring up a low number. I just wonder about shooting a drop at 180? The range for remission on a human meter is 40-120 but I don't know where that would be on a pet meter.

 

That sounds like a plan

 

I looked at your SS and it's a touch call - I don't use the pet meter any more but I miss it so much
I wouldn't shoot more than 1 drop at 180 that's for sure - but you didn't shoot at amps of 214 and got a 250 next pmps. (how many drops are in 0.12 units)?
I think you could give a drop at 200- especially if you are around to monitor

 

I'd have to count the 0.12 as I draw 0.25 then squeeze out until the plunger is half way between 0.25 and the bottom mark. Will go do that now
Am I better waiting to see what happens? then working with the bg there and then?

Edited 4 drops it works out at..managed to stab myself haha now bleeding like a stuck pig and drinking lucozade just in case (glucose drink)

 

I don't think you have to worry about a stab of Prozinc -

 

@Carol & Murphy

You mentioned that you don't use the pet meter anymore but you miss it. Am I correct in assuming that it's because you find the strips SO expensive? I made a comment to that effect on my thread this morning. Would you mind telling me why you say you miss it? I'm not ready to move away from the AlphaTrak yet but I can see where its strips will make a big hole in my budget every month as I follow the FDMB way of doing things.

 

Hi Kris
I switched to human meter solely because I switched to Levemir and I was advised that it would be difficult to get advice using AT2 since everyone uses human meter. I did some comparisons initially between the two (there's a tab on my SS) and I was dismayed to see 100 point difference when in yellows - so while the human meter brings definite psychological benefits because what was blue on pet meter is now green, what was yellow is now blue, what was pink is now yellow etc I have to stop myself from being happy because those are false equivalents
I believe in accuracy and believe pet meters are the way to go if you can afford it- If I ever get Murphy stabilized, I will switch back to the pet meter

 

I have one vial of AT strips for the scary times otherwise I'm using freestyle lite strips at half the price. And my local pharmacist is letting me have them at a discount.

Check eBay for them too.
Also I get discount at some of the online stores so when they had the summer sale on I got a tub of the AT strips for £33

 

Thanks Carol. I'm more comfortable with the numbers on the pet meter and I can shoehorn the extra expense into my budget by being a little more frugal in other areas. Teasel and his siblings are very important to me so I don't mind doing that.

 

Sorry Tara - don't mean to hijack your thread.

Do you use the Freestyle Lite strips in your AT? I know some people do. As for eBay, I worry that it might be hit or miss for quality control (eg. expired goods, etc.). That's just me. For now, I'm glad to have found a valid Canadian pet pharmacy in my province that sells the AT strips more cheaply than my vet does. I have two 50 strip vials on my way to me now.

 

Yes yes I do, I believe the only difference is the calibration (at least that's how it sounded to me) if using them do not change the code for your FSL strips use the last code that you had when using the AT ones. When I checked them from the same blood sample there was only a couple of points difference. The FSL ones read higher. 18.9 on the AT strip and 19.7 on the FSL.

I will still buy the AT ones but only when they are on offer and with a coupon so the last AT ones were £45 and I got them for £33 plus free delivery

This site also gives me 10% cash back to spend in store when I buy something.

 

Thanks, Tara. More information for my FD encyclopedia .

 

I had help finding all this out so can't claim the kudos

 

Wahhh! No shot again! 158 what is she doing lol

 

Tara, so if i'm understanding correctly, you are using a pet meter?

 

Yes Alphatrak2
Her numbers need to be down to green?

 

Wow Tara, that means they are even lower on the human meter.....
I wanted to suggest you maybe give a drop of prozinc but now I know you are using a pet meter than I would not recommend it.
Take a look at Marlena&Rocky's SS , they also use a pet meter and see his numbers........ They are like yours....

 

They are like mine! I thought I had to go down more numbers..
She hit one yellow today but I don't think it was yellow because my strips read a point or so higher.

 

mmm well just keep doing what you are doing Tara! Because what you are doing has been great so far!
If Tempest has a cycle like this tomorrow I would start an OTJ trial........

 

I hope! Lol
How or what do I do there?

 

Well for sure not giving insulin (like you are already doing now) and just test the nadirs and pre shot numbers..
If everytime you get numbers between 40 and 120 (I don't know for sure what they should be on a pet meter) for 14 days then Tempest is OTJ.
@Carol & Murphy What are the numbers for a pet meter to be officially OTJ? I know a human meter needs to be betweein 40 an 120 but pet meters are a little higher right?

 

Good question Will need to research

 

Amps NS @ 160 but I can see the numbers creeping up.

 

Look at Marlena&Rocky's SS, Rocky was also creeping up somedays, but just stick with what you are doing. Only if Tempest goed above 10mmol than give some insulin (you talk in mmol right? )

 

Uh.. At the risk of sounding stupid.. No? Lol

 

It's okay. That are still in the ranges for AT. (Or what we think they are Wish we had a better range for them going into remission). Regardless, keep watching and give a drop if she reaches your shootable number.

Are you feeding small frequent meals? Some people think that helps a cat slide into remission.

 

I haven't been able to find remission numbers for AT2 - but I no longer have the package insert for the AT2. Does anyone still have it -and if so, can you see what it says about normal readings. I am quite sure it will give ranges 60s -120s but can't find documentation

 

I had read somewhere it was 70-150 on an AT, not sure where I saw that though...

 

that could be it

 

Sorry I thought you did. 10mmol is 180mg/dl.

 

Yes I'm giving her a few bites every time I test and if she wants to eat then she can as I leave food out if she wants to graze

I still have all the instructions that came with my AT is this what you mean Carol?

 

Tara - can you look at the sheet above and see what is says is the normal blood sugar for a cat?

 

Going by that booklet in the AT box it says 3.6 is low and 13.9 is high but it doesn't say what he normal range is so I'm having to assume it's between those two?

 

That is not the same as a normal blood sugar
I think Sharon is right that 70-150 or so is a normal reading

 

So we are still a bit high then. Keeping positive though!

 

But you are oh so close
@Bobbie And Bubba can give you the protocol for OTJ trial

 

I know! I'm thrilled to bits just being where we are and in such a short space of time. I know we aren't there yet but I'm so hopeful and still praying.

 

Here are the OTJ trial instructions so you have the info:

Start the trial on the next green pre shot.

If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!

Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

After 14 days of no insulin, we have a party!!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Good luck with the trial!!!

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
During an OTJ trial IF the AMBG or PMBG is blue (not sure there is range but hoping under 120) the next test is suggested to be +3 or +4 to see if they make it to green

 

Thank you so much Bobbie!
Gosh this is going to make me hold my breath a lot! Lol so hopeful. I will read and re-read all that so it sticks in my head. Fingers and paws crossed.

 

Bobbie - She is using the AT2 so we are not sure about the green vs blue

 

The instructions for the OTJ trial are for either meter.

 

The range that I was given from my vet for judging how well a diabetic cat is doing is as follows:

• above 9 up to 12 nmol/L - acceptable but getting high
• 5 - 9 nmol/L - ideal
• as low as 3 nmol/L - acceptable but getting low
• less than 3 nmol/L - hypo danger zone

 

Thanks Kris

 

This is so exciting and encouraging! Good luck, Tempest!!!

 

It is very exciting! thank you for the encouragement.

 

It's so nice to see all these kitties quickly go OTJ - I watch wistfully as Murphy is now technically a long term diabetic (and not yet regulated)

 

Oh, Carol, I suspect that I'm heading down that road too.

 

Oh Kris - you have 5 more months to go - but I'm curious about Teasel - diabetes is a 6 year old is not that common, I believe
Does he have any other health conditions?

 

Hi Carol,
Teasel is a "Pandora" cat, a label that vets sometimes use for cats that display a tendency toward a wide range of inflammatory conditions. He's had many bouts of idiopathic cystitis and one of what might have been pancreatitis (never officially diagnosed). Maybe this is what set him on the road to FD. His sister is prone to eosinophilic plaques (raised itchy bumps) on the backs of her legs and patchy rashes on her face. She eats strictly prescription hypoallergenic food. There's a genetic component for sure, although their brother is much less afflicted. I think this all makes Teasel harder to regulate and very unpredictable in his response to insulin.

 

Hi Kris - okay I got it now Murphy also has triaditis - and seasonal allergies
Next time you go to the vet, you might ask about a new drug called Apoquel - it is for cutaneous allergies but they are trying it for a wide range of allergic conditions. It's done wonders for Murphy's congestion

 

Carol, I can understand. Smokey is in the same boat.

 

Hi Paula
Yes, there is definitely a cadre of us with the classic difficult kitties

All we can do is keep on keeping on

 

It's all we can do.

 

don't give up yet. I will keep sending positive vibes your ways.