1/22/18 - AMPS-292 - Crazy numbers! 72 +6 to PMPS 346 - Big Bounce Tonight

Just when I'm thinking we spent too much time in the yellows - see SS for last week - a sea of yellow; here we are all over the map.

I was finally able to get a BG solo and figured I'd seize the opportunity to get as many readings as I could. The SS tells the tale - Luci is all over the place with these readings.

Couple of thing different yesterday was that she got as a treat, a few 'pea-sized' pieces of light string cheese. She loves that! I thought cheese was fat/protein...shouldn't be any carbs in that. Gave her a few teaspoons of Nutrish - says 'grain free' on the label; (why don't they put the nutritional info on those labels? Like Protein=x, carbs=x)...no, it's all these percentages..not helpful to this reader. Otherwise she's on FF pate.

The vet still relies on the glucose strips and wants me to continue reading the UA. I don't mind but he feels my 'meter' is reading low so I suggested we bring her in for a 'comparison'. I'll bring my meter, we'll do a poke and both of us will get a reading at the same time to compare exactly how low my meter is reading. After that I can do the math; if I need to add 50 or 80, whatever...then go from there as to increasing her dosage. He also said we could get a fructosamine - but I thought that was to establish whether Luci has had too much glucose in her system over the past weeks - well that's a no brainer - of course she has! Am I wasting money on a test that I know is going to come back positive?

Finally, is it time to start thinking about a dose increase? From 1.25 to 1.5? I thought NOT when I saw all those greens yesterday - don't want to push my luck...she's getting there...and then she goes and blows that theory with PINKS...what's up with all this wild swinging about? When is she going to settle down? I'm afraid to adjust dosage unless we're getting some of the same numbers for days - like all those yellows last week...time to think about a dose increase...

Luci is giving me a run for the money - no doubt - we're going to try to outsmart her and figure this out, get her on the right dosage and hopefully on the road to The Falls!

 

Lovely greens yesterday! What you are seeing is completely normal. Actually, better than normal, I'd love to have your numbers. Don't be discouraged by pink. Over time, I expect her numbers will flatten out.

There is not much room for an increase. Are you doing TR or SLGS?

 

Yes. She is bouncing. It’s frustrating but she will come down again.

 

Also wanted to add - There is no "math" to compare numbers between human and pet meters. Best not to try this. You will go crazy. Vets often suggest fructosamine test, because most people don't home test. The data in your SS is far more valuable than this test. Save your money for things you can't do yourself.

Nutrish is 11-18% carb depending on variety. You may wish to review food charts posted in health forum ( sorry writing from my phone and can't post link for you).

Please keep asking questions so we can help!

 

Maybe the Nutrish was a little higher than FF pate - will hold off on that for now - and will store with other higher carb foods (for emergency use). Thanks!

 

I Knew you would get there!!!

It's true that it looks like she has 'suddenly' began to see green, but my best guess is that some of those pm cycles she saw something other than yellow. Take yesterday, and the day before am cycles, imagine you hadn't gotten any tests midcycle. Then it would be easy to think that she was just in yellow all the time. I think given the results you have been getting it is quite likely that on nights when you have not been able to get those midcycle tests you were missing some blues. ( That's why we kept 'nagging')

I think the most likely explanation for the higher numbers today are 'It's a bounce' . Bounces occur when their numbers get to a point where they are lower than they are used to (but still in a safe range) or if their BG drops a little faster than normal. Yesterday she dropped 80 pts in an hour(that is fast) and also got into a nice healthy range (all be it one she is not used to), that is most likely the reason for the higher numbers you are seeing now. Bounces will pass, we largely ignore them, they usually clear within 6 cycles, but looking at the patterns on Luci's ss my feeling is she is clearing them sooner. 3 to 4 cycles.
Look to her clearing the bounce.
While she is bouncing she may bobble about a bit but will largely stay flat and there will be no distinct curve. If you find a PS that is significantly lower (ie it appears to be falling with respect to earlier tests in the cycle) that may well signal she is starting to clear the bounce.
Now you and hubby can test solo you are getting a much better picture of what is going on and can be more confident that you are not missing potential lows.

I would save your money on the fructosamine, it isn't going to give you any useful information, the tests you are getting at home is a much better representation of how Luci and her BG are doing. Fructosamine is not a useful tool for deciding on dosing, even more so if you have a care giver who is testing like you are now.

By all means, compare the numbers with your vet, but a word of warning and some info in advance.
At high numbers the difference between the two is higher than at lower numbers.
We have members that have done side by side comparisons of numbers for a long time and there is no correction factor that can be applied to AT versus human meters.

The only number that we have that is equivalent, after gathering much data, is that 50 on a human meter is equivalent to 68 on the AT.
50 is the take action point (we start giving high carb to keep kitty safe)
and you probably want to know that the range for a healthy cat with a human meter is 50-80

For those of us that follow TR this protocol, which forms part of a peer review study was done with everyone testing using a human meter, in this study, below 50 would earn a reduction, and you attempt to have the nadirs regularly fall in that 50-80 range.
Have a look at George's numbers when he got regulated and went into remission, that's what you would expect to see in a non diabetic cat (or a diabetic that is in remission) April 2016.

I am giving you this info, because we have seen time and time again, how the use of human meters freaks most vets out because they are used to the numbers they get in their lab equipment and with the AT read higher, so they don't know how to interpret the numbers we get with a human meter, they don't understand the differences (it's just not in their experience, my vet freaked out the first few times, then she got comfortable with it)

The fact that the AT and human meters have the biggest difference at high numbers, is neither here nor there, since dosing is based on the lows, not the highs.

Sue hasn't committed to a method yet, but there is a history of DKA so that trumps protocol.

With that 72 yesterday (and the recent run in greens), I think I would hold the dose for now and see where she lands when she clears this bounce.

 

Grain free doesn't always mean carb free, unfortunately. Nutrish is on the food list http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Depending on which variety, it ranges from Medium carb to high carb.

 

What is 'AT' ?
This sure is complex isn't it? But I can see that I can benefit from all the info that has been shared by past members...the thing about the difference between high vs low numbers..oh my!

 

That's the pet meter, Alphatrak, it's the one that most vets use.

 

Just looked at the SS, I think that Luci looks to be clearing the bounce this morning.

That drop at +2 is quite significant, she may be heading to green again or that steep drop may trigger another bounce.

I wonder which it is??
Don't know what time you are on, but if anyone is home it might be an idea to grab another test at +4/+5

 

Luci is already coming back down into the blues. Keep checking, but you don't need to do it every hour.

I need to ask you to fix your SS. 1/20 and 1/21 are missing so now it looks like today is 1/24 on the SS. If you can't fix it, post and we will get someone to help.

(Gill and I posted at the same time.)

 

Wow! That's news! I thought I was 'supposed to check frequently' and since I've mastered this SOLO...poor (sugar butt, Luci)...She's trained now...she knows when I'm coming...it's all about the treats. So HOW often would be ideal?

And THANK YOU for pointing out those dates on the SS! I was able to fix...thankfully!

I have another doctor's appointment at 11:15 - hoping to be back within the noon hour and I can get one then...and should be able to get a 5+ as well...

I sure hope she doesn't bounce again...but we will continue to work through this before making any changes...

 

I still see an error on the SS. 1/20, 1/21, 1/24, 1/22, 1/23, 1/24. If you could copy the reads from today onto the 1/22 line and delete the first 1/24 line, you should be all set.

Also, today is 1/22 so you may want to change that as well.

Data gathering is wonderful and necessary if the cat is going low ... Know Thy Cat. Once you know which times are the best to check, then you don't need to check hourly. However, if your kitty is happy to be checked for a treat, then do it. Usually, you check early in the cycle to see if it would be an active cycle. If it is, then you need to check more frequently. But if it shows numbers are on the upswing, then you can take a break for a few hours then check again towards the end of the cycle to see if they are coming back down for the shot times. Does that help? Disclaimer: I am not a pro.. I'm speaking from my own experience.

 

Can you clarify for me what is an active cycle and how do I recognize one?

Thanks!

I’ll work on that SS.

 

Sue, you and George and Luci are doing great. Bounces suck, but they do pass. Myagi's in an ugly bounce right now. If you look at his ss for 2017 you'll see him all over the place. Then Jan 1st red! Then, on to better things once cleared. It's one of the hardest parts for me personally, but you just ride it out. You're doing great.

 

The definition of active cycle can be found here.

 

Thank you for that link! I thought I'd read over that info previously - but in one side, out the other...I was overwhelmed when I read that...had no meaning for me before now! I get it, finally...

And thank you again for guiding me in fixing that darn spreadsheet...I think I've got that now too...take a look

 

I see errors extending into February.
I'm calling @Marje and Gracie for her help because she is the one who developed the SS and if you give her the editing rights, she can get it all polished up for you.

 

I found the problem....when I created my column of dates I selected 'weekdays'...and so every weekend Luci and I are just taking off...for parts unknown... Well not really...so I've added those weekend dates back in.

Does anyone have a good recommendation for getting all the dates of the year that include the weekends? Also, how do you print this SS? I'd like to take it to the vet next time we go...

Thank you again for your excellent proofreading!

 

I can do that easy for you with editing rights. It’s faster for me to do it then try to explain how to do it as it looks like you’re formatting is off. Please just send me a PM so I can get editing rights from you.

 

How do I send you a PM?

 

Click on “Marje and Gracie” to the left and then “start a conversation”.

 

Go to the tab that says inbox, click on that, select start a conversation, and in the box that says participants start writing marje and click on her avatar when it appears in the drop down list.

ETA Marje's method is less long winded.

 

I think we just had our first 'furshot' - darn it all...She flinched just as I grabbed her scruff around her shoulder .... I can't be sure if it went in or not...I could not feel any wetness on her fur...but if she ducked just right and I pressed the plunger it's possible it just went off into the floor behind her...it's such a tiny amount of liquid in there... I will not risk another injection tonight...just in case it was just me..

I'm really tired tonight - going to turn over the BG watch to DH...I have to retire early..too much pain + too long of a day ... I'm so tired my vision is blurring...

 

If needed, does your DH have access to post on here? That way, if the numbers drop and you're not available, he could post for help.

 

Yes but he’ll wake me up... doesn’t know how to post to group..

 

Hope he doesn't need to.

 

That's what we always recommend when we suspect a furshot. You can fever be sure how much got in, so giving a second shot can result in you overdosing your cat.

Try not to worry about the furshot it happens and Luci will recover.

Hope you are feeling better after a good night's rest.

 

Looks like it was a fur shot - if I can see that her numbers never came down last night - DH took a couple in the middle of the night. I was up at 5:30 for another one...so we didn't have to worry about her numbers going down too much...drats!

Hoping that today will go better - it's my darn fault - my back is still hurting and I'm stiff - I don't like bending over to pick her up if I don't have to..so I tried shooting her while she was on the floor eating her dinner...but I can see now that's not going to be an ideal location to get a good grip on her and avoid these flinches...she seems to know what's coming. I've got some new syringes now - going to see if a smaller gauge makes a difference.