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Another low PS...what is going on

Discussion in 'Feline Health - (The Main Forum)' started by AmyB, Aug 5, 2019.

  1. AmyB

    AmyB Member

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    Jul 25, 2019
    I think I'm going to try 1.75 today because Salem's pre-shot an hour ago was 160 on ReliOn and 250 on AlphaTrak. Now it's 155/225?? Is it normal for it to just go down like that? I mean I know it's not by much but still. I don't want to not give him anything but it's staying pretty low. Also do the two meters normally have that big of a discrepancy? I'm mostly using the ReliON for everyday stuff but I need to use the AlphaTrak to give the vet some numbers since it's what they use up there.
     
  2. Sarah&Soph

    Sarah&Soph Member

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    There can be up to 20% variance in readings from the same meter, so 160/155 and 250/225 are basically the same number.

    And yes there is generally variation in the meters, which varies. I’ve had them read two points apart and nearly 100 points apart. That’s why it’s generally best to stick with one meter for your own sanity lol, trying to compare readings will drive you crazy
     
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  3. AmyB

    AmyB Member

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    Yeah that makes sense. I'm trying to just stick to one, but the vet wanted me to give him readings with the AlphaTrak so I bought one just for that. I just don't know how to tell what the more "accurate" number is? I know neither one of them are really technically "accurate", but I just want to have an idea of where his glucose is at. It's confusing when he's safe to shoot on one but not on the other?
     
  4. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    The difference between your Relion and AT2 meters will be greater the higher the BG. At low range numbers the difference won't be that big but at high readings it can be very significant looking. And as mentioned, both have a variance allowance so if the human meter reads on the low side and the AT2 on the high side, the difference can be surprising.

    Neither meter is more accurate than the other. Cat blood differs from human blood. The human meter is reading cat blood as if it were human whereas the AT2 is reading cat blood as cat blood. They are two totally different measures. Picking one meter and using it is the best way forward. If you did a curve for a day and took tests with both meters, the curve would look very similar but the curve line for the AT2 would be higher than the human meter curve.

    As for safe to shoot numbers, stick to one meter for decision making. On the human meter we recommend not shooting under 200 until you have lots of data. Once you have data, you can slowly back that up. So if you get a pre-shot of 190, you try shooting. If that works well, you can then back up to 175 for instance. Systematic trials are really the only way to know how low a pre-shot is safe to shoot for your cat.
     
  5. Sarah&Soph

    Sarah&Soph Member

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    I had the same dilemma when I first switched too, but it’s really the trends that are more important not the exact numbers, other than the take action number and the ranges you’re trying to be in. That being said, I think most if not all of the protocols here were written using human meters. I eventually learned how my cat responded to the dose, and that makes it a lot easier to know what the true no shoot number is for your particular cat
     
  6. CandyH and Catcat

    CandyH and Catcat Well-Known Member

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    from what I understand, the reagent on the strip is similar for most of the "human" meters, and a slightly different combination on the "pet" meters, so there will most always be a difference between the readings ... but each meter will "draw the same curve" -- in other words, you compare the meter readings to the readings from the same meter .. the scales are different, however LOW is LOW and HIGH is HIGH and increasing numbers (or decreasing numbers) tell the same story :smuggrin:

    it's like snapshots selected from a video -- one picture doesn't tell the whole story but a series of them, does ;)

    remember, the vet is getting information from the manufacturers of the meters marketed to them .. so most of them are biased towards those -- but vets have been using the meters originally designed for use by humans, for many years before these "pet-specific" meters were ever developed -- and the protocols/advice on this board was developed years ago using the meters in use at that time ("human" meters) :):joyful:
     
  7. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Actually the reagent is the same on the AT2 meter and the Abbott human meter strips. The difference is in the algorithms and how the meter calculates plasma glucose. Cats and humans carry different percentages of glucose in their plasma and each meter is designed to read based on the blood it's supposed to read. The AT2 has to be coded because the strips are batch tested to determine what code will provide the most lab accurate readings for cats, dogs or other species.
     
  8. CandyH and Catcat

    CandyH and Catcat Well-Known Member

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    thanks -- I was getting information elsewhere, glad to know what the reality is -- not sure if the reagent on the Arkray strips and the Abbots are the same, thanks for the correction
     
    Last edited: Aug 5, 2019
  9. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    There are different reagents used in human meters. Depends on the meter. The Arkay strips may very well be a different reagent as are other makers. The AT2 meter was developed from the original Freestyle Freedom Lite human meter so uses the same reagent as the Freestyle meters.
     
  10. AmyB

    AmyB Member

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    So really the goal isn’t so much the numbers themselves, but staying within a range and seeing the pattern of how he’s reacting to it? I think I’m overthinking a lot of this even though it is pretty confusing. I should be more focused on getting curves to see what it’s doing rather than focusing on the individual numbers.
     
  11. CandyH and Catcat

    CandyH and Catcat Well-Known Member

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    you got it, you got it, you got it !!!! :bighug::bighug::bighug::):cat::)

    :joyful::joyful::smuggrin::smuggrin:
     
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  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Exactly. Don't focus on individual numbers. Each reading is a moment in time.......your spreadsheet is a movie. Candy said it well above .....
    Curves are fine if you can't get mid cycle tests BUT a curve is still only one day out of many. Random testing daily can be more accurate than curves because kitty may be having a very good or bad day when you happen to be doing a curve. That said, a curve helps immensely when mid cycle testing is difficult to do due to work schedules etc.
     
  13. AmyB

    AmyB Member

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    Yeah my biggest problem right now is that his mid cycle hits when either I’m at work or asleep. I should be able to get some this week though. I just feel like I have no idea what dose he should actually be on so I’ve been keeping him at 2 because at least it’s bringing his numbers down.
     
  14. AmyB

    AmyB Member

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    Well today we're at 127 AMPS so I'm just going to skip. I'll be at work all day. I suspected he was going low at night and I was right. I mean not dangerously low but pretty low. He also sits and sleeps in the closet all night so I'm not sure he feels well when it drops.
     
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I would reduce the dose to a max of 1.75u tonight if pre-shot is high enough to shoot. You really don't want to be skipping shots if at all possible and reducing a bit might even things out so you can shoot more consistently every 12 hours. It's highly likely Salem is feeling poorly due to the ups and downs with his BG.
     
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  16. AmyB

    AmyB Member

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    Yeah I think I’m going to reduce it. He’s just not coming back up enough with the 2 now.
     
  17. AmyB

    AmyB Member

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    Would it be safe to give him either .5 or 1? Just so he'd have something in his system?
     
  18. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think at that pre-shot it would be better to skip. While you did shoot 2u once at a pre-shot of 90 without any problem I would not have recommended it. There is no telling what Salem might do with a reduced dose and if he happened to have a particularly active cycle, there is the potential for him to go lower than ideal. Best to try shooting those lower pre-shots when you can monitor IMHO and to take the shootable number down in small steps to ensure safety.
     
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  19. AmyB

    AmyB Member

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    I think I’m more comfortable doing that anyways. I skipped the other day and he went up a little bit but it wasn’t super high at least. And when I shot the 2 on 90 I was feeding him high carb stuff the whole time to make sure he didn’t go lower and I definitely can’t do that today. I think I’ll try the 1.75 for a few cycles and see how that goes.
     
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  20. AmyB

    AmyB Member

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    Welp after not shooting this morning his PMPS is at 240??? This whole continually dropping thing is throwing me off. He should be okay to get 1.75 tonight I assume but I'll keep an eye on him tomorrow when I give it.
     
  21. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Interesting that Salem's BG didn't go up that much despite the missed shot. Really wondering what AMPS will be today!
     
  22. AmyB

    AmyB Member

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    AMPS is 122....I woke up around 4 I think and took his BG with the AlphaTrak and it was 280 something at nadir? I really don't understand! Should I bump him down even more today and just see what it does? Could it be possible he's bouncing and that's why he was so high at nadir last night and down this morning? He's pretty lethargic at night and now he's super perky this morning.
     
  23. AmyB

    AmyB Member

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    Okay I stalled a little bit and he went up to 160. I'll be home in the afternoon to test him so maybe I can go ahead and give him 1 or 1.5U?
     
  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Well skipping doesn't seem to be bothering his AM numbers much at all. Interesting.
    I assume you cannot monitor through the day today. If that's the case, I think I'd skip again. Wish he'd do this for the PMPS instead so you could try a lower dose on the low pre-shot.
    Tonight reduce him down to 1.5u and see what he does. All you can do right now is try to find a dose that can be consistently shot twice daily. Overall he's not doing badly so patience is key.
     
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  25. AmyB

    AmyB Member

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    I'll actually be home this afternoon so I can monitor. And yeah he's been acting mostly fine and I've been testing for ketones and all that so I'm not too worried about him getting a little high. Would you recommend 1 or 1.5 as a lower dose? He's at 160 but the food doesn't bring him up too much.
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok we crossed posted. If you will be home for expected nadir (around +5/6) then I'd try 1u at the lower pre-shot. The problem right now is that we don't know if 1.5u will result in low pre-shot like 1.75u did so I'd reduce to 1u for this cycle. That should be fine until you come home to test. Leave some LC food out for Salem to eat in your absence just in case he needs it.
     
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  27. AmyB

    AmyB Member

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    Yeah I'll only be gone for 2 hours today, around +2 to +3 so I can test during nadir. 1U seems a safe bet I think. It didn't even make a dent when I started him out I think but I also started him on insulin and switched food over at the same time and I think he's had a huge drop just from the wet food. I wish I had been monitoring him from the beginning so I could have seen what it did but oh well.
     
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  28. AmyB

    AmyB Member

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    Okay I just gave 1U so we'll see what that does. I'm wondering if I need to have the vet look at his teeth again. He checked them and said they looked fine but Salem is pretty much nonstop licking his lips and smacking his mouth and I know he's not nauseous bc he's eating just fine so I have no idea what that is.
     
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  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Never hurts to get his mouth checked again. Things can get missed with a visual inspection since most cats are none too pleased with someone prying their mouth open to look. Could be something was brewing that didn't get noticed at last check.
     
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  30. AmyB

    AmyB Member

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    Okay +6 we're at 163 so it at least did something? I think I'm going to try the 1.5 tonight. I'm worried about changing his dose around too much but he's going low at night and then not coming back up and I'd rather avoid that. I'm trying to decrease it slowly at least?
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I agree not changing doses is best but this morning's pre-shot was much lower than you've shot before, thus the reduction suggestion. If BG is 200 or greater tonight then I agree 1.5u would be the way to go. Kind of surprised by that +6. Seems like it may be a very flat cycle.
     
  32. AmyB

    AmyB Member

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    Yeah I’m hoping I can stick with the 1.5 for a few days and see what it does. I just want to find a dose that works but he’s making it hard! I’m glad I’m testing and doing all of this bc if I had gone by what the vet said he probably would have had a hypo by now. But his overall BG has dropped a lot so maybe I should talk to him about that.
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Did you change Salem's diet when he was diagnosed from high carb (perhaps dry food) to the low carb wet diet? If so that can have a very significant effect on dropping BG. Your vet started Salem off on a higher than normal starting dose. That 2u plus a diet change likely would have sent Salem very low.
     
  34. AmyB

    AmyB Member

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    So the vet started him on 1u and we went up by half units every week. But I did switch him over to wet food at around the same time and then I found out later that there are certain wet foods with lower carbs than others so I started doing that about two weeks ago so I’m sure it had an effect. The problem is also that he was going off of one blood test done at the vet usually at around +4 when I don’t think Salem hits nadir until around +6. So it’s probably a combination of all of those factors?
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Yes definitely a combination. And one off tests in the vets office....well...that just won't work. The change to the LC wet diet though has probably made a big difference.
     
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  36. AmyB

    AmyB Member

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    Okay PMPS on the ReliOn is 166 and on the AlphaTrak 2 it's 268??? He's safe to shoot on one but not the other so I have no idea what to go by.
     
  37. AmyB

    AmyB Member

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    Okay I tested the AT2 using the control solution and it was fine so I'm just going to go based off of that. I'm going to assume he's probably okay to shoot the 1.5 tonight but I'm definitely not going higher than that.
     
  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Amy, I know my human meter tended to read low at low range numbers. I also know it's been suggested the Prime reads a bit low but at what range(s) I am not sure. That said, if using the Prime as your only reading, take it at face value and NEVER assume it's reading low. Since you have the AT2 and the reading is well over the no shot threshold we use with the AT2, I agree with your decision to go ahead with the 1.5u dose.
     
  39. AmyB

    AmyB Member

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    Okay good, I'm really trying to stick to one or the other but it's helpful to have both at times like this. He really needs to get a higher dosage tonight I think so I'm going to try the 1.5. I'll leave food out just in case, but it's less than I've given him the previous nights.
     
  40. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Just for future reference, I would add a comment into the remarks column about the readings difference and the decision to go ahead with the insulin tonight.
    And make sure you get a before bed test so if he is dropping you can set an alarm to retest or prop him up with higher carb food. It really helps to grab a test around +3 or so if possible as that will often tell you if the cycle is going to be an active or quiet one.
     
  41. AmyB

    AmyB Member

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    +2.5 we're at 154 on the AT2. I might set an alarm for +5 just to see where he's at? Maybe this dose is going to be a good one...
     
  42. AmyB

    AmyB Member

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    He’s skyrocketed up to 412 this morning.....I genuinely don’t know what to do. He’s just laying on the floor in the closet and he seems like he feels awful.
     
  43. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Which meter is that 412 on? Are you checking Salem for ketones?
    Can you also bring the spreadsheet up to date...it makes it so much easier to assess the picture. :)
     
  44. AmyB

    AmyB Member

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    412 is on the AlphaTrak. I tested him at +5 and he was 212 this morning. And I tested him for ketones two days ago and he was fine.
     
  45. AmyB

    AmyB Member

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    I'm scared that all of this lowered dosing is making things worse. I might take him into the vet today and just make sure nothing else is wrong.
     
  46. AmyB

    AmyB Member

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    And I might take him back up to 2 and do a curve using the AT2 today because I'm wondering if my ReliOn is running really low and causing me to shoot lower when I shouldn't.
     
  47. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'd check the ketones again as soon as you can just to be on the safe side. That reading on the AT2 would likely be a pink on the Relion so take a deep breath. I have to wonder how low he went yesterday on the 1 unit and if he went low and was still lower at PMPS then what you are seeing now is a bounce. I'm not sure what to tell you. I think Salem is likely feeling punky because of wide swings in BG. How about testing with the Relion and see what that reading is? I still think you are confusing and frustrating yourself using both meters. The AT2 is going to read higher the higher the BG and that looks far more scary than it really is.
     
  48. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    DO NOT take him back to 2u. It wasn't allowing you to shoot twice daily consistently and that often means the dose is a bit too high. If Salem is bouncing that bounce could break anytime and if it does and you can't monitor, he could potentially get into trouble.
     
  49. AmyB

    AmyB Member

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    Okay he's at 258 on the ReliOn so maybe try the 1.5 again and see what it does?
     
  50. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good idea! :)

    From now on I would also note any AT2 readings in the remarks column rather than in the cells (or stack them in the cells) but it gets really confusing when the PMPS is showing the Relion reading and then the reading at +3 is from the AT2. The pattern of readings is being lost. The pattern will look basically the same for both readings but the Relion pattern will be lower overall.
     
  51. AmyB

    AmyB Member

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    Okay I'll do that. I'm trying to take readings with both when I can just so I can show the vet when I talk to him. This is just driving me crazy with how all over the place it is. I was hoping the 1.5 would be a good dose since he seemed to respond well to it last night, but I only got two readings so I don't know how low he actually went. My main fear is that he's going low and bouncing which is causing all of this and making him feel terrible.
     
  52. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Bouncing is normal and there is nothing you can do about it but ride it out. You are still so very early in this journey and quite frankly Salem is doing much better than a lot of kitties at this point in time. Patience is key.

    When I was dual testing with both AT2 and a human meter, I simply created a separate sheet in the same workbook. I could keep the AT2 meter readings for the vet separate and neither the vet or me or anyone helping got confused. If you need a sample, click on my link to Menace's 2015 FS/AT meters SS. Mine is a bit different because I'm in Canada and use mmol but the general idea is still the same.
     
  53. AmyB

    AmyB Member

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    Well at +3 he's at 314 on the ReliOn so he hasn't gone down any. I'm guessing he must be bouncing bc he went down into the 100s last night. I guess I'll try and hold the 1.5 for a couple of cycles and if it's not effective I'll raise it to 1.75? I haven't spoken to the vet in a week but I'm dreading calling him trying to explain all of this. I feel like I'm just making things worse lowering the doses but it's like he's reacting better to it (except for today).
     
  54. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Holding doses through a bounce is frustrating but at this stage of the game, when ideal dose is still a bit of a mystery, it's the safest thing to do. We don't know how low Salem might have gone yesterday during the day on the 1u dose. He started lower but even with the lower dose, he might have dropped down more than you think. PMPS was not that high on the Relion (166) as compared to the AMPS. The bounce may have started last night and is continuing today.
     
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  55. AmyB

    AmyB Member

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    Okay I'm taking him into the vet on Saturday morning and I'm going to talk to him. I need to make sure I get some numbers using the AT2 though bc he'll want to see that. I'm just so confused about what to do and I feel like I'm making things worse bc he's acting more lethargic and like he doesn't feel well. I'm taking him early in the morning so at least the vet can see how low he runs in the AM. I'm also getting his teeth looked at just in case.
     
  56. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good idea to get the teeth looked at but be aware that the vet, based on the numbers on your AT2 sheet, may suggest taking Salem back up to the 2.5u dose which doesn't allow you to consistently dose twice daily. He won't be seeing the full picture the way you have been seeing it. Vets are great for most things but unfortunately, a lot of them are a little less great with feline diabetes.
    You might want to check with your vet as to what he considers "good" readings and when to withhold shots. But if you are having to repeatedly withhold due to low AM readings, then the dose definitely needs to be re-evaluated so you can shoot consistently.
    Salem doesn't feel well because of the bouncing and swings in BG. This will resolve as you determine the best dose for him to receive consistent shots.
     
  57. AmyB

    AmyB Member

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    My game plan is to keep Salem at 1.5 until Saturday morning and I can talk to the vet, since I think that dose I can consistently shoot at least. I’m going to go over all of my concerns with him and see what the best option would be going forward. I think he’s not used to people being this involved so he probably hasn’t mentioned things just because most people there can’t handle it. I’m just kind of obsessive when it comes to things and of course my cat’s health is one of them. Also I like to do research and handle things myself when I can but I feel very out of my depth here. Also I’m hoping nothings wrong with his teeth but the way he’s been smacking his mouth all the time has me concerned.
     
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  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Amy, you sound so much like me that it's uncanny. Your use of both AT2 and human meter reminds me so much of myself. Believe me when I say, mixing meters takes a lot of self discipline not to panic over readings on either meter. It tends to confuse the situation when you are so early in this journey. I however was dual testing on the same drop of blood each time I tested so I had comparisons for EVERY test. I admit I like and trust my pet meter the most despite my use of a human meter BUT I also came to the conclusion that unless my girl was in very low numbers on the human meter, the difference didn't matter. I know my human meter (not the one you are using) reads low in low ranges so when I got a low human meter reading, I double checked it against the AT2 to decide what the best course of action was. You have not encountered any readings low enough to be affected by this difference yet.

    When I first mentioned a human meter to my vet she looked at me like I had horns growing out of my head. Fast forward and my vet emailed me wanting to know what normal readings were on a human meter because she had a client who insisted on using a human meter. A human mete is just as good as the AT2 but the numbers will read lower.

    You are so early in this dance and getting most kitties regulated is a marathon NOT a sprint. You are going to have to be patient and let the numbers from ONE meter guide you as to how to proceed. Your vet is not going to be available to guide you 24/7 so you need to gain some confidence in your ability to interpret and deal with what Salem throws at you. I understand your desire to keep your vet involved but to be honest, most of here deal with dosing ourselves because we are the ones holding the needle and on duty 24/7.
     
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  59. AmyB

    AmyB Member

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    Sigh....PMPS is 222 on at2 and 130 on reliOn....

    And yeah I agree with that, I just need to figure out what numbers I’m shooting for and what I’m looking for, which is honestly what I’m still confused on. I’m hoping the vet can clarify what they consider to be “good” numbers but I’m hoping that if I can keep Salem in the 200s and 100s he’ll be okay? I’ve read all of those different definitions of regulation and I don’t think I could manage tight regulation but I want to get him in decent numbers.

    I've been testing using the same blood with both meters just so I have more data. My problem right now is I know the vet is going to want to see data from the pet meter so I'm trying to use that, while also using the ReliOn so I can have a standard for it too, since once I get him more regulated I'll probably just use it exclusively. I know the numbers are going to be pretty drastically different, I just want to get an idea for how both of them are reading. I'm keeping separate spreadsheets now which I think will help.
     
    Last edited: Aug 8, 2019
  60. AmyB

    AmyB Member

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    Ugh okay +7 is 340 on the at2 so the 1.5 dose isn’t doing anything. I probably need to bump him up again. He barely went down from 437.
     
  61. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Amy, when I look at those numbers I see something totally different than you. The day cycle yesterday was not that bad. Salem didn't drop a lot but he also didn't bounce up high at the end of the cycle either. Not quite flat but flatter than he has been. He seems to have a later nadir (around +6 -7) so may have gone a bit lower yesterday than you are seeing. Not sure what he did early in the night cycle last night but you can't jump on one reading at +7 and start altering your plan of attack or you'll never get him figured out.

    I understand wanting to get readings for the vet BUT pick one meter and dose according to it rather than reacting to one higher reading on the AT2. When you aren't getting the results you want it's fine to make changes BUT you need to give every change a chance to really see what it is or isn't doing. Salem's BG is not that bad right now and you are able to shoot twice daily so I'd hold the 1.5u dose for today at least.
     
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  62. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    I know it’s hard to be patient when you see not so great numbers because we want our kitties feeling better NOW, but I second everything Linda has said. Salem is looking great considering how short of a time it’s been since he was diagnosed. You’ll hear this a lot on here, but it really is a marathon not a sprint! Gotta give the dose some time to work
     
  63. AmyB

    AmyB Member

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    Jul 25, 2019
    Okay I’ll keep him on the 1.5 at least through tomorrow. I can’t help but panic when I see those higher numbers since he’s been pretty low for a while. But I need to take it slow and not jump around everywhere.
     
  64. AmyB

    AmyB Member

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    Well you guys were right I’m glad I kept him on the 1.5 cause +3 we’re at 171 on the at2. I have to go to work during his nadir but my brother will be here so I might try and show him how to test and see if he can check on him.
     
  65. AmyB

    AmyB Member

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    Jul 25, 2019
    Okay I’ve been at work but before I left I took a +4 and he was at 80 on the reliOn and 150 on the at2. That’s on the 1.5 dose. I’m going to hold it through tonight and try and get some readings to show the vet tomorrow.
     
  66. AmyB

    AmyB Member

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    Jul 25, 2019
    QUESTION- I just accidentally left the insulin out for like 30 minutes is that going to make it ineffective? I really don't want to have to buy a new bottle but I guess I will if I have to.
     
  67. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    It should be just fine. A sign that it has gone bad would be little white floaty bits in the insulin, but that would most likely be from having been left out overnight or longer. Thirty minutes is not a very long time.

    Edited to add: People have left Prozinc out for much longer with no problems. It happens.
     
  68. AmyB

    AmyB Member

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    Jul 25, 2019
    Okay good. I'll check it before I use it tomorrow at least.
     
  69. AmyB

    AmyB Member

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    Jul 25, 2019
    Yeah the 1.5 isn't going to be enough we're at +3 and 441 on the AT2. I feel dumb going to the vet just to have him look at his teeth when they're probably fine but oh well.
     
  70. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    No doubt a bounce from the lovely lower readings earlier during the day. It's normal for this to happen and you just have to ride it out. As Salem gets down to lower readings more frequently, he'll get use to the lower numbers and the bouncing should settle.
     
  71. AmyB

    AmyB Member

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    Jul 25, 2019
    Okay he’s at 309 this morning so that’s not great but not awful. We’re going to the vet which I’m pretty nervous about just because I have to explain all of this. I definitely don’t think he needs to be on the dosage the vet last had him on though and I’m hoping if I show him the lower numbers I’ve been getting with the 1.5 he’ll agree.
     
  72. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Proof's in the pudding. If you can't give insulin consistently twice a day, you can end up in one big bouncing session with one high and one low cycle which makes kitty feel awful, gets you frustrated and no progress being made. Hopefully your vet will agree but even if the vet doesn't, you hold the needle and you need to be comfortable with what you are doing. This is a very hands on disease that requires 24/7 attention and no matter how good your vet might be for most things, diabetes is definitely one of those things that really requires the vet to be your partner rather than a dictator. Your vet sees Salem periodically and otherwise only has your reports to base decisions on. It's difficult if not impossible to handle diabetes well with one size fits all instructions and your vet just doesn't have the ability to give you much more than that because he is not following Salem on a day to day basis.
     
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  73. Sarah&Soph

    Sarah&Soph Member

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    It took me way too long to realize this, but even if your vet does not agree with you, you don’t HAVE to take their advice. At the end of the day, you know your cat and what’s best for him, and unfortunately many vets are just not educated or experienced treating feline diabetes. I had one look me in the face and tell me home testing is useless and can’t tell you anything, and this was AFTER my cat had been hospitalized for a severe hypo!
     
  74. AmyB

    AmyB Member

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    He’s at least fine with me home testing and he’s always telling me I ask way more questions that any of the other owners so maybe he’s just not used to someone being this involved. I’m going to suggest to him I keep at the 1.5 for a few more days and see if he levels out and if not I can bump him up.
     
  75. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If your vet is Ok with you questioning things, he's a keeper even if you don't always agree 100% with each other. I also love the fact that he is pro home testing. You seem to have a vet who is more savvy than some and likely willing to work as a partner and that makes all the difference in the world.
     
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  76. AmyB

    AmyB Member

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    Jul 25, 2019
    Andddd he does have an infection in his teeth. Why am I consistently right about this stuff. So he’s getting antibiotics and the vet said to leave him at 1.5 because as the infection clears up he’ll probably get more regulated.
     
  77. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Mom's intuition! You know your cat. Glad you took him and he'll be on a better path very soon. :)
     
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  78. AmyB

    AmyB Member

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    Jul 25, 2019
    Yeah I’m glad I took him now. The infection is probably part of what’s causing him to not feel well so once it clears up and I can get his teeth cleaned hopefully he’ll be better. The problem now is I have to get him somewhat regulated because they can’t put him under until his glucose is under control. But I’m really hoping getting rid of the infection will make his numbers more stable.
     
  79. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    Glad you caught the infection quick!
    Your vet sounds like a good one. If you are comfortable with it, you could give him the link to your spreadsheet via email, and he can reference it as needed. I gave my vet the link, and always bring my phone to show the sheet to the techs/diff vet, and just to have it handy
     
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  80. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    While I agree you need to get the infection dealt with, the dental issues likely are partly to blame for the lack of regulation. Catch 22. Salem does not need to be regulated to get the dental issues looked after. Getting the cleaning/extraction if needed done, will likely help get her regulated so I'd opt to get that done as soon as the antibiotics have alleviated the infection.
     
  81. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    Sophie got her dental done when she was not regulated at all. They let her BG run well into the high 300s during the procedure. That being said, she had hers done by a board certified team
     
  82. AmyB

    AmyB Member

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    Jul 25, 2019
    The vet was saying something about we just need his BG to be low when they do the cleaning since he’s under anesthesia? He wants to do it as soon as the antibiotics clear up the infection bc he thinks that will lower him enough to get him into those numbers. Which at +4 he’s at 104 on the AT2 right now so who knows maybe this dose will be fine. It just means I’m going to be watching him like a hawk for the next few days to make sure he doesn’t get too low.
    Not sure how fast the antibiotics work but he’s currently up and playing which he hasn’t done in a while.
     
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  83. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Salem is looking much better on the 1.5u dose and the last couple of day's BGs shouldn't preclude getting the dental work done. :)
     
  84. AmyB

    AmyB Member

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    Jul 25, 2019
    Yeah I’m pretty happy with how this is going even though dealing with the dental work will be annoying (and expensive). Hopefully getting that under control will be what he needs to get more regulated.
     
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  85. AmyB

    AmyB Member

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    Jul 25, 2019
    Does anyone have an idea of if the infection clearing up will drop him significantly? He got an antibiotic shot this morning and I'm not sure how long it will take to start working on the infection. I'm still going to be testing him frequently, I just don't know how worried I should be about him dropping suddenly. He was at 261 PMPS on the AlphaTrak tonight.

    Okay at +3 he's in the 300s so I'm guessing he's not going low tonight. I'm going to try and take advantage and get a full night of sleep. I'm assuming the infection is probably driving his numbers up at night? Also now I'm paranoid about DKA since he has an infection, but he's on antibiotics already so hopefully that will help clear it up and then I'll get him in to have the cleaning at the end of this week. At least during the day he's getting low enough.
     
    Last edited: Aug 11, 2019
  86. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Yes clearing the infection could bring down his BG but you are testing enough to catch it so try not to worry. They'll likely come down gradually.
     
  87. AmyB

    AmyB Member

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    Jul 25, 2019
    So at +3 today he’s at 423....I don’t understand how he had such good numbers yesterday but they’ve been high since then. I was really hoping this dose would be a good one. I hope I’m giving him the insulin right?
     
  88. AmyB

    AmyB Member

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    Jul 25, 2019
    Just an update, Salem hasn't gone down much today. I'll see what he's at at +3 before I go to bed. I'm just feeling discouraged because yesterday he went down to 104 (80 on the ReliOn) and now he won't go below 200. I don't know if it's something to do with the antibiotics maybe or if he needs to go up on his dose later this week. I'm still keeping him at the 1.5 for now though.
     
  89. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Amy, chances are good it's a bounce (spreadsheet isn't updated so I'm guessing). Bounces happen when BG goes down to levels that are no longer familiar or comfortable for the cat. Salem has to learn that those lower readings are a good thing rather than something to fight against. You can't do anything to stop them.....they tend to calm down with time. They are frustrating and maddening for us but they are simply a normal biological occurrence. Stay the course for the moment until you see whether the antibiotics bring BG down at all.
     
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  90. AmyB

    AmyB Member

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    Jul 25, 2019
    Seems like you're right, we're at 205 AMPS on the AT2. I'm going to stall for about 15 minutes and see if he goes up any but I'll be home around his nadir so I can keep an eye on it. I'm curious to see how much the 1.5 drops him.
     
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  91. AmyB

    AmyB Member

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    Jul 25, 2019
    Oh boy we're almost at +3 and he's at 116 on the AT2. I know he still has room to go lower but that makes me nervous. Sometimes he hits his low point at +4 sometimes it's later.
     
  92. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Feed him a snack of LC. You want to "feed the curve" to keep him in the high greens and low blues. Get him used to hanging out in these numbers.

    And can you update your spreadsheet please?
     
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  93. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Salem is fine and in perfectly safe range with lots of room to drop a little more quite safely. Those lower BGs can be very hard to get use to when we are so accustomed to higher readings but they are exactly what you need to strive for to allow Salem's pancreas to heal and start to function better.
     
  94. AmyB

    AmyB Member

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    Jul 25, 2019
    Okay so I just fed him some LC food and we're at +4 at 87 (AT2). Lately he's been peaking at +4 so I'll see if he starts going up after this. He must have been bouncing this weekend bc 1.5 seems like it's enough.
     
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  95. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Lovin' those numbers today. Go Salem!
     
  96. AmyB

    AmyB Member

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    Jul 25, 2019
    Yeah he really does love throwing me for a loop! I just hope this dose doesn't take him too low so I don't have to worry about him going low at night. I mean I'll probably set alarms and wake up and test him anyways but still. Hopefully he won't bounce again because I really want to get him in to get his teeth done this Friday.
     
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  97. AmyB

    AmyB Member

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    Jul 25, 2019
    Okay 30 mins later he's up to 125 so maybe +4 is the new nadir? So weird that he does that.
     
  98. CandyH and Catcat

    CandyH and Catcat Well-Known Member

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    Apr 23, 2019
    LOL -- he's a cat ! :p:cat:
     
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  99. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    He's a cat....it's in the "Cat Rulebook"....Never let da hoomin predict what you are going to do in anything!!
     
  100. AmyB

    AmyB Member

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    Jul 25, 2019
    PS tonight was 342. I really hope he's not bouncing again. That must be what he's doing to have low numbers one cycle then go up dramatically the next? I'm going to see where he's at +3.
     

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