3/19 Ella +12 212 need dose help pls AT

Hello Everyone,

Marjorie suggested that I get a +11 reading but I didn't get the post until now so I did a +12.

+6.5 reading last night was 369 and AMPS is 212
All done on the Alpha Trak.

Do I dose her at 3 u?
She is eating dry m/d

Please see original email:
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=66579

Thanks
tamara

 

Re: 3/19 Ella +12 11.8 need dose help pls AT

Hold on, let me look.

 

Re: 3/19 Ella +12 11.8 need dose help pls AT

First, Good morning

I found this is what Julie wrote last night:

So, because you don't have enough data yet, I agree with Julie, and advise you to skip the shot this morning. You can go ahead and feed Ella, now.

When you have a chance, please Edit the Subject Line in your first post from 11.8 to 212 as the USA version of numbers is what we are all used to seeing.

Welcome to Lantus Land.

 

Really but she was at 369 at nadir last night. I have already fed her. She ate a bit less than normal but is now lying on the bed very quiet. I'm going to test again.

 

wow she ate half an hour ago and now she is 171. I have to go to work. I left her food and water out. I hope she will be ok.

Thank you

 

I thought she was coming down from a bounce.

See you when you get home. I would test as soon as you get home, and post, so we know where she's going.

Have a good day.

 

Hi Dyana,

Thanks for your support
Do you think it's odd that she dropped half hour after she ate? Should I be worried. She didn't look that well when I left.
This is going to be the longest day ever!
Tamara

 

Is there any chance you can run home at lunch since you're worried?

 

Hi Sienne,

It's an hour drive round trip but I will try. DO you think her n umbers are cause for concern? Why did she drop after she ate?

 

If it was only 30 minutes after eating, the food might not be affecting her BG yet, especially if it was dry food.

Carl

 

ARghhh!!! I just got off the phone with my vet and he now recommends 3 units regardless. He said I should have dosed her at 59 as the Lantus is long acting and she would have been fine according to the numbers I gave him. He also said to not test her blood glucose everyday because that will just make me nervous and not to bother changing her food to canned because she is a picky eater.
Is it time to get a new vet?
I'm so frustrated!

 

he is wrong tamara. you may very well have had a dead cat if you had shot insulin into a cat who was 29. he is absolutely wrong. yes, lantus is long-acting. it takes about 2 hours to onset after the shot. there is also some carry-over from the previous shot that would still be lingering. even the most experienced of us, who shoot the lowest numbers, do not shoot under a 50, which is 80 on your AT.

he simply doesn't understand lantus - and as i said yesterday, many vets do not. so if you think he's good on everything else, just come here for your diabetes advice and use him for everything else. if you think he's not good on everything else then a new vet would be in order.

regarding your ss - can you update it to reflect the 4units dose that was given? sienne was giving you advice yesterday based off of your ss, which we all do, and thought you were giving 3 unit doses. i'm unclear if ella got 1 or 2 shots of 4u. it's not on the ss anywhere - i'm looking at your original post yesterday here:

 

Hi Tamara and Ella and welcome to Lantus Land,

I completely agree with Julie: if your vet is good with everything except Feline Diabetes, you should continue going to him/her for those other health issues, but come here for diabetes support. Everyone here does FD full-time! There is an incredible store of knowledge here and people willing to share and to help.

I hope you are able to get home in mid-day today to get another test.

Welcome, again, and it is going to feel strange to me to see my name in a subject line!!!

Ella & Rusty

 

I'm seconding (make that thirding) Julie and Ella. Vyktor's vet is for everything else, here is for his diabetes. Although at least Vyktor's vet admits he doesn't understand lantus...

Vets that say you shouldn't home test make me very nervous though - to me that seems to point to a fairly low level of intelligence.

 

Since I tend to be blunt and to the point, I'm going to say what everyone is thinking. Your vet is an idiot -- at least when it comes to Lantus dosing.

Gabby has been diabetic for almost 3 years. I'm experienced with using Lantus. I shoot low. I WILL NOT give my cat insulin if her BG is 29 (which is what the value of 59 converts to when you're using an AlphaTrack). Personally, I would ask your vet to give his cat 3.0u of Lantus on a BG value of 29 and see what happens before he suggests that you do it. If you had shot, we would, to a person, have yelled at you to get your cat to the ER. What I would do if I have a value of 29 is give my cat a good sized portion of HC food. Yes, Lantus is long-acting. That also means that if a cat is having a hypoglycemic crisis it can take 16 hrs or more to get BG levels back under control. Having done tag teams with people here helping someone stay up all night to monitor their cat, I can think of nothing more stressful.

You did exactly the right thing by skipping.

Vets also have a rather skewed perception of testing. It doesn't stress the cat unless you try to restrain your cat. It empowers you. You have control as long as you have a meter, strips, and HC food. You are also not dependent on the vet for curves and fructosamine tests (and, therefore, the vet makes less $$.)

 

:lol: yes, sienne, i'm thinking that too. the real point for me is, what vet wouldn't err on the side of safety when injecting insulin into a cat? cats can die from hypoglycemia - it's not a "ho hum" event. his "go for it no matter what" attitude is scary to me, tamara.

 

I agree, Tamara. And you can ask him if he will pay your ER bills if you shoot that low. Since the peak of the insulin is about six hours after the shot, and if she didn't bounce, it would have been a life threatening situation. Yes, most here want their kitty in remission but we are, first and foremost, about keeping our babies safe.

I hope you looked at those SPreadsheets I linked for you so that you can see what kitties can do when clearing a bounce. Dyana gave you excellent advice this morning and I hope you were able to get home to check her.

We are here to help. There are two things we have over the vet community : we all live and breathe FD 24/7 and we have a very large membership where we see things the vets probably never know happen AND there is usually always someone on board to help you...I'm sure your vet would have not taken a phone call in the middle of the night....

 

quick email....yes I rushed home during my lunch and she seemed ok. She was very thirsty and usually is from +1-+4.
I probably left out too much food as she went to town and measured at 20.1 or 361.8 and will probably increase from there. That was at +5.
Besides the hypo scare I'm also nervous about ketones. Does she have an increased chance of developing them by skipping shots?


will post with a pmps tonight.
Tamara

ps. haven't had a chance to read through all the posts but thanks again for your support.
Tamara

 

in everything you are weighing the risks. the risk of hypo if one shoots too low and the cat is unmonitored is greater in my mind than the risk of ketones.

how is ella feeling today? this weekend we were talking about fever, diarrhea, etc. - how is she now? does she seem at all sick?

it's very important that she eats. it's ideal if we can help you get her switched to low carb canned. that alone will bring her numbers way down.

 

Her diahhrea is gone. She is eating well and last we checked the fever has subsided. There are two vets we have been dealing with on atleast a bi-weekly basis regarding Ella's health since her bout with pancreatitis. They both work at the same clinic but have different advice on dosing, feeding, neddling ect. I called him on it today explaining how confusing the information is but he just danced around it. I'm off to get more strips and will post later.

Tamara

 

PMPS 427

I went in to speak to the 'better' vet today and she wants me to keep her at 3 units for the next couple of days. We spoke at legnth about the risks and my concerns and she was adamant that I keep Ella on 3 units that she did offer to pay the ER bill when I asked. She has been working with us on a weekly basis since Decemeber so I feel so torn. I believe in you guys as you deal with diabtes 24/7 and really seem to know your stuff but I'm still tron. To ensure that Ella is not low when dosing, she wants me to do the PS an hour before giving food so if she is a bit low we can test her again before giving the shot.
It made sense to me but I'm a newbie.

Does 3 units sound about right for tonight?

Tamara

 

and just so you know...i would never want her to get to a place where she had to go to the ER. It just helped to give me a bit of confidence in her decision.

 

you hold the syringe, tamara, so of course you make the decisions.

you can go with the 3 units that your vet recommended - but no matter what the dosing is, you have to have a no-shoot number that you don't give insulin under that point. did your vet give you a number like that? if not, honestly, i would not follow that advice. it isn't safe and it completely doesn't make sense. insulin changes blood sugar. you can't have it too low. i just can't follow the logic that no matter what, you would shoot.

i can agree with your vet that she wants you to shoot something 2x a day - the problem is that doesn't mean "no matter what the BG is doing." lantus does want shots of the same dose every 12 hours to do its best - so what we generally have people do is reduce the dose so that they can shoot doses of the same amount every 12 hours.

i have to run out the door and haven't really answered your question, but it's the best i can do at the moment.

i'd encourage you to edit your subject line regularly throughout the day, because when it stays the same all day no one knows you have a new question. can you put something different up there now to get some attention? thanks!

 

I think the 3u is fine for right now. I am like Julie in that I don't agree with a vet saying to put the cat on 3u and leave her there for the next couple of days regardless of what the BG is. Here's what we know:

1. 4u was way too much for her

2. we have a "no shoot" number right now of 230 on the AT if you can't be there to monitor. Once you have a little more data at the 3u OR you will be there to monitor, we can work that number down provided you have plenty of supplies (test strips, HC food, karo, etc) and you can monitor. If she throws you another PS below the 230 without you having the supplies or the ability to monitor, we are going to suggest you keep her safe and skip again.

3. she's just had one cycle at 3u and she cleared her bounce from the 59 pretty quickly; if you can get at least one mid-cycle test at night, then we might have a better idea what she is doing with this dose. It's GREAT that you got that mid-cycle test last night!! Good job.

I think the 3u is ok to keep shooting as long as you get a PS number above 230 (AT) and she does not go below 80120 (AT) during the cycle.

I also recommend that if you get a PS at or below 230, post and ask for help; if you are going to be around to monitor and have supplies, we can help you safely shoot.

Ok...remember when we told you to not feed between +10 and +12 and to post a +11? That's what you want to do. This tells me your vet does not understand the terminology. You do a +11 test, you post the number, if she's really low, we'll tell you what you need to do; then you retest at +12 and if the number is high enough to shoot, that is your PS. We never call a test a "preshot", wait an hour, retest, and then shoot. If she's too low at +11 and you retest at +12 and she's too low and retest at +13 and she's high enough, then THAT becomes your PS.

I know it's hard to make the leap of faith. As Julie said, you hold the syringe. It's interesting to me that she said she would pay for an ER visit; that tells me that she is willing to put you in the position of needing one; we aren't.

ETA: The other thing is....don't just stop the dry. If you do, we absolutely have to take the dose way down. As the dry is reduced, her dose will have to come down.

 

Tamara,
What, if anything, did the good vet say about the 59 that you got yesterday morning? Did you give her all the numbers from yesterday? Did she see that Ella's BG dropped from 369 to 171 over a 7 hour period from last night's nadir until one hour past her AMBG test? Did she say that you should have shot 3u this moring on that 212 reading you got? Did she believe you should have shot into a falling blood glucose number? If she said "yes" to any of those questions, then her advice is just as bad as the "bad" vet's advice.

These people in TR know what they are doing. They know what they are talking about. They have dealt with more diabetic cat "cases" in the months or years they have been posting here than both of your vets combined will ever deal with in their careers.

I don't use Lantus. I've never had to learn the protocol, I don't know how a cat "normally" responds to the treatment. If I was on a desert island with a printed copy of the protocol, I could fight my way through it and treat my cat. What I am sure of is that when he and I were "rescued", he'd still be alive, and maybe even off the juice. On the other hand, if all I had was a cell phone and your vet's number on it, I can't say I believe my cat would still be around when the rescue ship came by.

I think you should cut back to 1u, change the diet to all canned low carb food, and basically "start over". Use this forum as your rescue boat. Going back to day one and starting over is not going to harm Ella as much as the advice your vets are giving you would.

Carl

 

If you do stop the dry food suddenly, I have to agree on cutting the dose way back. Also....because she is still on some dry food, you will not be able to do the tight regulation protocol. The TR protocol requires that kitty be on a low carb canned or raw food diet; no dry food. At all. So under the Start Low Go Slow protocol, she would earn reductions when she gets below 120 on the AT.

 

if i recall correctly (and i didn't go back and read all of the previous posts) isn't she still on dry because you were having trouble getting her to eat the canned food?

 

Hi Majorie and Julie,

Thanks again for repying to my post. I'm feeling awful that I have been monopolizing your time as I'm waffling here.

The no shoot number is below 126. This conversation came about when I asked why the other vet told me it was ok to shoot at 59. She said that if I did my PS an hour before and it was 59 but Ella ate food that brought her past 126 then it would be fine to shoot. I don't know how many times I stressed that I was concerned that she would go too low and that I wouldn't be home to take care of her. She was positive that 3 units would be fine. She said that holding off on doses here and there would effect the overall picture of the curve.

So could you please clarify when I should feed Ella between the +11 and +12 test?
Also, I'm a bit confused in regards to the difference between the Alphtrak numbers and the ones people are comparing them to. Isn't the meter calibrated specifically to a cat? When my vet gives me advice on BG levels it coincides with the numbers on my AT.

I don't feed any wet so it sounds like I'm in the wrong section. Where is the Start low group?

Just saw your post Carl,
Yes the vet saw all the numbers and believed I should have shot this morning as I should shoot anything 126 and above according to my AT. She saw that Ella spiked at +5 and says that the insulin shot would have regulated her bg better.

I'm so new to this all and feeling very overwhelmed. Unfrotunately I am running low on strips. I thought they were ready to be picked up today but I have to wait a bit longer so may not be able to do all the tests for the data.

Thanks for continuing to read my posts. I apologize if they are frustrating. I'm still trying to wrap my head around all this and thank you for your patience.

Tamara

 

Hi Majorie and Julie,

Thanks again for repying to my post. I'm feeling awful that I have been monopolizing your time as I'm waffling here.

The no shoot number is below 126. This conversation came about when I asked why the other vet told me it was ok to shoot at 59. She said that if I did my PS an hour before and it was 59 but Ella ate food that brought her past 126 then it would be fine to shoot. I don't know how many times I stressed that I was concerned that she would go too low and that I wouldn't be home to take care of her. She was positive that 3 units would be fine. She said that holding off on doses here and there would effect the overall picture of the curve.

So could you please clarify when I should feed Ella between the +11 and +12 test?
Also, I'm a bit confused in regards to the difference between the Alphtrak numbers and the ones people are comparing them to. Isn't the meter calibrated specifically to a cat? When my vet gives me advice on BG levels it coincides with the numbers on my AT.

I don't feed any wet so it sounds like I'm in the wrong section. Where is the Start low group?

Just saw your post Carl,
Yes the vet saw all the numbers and believed I should have shot this morning as I should shoot anything 126 and above according to my AT. She saw that Ella spiked at +5 and says that the insulin shot would have regulated her bg better.

I'm so new to this all and feeling very overwhelmed. Unfrotunately I am running low on strips. I thought they were ready to be picked up today but I have to wait a bit longer so may not be able to do all the tests for the data.

Thanks for continuing to read my posts. I apologize if they are frustrating. I'm still trying to wrap my head around all this and thank you for your patience.

Tamara

 

Tamara...you aren't monopolizing our time. We WANT to help you.

The reason most of us do not use the AT is because it is expensive, the strips are expensive, and if you run out of strips unexpectedly then you're in a real bind....you can't just run to Walmart and get them. Most of us use human glucometers. Vets would like you to believe that they are inaccurate and cannot be used for cats. But the tight regulation protocol which is the only protocol that has a scientific basis and has been published in a scientific feline veterinary journal, used both a human glucometer and the AT. Because diabetic supplies are expensive, we go with what is cheaper and works.

We do not feed between +10 and +12 except if the BG is in the 40s (70s on AT). When you got the 59 and fed and the BG came up, you would have been shooting a food spike if it was within a couple of hours of when you fed. And where did she come up with a no shoot number of 126? Is it based on science?

Tamara....all we can tell you is that this group has gotten a few hundred cats into remission, we follow a protocol based on scientific research (what protocol does your vet follow and what is the scientific research behind it?). We are all about safety...we would not suggest you shoot an unsafe number and leave. Would your vet do that with her child?

You are welcome to do the SLGS protocol and stay in this group. We have a lot more members active most hours of the day and night.

It's your decision Tamara. I might suggest you show your vet some of the SSs I showed you ....I think she has no clue how low a cat can drop mid cycle.

 

Hey Tamara,

I sympathize with how you are feeling. It is a lot to take in and many vets, and people have different opinions. I know you want to make sure that you are doing right by Ella :YMHUG:

Vets dose the insulin based on "ideal" body weight, (I think I recall that Ella is a Maine Coon?)...Hehe...Ella and Elie Good couple.

Anyhow, for large cats like Maine Coons, ideal body weight can be above 15 lbs. That is a lot of insulin. Our vet said that based on that textbook equation he would need like 5 units, and that is likely too much. We started at 2 units but couldn't stay at that dose because of how he was testing. If you notice on a few people's sheets, the dose seems to change quite a bit...and the numbers lead them to those decisions. I'm sure you will end up changing dose a few times ;-)

If you gave the insulin without testing as the vet suggested...maybe ignorance is bliss, but I would rather know...especially since most animals are not "textbook".

All the best to you both!!!

Tanya

 

you don't need to apologize, tamara. you're in the right section - this is "Lantus Land" and while most of us do the TR Protocol, there are several people using SLGS as well. it's just that we know the change to canned low carb food will immediately drop ella's numbers and dosage need.

but am i remembering right that there's a reason she's eating dry? just know that you're going to get some of the same questions over and over as different people try to help. it's not criticism, it's just trying to figure out what's most helpful.

you are not the first person that's had a vet that didn't know much about the insulin management. i had one as well. we hear a similar story probably at least once a week here.

you're caught in the "crap, should i believe the vet that i have to work with and who i will have to turn to if there's an emergency or the internet stranger people who seem to know a lot more than my vet - but they're the internet people" spot. i suspect every one of us stood in that spot. it's a lousy spot to be in. i don't know how to help you move out of that spot except to try to educate you more about feline diabetes and the science about how it's treated.

here's a thought. the protocol that has been published in scientific journals and is accepted as the protocol for treating diabetic cats may persuade your vet. i've uploaded a copy of it here and perhaps you can study it yourself, then take it to your vet. i've also added the AAHA Diabetes Guidelines for treating dogs and cats. that doc has the dose getting decreased if there is a test that is less than 150 (which would be 180 on the AT).

another thought - would you ask your vet how many diabetic cats she has treated using glargine (lantus) and how many have gone off of insulin? that is a very reasonable question to ask - you are entrusting your beloved ella into her care and you want to know she has the experience you need. we've had 3 OTJ (off the juice) parties in the past 3 or so weeks, we have one more cat on a 2 week trial right now and 2-3 more cats who will likely be off within the next couple of weeks. we've had nearly 200 cats who used lantus, going through this website, go off of insulin overall. they all have followed this protocol.

your meter is fine. the TR Protocol gives numbers for both the AT and the human meters. most of us use the human meters because they are a fraction as expensive to use. the difference is about 30 points - it's easy enough to subtract 30 points from your AT numbers to compare to others using a human meter.

hang in there! this is a tough phase but it gets easier as you learn more. :YMHUG:

 

oh yeah, and about taking up people's time - i know i'm more than willing to help teach new people and give advice because that is exactly what saved my own cat's life. i don't resent it. i had a vet that had us using the wrong syringes even - meaning that punkin got 2.5x the insulin that he was supposed to be getting. the people here figured it out and got us straightened out.

i adored that vet on a personal level, and had been with him for probably 20 years. i stayed with him for another 9 months after punkin was diagnosed before i finally decided that me liking the vet wasn't what it was about. it was about punkin's health and who was going to be able to help him. at that point i found a vet who has 2 diabetic cats of her own. she doesn't follow the TR protocol, but she knew of it and supports me in the ways i ask her to.

punkin is diabetic because he has a tumor in his pituitary gland. it's called acromegaly. the folks here figured that out too. when i asked my vet to have punkin tested for it he had never even heard of it. he talked to his 2 partners (3 vet clinic, full-time and well-established) and the other senior partner had never heard of it, the newest vet recognized the word, but that's all.

my situation is specific to punkin, but everyone here has a story. someone who was here when we arrived helped us. we love our cats and want them to live as long as possible. we're giving our time because that's what others did for us - we're just paying it forward. if we resented it, we wouldn't do it. we don't mind.

ps, sorry i'm so long-winded! :lol:

 

My vet didn't really want to put a number on 'not shooting' and reluctantly said 126 because I strongly felt I needed some guidelines. She doesn't agree with signalling out one number as the decision maker and constantly says its all bout the big picture. Perhaps this is why she wasn't too concerned with 59?! She mentioned that they have been successful in treating many cats into remission using Lantus at I beileve an 80% rate. I'll be honest I'm exhausted so that number could be higher or lower.

I have a question: Ella gets extremely thirsy from +1-+3. You might laugh or cry, not sure, but I have created a bit of a monster as she only wants to sip cold water out of a syringe during these hours. She is toally capble and does drink water from her bowl after meals but during these hours she is desperate for water and I believe it is because she is in a super hyper state as she consumed her food at +12. Also, she seems more content when she is at a higher BG rather than low or what is considered normal levels. Have you seen this before?

I agree that 4 u was way too high. She was on 3u for a while which didn't produce a great curve so that perpetuated 4. The needles I use don't go by.25 increments. Are there glargine specific ones that do?

I have to say that you folks are extremly special for donating your valubale time to help others in need. It's beautful that people are paying it forward. I feel blessed that you have shared your insights and time with me. Not sure what tomorrow will bring. Julie mentioned it well in her post. I do feel like I'm in a tricky spot. I do believe that everyone has the best intentions for EllA and the ball is in my court to pick a path. Not sure if I will be able to take a mid cycle test as I kind of want to reserve my strips for morning bg's. I will update as I get data.

Thanks again everyone!
Tamara

 

And to add to Julie: I also had a vet I adored....she is known nationally and has been a vet 25 years. But she was against home testing and supported only urine testing and shooting blindly. But when I told her what I wanted to do, she agreed. After a couple months, I showed her Gracie's SS. She couldn't believe it. Because of family illness, she had to sell her practice and we went to the clinic where we are now. They are great vets...we love them all; but they had never heard of levemir. I actually did a full presentation about FD at our home for the five vets. They were astounded at the knowledge in this group....especially in comparison to how little they admitted that they actually know about FD. They all went to some of the most well respected vet schools....

 

re the water - have you ever tried a fountain? some kitties seem to love them and drink happily from them. that might meet her desire for catering without it requiring you to hold a syringe! silly kitter! :lol: i had one that only drank from a faucet. she was a pain but i sure adored that girl!

the appearing to like higher numbers - yes - many of us have noticed that our cats are accustomed to higher numbers and they seem tired and lethargic when their BG goes down into normal, non-diabetic cat ranges. i've seen it in punkin also. i suspect it's like when my caffeine gets taken away - it might be my natural state, but i feel like death warmed over! :lol: i understand that they get used to it the more they are there.

syringes are available that have .5u (one half unit) markings. we eyeball to see the .25u doses. there are pictures in the "new to the group" sticky at the top of this forum.

and you're welcome!

 

Tamara:

We've been having a back channel discussion regarding Ella.

I hope you will be back today. I apologize if we scared you or put you in a difficult position. We don't want to compromise your trust in your vet. It's great that your vet is not like the complacent ones who think it is ok for the kitty to be in the 300s all the time.

Maybe we should take a step back and do one very important thing. Is it possible for you to get an inexpensive human glucometer like a Relion Confirm from WalMart and a box of 50 test strips for it? Neither should be expensive. It requires just a tiny drop of blood. What would be a great thing to do is to run tests on both meters so we can get a comparison. It was brought up in our group that a few members with ATs have found that at low numbers, the AT and the human glucometers are close. There "can be" up to a 20% variance in readings on the same meter and between meters. It would be a great thing to know how close your AT is to a human glucometer, especially at low numbers.

If the 59 on your AT yesterday was actually close to what it would have been on a human glucometer, than Ella was very safe at that number; however, we still would have recommended against shooting because you weren't going to be there to monitor and you did not have any data for shooting low like that. Once a member builds some data and knows how their cat reacts to food management and the insulin, then we strongly encourage shooting the 50s. It's the best way to get into tight regulation and hopefully remission.

We do "shoot low to stay low" and it's good your vet is on that same path. Now we just need to identify the difference in meters so we're all confident of the numbers when we make suggestions.

Hope to see you back and we will do what we can so you don't feel pressured or caught in between.

 

Ok I'm back and feeling a bit sheepish as I broke all the rules today but all seems well for now.
As you know the vet said to dose her at 3u. Well she was at 219 at +11 and dropped to 185 at +12 so what did I relunctantly do?...I gave her 2 units as a compromise and have pretty much had an anxiety attack all day. nailbite_smile I raced home from work and did a bg and she was 333 at +8.

I wanted to listen to everyone's advice and so I made a compromise. And then after the shot I remembered that Lantus needs to be decreased by .25 u at a time...well I obviously didn't do that. I left a message for my vet and she will probably be very frustrated with me as she spent quite a bit of time with us last night and really wants me to stick to the 3u.

I'll be honest, I've been an emotional wreck over this all. I feel so overwhelmed by the caring support from this group and believe that I can trust you with the health of my baby girl. At the same time I feel like I should attempt to follow the advice of my vet as they have truly been here for us since her diagnosis.
Since the day Ella came back home from her bout with pancreatitis, our relationship has grown. She is extremely significant to me. She was my very first foster failure 9 years ago and since then, we have had many felines enter our revolving door and she has been accepting almost every step of the way. We care for so many pets at a time that it can be tricky to spend qaulity time with her but since her illness she gets top priority and being a Calico, she relishes every moment.

At this point I feel that I've probably tinkered too much with her dosages in the past few days. I do know that her dry food spikes up her glucose in a big way but it was obvious that 4 units was too much. She hasn't been all that purry lately, probably over a week, since her fever and diahhrea and rebound. We've also tortured her ears so maybe that is playing a part.

Perhaps getting a human meter would be a good idea for a comparison. Is the variance only when numbers are low or for all numbers?
I'm considering following the vet's advice and perhaps staying home to moitor tomorrow. Do you think I am majorily messing with her system by not dosing, low dosing, high dosing?

You can check out her SS and see what you think.

Oh and I have been thinking about getting the fountain. It would sure give me a break from watering her when she's hyper!

Speak to you soon,
Tamara

 

You've raised a question that we were discussing. One of the truisms (if there are any with cats) is that every cat is different (ECID). While some cats maintain a 30 point difference between an AlphaTrack and a human meter, some do not. Personally, I'd rather err on the side of safety especially with someone who's new to the Board and when we haven't had a chance to get to know their cat or if they are OK with managing low numbers. If you can get a human meter and collect some data comparing the two meters at low, mid-, and high ranges it will go a long distance to know how the numbers stack up.

Fundamentally, your vet's suggestion was OK. Many of us routinely shoot in the 50s. We don't know if that was truly a number in the 50s with Ella or if it was 30 points lower. Only some comparison testing will tell you that. Ideally, you'll want to get comfortable with shooting low numbers. (If you scan the subject line on the Board, you'll see that people do, in fact, shoot low.)

I wouldn't worry about having dropped the dose. If you think the overall dose was too high, you did a one time course correction. Lots of people here have done that. If the dose needs to be raised, I'd encourage you to do so in 0.25u increments so you don't speed past what would be a good dose for Ella. I've attached the journal article that describes the dosing protocol that we use. This article from one of the leading veterinary journals may be of interest to your vet. If nothing else, it's a place to start a discussion.


I would stick with the 2.0u tonight. Generally, you want to hold the dose for 2 - 3 days. It does look like Ella is bouncing off of the blue numbers. That's not unexpected in the least.

Most of us have found that having a diabetic cat creates a very special bond. I'm not sure if it's because they allow us to poke them with very little protest or it's a matter of knowing that these fiercely independent animals come to trust us. It's pretty amazing.

 

Just a quick reply here as I am out. We are glad you are back and you did not break any rules here. Maybe with your vet but that is between you two

The variation in readings can exist at any number but obviously 20% of a low number is much less than 20% of a high one. For instance the 211 and 185 you got today are basically the same number as they are within 20% of each other.

FD is stressful enough at first and we dont want to add to that. We can give you our suggestions and you can discuss things with your vet and then you make the decision that you are comfortable with.

Its ok if you shot 2u this morning. I would suggest you go back to 3u tonight unless she comes down to 200 or so. Then you could post and we could help you decide.

 

at 398 I gave her 3 units.

I'll report back in the morning.

 

((((((tamara)))))

i understand exactly what you mean about the bond with a diabetic cat. i think most of us feel that. you get so in tune with them, watching their behavior, caring for them all the time - it's the gift from this not very nice disease. as much as i wish punkin weren't diabetic, i can't regret this special bond i have with him.

at this point, stick with the dose you chose and we'll see how it does. sounds like you gave her 3 units tonight - just shoot 3 units again in the morning.

i think a second meter, ordinary one for humans, will help us answer the question. the cost of the new meter will be more than offset by the fact that the strips are so much less expensive than with an AT.

see you in the morning - although i think your shoot time is 4am for me, so i won't see you then! post anytime if you need help, someone's likely to be online. :YMHUG:

 

Thanks for the article Sienne! It was very informative!

Thanks for the hugs everyone

 

Hope you and Ella are having a good day!

How did the 3 units go tonight? Have you done any additional tests tonight after PMPS?

Tanya

 

243 at AMPS. Only a few strips left so I'm being conservative. Giving her 3u and will be home today to monitor. If I could do only one or two tests would it be between the +6 and +8 range?

Tanya: didn't test her throughout the night.

 

Tanya:

We open a new thread (aka "condo") on a daily basis -- one condo, per cat, per day. At this point, your data from Monday isn't current. In addition, Ella's condo is getting pretty long.

 

Thanks for the heads up on how the forum works Sienne. I have started a new 'condo'

Tamara