3-9-29 TYLER AMPS-78/75@+4/92@+8/PMPS-71/78@+3

http://www.felinediabetes.com/FDMB/threads/3-8-20-tyler-amps-84-83-4-5-76-8-pmps-80-88-4-25.226747

Wishing you all a wonderful day, it's going to be 69 degrees here in N.J. today
Praying all of our kitties surf safely

 

78 You go, sweet Tyler

 

Tyler is happy too Beth

 

Only greens !!! Looks like he's getting there !
Have a beautiful day, Diane!

 

Hi Lyane yes Tyler sure is getting there, congrats on the reduction and I hope that Peanut gets his ear cleared up today

 

Diane asked me to look at Tyler's SS and see about reducing the dose. This is from the TR Protocol:

Alternatively, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.

I think Tyler's numbers meet this. He's only had a few blips into low blues. I'd try the reduction to a drop dose. You can always go back up.

 

Beautiful!

 

Hey Carla just so I understand when you say the cat regularly has its lowest BGs in the normal range of a non diabetic cat healthy (50-80 mg/dL do you mean his numbers after his AMPS and PMPS numbers?
Yes he does have a few blips into low blues
Do his AMPS and PMPS have to be between 50-80 ?
Or is it just during the testing I am doing during the cycles
This is still pretty new to me, thanks so much
I'm just a little nervous if I see some blues pop up
How long does someone do the drop dose if the numbers are between 50-80?

Not to jump the gun, if I plan on trying the drop dose and all is good
what would be the next step

 

It says lowest numbers, so I was looking at mid cycle numbers.

 

These should be under 100 overall.

 

So mid cycles should be 50-80
and his amps and pmps should all be under 100 @carfurby

 

Bella is looking good himself

 

MeWowZa! Put a Lime in da Coconut! Tiki Hut Time!

 

Yes on the mid cycle numbers. PS numbers should be under 100 overall. Which I read to mean you can have a few low blue numbers.

 

Ok thank you Carla
How long does someone do the drop dose if the numbers are between 50-80?

Not to jump the gun, if I plan on trying the drop dose and all is good
what would be the next step be @carfurby

 

7 days.

I think it's OTJ Trial. I know some people give "some" insulin, but I think that's the same as the drop dose.

 

@Deb & Wink
@Wendy&Neko
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
@Judy and Boomer
Hey guys when you get a chance would you take a look at #7 and TYLER'S spreadsheet, Carla gave me what she thinks, which I appreciated, I just wanted to see what all of you might have to say,
Carla please don't be offended that I just wanted to see what others think, I value your opinion

 

So here's my thought...

Tyler's numbers are exquisite. If it were me, I'd go with the "some" insulin option -- push on the plunger of the syringe as hard as you can, insert needle into the Lantus, release the pressure. That will give you about a drop of insulin. Stick with that amount for a week and I suspect good things will be happening (anti-jinx).

 

Hey Sienne , thanks for replying, Yes someone else told me the same thing about pushing on the plunger, I just hope some insulin will be in it lol
I was just leary about some of the blues that was on his SS
I might just give it one more week, then try the drop dose
Like everoeve says if it doesn't work out I can always go back to the 0.10 dose Thank you @Sienne and Gabby (GA)

 

Diane, while I'd love to tell you that I think Tyler is ready for an OTJ trial, there are a couple of items that concern me.

1. Tyler's pre-shot tests have still been a bit higher than the 50-80 normal BG ranges that we look for before starting an OTJ trial. It's the higher "blips" into the 90 + range that have me concerned as well as those over 100 readings.

"the trial starts when numbers are in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range." Quote is from the thread I posted at the very bottom of this reply.

2. It's really hard to measure those tiny, tiny doses. Even using calipers to measure can be challenging. So there may have been a teensy weensy bit more insulin one day than another.

3. While the Relion Prime meter is recommended here often, it failed an independent accuracy test in HUMANS a few years ago. Yes, it's accurate enough most times to test a cat's BG levels. Yes it's accurate enough most times to test a human's BG levels. Yes it initially passed the FDA criteria to be approved for sale.
This article on blood glucose meters is from 3 years ago, 2017 but much of the information should be accurate still. https://diatribe.org/are-blood-glucose-meters-accurate-new-data-18-meters

But there is that little niggling doubt in my mind that Tyler's BG numbers could actually be a bit higher than you are getting with the testing. For that reason, I'd much rather see you try the drop dosing for a bit, to see what Tyler's BG numbers look like on that infinitesimal dose.

Keeping all paws crossed that he continues with those wonderful green BG readings. But since he is a long term diabetic, you want the strongest remission possible for him.

Tyler has been coming down the dosing scale quite beautifully the last few months. Let's keep that momentum going. So do keep testing with your current Relion Prime meter and try that drop dosing for at least a week to 10 days and then reevaluate. If there is any way you can test your meter against lab values, that could be helpful also.

http://www.felinediabetes.com/FDMB/...ng-reductions-and-starting-otj-trials.150160/

For your reading pleasure.

p.s. From Deb, who has written yet another "short story" in response to a question.
"Sorry about that chief." - Maxwell Smart

 

I agree with Sienne. His numbers are great.
I’d also try the drop and see how you go. You are doing a great job! You too Tyler!

 

Hey Deb I have to agree with you about some of Tyler's numbers, I actually didn't want to start the trial, I was wondering about starting the drop dose, I wanted to keep giving the 0.10 for a little while longer and gather more information.
Do you think I could postpone the drop dose for a while, and see what his numbers are with the 0.10, I'm really not in a rush to try the drop dose
What do you think about that

About the Relion Prime meter yes I came across that the other day and it made me worry. Now I'm wondering if I should change meters

I'm sorry but I don't know what you mean when you said
If there is any way you can test your meter against lab values, that could be helpful also @Deb & Wink

 

Thank you Bron, now I'm worried about the review on the Relion Prime meter , the article that Deb posted for me to read up on, I actually came across that awhile ago

 

Yes, go ahead and keep the 0.1U dose for a bit longer. It won't hurt. There is no rush. Tyler is doing well on the 0.1U dose, not dropping into too low numbers, in the 40's. If he did drop that low, then I'd say you need to reduce the dose, and the only dose smaller than 0.1U is the drop dose (sometimes called "some insulin").

If Tyler or Perry has an upcoming vet appointment for something else, your vet could take a blood sample and test it in-house using their lab equipment. Bring your meter to the appointment also, and test the same blood sample. That would be testing your meter against laboratory equipment, to see what the difference is in the BG readings obtained between your hand held glucometer and Lab equipment. Most vets will have some time of lab equipment in the clinic, such as Idexx or Antech equipment they have in the back. That is "in-house" equipment, meaning it's actually on site at the vet clinic.

The other type of test results, is when your vet sends out bloodwork, or urine, or other tissue samples to an off-site laboratory.

Even from one Relion Prime meter to another Relion Prime meter, there can be variability in the results.
No one test meter is perfect, no one meter meets the needs of every caregiver.

No, I would not change meters at this point. Simply be aware that the Relion Prime can be a bit less accurate than the FDA standards, and the the "repeatability" of some tests might swing a bit more than the 95% standard for meters. For instance, if you do a retest right away, because the first test number you got is a bit "unusual" from previous tests, there may be a bit more of a "spread" in the numbers between the 2 tests.

 

@Deb & Wink Yes I think I will continue giving him the 0.10 dose for awhile

Next visit to the vet I will remember to do that about testing it in house using their lab equipment

As for the meter, I got so nervous and was already looking at the other meters lol
I'm sort of a neurotic
I will stick with the Relion Prime
Thank you so much for your help, I truly appreciate it @Deb & Wink

 

Want to thank you for all your thoughts
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
I think I'm going to continue with the 0.10 dose for awhile before trying the drop dose
I appreciate all of your thoughts
I just feel more comfortable for now with the 0.10 dose
I hope no one is offended that I'm not going to try the drop dose yet after you giving me your thoughts
I truly appreciate them

 

I don’t think testing your meter against a test done in-house at the vets will achieve anything. The results will not be the same. I did that a few times in the early part of our FD journey and all it achieved was anxiety.

 

Most likely won't do it anyway, I don't need any more anxiety than I already have lol
A sick daughter who has RSD/ Complex Regional Pain Syndrome for 14 yrs now, no cure, not enough research, it's the most painful disease in medical history
Not many things to try for it

Perry with the kidney disease
Tyler of course
And now my dad who is showing early signs of Alzheimer's
I have enough on my plate , so not going to worry about the in house thing, it is what it is. At times I really feel ImI at my breaking point. Thank you again Bron @Bron and Sheba (GA)

 

One thing you may wish to experiment with is feeding. Tyler's pancreas is definitely sputtering. A few more meals spread out might help drop those preshots a bit. When cats get to small doses as your currently are at, it can help to feed a small meal at +8 or +9 to try to kick start the pancreas and push down those preshot numbers.

I also agree with Bron and Sienne on the dosing. If you are worried that is too little insulin, try counting the number of drops in your current 0.1 unit dose. Just twist the plunger and try to get even sized drops out. Then the new dose could be half those number of drops. Who knows, that might be "some" insulin. We have had caregivers measure drops in the 0.1 unit dose before, and discovered it's it was really just a drop, others had quite a few drops and could fine a lower dose.

 

Hi Wendy thank you for replying back
So you mean fill the syringe to the 0.10 line, then twist the plunger and count how many drops I get until there is one drop left, the pull the plunger down to suck that one drop back in, I read this on one of someone's posts

Or do you mean some people give more than one drop

 

I mean that people first count how many drops are in the 0.1 unit dose they are giving, by squeezing out all the drops. Then based on how many in that count, they decide whether the next dose is the one drop or more.

 

Diane you certainly do have a lot in your plate and I can well imagine you must feel at breaking point.
When you are anxious about something, everything can become overwhelming. Please remember you are doing an amazing job with Tyler and the meter you have been using has been fine up until now. I can’t see anything in his numbers that would indicate that the meter is not working as it should.

A coincidence.. I read this article yesterday.
https://www.google.com.au/amp/s/amp...n/news-story/a1dfe9ac15f9bd564b99c44074098bb3

 

OK I think I got it, I counted out some out before, it was 7 one time and 8 the next time
Let's just say I counted out 8 , so when I am ready to shoot I count out 7 and that last drop left I would suck up back into the syringe?
Sorry if I'm not getting it
I will try to spread his meals out better and at +8 or +9, believe me he gets enough snacks through the day and night cycle

 

Wow that is a coincidence, most people have it in their limbs, Ashley mainly has it in her ears, she cannot go outside, other than doctor visits
Any sound will make her ears worse, like someone is stabbing her with an ice pic, then the pain leads to her entire face, neck, eyes, even teeth
Its a pain in the summer, people cut the lawns, leaf blowers, we have to leave the house and go park some where until they are down
Do you know how exhausting that is
Same thing in the winter , snow blowers, leave the house

They do offer ketamine infusions which she has had, 10 days in a row, to long to explain but they didn't help

Most people get relief with some options, but not Ashley because of it being so bad in her ears, been all over, NYC, NJ, Michigan, Philadelphia, Florida

No doctor has come across anyone as bad as her having it in the ears, so its like she's in prison. No quality of life what so ever

And she's such a loving daughter and has so much to offer some one but it's not in the cards for her, my heart just breaks

I can't even begin to tell you about the depression and loneliness she feels

She also had 2 jaw surgery's for TMJ and that made the ears worse, besides that the jaw is all screwed up again , can't have another surgery, that would kill her

So alot of jaw pain now, which makes everything worse
What people read on the internet doesn't even come close to what people go through
I belong to many support groups and it's heartbreaking to read

Its actually known as the Suicide Disease, her best friend , same age 31 committed suicide 3 years ago, she couldn't take the pain any longer and didn't want to live yet life in bed
Many have committed suicide, mothers, dads, younger people
The damn Center for Disease Control and the FDA have no idea how many kill themselves
This is not a rare disease like many think, the number is overwhelming
Its been around since the civil war

They will never find a cure for this
Its just me and her, husband died 11 years ago age 51
I do have a sister and brother and my dad , but told you about him
He's all there yet, he is just sick over Ashley
She just doesn't want to live any more ,but doesn't want to die either

I'm sorry I'm rambling on.
If I could switch places with her I wouldn't think twice
She is 33 yes old , so got this around 19 or 20
Never got to experience those years, so she doesn't feel like she's 33
No boyfriend , her friends dumped her because she couldn't go out
So sorry to keep going on,
I will stop now because it just makes me furious ,angry and helpless that she has this . Thank you Bron for your kindness
I'm sure we will speak again

 

If your 0.1 units has 8 drops, maybe your next dose should be 4 drops. I just wasn't sure if how you measured 0.1 units was bigger or smaller.