? Help! Confused readings

Discussion in 'Lantus / Levemir / Biosimilars' started by Mimis mom, Oct 19, 2019.

  1. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    I have another question- what does it mean when the dosing methods were designed for the human meters (when referring to lantus). I am confused on the difference- I started with the freestyle lite, but after getting a super low reading and bringing her in to check on her (this was saturday october 12) they told me the human meter read 30 against the alphatrak which read 71... I don't get it. someone explain this to me like a kid. lol
     
  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    It is important to test before you feed and shoot to
    1. Make sure the number is high enough to shoot
    2. Make sure the cat will eat.

    Thanks to you and Marje for getting the spreadsheet up and running.
     
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  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Hi Rosa
    I see you have the SS up and running. That is great. Thanks @Marje and Gracie for helping with that.
    Don't forget to put in the amount of insulin you give each time you give it please.

    There are 2 different types of meters you can use to test Mimi.

    1. A human meter such as a freestyle lite or ReliOn meter plus many others.

    2. A pet meter such as Alphatrak.

    A human meter numbers in a cat are lower than a pet meter. This is normal.
    And it is perfectly fine to use a human meter for a cat. Most of us do here.
    Our two dosing methods are based on a human meter and we recommend you use a human meter.
    The normal BG numbers for a cat on a human meter are 50 -120

    On the Alphatrak meter the normal numbers for a cat are 68 - 150

    One of the main things to consider is the cost of strips
    It is much cheaper to run a human meter than it is to run a pet meter.

    The other thing to consider is that our two dosing methods are based on human meter readings not pet meter reading.
    It is much easier to follow the methods I think when using a human meter.

    Also it is much easier and quicker to get hold of human meter test strips.......

    It is probably more convenient for the vet if you have a pet meter, however you need to consider the cost and the convenience when using one of the dosing methods.

    Does that make sense?
     
    Last edited: Oct 20, 2019
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  4. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Hi Rosa,

    You have not put any times on your spreadsheet yet.
    Can you tell us what time you gave insulin this morning? and how much?
    The information is needed to help you with tonight's time and dosing. Do you want to get back to 9:30am and 9:30pm?

    It will all become second nature soon. I promise.
     
  5. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    This has not been established by the company or by vets. Roomp and Rand used 68 as the number on the AT below which to give reductions just based on safety margins.

    Rosa asked me the same question in a PM and I’ll reply here. The reason the readings are lower on a human meter is because it is calibrated for human, not feline blood. However, through the German Cat Diabetes Forum, and later Dr. Rand and Kirsten Roomp, the ranges for cats using a human meter were established. It is important to note that you cannot and should not draw a parallel between the two. Roomp and Rand in the Tight Regulation Protocol which I linked above, indicate that, for purposes of safety, below 50 should be used as the reduction point on human meters and below 68 on pet meters. This does not mean that 50=68 or that the two meters will always read 18 mg/dL apart.
     
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  6. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Thanks for clarifying Marje
     
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  7. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I do see these numbers stated alot. I bet if you asked ten different vets, you’d get ten different answers ;):blackeye: I’ve even seen some FB groups put those numbers on their pages as “normal” numbers.

    For our purposes here, if one is using Start Low Go Slow, the numbers for increasing, reducing, or holding the dose are the same regardless of whether you are using a pet or a human meter. For our purposes here, if one is using TR, the only difference in the ranges for increasing, reducing, or holding the dose is the reduction point. All other ranges are the same for human and pet meters.
     
  8. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019

    Yes it does make sense, however I did purchase an alphatrak as well as a supply of strips.. I have both meters. the strips are expensive, 50$ for 50 strips! And what sucks is if one is defective, well..

    Dr Pierson from catinfo said to purchase strips from eBay, which I did with the freestyle lite meter, but since I kept getting crazy low numbers I wondered if the strips were defective or damaged? (for instance one night it was 34)
    Im going to post all the numbers from the human meter asap.

    So what do I do then? pet meter or human? Here this whole time I thought i was being responsible getting the pet one :(
    so what does it mean then? if the pet meter is reading a certain number, I can't know what to dose with human Lantus? I read somewhere that the human meters read lower than normal because humans eat more variety of meals than us and they need to be more cautious or something to that effect. let me find the article.
     
  9. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    also, another question off topic.. I have an 8000$ vet bill coming my way, and with all the future expenses I will have for Mimi as well as "what if she gets sick in another way"
    are there any charities or do people do fundraisers to maybe help with the cost? I make 30,000 a year and I already had 3000$ I owed from earlier in the year from her bladder surgery.
    Its so expensive, I don't know what to do.
     
  10. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    where do you enter the time??
     
  11. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    It is best to stick with one meter or the other.
    Trying to go back and forth between a human meter and an animal meter does not work. It is like comparing apples and oranges.
    We do know what numbers are good and what numbers are not on both types of meter.

    The "take action" number on an AlphaTrak is 68.
    Because Mimi went below 68 on the AlphaTrak last night, it was recommended that you decrease the dose by 0.25 units.

    The "take action" number on a human meter is 50.
    If you had been using a human meter, the number would definitely have been below 50 and it would be recommended that you decrease the dose by 0.25units.

    A high reading is a high reading on any meter.

    We can help you figure out dosing for Lantus.
     
  12. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    For tonight, entire the time in the unit column on the row of today's date 10/20/2019. So, 1.25u @11.30 (or whatever the time is when you give the insulin
    Tomorrow morning, you would enter the time and unit in the unit column of tomorrow's date 10/21/2019.

    If it would be easier, @Marje and Gracie can add a time column.
     
  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    No, please do not do that. It makes more work for me to fix it. It’s quick and easy for me to add a time column for you.

    Quite often here, there are alot of people posting quickly so it’s really important that you always scroll back and make sure you didn’t miss information. The link I gave you on the two methods discusses dosing. :):) However, we recommend that if you get a 150 or below (either meter), that you don’t feed her and don’t give insulin yet but stall the shot and the meal and post here first. There is usually always someone around who can walk you through the options and whether you should shoot or not; if they recommend you shoot and you do, someone will stay with you to be sure the BG doesn’t drop too low.
     
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  14. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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  15. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    You’re welcome and it’s done :):):)
     
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  16. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015

    The 34 you got on the human meter was most likely correct.
    If you get a low number like that again......do another test to check it was correct.
    Any number under 50 on the human meter and under 68 on the Alphatrak meter are the take action numbers.
    To take action..you feed some high carb food .......or if the number is much lower than 50 add some honey or Karo othe high carb food.
    Do you have some higher carb food at home?
    And honey or karo at home?

    As you have those large bills to pay the vet, I would swap back to the human meter and just use that....because it will be much cheaper for you to use a human meter in the long run.
    And as the two dosing methods ( tight regulation and start low go slow) are based on the human meter, that will be much easier.

    We can help you with the dosing which means you won't have to go back and forth to the vet and that will save money.
    At the moment we really want to get Mimi completely over the DKA and you can help with this by ensuring she gets enough food, her insulin every 12 hours, plenty to drink and you are testing the BG levels before every shot and during the cycle.
    If you can make sure all these things happen she should be much better soon and you won't have more vet bills....
     
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  17. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Does she still have DKA? when she was discharged she had no trace of ketones anymore.. I haven't figured out how to test her here because I have missed when she pees!! I haven't been home longer than a few hours to try and watch her closely. I think I need the blood ones..
    Also, should I use up the Alphatrak ones at least since I just bought 50 of them? I am still confused on how you dose differently depending on the meter- do you mean when you guys look at my spreadsheet and see Im using an Alphatrak you take that into consideration? Am I overthinking this?
     
  18. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    I also finished her spread sheet!! its up to date! took me almost 3 hours, just inputting
     
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  19. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    Also, this is for the group- Why do you think she went DKA in the first place if I was treating her? was it the Vetsulin? The emergency vet said that usually happens to cats that go undiagnosed? She was on frozen raw all summer after her bladder surgery, but again that was the one with 8 % fruits and vegetables which I didn't know about...
    She also was overweight (15 lbs) from the time she as probably 6 to 10 (she's 10 now)
    after the bladder surgery in May she started to lose weight which I thought was because of the switch to raw, but then she lost a pound in a week and thats when I brought her in

    She did have Pancreatitis and Gall Bladder buildup, which was treated with antibiotics, Zofran and Urisodiol.
     
  20. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    As I mentioned before in a post, Mimi does not still have DKA but she is recovering from it, and there is still the possibility of ketones reappearing if she does not get enough food and insulin. So to prevent that happening, we want to do everything possible to get her better.

    So your job is
    • Make sure she is getting plenty to eat over the day and night
    • Make sure she is getting her insulin
    • Make sure you test before every shot to see it is safe to give the insulin
    • Test inbetween the shots to see how low the insulin is taking Mimi
    • If you are unsure what to do, post and ask for help
    • If the BG is under 150... stall ...don't feed and don't give the insulin and post and ask for help. Test again I 20 minutes to see if the insulin if going up.
    • Try and test for ketones.....important!!
     
  21. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    A high number is a high number on both meters. It is the low numbers especially where we take the fact that you are using an AlphaTrak into consideration as it is the lowest number during a cycle that dosing is based on.

    Well done! Congratulations!

    DKA = not enough insulin + not enough food + an infection or inflammation going on somewhere. The pancreatitis and gall bladder would have tipped her over the edge into DKA. Losing a pound in a week means she was not eating enough as you thought she was.
     
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  22. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I have. To go out in a minute but looking at her SS Mimi had 4 missed doses of insulin in a few days and then she didn't eat a lot on the last day. Both those can contribute to ketones forming which then lead to DKA if u treated. If she had an infection or inflammation as well...the. That completed the recipe that's needed for DKA which is
    Not enough food/calories
    Not enough insulin
    An infection or inflammation
     
  23. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Rosa, do you think you could print off this whole thread and keep it for reference please.?
    It has a lot of information for you in it and if you had it printed off you could Hilite some of it .
     
  24. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    ok so 150 on the pet meter I assume- or both human and pet.. or did someone just say that- sorry I haven't slept much, I am exhausted
     
  25. Mimis mom

    Mimis mom Well-Known Member

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    Yes I will attempt to - let me see if my printer is working properly
     
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  26. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    ya and me not knowing I could have just lowered the dose instead of skipping all together- which I did not know - I was just so scared of HYPO and I thought she was maybe getting better.
     
  27. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Both meters.
     
  28. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019

    the pound a week (she's at 10.2 now I think) was more like- she was 11.6 one week (this was in August, before diagnosed) I wanted to weigh her because she seemed to be getting smaller, and thats when it was 10.4. During this time she was ravenous. inhaling her food and wanting more. eating way more than I ever saw her eat in the 10 years Ive had her.
     
  29. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    It's hard if the vet did not tell you
    However you have come to the best possible place now and we will help you.
    Remember if you are unsure of anything ...just ask.

    Have you got any more tests in Yet?
    And when is the next dose of insulin due?

    I have to go out now but will look in later.
    Hopefully @Red & Rover (GA) twill be around for a while
     
    Last edited: Oct 20, 2019
  30. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Unregulated diabetic cats cannot process their food properly and so they get hungry messages from their brain. As Mimi becomes more regulated, her hunger will decrease.
     
  31. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    I'm around for another 45 minutes. That will be 12:30am EST. I have an earlier than usual morning.
     
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  32. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    ok just tested her- she's about 30 minutes from the last time I gave her a dose and she 165... she was on 1.25 units
     
  33. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Okay. Do not feed yet if you have not already and take another test 20 minutes after the first test.
    Going to try and get some eyes on your spreadsheet.
    @Marje and Gracie @Bron and Sheba (GA)
     
  34. Mimis mom

    Mimis mom Well-Known Member

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    she also had a small meal at 8:00 pm
     
  35. Mimis mom

    Mimis mom Well-Known Member

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    ok! thank you!
     
  36. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Did you get another test in?

    To add the test to your spreadsheet, since it is considered part of the same hour as the PMPS:
    Click in the PMPS box.
    Place the cursor after the 165
    Insert a comma then the new number @+.3
     
  37. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    tested again- 184.. I need to know what i should dose her so I don't get too off schedule
     
  38. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    updated in SS
     
  39. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Mimi is slowly on her way up.

    If you can test tonight, feed her, then give the 1.25 units.
    You would need to test at:
    +1 (there may be a food bump, ignore it – food wears off and the number is not a sign that Mimi is safe and you can go to bed)
    +2 (to see which way Mimi is headed, up or down)

    If +2 is the same or lower than the shot number, then you would need to test at +4. A +4 is probably a good idea anyway.

    @Bron and Sheba (GA) is in and out (she's in Australia) but should be back around +4.

    @Chris & China (GA) is often online at this time of night (she's in the US).



    If you run into low numbers, here is the What to do in case of Hypo link. The document is written for a human meter.
    Since you are using an AlphaTrak, the number you do not want to go below is 68.

    And from Don't Panic. How to Handle Low Numbers (here, I have changed the numbers to AlphaTrak numbers for you)
    If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 68mg/dL or 2.8 mmol/L.)
    • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
    • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
    • Repeat the above steps every 15 – 20 min. until your cat tests in the 68 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
    • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
    • Test in an hour and follow the same steps.
    DO NOT become complacent. If numbers have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
     
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  40. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    so give 1.25 units right now?? after she eats?
     
  41. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    If you need to change the title of your thread to 911.
    Go up to the top right corner. Click on "edit title"
    upload_2019-9-19_11-4-47.png

    Then change to a 911


    upload_2019-9-19_11-5-35.png


    This also allows you to put the current numbers into the title of the thread so that people can see that the situation is serious.
     
  42. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Yes - if you can get a few tests in later tonight.
     
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  43. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    ok on it, thank you!! Ill be updating!
     
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  44. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    You will need to test an hour from now at +1.
    If that number is similar to or lower than 184, immediately ask for help.
    If the number is higher than 184, then you need to get a +2 test to see if the +1 was a food bump.

    I likely will not be online but someone will be.
     
  45. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    G'night. I hope you and Mimi have an easy night.
    Do post your +1 and +2 numbers so that anyone reading your thread can keep track of Mimi. Questions on the numbers are welcome.
    And holler for help if needed.
     
  46. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I’ll be watching for the +1 and +2 readings Rosa.
     
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  47. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    +1 number is 218.

    will wait for +2 to see if theres a bump. . if it goes up from 218 on +2 is it safe to go to bed? lol.
     
  48. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    also, Alphatrak is the same company as freestyle.. I put one of the freestyle test strips into the AT and it seemed to read! it was like 208 with the freestyle test strip and then 218 with the ones from the AT container.. they look identical. hmmm
     
  49. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    That's normal to see a bit of a food bump like that.
    And I see you have already put it in the SS..well done! That's great!
    Let's see what the +2 is
    I'll watch for it
     
  50. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    No don't use strips from another meter with your Alphatrak meter. It is not safe.
    You would be far better off just sticking with the human meter when you run out of the Alphatrak strips.
    Safer and cheaper.
     
  51. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    2+ is 209
     
  52. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I would get a +4.
    Can you set the alarm for 2 hours?
    Will you wake up?
     
  53. Mimis mom

    Mimis mom Well-Known Member

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    Yes I will. Does this number seem normal at all?
     
  54. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    So far so good.
    You are both doing well.
    Are you going to give her a low carb snack soon as one of her new routine snacks we talked about yesterday?
    See you in two hours.
     
  55. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    +5 point 169

    just gave a plain turkey slice afterward (inhaled it right up)
     
  56. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    i gave her some freeze dried raw turkey bites
     
  57. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Rosa, Mimi is having a very nice cycle.
    Are you able to leave some food out for her that she can just eat herself without the other cat getting to it?
    Maybe put her in a room on her own without the other cat?
    If you can do that, I think you would be ok to go to sleep now.
    Leave out a good portion of low carb food for her to snack on for the rest of the night.
    I will wait for the answer.
     
  58. Mimis mom

    Mimis mom Well-Known Member

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    Ok sounds good. She’s cuddling with me right now
     
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  59. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Can you give her more food and separate her from the other cat?
     
  60. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Please start a new thread for Monday. This one is getting way too long. You want to start a new thread every day. Please see the format for the subject line -- Date. Cat's Name. AMPS-#, +#, etc.
     
  61. Mimis mom

    Mimis mom Well-Known Member

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    Oct 12, 2019
    I gave her that turkey slice after, and passed out.. I was so tired..
    can you tell me what the hash tags mean for when I start a new post?
     
  62. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    The hashtags is the number of the readings. Take a look at the home page of the Lantus forum and you'll get a good idea as to how to create the title for the new thread: http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

    For example, yesterday's thread should read: 10/20 Mimi AMPS = 438 / PMPS = 165, +1 = 218, +2 = 209, +5 = 169

    You'll update the title as the day goes by and if you run out of room I'd just delete the numbers that aren't important (low numbers and PS numbers are important).
     
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