New Member (sorta!) and Looking for Advice about BG

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Keviiiiiin!, Aug 11, 2020.

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  1. Keviiiiiin!

    Keviiiiiin! New Member

    Joined:
    Jun 30, 2020
    Hi there! I am Lucy, and my cat is Kevin. He was diagnosed on 6/18/20, and we've been learning as much as we can about managing his diabetes together! Thanks to this group, we changed from all dry Royal Canin to all Fancy Feast pates (thank you for that amazing food spreadsheet!!), and we've started to try to take home testing more seriously. Anyway, I've been reading all the posts and educating myself, and couldn't have gotten through the initial struggle without this group/the FB group.

    Diagnosed: 6/20
    Insulin: Lantus 2u/day

    I do have a question about Kev's BG. Here's my spreadsheet: https://docs.google.com/spreadsheets/d/1X5y-vpmPDy3l0WXEvRy7Unc9oUrKSDNoO-EK4mHQd7U/edit?usp=sharing

    As you can see, we didn't start testing every day until about 7/21, and then didn't start testing AM and PM until 8/4. I am learning!

    My questions are for over the past 10ish days with the AlphaTrak2:

    1. Have we been doing the right thing by not shooting when it's green?
    2. The 69/78 -- isn't that lower than a normal cat's BG range? Why is that happening? Is that ok?
    3. Does the AlphaTrak measure a bit higher than the ReliOn? It seems higher recently than the earlier numbers that I got with the human meters.
    4. Is it normal to miss so many shots like this? We've skipped so many lately.

    Anywho... thanks so much for any advice you may have, and more than anything, thanks for all the wonderful information on this site. My new hobby is just reading threads on here.
     
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  2. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    First of all...I think I would have named this kitty Kevin. He actually LOOKS like a Kevin! Hello Keviiiiiiin! lol and Hi Lucy!

    Yeah I'm afraid youre going to need a few more numbers in this spread sheet for our helpers to give accurate advice. I do believe some of our helpers (who have been around a long time) can glean some kind of action, from what you have recorded.
    Hold on for more advice and WELCOME TO OUR HEALTH FORUM!
    jeanne
     
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  3. Keviiiiiin!

    Keviiiiiin! New Member

    Joined:
    Jun 30, 2020
    Thank you so much, Jeanne! Our vet has been asking us to do a home curve as well... I think that I'm a little intimidated, but I know I just need to do it! Especially if it helps to get better and clearer numbers for him. Thank you for the nudge!
     
  4. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Hi Lucy , Kevin is adorable
    You really have no tests after any of the pre shots AM or PM
    I don't think anyone can give you any advice on doses
    Can you get a test in let's say @+3 , @+5. @ 7
    Then next time @+4 , @+6 @+8
    So we can see how the lantus is working, what his lowest BG will be
    This goes for both AM and PM tests
    Scatter the tests at different times of the day and try to stick with one meter
    Do you think you can do this
     
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  5. Dusty & Roe

    Dusty & Roe Member

    Joined:
    Apr 28, 2020
    Hi Lucy and Kevin Lucy you will find this group is so knowledgeable Please ask any questions you can think of that is how you will learn A Great Big Welcome to the both of you Kevin is such a Cutie
     
  6. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Hi Lucy!

    Welcome to you and Kevin! Have you considered checking out the Lantus / Basaglar/ Levemir Insulin support group (ISG) on this site? there is a lot of Lantus specific information (including dose change information) and many members highly experienced in using Lantus. This ISG can seem overwhelming at first since there are a couple formatting protocols with titles and a lot of traffic, but the community is totally welcoming and will help you get comfortable :joyful:

    One thing I notice is that you are using the wrong spreadsheet for the alphatrak, animal and human BG monitors are not the same (as you reference in your post) so there are actually different goal posts for what are safe and dangerous numbers when using them. I recommend switching to the World Spreadsheet Template for Pet Meters so that you have a more accurate idea of when Kevin is in safe or dangerous BG levels. You can find it, with directions how to use it HERE

    Congrats on switching to fancy feast! what a financial relief eh? I was so happy to know that there are affordable options safe for a diabetic kitty :)

    RE: Your Post:



    Short Answer: I think yes.(my opinion)

    Long Answer:
    When you start using Lantus, the general consensus on this forum is that it is very helpful to choose a dosing method meant for a depot style insulin such as Lantus. There are two to choose from (linked above) Start Low Go Slow (SLGS) and Tight Regulation (TR). Please read over the sticky in the Lantus ISG (also linked above) to see which one might work best for you. It is important to note that you don't have to stick to one method forever, for example, I started as SLGS and then switched to TR once I felt I was ready for it. It is also important to note that both of these dosing methods were developed for a human glucosometer, I chose to use human due to price point mainly but do what is right for you ;)

    With that preamble behind us, due to the amount that you test, right now you basically would be advised to stick with SLGS, as TR requires more frequent testing and more frequent dose changes. SLGS suggests that with any numbers below 90mg/dL(on a human meter) that a decreased dose of 0.25u is actually recommended. This would bring Kevin's dose to 0.75u. You are getting below 90 on a pet meter so I feel it is even more advisable to decrease dose.

    If you aren't comfortable following these dosing protocols I definitely think it is advisable for you to be skipping any green numbers ESPECIALLY since you are using the human spreadsheet for a pet monitor.


    For a cat without diabetes, it is normal to see some of these lower numbers as it is their natural BG level *however* Consider that using a pet meter anything 68 and below is considered risk for a hypoglycaemic event.

    When you get into these lower numbers that are produced with the use of insulin you really need to be careful because it isn't the cats natural BG level... it is produced with insulin. The insulin *could* cause Kevin to drop lower and worst case scenario drop Kevin into a hypoglycaemic event. If you are getting numbers this low I definitely recommend propping his BG up with some MC or HC food and testing again after 15 mins and then 30 mins to see if his BG is coming up.

    It is very important that you read the sticky on treating Hypos, which from your post I am sure you already have... but just in case Please go over this sticky on how to recognize and prevent Hypos



    It does, there is no direct comparison that can be made between human and pet meters for conversion, but generally pet meters read higher than human. It is best to choose one meter and stick with it, instead of comparing results between the two. And to double down on my above tip, I think it is important you switch to the pet meter spreadsheet so you are using the right BG reference ranges :)


    While I agree that you don't have a lot of test data, with the numbers you are seeing in Kevin, along with the skipped shots, I personally would decrease the dose in his situation. Would you be comfortable trying 0.75u 2x/day? HERE is a sticky outlining measuring doses.

    You really are doing great testing Kevin, but as others have mentioned a curve would be really helpful to understand how his cycles are really going, additionally, I really would like to encourage you to at least grab a test before you go to bed at night, most cats have a tendency to drop at night and a before bed test is the best indicator for if you need to be worried about that happening.

    @Marje and Gracie, @Wendy&Neko and @Sienne and Gabby (GA) are our site moderators and have a great understanding of how Lantus works: if one of you ladies have some time, would you mind taking a look at Kevin's SS and Lucy's questions? Additionally, I have recommended the idea of a decrease to Lucy. I would value one of your opinions as a second opinion.

    Sorry for the lengthy post, I have a habit of being long winded:)
     
  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Please switch to the pet meter spreadsheet like AmandaE suggested so you are using the right BG reference ranges , Good Catch @AmandaE :cat:
     
  8. Keviiiiiin!

    Keviiiiiin! New Member

    Joined:
    Jun 30, 2020
    Hi Diane, yes! I can do this! I'm committing to this curve :) Thank you for the advice on alternating the hours I do it!
     
  9. Keviiiiiin!

    Keviiiiiin! New Member

    Joined:
    Jun 30, 2020
    Amanda, holy cow!! I wish I could send you some appreciation flowers for the time you spent on your reply. It was incredibly helpful. And DOH! I remember seeing the two spreadsheets when I was setting up, and of course that flew out of my mind as soon as I had my human glucometer. Thank you SO MUCH for the reminder. I'm updating my spreadsheet immediately to the pet one, and will update my link in my bio, too! I'm so happy you caught that.

    I read the thread on hypos, but will re-read. And I'll work on getting additional testing data. I was a tiiiny bit intimidated by the ISG, but you have given me the nudge I needed to just dive in and get educated! I'm SO grateful for your reply! It made a big difference for how I'm navigating this with Kev.
     
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  10. Keviiiiiin!

    Keviiiiiin! New Member

    Joined:
    Jun 30, 2020
    On it! Oh my gosh I feel so silly, but I'm so glad you all caught that. Thank you!!
     
  11. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Don't feel silly at all, there is so much to take in and we all can't remember everything. Just a reminder just checked your spreadsheet, don't forget to change the 2 green numbers up top to read the pet meter numbers, also in your signature please add you are using the Alpha Trak

    Dark green 68-99
    Neon green BG <68 :cat:
     
    Last edited: Aug 11, 2020
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Where do you live? If it's in the US, you want to use the US spreadsheet for the pet meter

    Anyplace else in the world, then you'd use the "World" spreadsheet for the pet meter

    And if you get tired of paying $1 per strip for the AT strips, there's no reason you can't use a human meter. Most of us do and all the dosing methods we use were developed using human meters so we're very comfortable with them.

    When you start testing 4-10 times a day, those $1 strips add up quickly!!
     
  13. Keviiiiiin!

    Keviiiiiin! New Member

    Joined:
    Jun 30, 2020
    I grabbed the US one -- which is the right one for me. Thank you! I've updated my signature, too, with my new spreadsheet. And yes, I am not getting rid of my sweet little ReliOn Compact, because those AlphaTrak test strips are so expensive. I switched over to the AlphaTrak recently because my vet gave it to me. I was having trouble getting a big blood drop from Kevin, and he was having FEELINGS about me sticking him a bunch of times in one sitting. My vet said that I might have more luck with the AlphaTrak2, and she was right, it takes less blood. However, not being an heiress, I feel the pain of those strips.

    Also, unrelated, is it weird that I fangirled a little when you replied? In my mind, you are a FDMB celebrity lol.
     
  14. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Hardly, but I appreciate the confidence and compliment! I learned from some of the best! (who are mostly still here, like Marje and Gracie, Wendy&Neko, Sienne and Gabby)
     
  15. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    LOL she is! :D

    eta Rock Star is more like it. At least to me. :)
     
  16. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Me too!! a simple mistake... much like the 'World' template I recommended... default reply since I'm from Canada ;)

    Glad you liked my lengthy post, it was my pleasure :D

    It is totally intimidating, but definitely worth throwing yourself in there, you will learn a lot in a short amount of time. Plus it is good to have a group of members that you're familiar with that know the general effects of the insulin that you can count on to steer you in the right direction!

    hope to see you over there :cat:
     
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