? To shoot or not to shoot?

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Squeakycats

Squeakycats

Member Since 2017
Hi, all--

I could use your advice again tonight. I'm trying to keep my kitty Misha on a small amount of insulin just a little longer, to see if we can get him to where his numbers are in the green zone more often, rather than the blue. I keep getting into situations like tonight's, in which I'm not sure whether to proceed with his (tiny, tiny) injection.

I normally test/feed/shoot around 7:30 pm, but when I got home at 6:00, he was really hungry. I tested then, and he was at 120 on the AlphaTrak--65 on the Relion meter. I fed him and figured I'd wait and test again closer to his usual time and decide about the shot. I then fell asleep on the couch :rolleyes: and have just tested him again now--it's 8:30. He's now at 111 on the AlphaTrak--I didn't do the Relion because I didn't have enough blood and his ears are getting really sore.

I know the general idea is "shoot low to stay low," and I guess I could go ahead and plan to get up and check him during the night, but...is that probably the right thing to do? My husband is able to stay home tomorrow and keep an eye on him if necessary (I suspect we'll be facing some version of this choice again in the morning). Am I right that I should go ahead with it and just try to keep an eye on him? Or should I just let him be and see what's up in the morning?

I'm about to put all this stuff in my spreadsheet...
 
Shooting low is scary. I usually go for it, though. I use an AlphaTrak. When Yum has blood work done, the labs say the normal range is 71 to 159 or 72 to 175. I don't worry about boosting her numbers until they go below 68. I see you skipped the drop. I'm sure that was a good decision too.
 
Hi

I'm really sorry no one saw your post and came to answer your question. I agree that Misha probably needs to stay on insulin a little longer. Since it was so much later when you woke up, skipping was probably the better decision, as you would have had to work your shot time back in 15 minute increments. If the situation is similar in the morning (without the nap), since your DH can monitor, I would go ahead and shoot.

I find your SS a bit confusing. It says at the top that you are using the Alpha trak, but some of your cells have (AT) next to second readings. At what point did you start using both meters? After that point, are the readings from the human meter, except where noted? I would encourage you to chose either the AT or the human meter and stick to it, as comparing the two will drive you, and anyone who tries to help you, crazy!

Sometimes, when we have a cat that is on a micro dose and keeps earning reduction, but is still hitting blue numbers, we recommend you try feeding a slightly higher carb food so you can keep giving insulin without risking a hypo. So if Misha is currently getting a 3-5% food, try a 8-10% one. Of course, this only works with cats that are fairly carb sensitive.
 
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Thank you both! Sorry about the spreadsheet! I have been trying to decide which meter to use, but I have a separate spreadsheet now for the Relion, so I should clean up the AlphaTrak one. It's confusing...the Relion numbers seem to be green more often (on the other spreadsheet I set up that is based on the human meter template). I am confused about whether he would count as in the normal range if I were only using the Relion meter, and if so, what that would mean. He's not symptomatic.

That's a very interesting idea about the food--and I think I might feel more confident if I could leave something slightly higher carb out for him to snack on if he feels like it, even if I don't totally change his diet. I haven't tracked things well enough to have a good sense of how carb sensitive he is. I guess this is all sort of an experiment. I wish the stakes were a bit lower! I don't know what I would do without all the wonderful folks on this board!
 
Squeakycats said:
Sorry about the spreadsheet! I have been trying to decide which meter to use, but I have a separate spreadsheet now for the Relion, so I should clean up the AlphaTrak one.
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Sorry, I didn't realize you had a second spreadsheet. I was in a hurry and just clicked on the link without reading. :oops:

Squeakycats said:
That's a very interesting idea about the food--and I think I might feel more confident if I could leave something slightly higher carb out for him to snack on if he feels like it, even if I don't totally change his diet
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You could go with something like 10-12% or so. Try it when your DH can monitor, and then you'll know.
 
I should be able to try this weekend, if I can find the right food! (His chicken allergy and general fussiness always make life complicated on that front.)

110 AlphaTrak and 67 Relion this morning...classic! I went ahead with his tiny dose; DH is going to keep an eye on him today. And I can be home and actually test him tomorrow.

I do have a second sheet, but right now I think I still have numbers in the AlphaTrak one from when I first started messing with the Relion; no reason now to keep those there!
 
Squeakycats said:
I should be able to try this weekend, if I can find the right food! (His chicken allergy and general fussiness always make life complicated on that front.)

110 AlphaTrak and 67 Relion this morning...classic! I went ahead with his tiny dose; DH is going to keep an eye on him today. And I can be home and actually test him tomorrow.

I do have a second sheet, but right now I think I still have numbers in the AlphaTrak one from when I first started messing with the Relion; no reason now to keep those there!
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AlphaTrak officially says their numbers are 20% to 30% higher than human meters.
 
MJW said:
AlphaTrak officially says their numbers are 20% to 30% higher than human meters.
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Side by side comparisons by people here have shown that isn't consistently true.

ETA: Pick one meter and stick with it, or you will drive yourself crazy.
 
Wendy&Neko said:
Side by side comparisons by people here have shown that isn't consistently true.

ETA: Pick one meter and stick with it, or you will drive yourself crazy.
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I agree 20% to 30% is off. I keep a table of dual measurements when I see them on spreadsheets and the ratio of human to AT2 ranges from 56% to 80% so far. A rather wide range.
 
So many decisions to make...some people say the pet-specific meters are more accurate, but others point out that they've successfully managed cats for years using the human ones, which are cheaper to use (and easy to get strips for immediately if I run out for some stupid reason). The Alpha Trak numbers suggest he still needs some insulin; the Relion ones, if I'm reading that spreadsheet right, suggest he may already be in the normal range. I want to do what's best for him and am not sure how.

Same thing with food...I know I need to avoid chicken--I have what I think is very good evidence that he has a true allergy to it. But should I be doing raw food? Raw food advocates tell stories where it seems to have cured everything, and they have answers for other people's objections. But the objections make sense to me, too, and a veterinary nutritionist I highly respect strongly recommends against raw (she's an actual specialist at a vet school who was incredibly generous and caring in helping me sort out the allergy issue, and she shared what seemed to be legitimate, independent studies). She also said that the scientific jury is out on canned food vs. dry and had evidence for that--and I really do respect her opinion. I asked her directly about studies being influenced by food manufacturers, and she sent things that weren't (that was specifically about the raw food, but I assume she had them for the dry vs. canned as well) and displayed such a genuine desire to help my cat--she asked about him regularly even when I didn't contact her. But of course Dr. Pierson makes a very compelling case that wet food is absolutely critical; what she says makes intuitive sense to me, and having had a kitty in the past who had a urinary tract obstruction, I know that I do not want to have that happen ever again if I can help it. But I know several people whose cats have never eaten a bite of wet food in their lives who have lived to 17 or 18 in apparently excellent health--that's anecdotal, but a lot of the evidence in these discussions appears anecdotal. I've spent god knows how much money trying out different canned food that my cats snub, but they'll happily eat Evo, Young Again, not-too-moistened Primal raw nuggets...crunchy things. But I don't want to choose what's convenient for me over what's best for them and just let them manipulate me, which I think they love to do!

And even if you make a choice about wet vs. dry food and are content, you have to pick a particular brand and decide how often to feed it--if you go with the dry, do you listen to the Young Again people who say you can just free-feed it (that would be so convenient, obviously) and have your cats lose weight (my civvie needs to) and be less anxious (my civvie is anxious about food)? Or do you listen to people whose cats binged on it and gained a bunch of weight? If you pick wet, again, which brand? And how often--2 meals? 3? Leave it out all day? Is fish ok (that'd be nice for me, since chicken is out and I am afraid to try other poultry--I don't want to end up with him on steroids for a severe reaction again)? Does it depend on the kind and source of the fish?

If you are still reading this, thank you; you are a brave soul! I know nobody has all the answers...it's just so difficult to sort it all out, and I want so much to do what's best for both of my cats--preferably while also not going completely insane and spending my whole paycheck!

I guess if I have a question, it's this: if I were using the Relion meter and the numbers were consistently in the green zone, would people be recommending an OTJ trial at this point, do you think? Obviously I have a ton less data, but everything on my little Relion sheet is green...but many things on the Alpha Trak one are blue.
 
Sometimes I say to myself "You know, crazy lady, there probably *are* more serious issues in the world, and if you look at the actual cat--you know, that cat we're obsessing about here--he actually looks good." And than I say "But what about _____?!?" My brain needs to take a serious vacation!
 
Here's the secret...they are Cats. :) not trying to demean your struggle. But seriously if you keep at it you will really not solve anything. IMO you could have 50 vets, civilians in a room and most will have their own opinions and statistics. You have to chose who you will trust. Dr. Lisa has proven herself to me and until anyone convinces me otherwise she is who I will trust. And of course these wonderful people here on this forum. Listen to your gut. You know what is best for your kitties, and at the end no matter what the outcome you are doing only what you can. We can tell you want the best for your furbabies. Did you read the thread about knowing what you can do for your kitty and FD? You have to take care of yourself as well. Remember to breathe. In and out.:bighug::bighug:
 
Bwahaha. I worry like this every day too! Glad to hear I am not alone! When Yum's mother's kidneys started going, I spent a fortune on different foods trying to minimize phosphorus in their diet. I still have rejected cat food cans piled up in the pantry. Yum didn't like any of them. She lost weight and her thyroid numbers were slightly elevated and the vet thought she had hyperthyroidism. I almost had her treated, but in the end she just wasn't eating enough because she didn't like the food. When I finally found a low phosphorus food they all liked, it turned out to be high carbohydrate and maybe that's why she is diabetic. Now she is eating super high phosphorus low carb FF classic and I am thinking I need to have her kidneys checked before I start the food craziness again. She did go OTJ after about 5 days of insulin this past Christmas---probably because I cut out the hi carb wet food and the hi carb kibble. We know they were bad---right? Well, the kibble was oral care---so now I worry her teeth will go bad without the kibble. Is oral care kibble just marketing? I don't know.

I use an alphatrak2. I bought it before I found this website, because my vet has one. I like being able to compare its numbers to Yum's annual lab report numbers from the years before she was diabetic. I also like comparing the numbers to the lab report normal reference range of 71 to 159 or 72 to 175. I convert the alphatrak numbers by multiplying them by .8 or .7 when I am evaluating the greens or blues with the website rules and feeling happy or sad. Since I am doing TR, I take the alphatrak2 68 BG as the number requiring intervention. I think it would be easier to use this forum with a human meter, but for now I am sticking with the vet approved alphatrak and giving my calculator a workout.
 
I bought the AlphaTrak 2 before I found the board, too. I wasn't aware of the reference range...according to that, this kitty has been pretty solidly in the normal range for about 2 weeks, which is encouraging! Is that the range you're trying to keep Yum in with the TR? (71 to 159 or 175--why are there 2 ranges?) Or do you have a narrower/lower target?

I think there's a pretty broad consensus that the oral care thing is marketing, and when mine barf dry food up for some reason, it hasn't been chewed...but what do I know?!? :p But Phoebes is right--whatever we do, we have to remember we're doing the best we can! And at least it's sort of interesting..I have learned a ton about diabetes from this experience. I hope I won't need that information for myself or my human family members, but I like having a better understanding of it.

I hope Yum's current food works out well on both the kidney and diabetes fronts!
 
Squeakycats said:
I bought the AlphaTrak 2 before I found the board, too. I wasn't aware of the reference range...according to that, this kitty has been pretty solidly in the normal range for about 2 weeks, which is encouraging! Is that the range you're trying to keep Yum in with the TR? (71 to 159 or 175--why are there 2 ranges?) Or do you have a narrower/lower target?
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I believe different labs give different ranges. ECID. Prediabetes Yum's numbers were around 100 or 130---at the vet, where they were probably elevated by stress. So I think those are good upper limit long term numbers. For now I want her in low normal numbers: (1) because the board experts say healing takes place at low numbers; (2) because I am following the protocol with reductions at AT2 68. I will talk to my vet about the extra healing power of low end numbers, especially if I grow weary of heading off BG crashes.
 
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