2/5 Zelda - 200 AMPS

Peter Moore

Peter Moore

Member Since 2019
Not a bad day so far. Very glad to see the 2 drops got her well back in the blue this morning after yesterday's fiasco. Still not certain she truly "earned" the reduction from 0.1 but will give it a few more days.
 
Oh also, amusingly, I'm pretty sure she's starting to get that testing time = treats. I still have to wrap her in a heavy blanket for it, and she still squirms a little (sometimes a lot) once I have her down and am trying to get the reading (the WORST is when she flinches just as I try to touch the sensor to the blood drop). But afterwards she DEMANDS HER TREAT! :)
 
Slowly but surely Zelda is getting there. :woot: Just imagine.. you can test her without any help someday. When I test Rex, I bring the kit to him, sit down, poke his ear, take the reading, rub his head, get up and leave. He doesn't budge a muscle. He loves rubs as much as treats so I don't give treats anymore (he's a bit overweight).
 
Hey so I'm bringing her in later this week (probably Friday) to follow up on the ear. Does anyone thing it's worth doing a 12-hour curve while she's there, to assess what a full week of 2 drops twice daily looks like?
 
Peter Moore said:
Does anyone thing it's worth doing a 12-hour curve while she's there, to assess what a full week of 2 drops twice daily looks like?
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Been following your interesting journey with Zelda. Love your avatar BTW!:D

I definitely think it would be a waste of time to have a curve done at the vet. Zelda is likely to be stressed out and that causes most kitties BG to go up some by as much as 100 points....in some cases even more. Being in a strange environment with all the strange sounds and activity is hardly going to give you a picture of Zelda's current "usual" cycles. While curves can be helpful when done at home, they still only give you a snapshot of one day in many and if it happens to be a particularly good or bad day, it can be misleading. Daily testing gives you a movie and a much better perspective on what Zelda is up to and how to best move forward toward getting her regulated.
 
MrWorfMen's Mom said:
I definitely think it would be a waste of time to have a curve done at the vet. Zelda is likely to be stressed out and that causes most kitties BG to go up some by as much as 100 points....in some cases even more
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Oh my. Yes, well just FYI we've done curves at this location before - see e.g. 1/22/19 and 11/15/18 - and she likes the staff there (and they love her!) and there's definitely no stress spikes reflected in those numbers, so I'm not quite so worried about that aspect of it. I'm more wondering if it's worth having a precise nadir so we can decide whether to stay at 2 drops, go down to 1, or go back up to 0.1. But maybe I'll give it a few more days of sporadic testing and decide then.

I wish I could test with the frequency that others here do. It's just not possible for many reasons, unless I can find a doctor with the cajones to try the Freestyle Libre, but none of them are willing to even try it. Afraid of getting sued I guess.
 
Have recently been following a kitty with the Freestyle Libre installed and while the graphs it displays can be a bit helpful, I firmly believe in the other kitties case, that had we not encouraged the care giver to also test manually for comparison, the cat might have been seriously overdosed or worse.
The Freestyle Libre site specifically states that the Libre is not meant to replace a diabetic's normal routine testing pattern. The readings seemed to be somewhat erratic and we witnessed a difference in readings of up to 60 points between the Libre and a manual glucometer with the Libre reading high and this was a common complaint amongst human users too along with it reading too high at low range too.
While the Libre may have it's place, it doesn't appear to be the panacea diabetics were hoping for and is of limited value IMHO for our cats.
 
If you are sure Zelda doesn't get stressed out at the vet (you lucky soul!) then it's really up to you and if you're finding it difficult to test and consistently be able to get at least 4 tests per day, then yes it might give you some perspective on how the 2 drops are working for Zelda. Personally I never found a one day curve of any value to me even when done at home.....it was the longer term picture that told me a much more complete and accurate story.
 
@MrWorfMen'sMom (Star Trek reference?) thank you! That makes sense.

MrWorfMen's Mom said:
The Freestyle Libre site specifically states that the Libre is not meant to replace a diabetic's normal routine testing pattern.
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Wow that is definitely not how they advertise it. I would have thought some lawyer wrote that.

What I've been suggesting to the vets is that we would do a 12-hour curve with the libre and manual tests to compare and calibrate, and that we'd not make actual dosing decisions based on the libre alone. I fully recognize(d) it would be an experiment. That didn't seem to assuage anyone though.
 
Also +6 178. Turning out to be a blue day (and not in a bad way). :)

I miss seeing dark green though. Still, we used to have days like this from 0.5 units twice a day, so this is undeniably progress.
 
From what I have found from both a friend of mine, and the cat on this board, is that the Libre is great tool for showing patterns. While both accuracy and precision are desired, we may end up with only precision on the Libre. Home tests compared to the Libre readings at home, done past the first 24 hrs, with each sensor would tell us the accuracy and precision. That said, if that sensor is accurate, it would help immensely to see the patterns when testing is not feasible, and would be a basis for either changing up meal carbs or patterns. Since each sensor can be different, it would of course vary how much you could rely on it ... but the patterns should be similar.

If the curves at the vet are similar to those at home, then that could be a good way for you to get those extra tests that you wouldnt otherwise get.
 
Peter, given that you are using an AT2 meter, you might not see the dramatic differences in BG that we saw with the other cat, however it would be anybody's guess what if any difference there might be without specific comparison testing. You might find the Libre would read low as compared to the AT2 since the AT2 typically reads higher than a human meter and the difference between the AT2 and human meter generally gets progressively larger the higher the BG. I agree the graphs showing the patterns are helpful and the pattern from both meters should be the roughly the same but it also seems to me that it might simply serve to confound the picture more with so many unknown variables at play. I still think it's easier to pick a meter and stick with it unless of course you're all right with turning your cat's diabetes into a research project. ;)
 
Much better today. The amoxicillin is no doubt kicking in now to help with the infection.

Just reviewing the SS again and I was wondering why you didn't hold the 0.1 dose and gave the reduction to 2 drops when she was starting off yellow?
 
Bobbie And Bubba said:
The amoxicillin is no doubt kicking in now to help with the infection.
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I think the amoxicillin compound (with glycerin) actually caused the spike. The infection has been going on for weeks. We're back to baytrill. But yes it's definitely improving.

Bobbie And Bubba said:
Just reviewing the SS again and I was wondering why you didn't hold the 0.1 dose and gave the reduction to 2 drops when she was starting off yellow?
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Because I was concerned about repeatability. Compare 1/31 AM to 1/31 PM to 2/1 AM. I was not confident I was dosing it consistently and thought 2 drops would be safer.

But if her nadirs are above 150 and clinical signs return, AAHA guidelines would say to consider an increase.

Also, not for nothin', if the spike WASN'T caused by the medicine, then 2 drops caused a 120 point drop in 12 hours between last night and today. She is SENSITIVE to this stuff now.

However, I'm resolved that if we do go back to 0.1, it's going to include small amounts of Orijen dry again. No one get mad. :) I just think it's safer that way.
 
+9 226.

I'm assuming the little bounce was from the meal at noon, which has been SOP on days I'm home.

One thing is that Fancy Feast Chicken (today's meal) has more carbs than Turkey & Liver or Beef. I wonder if she really is THAT sensitive to the small differences in carbs. If so then DM really would not be appropriate at this low dose.

Anyway I had her jump across high chairs (she loves doing that - including through a hula hoop! - little acrobat) for beef treats to try to bring it down some.
 
Awesome that Zelda likes to do some tricks but exercise could increase rather than decrease BG if it's strenuous enough and/or if there is not enough insulin to deal with the extra BG the body pumps out to provide the muscles with needed energy for the exercise.
 
I thought that the Freestyle Libre was helpful and would probably still buy it again, but I wouldn't buy the reader as the phone app is better. But yes, I'm glad that I went wither other people's recommendation of getting a glucometer for better accuracy for testing before shot time.
 
Hey didn't disappear. :) 200 AMPS today. Urine strips remain 0 so taking it light on testing today while I continue to deliberate on whether to return to 0.1.

I think at this teensy dose, WHEN I feed might matter as much as what I feed. So I'm trying to avoid the pre-shot gorging that used to be the norm and try to spread out breakfast more over the hours when the new shot is working.

Here's my dilemma about the dose - these are numbers we used to see from 0.5 twice a day. Over time (a month or so) she naturally got lower on her own, even without being "tightly" regulated. And this is a SAFE dose at this point.

On the other hand the science says we should be as tight as possible at all times, and being past the six month mark, I don't know how long our window of opportunity for true remission will last.
 
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While it's true that the odds for remission go down with time passed, remission is never off the table. My girl went OTJ after 3 yrs 7 mos and 17 days and she has a high dose condition, was diagnosed at a young age, and was a kibble addict well past 2 yrs into our journey. While this seems a long time to reach remission, it's far from the longest. Another member's cat went OTJ after 11 years. I think that might be the all time record! Never give up hope!
 
Oh wow, thank you @MrWorfMen's Mom . That makes me feel better. :) I was getting a little demoralized from statistics that say the bulk of remission cases happen within 6 months, and that to maximize chances you need to achieve good control within a few weeks, which is probably the thing that made me MOST upset with the original internist who told me things like "numbers don't matter" and not to test. RHGH.

But, I take your point - this can't and shouldn't be rushed.
 
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