4/27 Biscuits amps High +7 543 pmps 522!! Not high.. increased to 9.5u

As I said I'm not really good at following the spreadsheets !! The colors were yellow and blue but the insulin was increasing (I was told by the vet anything under 300 is good)
Is this because of a high dose condition? What's the ideal bg we're aiming for?
 
Mollycat said:
What's the ideal bg we're aiming for?
Click to expand...
Normal BG range for a non diabetic cat is between 50-80.

What range you are aiming for depends on a number of factors, whether or not you have a high dose condition, what protocol you are following.

Let's take a 'regular' sugarcat, following TR, you would be aiming for nadirs between 50-80 (using a human glucometer), so if a kitty was nadiring in the blue you would still continue to take the dose up gradually, until you start to see those nadirs, only taking the dose down if they drop below 50 or spend a week in normal numbers. Take a look at my boys ss for examples of the latter.

If you were following SLGS, however, then you would increase the dose if kitty was above 150, holding the dose if it were below 150 taking reductions if they dropped below 90. (human meter)

Those care givers dealing with an acro cat, because of the nature of the condition, will sometimes try and give themselves a bit more headroom when taking reductions. But usually most are aiming to minimize the impact on the kidneys by keeping the kitty below the renal threshold (point which glucose starts to show in the urine), usually this would be keeping them below 200 for the most part, so dose adjustments would be made to achieve this.

It would certainly be great to see numbers below 300 for Biscuit, and it would be progress, but between 200-300 that would still most certainly be above renal threshold and would only be a starting point. Realistically for the sake of her health, once you start seeing some of those yellow numbers, the goals would change and you would be aiming to get her down to blue (below 200) and then green perhaps. You yourself will be able to determine her renal threshold by checking for glucose in urine when she starts to get into low yellows and blues (the threshold differs from cat to cat)

So in Titan (the ss marje linked), the dose continued to be raised until he was seeing those numbers that were keeping him below the renal threshold, we didn't stop, just because he got below 300, though CG did slow down with the increases, waiting a little longer between dose changes. If you look down further you see as Titan saw some lime greens the dose was reduced systematically, and adjusted to keep him in those blues below the renal threshold.

Hope that helps explain it a little.
 
Mollycat said:
As I said I'm not really good at following the spreadsheets !! The colors were yellow and blue but the insulin was increasing (I was told by the vet anything under 300 is good)
Is this because of a high dose condition? What's the ideal bg we're aiming for?
Click to expand...
The dose was raised even when numbers were coming down because the goal is to have the BG between 50-120 on a human meter with the preference between 50-100.

Anything above 120 is out of normal range on a human meter. Renal threshold, although it varies from cat to cat, is between 200-250 on a pet meter so less on a human meter. “Anything under 300” is not good unless it is in the normal range or approaching it. Vets are often happy with what we classify as pink or yellow numbers because there is a margin of safety in their eyes. That’s because they aren’t available to you when the numbers do come down into blue or green.

I’m assuming you also looked at Titan’s 2017 tab? I forgot to tell you that was the really telling one.
 
Gill & George said:
Normal BG range for a non diabetic cat is between 50-80.

What range you are aiming for depends on a number of factors, whether or not you have a high dose condition, what protocol you are following.

Let's take a 'regular' sugarcat, following TR, you would be aiming for nadirs between 50-80 (using a human glucometer), so if a kitty was nadiring in the blue you would still continue to take the dose up gradually, until you start to see those nadirs, only taking the dose down if they drop below 50 or spend a week in normal numbers. Take a look at my boys ss for examples of the latter.

If you were following SLGS, however, then you would increase the dose if kitty was above 150, holding the dose if it were below 150 taking reductions if they dropped below 90. (human meter)

Those care givers dealing with an acro cat, because of the nature of the condition, will sometimes try and give themselves a bit more headroom when taking reductions. But usually most are aiming to minimize the impact on the kidneys by keeping the kitty below the renal threshold (point which glucose starts to show in the urine), usually this would be keeping them below 200 for the most part, so dose adjustments would be made to achieve this.

It would certainly be great to see numbers below 300 for Biscuit, and it would be progress, but between 200-300 that would still most certainly be above renal threshold and would only be a starting point. Realistically for the sake of her health, once you start seeing some of those yellow numbers, the goals would change and you would be aiming to get her down to blue (below 200) and then green perhaps. You yourself will be able to determine her renal threshold by checking for glucose in urine when she starts to get into low yellows and blues (the threshold differs from cat to cat)

So in Titan (the ss marje linked), the dose continued to be raised until he was seeing those numbers that were keeping him below the renal threshold, we didn't stop, just because he got below 300, though CG did slow down with the increases, waiting a little longer between dose changes. If you look down further you see as Titan saw some lime greens the dose was reduced systematically, and adjusted to keep him in those blues below the renal threshold.

Hope that helps explain it a little.
Click to expand...
It does, but I'm not expert on the abbreviations!!
 
As Marje and Gill have said, you really do want to get numbers below renal threshold. Long times in high numbers can wear out the kidneys. Should Biscuits have acromegaly, and I am hoping not, it is a condition that is hard on kidneys by itself. There are a couple other reasons you want lower numbers. First is glucose toxicity, where kitty gets used to higher numbers and their little bodies think of them as normal. It means you need to go even higher in dose to break through insulin resistance, and you get a whole lot of bouncing. The second reason you want to aim for lower nadirs, is that lower nadirs in general mean lower high numbers from the bounces. I found that if I could keep Neko at a dose where nadirs were in the 70’s, I could keep her below renal threshold. With a high dose cat, your focus changes from being tightly regulated in the hopes of reduction, to below renal threshold and safe. Both acromegaly and insulin auto antibodies add an element of unpredictability to the blood sugars, but caregivers can learn enough to keep their cat safe and roll with the surprises.

I think most vets aren’t comfortable with numbers below 200 because the majority of their clientele do not home test. So the 300 gives a margin of safety. My vet was a little more adventurous and OK with mid blues.

In the mean time, keep marching on. One of the long ago members here, a vet tech, said “be the tank, a tank gets wheee it’s going”. We have seen lots of cats seemingly stuck in higher numbers, be they black, red, pink, or even yellow. Not so much with the yellow, but the rest benefitted from fast tracking to get to that dose that moved their kitty. Unfortunately the spreadsheet of Polly is no longer available, but she was stuck in yellow forever. It wasn’t until she hit ten units that she started to see significant movement.
 
I feel terrible that he's been high for over a year and thinking about what it's doing to his body. As you all know it's so exhausting hoping each test brings a better number. I'm going to increase tonight. I trust your advice.
 
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