? need experienced opinions on spreadsheet / progress

CandyH & Catcat

CandyH & Catcat

Very Active Member
trying to do a curve at home, prior to vet appt tomorrow (Monday)

just scared myself, my initial check at +8 read LO

I believed it, fed Catcat a couple of Whisker Lickin's treats (high carb) -- then checked Google for possible explanation (he wasn't showing signs of hypo)

could have been "not enough blood" -- drop looked big enough but Catcat usually fights me, it smears

got another test strip out, rechecked, got the 107 reading (but yes, had given him a tablespoonful of Meow Mix tenders, plus one of Friskies pate as well, plus some bonito curls)

do you think: has he been "in normal range" half the day? are we at the right dose yet, considering his AMPS and PMPS are still higher than I'd like?

wanted to get your input / feedback since you are far more experienced with FD management than my vet (who is open to learning)
 
Hi,

The pattern of the numbers you're seeing is quite 'typical' for Vetsulin, with fairly steep drop, and higher preshots ('possibly' due to relatively short duration).
However, it looks to me like the numbers he's dropping too are too low. He dropped to 65 at +3 on 10th May, and may have dropped lower after that. It may also be the case that he's dropping lower at night (quite a few cats do)... At those kinds of numbers there is no buffer of safety at all.
For newcomers to Vetsulin the general starting advice is to try to not let the blood glucose drop below about 90. That is because Vetsulin can drop the blood glucose pretty steeply, and trying to not let it drop below 5 gives some buffer of safety.

My suggestion would be to reduce the dose slightly to keep Catcat in a slightly safer range of numbers. It may also be that lowering the dose helps to even out the numbers a bit.

Eliz
 
Elizabeth and Bertie said:
Hi,

The pattern of the numbers you're seeing is quite 'typical' for Vetsulin, with fairly steep drop, and higher preshots ('possibly' due to relatively short duration).
However, it looks to me like the numbers he's dropping too are too low. He dropped to 65 at +3 on 10th May, and may have dropped lower after that. It may also be the case that he's dropping lower at night (quite a few cats do)... At those kinds of numbers there is no buffer of safety at all.
For newcomers to Vetsulin the general starting advice is to try to not let the blood glucose drop below about 90. That is because Vetsulin can drop the blood glucose pretty steeply, and trying to not let it drop below 5 gives some buffer of safety.

My suggestion would be to reduce the dose slightly to keep Catcat in a slightly safer range of numbers. It may also be that lowering the dose helps to even out the numbers a bit.

Eliz
Click to expand...
yes, that fairly steep drop is why I'm feeding a heaping tablespoon to Catcat, started out giving 2-3 tablespoons every 2 hours, now transitioned to 1+ every hour, for the first half of the cycle, to even things out and keep him from going hypo -- I tend myself towards hypoglycemia and am officially prediabetic, so at least for me, I know frequent small meals help even things out

possibly you didn't look at the vet's curve, which got me going that direction, on her meter (am assuming Alphatrak as that's what she told me to buy)
preshot = 418; +2 = 132; +4 = 52; +6 = 82; +8 = 125 .. this was on 2 units, since reduced to 1

alarmed us; at least I'm assuming it alarmed her, that's why we agreed to reduce the dose at that point

drop at night is something I can't do much about, as it is, I'm feeding around 5 ounces of food at 10 pm, (+3) then Catcat wakes us up at 5 AM or before, searching for food, going out to hunt mice .. my body needs more than 6 hours' sleep -- and I'm too woozy to fight Catcat to get the blood droplet to test when I first open my eyes, need a cup of coffee first (actually hot milk with coffee to flavor it) to get me started, yes my morning solution to my overnight hypoglycemia

I would love to get the preshot numbers lower, would love to move him towards remission since I'm seeing the mid-cycle numbers gradually dropping; I'll be presenting my (and your) concerns to the vet when I see her in a couple of hours

have several events coming up later this month and through the summer (Relay for Life, for one) and hope I don't have to cancel those to stay home and caretake Catcat
 
oh, I see now I didn't express my thanks for your helpful reply, I had been thinking that we were close to the right dose, maybe a squeesh high -- what I didn't mention is that for the evening dose, I've been giving a "scant" 1 unit, aligning the plunger just short of the 1-u mark, as well as feeding a tablespoon of food at +1 and +2 with a larger helping at +3 .. haven't been doing as much testing on the PM cycle because I'm tired, not at my best, and I'm sure Catcat picks up on my distress -- he's been leaving part of that late night feeding behind, far as I know he's not eating anything after that, think he is sleeping part of the night curled up with adult son and his dog (husky/lab mix)
 
CandyH said:
drop at night is something I can't do much about..
Click to expand...
We don't know that he 'is' dropping lower at night. It's just that quite a few cats do. So, given the low numbers you're already getting during the day there's not much of a buffer if he is dropping lower at night. Hence my suggestion to reduce the dose a tad.

It 'may' be that the numbers would even out a bit if you do reduce the dose. Those steep drops and low nadirs 'could' be making the preshots higher than they might otherwise be.

CandyH said:
I would love to get the preshot numbers lower, would love to move him towards remission
Click to expand...
It's very early days, and once his body starts to heal, who knows what might happen....

CandyH said:
have several events coming up later this month and through the summer (Relay for Life, for one) and hope I don't have to cancel those to stay home and caretake Catcat
Click to expand...
If it's a matter of a missed shot here and there that's not the end of the world. We all have lives to live. If you're away longer, is there anyone who can look after Catcat for you?
 
nope, no backup for Catcat if I'm gone, hubby, who *might* be able to (though he's 89, has had cataract surgery, loses track of time) would usually be going with me; adult son is alcoholic, I don't feel I can rely on him for much, he feeds the barncats, however they also hunt so not a problem if he misses

OT -- second husband -- Scottish -- worked for Hunting Aircraft before emigrating to the USA -- Boeing import -- we spent part of our honeymoon in Weybridge, he showed me around some of his old stomping grounds -- stayed at the Hand and Spear, then up to his hometown of Cardross, out to his sister's cottage in Carrick, then back to Weybridge, and back via Gatwick to Seattle, over the pole

Catcat just appeared, reminding me he is due for his first morning snack (+1-1/2)
 
back from the vet, she was skeptical about the difference between Confirm and Alphatrak -- so we did a simultaneous test with my meter and hers, with blood drawn from leg vein -- now she feels more confident about numbers I'm getting, even if they aren't same numbers as the Alphatrak

(not sure it helped, but this morning's was probably a fur shot -- so he wasn't down in the "normal nondiabetic" range at +3)

after evaluating the spreadsheet I'm keeping, examining cat, talking about daily schedule, weigh-in -- he's up to 12.3# (~5.6 kg) target 15, up from 10 at diagnosis; she said, let's give him the dose that the values suggest -- 1 unit, maybe a little less, maybe down to 1/2 unit, she said that it's difficult to measure less than even units -- and on the U-40 syringes without half unit marks that they stock, she is correct -- what she doesn't know, and I didn't tell her, is that I have some U-100 syringes, and the conversion chart is here on the board - check check and double check to make sure I read and set it right

so I'll see what the PMPS shows, guessing that a scantier dose -- .75 if I can manage it -- might give a better value come morning, at least that way he won't go hypo overnight

dental, she says, can wait a while, let's get him more nearly stabilized on the insulin
 
CandyH said:
so I'll see what the PMPS shows, guessing that a scantier dose -- .75 if I can manage it -- might give a better value come morning, at least that way he won't go hypo overnight
Click to expand...
The 0.75 sounds like a safer bet than the 1 unit. And it's good that you have U100 syringes if you need them. :cat:
 
looks like the pre-shot numbers are increasing slightly on the .75 u dose -- I'm planning on sticking to that for the PM and try out the scant-1 u dose in the morning, checking between +3 and +5 to make sure I didn't do a fur shot again, and to see what's happening somewhere around nadir time

of course he's not happy with testing and with food only appearing when I dish it up; he's started swatting at me when there's no food in the dish, still growling at test time, but he seems to be moving towards accepting it without going into full fight mode .. he loves the bonito curls, the Meow Mix, and works very hard to eat the full size dried sardine -- was reading something the other day about it being good for cats to have to work at their food -- package does say to break the fish into pieces for "pets under 20 pounds" -- and if he can't manage it after half an hour or so, I do that - it''s human grade food -- gives him a little extra dose of the Omegas 3 and 6, plus the calcium from the fish bones -- I like it that it's semi local, from Vancouver BC, 200-some miles north of us
 
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