29Feb2020/Maxi/PMPS(417)+3(376)+6(347)+9(422)

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http://www.felinediabetes.com/FDMB/...mps342-2-335-4-299-6-262-8-283-10-469.226318/

He will likely need another increase after 5 days, but I'd wait for this new(er) dose to settle in since you started to see some blue numbers and it's only day 2. We've been at this since November and if you check our S.S my guy still bounces a bit and we just got out last bout of glucose toxicity in order....
I really have to stay on his increases, but can't sometimes due to my work schedule ( overnights)
 
You need to hold the dose for at least 6 cycles on TR. You are starting to see some blue numbers so yes the insulin is working. .

Thank you, Bron.

But does this really count as seeing blue numbers? He had one (high one) yesterday, and the last blue numbers were 8 days ago. Well over the majority of his numbers, including during the last week, are far from blue.
 
Thank you, Bron.

But does this really count as seeing blue numbers? He had one (high one) yesterday, and the last blue numbers were 8 days ago. Well over the majority of his numbers, including during the last week, are far from blue.
I know it is frustrating seeing higher numbers but you can’t go any faster than you are going now. Maxi isn’t used to normal low numbers any more and he thinks the higher numbers are normal. He looks like he has bounced from the blue today with those two red numbers following.
You are still very early in this journey. You just haven’t reached his best dose yet. You will get there.
 
Thanks, Ari.

What happened to Makoto during his bout of glucose toxicity?

Just those higher numbers and some days of being above his renal threshold- which sucks. He seems a bit hungier and has less energy sometimes It also seems to reset his " normal range " of BGs and cause a bit of bouncing when we start getting better numbers in the 100s again, but not much at all. Eventually, they bounce less and clear bounces faster. But it took a few days to see improvement ...
 
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Just those higher numbers and some days of being above his renal threshold- which sucks. He seems a bit hungier and has less energy sometimes It also seems to reset his " normal range " of BGs and cause a bit of bouncing when we start getting better numbers in the 100s again, but not much at all. Eventually, they bounch less and clear bounces faster. But it took a few days to see improvement ...

Ari, what does “above his renal threshold” mean?
I looked at your spreadsheet, and it seems you try to do a lot of tweaking. My friend suggested that Maxi needs to eat more often and that would help regulate his glucose. What do you think of that?
Because I can’t feed him several times a day on many workdays, I decided to feed him regularly every 12 hours, and the vet said that was fine. However, since then, I have given him snacks. But nothing seems to have changed his numbers.
 
Ari, what does “above his renal threshold” mean?
I looked at your spreadsheet, and it seems you try to do a lot of tweaking. My friend suggested that Maxi needs to eat more often and that would help regulate his glucose. What do you think of that?
Because I can’t feed him several times a day on many workdays, I decided to feed him regularly every 12 hours, and the vet said that was fine. However, since then, I have given him snacks. But nothing seems to have changed his numbers.

The renal threshold is the BG number at which cats dump glucose in their urine...it's usually the high 200s- Makoto's is around 258/260 based on labs.
Without snacks during the day, Makoto wouldn't be as regulated as he is I think. Fasting causes fluctuations in his BG- although his vet said food every 12 hours was okay....we don't do that. He ate every 4-6 hours in the beginning and eats every 2- 4 now...even if it's just a snack. Feeding in the first 4-6 hours of the cycle helps a lot of cats hold onto better numbers and stop the sudden drops that can causes bouncing- sometimes. We use an automatic feeder and even when I lived in a multiple cat household- I've used them.
 
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But the great majority of his numbers are in the high 200s or above, and I can't help but focus on that.
 
The renal threshold is the BG number at which cats dump glucose in their urine...it's usually the high 200s- Makoto's is around 258/260 based on labs.
Remember, Ari is using the AT, not the human meter. Renal threshold is lower numbers if using a human meter, which you are. Neko's was around 220 (human meter), but I have heard of some cats being in the upper blues. ECID. Neko's internal medicine said it's worse if they are constantly high. Maxi is seeing odd break.

Today is cycle six on this dose, you can increase to 3.25 now.
 
Remember, Ari is using the AT, not the human meter. Renal threshold is lower numbers if using a human meter, which you are. Neko's was around 220 (human meter), but I have heard of some cats being in the upper blues. ECID. Neko's internal medicine said it's worse if they are constantly high. Maxi is seeing odd break.

Today is cycle six on this dose, you can increase to 3.25 now.

Thank you, Wendy.
I didn't understand most of what you wrote (What is ECID? It's not in the glossary), but what I glean is that Maxi may be past his renal threshold. Though I wouldn't say Maxi's numbers are constantly high, I can say they have been pretty consistently high.
Maxi had 3.25 this PM.
Do I have to test him every 2 hours?
 
ECID = each cat is different. Renal threshold with a human meter is lower numbers than on the AT pet meter. It's not the same number for every cat, but rather in a range.
Maxi had 3.25 this PM.
Do I have to test him every 2 hours?
No, he's high enough. You could test either at +2 or before going to bed. If you see a big drop from preahot at +2, then you'll probably want at least a +4. Depend what the numbers are. Post your next test test and ask if uncertain.
 
The renal threshold is the BG number at which cats dump glucose in their urine...it's usually the high 200s- Makoto's is around 258/260 based on labs

I saw in his bloodwork where his BG levels were from his vet when he also showed glucose in his urine. Last recheck his BG was 200 and there was no glucose. I also use urinalysis strips at home , but they are a bit less consistent ...and I'm comparing them with my early evening BG readings on my glucometer so ....
 
Every time Neko went in for urinalysis, I always tested her before and after. There is a bit of delay in sugar in the urine after in the blood. But I could look back and see what her numbers had been and when she did or did not have glucose in urine. The ketodiastix can show if glucose is spilling into the urine, like urinalysis strips Ari mentions.
 
Thank you, Ari and Wendy.

I have ketone test strips. Are they the same as ketodiastix? When I tried them, I couldn't read them because the colors were different from the colors on the guide on the box. Do ketone test strips also test for glucose in urine? Should I be testing Maxi's urine for glucose?
If you find glucose in urine, and if you figure out the renal threshold, what do you do with that information?

Wendy, I'm very sorry about everything Neko and you went through. She was a very beautiful girl.

I saw Neko took 3 kinds of insulin. Why the changes?

Maxi's +7: 304
 
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