Risk of hypoglicemia? Low numbers even with half of insulin dose

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Amanda Guimarães said:
BTW I should start a new spreadsheet, I think? For the human meter?
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When I changed from the AlphaTrak to the human meter I saved a copy of the AT document as a new document that isn't public so I could use that exclusively to record data from curves I did (using the AT) that I would report to my vet.

Then @Marje and Gracie kindly converted the original spreadsheet so that the relevant reference numbers would appear. (I sent her a pm and she replied telling me the things I needed to do to give her editing rights to the document.) So if you look at Lola's SS you'll see the first section clearly says AlphaTrak but then there's a clear line where the human meter readings start.
 
Critter Mom said:
Normal feline BG reference ranges:

Alphatrak veterinary meter: 3.9-8.3mmol/L (Information provided by my vet. Lab analysers work to similar range, e.g. IDEXX UK use 3.9-8.0mmol/L).

Human meter: 2.8-6.7mmol/L
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Human meters read lower than pet meters.
The dosing methods used on the FDMB were created with meters calibrated for humans. All referenced numbers here on FDMB correspond with meter for humans including the numbers and colours on the spreadsheet
EXCEPT the tree green range will change to 2.7 -5.5 and the lime green (or take action/hypo territory number) will be <2.7 for a human meter spreadsheet.
 
Shelley & Jess said:
Hi Amanda!
Just checking on how Severino did last night with no insulin - looks like he did fantastic - that AMPS this morning of 90mg/dl (5 mmol/L) is just where you want him.
I see you gave him 0.5u insulin this morning. I recommend getting a +2 this morning to see how he handles it.

Keep us posted please!
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I managed to contact a Veterinarian and Researcher that works at the University Animal Hospital in Uppsala in Sweden. She was very kind and looked at Severino spreadsheet, at the veterinarian answer, and gave me her veterinarian point of view for free. That´s why I have shot at 5

"Wise to reduce the dose. Does not look like he should have more than 0.5 IU. Maybe 0.25 may be enough, but preferably you should not change the dose more often than once a week, so it would give a few more days at the current dose. Since he has not been on insulin for so long, I would not give anything if he has below 5 in glucose. If he is alert and the meter shows 3.8, I would not do anything but have a little extra control over the next few hours. If you are still worried or if you can not keep him under supervision, it is not wrong to give a little extra food. If it continues like this, I think there is a good chance that he will be insulin-free! I think you can measure glucose morning and evening before giving insulin and then make a curve when he has been on the new dose for a week. Then measure every two hours and as you approach nadir you can measure even a little more often. You have an occasion where he goes from 4 something up to 16 from one hour to the next. Could be a recoil. If he has more like this or is often so low below 4, I would try to lower to 0.25 IU. You are doing great!"

What is 5 in a pet-meter in a human meter? :p
 
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Thanks a lot!!! <3
Shelley & Jess said:
Human meters read lower than pet meters.
The dosing methods used on the FDMB were created with meters calibrated for humans. All referenced numbers here on FDMB correspond with meter for humans including the numbers and colours on the spreadsheet
EXCEPT the tree green range will change to 2.7 -5.5 and the lime green (or take action/hypo territory number) will be <2.7 for a human meter spreadsheet.
Click to expand...
 
Amanda Guimarães said:
I managed to contact a veterinarian researcher that works in the University Animal Hospital in Uppsala in Sweden. She was very kind and look at Severino spreadsheet, at the veterinarian answer, and gave me her veterinarian point of view for free. That´s why I have shot at
...
What is 5 in a pet-meter in a human meter? :p
Click to expand...

What a wonderful resource!

I'm not sure I'm answering your question about the "5", but I think I am: If you look at the bottom right of the SS you'll see a tab for US, one for World, and another for Labs. If you click on the World, it should give you the page you need.

No, it's bottom left, not bottom right!
 
Amanda Guimarães said:
Yes :D I´ve created a new one. Both are in my signature :)
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Using a new SS is not a good idea as we need to be able to see past cycles. It’s really difficult to have to go back and forth between two SSs. If you will just send me a private message, I will be happy to fix this for you so you just have one SS.

There is no equivalence between the human and pet meter. That means a 180 on a human meter is not always the same number on a pet meter. Also, I know it’s a pain, but we only use US numbers here and most members do not know how to convert World to US numbers so it’s best if you speak in US numbers. Instead of “5”, you would say “90”. We would appreciate that.

Thanks and I look forward to hearing from you so I can fix the SS.
 
Marje and Gracie said:
Using a new SS is not a good idea as we need to be able to see past cycles. It’s really difficult to have to go back and forth between two SSs. If you will just send me a private message, I will be happy to fix this for you so you just have one SS.

There is no equivalence between the human and pet meter. That means a 180 on a human meter is not always the same number on a pet meter. Also, I know it’s a pain, but we only use US numbers here and most members do not know how to convert World to US numbers so it’s best if you speak in US numbers. Instead of “5”, you would say “90”. We would appreciate that.

Thanks and I look forward to hearing from you so I can fix the SS.
Click to expand...

Hey @Marje and Gracie,

am still going to use my pet meter for glucose curves. In cases of hypoglicemia too. Because of that, it doesn´ feel practical to have just one schedule?

Another question, how would you fix the SS if there is no equivalence between the human and the pet meter? I just want to understand, don´t get me wrong.

I normally say both numbers but I have stopped since two days ago because mostly people in europe answer to my threads - probably due to the timezones. But I can post both again.
 
Amanda Guimarães said:
Hey @Marje and Gracie,

am still going to use my pet meter for glucose curves. In cases of hypoglicemia too. Because of that, it doesn´ feel practical to have just one schedule?

Another question, how would you fix the SS if there is no equivalence between the human and the pet meter? I just want to understand, don´t get me wrong.

I normally say both numbers but I have stopped since two days ago because mostly people in europe answer to my threads - probably due to the timezones. But I can post both again.
Click to expand...
You don't need two meters. So there's really no reason to confuse yourself and do curves with one, and daily readings on another.
 
Amanda Guimarães said:
I managed to contact a Veterinarian and Researcher that works at the University Animal Hospital in Uppsala in Sweden. She was very kind and looked at Severino spreadsheet, at the veterinarian answer, and gave me her veterinarian point of view for free. That´s why I have shot at 5

"Wise to reduce the dose. Does not look like he should have more than 0.5 IU. Maybe 0.25 may be enough, but preferably you should not change the dose more often than once a week, so it would give a few more days at the current dose. Since he has not been on insulin for so long, I would not give anything if he has below 5 in glucose. If he is alert and the meter shows 3.8, I would not do anything but have a little extra control over the next few hours. If you are still worried or if you can not keep him under supervision, it is not wrong to give a little extra food. If it continues like this, I think there is a good chance that he will be insulin-free! I think you can measure glucose morning and evening before giving insulin and then make a curve when he has been on the new dose for a week. Then measure every two hours and as you approach nadir you can measure even a little more often. You have an occasion where he goes from 4 something up to 16 from one hour to the next. Could be a recoil. If he has more like this or is often so low below 4, I would try to lower to 0.25 IU. You are doing great!"

What is 5 in a pet-meter in a human meter? :p
Click to expand...


That's The Benefit Of A Comprehensive Nation State System in Sweden :D
And LAWS. :D
 
Amanda Guimarães said:
Hey @Marje and Gracie,

am still going to use my pet meter for glucose curves. In cases of hypoglicemia too. Because of that, it doesn´ feel practical to have just one schedule?

Another question, how would you fix the SS if there is no equivalence between the human and the pet meter? I just want to understand, don´t get me wrong.

I normally say both numbers but I have stopped since two days ago because mostly people in europe answer to my threads - probably due to the timezones. But I can post both again.
Click to expand...
I would highly discourage you from going back and forth between meters. Pick one, stick with it. Don’t use one to do curves and lower numbers and another for everything else. It’s just not what we recommend here as it is not necessary. Also, we have lots of members who need help and if you do need help in a low numbers situation, it takes more time to go back and forth between SSs to see what he’s been doing and what a curve looks like and then to where you are keeping track of numbers. It’s not hard to learn human meter BGs and the significance.

What I do with the SS is reformat it so that the colors code for the human meter instead of the Pet meter. For example, for the pet meter, anything below 68 colors bright green. But not so with the human meter. It doesn’t code bright green until the BG drops below 50. So the reformatting is not making a conversation between the pet and human meters. It is just ensuring that the SS formatting equates to the meter you currently use. If you switch to a human meter all the time, then I reformat it to color for those ranges starting the date you switched but we still have all the data from the pet meter in the correct color codes on the same SS.

If you do not feel comfortable switching 100% to the human meter, then I’d recommend you don’t switch at all. It will be more expensive for the strips but it will be easier for you and us in just dealing with one meter and one SS. Believe me, if I had a dime for every time a new member wanted to do what you suggest, I’d be rich ;):smuggrin: So you aren’t the first but, almost everyone makes the full switch to the human meter. Just let me know.

Finally, I urge you to join the Prozinc ISG and start posting there instead of Main Health. You’ve been here long enough to learn the basics and you’ll get Prozinc- specific advice and learn more from other PZ users.
 
Amanda and Severino is already in the prozinc group, and Amanda Beautifully works and operates in a 3-Language Portugese, Swedish and English Interface.
We might be considered Peasants to the rest of you here, but This Is Our HUGE SWEDISH STATE Swedish University of Agricultural Sciences, SLU, were our STATE COUNTRY STATE Veterinarians and Veterinarians Researcher sit ... which Amanda contacted Direct ...
.... so if THEM and also Severino's Veterinarian wants to get some comprehensive understanding of your spreadsheets, when Amanda sends them to them ... explanations should be due, as you did Marje.

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Hey everyone! Just an update on why I´ve got quiet around here.

I got suddenly sick on Friday evening, with high fever. I have tested for corona yesterday (which I really hope I don´t have; I have been isolating myself for a long time now) but I might have influenza.

My partner has been taking care of Severino and measuring with the pet meter. He´s insulin free since 30/11 based on the fact that he has been lower than 5 (90) pre-shot.
 
Amanda Guimarães said:
Hey everyone! Just an update on why I´ve got quiet around here.

I got suddenly sick on Friday evening, with high fever. I have tested for corona yesterday (which I really hope I don´t have; I have been isolating myself for a long time now) but I might have influenza.

My partner has been taking care of Severino and measuring with the pet meter. He´s insulin free since 30/11 based on the fact that he has been lower than 5 (90) pre-shot.
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Sorry Amanda! I got Covid March 12. It sure wasn't influensa! Started with Severe Dry Coughing. 38,5 C fever with fever lowering. Impossible to even get air through in lungs in breathing. Severe Nasty Internal Yuck Inflammation virus-replication spreading in lungs ... and Heart. I was already a Heart Patient. Covid is treasurous, Day 3 a seamingly feeling a little better can come. With a fast turn though for even critical worse, with total crashing Day 5. Don't hesitate at all to call an ambulance to go straight to a Covid-ER.

Jag håller Tummarna för Er att Du blir bra!
 
Ann & Scatcats said:
Sorry Amanda! I got Covid March 12. It sure wasn't influensa! Started with Severe Dry Coughing. 38,5 C fever with fever lowering. Impossible to even get air through in lungs in breathing. Severe Nasty Internal Yuck Inflammation virus-replication spreading in lungs ... and Heart. I was already a Heart Patient. Covid is treasurous, Day 3 a seamingly feeling a little better can come. With a fast turn though for even critical worse, with total crashing Day 5. Don't hesitate at all to call an ambulance to go straight to a Covid-ER.

Jag håller Tummarna för Er att Du blir bra!
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Sorry about that Ann!! Thats sounds awful :-( Happy you got better! Thank you for your votes!
I called 1177 (the healthcare telephone number) and they think it´s influenza, but that I should call emergency if I get breathing symptoms.
No breathing symptoms, coughing or sneezing.
 
Do call ambulance. Don't hesitate. And don't be scared when the ambulance arrive in that case. They are well Covid-protected, to protect themselves. They will come with the standard Oxygen Pulsoximeter, Blood pressure, lung and heart listening.
It wasn't the 1177 who helped me. I am glad I have My Chinese friends in both Wuhan and Beijing in the start of the year, with medical direct info. And my own First Responder Medical Training e.t.c e.t.c. And I have My Own Real Family HEROES. We're Kind of Close Knit ;).
Send PM to me in Swedish if you need help.

Sov Ordentligt! Vila!
 
A high fever is never anything to take lightly, but these days it's especially scary. I do hope you are recovering. Isn't it lovely to see all those greens on Severino's SS, without insulin!
 
Hello everyone :)

After many hours sleeping I feel I am getting better :) Hope tomorrow will be a regular day! I also don´t have corona!!! Thank you for asking <3

Updates about Severino and a question: Severino will be out of insulin for the next week - it has been advised by the veterinary. He will only eat is low carb food. The veterinary, this time, sent instructions in CAPITAL saying we shouldn´t measure his glucose this week. We are of course no longer listening when it regards to that (I really don´t understand his resistance, but whatsoever). Do you reccomend glucose readings during this period? In which way?
 
Hi Amanda - so glad to hear you are feeling a bit better!

Yes you should test. Here are some guidelines about when to test when you try stopping insulin:

1. Test at your normal AMPS and PMPS times. Remember, you want a 2 hour fast before those AMPS and PMPS test times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.

2. If your cat is green (0-99 mg/dL human meter, 0-130 mg/dL pet meter, 0-5.5 mmol/L) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue or higher (100-199 human meter, 130-230 petmeter, 5.5-11 mmol/L), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!

3. Your cat may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

Hope this helps!
 
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