2/24 Dora AMPS 475 +5 277 (!)

Dora the Explorer

Dora the Explorer

Member Since 2020
https://www.felinediabetes.com/FDMB/threads/dora-higher-after-increase.243565/

So frustrating! It’s only the second day at 3.25 units but over a week since the bump to 3. And she’s is only going higher.

note that these are AlphaTrack numbers, and I did catch her eating an hour before this test, but she was high at +7 already. I asked my husband to test with the freestyle kite and it read 275. 200 lower! I’ll do a test with the tester solution but we have two meters and they’ve been running about the same for these high weeks.

does she need to go to the vet? What should be my plan for the next week? Thank you :-(

jane
 
If you consider meter variance, she has been flattish for the last 2-3 days. Today's high could be on account of a food bump if she ate an hour before her AMPS.

Dora the Explorer said:
I asked my husband to test with the freestyle kite and it read 275. 200 lower!
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That's quite a difference! What strips are you using with the AT? @Gill & George
Btw, why not stick to the human meter? Cheaper strips as well.

Dora the Explorer said:
does she need to go to the vet? What should be my plan for the next week?
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Does she look okay besides the higher numbers? At these levels she may still be hungry and very thirsty and peeing a lot more. Like I said yesterday, she needs more insulin and you test enough for TR. I would follow TR, at least till you get close to her good dose. Get her in better numbers sooner.

Glad you are testing regularly for ketones :)
 
Dora the Explorer said:
ote that these are AlphaTrack numbers, and I did catch her eating an hour before this test, but she was high at +7 already. I asked my husband to test with the freestyle kite and it read 275.
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It's normal to get a big variation between the human meter and pet meter at the higher levels.
I used the freestyle lite meter as a backup meter and had no problems with it, it maybe measured a little lower than my other meter (which had a larger sample size)

I agree with @Bandit's Mom , it looks as though Dora needs more insulin, and you may be fighting with glucose toxicity, this is where persistent hyperglycaemia leads to insulin resistance, resulting in a need for a higher insulin dose, more info here on SLGS it will be harder/slower to overcome, because you have to hold on to doses for at least a week.

On TR you will be able to change the dose every 4 to 6 cycles, if the numbers are high, it will allow you to get to a better dose for her more quickly, but within a safe framework, if you follow the guidelines, if you then want to take things a bit slower, you can always switch back to SLGS if you find that TR is too much. You test enough (as long as you are always getting a before bed test) to do TR.
 
Should you decide to follow TR. you increase the dose day after tomorrow if she doesn't see any blues on this dose by then. (You hold the dose 3 days in all)
If you see only numbers above 300, you increase by 0.5U to 3.75U.
 
Thanks to you both - I suppose I have made the mental decision to switch to TR but I haven't changed it on the spreadsheet or my profile. So I will change her up day after tomorrow - I guess I should have done a larger increase to 3.5 when I upped from the three units. I'm terrified to have her at 4 or higher. Do you think I should start using the freestyle lite until she's more stable, both so my numbers will be in line with what you quote and so I won't have to look at numbers in the 400s?

As for how she is acting, she is just sleeping in the sun in the window. She ate her breakfast like normal, and she's not any different in terms of drinking and eating, but she usually isn't. Ever since starting insulin the thirst has been normal and her eating was always normal. Earlier this year when she was sick and something sent her into the 500 and even low 600 levels, she was drinking again, but after she finished her medicine she came back down and I thought we were on the way back down to good numbers, but I guess not. Maybe I wasn't aggressive enough with her insulin while she was recovering (or ever) but I kept thinking she would drop too low. And why does she have these random blue and yellow numbers scatted few and far between? Is that insulin resistance? How high do you think she will need to go to combat this? I feel so bad for her - trying to my best but it's just not good enough.

So to clarify for TR we would test as always before each shot, but also at random midcycle times, once or twice during the day and then before bed? So we wouldn't need to always be waking up all night and testing her at 2-3am as well? She generally gets her shots at 7/7.

Thank you again, I really appreciate it.

Jane
 
Dora the Explorer said:
Do you think I should start using the freestyle lite until she's more stable, both so my numbers will be in line with what you quote and so I won't have to look at numbers in the 400s?
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Since both dosing methods were devised using human meters, the recommendation is that it is better to use a Human Meter when following either TR or SLGS, so yes I would swap to the freestyle lite, it takes the guesswork out of it.

It will make the SS look prettier too.:D
Dora the Explorer said:
So to clarify for TR we would test as always before each shot, but also at random midcycle times, once or twice during the day and then before bed?
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Yes
Dora the Explorer said:
So we wouldn't need to always be waking up all night and testing her at 2-3am as well?
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You may need to at times.
Have you got an autofeeder? It helps if you need to sleep and you can leave food out in it, you can leave HC or MC or LC so you can sleep easy. It was a godsend for us, meant I could sleep and not get up for room service for George. Also handy if you have to nip out to the shops, or have to leave for work.

Dora the Explorer said:
And why does she have these random blue and yellow numbers scatted few and far between? Is that insulin resistance?
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Yes, she seems to go a little lower, insulin is still not quite enough and she goes off the dose.

Dora the Explorer said:
She generally gets her shots at 7/7.
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That was my shooting schedule, I generally went to bed at 11, so it gave me a chance to get at least a +5, but more often than not I would get a +2 and +3, he was usually sat by me on the sofa anyways.
 
Thanks - excuse my lack of skills to copy and paste and reply as you did - very cool !

Anyway, I actually have five cats we usually feed them "second dinner" at bedtime and then Dora mostly sleeps through the night without being hungry. The other cats usually eat all the food overnight and then we feed her when we get up around 6:30. Last night they left some in the bowls and I caught her on the camera eating it at around 5:30am. But since I know she was high at 2:30 I don't think she would have been much lower had she not eaten it.

We also have a microchip feeder for dry food for the other cats; Dora hates seeing them eat from that but she's resigned to it now. She only eats low carb pates. I tried Young Again Zero but it was shortly after that that she had the bacterial overgrowth in her belly and had to go on flagyl for a week so I try to only give her freeze dried chicken (she had figured out that when the dogs come in from the yard, they get treats, and she would come tearing through the house for a treat of her own, so I think she had too much freeze dried chicken and maybe it expanded in her belly? Or maybe she didn't do well on the Young Again?) She tolerates the Dr. Elsey's but it raises her sugar. Sometimes I'll give her one or two nuggets as a treat.

She's still sound asleep in the sun, so I'm not expecting a low number for her midday read but you never know. Usually she's alert and chirpy when her numbers are good.

Do you think I should proactively have her on some of the B12 (is it?) for her legs? She doesn't have trouble but she's a young cat and I do see her stretching them out behind her often when she wakes up.

Edit to add: we also have two dogs. Everyone (including us!) is aging together and the one dog is sick with CHF. He is on a strong diuretic and gets let out in the middle of the night so that's when my husband has been testing Dora if not before we go to bed.
 
Update: this midday reading was 277 and the Freestyle lite was 174 (or close to it, I lost my phone and am now doing this from memory, I haven't updated the SS yet.) So if I had been posting all Freestyle numbers it would seem much less alarming. I just ordered two new tubs of AT strips, though!

So that is exciting. She ate voraciously and is now back on her condo in the window. Fingers crossed! Will see what happens and post after dinner.
 
Dora the Explorer said:
Thanks to you both - I suppose I have made the mental decision to switch to TR but I haven't changed it on the spreadsheet or my profile. So I will change her up day after tomorrow - I guess I should have done a larger increase to 3.5 when I upped from the three units. I'm terrified to have her at 4 or higher. Do you think I should start using the freestyle lite until she's more stable, both so my numbers will be in line with what you quote and so I won't have to look at numbers in the 400s?

As for how she is acting, she is just sleeping in the sun in the window. She ate her breakfast like normal, and she's not any different in terms of drinking and eating, but she usually isn't. Ever since starting insulin the thirst has been normal and her eating was always normal. Earlier this year when she was sick and something sent her into the 500 and even low 600 levels, she was drinking again, but after she finished her medicine she came back down and I thought we were on the way back down to good numbers, but I guess not. Maybe I wasn't aggressive enough with her insulin while she was recovering (or ever) but I kept thinking she would drop too low. And why does she have these random blue and yellow numbers scatted few and far between? Is that insulin resistance? How high do you think she will need to go to combat this? I feel so bad for her - trying to my best but it's just not good enough.

So to clarify for TR we would test as always before each shot, but also at random midcycle times, once or twice during the day and then before bed? So we wouldn't need to always be waking up all night and testing her at 2-3am as well? She generally gets her shots at 7/7.

Thank you again, I really appreciate it.

Jane
Click to expand...
Jane...I know exactly what you mean about "I'm terrified to have her at 4 or higher" but in case it helps you feel better, Minnie has just gone up to 4 which finally seems to be bringing her down from black/red to pink. I re-read the Dosing Methods sticky again last night and this popped out at me this time which made me feel much better, so I printed it out! Not sure why it didn't sink in the first 5 times I read it :) I'm cautiously hopeful that we get to increase by only 0.25 units tomorrow. I'm also stuck with the AT for now because I can't get enough blood for the other meters. Too many things to stress about so I'm sticking with it for now until that part gets easier. Now I just have to get her out from under the bed for our +3 test...

Good luck to you and Dora!

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
 
Bandit's Mom said:
can you cancel the order?

if you switch to a human meter, will need to make a formatting change to your SS - I can do that for you once you make the switch.
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Alas not, they arrived yesterday. It's ok, as you know, we go through them quickly. And I have the AT for a cross check so when we do switch I'll know what the "usual" range would be. I'd rather get her stable on the curve we have been on just so I'm confident that it's real and not just meter variance, also, I think. It's so cute and purple-y!
 
Liz & Minnie said:
Jane...I know exactly what you mean about "I'm terrified to have her at 4 or higher" but in case it helps you feel better, Minnie has just gone up to 4 which finally seems to be bringing her down from black/red to pink. I re-read the Dosing Methods sticky again last night and this popped out at me this time which made me feel much better, so I printed it out! Not sure why it didn't sink in the first 5 times I read it :) I'm cautiously hopeful that we get to increase by only 0.25 units tomorrow. I'm also stuck with the AT for now because I can't get enough blood for the other meters. Too many things to stress about so I'm sticking with it for now until that part gets easier. Now I just have to get her out from under the bed for our +3 test...

Good luck to you and Dora!

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Click to expand...

Thank you!! I know, I have read both SLGS and TR 100 times in the last year and I still thought TR meant I had to test every couple of hours.

FYI the Freestyle Lite strips are identical to the AT2. They take the same little tiny drop of blood. So if you want a human meter, there's your guy. The only bad thing is that the strips are cheaper than the AT but not as cheap as the ones everyone on here seems to favor. No matter to me the cost, though, I am all in for the less blood, the better! Thank you for the encouragement on going up to 4. It seems so shocking when initially we started on 1 and Dora went down to 62. (Once.)
 
Dora the Explorer said:
Thank you!! I know, I have read both SLGS and TR 100 times in the last year and I still thought TR meant I had to test every couple of hours.

FYI the Freestyle Lite strips are identical to the AT2. They take the same little tiny drop of blood. So if you want a human meter, there's your guy. The only bad thing is that the strips are cheaper than the AT but not as cheap as the ones everyone on here seems to favor. No matter to me the cost, though, I am all in for the less blood, the better! Thank you for the encouragement on going up to 4. It seems so shocking when initially we started on 1 and Dora went down to 62. (Once.)
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Where are you getting the Freestyle Lite strips? Everywhere I look they're the same price as AT (or sometimes more)... I've found a few other human meters that also take the 0.3microliter of blood but only the AT and Freestyle have the little "antenna" on the side which is so much easier for me.
 
Liz & Minnie said:
Where are you getting the Freestyle Lite strips? Everywhere I look they're the same price as AT (or sometimes more)... I've found a few other human meters that also take the 0.3microliter of blood but only the AT and Freestyle have the little "antenna" on the side which is so much easier for me.
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Hmm, I think I get them from amazon - once I forgot the AT though and had to buy the strips at CVS and I swear they were like $70, it was ridiculous! Maybe they were on sale when I got them - I hope they're not the same as AT but I could see why they would be. They are wonderful to use. (just checked amazon, looks like they are $30.98 vs. $50 for the AT2)
 
Dora the Explorer said:
Hmm, I think I get them from amazon - once I forgot the AT though and had to buy the strips at CVS and I swear they were like $70, it was ridiculous! Maybe they were on sale when I got them - I hope they're not the same as AT but I could see why they would be. They are wonderful to use. (just checked amazon, looks like they are $30.98 vs. $50 for the AT2)
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Thank you!!! They weren't that price last I looked :)
 
I believe the Relion from walmart has a very small sample as well, and the cost saving is greater (I'm in europe so I'm just reporting what I have read)

Dora the Explorer said:
I'd rather get her stable on the curve we have been on just so I'm confident that it's real and not just meter variance, also, I think. It's so cute and purple-y!
Click to expand...
It's easier to make the swap when the numbers are higher, I had to swap from my usual meter to a freestyle lite (george sent his meter for a swim in his fountain) just when George started venturing into low greens, that messes with your head much more.

Yellow is too high, purple is too high, it doesn't matter, really, you can't make any sense of the comparisons anyways, that's why there isn't a conversion.
The IMPORTANT point is that the methods were developed with human meters not pet meters, so they are easier to follow and you can take full advantage of the methods, you cannot do that with a pet meter.
 
Gill & George said:
I believe the Relion from walmart has a very small sample as well, and the cost saving is greater (I'm in europe so I'm just reporting what I have read)


It's easier to make the swap when the numbers are higher, I had to swap from my usual meter to a freestyle lite (george sent his meter for a swim in his fountain) just when George started venturing into low greens, that messes with your head much more.

Yellow is too high, purple is too high, it doesn't matter, really, you can't make any sense of the comparisons anyways, that's why there isn't a conversion.
The IMPORTANT point is that the methods were developed with human meters not pet meters, so they are easier to follow and you can take full advantage of the methods, you cannot do that with a pet meter.
Click to expand...

sorry I’ve been absent! I had to go in to work today and it’s two hours away. She’s in the 200s on the freestyle and the 3-400s on the AT2. But I did go ahead and switch the numbers to freestyle in the spreadsheet. I guess she will need a higher dose beginning tomorrow:-(
 
Gill & George said:
No worries

Yep if you are making the change to TR, take her up to 3.50

Can you change the signature to reflect that you are doing TR please, I see you have already changed it on the SS. thanks.
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yes! I will update that. Also, I couldn’t access this am as I guess the board was down but she was at 172 AMPS so I didn’t go up just yet. I wasn’t sure if that was a “raise .25” or “hold” level. I can go up tonight or in the morning if it’s a raise. Thanks!
 
H Jane, you don't need to mention the current dose on the Signature. But please do add the meter that you are using?

With nadirs in blue, you would hold the dose 10 cycles (5 days) before increasing.
 
We did get the midcycle test and the PMPS and a +4.5. I didn’t have my phone handy so just plugged them all in.

She’s back up there again. So frustrating. Do I still hold for ten cycles? She had one good number like this about a week ago also.

Still acting completely fine.
 
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