Abbott Progress

AbbottTheCat

AbbottTheCat

Member Since 2022
I would love to get some feedback on Abbotts spreadsheet. He’s been back and forth between doses for many months now, you will have to look at last years sheet also to get the full picture. His PS have never been all green for very long although he always seem close but never quite gets there. It makes me wonder if it might be worth it taking a shot at OTJ with the higher PS. It seems to be one of those borderline cases. Bhooma probably knows his patterns best since I bug her the most :).
Would love to hear from some other veterans on the forum as well. Please feel free to tag others in your reply. Thanks.

@Bandit's Mom
@Wendy&Neko
 
He did see a lot of green at 1U - including green preshots. His preshots have been creeping up but they're still within meter variance of green and his nadirs are in the 50-80 range. He even dropped to 59 on this dose a few nights back. But for the preshots, he does qualify for a reduction based on a week in normal values...and the preshots are the last to come down. I'm not sure whether to take a reduction tomorrow or go back up to 0.75U to get rid of the blues. Or whether a snack at +8/+9 will help bring down the preshots.

Let's see what @Wendy&Neko and @tiffmaxee have to say.

Link to previous post:
https://www.felinediabetes.com/FDMB/threads/01-24-abbott-pmps-84.273414/
 
Great summary thanks! I would add that he has been in this exact spot before and I went all the way down to a drop dose but his PS never did come down, so it’s kind of a trend of his.

and that was with snack at +8.5 in all the doses .25u and under
 
This may seem off the wall, but your blue preshots are all super close to green. I wonder if you were using a different meter if they would be green. I have a ReliOn Premier Classic and a ReliOn Prime (not sure if they sell the prime anymore?) and the Prime always read just a bit lower than the Premier. On another group (admittedly not as good as this one! :-) ) they told me that the Premier read higher... and I did find that it read a little higher.... so I don't know if it's worth it to even try this... but I am curious. Just my off the wall observation.
 
Suzanne & Darcy said:
This may seem off the wall, but your blue preshots are all super close to green. I wonder if you were using a different meter if they would be green. I have a ReliOn Premier Classic and a ReliOn Prime (not sure if they sell the prime anymore?) and the Prime always read just a bit lower than the Premier. On another group (admittedly not as good as this one! :) ) they told me that the Premier read higher... and I did find that it read a little higher.... so I don't know if it's worth it to even try this... but I am curious. Just my off the wall observation.
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That's a good observation, Suzanne. I too remember reading somewhere that the Premier has on occasion read higher than the AT!

@tessa's mom recently changed from the Premier to a Contour Next:
https://docs.google.com/spreadsheet...J6_z8dnm4OXp-HpmntsbzQU_v0CbrsUOri2H6/pubhtml
 
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Bandit's Mom said:
That's a good observation, Suzanne. I too remember reading somewhere that the Premier has on occasion read higher than the AT!

@tessa's mom recently changed from the Premier to a Countour Next:
https://docs.google.com/spreadsheet...J6_z8dnm4OXp-HpmntsbzQU_v0CbrsUOri2H6/pubhtml
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Thanks, Bhooma. It's just a thought because Abbott's preshot numbers are so close to green and are within meter variance. It could make decision making easier in this case (make us humans feel better!)
 
Yes I’ve had this thought before. The question is exactly what numbers are within meter variance. If you look at the 2022 ss you will see that when he was down to a drop dose he had PS numbers like 125. So it’s very difficult for me to determine if a number like that is within meter variance if also factoring in that the premier reads high. I’ve also heard that the premier reads low! And I’ve read several posts on meter variance. Either way, I have to make a decision if I should take him down to a drop dose again when I’m consistently getting numbers like this. If you really look at the ss you can see his cycle numbers have been VERY consistent for a few months now. It’s the PS numbers that vary.
 
I don’t want to be a party pooper but he hasn’t hit really low green. Are you feeding only lc? Do you have a backup meter to try out this theory? He’s definitely tightly controlled. I know we often have suggested people switch from the AT to a human meter and sometimes they go into an otj trial but that is usually when on a drop dose and still seeing blues. My backup read higher than my go to meter except when it didn’t.
 
tiffmaxee said:
I don’t want to be a party pooper but he hasn’t hit really low green. Are you feeding only lc? Do you have a backup meter to try out this theory? He’s definitely tightly controlled. I know we often have suggested people switch from the AT to a human meter and sometimes they go into an otj trial but that is usually when on a drop dose and still seeing blues. My backup read higher than my go to meter except when it didn’t.
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Yes I’ve always fed only LC and freeze dried single ingredient treats. I have the Premier meter and no back up.
 
And honestly there is no party to poop, I have to make some real decisions here because it’s been much of the same for a very long time now.
 
Suzanne & Darcy said:
Thanks, Bhooma. It's just a thought because Abbott's preshot numbers are so close to green and are within meter variance. It could make decision making easier in this case (make us humans feel better!)
Click to expand...

Actually, his last vet visit we used the same blood sample on my meter and the AT. the AT was 120 while my Premier read 81. I’m not sure what version AT the vet had if that makes a difference.
 
Quoting from Reminder: *earning* reductions and starting OTJ trials
reduction *earned* when the cat regularly has its lowest BGs in the normal range of a healthy cat (50 - 80 mg/dL) and stays under 100 mg/dl overall for at least one week and following TR
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That does not mean blue preshots, and says "stays under 100 overall for one week". The reduction from 1.0 units to 0.75 units was earned this way. Abbott's current numbers do not warrant a reduction. I wouldn't look to find another meter or play games with meter variance but rather read the meter at face value.
 
Wendy&Neko said:
Quoting from Reminder: *earning* reductions and starting OTJ trials

That does not mean blue preshots, and says "stays under 100 overall for one week". The reduction from 1.0 units to 0.75 units was earned this way. Abbott's current numbers do not warrant a reduction. I wouldn't look to find another meter or play games with meter variance but rather read the meter at face value.
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Hi Wendy, just to clarify, does one ignore low blue preshots when considering "stays under 100 overall for one week"?

In this specific case, does Drew hold Abbot's dose or go back up to 0.75U?
 
Thanks. You’d have to go back to last time he was at 2u to find all green PS numbers and even those are higher greens. I understand that by the book he needs to be under 100 to qualify for a reduction but his 2022 sheet and these past few months show that his PS numbers trend on the high end while his cycle tests are consistently in the greens.

Has there been the odd exception where a cat will have 85-110 PS numbers and still go OTJ with the caveat that they just trend a bit on the high side PS?

Wendy&Neko said:
A rare low blue preshot might be OK, but not as many as Abbott is seeing. Drew could try an increase, and see if it either gets more green, or a reduction earned by going under 50.
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AbbottTheCat said:
Has there been the odd exception where a cat will have 85-110 PS numbers and still go OTJ with the caveat that they just trend a bit on the high side PS?
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There have been caregivers who have decided to deviate from TR and take reductions outside of the guidelines. You hold the syringe, that is your right. If you read through the responses to the thread I linked in post #13 above, you will see that what often happens is a remission that is not as strong. Meaning, higher chances of falling out of remission. Yes, some people are lucky and it works.

When are you feeding Abbott now? It's too early in his FD journey to try a snack at +8 to +9. We wait to suggest that until kitty is on a smaller dose and there is clear signs his pancreas is sputtering.
 
Since July 10th, he gets an auto feeder at +1,2,3,4. currently not getting +8,9 snack. I only ever did that on .25 and lower.

what are the clear signs of pancreas sputter?
 
Sounds like your feeding plan is a good one.

Abbott's preshots were all green the last 7 days of 1.0 units, at 0.75 units he had 5/19 preshots blue, of 16 shots at 0.5 units, 11/16 were blue. His numbers don't seem to be as good as the dose goes down. During the first period of time on 1.0 units, since Jan 17, he was getting maybe half PS blues, then it looked like his body/pancreas got the memo and his PS turned all green.

Having said that, his last couple days look like he's really trying for all green preshots. You can always hold a couple more days and see if things improve.
 
I’ve tried +2,3,4,5 with some good results but he was dipping too much at onset so I went back.

thanks for tallying up those numbers, I was going to get a running average going in the spreadsheet PS numbers but I think the ratio of blues to greens is more illuminating, hadn’t thought of that.

yes I agree, it does look like he’s trying to work this dose. It seems lately that holding the dose for longer has been getting more green PS. It was never my intention to reduce right now. I just wanted to hear what everyone thought in general.

So it’s mainly the PS numbers that signal when the pancreas is getting going?
 
The other thing that signals pancreas working is his response to food. Since you feed the first 4 hours of the cycle, but that looks like also when insulin is stronger with him, it's hard to say whether the pancreas is bringing down the numbers in response to food or it's the insulin working. Overall going to lower doses does indicate some pancreas healing.

It's been a few years so harder for me to find an example on Neko's SS, but there were times when her numbers went up to the end of the cycle, I'd feed her and shoot, and her numbers would drop before onset, instead of continuing up. Her onset was +5 on Levemir, so easier to see. And often acrocats have working pancreas, but it's just being overwhelmed by the insulin resistance caused by the excess growth hormone.
 
Interesting. Is there anything you would recommend trying? Maybe testing at different times, or skipping some meals once or twice as an experiment to see how much work the pancreas is actually doing?
 
What do you all think of the current numbers? Looks like he was working the dose fairly well. I could hold or increase but he hasn’t quite earned a reduction I’m guessing.
 
Following this discussion closely, as Faraday has spent a lot of time with blue preshots and green cycles. We're finally getting back to low blue PSs after some holiday wonkiness of higher blue PSs.

At this point, I'm holding out until we get consistent green PSs to go down, as previous attempts at reductions after a week in "near-green"/within-meter-variance-of-green PS#s didn't hold for him.

I'd hold out for a week in actual greens for a better chance at the reductions sticking!
 
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