Mew and me, and introduction (Libre2 and ProZinc)

Mew's Dad

Mew's Dad

New Member
Mew.JPG

I would like to introduce Mew, my bestest furry little buddy who was diagnosed with Diabetes back in late January of this year.

It has been a challenge getting him regulated, he is improving. His appetite and drinking has reduced, his neuropathy is almost gone and it has been a very long road.

As part of my quest for forgiveness and knowledge, I have written up all I have learned in a PDF (attached) and built a visualization tool for his Libre 2 data (attached). I would love to hear feedback and possible suggestions for improvement on the tool I have built, it is a work in progress. A snapshot below:
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Attachments

You have done an incredible amount of work! I'll be honest, I don't have the time to read through the 50 pages. How can we be most helpful?

We do ask members to use our spreadsheet rather than the graphs from the Libre. The spreadsheet allows us to view trends and frankly, for the experienced members, we are used to the way the spreadsheets are formatted. I've been around here a long time and I'm pretty well wed to the spreadsheet. If you convert over, you don't need to move over all of your data. A few weeks worth would be fine. The information on the spreadsheet and setting up your signature are in this post on helping us to help you. Your signature provides us with basic information so we don't keep pestering you with the same questions.

You may want to take a look at the sticky notes at the top of the Prozinc board. It will give you a feel for how we approach dosing.
 
I was thinking of using the same approach as you folks do with the spreadsheet and put the model and document in my signature. Moving the model data over to the spreadsheet is a ton of work.

I have debated adding a Libre 2 import feature to your spreadsheet. Unfortunately, I cannot share the model easily for multiple users without a huge cost, but I do code in a lot of languages and may take up the challenge. That would take time.

I don't need dosing advice really. I'm not looking to get help, at least not yet. Insights are good. I might have an incorrect approach.

His case has been a challenge and I have been reading everything I can absorb that has been posted already. Good advice and people here.

This is more about sharing.
 
Hi Mew and Dad,
Mew is such a handsome boy.
Your document is very impressive. And your dedication to your sweet buddy is evident.

We are happy to help you any way we can.
As Wendy mentioned, I have been using a Libre 3 for almost 3 years now.
I like it since it sends the data instantly to the app on my phone so I know what’s going on 24/7 without needing to physically scan my cat (as is needed with the Libre 2).
What country are you in? That can dictate what Libre is available to you. I’m in the US.

Feel free to look at my spreadsheet for an example of how I track the data.
I generally note the sensor reading each hour, and more if she dips even lower (we track nadirs to understand how low the dose is taking the cat to make dosing decisions safely).
Feel free to ask any questions, if you have them.

Check out the document on using a Libre CGM.
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats
 
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Staci & Ivy said:
Hi Mew and Dad,
Mew is such a handsome boy.
Your document is very impressive. And your dedication to your sweet buddy is evident.

We are happy to help you any way we can.
As Wendy mentioned, I have been using a Libre 3 for almost 3 years now.
I like it since it sends the data instantly to the app on my phone so I know what’s going on 24/7 without needing to physically scan my cat (as is needed with the Libre 2).
What country are you in? That can dictate what Libre is available to you. I’m in the US.

Feel free to look at my spreadsheet for an example of how I track the data.
I generally note the sensor reading each hour, and more if she dips even lower (we track nadirs to understand how low the dose is taking the cat to make dosing decisions safely).
Feel free to ask any questions, if you have them.

Check out the document on using a Libre CGM.
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats
Click to expand...
I'm in Canada, they just released the Libre 3 here but it's 25% more than a Libre 2 with no real benefit so I stay with the Libre 2. The Libre 2 also has a phone app. I just leave my app phone near the cat and take another phone I installed LibreLinkUp on with me when I get out of range from him. It's delayed about a minute, but I don't get signal loss that often.

I don't know how I could have gotten this far without knowing what's going on 24/7. The low glucose alarm has saved his life a few times. I can even be proactive and feed him if I am sure his glucose is going to go low before it happens.

He's pretty sneaky and if given a chance, will remove the sensor himself. A while ago, he went through 5 sensors in two weeks.

I just got everything set up for the spreadsheet. I think I'd rather just build a macro to import the CSV data into the sheet. I don't plan on using it. I prefer my own Power BI dashboard which gives me way more information, but I can see others finding it useful.
 
Mew's Dad said:
I'm in Canada, they just released the Libre 3 here but it's 25% more than a Libre 2 with no real benefit so I stay with the Libre 2. The Libre 2 also has a phone app. I just leave my app phone near the cat and take another phone I installed LibreLinkUp on with me when I get out of range from him. It's delayed about a minute, but I don't get signal loss that often.

I don't know how I could have gotten this far without knowing what's going on 24/7. The low glucose alarm has saved his life a few times. I can even be proactive and feed him if I am sure his glucose is going to go low before it happens.

He's pretty sneaky and if given a chance, will remove the sensor himself. A while ago, he went through 5 sensors in two weeks.

I just got everything set up for the spreadsheet. I think I'd rather just build a macro to import the CSV data into the sheet. I don't plan on using it. I prefer my own Power BI dashboard which gives me way more information, but I can see others finding it useful.
Click to expand...
Oh that’s great that you have the app and you can send/receive data.
Here the Libre 2 requires you to manually scan your cat and doesn’t send the data.
I hate it and quickly switched to the 3.
Anyhow, sounds like you have it all under control!
Will Mew tolerate a tee shirt or something to cover the sensor? I see he has a top on in your pic.
My girl wears a “tube top” with no sleeves and is pretty good about it.
With no top she would also rip the Libre off. I can’t have that going on since she won’t tolerate my poking her many times a day.

I hope Mew is a good boy and does well with some support here. Give him some chin scritches from me 😻
 
Staci & Ivy said:
Oh that’s great that you have the app and you can send/receive data.
Here the Libre 2 requires you to manually scan your cat and doesn’t send the data.
I hate it and quickly switched to the 3.
Anyhow, sounds like you have it all under control!
Will Mew tolerate a tee shirt or something to cover the sensor? I see he has a top on in your pic.
My girl wears a “tube top” with no sleeves and is pretty good about it.
With no top she would also rip the Libre off. I can’t have that going on since she won’t tolerate my poking her many times a day.

I hope Mew is a good boy and does well with some support here. Give him some chin scritches from me 😻
Click to expand...
In the document, I went into this topic in depth. He currently is doing well with the sensor attached on his shoulder, secured by a bandage and under a halter. The halter is more rigid and he can't get under it. I secure the sensor with a bandage so it doesn't get exposed. Shirts, he licks through and manages to get under the fabric.

So far, I have managed to get 10-11 days each from the last two sensors. I'm trying to keep that trend going. He also seems to tolerate it better, he can groom more of himself and he seems to be less irritated versus the shirt.

Biggest problem is he is a picky eater, but I cover all that too. It's why I wrote it up. It may be long, but as cute as he is, he is also smart, stubborn, picky and a real pain. I guess I love him more for that. I can't say many other cat dads have such problem kids, so I wanted to have a single resource people could go to when faced with a real problem cat.

I am liking that he now comes for lap snuggles at least once a day, I missed that.
 
Hello from the west coast of BC.

Just from skimming your document, your section on blood glucose should mention if you are reading with a pet or human meter. The Libre is a human meter, and not really testing blood. The Libre tends to show lower values than a human BG meter would under 100. We recommend that people test manually if the Libre is showing low values. You'll also see different values for what is "normal range". I've manually tested a few non diabetics, mine and a friends. One here tested 49, the others mostly in the 50's, with one on steroids going up to 70's. The one at 49 and other at 53 were definitely not in hypo range.

Fructosamine ranges vary by lab somewhat. The latest Idexx report I saw had somewhat different ranges than what you list: Reference Ranges for Fructosamine Test

HST (hypophysectomy) aka acromegaly, I have lots to say about what you've written, but that would take too long. BTW, my acrogirl did not vomit until several years after her diagnosis when her CKD then GI disease started to appear. You might want to read this paper that was recently posted. Good section on HST there.
iCatCare 2025 consensus guidelines on the diagnosis and management of diabetes mellitus in cats
https://journals.sagepub.com/doi/full/10.1177/1098612X251399103

Royal Canin Glycobalance, if that is what you are feeding is 14% carbs for the wet. What we consider medium carb. Ideally you want something under 10%. We don't recommend the prescription foods, definitely not the dry food which is too high in carbs for a diabetic cat.

Section on insulin types: Determir/Levemir will no longer be available in Canada after this year, and only a few places in the world near year and none after that. You should take it out of the table. And by the way, the "potent, used for difficult to regulate cases" is for dogs. Onset averaged 4 hours, 5 in my girl. In cats it was a great insuiln, I'm really sad to see it's an option no longer available for use.

I could say more, but this post is long enough. A lot of what you said is good info, it'd be really good to have a section summarizing what is relevant to Mew.
 
Wendy&Neko said:
Hello from the west coast of BC.

Just from skimming your document, your section on blood glucose should mention if you are reading with a pet or human meter. The Libre is a human meter, and not really testing blood. The Libre tends to show lower values than a human BG meter would under 100. We recommend that people test manually if the Libre is showing low values. You'll also see different values for what is "normal range". I've manually tested a few non diabetics, mine and a friends. One here tested 49, the others mostly in the 50's, with one on steroids going up to 70's. The one at 49 and other at 53 were definitely not in hypo range.

Fructosamine ranges vary by lab somewhat. The latest Idexx report I saw had somewhat different ranges than what you list: Reference Ranges for Fructosamine Test

HST (hypophysectomy) aka acromegaly, I have lots to say about what you've written, but that would take too long. BTW, my acrogirl did not vomit until several years after her diagnosis when her CKD then GI disease started to appear. You might want to read this paper that was recently posted. Good section on HST there.
iCatCare 2025 consensus guidelines on the diagnosis and management of diabetes mellitus in cats
https://journals.sagepub.com/doi/full/10.1177/1098612X251399103

Royal Canin Glycobalance, if that is what you are feeding is 14% carbs for the wet. What we consider medium carb. Ideally you want something under 10%. We don't recommend the prescription foods, definitely not the dry food which is too high in carbs for a diabetic cat.

Section on insulin types: Determir/Levemir will no longer be available in Canada after this year, and only a few places in the world near year and none after that. You should take it out of the table. And by the way, the "potent, used for difficult to regulate cases" is for dogs. Onset averaged 4 hours, 5 in my girl. In cats it was a great insuiln, I'm really sad to see it's an option no longer available for use.

I could say more, but this post is long enough. A lot of what you said is good info, it'd be really good to have a section summarizing what is relevant to Mew.
Click to expand...
Very good feedback. I'll incorporate your suggestions when I get back to editing it. I admit, HST is something I know nothing about and had to rely on online sources because I felt it was something that people should at least know about.

I am using the Royal Canin diabetic prescription food. I don't know if that is what you are referring to as "Glycobalance" and am curious how you managed to determine it is 10% carbs. I had to try to calculate carb content from the nutrition information on the label which can be highly inaccurate.

I did try using non-prescription, low carb food and while it appeared promising, I found that the formulation and variation in quality between batches or even can to can drove me back to prescription just because it is generally consistent.
 
Mew's Dad said:
Very good feedback. I'll incorporate your suggestions when I get back to editing it. I admit, HST is something I know nothing about and had to rely on online sources because I felt it was something that people should at least know about.

I am using the Royal Canin diabetic prescription food. I don't know if that is what you are referring to as "Glycobalance" and am curious how you managed to determine it is 10% carbs. I had to try to calculate carb content from the nutrition information on the label which can be highly inaccurate.

I did try using non-prescription, low carb food and while it appeared promising, I found that the formulation and variation in quality between batches or even can to can drove me back to prescription just because it is generally consistent.
Click to expand...
Geez, brain is still fried from work.

Was going to say I have lived most of my life in BC. My 10 years in Victoria was memorable, 23 in Fort St John, Tofino was a real experience and I know most of BC like the back of my hand. Currently, I am in Calgary, Alberta, but may head back to the Island when I retire.
 
Wendy&Neko said:
Calgary also a pretty part of Canada. I need the ocean for my "blue therapy", so the coast it is.

You also reference the catinfo.org website in your document. It's a good read, though a long one. Not sure if you've read this section: Feeding Your Cat: Know the Basics of Feline Nutrition – Common Sense. Healthy Cats.. Low carb food is a huge part treating diabetes. The 14% part of RC glycobalance I got from this food chart on the catinfo website.
Click to expand...
Ah, very familiar with Catinfo.org and that chart and used it a lot, it's referenced in the document. I can guarantee the Glycobalance is not the same thing as the prescription diabetic food.

If you ever get a chance, get a water taxi from Tofino and go to Hotsprings Cove: Hot Springs & Nism̓aakqin Park – Maaqutusiis Hahoutlhee Stewardship Society (MHSS) I am a hot springs junkie and when I lived in Tofino, I camped there for two weeks.
 
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