1/29 Hendrick AMPS 431 +3 233 +4 195 +6 177 +8 243 PMPS 438 +3 350 +5 299

Hendrick Cuddleclaw

Hendrick Cuddleclaw

Very Active Member
Yesterday's Thread

Did AMPS with AT2, then switched to using a human meter (CareSens is the brand) and will use this human meter for all tests going forward.

3 days of high 500s at AMPS, today 431. Maybe he is clearing that bounce. AMPS is between 6 and 630am and last snack was tablespoon of 0 carb at about 10pm

Looking for any suggestions on a canned food for Hendrick he can eat well, he wont eat pate and also doesnt like thin shreds. Needs to be chunks (like DM Savory Selects, ideally...but lower carb of course) or larger shreds like his favorite but too-high-carb Wellness Core Hearty Cuts.

I am beginning to wonder if multiple vet visits have missed a dental issue, sometimes when eating he suddenly whips his head side to side and pieces go flying -- especially the thin shreds. As if a piece is getting stuck somewhere and it is causing discomfort. This also will sometimes put him off entirely and he will cease consumption.

Larger chunk-type food he doesn't seem to do the head thing quite as much if at all.

I should post a video. Any thoughts or suggestions are appreciated.
 
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Looks like it's time for an increase. If you're following TR you can increase every 6 cycles unless you see nadirs under 200. I'm not seeing anything under 200.

Would you be open to switching to a human meter for a while so we can see what the numbers really look like? AT2's tend to read higher than human meters...
 
Sue and Luci said:
Looks like it's time for an increase. If you're following TR you can increase every 6 cycles unless you see nadirs under 200. I'm not seeing anything under 200.

Would you be open to switching to a human meter for a while so we can see what the numbers really look like? AT2's tend to read higher than human meters...
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I will do whatever you think is best for my buddy Hendrick to hopefully get him regulated and feeling better

My wife bought a human meter at one point we've just never used it. We'll give it a go
 
I can't believe yesterday was the first time we actually got two tests per cycle other than fur shot day. I feel so stupid that I didn't realize two tests per cycle was the minimum for TR, I thought it was two/day min. Also keep in mind we were inadvertantly feeding him mostly 13-16% calories from carbs food that we mistakenly thought was sub-5%, for the last week or two. So we were thinking stick with the 1.25 while we transition away from those HC/MC foods
 
Hendrick's mom and dad said:
Looking for any suggestions on a canned food for Hendrick he can eat well, he wont eat pate and also doesnt like thin shreds. Needs to be chunks (like DM Savory Selects, ideally...but lower carb of course) or larger shreds like his favorite but too-high-carb Wellness Core Hearty Cuts.
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I did a search on our site and found this posted from one of our members
On the food chart take a look at Fancy Feast Roasted/Flaked /Chunky
They are not pates, some are 4, 5, or 6 % carbs
Chunky Chicken Feast - is 4% carbs.
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Hendrick's mom and dad said:
I can't believe yesterday was the first time we actually got two tests per cycle other than fur shot day. I feel so stupid that I didn't realize two tests per cycle was the minimum for TR, I thought it was two/day min. Also keep in mind we were inadvertantly feeding him mostly 13-16% calories from carbs food that we mistakenly thought was sub-5%, for the last week or two. So we were thinking stick with the 1.25 while we transition away from those HC/MC foods
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It's a learning experience. I wouldn't wait much longer because those foods, while high in carbs, are not the highest...so between his poor pancreatic function and the moderately high carb foods his numbers 'may' have been influenced somewhat, but I'm concerned that they shouldn't really have been this high. Those reds and blacks are a clear indication of needing more insulin.

Once you've removed all the medium carb foods - hopefully immediately - and a day of 1.25 and you've not seen any better numbers, I'd say increase to 1.5 until you see better numbers - even yellows (200-300) at this point would be an improvement.
 
Sue and Luci said:
It's a learning experience. I wouldn't wait much longer because those foods, while high in carbs, are not the highest...so between his poor pancreatic function and the moderately high carb foods his numbers 'may' have been influenced somewhat, but I'm concerned that they shouldn't really have been this high. Those reds and blacks are a clear indication of needing more insulin.

Once you've removed all the medium carb foods - hopefully immediately - and a day of 1.25 and you've not seen any better numbers, I'd say increase to 1.5 until you see better numbers - even yellows (200-300) at this point would be an improvement.
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Yes he has had nothing above 10% since Thursday, trying to get him off the 10% stuff too, gave him less past two days but atm it is one of the only things he is eating well (DM Savory Selects) and seeing as he still has ketones (.9 yesterday, we'll see what today's value is at +3) we also want to make sure we are getting lots of calories in him of course
 
I'm glad to see that pm +3 test :). I wanted to offer some additional clarification regarding TR, since as I have pointed out, what you were doing was not TR.

I won't belabour the point, but from my perspective, the TR dosing method is aggressive enough, and without meeting the minimum testing requirements that the method calls for, that presents additional risks. So, I think we've worked that out, now that we'll be seeing a test at night going forward ;). Great - we are following TR, let's go back to the sticky and see what we should be doing.

From the TR Sticky:

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.

We did see nadirs under 200, but unfortunately we had a fur shot on 24Jan2022, so with TR that messes up our count. We then saw 196 on Jan25th. But, no pm mid-cycle tests thereafter for a few days, so we don't know what was happening then (again, I am not going to belabour the point ;), but unfortunately it factors into the decision of whether to increase the dose).

So today is cycle 10 after the fur shot. I would suggest you see how today goes, and this evening as well just in case, particularly if you are better able to test during the day, that might be the better time to do an increase. Had we seen previous nighttime tests, arguably today you could have increased. Does he need an increase? Probably BUT: Here is a good post that I'd like to share.

Should I increase the dose?

Note: "How low has the current dose taken kitty over the last 72 - 96 hours?". This is why I am suggesting waiting until you are sure of what is happening at night.

One last comment. From my perspective, it is important for new caregivers to start off on the right foot when it comes to the dosing methods we follow here, since there was a lot of time and effort put into them. I don't recommend picking and choosing what parts of either method to follow, and perhaps that is why I am a bit passionate about clarifying things, when I see that there is perhaps some confusion, take it FWIW.
 
Sue and Luci said:
Looks like it's time for an increase. If you're following TR you can increase every 6 cycles unless you see nadirs under 200. I'm not seeing anything under 200.

Would you be open to switching to a human meter for a while so we can see what the numbers really look like? AT2's tend to read higher than human meters...
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Did the +3 just now with both the AT2 and a human meter (CareSens)

Human Meter displayed 233, AT2 displayed 281

Ketones came in at .7 thankfully, down from yesterday's .9

I am frankly floored we did all 3 with one poke. Wasn't easy but we got it with a little ear-milking

I am pondering a way to note the SS that we have switched to a human meter mid-stream.
 
Hendrick's mom and dad said:
Did the +3 just now with both the AT2 and a human meter (CareSens)

Human Meter displayed 233, AT2 displayed 281
Thank you! Good to see that 233.

Ketones came in at .7 thankfully, down from yesterday's .9
:)

I am frankly floored we did all 3 with one poke. Wasn't easy but we got it with a little ear-milking
Congratulations! Sometimes if you get the drop you can scoop it up with the back of your thumbnail/fingernail and use it for multi-purposes - if you've got a big enough drop.

I am pondering a way to note the SS that we have switched to a human meter mid-stream.
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You can click on your SS - insert a row - select format/merge to push all the cells together; format/align/center / write on there 'Switching to Human meter at 3+; select a different background color using the little 'paint bucket' at the top of your SS - it'll help folks to know you've switched.

It's much appreciated and I think you'll see somewhat better numbers with the hooman meter.
 
Sue and Luci said:
You can click on your SS - insert a row - select format/merge to push all the cells together; format/align/center / write on there 'Switching to Human meter at 3+; select a different background color using the little 'paint bucket' at the top of your SS - it'll help folks to know you've switched.

It's much appreciated and I think you'll see somewhat better numbers with the hooman meter.
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Ah ok thanks for the SS suggestion, will do

based on another post I read, that 233 at +3 is a bit of a steep dive no? I gave him a teaspoon MC (10-13%), which is normal for this time of day
 
Hendrick's mom and dad said:
Ah ok thanks for the SS suggestion, will do

based on another post I read, that 233 at +3 is a bit of a steep dive no? I gave him a teaspoon MC (10-13%), which is normal for this time of day
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Yes, that's a significant drop - AMPS was AT2 so you've got to compare that with the 281...still quite a drop. A teaspoon of MC and another test in an hour please. Don't want him to drop too low, too fast. He'll bounce really hard if you let him get too low...it's like walking a tightrope now...keeping him on the downslide, but slow and easy...
 
Sue and Luci said:
Yes, that's a significant drop - AMPS was AT2 so you've got to compare that with the 281...still quite a drop. A teaspoon of MC and another test in an hour please. Don't want him to drop too low, too fast. He'll bounce really hard if you let him get too low...it's like walking a tightrope now...keeping him on the downslide, but slow and easy...
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Omg I'm actually get the hang of this -- that is almost verbatim what I told my wife when I saw the 233 "hmm thats a fast drop we're going to need to test again in an hour or two, don't want another bounce from getting too low"

ty!!
 
Hendrick's mom and dad said:
Omg I'm actually get the hang of this -- that is almost verbatim what I told my wife when I saw the 233 "hmm thats a fast drop we're going to need to test again in an hour or two, don't want another bounce from getting too low"

ty!!
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Exactly! And @Christie & Maverick have given you some excellent advice! Please read that carefully :) Thanks Christie for taking the time! Excellent points for moving forward!
 
Learning how your cat responds to carbs and insulin takes some time, usually when feeding the curve, you would start with usual LC food, particularly if you can test. Sometimes feeding a couple bites of LC food slows them down enough, I don't know if I would have grabbed the MC right away, it may be a bit too much, but it is a bit of an experiment to learn what works for Hendrick.
 
Christie & Maverick said:
Learning how your cat responds to carbs and insulin takes some time, usually when feeding the curve, you would start with usual LC food, particularly if you can test. Sometimes feeding a couple bites of LC food slows them down enough, I don't know if I would have grabbed the MC right away, it may be a bit too much, but it is a bit of an experiment to learn what works for Hendrick.
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yeah i may have overreacted...guess we'll find out soon here...another test coming up in next 20 min
 
Christie & Maverick said:
Learning how your cat responds to carbs and insulin takes some time, usually when feeding the curve, you would start with usual LC food, particularly if you can test. Sometimes feeding a couple bites of LC food slows them down enough, I don't know if I would have grabbed the MC right away, it may be a bit too much, but it is a bit of an experiment to learn what works for Hendrick.
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we are blue! 195
 
I am really starting to think that his bounces have mostly been due to diving too low at night

Look at those PM +3s we got a few days ago of 118 and 124 -- we are zeroing in on his nadir and it is clearly around +5 so....

like idiots, when we got those low blues at 930pm on those days (1/21 and 1/23) we just said YAY BLUE and went to sleep

I bet he dipped under 100 at +5 on 1/21. @#$%

I now understand your frustration with us @Christie & Maverick , we took on TR but were most definitely not doing it. And it has led to some lost time. I see that now so clearly. Dammit now Im tearing up, stupid onion factory
 
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we'll be doing a PM +5 tonight i think, unless his +3 is pink. But if it's blue, definitely doing a PM +4 and/or a +5

any thoughts on next test here...+5 needed or wait until +6 to make sure he has hit the nadir

@FrostD or @Christie & Maverick or @Sue and Luci ?

I am thinking +6 but will of course take your guidance
 
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Hendrick's mom and dad said:
I now understand your frustration with us @Christie & Maverick , we took on TR but were most definitely not doing it. And it has led to some lost time. I see that now so clearly. Dammit now Im tearing up, stupid onion factory
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I am not frustrated with you at all ;), I hope I didn't come across that way, just trying to do some guidance based on my own experiences. I kind of think of it like following a recipe for a cake, if you cut corners, don't add the right ingredients, or enough of them, and only bake it for 15 minutes, well all you end up with is a half baked cake no one wants to eat :p
 
You can usually make pretty reasonable inferences as long as you catch a test close to nadir. Even if he is bouncing from lows, I really don't see him having gone below 90...and for purposes of TR and intervention, we only start to raise an eyebrow if we see 60-70 on human meter near nadir (reductions below 50 on human meter, 68 on AT).

Nighttime when sleep is a little more precious, you actually want to test about an hour before nadir (at least at these numbers). That way you can intervene with food if needed before they get too low.
 
FrostD said:
You can usually make pretty reasonable inferences as long as you catch a test close to nadir. Even if he is bouncing from lows, I really don't see him having gone below 90...and for purposes of TR and intervention, we only start to raise an eyebrow if we see 60-70 on human meter near nadir (reductions below 50 on human meter, 68 on AT).

Nighttime when sleep is a little more precious, you actually want to test about an hour before nadir (at least at these numbers). That way you can intervene with food if needed before they get too low.
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hmmm so based on what we know right now, a nightime test at +4 instead of +3. As nadir appears, at least based on what data we do have, to usually land around +5

do I have that right

so...we got a 177 at +6 and now I don't know what to think. Was he lower at +5 and is now on his way back up? I guess that is likely....wasn't planning another test until PMPS but maybe now we should toss in a +8?
 
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Christie & Maverick said:
He's coming down nicely, flattened a little to +4, I agree with your thoughts for +6:)
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so with +6 coming in at 177 I don't know what to think, was expecting he nadir'd at +5 and I'd see something higher than the +4 195

maybe we should do another test at +8? I was planning on leaving him be until PMPS

ironically, at one point we had planned a curve today but then a member here said no need to do that as long as we were testing daily, multiple times a day. Well today is just about shaping up to be a curve anyway lol.
 
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I just realized that's teh first time we've ever got blues in two consecutive tests. He's got to be on the way back up now, +8 probably not needed

wife wants to do it anyway, so we might.
 
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Looks like he's still dropping. If you can, I would definitely get a late cycle test just so you know what you are dealing with before shot time rolls around, you get a number lower than you're used to, and you have no idea whether it was a drop from 177 or a rise from 80. Cats nadirs are never fixed, but with time you will be able to note patterns with your own cat. Ruby likes to go lower early in a cycle, until she doesn't. :)

Here's a great bit of reading that had me convinced that getting the nadir is not the end all and be all of TR: https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/
 
Katherine&Ruby said:
Looks like he's still dropping. If you can, I would definitely get a late cycle test just so you know what you are dealing with before shot time rolls around, you get a number lower than you're used to, and you have no idea whether it was a drop from 177 or a rise from 80. Cats nadirs are never fixed, but with time you will be able to note patterns with your own cat. Ruby likes to go lower early in a cycle, until she doesn't. :)

Here's a great bit of reading that had me convinced that getting the nadir is not the end all and be all of TR: https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/
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great read ty. If this IS a bounce-clearing day he could go lower according to that
 
Hendrick's mom and dad said:
hmmm so based on what we know right now, a nightime test at +4 instead of +3. As nadir appears, at least based on what data we do have, to usually land around +5

do I have that right
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It really depends on what you want to do. Most o us do the +2/+3 before bed as a standard test, then based on that decide if/when to set an alarm. Generally speaking, if it's higher than PS take the night off. If it's flat, a test right at nadir is probably fine. If it's a drop, then an hour or so before nadir. Big drop,well that's another story, I'd ask for advice on that.

Mr Kitty was never really predictable enough for me to do that, so I often got up middle of the night anyway to check him
 
Hendrick's mom and dad said:
Yeah his best day yet by far, also to be noted FIRST day using a human meter
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And I think a bit closer look into the reality of the situation. Hopefully those numbers will help guide you on your testing decisions...when falling, set that alarm and get more tests...if flat and or rising, maybe not so often...but in the early days they can be tricky tricky...

No test is ever a bad test...always good to know and see what's going on in there, ya know?
 
fingers crossed for a pink PMPS but history says Red or Black

I'm not sure I ever saw it written down in the TR instructions but what we've been doing for PMPS or AMPS is a BG test that is technically a +11.5

Then we feed, and at +12 we shoot. Is that right for PS test? I didn't see how else to do it. Unless people feed, and then test and shoot about the same time? That doesn't sound right to me.

{edit} called it -- PMPS 438
 
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Hendrick's mom and dad said:
fingers crossed for a pink PMPS but history says Red or Black

I'm not sure I ever saw it written down in the TR instructions but what we've been doing for PMPS or AMPS is a BG test that is technically a +11.5

Then we feed, and at +12 we shoot. Is that right for PS test? I didn't see how else to do it. Unless people feed, and then test and shoot about the same time? That doesn't sound right to me.

{edit} called -- PMPS 438
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At AM or PM pre-shot the routine is test, feed, shoot - I do it within a 10-15 minute window. Luci eats a little and then I can easily give her the injection - then she goes back to eat a little more. It can be done and posted to your SS as a one entry - rather than a 11.5 / 12 series of events. Some folks will actually test an hour or so ahead of time just so they know what's going on...
 
Sue and Luci said:
At AM or PM pre-shot the routine is test, feed, shoot - I do it within a 10-15 minute window. Luci eats a little and then I can easily give her the injection - then she goes back to eat a little more.
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Ok thanks, yeah that is almost exactly our routine although usually by the time we shoot it has been a good 30 minutes since test, with Hendrick spending that time eating. He does not eat fast at all. Takes a good hour to get a full meal in him really, from 6pm through shot time at 630 continuing to 645 or 7.

so we've been testing right about 6-6:15PM/AM, feeding, then shooting as close to 6:30 AM/PM as possible, then he keeps eating for a bit
 
FrostD said:
That was a nice little surf, definitely better than he's been. Looks like beginning of a bounce perhaps, no more tests needed if you want a break
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PMPS coming in at 438 count as a bounce? I imagine it does just not sure exactly what criteria qualifies a 'bounce'

If so, poop. Was hoping he was bounce-clearing today and staying level enough to avoid another. Not sure what else we could have done to keep him flatter. :(
 
Little hard to say. Could just be not enough duration because dose isnt right yet. Better than black at least!

You're doing everything you can. At some point, his little body has to do the rest. That was still a bit of a dive to +3 so could have been a little better, but that's nitpicking a bit with you guys being so new to this.
 
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