1/8/25 Raven AMPS 139 PMPS 219 - now has Libre

[SophieFRA]

Hi all,

Raven was at 139 preshot this am and for PMPS now again at 219. He was at the internist most of the day. I‘m awaiting blood work results (and based on that more discussions on food), but they agreed that he looks and acts so much healthier (although he lost some weight - but he is still hefty).

To gather more data they advocated for placement of the freestyle libre for more data (which I agreed to - so he‘s got that on now). They asked me to stick with 2.5u dose until they tell me otherwise. I will do that as long as I don’t start getting data strongly indicates otherwise and then I will flag for them.

So I will unfortunately temporarily pause on following the protocol. They also asked me to not test as to not skew data with ear pricks. Will for sure still do preshot checks and look at libre data beyond that. Not super happy about it, but in the end I want to work with them to figure out how to get him healthy.

Per Libre, he was in low 200s this afternoon, dipped into high 100s and now again in low 200s - in fact my relion check was pretty close to libre (so much for not being able to work with human meter numbers…).

https://felinediabetes.com/FDMB/thr...4-167-6-147-8-128-pmps-98-2-139-4-128.297274/

 

[Staci & Ivy]

Hi all,

Raven was at 139 preshot this am and for PMPS now again at 219. He was at the internist most of the day. I‘m awaiting blood work results (and based on that more discussions on food), but they agreed that he looks and acts so much healthier (although he lost some weight - but he is still hefty).

To gather more data they advocated for placement of the freestyle libre for more data (which I agreed to - so he‘s got that on now). They asked me to stick with 2.5u dose until they tell me otherwise. I will do that as long as I don’t start getting data strongly indicates otherwise and then I will flag for them.

So I will unfortunately temporarily pause on following the protocol. They also asked me to not test as to not skew data with ear pricks. Will for sure still do preshot checks and look at libre data beyond that. Not super happy about it, but in the end I want to work with them to figure out how to get him healthy.

Per Libre, he was in low 200s this afternoon, dipped into high 100s and now again in low 200s - in fact my relion check was pretty close to libre (so much for not being able to work with human meter numbers…).

https://felinediabetes.com/FDMB/thr...4-167-6-147-8-128-pmps-98-2-139-4-128.297274/

Please be sure to check all low numbers on the Libre to be sure.
I would check anything under 65 or so since you are just starting out.
It’s great if the meters run very close. (Mine don’t run that close)

Your vet doesn’t need to know you are checking. And you want to keep Raven safe

 

[cecile & bella]

They won't be in your house to check if you're testing or not
And the Libre is a human meter, too.

 

[Wendy&Neko]

They asked me to stick with 2.5u dose until they tell me otherwise.

Are you going to continue to test for ketones, should he go back the BG numbers he was seeing on 2.5 recently?

They also asked me to not test as to not skew data with ear pricks.

Ear pricks don't skew data, they verify it. As Staci, who has tons of experience with the Libre said, make sure to double check any low numbers, should you see them.

I'm glad to hear he's feeling better in those nicer numbers.

As above, the Libre is a human meter. But it doesn't test blood glucose, it tests glucose in the interstitial fluid. Which is the fluid under the skin. It is great you will get more data each day. If you are testing with the Libre and human meter, you might want to record both on the spreadsheet, so you can get an idea how close together they are. Maybe mark one of the readings, such as 219L if done with the Libre. Also indicate on the spreadsheet when a new Libre is attached. It can sometimes giving wonky numbers at first.

 

[SophieFRA]

They won't be in your house to check if you're testing or not
And the Libre is a human meter, too.

Yes I know. So ironic…

 

[SophieFRA]

Are you going to continue to test for ketones, should he go back the BG numbers he was seeing on 2.5 recently?

Ear pricks don't skew data, they verify it. As Staci, who has tons of experience with the Libre said, make sure to double check any low numbers, should you see them.

I'm glad to hear he's feeling better in those nicer numbers.

As above, the Libre is a human meter. But it doesn't test blood glucose, it tests glucose in the interstitial fluid. Which is the fluid under the skin. It is great you will get more data each day. If you are testing with the Libre and human meter, you might want to record both on the spreadsheet, so you can get an idea how close together they are. Maybe mark one of the readings, such as 219L if done with the Libre. Also indicate on the spreadsheet when a new Libre is attached. It can sometimes giving wonky numbers at first.

That all makes sense. I will for sure test for low numbers and will continue testing throughout day (perhaps slightly less frequently) and good idea on listing both numbers — though I‘ll miss the satisfaction of the color popping up .

The vet tech suggested that the ear pricks might stress Raven and raise numbers. I doubt that given how much he gets tested but may dial it down a little.

Unfortunately he‘s back in the 300s, but I guess the insulin hasn‘t quite kicked in (and I gave him pm shot late since the different schedule messed up Raven‘t appetite and I had to puree the food for syringe feeding). If it stays high will ask vet if I can go back to 2.75. ketones are 0.1 (low end of normal range).

i just measured at -+2 and it was 365 on relion and 348 on Libre. So not quite as close but also not crazy off.

Thank you all so much for weighing in!

 

[SmallestSparrow]

Im going to say something unpopular that will be ignored. The libre is a human meter. So is the handheld you are using. so there’s no mystery that they read similarly. They just don’t read like a true lab value for a cat The ENTIRE point of the libre is to get continuous data NOT AFFECTED BY STRESS. Semi reliable data BECAUSE THEY ARE BOTH HUMAN METERS. But for removing the question of stress, they are much better than your handheld.

Ear pricks CAN stress a cat. They stress mine. They stress many here that fight their owners. Pricking their ear anyway DEFEATS THE PURPOSE. Anyone who says their cat purrs though the entire process—news flash those cats are self soothing.

As a physician I tell you that deceiving your health care provider —human or animal—ends poorly. If you don’t want to comply, be honest and tell them so they know how to interpret the data you will be providing. Otherwise you do a great disservice to your cat.

The only time you would need to double check the libre would be if it showed a very, very low value That you think you need to take intervention and then you should mark it for the vet. But if you think you need to test your cat manually for any other value, in addition to that you need to tell your vet just be honest

edit: anyone wanting to disagree re sticks first do this for one month: before sticking your cat stick one of your fingers. Every time. No exceptions.

 

[Wendy&Neko]

The vet tech suggested that the ear pricks might stress Raven and raise numbers.

The vet tech has clearly never had a diabetic cat. Neko used to go to her testing station when numbers were getting low - or hang out in front of the fridge. Sometimes she conned me into a test, just because she wanted a treat, not cause she was low. She purred through the test because a treat was coming next. And no, it wasn't self soothing, she was asking to be tested. Because she knew I'd feed her afterwards if low. She was all about food. Cats sense a person's stress too. If you are stressed about testing, the cat knows that and it stresses them. Pretty sure my finger tips have more nerves that the edge of a cat's ear. I've also done an hour of a lot of finger BG testing every few minutes when I got my lactate threshold and VO2 max testing done. I didn't even get food after! But I survived.

i just measured at -+2 and it was 365 on relion and 348 on Libre.

That's really close given there can be a margin of error of 15-20%. The question will be what it's like below 100.

 

[Tim & Pookey]

Ear pricks CAN stress a cat. They stress mine. They stress many here that fight their owners. Pricking their ear anyway DEFEATS THE PURPOSE. Anyone who says their cat purrs though the entire process—news flash those cats are self soothing.

This is an interesting thought, and I’ll bite for conversation sake.

I don’t know how reputable of a source this is, but here’s an article where they did research on stress induced BG levels.
https://www.vin.com/apputil/content/defaultadv1.aspx?pId=20539&id=8506496

They go on to say that BG levels can increase as much as 194 mg/dL during a 5 minute spray bath (poor kitties)… but there is a time element to that. So if your ear prick did cause some stress, in my mind it wouldn’t have an immediate impact and your result would be valid.

 

[Wendy&Neko]

I once had to take Neko's buddy to an ER vet on a Sunday for a cystitis episode. It was almost an hour away, and a male vet and one he didn't know. Semi feral kitty only did well with female vets. BG around 220 on the blood work. 53 at home the next day. Fortunately they had sent me the b/w results before calling, so I was able to tell them he wasn't diabetic.

@Tim & Pookey I'd trust the author Jacquie Rand. She's one of two authors on the TR protocol. She's done a lot of research on FD.

 

[SophieFRA]

Im going to say something unpopular that will be ignored. The libre is a human meter. So is the handheld you are using. so there’s no mystery that they read similarly. They just don’t read like a true lab value for a cat The ENTIRE point of the libre is to get continuous data NOT AFFECTED BY STRESS. Semi reliable data BECAUSE THEY ARE BOTH HUMAN METERS. But for removing the question of stress, they are much better than your handheld.

Ear pricks CAN stress a cat. They stress mine. They stress many here that fight their owners. Pricking their ear anyway DEFEATS THE PURPOSE. Anyone who says their cat purrs though the entire process—news flash those cats are self soothing.

As a physician I tell you that deceiving your health care provider —human or animal—ends poorly. If you don’t want to comply, be honest and tell them so they know how to interpret the data you will be providing. Otherwise you do a great disservice to your cat.

The only time you would need to double check the libre would be if it showed a very, very low value That you think you need to take intervention and then you should mark it for the vet. But if you think you need to test your cat manually for any other value, in addition to that you need to tell your vet just be honest

edit: anyone wanting to disagree re sticks first do this for one month: before sticking your cat stick one of your fingers. Every time. No exceptions.

Thank you for weighing in. I do get their point and I think it greatly depends on the cat. So for some it may cause major stress and skewed data. Raven really doesn‘t seem to mind the ear pricks. I don‘t give him a treat after (though I used to after shot and he‘d jump up in his chair awaiting his shot and purred throughout it). He doesn‘t purr for the shot now that I don‘t give him a treat - I still need to figure out what treats I can give him since he got freeze dried rabbit before and I‘m not feeding any raw due to bird flu now - so it suggests a correlation between purring in anticipation of treats, not self soothing. Of course this is just anecdotal and not science

As for deceiving health care providers, I agree. I did tell them I would dial back self tesring but would not stop. I‘m very honest with them. We all want what‘s best for Raven.

 

[SophieFRA]

The vet tech has clearly never had a diabetic cat. Neko used to go to her testing station when numbers were getting low - or hang out in front of the fridge. Sometimes she conned me into a test, just because she wanted a treat, not cause she was low. She purred through the test because a treat was coming next. And no, it wasn't self soothing, she was asking to be tested. Because she knew I'd feed her afterwards if low. She was all about food. Cats sense a person's stress too. If you are stressed about testing, the cat knows that and it stresses them. Pretty sure my finger tips have more nerves that the edge of a cat's ear. I've also done an hour of a lot of finger BG testing every few minutes when I got my lactate threshold and VO2 max testing done. I didn't even get food after! But I survived.


That's really close given there can be a margin of error of 15-20%. The question will be what it's like below 100.

yes honestly I don‘t think it stresses Raven much if at all. He likes the attention. And he‘s very smart. I get the sense he knows I‘m trying to help him.

I‘ll dial back testing on meter but won‘t stop snd I will talk to vet today about dose. I think he‘d fare a lot better with 2.75 again. He‘s in 300s to 400 with 2.5 dose again now.

I look forward to actually speaking to internist when I get the blood work. Yesterday was a drop off appointment which is why I did‘t get to speak with her. The vet tech was very nice and definitely well-meaning, but I feel lile she had given some tslking points and didn‘t have all the knowledge to weigh in on my follow up questions.

 

[SophieFRA]

This is an interesting thought, and I’ll bite for conversation sake.

I don’t know how reputable of a source this is, but here’s an article where they did research on stress induced BG levels.
https://www.vin.com/apputil/content/defaultadv1.aspx?pId=20539&id=8506496

They go on to say that BG levels can increase as much as 194 mg/dL during a 5 minute spray bath (poor kitties)… but there is a time element to that. So if your ear prick did cause some stress, in my mind it wouldn’t have an immediate impact and your result would be valid.

Super interesting. Will need to read. I did have to give Raven a paw bath yesterday because he peed on a plastic matress at the vet (while I was picking him up and was then sitting/walking through the puddle). He didn‘t love it. First time I‘ve ever attempted „bathing“ him, but his paws were soaked with urin.

he clearly thought the matress on the floor of the office (for dogs I assume) was a litter box…

 

[cecile & bella]

Bella is not stressed by tests either. She acts like Wendy describes, comes to sit where I test her and waits, even when I would not test her, just because she associates it with being fed. She does not purr usually but will lick my hand. And I don't hold her, so if she wanted to leave, she could. She does when my son tries to test her
I was always honest with our vets, I said I did not feel confortable not checking her, I explained what I was doing with the dose, and asked if it would be Ok to manage her diabetes myself and ask if I needed help. They prescribe and check her numbers (I tell them, never gave access to her SS either), and usually are impressed by how well she is doing. I never had any issue of a vet who would not want to keep us because of that, to the contrary, they seem very OK with it. At the beginning of course it was different, but the vet saw how well she was doing and agreed that something 'clicked" (she previously thought Bella had a resistance to insulin. You can look at her SS, as soon as I started following TR here, she improved radically, in Feb-March of 2022).
For what it's worth, I don't think the AT is superior to a human meter to test cats. What is important is having a range of numbers, knowing what is dangerous (the low values vary from meter to meter, it's 68 on the AT, 50 on human meters), and look at how the numbers you get evolve relatively. That's my opinion anyway
I am sure Raven will be doing well, you are very attentive to his numbers and health