11 Sept | Girlie | AMPS 148; +2=52; +3=79; +3:30=65; +4=86; +5=110 Whew!

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Got it - timer set.

Just curious: does this merit a 911 or just a normal question mark?

Her numbers so it's easier:

PM +11 = 209
AMPS= 148 (LC 4 food)
+1:30= 101 (gave LC 4 food)
+2=52 (was anxious for food so knew she was diving)
 
She's sitting patiently in front of her food bowl, giving me a dirty look and wondering why I won't give her more food!
 
We like to save 911 for medical emergency. You can always use the ? Icon and have HELP in the subject line. You can take the 911 off as soon as you have a response.
 
She's now sitting next to my chair, purring (and she's not a cat who purrs much), and looking much aggrieved... 7 minutes to go...hate this waiting...

Also have HC 20 food; will be curious to see what the HC 16 does this time; last time I went for both! :eek:
 
Whew! The HC worked quickly: now 72

I'm assuming I should just give her some LC food now? I do have the protocol right in front of me, but just wanted to double-check as she's AlphaTRAK and the act number is 68
And test in 15 again.
 
Yes, LC food and test in 30 after that. It can take 20-30 minutes for the carbs to go from from the plate to the bloodstream.
 
Ok, done: LC 6

Have an acupuncture appointment in 2 hours: if her numbers are still okay by then, I assume it's okay to go, or should I reschedule for tomorrow?

She's earned a reduction, then, I assume? And here I thought a few days ago she might need an increase...shows how good I am at reading numbers, eh?
 
Let's see where she is in 1/2 hour before you cancel the appointment. How long will you be gone? Since she's earned a reduction, you can always carb her up to a safe zone.
 
Wendy&Neko said:
Let's see where she is in 1/2 hour before you cancel the appointment. How long will you be gone? Since she's earned a reduction, you can always carb her up to a safe zone.
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She's now 79. We'll be gone ca 2 hours all up including transport time. I can take food and my test kit with me; she's very mellow about the whole acupuncture thing.

What should she be up to, do you think, before I decide to go in for the acupuncture?

Also, I'm at the end of my AlphaTrak2 test strip vial; I've got about 13 strips left, but might be able to get some at the vets today until my order arrives late tomorrow afternoon. I do have the Freestyle Lite test strips; I've been doing a side-by-side comparison for a while now and they seem pretty close, although I prefer to use the ATrak2 when she's diving or in lower numbers. Any thoughts on that, or should it probably be okay as she'll be getting a reduction this PM and I could always carb her up a bit?

Of course I have to go into work tomorrow afternoon...sigh...
 
I know a number of people use the Freestyle strips in their AT meter. I am not fond of that because the AT meter is made by a different company than that which sells the Freestyle strips. They used to be the same, but Abbott sold the pet meter business to Zoetis so who knows what they will do. I would trust Freestyle strips in the Freestyle meter. But it's your call and you have done tests.

Good to see her flat now, but the question is where she will be two hours after HC and when it wears off. Since you can test and feed while you are fine, I might stick to LC and see where she is before you go. Worst case, you give HC just before you leave to keep her higher while you are gone.

Side note, I used to take Neko's BG before her acupuncture and told her acupuncture vet what it was. It got so she could tell roughly where Neko was by how she felt.:cool:
 
Wendy&Neko said:
I know a number of people use the Freestyle strips in their AT meter. I am not fond of that because the AT meter is made by a different company than that which sells the Freestyle strips. They used to be the same, but Abbott sold the pet meter business to Zoetis so who knows what they will do. I would trust Freestyle strips in the Freestyle meter. But it's your call and you have done tests.

Good to see her flat now, but the question is where she will be two hours after HC and when it wears off. Since you can test and feed while you are fine, I might stick to LC and see where she is before you go. Worst case, you give HC just before you leave to keep her higher while you are gone.

Side note, I used to take Neko's BG before her acupuncture and told her acupuncture vet what it was. It got so she could tell roughly where Neko was by how she felt.:cool:
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Down to 65 now, so gave her some more HC food. Gave her the HC 20 this time. She really wants food! Good to see her body is keyed up to tell her what to do. I am a bit surprised that she's dropped down again - different from previous hypo episodes.

Cool re: your acupuncture vet.

Noted what you said re: the test strips. I think I need to get a human meter as backup or to switch to.
 
Always good to have a backup meter. I was afraid with the early drop that she might not be done with going down. Good plan on the higher HC.

Up Girlie!
 
Wendy&Neko said:
Always good to have a backup meter. I was afraid with the early drop that she might not be done with going down. Good plan on the higher HC.

Up Girlie!
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She's now at 86: the HC 20 clearly brings her up fairly quickly, I guess?

It's either today or next week for the acupuncture: not sure whether to go or give Girlie a quiet day today at home, though she's very mellow at acupuncture. What do you think?

Is it a good thing that she seems determined to earn another reduction after her last one on 3 September? Could this be an explanation for her close to/more than 100 point drops by +2 that she's done on 1 Sept, and 7-11 September? Historically, she does like to do early deep dives (by AM +2 or +3), but I was just wondering if there is any rhyme or reason for this or if some cats just do this?

I have a backup AlphaTRAK, but forgot to order the new set of test strips until today. Bad cat mom! I should get a Freestyle Lite meter as another backup. From memory: was that the one you didn't like in the US? Two vets I know use the Accucheck, but not sure whether you have that in the US or Canada. My vet only wants me to use AlphaTRAK...
 
Does your vet look at your SS frequently? My vet uses a onetouch in her office. At one point she asked if I wanted to use the AT. Umm, no? Hard sale when she was using a human meter. Especially since she isn't paying for the strips. There was an issue with the Freestyle Lite 5 years ago. Ancient history and they have newer models now that people here have used.

As for the drops, I just think that's Girlie's style. :p

The acupuncture today is your call. At what + time would it be?
 
Wendy&Neko said:
Does your vet look at your SS frequently? My vet uses a onetouch in her office. At one point she asked if I wanted to use the AT. Umm, no? Hard sale when she was using a human meter. Especially since she isn't paying for the strips. There was an issue with the Freestyle Lite 5 years ago. Ancient history and they have newer models now that people here have used.

As for the drops, I just think that's Girlie's style. :p

The acupuncture today is your call. At what + time would it be?
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I had to cancel it as I'm too late now as it is, unfortunately. Such a pity! Oh well: today is diabetes day, not arthritis day, I guess. Acupuncture vet (Pam) is only there two half days a week, but she's great at what she does, so that's that! We go to her.

Not keen on Girlie's style, I have to say, but we'll find a way to make it work when I'm back at work next week. I'll just move her shot time up so that I can get a +3 in before I leave. Good thing I like early mornings! :-)
 
Wendy&Neko said:
Does your vet look at your SS frequently? My vet uses a onetouch in her office. At one point she asked if I wanted to use the AT. Umm, no? Hard sale when she was using a human meter. Especially since she isn't paying for the strips. There was an issue with the Freestyle Lite 5 years ago. Ancient history and they have newer models now that people here have used.
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My vet was against testing so much at first; then again, she was the one who had the idea that we should start Girlie on 1 Unit 1x/day and who didn't think I could do 0.25 doses. That's one of the reasons why they tried Caninsulin when Girlie was in hospital following her hypo and then hit really high numbers.

She doesn't know I go on FDMB, but she LOVES the SS and all of the data now. She thinks it's fine for Girlie to drop below 68 on AlphaTRAK - she's convinced that I shouldn't worry about Girlie suddenly diving into low numbers when I'm at work and that Girlie would self-monitor and eat LC food and be fine if she did dive even to dangerously low numbers. Not sure I agree with that, myself, but Girlie is my cat and if I want to be proactive about a hypo (which under 68 on AlphaTRAK technically is, right?), then I will.
 
We have a "take action" number that is higher than hypo, because we want a little margin for safety for cats on insulin. 50 is the human meter take action number, but it's not uncommon to see non disbetic cats in the 40's. Other than hunger, did Girlie show any hypo signs? Unless you had blood tests from before Girlie was diabetic, you may not know what is normal for her.
 
Bobbie And Bubba said:
What a cycle. Hope you get to make your acupuncture appointment.

Congrats on the reducie!
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Didn't get to the acupuncture appointment, unfortunately. But at +5=110 and she's no longer ravenous for food, thank goodness.

I'm glad for the reducie! Easier for me to draw a 0.5 than a 0.75. :-)

Getting a reduction is a good sign, isn't it? Although we'll have to see, I guess, if it holds.
 
Wendy&Neko said:
We have a "take action" number that is higher than hypo, because we want a little margin for safety for cats on insulin. 50 is the human meter take action number, but it's not uncommon to see non disbetic cats in the 40's. Other than hunger, did Girlie show any hypo signs? Unless you had blood tests from before Girlie was diabetic, you may not know what is normal for her.
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I know she must have other records, but the most recent one I have pre-diabetes was a blood test in April 2016: BG was 88 (4.9). I know the vet has never mentioned this as an issue before, though. I can try to get previous tests as she's had her blood tested fairly regularly because she's been on Phenobarbitone; not sure whether they also ran all the normal tests as well, though.

She didn't show any other hypo signs: just really, really hungry, licking her bowl clean - the same "tells" she gives when she's diving. She's a very polite cat, though, so other than looking aggrieved that there was no food; sitting next to me; and purring a lot (she doesn't normally pur that much), that's it.

So is there a "get yourself to the ER NOW" level? Or do you only do that if they're showing obvious signs and you've tried everything else and the BG levels won't go up?

The first hypo she had was when she had the Freestyle libre monitor implanted on her shoulder. That would only give readings down to 40, though. I was completely unprepared for a hypo, so I gave her the only HC food I had: her old dry food. She ate it, but not all of it. Then I handfed her liverwurst as she was not eating much at the time anyway and that's the only thing she'll eat no matter what. That night she certainly didn't show the ravenous hunger that she did today or that she normally shows now when her BG is taking a deep dive; she didn't have any signs at all, really, though on 4 July: I only picked up the low reading because I scanned her implant. Now that she's on Mirtazapin, it's easier to get her to eat and she's more interested in food in general.

I have to add that I ended up not really trusting the Libre BG readings I got, anyway; once she got back from hospital, she was almost always in the black, and I kept getting errors until it finally died on 15 July and I had to bite the bullet and do my first manual test. I've been a convert to manual testing every since. :-)
 
The thing with blood tests at the vet, they can be elevated due to stress. I had a civie at the vet for another reason, and his bloodwork showed glucose over 220. Vet was concerned about diabetes. Home test next day was 53. :D

The "get to ER" number may be situation specific. If someone accidentally gave too much insulin, the number may be higher than if a regular dose was given. Not being able to get the cat up with carb intervention is definitely one sign. I did catch Neko in the 20's (human meter), but she came up quickly with syrup. If she hadn't, I would have been in the car with syrup in hand. Showing physical signs of hypo other than hunger are also signs to watch for. In the 20's, Neko had no other signs. Scary!
 
Wendy&Neko said:
The thing with blood tests at the vet, they can be elevated due to stress. I had a civie at the vet for another reason, and his bloodwork showed glucose over 220. Vet was concerned about diabetes. Home test next day was 53. :D

The "get to ER" number may be situation specific. If someone accidentally gave too much insulin, the number may be higher than if a regular dose was given. Not being able to get the cat up with carb intervention is definitely one sign. I did catch Neko in the 20's (human meter), but she came up quickly with syrup. If she hadn't, I would have been in the car with syrup in hand. Showing physical signs of hypo other than hunger are also signs to watch for. In the 20's, Neko had no other signs. Scary!
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Wow - that is very scary. That would be 2 on a pet meter - just 2 points (subtracting 18 to get to the pet meter number). I think I would self-destruct at that point with nerves... Well done, Wendy...
 
I've heard that at the smaller numbers, the AT and human meter are closer. The 18 points at 50/18 are not indicative of the rest of the range. And I was a bundle of nerves at the time. Longest wait ever for the next test.
 
Wendy&Neko said:
I've heard that at the smaller numbers, the AT and human meter are closer. The 18 points at 50/18 are not indicative of the rest of the range. And I was a bundle of nerves at the time. Longest wait ever for the next test.
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I bet. For me, that's the worst part of getting a really low reading - waiting the 15 or 20 minutes to see whether your chosen solution (LC, MC, HC, honey or glucose syrup) - has actually done the trick and brought the levels back up. That's nail biting time... :nailbiting:
 
Girlie is certainly keeping you on your toes!!

One comment, not necessarily intended for Girlie but for anyone following this thread. I had 2 FD kitties. One would become ravenous when his numbers were the low, the other one can hit very low numbers and not show any signs. My ravenous one was the first diagnosed and I could always depend on him to let me know when he was dropping. When my second was diagnosed, I was very surprised when she did not react the same way. Maxie has hit numbers like 1.9 (34 US) on a pet meter with no signs of hunger and I only caught those sort of numbers because of regular testing.

Also in humans there is something called "hypoglycemia unawareness". This happens more often with Type I but can also happen with Type II. Basically the normal body warning processes for hypos do not "work" correctly and they are not aware when they hit hypo numbers nor does the usual defence systems kick in as they should. I think it fair to extrapolate this information and consider the possibility that this can occur with kitties as well. Article on this:

http://www.diabetesnet.com/diabetes-control/low-blood-sugars/hypoglycemia-unawareness

Just so that people are aware of the differences in how different kitties can respond to hypo numbers and not just rely on their kitty "letting" them know when they are going too low. Regular testing ( which Girlie certainly gets ;)) is the best way to see hypos happening and avoid serious hypos.
 
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