1st AlphaTrak reading of 348 (in vet's office)

[SarahL]

Miko originally was diagnosed last week at a 437 BG reading in his blood panel taken at the vet.

I just received my very expensive AlphaTrak2 (yes, I really should have done more homework before ordering -- placed my order for my Arkray Glucocard 01 tonight!) and went in to the vet's for a demo on how to use it.

Miko tested at 348 on the AlphaTrak2 (at the vet's office) today about 6 hours past his AM insulin injection. He's been on one unit Lantus BID since 7/18 p.m.

I'm working on getting bg readings at home as fast I can with my little guy, as I'm eager to see what his numbers read throughout the day and without the stress of the vet's office.

My vet wasn't in today, so I'm not sure if she will recommend an increase in his dosage or not yet. I'm definitely worried about an increase in dosage without being able to test at home reliably yet (he's difficult to manage, so big learning curve for both of us).

Eager to know what you all think about his progress so far, with what limited info there is without the home tests in place. I want to see my little guy playing again -- he declined so quickly in a matter of days. Of course I will wait to talk to my vet, but I know so many of you have so much experience. Is 1 unit BID and more time still the way to go? Would the AlphaTrak2 variation come in higher, lower, or about the same to last week's the blood panel reading?

Thank you for all your help and support <3

Sarah

 

[BJM]

As it happens, there is a protocol for using Lantus and adjusting the doses.

Also, the 2010 American Animal Hospital Association guidelines to review and discuss with your vet.

Once you set up a sharable Google Docs spreadsheet and start entering test data, you'll be ready to post in one of the Lantus Forums. Instructions are here.

 

[SarahL]

As it happens, there is a protocol for using Lantus and adjusting the doses.

Also, the 2010 American Animal Hospital Association guidelines to review and discuss with your vet.

Once you set up a sharable Google Docs spreadsheet and start entering test data, you'll be ready to post in one of the Lantus Forums. Instructions are here.

Thank you so much, BJM -- this is all so helpful. So much to take in, and the guidance is very appreciated.

I notice in your signature line you say your kitty Spitzer's condition was caused by a blood clot, not diabetes -- could you tell me more about this and how you diagnosed it? My kitty Miko has been on a raw diet, always lean and active. He's a neutered male and possibly part Siamese or Burmese, so there could be a genetic component that's overriding the lifestyle, but he also has a heart murmur between a grade 3 and 4 that was discovered a couple years ago and has been stable in last couple ultrasounds (most recent in February)... so I'm curious about the blood clot possibility... Thank you and purrs to you and Spitzer.

 

[BJM]

What Spitzer had was a saddle thrombus - a clot which straddled both arteries going to the hind legs. It blocked blood flow which was very painful and impaired function. I had never heard a cat cry out in pain before. What I saw was Spitzer stumbling, staggering, and crying out. If you ever see that, it is an emergency, if only to stop the horrible pain with euthanasia.

Removing the clot gave no guarentee of a return to normal function, as lack of oxygen causes tissue death. He could have been left partially or completely paralyzed, and/or in permanent nerve pain if treated. And treatment, even if unsuccessful, was going to be in the thousands. Additionally, cats which develop blood clots are very likely to develop another one within 10 months. I couldn't put him through it.

The vet indicated they heard a murmur; one had not been mentioned previously. A heart murmur suggests that blood is not moving smoothly through the heart and is slowing down. Blood which slows may clot. You may wish to discuss if an anticoagulant would be appropriate.

He had had a GI biopsy previously that week which may have contributed to throwing the clot. The results of the biopsy indicated inflammatory bowel disease (IBD), and inflammation may contribute to clot formation.

 

[SarahL]

My apologies -- I didn't realize he had passed. I am so very sorry for your loss -- he was so lucky to be so beloved by you in his life. <3

 

[Wendy&Tiggy(GA)]

Good job on the testing. I wouldnt increase yet until you have more of your own tests for 2 reasons:

1. The vet tests could well be inflated due to stress
2. That pink and black could well be a bounce .. and I want to see if it clears today or tomorrow so see if you can get a midcycle test (5-7 hours after am shot) today as well as the mandatory preshot tests - and a before bed test.

When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.

Wendy

 

[SarahL]

Good job on the testing. I wouldnt increase yet until you have more of your own tests for 2 reasons:

1. The vet tests could well be inflated due to stress
2. That pink and black could well be a bounce .. and I want to see if it clears today or tomorrow so see if you can get a midcycle test (5-7 hours after am shot) today as well as the mandatory preshot tests - and a before bed test.

When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.

Wendy

Thank you SO much, Wendy! This is so comforting.

I know it's a slow process, but I was still definitely daunted by his coming in at 514 on the at home Alphatrak2 test I managed to do this morning. Since it was our first success, it was not without challenges, and the glucometer did take a fall with the lancet pre-blood and there may or may not have been a fine mist of halo freeze dried salmon over everything (he's now accepting those as bribes instead of kibble! ) Not sure if those things could have also impacted any reads. But I was BEYOND THRILLED to have a success under our belts! Knowing that the ear tests are a possibility makes me feel so more able to safeguard him through this process.

And so good to know about the bounces and panicking livers. Thank you!!