5/03 Buffy AMPS 450, 6+ 503 ---Dose increase?

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Buffy-&-Cindee

Buffy-&-Cindee

Member Since 2014
Hi....

I've only been testing Buffy before each meal because I was getting obsessed with it and my doctor told me to stop because it was just stressing me out. I’m worn out physically and mentally (work related) and my Dr pretty much told me on Friday to de-stress because I’m not headed for… but am the road for a heart attack. This situation with Buffy is not helping and she keeps getting worse. I hope you guys will be able to give me some advice based on the tests that I have taken.

You’ll notice that I have two readings, one for the Alpha Tracker and one for the Relion meter. Reason being…I took all the meters I have and had the vet test them against the Idexx analyzer. They drew blood and tested them all from the same sample. The Relion was the closest, being 30pts lower than Idexx. The Alpha Tracker was 60pt higher. So for awhile at least, I’m testing her with both from the same drop of blood. This morning was rather strange, there was only 1pt difference…didn’t really matter, they both were high.

I took her to the vet on 4/13 and he suspected an infection so he put her on Clavamox for a week. Her numbers did start to come down back into an “acceptable” range. But 3 days after she was off the antibiotics, they started to slowly increase again. Called the vet and he put her on another week of Clavamox. You can tell from her spreadsheet, it’s not working this time. They are higher than ever! Tested her for ketones and she’s still safe there. Her behavior has been normal until last night. Normally she's hungry and will lick the plates of my other cats. Not last night or today. She ate half of what she normally would which is really odd for Buffy. Other than that, no symptoms. No excessive drinking or peeing. She plays with her favorite toy all day long, just as usual.

I’m wanting to increase her dosage tonight but wanted to hear what the pros here think before I do that. I’d like to bump her up to 3.0. Clearly either the dose is entirely too low or the Lantus just isn’t working for her. The 503 reading is the highest she’s ever tested and I'm worried but I hate to call the vet on a Sunday.

Cindee
 
Hi Cindee
Have you seen my signature link Glucometer Notes? You might find it helpful to read. Glucometers aren't intended to replace lab equipment. They are meant to serve as a rough guide for home monitoring, to let you know if the glucose might be dangerously low, or if control was lacking.
What protocol are you using for Lantus - Tight Regulation, or Start Low, Go Slow? Both have guidelines for dose adjustment. With Tight Regulation, you could increase the Lantus 0.25 units.
 
When you say that Buffy had an infection, do you mean urinary tract infection? If so, it's best if the vet takes a urine sample via cystocentensis and does a urine culture to see what bacteria is causing the infection. It could be that Clavamox is not the right tool for the job.

We normally increase in .25U increments (regardless of protocol) and I see you last increase was by .5U even though you were getting some yellow nadirs and earlier blue nadirs. I wonder if that increase to 2.5U was too much?
 
BJM said:
Hi Cindee
Have you seen my signature link Glucometer Notes? You might find it helpful to read. Glucometers aren't intended to replace lab equipment. They are meant to serve as a rough guide for home monitoring, to let you know if the glucose might be dangerously low, or if control was lacking.
What protocol are you using for Lantus - Tight Regulation, or Start Low, Go Slow? Both have guidelines for dose adjustment. With Tight Regulation, you could increase the Lantus 0.25 units.
Click to expand...
I'm using Start Low, Go Slow. It was working...but something went sideways. We just don't know what.
 
Wendy&Neko said:
When you say that Buffy had an infection, do you mean urinary tract infection? If so, it's best if the vet takes a urine sample via cystocentensis and does a urine culture to see what bacteria is causing the infection. It could be that Clavamox is not the right tool for the job.

We normally increase in .25U increments (regardless of protocol) and I see you last increase was by .5U even though you were getting some yellow nadirs and earlier blue nadirs. I wonder if that increase to 2.5U was too much?
Click to expand...
The vet suspected a urinary infection but I don't believe they took a sample. That was the next step. She has no signs of a urinary infection. I'm very familiar with them. I know it could be lurking but definitely no symptoms.
 
BJM said:
Hi Cindee
Have you seen my signature link Glucometer Notes? You might find it helpful to read. Glucometers aren't intended to replace lab equipment. They are meant to serve as a rough guide for home monitoring, to let you know if the glucose might be dangerously low, or if control was lacking.
Click to expand...
Yes I have. I just wanted to know which of the glucometers were closest to the Idexx analyzer that my vet uses.
 
Allegedly, the AlphaTrak should most closely match the Idexx analyzer, within the +/- 20% variance allowed by the FDA.
So, multiply the AlphaTrak number by 0.8 to get the low estimate, and by 1.2 to get the upper estimate. The Idexx number should be between those.
 
I'm wondering if you're describing pancreatitis. Take a look at the New to the Group sticky, near the bottom of the post in the single-topic posts, for the Primer on Pancreatitis that Marje put together. It's very common in diabetic cats.

Others who wanted to use 2 glucometers to compare them have opened a new tab for one of the meters. It's really, really hard to see what's going on the way her spreadsheet is laid out right now.

If you think the pancreatitis symptoms seem to describe what's going on with Buffy, you may want to have the Spec fPL test done on her.
 
julie & punkin (ga) said:
I'm wondering if you're describing pancreatitis. Take a look at the New to the Group sticky, near the bottom of the post in the single-topic posts, for the Primer on Pancreatitis that Marje put together. It's very common in diabetic cats.

Others who wanted to use 2 glucometers to compare them have opened a new tab for one of the meters. It's really, really hard to see what's going on the way her spreadsheet is laid out right now.

If you think the pancreatitis symptoms seem to describe what's going on with Buffy, you may want to have the Spec fPL test done on her.
Click to expand...
julie & punkin (ga) said:
I'm wondering if you're describing pancreatitis. Take a look at the New to the Group sticky, near the bottom of the post in the single-topic posts, for the Primer on Pancreatitis that Marje put together. It's very common in diabetic cats.

Others who wanted to use 2 glucometers to compare them have opened a new tab for one of the meters. It's really, really hard to see what's going on the way her spreadsheet is laid out right now.

If you think the pancreatitis symptoms seem to describe what's going on with Buffy, you may want to have the Spec fPL test done on her.
Click to expand...

Sorry if her spread sheet is difficult to understand. It's no different than before, just documenting the two different glucometers, for my own benefit so I would have a better grasp of which one is closer to Idexx. It indicates on the left side of the sheet which glucometer. I won't likely do it much longer. I just have to choose which one I'm going to use from here out.

Thank you for the steering me to the pancreatitis thread. I read it...she doesn't have any of the symptoms. Oh and she ate really well tonight, just like normal. I gave her her normal dose tonight and will try to stay up as late as I can to test her before I go to bed. Next step will be a call to her vet tomorrow. He's not a fan of Lantus but he did say that he might start increasing her dose. If that doesn't do the trick, then he said he's consider trying another insulin.
 
BJM said:
Allegedly, the AlphaTrak should most closely match the Idexx analyzer, within the +/- 20% variance allowed by the FDA.
So, multiply the AlphaTrak number by 0.8 to get the low estimate, and by 1.2 to get the upper estimate. The Idexx number should be between those.
Click to expand...
Based on the tests at my vet's office, the Alpha Track measures 15% higher than Idexx. The Relion measures 10% lower. One thing I have learned throughout all of this, is that glucometers are not really very accurate...any of them. I'll probably use the Alpha Track test strips that I have until they're gone, then probably switch to Relion and make the necessary % adjustments. I personally like the Relion better than the Alpha Track because with the Alpha Track you can see the blood being drawn up whereas you can with the Relion
 
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