5/27-28: Pum'kin PMPS 414 +4 216 +6 199,310,291 AMPS 415

[Gracielinda Prescott]

Right when I thought we were doing well yesterday, the struggle continues. Pum'kin's AT2 arrived, coded it, tested control solution, and vet showed us how to use it on her diabetic office cat. We left feeling excited that we would have accurate readings. Pum'kin was loving the new foods and I thought we turned a corner.

PMPS was 414. I expected it to be higher than the Contour the past 30 hours, but then I stupidly let my husband convince me he needs more insulin. Husband has been a wreck, worried constantly and it doesn't help that we have to be away starting in a week for an extended period of time and have a cat sitter who is uncomfortable with diabetics. Pum'kin eats, we give him 2 units (vs. 1), he eats more. We test +4 216,+6 199. I think 199 is a little high considering he was 216 2 hours earlier so I retest immediately and get 310 & 291! AMPS is 415. I'm losing faith in home testing with 3# so different within minutes of each other. Could he be peaking early at +4? It could make sense being I found him @19 +3.5 the day he hypo'd. Per the advice I received last night, we dosed 1 unit this morning.

It appears URI is going around as I've heard 5 of 10 cough or sniffle over the past few days. We've never had URI, have 2 semi-ferals that can't be touched, let alone medicated. I've got 2 coughers on Veraflox, planning to increase everyone's Nu-Pet Feline Granular (minus Pum'kin due to the grains) and dose everyone with Life Gold. Pum'kin was one that sniffled a few times last night, otherwise eating, purry and playful (not on Veraflox). I'm not sure he's actually sick.

Does anyone have experience with Blood Sugar Gold? I bought a bottle a few months back, but haven't used. I love Pet Wellbeing's products. My Tadpole who has very early CKD has reduced BUN and creatinine values on once-a-day Kidney Support Gold (and eats only raw). Even though Pum'kin has been diabetic 5 years and unlikely to remission, I'm tempted to try it since we're essentially starting over. Being a vegan who has practiced homeopathy and healing with food for all of my adult life, shooting my cat with insulin is quite contrary to my beliefs...but so is feeding ground bunnies and chopped chickens for my carnivorous housemates.

 

[Ann & Tess GA]

Don't give up, FD is a marathon not a sprint. The AT is no more "accurate" than human meters. It is simply calibrated to a different scale which most vets are used to. Once you are used to the conversions, they won't seem so different. That said, no meter (human or animal) is exact, By law they are allowed to vary by 20%! That's each reading, so you can't assume that every reading will be the same % different. So the 199 could actually be anywhere from 159 to 239, the 310 could be between 248 and 372 and the 291 between 233 and 349. His BG is somewhere in the overlap. A lot of things from the size of the blood drop (too big or too small) to the time between tests, sometime meters don't do well if used again too soon, can vary the results. Pum'kin was probably in the 230 to 250 range.

The shed that builds up w/ Lantus needs stable dosing, every time the dose is changed the shed readjusts and numbers can be off until things stabilize. Pum'kin's shed has had a lot of changes lately. You need to sit down and breathe. I know the high numbers are stressing to you, we have a saying here though "Better too high for a day than too low for an hour!" You need to slowly work up to the right dose to prevent getting into a hypo situation again. that means holding a dose for at least 6 cycles and increasing or decreasing by 1/4th unit increments. It is also possible that Pum'kin is going low at night and then bouncing from those low numbers and you just haven't caught it.

I've never heard of most of those supplements, so no comment there. However, the Veraflox is an anti-biotic. URIs are usually viral infections and anti-biotic won't combat a virus. Did you vet recommend it? If there is a secondary bacterial infection it may help that but not the virus. l-Lysine is good for fighting off viruses, I get the human type and add the contents of the capsule to Emma's food when she needs it. Also, I looked at the Nu-Pet Feline Granular, there are no grains in it. Wheatgrass isn't a grain once it is sprouted.

 

[julie & punkin (ga)]

Not sure if anyone has explained the depot to you yet, or how Lantus works best. Interestingly, it's most effective at lower ranges. When you're at the right dose, Lantus can hold down the blood sugar and the curve can become a flat line for all day/night. It's pretty amazing. Take a look at some of the subject lines on the Lantus/Lev group - Max immediately comes to mind - and you can see some cats don't have their blood sugar hardly move over the whole cycle. That's Lantus at its best!

It doesn't do very well at yanking down high numbers, though. It will bring them down, but it works best to systematically increase the dose by small increments and as you do so, the blood sugar will respond and will come down, but not all at once. I don't blame your husband for cringing at the high numbers - they bother everyone! Let him know that we do have cats on here who might be 400+ at preshot, drop to 40 a few hours later and be back over 400 at the next shot time. Of that kind of cycle, though, the important number is the 40 and the dosing is based on that 40 rather than on the high numbers.

For the best information on the depot, take a look at "Sticky: Lantus & Levemir: What is the Insulin Depot?" The whole concept was new to me, but it helped me to think of it as being somewhat like a timed release medicine.

Looking at his dose before the one shot of 2u, we can see that the 1.0u was bringing him into yellow numbers on your Bayer Contour. That's a good bit of information to know, because he was likely still in a bounce from the 19 he got to 2 days before that. If you can hang onto the 1.0u for at least 6 consecutive cycles (counting this morning) we'll be able to see what changes you need to do with the dose. 1.0u might be too low, especially since you were giving him 3u before, but the main idea is to hold the dose constant and then be able to see what it does.

If we haven't given you this post to bookmark yet, here is "Where Can I Find?" It's basically a table of contents to the Lantus/Lev support group documents and some interesting past posts.

You might want to insert one row on your spreadsheet and write something like "AT2 from this date on" or whatever that designates very clearly that now we'll be looking at AT numbers. The scale is different - as Ann said, it's not that one is wrong, it's just calibrated differently and because most people use human meters because 1) the human strips are relatively cheap and widely available, 2) our documents use human meter numbers - so unless it's designated as AT, all our reference docs are using human glucometer numbers. So you want to make sure anyone helping you is aware that you're using an AT so you don't get incorrect advice. Your numbers are going to look higher, too, so don't let that discourage you.

I know you've been doing this for 5 years - I'm impressed! You've obviously done a great job of taking care of your little guy!