6/22 - Boots - AMPS 192 | +5 182 | PMPS 148 | +1 149

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Megan and Boots (GA)

Megan and Boots (GA)

Member Since 2015
Last post: http://www.felinediabetes.com/FDMB/threads/6-17-boots-amps-207-5-192-11-167-pmps-142.139631/

Poked the crap out of the poor boy yesterday, so not a lot of readings today.

Gotta say, we're all enjoying hanging out in the blues for the past couple of days, pretty consistently. Boots had his first <200 AMPS today (his AM is almost always higher than PM). And while just last week it was exciting to drop under 200 during the cycle, now it's the norm, and yesterday was really great (plus it was the first day we really attempted to do lots of readings to get a more complete picture).

So, some general questions for anyone (as well as my generally rambling thoughts):

How is he looking? It sure seems good to me - in general he doesn't seem to fluctuate a ton during any given cycle. I've seen others' spreadsheets with green to red and everything in between over the course of a day, which would scare the crap out of me.

We've realized we really don't have a lot of PM cycle readings, and that cycle always seems to start out lower than the AM. I've been avoiding getting up in the middle of nights to get readings but am wondering if I should now and then just to see where exactly he goes overnight. He starts PMPS generally lower than AMPS, and lately has been holding fairly steady through +3/+4 PM, but I don't really know what goes on after that. I don't want to be a bad mama to him, but unfortunately, he's not the only one with a chronic health issue (me!), and I need as much sleep as I can get. Not that everyone doesn't need sleep. I don't know. Guess I should just suck it up a couple of nights and try to get a reading here and there in the PM cycle. Do folks generally try to do that, just set an alarm now and then? Should I try for a particular time do you think, based on his numbers? I could do a +11 pretty easily, that's when I wake up basically, not sure why I haven't been thinking to grab one then anyway.

Got some good news late last week: we had brought in a stool sample from Boots to be analyzed. It had been noticeably darker for several days. Well the lab found no sign of blood. Whew! Vet suspects it could just be diet related, since he recently and abruptly changed from kibble to low-carb canned food after 12+ years of being hooked on the dry. No other weird symptoms though, which was comforting, but glad to know the labwork showed no blood, parasites, etc.

This is long-winded enough :) Would appreciate some extra sets of eyes on Boots' sheet and any thoughts or insight you have about his numbers/curve, dosing, etc.

Hope all are doing well tonight - peeps and kitties alike!
 
Megan, I don't get a lot of PM cycle tests myself, but I have seen the suggestion that you drink a BIG glass of water just before bed so that you wake up having to go to the bathroom, and do a quick test then.
 
That's an amusing (but good!) idea. I know that in the past couple months, Boots has been waking us up in the middle of the night - generally between what would be his PM +7 to +10 range - hunger - and one of us tends to get up to feed him something then. Wake up time for us is aruond +11. And bedtime is +3(ish). So I'm wondering if we capture +1, +2, and/or +3, then a +8 (or so, whenever he wakes one of both of us anyway), then a +11... is that enough of a complete picture of his PM cycle? Or should I set an occasional alarm for a +5 or +6? Some weekend nights we are up pretty late, at least late enough to get occasional +5s (though not much lately, since we've been so tired because of him waking us up at night!).
 
Boots is looking much better on this dose! Nice to see more blues!:cool:

Since this is only cycle 4 on this dose, let's see where he's at in a couple more cycles...some of those numbers are getting close to green since you're using the AlphaTrak

That AMPS is usually the last number to come down due to something called "Dawn Phenomenon". It's normal for even non-diabetics to be higher first thing in the morning

There's no reason you need to test every hour (or every 2) every day. You're right that Boot's ears are going to get touchy! If you can just sprinkle tests at different times during the cycle, that's good enough...Maybe at +3/6/9 one day and +2/5/8 the next
 
I subscribe to the drink water before bed because it makes me get up and wake up enough to think I should test.
I have also been one to nap on the couch....in addition to the fluids....so that I might get a +5 or 6 at night. And if numbers warrant,
I then go climb in bed. If they don't, I stay on the couch.
just try to do some random times.... it's good to learn what's happening in the night, especially since most kitties go lower at night.

I have health conditions too so I know how you feel about keeping that sleep a priority
 
Thanks! And you actually reminded me of another question - I adjusted my ranges/colors on my spreadsheet, based on Saoirse's Alphatrak Spreadsheet since we're using the AT2 meter and strips, and I think the original SS I copied was scaled for human meter readings. Do these ranges look right for AT2? specifically, the target range being 80 - 140 or so?
 
I would suggest changing your less than 80 color to a lighter/paler green.... red is already used and some of us who glimpse at your sheet
will see red and have to actually think....

it's kind of like that mind game....
green yellow

rather than
green yellow
 
It is nice to see more blue on Boot's spreadsheet. Can you remind me again whether you are following the Tight Regulation Protocol or Start Low Go Slow Method for dosing? It would help if you would put either TR or SLGS in your signature line, then I can stop asking that question. ;)

Has anyone ever mentioned the significance of a +2 test to you? If the +2 is about the same as the preshot, you'll get a normal Lantus cycle. If it's quite a bit lower, it'll likely be an active cycle, and those are the nights it would be good to try to get that +5 or +6 test. If the +2 is higher than the preshot, it'll be a quieter cycle.

As for the spreadsheet, I don't find it helpful to differentiate the BG categories as you have. I'm getting used to looking at a regular spreadsheet with AlphaTrak numbers in it. I don't know why the 80 is significant. If you are following TR, the reduction point is 68 on an AT. If you are following SLGS it's the AlphaTrak equivalent of what is 90 on the human meter.
 
Ack, sorry. I meant to do that. Tight Regulation.

No, hadn't heard the +2 rule before. That's interesting! Somehow never picked up on that in my reading in the forums. Really good to know. I'll have to look back at his prior +2 readings to see if that seems to hold true for him. Thanks for the info!

So regarding the spreadsheet, I guess I am looking to know what does make sense for ranges for AT2. I just grabbed those from CritterMom's sheet for Saoirse because it sounded like people recommended it for AT2 tracking. I know so many here use human meters, but is there somewhere I can see what the ideal "normal" range is when using an AT2? I do recall actually now that you mention it, someone telling me 68 was the low threshhold for AT2 readings, and to do a decreased dose if that is the reading. So is 68 - ??? the normal range that I want to get Boots into on a daily basis, when using an AT2?
 
Chris, just read that article on the Dawn Phenomenon - could that be why he loves (haha) to time his "Feed Me" song every night right around 4-5am normally? Is that maybe when his levels shoot back up to be closer to where the AMPS number winds up?

Could also just be plain ol' hunger, I guess ;) On an average day (a work day), he eats a meal at about 8:15 (just before we go to work, just after his AMPS and shot), normally a lunchtime meal around 1pm if I can get home, a 5:30ish meal after work, another small meal right after PM shot, and then another before we go to bed around 11pm. So eating several small meals through the day, only to be expected to then wait 8 hours overnight to eat again in the morning just might be too much in his current state (this never used to be an issue, pre-diabetes). So now, tack onto that list generally a small meal/snack around 4-5am, then again around 6:30am just before we are ready to get up.
 
I'd also encourage you to use the original spreadsheet colors that came with the template. It's very confusing to others looking at the spreadsheet if you have different colors. After a while of studying spreadsheets, many of us look at the colors more than the numbers.

Basically the most significant number on an AT2 is 68 if you are following Tight Reg. If you look at the actual protocol, it says to use the same dosing guidelines except to reduce at 68. So we treat the rest of it all the same as with the human glucometer.

Overall he looks good. Flat blue is nice. If you're following Tight Regulation, green is your goal. The idea is to aim for the 50 or so points above the reduction point. Getting a cat into normal numbers allows their pancreas to heal, if that is at all possible.

I agree with Chris' comment that you don't need to be testing so often unless you're just addicted to the test data! I didn't test in the middle of the night unless I thought punkin was going to head into low numbers. It is good to sprinkle tests around here and there - and if you see wide open white spaces in the spreadsheet, sprinkle a test in here and there when it works to do so. Looking at his spreadsheet, I don't see any reason to set an alarm unless you think he's headed for low numbers (under 68).
 
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