7/22 Max +11.25 120 +11.75 114 How to shoot? Regular dose?

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max&emmasmommie

max&emmasmommie

Member Since 2012
Hello everyone. Hope you are all well. I think I may need some dosing advice this evening. Max's shot time is 9 pm Pacific Time. Last night he was at 50 three and a half hours after his shot. I fed him and ate very, very well - about double what he usually eats at a sitting. I'm giving him 2.75, and I wonder if it's too much. I am not at all comfortable trying to keep him between 60 and 120. I would prefer him to be between 90 and 150 or above. He may bounce tonight, but the issue remains the same. I want to stay safe, but regulated. Any advice will be appreciated. I'll post at about 8:00 about how his +11 reading turned out.

Link to day before yesterday's post: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=75413
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

So, given these lovely numbers, you're not interested in tight regulation or the potential of remission? Max is only a few months from when he was diagnosed so these are real possibilities. In addition, once numbers are above 220 (approx.) you start risking being over renal threshold. I'm not trying to twist your arm. Not everyone wants to consider remission. I just want to be sure we understand your goals.
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

I have to admit I'm somewhat tempted to try tight regulation after seeing these numbers. Max is quite old, and has been so high for so long. I didn't realize it was likely enough to be worth trying it. He may have been diabetic since last October. September 2011 was the last time he tested at normal glucose levels without insulin. Have very many cats with CRF gone into remission or is that a strike against him?

I would be willing try it and see if I feel that I can keep him safe on tight regulation. It's hard to imagine having to devote even more time to his illness, but maybe if he was better regulated I would actually spend the same or less time. I suppose it's really not possible to know how long it would take. I suspect it varies wildly.
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

I wish I had a crystal ball and could tell you what the outcome would be. With a cat that has kidney issues, I would certainly want to see his BG values below 200. The only way to really know where your cat's renal threshold may be is to test for urinary glucose. Ketodiastix will let you do that -- they test for ketones and urinary glucose.

I don't know how age factors in. It may effect insulin metabolism or it may not. I'd be more concerned about age as an issue if Max had been diabetic for a long time. As it is, he's been diabetic for only a few months.

I guess my thinking is that you lose nothing by trying. If it's too much work or Max isn't responding, you can loosen things up. Whatever you opt for, I'd encourage you to do what you can to keep Max's numbers, on average, below 200 in order to spare his kidneys. No matter what you decide, you know that we'll support you.
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

Thank you, Sienne. I really appreciate you support. It's very scary to think of his BG dropping to low and having an emergency. I suppose that if I want to try Tight Reg, keeping him at 2.75 is the thing to do unless or until I see much lower numbers?

Fifty is scary, but he did eat very happily. I was awake, and walked into the room. I suppose TR means getting up at least twice after going to bed at 9:30 or 10 if my shot time is 9 -- once around +2 or +3 and once at +6. I get up about twice more with Emma, but I can fall back to sleep pretty quickly after that if I don't turn on lights and get all riled up by doing something else.
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

Oh, by the way, on Melissa and Popcorn's "How to Treat Hypos" are those numbers on a pet meter or a human meter?

I understand that 50 on a Human Meter (Relion) is about 80 on a Pet Meter/AlphaTrac by most estimations. So, if "normal" is 80-130 (right?) then last night at +3.5, Max was at the lower edge of normal (plus or minus 20% which means he was between 40-60 on the Relion meter.)

Second question: If Melissa's cheat sheet uses human meter numbers (not Pet Meter/AlphaTrac) then, for the purpose of hypo prevention, should I consider a 49 on a human meter to be "under 40" because the variance is 20% which means it's possible the real number is 39-58? (I realize his behavior is most important.)

Third question, even if the number is below 40 (either on the meter or when considering the 20% variance), if the cat eats happily is it necessary to give Karo? If not, at what number would Karo be required when the cat is willing to eat a fair amount of food?

Thanks!
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

Dale

The How to Treat Hypos are human meter numbers.

You know, I just take a number at face value. If it says "30", I don't think "well....this could be 24 or it could be "36"....they are all low numbers that need the same response. And at low numbers, you see much less variation than you do at high.

If you get a 49 on a human meter, consider it to be a 49. Don't overthink it. Really, the variance issue just helps us see if a kitty is flat or is actually showing some movement in numbers. So just focus on the number you have on the meter. I have two One Touch ultra minis. They ALWAYS test within 1-2 mg/dl of each other and often test exactly the same. Meter variance does usually apply to just the meter you are using and not between meters but I have to think my meter is pretty reliable if one like it tests that closely.

As far as when to give karo, it might not ever be necessary. Hopefully, you would have some data built up on how he reacts to different carb foods; if he drops below 40, you might be able to bring him right up with food and/or gravy. If you get a low number, post here so we can help you .....we walk many members through low cycles.

Keep in mind that you are in control. If you have data, you have food, you are testing....you can control the numbers.
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

Hi. Thanks, Marjorie!

Max tested at 120 at +11.25. The last time he was that low around shot time was last night, and he dropped to 50 at +3.5, ate and then was at 82 at +6. Should I stick with 2.75 tonight? I anticipate the answer will be yes, test at +2 and go from there.
 
Re: 7/22 Max Pmps 128 +3 (nt) 50 +6 82 Amps 137 +3 71 +5 89

I tend to refer to the info we use here on dealing with low numbers. There is a difference between a cat dropping into low numbers vs. a hypoglycemic crisis. Many of our cats will dip their toes into the 30s. While I wouldn't want Gabby to stay in the 30s, she's definitely visited there. (She's visited the 20s, too.) Because we monitor and use food to steer the curve, it's rare to see a cat here that is severely hypoglycemic. Likewise, because with TR, you are systematically increasing the dose, hypoglycemic episodes are unlikely.

With an AlphaTrack or other glucometer calibrated for cats, the normal BG range is 80 - 150. Dose reductions would be for any number below 80. I think you will make yourself a little nuts if you try to calculate the range around every number you get when you test. The number is the number. Where I think it's helpful to consider the variance is when someone says they're seeing jumps in numbers. When you begin to factor in the variance, often the numbers are fairly flat. Otherwise, I don't worry about it.

What and when to feed is more complicated. A lot depends on how carb sensitive your cat is. For example, Jill's Alex will get a 30 point bump in numbers from a piece of freeze dried chicken. Alex is very carb sensitive. If Alex's numbers are low, Jill can feed low carb. On the other hand, Gabby has a tendency to drop fast and early in the cycle. I use HC in order to put the brakes on. If there's not a great deal of momentum behind the drop, though, I may use LC to slow things down and encourage a surf. (You can see the notes on Gabby's SS.) Unless your cat is very carb sensistive, if numbers are below 40, I would use HC. If they are not coming up relatively quickly, I would add a drop or two of Karo. Again, some of this depends on knowing your cat.
 
Re: 7/22 Max +11.25 120 +11.75 114 How to shoot? Regular dos

Ok, Sienne. Simplify.

Max is at 114 at 11.75. So, he's dropping. Dose?
 
Re: 7/22 Max +11.25 120 +11.75 114 How to shoot? Regular dos

Just pointing out that a 120 and a 114 are pretty much the same number. Max is surfing!!

If you have strips, HC, and can stay awake to monitor, your good to shoot. You've shot numbers in this range before. (I think you're so used to seeing Max in high numbers, this has got to seem strange!!)
 
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