9/22/2022 Phoebe AMPS 138, +4 99, PMPS 87

sam_j

sam_j

Member Since 2022
https://docs.google.com/spreadsheet..._1zOmdvZNcpAhAt4uFq4Ua1VA/edit#gid=1182885903

Yesterday morning I found a big barf full of food when I woke up. But Phoebe was normal all day so I didn't think much of it. Then in the evening (around 2:30am) Phoebe barfed again. This time it woke me up, so I tested her and found her BG was only 79 despite having no PM shot earlier in the evening. I am guessing that there is simply too much insulin in her "insulin depot" and it might have driven her BG too low, making her overly hungry and causing the food throw-up?

Due to the above I was on the fence about giving her a dose this AM, but since her AM preshot number was higher than normal (138) I figured I'd give her another 0.25 unit dose.
 
Ah, yeah I changed the color coding for myself so that greens matched the 80-120 reference range, with <80 being light green and >120 being blue. I'm still following the dosing protocols based on the BG reading for an AlphaTrak meter, I just changed the colors to give myself an easier ability to see when Phoebe's BG is above, at, or below the normal range.
 
PMPS 87, so I'm going to skip the PM shot again because I'm afraid of a repeat of what happened last night.
 
Although you may like what you've done to the colour changes, it's going to make it harder to get help on dosing if you change the spreadsheet to have different colour schemes that what we have used to. After looking at hundreds of spreadsheets, my brain is wired to think of below 68 as the danger zone, not 80. Not sure where you got the 80 number? We've seen cats off of insulin be below 80 on the AT. As far as the AT goes, the only difference between it and human meters is that with TR reductions are earned by going below 68. The rest of the numbers stay the same. I see you changed your dosing method to TR since your last post, but if you don't want her going below 80, maybe SLGS is a better fit for you.

I tried to figure out what happened last night, and I don't see any low numbers on the spreadsheet, just a vomit. What sort of food do you normally leave out for her to munch on at night? If you are feeding kibble regularly, as per your notes, you will not be able to follow TR.
 
I leave out Fancy Feast pates, which is the only food the cats are regularly fed. I only feed kibble if she seems off or if she has a low BG (usually low 70s or lower, since that's when she starts behaving differently), and even then it is a very small amount. Maybe a single tablespoon.

I didn't catch any super low number last night, I only hypothesized about its existence based on my past experience where Phoebe gets really hungry when her BG gets low (70 or lower). I assumed her BG had gotten low and compelled her too eat a lot of the FF while we were asleep, and then she got sick and threw up. By the time I was able to measure her BG it had risen to 79. At least, that's how I explained it in my mind. I fed her a small amount of kibble after the vomit just to keep her from potentially going back down too low. I feed kibble because it's the only non-LC food she'll eat.

I understand the confusion about the colors and switched them back for convenience with the rest of the board. Though I am confused as to why the color scheme turns blue at 100 for both a human meter and a feline meter. Wouldn't a 100 on a feline meter indicate a lower "true" BG concentration than a 100 on a human meter? I'm not *quite* there yet but the TR guidelines for an OTJ trial say this:

During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission
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I would have thought those numbers would be different depending on the type of meter one uses.
 
We don't have a way of converting numbers from an AT to a human meter, or vice versa. When people have tested comparing results on the same blood drop with the two types of meters, we also haven't been able to figure it out. Sometimes the AT reads lower than a human meter in numbers below 100, sometimes higher for a particular test. So we just stick with the same number for TR, whether using an AT or human meter. The only difference being the use of 68 for reductions on an AT.

And there is this bit that was written on top of the dosing methods Sticky Note:
THE USE OF PET-SPECIFIC METERS IS DISCOURAGED BECAUSE THE DOSING METHODS USED ON THE FDMB WERE CREATED WITH METERS CALIBRATED FOR HUMANS. ALL REFERENCED NUMBERS CORRESPOND WITH METERS FOR HUMANS, NOT PET METERS.
Click to expand...
 
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