Blue AMPS 238 10/17

https://www.felinediabetes.com/FDMB/threads/blue-amps-437-10-16.236976/

Blue is at 238 AMPS so pretty good starting point but I do realize it's probably being influenced by the .1 for a couple of days.

He was a bad boy wanting to love on his sister Layla last night and she didn't want any part of it. He would not stop and it was the middle of the night. I finally had to close my door with him on the other side. I guess he's feeling pretty good.


Another game today Elise

 

Hi there, Patty!

I see your beautiful boy is starting his day with a sunbathe. Nice! Nowt wrong with his joie de vivre either, by the sound of things.


Mogs
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Lol Blue and his frisky self

good luck today!

 

PS:

With such a good AMPS I'd recommend grabbing a +2 test to get a feel for where the cycle might be going. There's a data gap and the depot's a bit messed up at the moment so you need to feel your way a bit for the time being.

Talking of a data gap, I suggest you chase down the BG readings for Blue that were taken at your vets. I think it's particularly important that you get hold of them because of the dilemma in which you have been placed about treatment approach. Now that you've decided to go with the 0.5IU q12h dosing instead of the 1.0IU q24h dosing, you need to have a view of the clinic BG data so that you'll be able to compare and contrast results for yourself and make a decision about the best approach for ongoing treatment. If asked, I suggest just saying you need the data for your home records, nothing more specific than that. They've provided you with the results of the blood work. They've no justification to withhold the BG data from you.

I recognise that you're keen to reduce test frequency at the moment but because you don't know where the depot's at I strongly recommend that you do the +2 tests each cycle for safety, and also check for nadir - typically somewhere between +4 and +6. I'd also recommend you do some checks around those times on the PM cycles for the next few days so that you'll have evidence of what's happening on both AM and PM cycles to support your preferred dosing approach. (IIRC they said that they considered that the second 0.5IU dose they gave took Blue "too low", but you don't know what their definition of 'too low' actually is so it would help you to be able to demonstrate that the dose you're giving keeps Blue in safe - ideally very healthy! - numbers.)

Sending some more scritches to the Bluebird and another for you.


Mogs
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Yes, I will check +2

I think I have all the readings. They only tested during the day. I just haven't been alone long enough to put the numbers into the SS. I can't concentrate very well with people talking.

Mogs, how are you feeling? Any better at all? How is your Noodle?

I love your kitchen too, Mogs. It's so warm and cozy and must be a joy to cook in.

 

Thanks Jeanne. Busy sports day today. You have a race to watch? I have Braves of course, and 2 football games. I'm not sure I'll make it through all that but Braves are a must.

 

2 RACES! Wheeeeeeeeeeeeeeeeeee I have a good friend who is an official and Kansas (todays race) is his home track.

 

You have a busy sports day too! I'm happy to have sports to watch again since I'm mostly still staying home.
I missed sports while no one was playing. I even watched the Braves win the World Series again, even though it was quite a while ago.

 

Blue's at 241 +2.5 so still in the general area.

 

Ive been watching old races the problem is they arent old enough. All the drivers Ive met are long gone now sigh Would be nice to see them again.

 

Lets go surfin now Blue

 

Might stay flat, might a bit lower by nadir.

Are you good with things, Patty? (I'm not sneezing as much but the fatigue's bad so I'm planning to retreat under the duvet shortly.)


Mogs
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I know you will be home so of course close supervision is not required. Lol.

 

Yes, all is good. I'll check him again in a few hours. He's so happy to be home. He's laying on me and seems to be feeling good.

Mogs I'll be okay. You take care of yourself.

I might lay down for a minute. Tech is playing #1 Clemson and it's not good.

 

Glad you're OK, Patty. So good to get such a lovely update about your Bluebird: he loves his mommy!

(((Patty and Blue)))




Mogs
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Yes, I'll be here through baseball and football. The first game was terrible. I thought they were going to score 100 points on us.
Good Luck Elise. I fear if we get to tomorrow we'll be in trouble.
Getting ready to test Mr. Blue and feed the gang.
Will post his number soon.

 

Yikes. 52 +6 so I gave him some medium carb food and a drop of honey. I'll retest to make sure he doesn't drop lower.

 

Gadzooks! At least he's quite well along in the cycle.

Wondering whether the course of antibiotics might be resolving some infectious process?

Any chance you could have a gander at the BG data from the vets and let me know:

1. The lowest BG recorded there.

2. How long after shot time it was recorded (+ time, please).

3. The dose that was given on that cycle.

4. The dose that was given on the previous cycle (or whether the previous dose was skipped).


Mogs
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OMG just trying to figure out the doses given by the vet and he gave additional .5 doses if he was over 200.
My GOD

 

<very rude words>!!!


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Looks like 106 was the lowest at 4:30 p.m. and dose was at 7 a.m.

I uploaded another report yesterday with curve if you can make it out. I have people back around
and can't concentrate. We're watching the game upstairs and it's getting ready to start.

I plan on retesting him in 5 minutes

I can't believe he did that!!! It's craziness No wonder he's low today.

 

He's at 63 now. Should I do anything else?

 

I realise you've got a lot going on over there right now but if you could manage to post the size of the dose that took Blue down to 106 I'd be grateful (trying to think about tonight's dose for you). If too busy, don't worry about it.

Re uploads, I've only seen the ones with the results of the blood work.

I'd suggest giving him a couple of tsps of low carb and test in 30 minutes. He hasn't come up much yet, but it is the later part of the cycle and thanks to the work you've done before you know that LC food is usually enough to stop numbers dropping below the 50 mark at this point. You still need to make sure he doesn't drop back.


Mogs
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I think this is it but can't tell for sure. There are a list of times and BG readings. I just can't tell for sure what they have done.

 

FYI, that's the lab results PDF again, Patty.

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I think they gave 1 unit at 7 a.m. and looks like they gave an additional .5 when he tested over 200

 

sigh...

 

That is completely nuts! How long after the first dose was the 0.5 given?


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Is there by any chance any mention of "R" insulin anywhere in the info they gave you?


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See if this is it.

 

I can't tell.

 

This one's got BG data in it. I'll have a butchers to see whether I can make any sense of it.


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85 +7

 

I'm having a hard time deciphering the plan and results.

 

They don't make it easy. Still going through it...


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When I have time I figured I'd try to highlight it or maybe write it down by date and time. It's very confusing and I'm not sure they've got all the info listed.

 

150 + 8.5

 

wow not bad!

 

I think you're good till PMPS now, Patty.

Still working on the BG stuff...


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You're a Saint

 

More sinner...



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I can’t make heads or tails out of what they gave Blue. I’m just glad you haven’t given him 1 unit. I never expected him to drop to the 50’s today. I am wondering if tge amoxicillin is helping and he’s been on tge wrong medication causing an infection causing him to not regulate. It also could be what we were doing is working.

 

I just came on. Busy with condo leak in garage and game and was helping Ale.

 

Hi Elise. Did your team win?

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Game is still going on. We are up 3-1. We need 4 more outs for a final game against Patty’s team. Now 3 outs away.

 

What is Simbadol? Never mind. It’s buprenorphine.

 

I don’t think they gave extra insulin. I think they gave him 1 u it in the morning and said to give .5 at night if over 200 but I could be wrong.

 

Game 7 tomorrow could go to anyone Patty. It’s hard t come back from 3-1.

 

I couldn't tell Elise. It says give .5 if above 200 and each time it was higher.

Congratulations! We'll do it again tomorrow.

 

It’s nice to have something to watch. I miss basketball already.

 

I know. I love baseball and will miss watching. I'll probably watch the World Series this year no matter what. I normally don't if we aren't in it. I'll cheer for whoever wins NLCS.
Falcons are 0-5 so not fun to watch. Tech got beat
today 73-7 OMG I napped the second half. Georgia is playing Alabama right now but I'm not that big of a fan. Where's that vaccine???

 

I hope the Astros lose. Cheaters! I don't want them playing in the WS

 

Me too,Patty. Dodgers were robbed.

 

Fascinating exchange. Ye might as well be speaking Swahili.


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lol

 

AGREE!

 

Ha ha ha cracking me up Mogs

 

Hey I just learned what a conker is.

 

Aaaaa what's that?

 

From Gil and Mac:
They are the seeds of the horse chestnut tree (not edible like the chestnuts that you roast from a "non-horse" chestnut tree). They are in a spiky covering which splits when they are ready to fall in the autumn.
Kids used to collect them, push a hole through them and thread a shoe lace or thick string through with a knot at the bottom . You then play conkers by taking it in turns to swing your conker from your hand at your opponent's conker until one cracks and breaks enough to fall off the string and so loses - technique shown below. If your conker had beaten 10 others it was a "tenner" and so on - it got quite competitive with eagerly watched battles especially when it was a high scoring conker .
Its probably banned in playgrounds now due to the amount of bruised knuckles that resulted from bad shots and the danger of flying bits of conker! Oh the fun we had in those days before computer games !

 

Happy days...






Mogs.

 

wait a min did I say that???

 

LOL very funny

 

Jeanne thank you for the new knowledge of conkers. Why were you learning about this?

I was born in WV and we had a chestnut tree in our back yard...and I did not know this

 

PMPS 256 so I'm thinking eventful...what say you?

 

Very possible. Get a +2.

 

OK, people. This is the best I can do with the vet BG/dose info. (All readings taken with Alphatrak meter, and all with likelihood of being stress-influenced.)

-----------------------------------------------------------------------------------------------------------------------

10.12.20

AM - Dose 0.5IU administered at home.

AM Mid-cycle at vets - BG in 300s (from Patty's forum post - no BG info for 10.12.20 in PDF)

------------------------------------------------------

PM Cycle - ???? (no info)
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10.13.20

HH:MM - AMPS ??? - Dose: ??? (no info)

13:43 - +??.?? - 296
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17:00 - Special orders: Insulin 0.5 units.
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17:00 - PMPS ??? - Dose: 0.5IU <--- Marked as administered.

[No BG readings for PM cycle]
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10.14.20

07:00 - Special orders: Insulin 0.5 units.
07:00 - Special orders: if >200 give another 0.5IU. <---- I think this may be a standing instruction to give a larger dose if any preshot is over 200 (sliding scale of sorts, maybe?)
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07:00 - AMPS - 634 - Dose: 0.5IU <---- Definitely administered (+14 after previous dose). No second note about med admin, so not clear if additional 0.5IU given (i.e. total dose 1.0IU)
09:00 - +2.00 - 400
11:30 - +4.50 - 147
12:57 - +6.00 - 128
13:57 - +7.00 - 124 <--- This is the only point where the vets have mid-cycle readings for a second consecutive 0.5IU dose (assuming they only gave 0.5IU). This may be what they consider to be too low.
14:57 - +8.00 - 132
15:57 - +9.00 - 142

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12:00 - Special orders: if >200 give another 0.5IU <--- NO IDEA why this appears at this time on the report. No comment about med admin at this time.
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17:00 - Special orders: Insulin 0.5IU. <---- Med admin charge code listed on report.
17:00 - Special orders: if >200 give another 0.5IU. <--- Not clear if this was given but with the 210 preshot and previous nadir I doubt whether they gave 1 full unit if no overnight monitoring.
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17:00 - PMPS - 210 - Dose: 0.5IU??? (+10 after AM dose admin!) <---- This may be why they told you he doesn't come up high enough, confusing given their 'special order extra 0.5IU if >200'.

[No further BG readings for PM cycle]
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15.10.20

07:00 Special orders: Insulin 0.5IU.
07:00 Special orders: if >200 give another 0.5IU.
07:00 Gave 1IU Lantus - Whiteboard note.
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07:00 - AMPS - 438 - Dose: 1.0IU Lantus
08:50 - +1.75 - 504 <--- Not sure if this is correct. It's the last BG number on report and can't be for next morning as Blue was discharged evening of 15th.
10:00 - +3.00 - 361
11:30 - +4.50 - 324
12:15 - +5.25 - 217
14:12 - +7.25 - 117
14:45 - +7.75 - 131
15:30 - +8.50 - 164
16:30 - +9.50 - 106 <--- Is this where they're getting the 18 hrs duration from? Taking the + time of the nadir and doubling it? There are NO +18 BG readings in the report to support their claim.
17:30 - +10.50 - 121

00:15 - +17.25 - 66 <--- Reading taken at home (human meter).
---------------------------------------------------------------------------------------------------------


Mogs
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I'm treating myself to a beer after all that. My brain is well and truly frelled.


Mogs
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Mogs you have the patience of a saint!

 

Sláinte, people!




Mogs
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LOL, you deserve it. It looks like there is a lot of detail left out. I also wondered how they came up with the 18-hour scenario.
Do you think the human meter I use has a different reading from the vet monitor? He seemed to dismiss my numbers because ”meter is not calibrated ”. Why isn't it? What would it be calibrated to?

 

More the tenacity of a terrier.

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She does. I'm impressed. I was having a difficult time with it.

 

Tampa Bay is up 3-0 in game 7 Elise. I just had to check it.

 

The way that glucose is distributed in the blood differs between cats and humans, hence the reason why human meters give lower readings than the 'actual' BG concentration of feline blood as would be read on a lab analyser. Meters such as the Alphatrak are calibrated to account for the way glucose is distributed in cat blood and consequently give readings pretty much equivalent to lab analyser results.

Both types of meter give accurate readings to within +/- 20% of the 'true' BG level of the sample measured.

The cat BG reference range for a pet meter is c.70-150mg/dL. The cat BG reference range used for human meters is 50-120. As you note, the range limits are lower than those for the range used with pet meters, because they take into account that a given sample should read lower on a human meter than on a pet-calibrated one.

The Roomp-Rand TR study presents its dosing protocols specifically for human meters and provides the evidence base for the human meter cat BG reference range used at FDMB.

Readings on both meter types are equally valid.


Mogs
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Patty, when you post the BG numbers above into your spreadsheet, you'll need to flag them as Alphatrak readings, e.g.

123 AT, 456 AT, 789 AT

I suggest also put something in the remarks along the lines of "AT = Alphatrak reading taken at vets."

If you do the above, you'll need to manually colour the cells using the paint bucket.


Mogs
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Good to know. When he said mine wasn't
”calibrated” I was confused. The reading he got would be higher than mine? How would I indicate this on a SS? I was going to enter the numbers into my current SS but it wouldn't be apples to apples.
Probably why he asked me 6 times about the 44 reading.

 

Oh I have never worked in a SS app so I didn't know I could do that. Thx.

 

I think I'm going to try to enter into SS tomorrow if possible. I have tennis at 1:00.
I tried to enter a couple readings earlier before uploading the document and there was a BG number in blood work that first day, so it wasn't listed separately. I believe one is the first day and it was 469 + 7
So confusing...you did a great job Mogs. Do you think I need to indicate the extra doses? Maybe in notes or along with BG number?

 

On his Alphatrak meter the reading for that sample would have been round about the low 60s, definitely below 70.


Mogs
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Maybe put the doses as best we can make them out into the main part of the spreadsheet with a question mark? Maybe put just question marks where we don't know whether any insulin was given? Then you could put notes in the Remarks column to say that insulin was given at vets and it was unclear how much was given at the various times? Best I can think of to suggest to you.


Mogs
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Cool! I added some color into some BG and added AT

 

I entered some BG into SS
I think I understand but not sure when and if he gave .5 so I might put an asterisk in the box we think extra was given and indicate in notes.
I've had three cats in my lap while I've been doing this! Good times

How's the beer Mogs?

 

That makes two of us! I'll see if I can summarise what I could work out from the report for you tomorrow.

The beer is going down very nicely!

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You're up late again. Hope you feel a little better. Did you get some rest earlier?

 

PTSD symptoms are bad at the moment so insomnia's worse, and also I'm having difficulty getting enough food into the Noodle thanks to the antibiotics. I have to be sparing with the appy stimulant because it increases her resting heart rate and so does the amlodipine for her blood pressure (she has hypertrophic cardiomyopathy as well as the CKD). She needs me to prompt her to eat and I can't do that when I'm in the Land of Nod, so at least there's a bit of a plus side to not being able to sleep.

Are you over the tiredness from the 'flu jab yet?

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Sneezing seems to be easing off, BTW. (Anti-jinx!).

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You have quite a balancing act going on at your house. I'm happy you are getting a little better and not sneezing as much.
You've felt bad for awhile. PTSD and insomnia is not a good combination. I hope you have good drugs.

I'm much better and not as tired. That could change at anytime with Blue.

He's at 355 +2 now so I was completely wrong. He was at 256 PMPS...WTH?

 

Trampoline time after the 52 earlier?

Glad to hear the adverse effects of the jab are wearing off.

I wish! I went through a slew of different meds for years. None of them helped, and some made things even worse. I'm very med sensitive so I can only take a small dose of my anti-anxiety med. Balancing side effects ain't the best.

I'm just waiting for Lúnasa to finish another bout of 'sleepy eating' and then I'm gonna head to my leaba. I wish you a peaceful and refreshing night's sleep, Patty, and I'll catch up with you later.

(((Patty and Bluebird)))



So glad he's back home!


Mogs
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Thanks Mogs. Sleep well. I'm already in bed with Layla bug needing attention. She likes petting when no other fur is around.
Love to your Noodle

 

Uneventful after all. Good night all.

 

Mogs is feline diabetes WARRIOR!

 

I do not know why my reply came out in this manner...
just click the link

 

My friend is in inspection this morning I'm off to watch him via computer bbialw