Blue High AMPS 11/5

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(((Patty)))

There is much trial and error in this process. Unfortunately because our little ones can only speak to us through their BG readings it can take a lot longer than we would wish. Take heart, Patty: each cycle teaches us a little more about how to do it better next time. :)

:bighug::bighug::bighug:


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Patty and Blue said:
Sally takes Bg readings 4 times a week and so far all is good. Seemed fast to go into remission, doesn't it?
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Sally has indeed been very diligent in her monitoring of Lily. It gives me no joy to say so, Patty, but alas, Lily isn't in remission. Not a single reading Sally took was in the normal feline reference range throughout the entire period since the vet advised her to suspend insulin treatment, and her numbers are gradually deteriorating. She's most likely spending a fair amount of time each day over the renal threshold (which increases risk of UTIs). Her numbers are high enough to warrant daily testing for ketones (standard safety precaution for cats whose BG levels exceed the renal threshold for part of the day). Unfortunately Sally's not catching enough +1 readings to check how high the BG is rising after Lily has eaten but the later tests in the cycle very much indicate that the food is bumping up BG levels and it takes the rest of the cycle for numbers to return to preshot levels. Lily still needs insulin. This is why I'm so worried.

Here is the spreadsheet for Blaze, Paola's boy. (NB: Readings are from an Alphatrak meter so numbers are higher than the equivalent human meter readings would have been - Alphatrak reference range is 70-150 cf. human meter range of 50-120.) Blaze's readings are fairly typical of what one should see BG-wise in a cat for whom the diet change and a short period of insulin support was sufficient to take them into remission:

https://docs.google.com/spreadsheet...-Zo7JOzcfcbzrqNl85xp592LTbPO6J89K5GA/pubhtml#

This is Lily's spreadsheet:

https://docs.google.com/spreadsheet...5WVl5oTbj9v316LvjjroBaCoY/edit#gid=1182885903

If Lily was going to drift down into in remission following suspension of insulin treatment her readings should have been almost solid greens with perhaps a tiny sprinkling of blue a week ago. :(

Patty and Blue said:
Seemed fast to go into remission, doesn't it?
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Not necessarily, Patty. Depends on the individual cat. Some cats - the lucky few - can actually go into remission pretty much immediately following a switch from a high to a low carb diet, and not need any insulin treatment.


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BTW, I think Lily definitely has a good chance of achieving remission but she still needs more time with the support of insulin (Lantus or Levemir, not Vetsulin) to enable the pancreas to rest and hopefully recover sufficient beta cell function.


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She said they were going to do a fructosamine test in 3 weeks. I asked her to not wait. She just tested and it was 191 but she thinks that's good.
I believe she is going to call tomorrow but that vet is only in on Tuesdays. I would ask someone else. :arghh: I'm hopeful she'll reach out to you Mogs.

Blue got into my honey butter...:( He's at 409 +10. I need to change my times. I'm half way on DST.
 
Patty and Blue said:
She said they were going to do a fructosamine test in 3 weeks.
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Sally is testing daily. The fructosamine result only provides an indication of the average BG for a period of weeks. Sally's BG readings tell her what is actually happening to Lily's BG levels - peaks and troughs - every day. The fructosamine test has value as part of the initial diagnostics when a cat is suspected of being diabetic or to give people who don't home test a rough idea of their cat's diabetic status, but for anyone home testing regularly, as Sally has been, the test is a complete waste of money because it has far less clinical value than the daily BG readings.

Patty and Blue said:
She just tested and it was 191 but she thinks that's good.
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Sally posted that her vet told her lots of cats run in the 200s and that it's absolutely fine for them to do so. (This is completely untrue.)

A rough estimate of the renal threshold range as measured on a human meter is about 200-230 (250-290 on a pet meter, according to the online Merck Veterinary Manual).

:(


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