Cliff Notes: Week of 12/19

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MiCo

MiCo

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Notes on Cliff this week:
  • Been working on "training" Dave/husband on the whole process of test/feed/shoot. He's shadowed me for a while, and can do the shot no problem. But he's having trouble doing the the BG test solo (if I'm not there to jump in/help/assist.) Part of it is nerves/confidence, and part of it is he has big hands and can be a bit clumsy. Any tips? I'm doing my best to transfer all of my knowledge/tips/tricks. :)
  • Next curve is due this weekend, but I will be leaving town Friday or Saturday--depends on the weather. I'm not sure if it makes sense to do the curve before leaving on 12/23 or wait until I get back 12/26. There are pro's and con's to each scenario.-->Emailed the vet. I'm gonna do the curve when I return.
  • However, I don't think Dave wants to bother with adjusting doses. I actually think I am going to pre-draw the syringes for him, because he's not really comfortable with doing that. I checked with our vet, and she said that was OK, just to roll the bottle before drawing the syringes, and to have Dave roll the syringe before administering.
  • I've noticed some weakness in his back legs, which I've read a little about neuropathy on here. I'm not sure that there's much we can do other than try to get his BG down. He definitely has good days where he climbs the stairs and jumps up on things. And then there are days when I can tell they he's not feeling his best and doesn't do these things.
  • Everyone is eating well, and little boxes are good. I've been testing ketones, and his blood ketones have been very low. He actually went down from 0.9 to 0.4--which makes me happy!
Fun stuff:
  • The tiny bowls that I ordered from Williams-Sonoma to put in our PetSafe5's showed up today. (They were back-ordered previously.) So, I'm excited to finally test these auto-feeders out. (I bought the bowls to make feeding/cleaning easier and also because Cliff has had issues with plastic and feline acne in the past.
  • A bought a PetCube camera on deep discount from Amazon last week (I think it was a flash sale.) I had been researching cameras for a while, and when this came up on sale, I decided to pounce. :) We set it up this weekend, and I am now obsessed with spying on the cats! :) Cliff mostly just sleeps, but Stella is a busy body, also checking on noises and watching the birds outside, etc..
    • Of course, the first day I am watching them from work, they have not been on the camera at all today! I have it in the living/dining room area--and I suspect they are sleeping in our bed while we're not at home!
    • I don't think the camera is worth full price, but if it goes on sale after the holidays, I definitely think it's work the $80 I spent.
 
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MiCo said:
part of it is he has big hands and can be a bit clumsy.
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I don't have big hands but they're very weak. I put the lancet needle in the holder/trigger and freehand that way - don't use the spring mechanism. I find the chubby shape of the holder/trigger is easier for me to hold. Maybe an idea for Dave?
MiCo said:
some weakness in his back legs,
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This might only be because he's sub-par from being in high numbers right now as opposed to actual neuropathy. It should improve when he's in lower numbers for a time.
MiCo said:
before leaving on 12/23 or wait until I get back 12/26
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You might go up to a new dose over the next couple of days and then you can leave it at that for the time you're away. Curve when you get back.
MiCo said:
A bought a PetCube camera
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Will set your mind at rest sometimes and other times you'll wonder where the heck they are and what are they up to. ;)
 
PMPS is 236! This is exciting. But nervous territory. Since we're using alphatrak2, I wrote down that pre-shoot should be at least 250. We are stalling 20 minutes and testing again. @Kris & Teasel and @Sue and Oliver (GA) is this the right protocol? Today is day2 at 4.5 units.
 
MiCo said:
We stalled 20min and he retested at 326. :)
Feeding and shooting now!
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OK! Exciting isn't it when things start happening? Can you test before bed tonight? I think Sue is more or less incommunicado for the next week. I'll be around though.
 
Kris & Teasel said:
OK! Exciting isn't it when things start happening. Can you test before bed tonight? I think Sue is more or less incommunicado for the next week. I'll be around though.
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Yes! I will do that. I can probably get a +5 or +6. I can even set my alarm for a later test. What do you suggest?

One thing to note, Dave did the first PMPS test and I wasn't watching him, but believe it was a good test. However, he gave Cliff his "post test treat" before we saw the # was lower 200's. Lesson learned-don't give the treat befor you see the BG #, but I don't think the treat would have made his BG jump 90 pts, right?
 
MiCo said:
Yes! I will do that. I can probably get a +5 or +6. I can even set my alarm for a later test. What do you suggest?

One thing to note, Dave did the first PMPS test and I wasn't watching him, but believe it was a good test. However, he gave Cliff his "post test treat" before we saw the # was lower 200's. Lesson learned-don't give the treat befor you see the BG #, but I don't think the treat would have made his BG jump 90 pts, right?
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If you're using freeze dried meat treats they shouldn't have a major effect. I always give Teasel one of these after a test and it hasn't been a problem.
 
MiCo said:
Yes! I will do that. I can probably get a +5 or +6. I can even set my alarm for a later test. What do you suggest?

One thing to note, Dave did the first PMPS test and I wasn't watching him, but believe it was a good test. However, he gave Cliff his "post test treat" before we saw the # was lower 200's. Lesson learned-don't give the treat befor you see the BG #, but I don't think the treat would have made his BG jump 90 pts, right?
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A +5 or +6 is good - you should be catching the nadir range. When you have to get up for work setting an alarm for a later test is painful.
 
+5.5 was 429
I don't know how to interpret these #s at all! I was so surprised by that PMPS, and his #s have been in the pinks & reds since.
Thanks again for your help! I don't know what I would do without this board & its support/resources.
 
MiCo said:
+5.5 was 429
I don't know how to interpret these #s at all! I was so surprised by that PMPS, and his #s have been in the pinks & reds since.
Thanks again for your help! I don't know what I would do without this board & its support/resources.
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Those reds this evening after that yellow this afternoon are likely bounce numbers. He might have been a tad lower than the yellow you captured and that set him off. The yellow itself might have felt uncomfortably low to his system after the high numbers he's accustomed to. Look at the red PMPS you had after a low yellow in the afternoon of 12/14.

"BG Interpretation 101". You realize, don't you, that all these courses are part of your FD degree requirements. ;)
 
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Kris & Teasel said:
Those reds this evening after that yellow this afternoon are likely bounce numbers. He might have been a tad lower than the yellow you captured and that set him off. The yellow itself might have felt uncomfortably low to his system after the high numbers he accustomed to. Look at the red PMPS you had after a low yellow in the afternoon of 12/14.

"BG Interpretation 101". You realize, don't you, that all these courses are part of your FD degree requirements. ;)
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Hehe... I hit the books hard after that yellow tonight. Re-read the Prozinc protocols, the advanced thread and some other links for good measure! I can't slack off over the holidays. Must keep learning!!
 
Today will be day 3 at 4.5 units. Guessing I should keep on moving up? Maybe by 0.25, or from 4.5 to 5 units--or is that too big a jump?
I might try to eyeball 4.75 for the next couple of days (tomorrow 12/22 and Friday 12/23), and then if we're still increasing, leave Dave syringes filled to 5 units? I think I will be here through the AMPS on 12/24.
 
MiCo said:
Today will be day 3 at 4.5 units. Guessing I should keep on moving up? Maybe by 0.25, or from 4.5 to 5 units--or is that too big a jump?
I might try to eyeball 4.75 for the next couple of days (tomorrow 12/22 and Friday 12/23), and then if we're still increasing, leave Dave syringes filled to 5 units? I think I will be here through the AMPS on 12/24.
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Your plan to eyeball 4.75 u for a few days is good. You'll have data for that dose. If things stay uneventful at 4.75 u I'd leave it there while you're away. He's surprised you with a few yellows recently and raising it to 5 u might trigger some anxious moments for Dave - ie. a nose dive that requires lots of testing and snack feeding. Is he practicing the ear pricking to keep it up while you're gone?
 
Thanks for the feedback. The plan this week is for Dave to do the evening routine. So, he'll get at least three more prick tests in--we can do more than that if he feels like he needs more practice. He did good last night. :)
 
AMPS=336
  • Stella insisted on being fed early-4:30. Should be ok bc I should get out of work early today.
  • Adjusted dose up to 4.75.
I'm excited, but nervous to travel. I know the cats are in good hands. I decided to leave Saturday AM after morning routine-so Dave only has to worry abt 4 test/feed/shoots. :)
 
MiCo said:
AMPS=336
  • Stella insisted on being fed early-4:30. Should be ok bc I should get out of work early today.
  • Adjusted dose up to 4.75.
I'm excited, but nervous to travel. I know the cats are in good hands. I decided to leave Saturday AM after morning routine-so Dave only has to worry abt 4 test/feed/shoots. :)
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We worry about the fur kids so much, don't we? I'm sure Dave can handle it - you can tell him I said so ;).
 
Kris & Teasel said:
We worry about the fur kids so much, don't we? I'm sure Dave can handle it - you can tell him I said so ;).
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Thanks, I will do that! I try to give Dave lots of encouragement, because I so appreciate him and what he does for me and the furbabies, but I could always do more. :):):)
 
@Kris & Teasel one more question--hope it's OK to ask here, rather than starting a new thread. Can you take a look at this amazon link and let me know if these are the FS lite strips you use? I paused on ordering, because one of the questions or reviews said they didn't work with AT2.

I recently placed and order for AT strips at AWD, and curiously, the price for FS strips was just as high!
 
MiCo said:
@Kris & Teasel one more question--hope it's OK to ask here, rather than starting a new thread. Can you take a look at this amazon link and let me know if these are the FS lite strips you use? I paused on ordering, because one of the questions or reviews said they didn't work with AT2.

I recently placed and order for AT strips at AWD, and curiously, the price for FS strips was just as high!
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Yes, those are exactly the ones I use. They're still relatively expensive compared to the ReliOn strips from Walmart. However, they're the same strip as the AT and made by the same company. Only difference is that they're not batch tested to ensure they'll give an accurate reading in an AT meter set at a cat code. Some same blood drop testing at the beginning will give you a feel for the difference in reading. So far for me - they read higher by 3 to 7%.
 
Kris & Teasel said:
Yes, those are exactly the ones I use. They're still relatively expensive compared to the ReliOn strips from Walmart. However, they're the same strip as the AT and made by the same company. Only difference is that they're not batch tested to ensure they'll give an accurate reading in an AT meter set at a cat code. Some same blood drop testing at the beginning will give you a feel for the difference in reading. So far for me - they read higher by 3 to 7%.
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Thanks! I ordered a box of FSL strips. They are not arriving for quite some time (delay in shipping) but I have 2boxes of AT2 strips for now. Realizing that if I test minimum of 3x a day, that's about 2 boxes of strips per month!
When I ordered the FSLite strips, a scale also jumped in my cart...so that will be a fun new column to add to my SS to track--kitty weights! How often do you track their weight... just curious!
 
MiCo said:
Thanks! I ordered a box of FSL strips. They are not arriving for quite some time (delay in shipping) but I have 2boxes of AT2 strips for now. Realizing that if I test minimum of 3x a day, that's about 2 boxes of strips per month!
When I ordered the FSLite strips, a scale also jumped in my cart...so that will be a fun new column to add to my SS to track--kitty weights! How often do you track their weight... just curious!
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I have a digital baby scale too. Great for kitties. I don't actually weigh them that often. Every couple of weeks maybe. I weigh Teasel to see if he's losing or holding and I weigh his brother Woody because he was getting too "fluffy". He's been eating the same DM wet food as Teasel since the beginning of July and has done really well in shedding some fluff. I don't bother weighing their sister, Meadow, because she seems to be at a good weight.
 
Kris & Teasel said:
I have a digital baby scale too. Great for kitties. I don't actually weigh them that often. Every couple of weeks maybe. I weigh Teasel to see if he's losing or holding and I weigh his brother Woody because he was getting too "fluffy". He's been eating the same DM wet food as Teasel since the beginning of July and has done really well in shedding some fluff. I don't bother weighing their sister, Meadow, because she seems to be at a good weight.
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Your kitties have such nice names! :)
 
Pmps=294
Kudos to cliff and Dave for getting this done...while I was still at work (not even in the house to stress or be a crutch.)

I decided over lunch this had to happen before I left for my travels. They had to get through this process on their own, while I was just a phone call away. I pulled a syringe over lunch and stored in the fridge. Left a index cheat sheet with test/feed/shoot notes. And they did so well!!

Dave said there was a little chase/hiss before the shot, but I think that's ok. I'd rather him put up a little fight, then to be lethargic and comatose and giving in. :) the BG test went well (that has been the bigger challenge, and now we all know it can be done!!)

So proud!! If I was away, this would be 1 down, 3 to go!!
 
All right!!! Dave's got this now! As we all know, it gets easier after doing it a few times...and it will make life much easier for you even when you return to know that if you get stuck somewhere or need to go away again for something you've got someone else who can help. :)
 
Rachel said:
All right!!! Dave's got this now! As we all know, it gets easier after doing it a few times...and it will make life much easier for you even when you return to know that if you get stuck somewhere or need to go away again for something you've got someone else who can help. :)
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Yes! This is the best holiday gift I could ask for. Peace of mind. :D We are a good team, and Cliff is a great patient. :cat:
 
+3 288
+5 181

Hubs just said, "so, I didn't give a fur shot!"

May do tests at +6, +7, and +8 tonight. Just curious. Will stop once # is rising again. I will be around all day tomorrow to monitor and track.

+6 186
 
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Amps=355
Day2 at 4.75 u (eyeball)-I have a system though. Pull to 5u and then push down just a little.

Cliff slept upstairs last night. I think we need to find/make space for litter box up here, because I can tell the up/down stairs is hard right now. Neither cat woke me up, but I rustled Cliff awake at 4A to keep 12hr schedule to start today.

Stella didn't come down to eat, but I brought her plate up and she cleaned it. Everyone seems good this am, maybe just a little annoyed that I woke Them up this AM!! Haha.

Gotta open my backup vial of AT2 testing strips and recalibrate the meter to new code and test with solution. Lots of other small Cliffy errands to do before I start to pack to leave tomorrow.
 
I've got a box upstairs and I think it makes a difference to my upstairs loving cat.

Getting up early is tough! Our poor kitties feel the same way sometimes :D
 
MiCo said:
Amps=355
Day2 at 4.75 u (eyeball)-I have a system though. Pull to 5u and then push down just a little.

Cliff slept upstairs last night. I think we need to find/make space for litter box up here, because I can tell the up/down stairs is hard right now. Neither cat woke me up, but I rustled Cliff awake at 4A to keep 12hr schedule to start today.

Stella didn't come down to eat, but I brought her plate up and she cleaned it. Everyone seems good this am, maybe just a little annoyed that I woke Them up this AM!! Haha.

Gotta open my backup vial of AT2 testing strips and recalibrate the meter to new code and test with solution. Lots of other small Cliffy errands to do before I start to pack to leave tomorrow.
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Cliff would appreciate a box upstairs for now. See - we develop our own systems for all the "stuff" around FD like drawing up doses. etc.
 
Kris & Teasel said:
Cliff would appreciate a box upstairs for now. See - we develop our own systems for all the "stuff" around FD like drawing up doses. etc.
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I got him a nice box, with a soft pad to go underneath and a new scooper-bc Dave asked for a new one, and he deserves nice things! ;) I will set that all up later.

Today, I:
  • Opened the new bottle of AT strips; calibrated the meter and tested a strip with the control solution-ready to go!
  • Shopped Target and Petco to get treats and back-up foods for Dave to have on hand. No one will go hungry, that's for sure!
  • Put together an e-kit for Cliff, using the toolkit handout from this site, pics attached! We have:
    • How to treat... Instructions
    • Karo
    • Two varieties of two brands of high carb food
    • Temptations treats
    • Two cans tuna
    • Back-up: lancets, ketone strips
    • Contact info for our vet and nearby Pet ER
    • Am I missing anything?
  • Stopped by the vet to return/get credit for a case of Purina DM that didn't work out, and to ask abt the insulin. Prozinc wasn't there yet, but should be later today.
Now, I'm gonna relax with the cats. I'll get a ketone test in later. Hope everyone is having a great day!

image.jpegimage.jpegimage.jpg
 
Ok, today's #s, is this a "bounce" because he went into a lower range of #s last night?
Amps=355
+3 462
+7 434

What's the protocol here? Stay the course at 4.75 units and hope he evens out? Recommendations appreciated.
 
MiCo said:
I got him a nice box, with a soft pad to go underneath and a new scooper-bc Dave asked for a new one, and he deserves nice things! ;) I will set that all up later.

Today, I:
  • Opened the new bottle of AT strips; calibrated the meter and tested a strip with the control solution-ready to go!
  • Shopped Target and Petco to get treats and back-up foods for Dave to have on hand. No one will go hungry, that's for sure!
  • Put together an e-kit for Cliff, using the toolkit handout from this site, pics attached! We have:
    • How to treat... Instructions
    • Karo
    • Two varieties of two brands of high carb food
    • Temptations treats
    • Two cans tuna
    • Back-up: lancets, ketone strips
    • Contact info for our vet and nearby Pet ER
    • Am I missing anything?
  • Stopped by the vet to return/get credit for a case of Purina DM that didn't work out, and to ask abt the insulin. Prozinc wasn't there yet, but should be later today.
Now, I'm gonna relax with the cats. I'll get a ketone test in later. Hope everyone is having a great day!

View attachment 25061View attachment 25062View attachment 25063
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Super organized! I'm sure you'll be in close communication while you're away. Any thoughts about Dave posting here if he's concerned about something?
 
Kris & Teasel said:
Any thoughts about Dave posting here if he's concerned about something?
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Ha, I did contemplate creating a login for him. :) he knows of the board, but is not the most tech savvy. I will be in close contact, & should be able to post here with questions, but i will see what his preference is!
 
Well, that was interesting! Cliff's first dive into low #s:
http://www.felinediabetes.com/FDMB/threads/cliff-low-bg-at-6.170145/#post-1850958

It's now past midnight, and I'll be up at 4am to dose him again. Definitely gonna back down, probably to 4u.

Will stay thru 9a to test him at +5. Contemplating delaying trip home until Sunday, just to get another day of testing/monitoring in. Will see how I feel in the AM. If I haven't slept much, I really shouldn't be driving 3+Hrs home by myself.
 
Amps=513
Which is to be expected.
  • Appetite was v good to start this am, but didn't clean plate as normal. Could decreased appetite/change in appetite be a side effect of low #s last night? Ate enough to shoot, but need to keep eye on this.
  • Decreased dose back to 4units, per suggestion.
 
MiCo said:
Amps=513
Which is to be expected.
  • Appetite was v good to start this am, but didn't clean plate as normal. Could decreased appetite/change in appetite be a side effect of low #s last night? Ate enough to shoot, but need to keep eye on this.
  • Decreased dose back to 4units, per suggestion.
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It's possible that the dive last night made him feel "off". Decreased dose is good. Are you still travelling today?
 
Kris & Teasel said:
It's possible that the dive last night made him feel "off". Decreased dose is good. Are you still travelling today?
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I'm not sure. I've definitely delayed leaving because of the weather (for now) because it's raining and cold here and I haven't slept much. I might just delay leaving until tomorrow AM bc it's been the past two PM/evening cycles that have been interesting.

A question-should I email my vet abt last night's episode? Or just tell her in my next curve email/if it comes up? I don't think she knows the extent of my at home testing, and I might have to explain a lot to let her know how I knew he was low.
 
MiCo said:
I'm not sure. I've definitely delayed leaving because of the weather (for now) because it's raining and cold here and I haven't slept much. I might just delay leaving until tomorrow AM bc it's been the past two PM/evening cycles that have been interesting.

A question-should I email my vet abt last night's episode? Or just tell her in my next curve email/if it comes up? I don't think she knows the extent of my at home testing, and I might have to explain a lot to let her know how I knew he was low.
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My opinion is that you're doing what's right for Cliff and you should keep any extra stress to a minimum for your own wellbeing. You don't need to feel "guilty" about home testing, nor should you have to deal with any hint of opposition from your vet. If you're like me, that would be upsetting even if I know I'm doing what's best for my kitty.

What we do here is quite different and far more hands on than what most vets recommend. Some vets have an ego that's an impediment. If you feel that your vet is more open-minded you can have a full discussion with her about what you're doing and why. I did that a while back with my vet and it was good. I wanted her in the loop, she trusts my judgment and her attitude is that the vet-client relationship should be collaborative.

So - maybe wait to mention it in the next curve email - if you want to.
 
Thank you for your kind and thoughtful reply, as always! I wish you could see my reaction when reading a reply like this--it's usually a smile, followed by a sigh of relief. This place really is "home" for diabetic cat caretakers. You really understand my thoughts and what I'm going through.
 
MiCo said:
Thank you for your kind and thoughtful reply, as always! I wish you could see my reaction when reading a reply like this--it's usually a smile, followed by a sigh of relief. This place really is "home" for diabetic cat caretakers. You really understand my thoughts and what I'm going through.
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Glad I could help, Michele. As we keep saying, we've all been there. :)
 
Yep I didn't even tell my vet I was home testing until I had a regularly scheduled appointment for a check up. I brought my SS in then and showed it to the vet.I remember she looked it over and told me I was doing great! But my vet was pro home testing...I never emailed or anything about numbers...I did wwhat I was going to do and showed her my SS at vet visits. I figured my cat...my right. I don't think there's a reason to tell your vet unless you just want to.
 
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