Continuing-Pantera-Uncontrolled BG

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https://www.felinediabetes.com/FDMB...c protein treats anymore) and she was in love.

we have a bag of Nutri Bites freeze dried wild caught salmon that's in the cabinet because nobody wanted it. It's a huge bag for dogs or cats. It's from Canada and has Salmon and mixed tocopherols as the only ingredients. What is that?
crude protein 60% min
crude fat 13% min
crude fiber 1% max
moisture 4% max
I just gave Pantera a piece and she scarfed it.
I just looked this up. Apparently it is in a lot of human food too.

Tocopherols are organic compounds derived from Vitamin E. There are four types ot tocopherols: alpha, beta, gamma, and delta - tocopherols, slightly differing in molecular structure.

Tocopherols are antioxidants. They prevent cells from oxidizing, or in other words they protect cells from damage. that's why manufacturers love tocopherols; they minimize oxidation, are resistant to high temperature food processing steps, are soluble in a variety of fats, and are relatively stable over time.
By protecting cell membranes and other cell structures from damage, Vitamin E has been shown to lower the risk of many degenerative diseases.

"Mixed tocopherols" are combinations of the four different types of tocopherols mentioned earlier. Each has a slightly different health advantage, so when mixed together, the body enjoys them all: protection from cardiovascular diseases, anti-inflammatory effects, diabetes prevention, and lowering hypertension.
 
Pantera said:
I just gave Pantera a piece and she scarfed it.
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Sounds good then for a treat!

Pantera didn't become diabetic overnight so it's going to take time to get her regulated so hang in there! I know you're still learning, but it really is important to get those Preshot tests. It's important to know where she starts and then how quickly she drops and how low. If she'll let you, you could test her while she's eating. (it takes 20-30 minutes for food to get broken down and into the bloodstream so if you can test her while she's eating, that would be great until you get better and she gets more used to it.)

On your question on the other thread, nobody closes their own thread. The Mods will occasionally close a thread but what we suggest is to just start a new thread each day and include the link to the previous thread like you did!
 
Are the tocopherols bad for her tho? it has salmon and tocopherols.

Did a preshot this morning. It was 491. +2 after eating it was 403. Added it to the chart. What does this tell us?
 
No. Tocopherols are in a lot of pet foods, mostly dry foods. If you worry about it affecting bgs, feed a different brand that doesn't contain it. I use this brand: https://www.nw-naturals.net/product/freeze-dried-treats/

Pantera said:
Did a preshot this morning. It was 491. +2 after eating it was 403. Added it to the chart. What does this tell us?
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Only that the AMPS was 491 and 2 hours after the insulin was given, the bg dropped to 403. Getting a few more mid cycle numbers will tell more, like when the lowest bg level of the day is before numbers rise again.
 
It looks like tocopherols are vitamin E, just as you noted. They are used as a preservative in pet food. From the sites I've looked at, they are safe for Pantera.
 
Ok. I sent an email to my vet explaining everything we are trying now, gave her link to the SS and the food list. She called me back. She would prefer we use the Alpha Trak, as it's adjusted for animals. Guess she isn't sure the ReliOn is accurate.
We will do this even though it is MUCH more expensive. I think it's what they use too, so ok.
She also said she had never heard of an issue with dry food affecting the BG numbers that much, but whatever we wanted to do regarding wet food. WE ARE GOING TO USE WET FOOD.

She said keep her updated on our numbers. I told her I thought she would always be updated on the chart with the link she has. Not sure she would get the updated numbers, but I told her we will be adding numbers at least 4x a day. I can
email her when we update it if that's what she wants.

Yes I am gonna give Pantera a small salmon treat after the ear sticks.

Has anyone ever compared numbers between alpha trak 3 and ReliON?
 
Yes. There are threads comparing the ReliOn and other Human meters to AlphaTrak.

https://felinediabetes.com/FDMB/thr...-with-alphatrak-vs-relion-glucometers.244099/
https://felinediabetes.com/FDMB/threads/alpha-trak-vs-relion-meters.83913/
https://www.felinediabetes.com/FDMB/threads/relion-vs-alphatrak-my-vets-opinion.225042/
https://www.felinediabetes.com/FDMB...een-alphatrak-relion-and-tru2go-meters.84459/
https://www.felinediabetes.com/FDMB/threads/vet-compared-my-reli-on-micro-to-his-alpha-trak.69976/
https://felinediabetes.com/FDMB/threads/alphatrak-vs-human-glucometer.165303/

Your spreadsheet auto updates every 5 minutes. Your vet just needs to remember to check the spreadsheet to see the latest numbers. Maybe call or email before the end of each week to remind the vet to check it for the latest numbers and if a dose change is needed.
 
ok. After reading those I am more confused than ever and don't see how any of these are accurate, for people or animals.
I told the vet what we have decide to do (instead of a specialist) and gave her access to the chart. My vet said she wants us to use Alpha Trak 3 (the 2 is discontinued).
We have been using ReliOn for 2 days now. Apparently, the AT3 will give MUCH higher readings according to what I read. How does anyone know what the real number is?

'maybe, kind of right' readings doesn't do it for me. I want true and accurate readings, plus I'm getting tired of stabbing my cat and none of the devices are truly accurate and
the vet kind of burst my bubble about testing. I thought it was great we started doing home testing, only to figure out she doesn't believe the numbers because its ReliOn. I'm so sick of this.

Now we have to order AT3 and it is not right on either AND the test strips or $1 a piece. Right now we test 5 times a day and that's not counting the ones you stick in too soon that then won't work
because they are coded. I'm so frustrated and irritated with all of this.
 
You don’t need to use alphatrak unless you are fine with the higher cost. It’s calibrated in the sense that the math formula it uses to turn the data it gets (small electrical current from the test strips chemical reaction with glucose) into a number. But if you can afford it go for it, not a bad idea to have the most accurate one possible.

EDIT; To answer your questions.

1.) “ how does anyone know what the real number is”? You don’t, unless you want to pay 100 bucks a pop for a blood test. A blood sugar meter is an estimator. The test strip will output more current the more sugar is in the blood and the meter reads this and uses a math formula to estimate the blood sugar value based on the current. They’re all reliable estimators; they’ll give you the same value on the same sample to within 15% random error usually. But using a human meter on a cat makes it a biased estimator, as the math formula they use to calculate reading from the current was built using human blood samples, not cats. All this really does though is mean that human meters consistently give readings around 20% less than a cat meter would though.
 
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Your vet doesn’t sound like they know how to treat feline diabetes. But to summarize my thoughts;

1.) You do not need to buy an AT3. Relion is fine; almost everyone here uses human meters and not alphatrak. Sounds like cost is a limiting factor here; no reason to spend 5 bucks a day on strips.

2.) our methods are built around human meters, we have different thresholds for hypoglycaemia and dose changes if you use AT vs a human meter. This is all well understood and not something to stress over.

Message me if you have questions.
 
Pantera said:
Apparently, the AT3 will give MUCH higher readings according to what I read. How does anyone know what the real number is?
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Typically the difference between pet meters and human meters is greater at higher ranges, and will get closer at lower blood glucose values. All meters can have an allowable +/-15-20% variance per FDA standards for accuracy. What might be helpful to consider is that you are looking at the overall trends and patterns in BG values regardless of the meter you use. If you haven’t seen it yet, here is the Beginner’s Guide to Vetsulin

If you are going to be making a switch to exclusively low carb canned food only, that can drastically affect the amount of insulin that is required. You may find that 3u becomes too much insulin very quickly, so more frequent testing/monitoring would be very important as you make the diet change. It would be a good idea to slowly transition between the dry to wet food rather than going completely straight to wet food.
 
We look more at trends than individual numbers so a human meter works just fine.

Normal blood glucose for cats is 50-120 on a human meter, 68-150 on a pet meter, so at lower numbers (which are the most important for safety), they are pretty close. As the numbers go higher, there will be more of a difference, but at high numbers, it really doesn't make a huge difference if they're 350 or 500. "Too high" is too high.

Use the meter you can afford to use. One that if you have to test 12 times in a day, you won't have to take a home loan out to buy strips. (and yes, there are times when you may need to test that often...like if Pantera is dropping too fast or too low). Another benefit of the Relion's is that if you run low on strips, you only have to run to Walmart to get more. With the AlphaTrak, you either have to order them online or buy them from a vet (if they're open). Our sugarcats have a bad habit of dropping too low at 2am on Sunday morning when there won't be any vets open for over 30 hours.

Many of us have had to change vets (some multiple times) before finding one that will work with us instead of dictating to us. That doesn't necessarily mean your vet is a bad vet. They may be great for lots of things but feline diabetes isn't usually one of them.
 
Chris & China (GA) said:
Use the meter you can afford to use. One that if you have to test 12 times in a day, you won't have to take a home loan out to buy strips. (and yes, there are times when you may need to test that often...like if Pantera is dropping too fast or too low). Another benefit of the Relion's is that if you run low on strips, you only have to run to Walmart to get more. With the AlphaTrak, you either have to order them online or buy them from a vet (if they're open). Our sugarcats have a bad habit of dropping too low at 2am on Sunday morning when there won't be any vets open for over 30 hours.
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^^ Yeah, that. I'm not aware of any pet meter and their test strips being sold at a Human pharmacy or even a pet store. You do need to plan ahead of time and order more test strips, taking into account shipping time and possible weather delays.

Relion is a Walmart only brand. If you don't have a nearby Walmart store that you can pop into last minute for test strips, it's probably not ideal to use this brand. A widely available brand such as OneTouch or AccuChek or Bayer is a better choice. Any pharmacy will have these brands.

Human meters and test strips are also FSA / HSA eligible (insulin syringes too but only the Human ones, not the pet / veterinary ones) so if you have those types of accounts, you can use those funds right away or get reimbursed later;)

Chris & China (GA) said:
Many of us have had to change vets (some multiple times) before finding one that will work with us instead of dictating to us. That doesn't necessarily mean your vet is a bad vet. They may be great for lots of things but feline diabetes isn't usually one of them.
Click to expand...

It doesn't hurt to shop around to find a vet who you feel can treat your cat's diabetes best. You don't necessarily need a specialist. There are lots of "regular" vets who are able to manage diabetic patients well. It helps that the pet owner is involved in their cat's care.
 
Most vets do not have a lot of experience with the day to day care of a diabetic cat. They go by what they were taught. If your vet is open to learning more about caring for a FD cat, this can be a good opportunity for both of you. I have been very lucky where most of the vets I have had were either very knowledgeable about FD and willing to learn new things. I only had one vet that was not willing and I told her that I was not going to follow her instructions (they would have killed my cats) and she is welcome to view the data that I provided to her. Eventually she figured out that I knew what I was doing. At that time I had my 2nd & 3rd diabetic cats (one was diabetic when adopted) and had been a member of this site for several years.

With most of my vets, I shared this site with them and invited them to check it out. They were open to listening to my questions and opinions about diet and insulin. Because of this, they started referring new patient owners to this site when their cats were diagnosed. They also discussed home testing and showed them how to test and take their own curves at home. When my first cat was diagnosed, they even gave me my first meter, which was a human meter.

I think the greatest thing was when I adopted Bandit a few years ago. I had changed vets at that time and he knew I had experience with diabetic cats. When I took him in to get him added as a new patient, my vet just asked me what insulin do I want to use, what is my planned starting dose and which dosing method I was planning to use. He agreed with everything I said. We discussed FDMB and how helpful it is. That is the best kind of relationship to have with your vet.
 
Thank you everyone for your advice. I was just 'having a moment' last night. We have ordered the AT3 starter kit. Of course our cat is worth it and we are saving money not having to go to the vet for curves all the time. This vet practice is one we have gone to for years and take our other cats there too. Our favorite DR wasn't available for 2 weeks so I had to pick someone else there. I would have been more confident if we had had him on this. She says she has consulted with other Dr's there. I was hoping she would want to learn something from this site also. I gave her links to the chart AND the Food List in case she wanted to share it with others. She said she has treated at least 30-40 cats for DM and has not had one who didn't respond to Lantus. I don't want to butt heads with her because we do have to keep going to this vet practice.

She didn't sound thrilled that I didn't want to go to a specialist yet, but I guess was ok with what we are trying. She suggested the AT3 so it would match their's I guess. Sounds like she doesn't take too much stock in my numbers with ReliOn.
She also sounded skeptical about dry food being part of the problem. (yet she suggested wet food when all of this started)

We will see what she says once we have AT3 numbers. Thanks again everyone. I just get frustrated with all the info I am getting from all sides.
 
It's your choice to use the AT3 or the Relion. But don't throw away that Relion. It is good to have a backup or a meter with strips you can get when you need one NOW. And you can always switch back later if you want to.

FYI, when I started, no one was using pet meters. We all used human meters. The dosing methods, including the one published in a peer reviewed veterinary journal before then all used human meters. My vet and I used to compare notes on meters and where to get the cheapest test strips. She liked the Onetouch cause it was closest to lab values. I cross border shopped and went for cheaper test strips (Relion) and it wasn't that different from the vet's meter. Next year the pet meter sales and marketers started getting busy. My vet said to me one day, "I've got a AT meter in now, I don't suppose you want one". I laughed with her, she was right. I stuck with my Relion.
 
yes we will definitely keep the ReliOn. We tested another cat last night just to see what it would do. It was 84. Then we tested my gf. Hers was 115 I think. Sounds about right to me. We will try the AT3 because the vet has one. (she probably has the 2 version I would guess) We are happy with the ReliOn, but I get the feeling vet doesn't trust the numbers. We will have to make sure we have plenty of strips like you say. AT3 is definitely a money maker for them.
 
What some people do is use the Relion for day to day testing, and use the AT3 when the vet wants a curve done.

You can't buy strips for the AT2 anymore. If your vet hasn't already, she'll be buying an AT3 soon.
 
I have had 6 diabetic cats (4 adopted) and never used a pet meter. When my first one was diagnosed in 2003, my vet gave me my first meter. What is important is that you use the meter consistently. We look for trends in how the glucose levels change to determine if the dose, or something else, needs to be changed. The decision is never made based on a single reading unless it is to skip the dose because the BG is too low.

If you can afford the AT3 and keep plenty of strips on hand, then use it if you want to. But having a spare meter on hand is a good idea. Especially one where you can get more strips quickly if needed.
 
Just tried the AT3 for pmps. it was 413. Wanted to compare to the ReliOn, but the blood drop went away because meter wasn't on and then the test strip erred out with too little blood on it. gave up.
 
She wasn't hungry this morning. Didn't eat so we didn't give a shot. Tonight we got her to eat putting tiki cat broth on her md dry food. Readings still in high 400's on both meters. Have an appt with specialist tomorrow. Thurs.
Anyone deal with a cat that isn't hungry? Is that normal for a diabetic? thx
 
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