HELP!!!!!!!!! NEED ADVICE

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Ok just pulled again from Alphatrak pet meter a little over 4 hrs. after meal : AMBG ~+4 192 mg/dl. Has gone up 9 points. :( About to leave to see the vet.
 
Kelli Vines said:
Ok just pulled again from Alphatrak pet meter a little over 4 hrs. after meal : AMBG ~+4 192 mg/dl. Has gone up 9 points. :( About to leave to see the vet.
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9 points has no significance, Kelli.

All meters have a margin of error. This is info about testing humans, but pet meters have the same error percentages. "The FDA states that blood glucose meters’ readings must be accurate within 20 percent, 95 percent of the time for glucose levels above 75 mg/dl (non-hypoglycemic). For hypoglycemic levels (under 75 mg/dl), accuracy is less stringent: It must be within 15 points of the actual measurement (also 95 percent of the time). This means if your actual blood sugar is 140 mg/dl, your blood glucose meter might tell you it measures 112 mg/dl, or 168 mg/dl."

This is frustrating, to say the least. There is a move to makes the margin of error 10 percent, but I don't know when that might happen.

Human meters do run lower than pet meters, but most people here just use different reference numbers because the test strips are some much cheaper and easier to get.

You are doing a great job so far!
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@Kelli Vines -

Great that you managed to snag that extra non-stress-influenced test (essentially the AM+4 BG result was pretty much the same as the AM+2 BG). Hope all goes well with the vet visit. Be sure to post an update later.


Mogs
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Well,I am really confused now. My vet says Sky is not diabetic based on the numbers from yesterday and this am. She still is not herself....a little shaky, and slight neuropathy in her back legs. He said no insulin and don't worry about checking her BG. o_Oo_Oo_Oo_O She just had an "episode". I could continue with the low carb diet. I really don't feel comfortable not checking her BG. How should I monitor her myself? How often should I check it and when? Help!!!!!!:confused::confused::confused::confused::banghead::banghead::banghead:
 
Kelli Vines said:
My vet says Sky is not diabetic based on the numbers from yesterday and this am.
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I've had this one. Saoirse was well and truly diabetic at time of Dx. A short while after she went into remission I had a feline diabetes specialist insist that she was no longer diabetic because her BG levels were falling within the normal reference range. This is incorrect: Saoirse was still diabetic but was now diet-controlled. If I had switched Saoirse back to a high carb diet that very day her BG levels would have gone straight back up again.

I dislike having to say this but I am actually a bit concerned about the breadth of your vet's FD knowledge at this stage. Firstly he didn't do adequate testing (no urine test, no fructosamine test) to confirm the initial diabetes Dx (and, being picky, it would have been much wiser for him to curve Sky straight away to check whether the 2IU dose was safe). Now he seems to be completely disregarding the clinical signs Sky presented with at time of Dx (PU/PD, poor hair coat condition, weight loss, neuropathy) and putting her previously elevated BG levels and clinical signs down to an 'episode', cause unspecified.

Part of the problem you have is that you now don't know whether Sky has had mystery issue temporarily elevate her blood glucose levels (her labs were fine, bar the glucose levels). If your vet had run a fructosamine test you'd have had a better picture of what was happening in the previous 1-3 weeks. The worry for me here is the neuropathy because it is a symptom of prolonged hyperglycaemia (more info here).

All you can do is continue to monitor Sky at home - at least for the 14-day period required to confirm a cat is in remission. Here's a post covering how to run a remission trial by member 'Chris & China' - NOTE: BG reference numbers are for a HUMAN meter.

You need to test at least twice a day for 2 weeks....If the Pre-shot tests are green (under 100) you don't need to do any more testing until the next "pre-shot" time

If you get a blue number (under about 130), go ahead and feed and test again in about 3-4 hours. If the number comes down, the pancreas is working.

If you can stay in mostly normal numbers (50-90 on a human meter) for two weeks, you can consider [the cat] officially in remission

If he consistently gets numbers higher than about 130 and/or he doesn't come down after feeding, he probably needs a little more time on insulin. We want a strong remission, not necessarily a fast one.​

(Original post here.)

(@Chris & China - When you have a moment could you post the recommended testing frequencies following a successful OTJ trial, please?)

I am not for one minute recommending you try this, but one way of checking whether a cat on a low carb diet and not on insulin is still diabetic would be to feed it some high carb food and see how it affects blood glucose levels.

WRT the neuropathy, I'd suggest you try supplementation with B12 methylcobalamin (e.g. Zobaline). All going well, Sky will stay in a good BG range and between the better regulated blood glucose levels and the supplementation the neuropathy symptoms will resolve in the near future. If the symptoms don't show noticeable improvement then go back to the vet (armed with all the BG test data you have).

WRT monitoring, if Sky's BG numbers do start trending upwards (especially if they are at the top end of the normal reference range or above) I'd suggest going back to the vet straight away. If you don't feel happy about the response you get remember that you always have the choice to seek a second opinion.

ETA: The normal cat BG reference range as measured on a human meter is 50-120mg/dL.

Hope some of the above helps.


Mogs
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Hey! Critter Mom, Do you have any info about running the remission trial using the AlphaTrak pet range values? What the green and blues are? That is what I am using now. I really don't want to "test" her out by feeding some carbs. :nailbiting::nailbiting::nailbiting: I would rather keep testing her BG doing the remission trial. I ordered Zobaline yesterday waiting for it to come. I will start trial in the am and go from there. I want to do what is best for Sky. I will go somewhere else if I don't feel satisfied. My kitties are my babies!!!!! You have helped so much!!!:bighug::bighug:
 
You're already on Day 4 of the remission trial, Kelli! :) (Be sure to get an evening BG check, BTW). Just follow Chris's guide above for the next 10 days (fingers crossed!).

A good thing to do is to record the food Sky eats every day alongside your log of BG numbers (especially if you give her different varieties of food). That way you'll be able to see whether low carb foods with different carb content and/or different ingredients affect Sky's BG at all. (Some kitties spike on foods containing beef or soy, for example, and other kitties are extra carb-sensitive - even when all the carb values for foods offered is under the 10% recommended for diabetic kitties!).

WRT number ranges to use for the Alphatrak, that's a bit of a tricky area. All of FDMBs guidelines have been developed over years for people using human BG meters. Unfortunately there's no 'magic formula' for converting human meter values to Alphatrak meter values. I went off and did my own thing completely (hence the non-standard colour coding, etc., in Saoirse's spreadsheet) so I'm a hopeless person to ask about this. I'm tagging @Chris & China and @Tuxedo Mom to see whether they may be able to give you some pointers when they're online.

As posted earlier, this is the reference range my vet gave me for normal blood glucose levels in cats as measured on pet-specific equipment such as the Alphatrak:

70mg/dL (3.9mmol/L) -- 150mg/dL (8.3mmol/L)

Kelli Vines said:
My kitties are my babies!!!!! You have helped so much!!!:bighug::bighug:
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Same here, although there's only my civvie left now ... :(

I'm very glad I've been able to help you a bit, Kelli. Be sure to post with any questions you have and, most importantly, please keep doing the daily bulletins with Sky's BG readings: OTJ trials are an extremely popular spectator sport round these parts! :woot:


Mogs
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Kelli Vines said:
Do you have any info about running the remission trial using the AlphaTrak pet range values?
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Normal would be 68- about 150, where on a human meter it's 50-120

So if you're using the AT, you'll still want the majority of the numbers to be "green" (under 100) but a low blue number isn't as concerning since it will read a little higher than the human meter
 
:p My brain is fried!!!! LOL Totally didn't think about this being day 4. LOL I didn't check BG before I gave Sky dindin,so what do I about getting tonight's reading? She ate about 3 hrs ago?
 
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Not bad. Holding round the same level as earlier. Be nice to see it go down a bit tomorrow though.

Here's more on notation:

AMBG = morning BG level

PMBG = evening BG level

Sleep meds are kicking in over here. Catch you on the morrow, Kelli. :bighug:



Mogs
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Last reading of day 4..... This is 3 hrs after eating dinner ~1/2 can FFC ocean whitefish and tuna PMBG +3 185 mg/dl. This has been a difficult six days. It really seems like longer. I am very tired and going to crawl into my bed. Good night to all and the precious fur babies.
 
Sky's AMBG 121 mg/dl (AlphaTrak meter) before meal, then ate ~ 1/2 can FFC chicken. Should I test again at +2 and +4 or wait until this pm before dinner? Day 5 of trial. Thanks!
 
Kelli Vines said:
Sky's AMBG 121 mg/dl (AlphaTrak meter) before meal, then ate ~ 1/2 can FFC chicken. Should I test again at +2 and +4 or wait until this pm before dinner? Day 5 of trial. Thanks!
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Sometimes you'll see a drop in BG after a meal if the pancreas is working. A test at +2 might be interesting. :)
 
Sky's AMBG +2 94 mg/dl. Result dropped from AMBG 121 mg/dl before breakfast,so does this mean her pancreas is working? and I can wait till the pm before dinner to check her again? Thanks!!!!!!! It feels like it is taking me awhile to get my mind wrapped around all of this. Results are from AlphaTrak pet meter.
 
She is bright and alert,dandruff is almost all gone,coat is looking better than it has been. She is still weak in hind legs waiting foe Zobaline to arrive. She has never been an overly active kitty,but has used the scratching post. She is not totally up to previous self,but heading in the right direction. Can I know wait until this pm before dinner for another BG? and if she has a small snack of FFC during the day how long do I wait for PMBG? Thanks!!!!!!
 
Glad to hear Sky is steadily getting better. That's what all this is about, after all! :)

It's OK to feed her normally whenever she needs it. Just make a note in her log of the time and the food offered (so you'll be able to spot if any varieties spike her BG levels). You just test morning and evening about 12 hours apart. If you do get the chance snag a test here and there a couple of hours after Sky has eaten to check how well her pancreas is responding after mealtimes.


Mogs
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She is doing well. I am still concerned about the neuropathy. She is moving around and jumping on the couch and rocker,but still appears to be weak in the back end. Zobaline arrived this afternoon, and I am going to give her one shortly. Should I give it 1 time a day or 2? I read somewhere on here that they will urinate out any excess. AMBG 140 mg/dl PMBG 116 mg/dl results from AlphatraK pet meter.
 
Hi Kelli,

Kelli Vines said:
AMBG 140 mg/dl PMBG 116 mg/dl results from AlphatraK pet meter.
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Both in the normal range so that 's Day 6 in the bag. Did Sky have the usual 10-hour fast overnight before the AMPS?

Kelli Vines said:
Zobaline arrived this afternoon, and I am going to give her one shortly. Should I give it 1 time a day or 2? I read somewhere on here that they will urinate out any excess.
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B vitamins are water soluble so yes, any excess will be excreted via the kidneys. Re dosage, from the Zobaline website:

Suggested Use: 1 tablet daily or as directed by a veterinarian
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You should be able to snap the tablet in two in the palm of your hand. It's easy to crumble the tablets between thumb and fingers to mix into food. If you want to give twice a day maybe use half a tablet in feeds 12 hours apart? (That's what I did.)


Mogs
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Yes, it was 10 hr fast overnight before AMBG. I'll go check out the Zobaline website. Do you know how long it takes for hyperglycemia to cause neuropathy? I know it's prolonged.I feel so bad that I maybe didn't catch it sooner.:( I hope the supplement helps her. I have two of my kids barfing from the wet food. I cut them off cold turkey from dry kibble. I am crossing my fingers tonight that neither barf. My hubby is getting upset over that. He stepped in a cold squishy pile. :eek: He freaks over that stuff...I just clean it up and go on. Have a good night. I will update tomorrow on Day 7 :nailbiting:. Have a good night.
 
I don't know how long it takes for neuropathy to develop.

Kelli Vines said:
I have two of my kids barfing from the wet food. I cut them off cold turkey from dry kibble. I am crossing my fingers tonight that neither barf.
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It might be an idea to do a reset and then gradually migrate to the wet food over a period of about a week or so, gradually increasing the wet food and reducing the kibble every few days.

Hope you'll wake up tomorrow in a barf-free zone. Will keep an eye out for Sky's progress report on the morrow.

:bighug:


Mogs
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Hi Kelli,

What a great WCR (Whole Cat Report)! :cat:

Thank you for keeping us updated with Sky's progress. Very nice start to Day 7, and Sky was just at the top of the normal range at PMPS. :)

If you do get a chance, try to get the odd spot check about two hours or so after Sky's meals to see how her pancreas is handling things after she eats. It would be nice to see her levels go a bit lower in response to food.

Fingers and paws crossed that the better BG levels and the Zobaline will soon sort out the neuropathy side of things. (((Sky)))

You have a good evening too, Kelli.

:bighug:


Mogs
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Hey! Mogs, Thank-you for caring about Sky! I will be pulling more BGs,but I am having to stretch out the ones I have until the ones ordered come in the mail. My AlphaTrak only came with 25 strips. Holiday here on Monday,so should be in Tuesday. I will pull 2 hrs after meal then. :)
 
Day 9 for Sky. 10 hr. over night fast for AMBG results from Alphatrak pet monitor. AMBG 94 mg/dl PMBG 109 mg/dl. Hopefully my strips come in the mail tomorrow, so I can pull some 2 hrs. after she eats. Have a purrrrrrrrrfect evening all.:cat::cat::cat::cat:
 
:woot:

Very nice, young lady!! (((Sky)))

Good to see the downward trend, Kelli. (Anti-jinx; we're a fierce superstitious lot here!)

How is Sky acting/feeling?


Mogs
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She is acting very well. She played with the kick stick some yesterday,and chased my hand under the covers. She still is having some trouble jumping on the furniture. The neuropathy seems to be some better. She is 100% better from 1-5-18. She was really rough. I have had no more barfing from her brothers and sisters.:D They are getting used to the all wet food diet. Thank goodness!!!!!!
 
What a great progress report, Kelli! :cat:

Thank you for updating us; we love to hear about little sugar kitties getting better. Fingers and paws crossed that, between the food change and the Zobaline treatment, the neuropathy issue will be resolved in the very near future. (((Sky)))


Mogs
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Day 11 for Sky. 10 hr. over night for AMBG results from Alphatrak pet monitor. AMBG 94 mg/dl, AMBG +2 90 mg/dl, PMBG 106 mg/dl. She seems to be doing better and better every day in how she feels. She has that twinkle in her eye again,and the neuropathy seems to be better also. I hope your numbers Mogs continue to do well (anti-jinx!!!!). Sweet dreams to all and their fur babies. :cat:
 
Yesterday was Day 12 for Sky. 10 hr. over night fast before AMBG results from Alphatrak pet monitor. AMBG 79 mg/dl +2 85 mg/dl PMBG 93 mg/dl. She is starting to walk on her toes again in her hind legs.:) She is still a little wobbly in the hind end,but getting better. She slept with me last night :D. She hasn't done that in a few months. I hope all other fur babies are doing well,as are their slaves!!!! LOL
 
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