Help reading Bella's numbers on spreadsheet, confused on were to go from here

[Christine and Bella]

Hello everyone,

So I had a scare and now I am spooked and feel horrible. Yesterday evening my cat had a lower PS value for her PM shot than I expected. It was around 150 to 160 when I was testing. I posted on here asking advice and on FB and was told that I could move forward with either her full dose (1 unit) or half a dose (.5). I decided to go with half a dose to be on the safe side since I had never seen such a low preshot value. Then I was told that her BG might be high the next day because she only got half of her dose. I woke up this morning and tested her BG and it was 320. I have given her a full dose before with lower numbers than that and she has done fine on it so I thought it would be ok to give her her full dose and that she would probably be trending high that day since I only gave her a half of a dose the night before. My husband was gone, and I needed to go run errands, this is the first day since she has been diagnosed that we have left her for an extended period of time and since her numbers seemed safe I wasn't as worried about it. Obviously I was mistaken. When I gave her her shot at 7:30am I was supposed to get home at around 12:30 pm to test her but I had unexpected things come up and got home around 2:00ish. When her libre sensor finally loaded the data onto my phone, it looked like she had a huge crash and went all the way down to hypo based off of what I saw. I am attached the screenshot of it below. After she went down to hypo (it said around 60) she had spiked back up like crazy and is continuing to spike right now. She seemed totally fine when I got home. I immediately tested her and the meter said 122 and after I tested her she ate some food (I had left out some food before I left for her too so I did have food out) I am so confused on what happened and why she crashed that fast and I feel horrible for leaving and lucky that she's ok. Would love to know why it did this, I am in the process of getting another phone and leaving it at home to monitor but haven't received that phone yet (someone is giving it to me). But now I will be making sure to not leave her alone until I receive this phone. I have loaded all of her numbers onto her spreadsheet, the ones with the * by it are the ones where I used the relion meter, the rest are libre sensor. Maybe she didn't eat enough in the morning?

 

[Sienne and Gabby (GA)]

First, there's a very good chance that the Libre gave you a falsely low reading. If you had tested with a handheld glucometer, it's likely you would have seen higher numbers. It's a quirk of the Libre that many caregivers have observed. We encourage members to get a manual test if you see low numbers on the Libre. It's also helpful when you're first starting out with managing your cat's diabetes to leave food out if you're going to be out of the house. My kitty was very food motivated so I would leave food in a timed feeder.

Numbers in the 80s are safe. It helps to remember that normal blood glucose is from 50 - 120. She should have been fine. As far as a lower pre-shot, you have a couple of options:

• Don't feed your cat and stall. Re-test in about 15 - 20 min. You can repeat this process to see if numbers are rising.
• Shoot a reduced dose.
• Skip the shot

Which option is best may depend on the circumstances. If you stall, you need to remember that the next shot is due 12 hours later. (We can help you get back on schedule.) Skipping a shot is not advised if you have a kitty that has a history of ketones. What works today may not be reasonable on another day so it can be useful to ask for help.

I'll also be frank. I would rely more on the input you get here about how to manage the numbers versus the advice from the FB group. You have no way to know if you're getting reliable information on FB. You don't have access to someone's spreadsheet or have any idea how much experience the person posting has. That information is accessible to you here. Many of the people posting on FB do not follow any dosing method so it can be a bit challenging to know if the information is well advised.

Also, you didn't mess up. There's going to be variability in your cat's numbers until you get her better regulated. Blood glucose levels do change depending on any number of reasons. And, most of us have been guilty of giving a fur shot. Our cats survive. We just really, really dislike seeing the high numbers!!

 

[Christine and Bella]

First, there's a very good chance that the Libre gave you a falsely low reading. If you had tested with a handheld glucometer, it's likely you would have seen higher numbers. It's a quirk of the Libre that many caregivers have observed. We encourage members to get a manual test if you see low numbers on the Libre. It's also helpful when you're first starting out with managing your cat's diabetes to leave food out if you're going to be out of the house. My kitty was very food motivated so I would leave food in a timed feeder.

Numbers in the 80s are safe. It helps to remember that normal blood glucose is from 50 - 120. She should have been fine. As far as a lower pre-shot, you have a couple of options:

• Don't feed your cat and stall. Re-test in about 15 - 20 min. You can repeat this process to see if numbers are rising.
• Shoot a reduced dose.
• Skip the shot

Which option is best may depend on the circumstances. If you stall, you need to remember that the next shot is due 12 hours later. (We can help you get back on schedule.) Skipping a shot is not advised if you have a kitty that has a history of ketones. What works today may not be reasonable on another day so it can be useful to ask for help.

I'll also be frank. I would rely more on the input you get here about how to manage the numbers versus the advice from the FB group. You have no way to know if you're getting reliable information on FB. You don't have access to someone's spreadsheet or have any idea how much experience the person posting has. That information is accessible to you here. Many of the people posting on FB do not follow any dosing method so it can be a bit challenging to know if the information is well advised.

Also, you didn't mess up. There's going to be variability in your cat's numbers until you get her better regulated. Blood glucose levels do change depending on any number of reasons. And, most of us have been guilty of giving a fur shot. Our cats survive. We just really, really dislike seeing the high numbers!!

Ok, thank you, someone on facebook told me that I should put her down to .75 for a week since she went lower, and I also saw that in the prozinc dosing article as well that if she went below a certain number, decrease for a week by .25 and then evaluate. I have been doing .75 for a couple of days but she hasn't budged barely at all in her numbers and she has been consistently high. Do you think I should go back to 1 unit even though it hasn't been a week based off of her info? I have updated her spread sheet

 

[Wendy&Neko]

She's bouncing now. Bounces can take six cycles to resolve. Tomorrow morning would be day six. Let's see whether she breaks that bounce tomorrow sometime. The Prozinc SLGS guidelines do say to reduce if she goes below 90, which she did. But that's 90 on a human meter and often the Libres show lower than a meter would.

 

[Christine and Bella]

She's bouncing now. Bounces can take six cycles to resolve. Tomorrow morning would be day six. Let's see whether she breaks that bounce tomorrow sometime. The Prozinc SLGS guidelines do say to reduce if she goes below 90, which she did. But that's 90 on a human meter and often the Libres show lower than a meter would.

Based of of her numbers from today what do you suggest I do as far as dosage? She is still consistently high. I gave her some sub q fluids on the oppostie side of her libre sensor on her body tonight as well (I do that for her kidneys and has helped her with her kidney issues) but now I think it broke my libre sensor so I have to wait until I get a new one and test manually. Because I have no libre sensor right now how often should I test until I get a new one?

 

[Wendy&Neko]

She's gone up from preshot to now at +3. That's a sign of a quiet cycle. You can go to sleep and test next at AMPS time tomorrow.

With SLGS you'd normally hold this dose for 7 days, but if you think that 85 read lower than it should (as Libres can do in lower numbers), you could increase back to 1.0 units. It would be good to get some tests where you can compare the Relion to Libre readings when under 100.