Introduction - Sybil’s mom

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Sybil’s mom

Sybil’s mom

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Advice needed at end please:
Hi everyone. I just started this journey the end of August with my sweet Sybil.
I am so thankful for this group and the FB group because I read someone else’s experience (didn’t recalibrate meter with new test strips) and I had no clue this had to be done. I’m using Alphatrak 3. I am thankful she shared it because Sybil has been mostly in the red and purple from the spreadsheet and after I calibrated the meter she was just in the blue! I was so happy because I’ve been taking this so hard and I’m so exhausted.

So, the vet tech told me don’t give insulin (ProZinc - 2 units every 12 hrs) when Sybil tests 60 or under. After reading a lot on this site and now that I have finally seen blue and have some hope, 60 seems awfully low to me. Any thoughts?

Thank you to everyone on here. This is such a stressful journey for me.
 
Sybil’s mom said:
Advice needed at end please:
Hi everyone. I just started this journey the end of August with my sweet Sybil.
I am so thankful for this group and the FB group because I read someone else’s experience (didn’t recalibrate meter with new test strips) and I had no clue this had to be done. I’m using Alphatrak 3. I am thankful she shared it because Sybil has been mostly in the red and purple from the spreadsheet and after I calibrated the meter she was just in the blue! I was so happy because I’ve been taking this so hard and I’m so exhausted.

So, the vet tech told me don’t give insulin (ProZinc - 2 units every 12 hrs) when Sybil tests 60 or under. After reading a lot on this site and now that I have finally seen blue and have some hope, 60 seems awfully low to me. Any thoughts?

Thank you to everyone on here. This is such a stressful journey for me.
Click to expand...
Sybil’s mom said:
Advice needed at end please:
Hi everyone. I just started this journey the end of August with my sweet Sybil.
I am so thankful for this group and the FB group because I read someone else’s experience (didn’t recalibrate meter with new test strips) and I had no clue this had to be done. I’m using Alphatrak 3. I am thankful she shared it because Sybil has been mostly in the red and purple from the spreadsheet and after I calibrated the meter she was just in the blue! I was so happy because I’ve been taking this so hard and I’m so exhausted.

So, the vet tech told me don’t give insulin (ProZinc - 2 units every 12 hrs) when Sybil tests 60 or under. After reading a lot on this site and now that I have finally seen blue and have some hope, 60 seems awfully low to me. Any thoughts?

Thank you to everyone on here. This is such a stressful journey for me.
Click to expand...

Welcome Sybil's mom, you are in the right place, it is overwhelming at first, but you took the right steps by first creating the spreadsheet, with this we can advise wisely, and any concerns you have is never small, it is important you learn about your baby's nutrition when diagnosed with diabetes, is important she eats low carb foods between 0-10%, prepare a HYYPO KIT that includes medium carb food between 12-14% and high carbs 15% also KARO SYRUP, in case Sybli's Bg gets lower than 50, this is a ready to use precaution, below there's a Dr's Food chart to choose from a variety of brands, the third column will have the amount of carbs, all gravy food contain high carbs as well as any dry foods they contain appx 20-25% carbs as well as treats , the more information we have about Sybil the easier will be to help you, and again Welcome :bighug::cat::cat:
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Welcome to FDMB!

If you wouldn't mind, could you set the access permissions for Sybil's spreadsheet to anyone with the link. The way you have it set, none of us can open it to take a look.

Much of the information that Maria mentioned is in this post on helping us to help you. You've already got your spreadsheet set up. There are also instructions for including information in your signature so we don't pester you by asking the same questions repeatedly.

You will likely notice that much of the time when we refer to blood glucose test results, we're referring to numbers from a human meter. To the extent that we have a way to translate numbers from human to pet meter, a 50 on a human meter is roughly equivalent to a 68 on a pet meter. (Maria is referring to numbers on a human meter.) As numbers get larger, the difference between the two meters widens. I've been here a long time and no one has made an attempt to figure out the actual mathematical formula for translating the numbers.

In the beginning of this journey, most of the numbers that are below 100 seem low! And, they seem scary. I would bet that in a relatively short period of time, you will want to see Sybil in blue and green. Remember, normal blood glucose is between 50 - 120. The more time your kitty spends in normal numbers, the greater the chance that she will be tightly regulated or reach remission.
 
Thank you so much for the welcome and I couldn’t figure out the access but I think I did it now with your info supplied above (I am on an iPhone so things come up off sometimes). Thank you!
 
CORKY said:
Welcome Sybil's mom, you are in the right place, it is overwhelming at first, but you took the right steps by first creating the spreadsheet, with this we can advise wisely, and any concerns you have is never small, it is important you learn about your baby's nutrition when diagnosed with diabetes, is important she eats low carb foods between 0-10%, prepare a HYYPO KIT that includes medium carb food between 12-14% and high carbs 15% also KARO SYRUP, in case Sybli's Bg gets lower than 50, this is a ready to use precaution, below there's a Dr's Food chart to choose from a variety of brands, the third column will have the amount of carbs, all gravy food contain high carbs as well as any dry foods they contain appx 20-25% carbs as well as treats , the more information we have about Sybil the easier will be to help you, and again Welcome :bighug::cat::cat:
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
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Hi there. Welcome! So you recalibrated your meter yesterday? I prefer a human meter and I never had the need to recalibrate my ReliOn meters (I had two) or my NovaMax blood ketone meter (although I did occasionally test the glucose meters with a test solution but I found that to be unnecessary as well. I’m happy that you are seeing better numbers now! That’s promising. Because of the nadirs from yesterday, let’s hold the dose for a week (from yesterday) and see how things go and decide what to do next.

Can you tell me what kind of food you are feeding and what your feeding schedule is (at what points in the cycle are you giving food.) what is your time zone? I am on Eastern.

Can you get your signature set up? Great job with the spreadsheet!!
 
Suzanne & Darcy said:
Hi there. Welcome! So you recalibrated your meter yesterday? I prefer a human meter and I never had the need to recalibrate my ReliOn meters (I had two) or my NovaMax blood ketone meter (although I did occasionally test the glucose meters with a test solution but I found that to be unnecessary as well. I’m happy that you are seeing better numbers now! That’s promising. Because of the nadirs from yesterday, let’s hold the dose for a week (from yesterday) and see how things go and decide what to do next.

Can you tell me what kind of food you are feeding and what your feeding schedule is (at what points in the cycle are you giving food.) what is your time zone? I am on Eastern.

Can you get your signature set up? Great job with the spreadsheet!!
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Hi there! I think I finally updated all of the files/signature/spreadsheet correctly. It’s a learning process.
So yes, the AlohaTrak needs to be calibrated each time a new set of strips is used and there is a code on the strips that you have to find and match on the meter. I’ve got that down. I’m pretty ok with the testing at this point. It was so stressful at first but she’s ok with it and I’m ok with that :)

It looks like overall her numbers are starting to trend down. I’m happy with that. I will do another curve in the next day or so.

Yes I am in Eastern time zone. I am so thankful for this group. It’s been amazing since this is where the accurate information is regarding feline diabetes.
Thank you!!
 
This is great news! I am happy to see some of the blue numbers on her spreadsheet. After you get the curve done, please tag me and/or post over on the ProZinc forum (I will then get an email in my personal email inbox telling me that a new thread has been started on that forum.) I can help you with her dosing. She’s making great progress so far. Well done!
 
Suzanne & Darcy said:
This is great news! I am happy to see some of the blue numbers on her spreadsheet. After you get the curve done, please tag me and/or post over on the ProZinc forum (I will then get an email in my personal email inbox telling me that a new thread has been started on that forum.) I can help you with her dosing. She’s making great progress so far. Well done!
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@Suzanne & Darcy I did the latest curve yesterday. Thank you so much for your help!
I have learned so much already.
 
For alpha trak users reading this also saying “I didn’t know that” I believe @Sybil’s mom is referring to the coding chip that is attached to the top of each new vial of strips. Just as when you initially set up the meter, when you open a new vial insert the coding chip. Unlike initial set up you won’t need to scroll through animals, the cat icon should appear and just press “M” to agree you are testing a cat. If you can stand “wasting” a costly strip you’d ideally also use control solution each time you start a new vial to be sure the strips and meter are still working correctly. Yesterday my primary meter failed a control solution check twice (by only one mg/dl but I’m still using my backup and will talk to Zoetis on Monday). So it happens. Also any time you get a reading that doesn’t seem right based on cat in front of you, repeat with a new strip. If wildly different, do a third strip. And do a control solution check. I’ve had wildly different more often with a human meter (precision Xtra)—the only time it’s happened with AT3 was when I got blood on top of the air vent (if you look at the wicking area of the strip there’s a tiny hole at the end toward the insertion end—this is the reason use instructions say ‘don’t get blood on top of strip’—it can really mess up results. I got nearly 500 covering the vent but repeats were 200s
Under the “?” Tab in the app You can find a detailed manual that includes instructions on the above, as well as on how to set optional notifications of a low hemarocrit (red blood cell percentage that can alter results), “high” and “low” warnings, and a “check ketones” warning (for higher BG) in the manual.

Finally the strips (all strips, including human) can be damaged by temperature and humidity extremes and give false results. for the AT this means keep them in the vial (it has a drying agent in the bottom of the vial), close the cap as soon as you remove a strip, and keep them at room temp (don’t leave in car)
 
And for anyone saying “whoa, back up meter, is she made of money?!” The AT strips and control solution are pricey. To me very pricey. And control solution should be replaced every three months after opening (same as human meters). So when I need a new bottle of control solution it only costs $10 more to order a new starting kit which includes the test solution, a vial of strips, and a bunch of lancets plus a meter. Hence a “backup” —I bought the backup kit with a discount coupon for a diabetic supply site so essentially the new meter was free…something AT users may want to try
 
What a lot of blue numbers you had in your curve yesterday. You can move to 2.25 units tomorrow if you like and can monitor. I say tomorrow because you already shot 2 units today and probably don’t want to increase at night. We can hopefully get those nadirs down to between 90 and 150, which is the target for SLGS. Could you possibly set an alarm tonight to take a test at anywhere in the +4 to +6 range? Some cats drop lower at night, so I would like a better idea of what he’s doing at night.
 
Ami, are you planning to stop feeding the high carb DM dry food noted in your signature? Is it the Purina DM Dietetic Management Dry Feline Formula you're feeding? If so, nothing special about the ingredients and it's 18% carbs - way too high for our diabetic kitties, even if it's just a little bit.

The reason I ask, if you're transitioning or thinking of stopping, I'd be careful increasing the insulin right now. Your curve yesterday was on target for holding the dose following SLGS (122-125-134) especially with the Alphatrak that reads a bit higher than a human meter. Removing the high carb dry may bring the BG numbers down even more and it'll be very important to be monitoring throughout both cycles everyday if you plan on removing the dry DM rx food to see what effect it has on the BG.
 
Suzanne & Darcy said:
What a lot of blue numbers you had in your curve yesterday. You can move to 2.25 units tomorrow if you like and can monitor. I say tomorrow because you already shot 2 units today and probably don’t want to increase at night. We can hopefully get those nadirs down to between 90 and 150, which is the target for SLGS. Could you possibly set an alarm tonight to take a test at anywhere in the +4 to +6 range? Some cats drop lower at night, so I would like a better idea of what he’s doing at night.
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Noting that she uses an alphatrak (human meters read lower than AT)—is 90-150 on a human meter or AT?
Edit: it could be, I’m just asking if you already factored in the AT to reach a nadir goal of 90 as I’m trying to learn
 
Yes. I was going to mention about the dry food that you have to follow SLGS. However, I would like to see your nadirs down closer to 90 and also hopefully get the AMPS and PMPS numbers down.

If you are able to cut out the DM it would be much better overall for Sybil. If you can do this then I would hold the dose at 2. You can still give the Dr. Elsey’s and follow SLGS.
 
I am aware of the Alpha Trak being used. And while we take into consideration the AT, we do not modify the entire protocol for an Alpha Trak. The “take action” number with an AT meter is 68. That is where higher carb food can be given as necessary along with karo only if necessary- along the frequent testing every 20-30 minutes. We do not have a different target nadir range for AT users. If Ami wishes, she can modify it herself. I have worked with many AT users and am currently working with other AT users; their cats have always been kept perfectly safe. A lot of the decisions are naturally based on whether the caregivers can monitor the cycles carefully. So that brings up another question for you @Sybil’s mom — what is your work schedule like or what is your typical availability to monitor Sybil’s cycles? We haven’t talked about that yet.
 
SmallestSparrow said:
Noting that she uses an alphatrak (human meters read lower than AT)—is 90-150 on a human meter or AT?
Edit: it could be, I’m just asking if you already factored in the AT to reach a nadir goal of 90 as I’m trying to learn
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Of course, @SmallestSparrow your kitty is on Glargine so many things are different about dosing with Glargine than with ProZinc. The SLGS target nadirs are the same though 90-150.
 
I will wait until you reply, Ami, to write much more, because we have now thrown a lot of information and some questions at you and I don’t want to confuse you. Okay? I will be around later on today — and there were not going to be any decisions made about changing anything today anyway. We have plenty of time.
 
Suzanne & Darcy said:
Of course, @SmallestSparrow your kitty is on Glargine so many things are different about dosing with Glargine than with ProZinc. The SLGS target nadirs are the same though 90-150.
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I wasn’t questioning your advice or judgement and I have no doubt you’ve successfully guided thousands if not more. I’m just new and trying to figure out when advice is given if it’s being given in “human meter” requiring me to adjust or if it’s already factored in. For example I know 75 is a “yay” number on a human meter. As I’m sure you know the AT has a 10% accuracy until below 100 when accuracy becomes +/- 15mg/dl so a 75 on AT could be “yay” meaning it’s up to 85 or could actually be as low as 60 which is an action number. I’m just trying to figure out what people mean is all.
 
SmallestSparrow said:
I wasn’t questioning your advice or judgement and I have no doubt you’ve successfully guided thousands if not more. I’m just new and trying to figure out when advice is given if it’s being given in “human meter” requiring me to adjust or if it’s already factored in. For example I know 75 is a “yay” number on a human meter. As I’m sure you know the AT has a 10% accuracy until below 100 when accuracy becomes +/- 15mg/dl so a 75 on AT could be “yay” meaning it’s up to 85 or could actually be as low as 60 which is an action number. I’m just trying to figure out what people mean is all.
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I understand. No offense taken at all! :) I am sorry if it seemed that way! I also sometimes have to write out/explain a lot of things for lurkers who don’t post but read the threads. I don’t want them to get the wrong idea. I also want Ami to know that we are going to be very careful with her baby! :)

Take action number on a human meter is below 50. The human meters are also allowed to have a frustratingly high “variance” of +/- 20 percent (and I have seen 25 percent quoted as well). It can drive you crazy, and a lot of people don’t understand it. It’s hard to explain to people that we are looking at trends, for example — to tell them that a 100 and a 120 are considered to be roughly the “same number” or that the cat’s BG be considered to be “flat” — or I prefer say stable — with those numbers. The differences can seem even greater when the cat is in higher numbers. I always tell people that when we are in the lower numbers (approaching the take action number) we need to just take the numbers at face value/take them seriously and be vigilant. If a person ever gets a number they’re uncomfortable with or one that just seems really unexpected (or just doesn’t seem right) I always encourage them to do another test right away to check that number. I have tested the same drop of blood with two different strips and have many times gotten the same number or very close — sometimes I have had a little variation. I don’t know that I ever personally saw a 20 percent difference.

I am sorry, Ami. I don’t want to hijack your thread or get into confusing things.
 
Suzanne & Darcy said:
I will wait until you reply, Ami, to write much more, because we have now thrown a lot of information and some questions at you and I don’t want to confuse you. Okay? I will be around later on today — and there were not going to be any decisions made about changing anything today anyway. We have plenty of time.
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Hi. I’m drowning in life right now and can barely do this as it is. I work a full time job and hour commute each way; my father is very sick and I am his caregiver and I have some health issues and the stress just doesn’t stop. I’m trying to stay afloat myself and I feel like I’ve been kicked so hard now with Sybil. I already don’t even have a life of my own. This is very taxing. I love Sybil so much and so now I have no personal life. I’m too busy taking care of everyone else. I have no help.
I will keep things as they are right now since I spent $200 in food from the vet and I can’t afford that mistake because I trusted what they told me. I’m trying to mix it with Dr. Elseys until I finish the DM dietetic but it will be a while. My roof was leaking and a disaster at home and the roof is going to start getting repaired this upcoming week so this is probably not a good time for changes. Thank you for your help and I’ll be in touch again. If something major changes in the interim, I’ll let you know. Thanks again. Trying to stay afloat.
 
Sybil’s mom said:
Hi. I’m drowning in life right now and can barely do this as it is. I work a full time job and hour commute each way; my father is very sick and I am his caregiver and I have some health issues and the stress just doesn’t stop. I’m trying to stay afloat myself and I feel like I’ve been kicked so hard now with Sybil. I already don’t even have a life of my own. This is very taxing. I love Sybil so much and so now I have no personal life. I’m too busy taking care of everyone else. I have no help.
I will keep things as they are right now since I spent $200 in food from the vet and I can’t afford that mistake because I trusted what they told me. I’m trying to mix it with Dr. Elseys until I finish the DM dietetic but it will be a while. My roof was leaking and a disaster at home and the roof is going to start getting repaired this upcoming week so this is probably not a good time for changes. Thank you for your help and I’ll be in touch again. If something major changes in the interim, I’ll let you know. Thanks again. Trying to stay afloat.
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Oh my, Ami. Big hugs going out to you right now. That is VERY overwhelming. Just take a breath. Sybil is doing very well right now and you don't need to change anything right now. You have done a wonderful job getting up to speed in taking care of her diabetes. I am amazed that you have accomplished this under the circumstances. Sybil is having very safe numbers on the 2 unit dose at this time. I would encourage you to always get preshot tests in before you give her the insulin and to get mid-cycle tests if you can (on a day off or in the evening) and to do a weekly curve if at all possible. If not a full curve because you just can't do it then to try to get a +4 and +6 perhaps. Cats' insulin requirements will sometimes change (increase or decrease needed) and we need to make sure that the dose is still a good dose for her and, in particular, that she's not dropping too low. If you need anything or just have a question or a concern, please reach out! Sybil is doing amazingly well in a short period of time and we would love to help with that. Take care, Ami. I look forward to hearing from you again. Tag me or post on the ProZinc forum. More hugs!
 
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