Newbie spreadsheet questions

[Wendy&Neko]

I have uploaded the latest spreadsheet and have a few question and welcome any comments on what I am doing so far. BL (before Lantus) Neko was diagnosed the third week of December and on Caninsulin, increasing up to 5 units BID where we were probably close to regulation in mid February. After seeing a wonderful locum at the vet a week later, I was shown how to blood test and put on Lantus - his idea, although I had asked the regular vet whether Caninsulin was best for cats. I am the first client to blood test at that clinic - they are open to it, just don't push it. They also don't understand Lantus as all the rest of their clients are on Caninsulin. For example, after last weeks curve the vet told me to up the dose to 2.5 during the day and 2.0 at night - which I translated with all the helpful documentation here to be a dose of 2.25. It makes some sense to do a lower dosage at night on a faster acting insulin. The locum will be back next weekend after my next curve, and he had told me to keep the same dose day and evening. I will look for information on Lantus to give the regular vet when she gets back from holiday.

We started Lantus with Wellness and a couple of Evo crunchies on top - she does love her dry food. After a week we went without dry - all wet, then began the conversion to raw, so she has some crunchies again, but this time it's bone. With her polyphagia, the food conversion was a snap.

As you can see from the spreadsheet, little miss Neko likes to bounce a bid, and her nadir seems to move after dose increases and then settle back closer to hour 6. I have had a couple of scares of low readings. The first was just before injection on a day I wasn't going to be home to test so we cancelled both injections. The second was yesterday just before our 6PM snack.

Questions:
- any comments/rationale for the two isolated green incidents? BTW, I am currently using the dreaded Freestyle meter but am going on a road trip across the border tomorrow to the Bellingham Walmart to pick up the Reli-on and a few months of test strips. Both times I got the little green numbers I barely had enough blood for a test, much less enough to try a second test strip.
- both times I got the green numbers in the spreadsheet were just before feeding, and I tested shortly thereafter and got much higher numbers. Any thoughts on how much food should impact the numbers? The first time was all of breakfast the second was just a tablespoon.
- my vet asked for readings every 90 minutes. How do would you enter that on the spreadsheet? For my entries on Friday the 9th, I just picked the hour the actual test was closer to since I wasn't that accurate about every 90 minutes.
- I am using the World version of the spreadsheet and the one on Google docs doesn't always do the colouring on the entries, although it does on the US sheet, and the downloaded works great on the World sheet. I am currently editing a version I've downloaded to my computer then copying the changes into the google docs version. Any comments on easier ways to do this would be appreciated.

And last question, not related to spreadsheet, I've read here that more smaller meals are better. Can anyone share an idea meal plan? We currently wolf all of breakfast just before the injection but dinner is split into meals at 6, 8, 11. The main course is at 8 with a tablespoon at 6 and 11. With Neko being so hungry, she is very active and vocal when she expects her dinner so changes there will have to be done gradually.

Thanks all for any help and advice.

 

[Blue]

I have uploaded the latest spreadsheet and have a few question and welcome any comments on what I am doing so far. BL (before Lantus) Neko was diagnosed the third week of December and on Caninsulin, increasing up to 5 units BID where we were probably close to regulation in mid February. After seeing a wonderful locum at the vet a week later, I was shown how to blood test and put on Lantus - his idea, although I had asked the regular vet whether Caninsulin was best for cats. I am the first client to blood test at that clinic - they are open to it, just don't push it. They also don't understand Lantus as all the rest of their clients are on Caninsulin. For example, after last weeks curve the vet told me to up the dose to 2.5 during the day and 2.0 at night - which I translated with all the helpful documentation here to be a dose of 2.25. It makes some sense to do a lower dosage at night on a faster acting insulin. The locum will be back next weekend after my next curve, and he had told me to keep the same dose day and evening. I will look for information on Lantus to give the regular vet when she gets back from holiday.

We started Lantus with Wellness and a couple of Evo crunchies on top - she does love her dry food. After a week we went without dry - all wet, then began the conversion to raw, so she has some crunchies again, but this time it's bone. With her polyphagia, the food conversion was a snap.

As you can see from the spreadsheet, little miss Neko likes to bounce a bid, and her nadir seems to move after dose increases and then settle back closer to hour 6. I have had a couple of scares of low readings. The first was just before injection on a day I wasn't going to be home to test so we cancelled both injections. The second was yesterday just before our 6PM snack.

Questions:
- any comments/rationale for the two isolated green incidents? BTW, I am currently using the dreaded Freestyle meter but am going on a road trip across the border tomorrow to the Bellingham Walmart to pick up the Reli-on and a few months of test strips. Both times I got the little green numbers I barely had enough blood for a test, much less enough to try a second test strip.
- both times I got the green numbers in the spreadsheet were just before feeding, and I tested shortly thereafter and got much higher numbers. Any thoughts on how much food should impact the numbers? The first time was all of breakfast the second was just a tablespoon.
- my vet asked for readings every 90 minutes. How do would you enter that on the spreadsheet? For my entries on Friday the 9th, I just picked the hour the actual test was closer to since I wasn't that accurate about every 90 minutes.
- I am using the World version of the spreadsheet and the one on Google docs doesn't always do the colouring on the entries, although it does on the US sheet, and the downloaded works great on the World sheet. I am currently editing a version I've downloaded to my computer then copying the changes into the google docs version. Any comments on easier ways to do this would be appreciated.

And last question, not related to spreadsheet, I've read here that more smaller meals are better. Can anyone share an idea meal plan? We currently wolf all of breakfast just before the injection but dinner is split into meals at 6, 8, 11. The main course is at 8 with a tablespoon at 6 and 11. With Neko being so hungry, she is very active and vocal when she expects her dinner so changes there will have to be done gradually.

Thanks all for any help and advice.

I really don't trust any of the numbers your Free Style meter is giving you; the others I know had a sea of yellow numbers, all in the 200s, and then when they switched to other meters, every one of them had higher numbers.
I just color the field in myself because I use a ss that does not have the tabs, for US and World, so I put 13.5 and 245 in the same field, then click on the yellow in the pallet at the top in the menu.

For meals, many people use an autofeeder.
Petsafe 5-meal Auto Feeder

As for how much to feed when, it depends on the cat.
Some cats have numbers like they are diving off a cliff after their meal so those owners often feed mini meals ... 1tbsp at ps, and every hour in the first 4, that way, the food is helping to slow down the drop. And slowing the drop also lessens your chances of the cat's numbers bouncing up again.

You pretty much have to experiment to see what works for your cat, but in general, you want to space out the meals and snacks as it helps to keep the BG numbers more level, and not like a roller coaster!
No food from +10 to ps.... if you are feeding at +11, then your next ps, 1hr later will be artificially high... it will be a food influenced number. Give the last bit of food/snack at +10.
The reason for the no food for 2hrs.... if you feed at 11 then test an hour later, you get a higher number and think it is safe to shoot. Next thing you know, an hour later, the number drops because that food wears off and then the insulin kicks in and you get an even lower number. Maybe something like ps, +4, +8, ps, +4, +8 would be a good start, then move the times around where they are needed.

As for the monitor, you can get the Relion but I would strongly advise you to have TWO Relion meters in case one goes pfffft, and then you are not stuck with 300 strips and no meter. The meters are something like $9 and the strips are pretty cheap but you will need to keep making trips south and it may be that the gas money will eat up what you save on strips cost. Keep in mind that the Relions will give you readings that your vet will not recognize, so you will have to convert all the numbers for your vet.
It would be good to have a spare Canadian meter; I love the Bayer contour, but my backup is the OneTouch Mini.

 

[Wendy&Neko]

Thanks for the tip on buying two meters. The gas is free on this first trip as I am going with a friend who is going to Bellingham anyway. We are going to her dog's chemo appointment which is over half way there so we'll just nip over the border while he is getting his drip.

I'm not sure the automated feeding machine would work for raw food, as raw isn't supposed to be out for more than 15 minutes before putting back in the fridge. I work out of home so can be home most of the time for mini meals. Her first evening snack is about 2 hours before PMPS so that works. Maybe I should spread out the morning one a bit like we used to. It is harder to spread out the meals if I have a sitter though, so I'd like to know how she reacts with one big meal. Looks like we'll still have a way to go to get the dose up, but I'll know better when I get a reliable meter. I was thinking of getting a Contour as a backup - just checking prices at various locations before deciding.

 

[Blue]

Thanks for the tip on buying two meters. The gas is free on this first trip as I am going with a friend who is going to Bellingham anyway. We are going to her dog's chemo appointment which is over half way there so we'll just nip over the border while he is getting his drip.

I'm not sure the automated feeding machine would work for raw food, as raw isn't supposed to be out for more than 15 minutes before putting back in the fridge. I work out of home so can be home most of the time for mini meals. Her first evening snack is about 2 hours before PMPS so that works. Maybe I should spread out the morning one a bit like we used to. It is harder to spread out the meals if I have a sitter though, so I'd like to know how she reacts with one big meal. Looks like we'll still have a way to go to get the dose up, but I'll know better when I get a reliable meter. I was thinking of getting a Contour as a backup - just checking prices at various locations before deciding.

Auto feeder would be great because you can make frozen cubes of food!
Lots of people do that.... mix your food and then plop portions into ice cube trays. When frozen, just pop them into a big baggie in the freezer. As you need them, take out portons and drop them into the feeder for thawing later. with small portions, the food will stay until thawed for the next feeder turn.

Do you have a Shoppers DrugMart Optimum card? If not, get one. I get all my supplies there and the points I accummulate from syringes meters strips lancets and anything else adds up to free insulin a couple times a year for me!

 

[Wendy&Neko]

I don't have a Shoppers card. The prices on most of their goods are a lot higher in the store near where I live. I did a survey of a number of places around me and the Shoppers price for the Contour test strips package of 100 was $6-$8 more than most other places.

 

[Blue]

Oh yeah? Where do you get your strips? What's the London Drugs prices like?

I would still get the Optimum card as if you ever get anything at all there, you get points.
I am currently sitting on about $60 just by my points.

 

[Wendy&Neko]

Good guess Gayle, London Drugs has the best price around here. They are $77.99 and $85.99 at Shoppers. LD usually throws in the meter when you buy your first package of strips too. They did for my Freestyle. If I go back there I'll educate them about Freestyle not being good for cats. When I talked to the pharmacist at Save on Foods, she was really interested because they get a lot of panicking people who have just had pets diagnosed. She even wanted the FelineDiabetes web site for more info.

 

[Blue]

You can also mention that I did report the issue to Abbott telling them they may want to check into the falsely low readings their FreeStyle meters are giving.
They replied that people could contact them and they could troubleshoot the problem with that meter, but I replied there was no incentive for people to help Abbott sort out the company's issues and that the people had already switched to other reliable meters.

I am glad you get good deals at LD; I will have to check their prices here in Wpg as there were no LD in Ontario, so I went with SD for supplies.

Awesome! I gave my vets info to have their clients come to fdmb for support as well.