Suzanne & Darcy
Very Active Member
Okay. Just let me know his AMPS and we will see about today.
Twix_Low AMPS Reading
- Thread starter Samantha Styles
- Start date
Samantha Styles
Member
Ok! So his Libre right now is showing 96, his ReliOn is showing 87
Samantha Styles
Member
I did not. I just have him PM snack set to one at 10, and I gave it a little earlier bc I had woken up and gone down to sit by him when his alarm went off. But it wasn’t anything outside of what he normally gets.
I over reacted the last time this happened and this time I tried to stay calm and just see how he handled it without much intervention and a simple snack. And by forcing myself back to bed and monitoring his numbers throughout night. It worked but was hard haha!
Suzanne & Darcy
Very Active Member
Also, look at those three readings you took at +4 last night. They were nearly identical — very very stable.
Suzanne & Darcy
Very Active Member
That’s perfect. So we know he stayed stable on his own with only the regular food. Good to know.
Suzanne & Darcy
Very Active Member
I think he would probably be fine on the regular dose, but since you are not going to be home today— how about just shaving a small amount off the dose and doing a skinny .75 (closer to the .5 line). Do you think you can do that? When do you leave for work? Has he eaten a good breakfast?
Suzanne & Darcy
Very Active Member
What do you think?
Samantha Styles
Member
He just ate a full can for breakfast! I can do a skinny 0.75. I leave for work in about an hour.
Samantha Styles
Member
I think I trust your advice and will defer to your suggestion. I’m very motivated to get him holding stable and maintain this good progress. I just obviously worry about myself getting complacent with decisions and potentially dosing him too high.
Suzanne & Darcy
Very Active Member
You are doing everything right. And according to protocol. That’s not to say he won’t earn a reduction at some point (maybe soon) and we will celebrate that as progress! I do not think he is in danger of a real symptomatic hypo event!
Samantha Styles
Member
it’s a
I thought so too and it’s how I’ve been handling it, but then I did more research and found out if I have a device home with him I can download a “share app” which allows me to track him remotely. It’s amazing! I only have this phone temporarily though, so I’m trying to find another one I can use more long term.
Suzanne & Darcy
Very Active Member
Well I am glad and you put the numbers in his SS too! Thank you! I have been thinking about him since this morning and just got back home a little while ago. I was thinking I would have to wait until you got back home to see how he’s done today. I feel relieved to see he had good numbers today.
Suzanne & Darcy
Very Active Member
Keep a good eye on Twix tonight. I think with that low pmps, I might have shot a skinny. But I know you will take care of him.
Samantha Styles
Member
Oh, eek! Okay, I will.
Suzanne & Darcy
Very Active Member
I was just reading your notes from last night. I am not sure I understand all the ins and outs of the Libre giving you a 49 and then not a 49 ?
Suzanne & Darcy
Very Active Member
I look forward to seeing what happened after the 56 - last reading last night. I think I am addicted to all this Libre information.
How is his neuropathy, by the way? And the hypothyroidism? Are you getting all that figured oit? I was just going back a nd reading some of the stuff that Daphne wrote about it. She really has done a ton of research on add this stuff because her cat also had the radioactive iodine treatment. Personally, if one of my cats ever gets hyperthyroidism, I am going for the radioactive iodine treatment as soon as possible. A very close friend of mine just recently lost her cat due to being sickened by methimazole (severe anemia) and due to vet mismanagement of the entire thing. It was awful.
How is his neuropathy, by the way? And the hypothyroidism? Are you getting all that figured oit? I was just going back a nd reading some of the stuff that Daphne wrote about it. She really has done a ton of research on add this stuff because her cat also had the radioactive iodine treatment. Personally, if one of my cats ever gets hyperthyroidism, I am going for the radioactive iodine treatment as soon as possible. A very close friend of mine just recently lost her cat due to being sickened by methimazole (severe anemia) and due to vet mismanagement of the entire thing. It was awful.
Samantha Styles
Member
Spreadsheet updated
he did quite well last night. But I will admit it was somewhat stressful. Haha. Anytime he’s skimming at 50 I’m always so nervous.I am also slightly confused by the Libre. But I noted it bc I’m not certain if it’s considered as earning a reduction. So when his alarm went off (happens anytime he’s below 55 with Libre) I had the app open and was watching numbers and it started showing low 50s & I know I saw a 49! I then went to do a manual test on him as well & I then fed him his normal pm snack a little early. After all this I then went into his graph (this new shared app is awesome because you can look at specific times on the graph and it tells you the exact number; no more of me pulling estimates off the graph) and it no longer showed the 49. The lowest it showed was a 57. So I don't 100% understand that yet and need to ask (there’s a Libre FB group - who knew!) I’m assuming bc of the fast drop the Libre’s calibration isn’t probably slightly off? Then once it settles out the data is more clear? Maybe?
His manual reading during this time was 66. But I had let him start his snack (distracts him and lets me get a better ear prick & I have to admit I don’t panic as much but I still get a little panicky and forget proper order of operations haha), so small chance it’s slightly skewed from that. But I tried to do it before he ingested much.
Suzanne & Darcy
Very Active Member
Well let’s see what his AMPS is in a few minutes. I think definitely a skinny .75 or possibly a full reduction to .5 units would be okay. Are you working today or at home?
Samantha Styles
Member
Haha! Oh man, yes, I’m also addicted to his Libre information. I am a bit obsessed. Hopefully that calms down.
His neuropathy is still bad. I started him on Zobaline which many swear by, I’m hoping that helps speed things up for him. I know nerves take a long time.
Samantha Styles
Member
I work today.
Suzanne & Darcy
Very Active Member
He’s at 110. What do you want to do?
Samantha Styles
Member
Yeah.. I’m not sure! Haha! He’s been lower at his previous pre shots and had good numbers all day. But also if I don’t get home before his peak low, then that might be stressful. If I follow the MPM he hasn’t actually qualified for a reduction (unless we are counting the 49 I saw on screen, but can’t find again.) I feel like he’s probably getting very close to earning a reduction, so maybe we’d be safe to do it,
Hmm.. this one’s tough. I do agree with either a Skinny or reduction. The S dose does feel like a harder measurement to keep consistent, but probably just bc I’m not used to it yet.
Suzanne & Darcy
Very Active Member
Let’s just give him a reduction to .5 units and see how it goes. We can always go back up later. I know you are hoping to get him into remission so I’ve been keeping that in mind. So for now, let’s reduce to .5 and hold that dose for a while and see how his numbers go. Okay?
Samantha Styles
Member
The remission has been in my mind too which I think is contributing to my obsession haha, but also helping me stay appropriately aggressive. But I agree and like this plan. I’m hoping I’m right in assessing that he’s right on the edge of earning one anyways. We’ll see how he charts!
Suzanne & Darcy
Very Active Member
I think he is on the edge of earning a reduction too, but it’s generally best to actually let them earn it. So I am taking the Libre 49 last night at face value.
Samantha Styles
Member
I didn’t have the time to fully reply earlier. I’m really sorry to hear about your friend and her cat. That is so sad.
> Thyroid: For Twix, the specialist prioritized getting his hypothyroidism under control before starting insulin. We put him on daily thyroid meds and confirmed his levels were stable before moving to insulin injections. My primary vet and specialist both now agree that his thyroid is well-regulated based on his panels and post-medication testing, and I feel confirmed with it based on his insulin response (doesn’t mean I’m right with that thinking though).
When Twix was hyperthyroid he did really well on once-daily meds (pretty sure it was methimazole) for about a year, and was a very healthy cat otherwise. We only did I-131 to get him off lifelong meds (that backfired on me) because I knew with age more things would happen and I wanted no meds and the healthiest cat we could have. While we caught his post-treatment hypothyroidism decently early, we didn’t manage it well initially. The vet had me give meds just a few times a week, which wasn’t the right call, and I even stopped them shortly after starting due to his poor response. I don’t know now if my specialist was involved in that decision, but looking back, I think switching to daily dosing could’ve helped avoid further issues. To be honest, I think we could have avoided DM had I gotten better thyroid regulation (based on covos with his specialist and my own self-research, but more of an assumption than fact). When the specialist got involved again before starting insulin, she recommended daily dosing, which made a big difference in Twix’s response to the medication. He didn’t have the same reaction to the meds as he did with the “few times a week” doses. His fur and response were much better than the first time. Hindsight is always 20/20.
> Support Group: I did try reaching out to the support group, but to be honest it was very overwhelming. It requires more spreadsheets and they were asking for additional testing. They were asking for numbers I already had, and given the expenses for Twix’s current care, I’m trying to avoid additional costs. Especially when I am going to need to do more testing soon with my vet. The tone and info overload were just too much for me at the time. But the board does have some good articles and info, which I’ve been able to dig into and I have been learning more about Hypo management. It has also prompted me to do more of my own research on this specific topic matter.
My main concern now is whether Twix needs his Hypo meds twice a day instead of once as was mentioned by Daphne. I’ve flagged this with my vet, and I plan to follow up with him once I see how his upcoming panel/results look with better DM management. I’ve come across some websites showing that some cats only do once-daily dosing with levothyroxine, but I plan to keep studying up on it. Right now, DM management is taking most of my time and energy and is the top priority. I recognize I also need to try to spend some more energy on this because I want to keep his kidneys in good shape as well.
> Neuropathy: His neuropathy hasn’t improved much overall. Some parts of the day seem a bit better, but he still needs breaks when walking. It’s definitely uncomfortable for him. I’m hoping that with better thyroid regulation, DM control, and starting Zobaline, his body will get the time it needs to heal properly. I am really hoping we start seeing results with his neuropathy in these upcoming weeks (fingers crossed).
Samantha Styles
Member
I think he is on the edge of earning a reduction too, but it’s generally best to actually let them earn it. So I am taking the Libre 49 last night at face value.
That's why I noted it in my spread because I'm like shoot, does that 49 count and mean he earned it or no!? Haha. I am thinking maybe the Libre was overreacting with sudden drops and takes a second to recognize it's own outliers. This is an assumption but it sounds like this sometimes happens with others if there is a compression issue with a cat lying on it or something like that, once the Libre recalibrates it seems to fix numbers on the graph. But now that I have learned that I need to test the Libre about 10-15 min after manual I have been able to get the numbers much closer, so this makes me feel more confident in the Libre numbers as well. So much learning to be had with all of this! Oh my!
Suzanne & Darcy
Very Active Member
Well at least you didn’t have to worry about him at work today since he’s stayed blue. Still since we gave him a reduction then we should stick with it for six cycles…. Or maybe 4 cycles.
Suzanne & Darcy
Very Active Member
Oh, and did you say you’ve checked his kidneys recently? Since his thyroid numbers have been good?
Samantha Styles
Member
Ok, copy, will give it a few cycles to see how it works out.
Samantha Styles
Member
We have not done a full panel on him again yet. But he did have a full panel right before this all started then we did more testing on him after beginning thyroid meds (kidney check and thyroid testing) but this was before starting insulin. So he hasn’t had a new once since getting his DM in better control. He’s due for another full panel in Dec. My understanding was his DM can also affect his kidneys so this would also need to be better controlled. Maybe I’m understanding this incorrectly.
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Samantha Styles
Member
He’s responding well to the reduction. Last night and today he was back in the green! His Libre did that thing again where it alerted that he was dropping low and during the “in the moment reading” it showed a 47, but once his levels evened out and I went back into his graph it only showed a low of 57. My guess is this has something to do with sudden drops and the Libre struggling to read? But I wasn’t home at the time so I didn’t feed a snack or interfere in any way, he leveled out shortly after the alert. But I’m not sure if we’d consider this as a reduction again?
Suzanne & Darcy
Very Active Member
I don’t think I would reduce again so soon. Especially since we don’t understand what’s going on with the Libre. Have you been able to find out any more about that from other Libre users?
Suzanne & Darcy
Very Active Member
Okay. He is trying to just barely dip into the higher greens, but I am still very glad to see the green and I think we will give him more time on this dose When I looked earlier today he was still in blue and I was waiting for you to update (but not bugging you! 
I also did see last night — that is a typical pattern for many cats to drop lower at night, but not all cats do it. Twix definitely has that pattern.
I also did see last night — that is a typical pattern for many cats to drop lower at night, but not all cats do it. Twix definitely has that pattern.
Samantha Styles
Member
Okay, copy. I’ll keep him on his current dose. I’ll be home this evening to keep an eye on him and if he drops low again I’ll try to get a ReliOn comparison.
I have not yet, but I will try to research this more and attempt to start a discussion with some people to figure out what those outliers are about!
Suzanne & Darcy
Very Active Member
This would be great! If the Libre does that again to see what’s up with the ReliOn.
Suzanne & Darcy
Very Active Member
I know they have that FB group for how to install your own Libre sensors.
Samantha Styles
Member
Oh that’s good to know!Okay. He is trying to just barely dip into the higher greens, but I am still very glad to see the green and I think we will give him more time on this dose When I looked earlier today he was still in blue and I was waiting for you to update (but not bugging you!
Yeah it’s crazy the resources that are available! I’m actually on that group so I will try to start up a convo to see if anyone knows something
Samantha Styles
Member
So from about 800am - 200pm Twinkie hovered in the low 50’s. His Libre did that thing again where it showed a 45 on the screen, but then later the graph showed a higher number. I think this will be very hard for me to ever catch with a blood test bc the Libre is delayed so I’d have to catch it before it alerts me.
I started a thread in the FB group and the only answer I got was “Libre doesn’t do static measurements instead you get a recoding of the journey in that region.” Someone said they spoke with Abbott and the Libre shows the averages. I don’t know if this is specific to all numbers or just the chart. I have a message into them as well to try to get some clarity.
He’s about 30 mins out from his PM shot and he’s hovering between 70-90. The only downside is when he drops below 55, his Libre alerts. So most of the afternoon his alarm was going off. If I keep this dose for PM, I may have to move the phone out of sensor reach or it’ll probably keep us up all night haha.
His pre shot reading is 103… I made the mistake of feeding him now bc we were feeding everyone else and he was going for their food. So waiting for delayed readings won’t be reliable.
I started a thread in the FB group and the only answer I got was “Libre doesn’t do static measurements instead you get a recoding of the journey in that region.” Someone said they spoke with Abbott and the Libre shows the averages. I don’t know if this is specific to all numbers or just the chart. I have a message into them as well to try to get some clarity.
He’s about 30 mins out from his PM shot and he’s hovering between 70-90. The only downside is when he drops below 55, his Libre alerts. So most of the afternoon his alarm was going off. If I keep this dose for PM, I may have to move the phone out of sensor reach or it’ll probably keep us up all night haha.
His pre shot reading is 103… I made the mistake of feeding him now bc we were feeding everyone else and he was going for their food. So waiting for delayed readings won’t be reliable.
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Suzanne & Darcy
Very Active Member
It’s interesting ho the Libre and ReliOn had the same exact reading of 70 this morning. He had really steady numbers today and surfed in green for a LONG time. Amazing. I can’t wait to se how the skinny dose works tonight. I do hope you will get sleep tonight! When do you next have a day off?
Samantha Styles
Member
Yeah he was green almost all day, which was awesome! I was hesitant with the dose without input so I opted to try a skinny.
My days off this week were yesterday and today, so my next one is not until next week.
My days off this week were yesterday and today, so my next one is not until next week.
Suzanne & Darcy
Very Active Member
How did he do last night?
Samantha Styles
Member
Lots of green again! He did hit below 50 again, however, this time it actually appeared on the graph after.
When I went down to check on him he was laying on his sensor (we just got a new dog bed and he loves to steal it and yesterday and today were the first time I’ve ever had his Libre read LO, so I think this bed allows him to lay in a way he puts a lot of pressure on his sensor) so there is a good chance there was a “compression LO” affiliated with this reading. But during the daytime yesterday with the compression LO the corresponding 40 number never registered on the chart after, but they did for last night. So I feel like it’s probably safe to take it as a true 45?
Unfortunately, I was way too tired to take a manual blood sample last night, which sucks now for comparison purposes. I just went downstairs to make sure he was okay and not showing any signs of hypo. I also convinced him to lay on his other side which then allowed the Libre to stop reading LO and it did start reading back in the 50s.
Anyways, that was a very long winded way to say I think he may be due for a reduction? It will suck if he’s not and it’s done too early, but it does add a layer of difficulty when I cant be home during the days to monitor him.
What do you think?
Suzanne & Darcy
Very Active Member
You probably already shot. I just got back home. I would go ahead and reduce by .25 because we can always go back up.
Suzanne & Darcy
Very Active Member
His BG was probably dropping this morning due to lack of food. That sometimes happens— and it then makes dosing decisions even more difficult. So stalling without feeding is sometimes helpful and sometimes just makes it harder to decide.
Samantha Styles
Member
Makes sense. I feel like he rarely makes these decisions easy ;-) he’s hitting in the 40’s again today the reduction, so I think that was a good call…
It will be interesting to see his chart after today & then assess how to handle his PM dose. My husband is home right now & he’s reading 44, so I’m going to have him give him his lunch early before he leaves for work. I’m not there to take and assess his actual. So I’ll be curious to see how his chart adjusts.
Twix was not doing the 2 snack times (unless I was there to bring the food to him in bed) so I started doing lunches at +4 with 1/2 can for the last couple of sessions and he’s actually been eating all of that. I may have to adjust this to +3 to better even out his curve.
Suzanne & Darcy
Very Active Member
You can always reduce the breakfast portion a little bit so he doesn’t get as full, then he may be more amenable to the snacks. You can take the full amount of food/calories that you want him to eat a.m. and p.m. and divide it up into smaller meals.
Suzanne & Darcy
Very Active Member
And the Libre says Lo again? Huh? I wish there was a ReliOn reading close to that time. Was he lying on the sensor again? How many days old is the sensor?
Suzanne & Darcy
Very Active Member
He should be very hungry if his BG is that low. Just keep getting readings to make sure he goes up. Can your husband do a manual test if necessary?
Samantha Styles
Member
Good points. I can try that. He doesn’t seem overly motivated to go to the food too many times each day, so the more snacks have been harder for me to get him to eat. I usually have to pick him up and put him at the feeder, or bring the food to him to get him to eat all his snacks. But less at breakfast may help.