What's the use? Day 2

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Hosanna

Member Since 2012
She tested 207 this morning. That's the lowest since last Friday, when she was 171, then shot up to 223 the next morning. It's these roller coaster numbers that have me stumped.
 
One thing you need to remember with glucometers. They are allowed to read within 20% plus or minus and still be considered to be accurate enough. So even testing the exact same blood drop, can give you different results.

So taking your 3 examples, here are the ranges.

207 + 20% = 248 207 - 20% = 165
171 + 20% = 205 171 - 20% = 136
223 + 20% = 267 223 - 20% = 178

What looks like numbers all over the place, what your called "roller coaster numbers", are really numbers all pretty much within the same range. You'll never get the precision you seem to be expecting, no matter what glucometer you use for testing.

It's why we have the spreadsheet with the color coding. So people can see the ranges with the colors and see patterns instead of focusing on the individual numbers.

What I'm seeing, is numbers below the renal threshold at pre-shot. With the tests you were able to get last night, we see that Martha dropped down to 90, into those nice green numbers. Fantastic! The Lantus is working to bring the BG levels down and into nice healing numbers.

I think you have been discouraged and not seeing that the insulin you have been giving Martha is working better than you expected. That is because you have only been getting a tiny piece of the picture with those pre-shot only tests. By testing mid-cycle, you are getting a much better picture of how well the insulin is working. Pretty darn good from what I see! :-D

If you are able to get some other mid-cycle tests, as your work and life responsibilities allow, you will get a better picture and know how much good you are doing for Martha.

Hang in there, OK?
 
The way you are explaining things, it is certainly more encouraging. It's still hard to understand this 20% thing.
I was able to get another mid cycle test today. This one I definitely do not understand. At +7 it was 240--! Surely that is not a "normal" number. At +6 last night she was 90. Surely she shouldn't be jumping that much in one hour.
 
Remember - insulin is a hormone, not a chemical "take 2 and call me in the morning" medicine. Many things can affect bg numbers...stress, excitement, food and other things. Food - the carbs can vary a bit from can to can also....those are indeed 'close' numbers.

HUGS!! I'd sure be interested in seeing a few mid-cycle numbers when possible too - looks like you're doing VERY well!
 
I'll do my best to get some more mid cycle numbers. Any idea why she was so high mid-cycle today? Even higher than her AMPS?
 
It was probably a bounce for yesterday's lower numbers. Hopefully, she'll clear it by tonight and you'll see lower numbers again during tonight's cycle.
 
To explain bouncing

Bounces - what are they and is my cat doing them?
When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". This can last a while. Months even.

But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
 
Today she has been in the 200's all day---207, 240,242. Two questions: How does one determine if the cat is having a bounce or if it is the true number?
And, what is renal threshold?
Thank you so much for the encouragement!
 
A bounce is a flat 24-72 hours after a low. So if he sticks at these yellows for much longer without another drop, I would call it a bounce. I also want to know if he dropped lower than 90 last night and I suspect he did.

Renal threshold is over 270 although every cat is different. It's the level at which blood sugar gets so high the body gets rid if it through the kidneys. Over time it damages the kidneys.
 
At her nadir--+4, she is 239. She is the same as she was 4 hours ago although she had insulin. I don't understand this. Last night this time, she was in the blue and green.
 
Looks like a bounce to me!

Bounces can also be because the cat dropped too low i.e. under 50. So once the bounce clears (once numbers start to drop) you might want to get more tests in to see how low she is going. you don't want to miss the low again.

Wendy
 
Nadirs, or the lowest point in the cycle do vary. So even though you did get a +4 test last night, that is not necessarily the low. The nadir is often somewhere between +4 and +7 for most cats, but you need to test to find that low point for your cat.

The day before, you got a low test at +6. The BG could have been lower than this earlier or even a bit later.

We know how difficult it can be to get those mid-cycle tests, but they give us the data we need in order to suggest changes in dose for Lantus.

Yes, I agree with Wendy this is likely a bounce, but we need data to help us support this and to decide if Martha needs a bit more insulin.

You also need to gather data so you can feel comfortable shooting when you get lower numbers, those numbers under 150. I suggest reviewing this sticky from the Lantus TR ISG on STICKY: LANTUS & LEVEMIR - SHOOTING & HANDLING LOW NUMBERS. You need to 'shoot low to stay low' and you need data to know what is safe for your cat. Sort of a catch-22.

I do think we can help you get Martha's BG numbers in a better range.
 
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