? Assistance with Vetsulin Needed - ? too high a dose

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I'm still working on getting Cooter swapped over to all wet food, plus he is a very large framed cat, so I can't really give you an answer on how much I feed him. The amount you feed will depend on Tux's weight and his appetite in general. The "pefect portions' on the sheba is a little misleading I think...it may be enough for some I suppose, but others would need more
 
billysmom (GA) said:
kako, the perscription diabetic dry foods are too high in carbs. My cat was borderline diabetic so the vet put him on dm dry. His BG went way up over renal threshold. I removed the dry and switched to ff wet and his BG dropped about 230 pts over about three days and even more over the next few weeks. The biggest drop was the first 24 hrs (130 pts). Not every cat drops that much (ECID) but some do. That's the reason why people here have been doing one thing at a time and being cautious. Also you said he was dehydrated. You want to use wet food. Dry is dehydrating.
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ff means Fancy Feast? I got 10 cans of classics today. I am staying with 1 unit injection and switch food to wet, and will wait and see. :)
 
Nederland said:
Since it's almost time for my bed, I will write down what my plan would be for tomorrow. You don't have to follow my advice, of course, Tux is your cat and you must have the feeling that you are doing the right thing for him. It's all your decision.

I would switch him to the wet food you bought, tomorrow morning (during daytime you can better monitor him). Usually the feeding advice is about 350 to 400 grams a day? I'm not familiar with your weight indications, I'm used to grams. No dry food anymore. So 35% would be appr. 140 grams wet food. I suppose he's hungry as he is so high in his numbers, so I take the 400 grams as a starting point. Please, convert the amount to the weight indication you are used to.

My advice is:
- test his preshot level
- give him 140 grams of wet food (35% of day quantity)
- after eating at least 100 grams (but preferably all), give 1 unit caninsulin 15 minutes after eating.
- do NOT feed him afterward, take away the leftovers (if he ate at least 100 grams of wet, it's enough)
- test +3, +4, and so on every hour until the level rises again on its own (without food or snacks, you may only give him 1 small chunk of meat, cooked or raw, after a test)
- when his level has risen without help of a snack or food since the shot, you can give him 60 grams of wet food (15% of day quantity)
- only if he drops under 72, you should give him the food immediately and not wait until the level rises again. But I doubt he will drop that low.

This way we will have an indication of where and how low his low point is at this moment, although it could change some time after the food is changed.

We'll decide on a new dose after seeing tomorrow's levels. If the food is changed to even lower carbs, maybe we'll stay on 1 unit, or go only to 1.25 unit. It all depends on waht we'll see tomorrow.

I will be online tomorrow around this time and earlier, but it's 11.30 PM now here, so I'll be off to bed soon. If tomorrow he drops under 72, I'll stay online longer to help.

Buy enough cans of food to last a few days.
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Jennie, thank you so much for detailed advice. I will follow them.
I got 10 cans of Fancy Feast also. :)
 
I saw the list of food in an earlier message, great!
I want to have you well informed by next Thursday, so you know what to do and how to continue.

If you decide to switch to another insulin, please feel free, because I would switch to lantus. But for the moment you still have caninsulin, so you need to know how to deal with that specific insulin. And we have to get his numbers down, they are way too high.

I suppose you are sleeping now. Good luck this morning starting the new food-and-shoot-regime. I'll check in later. In the meantime, I'll check how much 1 Oz is. It'probably not the Wizard of Oz ....
 
Kako said:
Hi Jennie, here are answers to our question.
- I was keeping inside the door of refridgrator. (We are just back from a new vet. Advised to store inside, not the door. So I just moved the insulin bottle to middle of the refridgrator)
- The bottle is clear. no white stuff. (does "on the neck of the bottle" mean on the top of liquid line?)
- No white thing floating. All white things is on the bottom of the bottle, sinking.

I will write what I was told by a new vet we tried today.
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Hello Kako,

I just wanted to add that you need also to protect your insulin bottles from light, which could alter it.
To preserve my insulin in the fridge, and whatever type it is, I have tinkered a special box starting from an After Eight packing :
IMG_1263.JPG
 
Nederland said:
I saw the list of food in an earlier message, great!
I want to have you well informed by next Thursday, so you know what to do and how to continue.

If you decide to switch to another insulin, please feel free, because I would switch to lantus. But for the moment you still have caninsulin, so you need to know how to deal with that specific insulin. And we have to get his numbers down, they are way too high.

I suppose you are sleeping now. Good luck this morning starting the new food-and-shoot-regime. I'll check in later. In the meantime, I'll check how much 1 Oz is. It'probably not the Wizard of Oz ....
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Good morning Jennie!
Yes, before your departure to your trip, hope things are settled. :)
Oh I am familiar with grams. Japanese grow up with grams and kilograms, so.
I have a Tanita scale, so no problem. I noticed 140 g is more than one can of Friskies. (one can: 5.5 oz =156 g)
I felt it's too much, so I gave him 70 g Friskies. Then 1 unit injection after 15 minutes.
As I tested earlier, I wrote the number at +11.
 
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First thing I noticed this morning that his dandruff is gone! He's had bad dandrull for the past 1.5 - 2 months, and he doesn't have it this morning!
When I pull his skin around the neck and let go, it goes back flat in one second. (Yesterday morning it took 5 seconds.)
Wet food is working. Hope it would help lower BG. :)
 
Good morning! It's almost 5 PM here ....
Okay, I hope it's not too little food, although I can't tell as I don't know the feeding advice per day of Friskies for a 10Lbs cat. Would he like to eat more? If so, could you give him 30 grams more right now? If he won't eat it, he probably had enough, but if he will, he will have enough of a buffer for the insulin.
I saw the level was lower this morning, fortunately. He's getting out of the stress mode.

Next test at +3 (if you want to test more, I can't stop you. But it's not necessary. Only if he starts to be wobbly, looking with glazy eyes etc, then always test). And after the 30 grams now, don't feed anymore until his levels rise again. I'll be here to help.

I just realised you use the Alphatrak. That means that in my message of yesterday, about taking action when he gets below 72, it should be changed to below 90 (appr.) on the Alphatrak meter.

Good luck today! And give Tux a cuddle from me.
 
Kako said:
When I pull his skin around the neck and let go, it goes back flat in one second
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Very good!

Not being dehydrated anymore also makes the level drop. there is more moisture in the body to dissolve the glucose in ....
 
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Nederland said:
Good morning! It's almost 5 PM here ....
Okay, I hope it's not too little food, although I can't tell as I don't know the feeding advice per day of Friskies for a 10Lbs cat. Would he like to eat more? If so, could you give him 30 grams more right now? If he won't eat it, he probably had enough, but if he will, he will have enough of a buffer for the insulin.
I saw the level was lower this morning, fortunately. He's getting out of the stress mode.

Next test at +3 (if you want to test more, I can't stop you. But it's not necessary. Only if he starts to be wobbly, looking with glazy eyes etc, then always test). And after the 30 grams now, don't feed anymore until his levels rise again. I'll be here to help.

I just realised you use the Alphatrak. That means that in my message of yesterday, about taking action when he gets below 72, it should be changed to below 90 (appr.) on the Alphatrak meter.

Good luck today! And give Tux a cuddle from me.
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70 g was what he wanted to eat. I will give him a bit more after the +3. Yes, I will give him a big hug, telling him it's from Jennie! He now is asleep, snoring. :)
 
No, don't give him anymore now or after the +3. Just test at +3, +4 and so on until the level rises again without extra food.
If 70 grams was all he wanted, it should be enough. It's very important at this moment that I can see how long the insulin works without the counter effect of food, even food with low carbs .....
I'll check every now and then in case he starts to act strangely. And around +3 to see what his level is.
 
Kako said:
As I tested earlier, I wrote the number at +11.
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I see, you changed that to +11. I'd prefer it in the AMPS column though (even though it's not exactly the right time). Then I can look at one line and see preshot - lowpoint - next preshot etc. It's easier than scrolling to the right to see what's there in the line before.
 
Nederland said:
I see, you changed that to +11. I'd prefer it in the AMPS column though (even though it's not exactly the right time). Then I can look at one line and see preshot - lowpoint - next preshot etc. It's easier than scrolling to the right to see what's there in the line before.
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OK, I will move the number back to AMPS.
 
Nederland said:
+3 lower, but not much ....
Í wonder what +4 will be.
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Tux has been hiding since +3 test. We both are really stressed. I place "fully hydrate him" our #1 priority at this point, and take break from frequent testing. I just shoot for Am&Pm S and +3 to be sure that he is safe.
 
Okay, stress and fear are also not good for his levels, and hydrating him is the most important thing at the moment. Poor thing.
Try to stay calm yourself, he also feels your stress. (I know, it's difficult). We always tell our members to actually tell the cat why they want to test him and shoot insulin, because for their health, that it will help him feel better. They understand. Talking calms him (and you). But for now, just leave him be. Monitoring can also be done by looking at his behavior.

There is no chance that he will have a hypo today, with these levels, so don't worry.
You can give him some food, if you won't test him anymore today before his next shot. Maybe he wants some, say about 50 grams of wet food? Not more.

I suggest you give him 100 grams of wet food this evening just before the shot, maybe he will eat all. Then shoot 1 unit. You don't have to test him this evening, maybe some rest will do him good.
And before you go to bed, give him another 50 grams of wet food. He'll have something for the night.

By the way, and this is very important, making sure he gets lower levels will also help hydrate him. Dehydration is caused by the amount of glucose in his blood. So we really need to get him down, in a safe way.
I think tomorrow morning you should increase the dose to 1.5 unit. But I'll post a message before you get out of bed tomorrow.

Normally we wouldn't change so many things at once (food, dose), but he really is too high in his numbers. I want him to go to pink numbers on his low point for the moment.
 
Before I go to bed, I want to explain the dehydration as best as I can. His high levels dehydrate him. His levels are above the renal threshold. That means that there is so much glucose in the blood, that the kidneys need to get rid of it through the urine. It requires a lot of urine to pee out the sugar. That causes dehydration. It can not only be resolved by wet food, although it does help. The levels need to get down.

Testing is always difficult in the beginning. All cats and owners need to get used to it. Fortunately, testing for caninsulin is most of the time only testing the low point (although the US-members are reluctant to accept that and I can understand why). The only thing is, we still need to find the timing of the low point and that requires a series of testing. If you don't manage today or tomorrow, no problem. Maybe Monday or Tuesday Tux is suddenly willing to be tested.
Until then: keep the feeding pattern (but a little less food than I first suggested, e.g. 100 grams before the injection and 50 grams 4 hours later), and test the +4 during the day time, before his little meal. We'll get an impression of what happens in his body.

We have cats that come running when the owner calls: 'testing!" They think it means "treat!". You do give him a little treat after testing? Maybe one day Tux will do the same ....
Keep up the good spirit and keep faith that all will be well.
 
Nederland said:
Fortunately, testing for caninsulin is most of the time only testing the low point (although the US-members are reluctant to accept that and I can understand why). The only thing is, we still need to find the timing of the low point and that requires a series of testing.
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We have very good reasons for that. Insulin is a hormone, not a drug and the way the cat's body uses it varies from cycle to cycle. No matter what insulin you use, a cat's low point can and does change - sometimes over a long period of time and sometimes suddenly. It can also change because the cat's insulin needs are changing. Only testing what was the low point a month ago could risk missing a very low number and, if the cat is starting to bounce at their previous low point could lead to chronic insulin overdose which is a dangerous cycle for the cat to be in.
 
Oh I must be exhausted. Suggestion 1.5 was for tomorrow AM, and it wasn't set.
I gave 1.5 tonight. Didn't test but he was acting normal for 3 hours after the injection. Then +3 tested 285.
I will stay up until I can know Tux is fine. And hope tomorrow AMPS will have a good number.
Tomorrow morning, I have to leave home after +3 test, and I will come back about time +5.
I am scheduled to serve for Children's Church so I can't skip church... unless I MUST stay home.
 
I see that although Tux dropped quickly from pre-shot to +3, the drop has slowed right down between +3 and +4. I would get another test right before you go to sleep just to make sure, but as long as that drop stays leveled out, he should be OK. He might well be bouncing by morning, so you might see a much higher number at his pre-shot test then - don't panic if that happens. :)

If you can get pre-shot and +3 tests on him tomorrow morning, I'm sure someone will be able to let you know if it's OK to leave him on his own for a couple of hours - he will most likely be fine but, of course, there's no way of knowing for certain until you get those tests.
 
manxcat419 said:
I see that although Tux dropped quickly from pre-shot to +3, the drop has slowed right down between +3 and +4. I would get another test right before you go to sleep just to make sure, but as long as that drop stays leveled out, he should be OK. He might well be bouncing by morning, so you might see a much higher number at his pre-shot test then - don't panic if that happens. :)

If you can get pre-shot and +3 tests on him tomorrow morning, I'm sure someone will be able to let you know if it's OK to leave him on his own for a couple of hours - he will most likely be fine but, of course, there's no way of knowing for certain until you get those tests.
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Oh thank you..... It's good to know... I will not be panic in the AM. :)
I planned to do +5 but Tux no longer wanted to wait to eat, and I am exhausted. So I fed him (he just finished eating) and we are going to bed.
 
I'm excited to see yellow numbers! Good decision to shoot 1.5, but I see you were worried. Don't worry, he still far from a hypo. But normally I would advise to increase the dose in the morning, when you are there to monitor and don't have to stay up late in case he drops unexpectedly low.

We seldom see bounces with caninsulin, actually. We do see Somoyi's, but only very rarely when the level was not yet in hypo levels.
We do see, with both available insulins, that the morning pre shot levels tend to be higher than the evening pre shot levels (also if no significant drop occurred the day before). If the cat has the same rhythm as the person (more active during the day, asleep during the night) it's because when waking we need our body to start functioning fully again, that requires fuel (=glucose), so the body produces some extra glucose to get started: start up hormones are responsible for that. In diabetics it results in a higher morning level. We never base the dose of caninsulin on a preshot level, only (of course) when it's very low, but there are usually signs beforehand that there will be a drop (a +4 that's dropping over the days). But very high unexpectedly? Just shoot the normal dose and look at the low point for more info.
Low points do tend to move, mostly when the food is changed. And Tux is just starting on his new food, and we are still trying to find the perfect dose (for this moment in time) for him, so things will change. It can take weeks to settle. But for now, we need some guideline of a possible low point to get him into acceptable levels and to make safe decisions on the dose.

Kako, if you could manage today during the day time to test pre shot, +3 and +5, +6 and so on until there is a rise in the level without food (that food part is important, and I do feel sorry for Tux if he has his low point at +6 ......), it would be very helpful. Just skip the +4 today, we know from yesterday evening that there was still a slight drop. If the +5 is higher than +3, you can give him his food. A good thing about you being away this afternoon is, that you won't have to see his food-begging eyes at +4 .....
I hope Tux is cooperative for the tests.

I'm still searching for a good amount of food per day. We use a rule of thumb: 100 grams of wet food equals 25 grams of dry food (in nutritional stuff that's in it). 1 can of 156 grams per day would equal 38 grams of dry food a day, and that is very little .... 2 cans may be too much ...
Since you will be gone in the afternoon, I would ask you today to give him 100 grams of wet food before the shot, just to make sure he has enough food in his body. If at +3 he is in the red, pink or yellow, it's safe to leave for your appointment. If he is in the blue I would stay at home to monitor or give him his food and do the mini curve another day. If he's in the dark green or light green, he must have his food immediately, don't wait till the next hour, and you really need to stay at home to monitor. Light green also requires dextro or honey, but I doubt very much that he will go that low and by that time (+3) I will be online again.

If at pre shot, he is black or red, you can safely shoot 1.5 unit. If he's pink (I can't imagine) I would lower the dose to 1 unit. I will not be online at preshot, Sunday - familyday, so this is just to be sure you don't overdose.
 
Hi Jennie,

Nederland said:
We seldom see bounces with caninsulin, actually.
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Given the cup-shaped nature of a typical Caninsulin curve, I'd be very interested to learn how you on the Dutch forum have been able to distinguish bounces from dose poop-out.

While I'm here, I'd like to say how much I value and appreciate the way that you are explaining the way that you and the other people on the Netherlands forum work both Caninsulin and feeding schedules. I am learning a great deal from you. When I was treating Saoirse with Caninsulin in the early days after her diagnosis I found myself trying to figure things out on my own a lot because the vets I was dealing with at the time were of precious little help. I am hoping to combine my own experience with what I'm learning about Dutch techniques to be (hopefully) better able to help other Caninsulin/Vetsulin users who arrive here in the future.

Doei! (sp?)


Mogs
.
 
Good morning! Tux woke me up climbing on my tummy. It's 534 this morning. It's better than 700 or 6oo!
Exact time is +10.75 but I will write the number at AMPS. And then is it OK to feed him and give insulin even though it will be one hour early?
 
Nederland said:
I'm excited to see yellow numbers! Good decision to shoot 1.5, but I see you were worried. Don't worry, he still far from a hypo. But normally I would advise to increase the dose in the morning, when you are there to monitor and don't have to stay up late in case he drops unexpectedly low.
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Good morning Jennie! It makes sense! In case making a change, morning a day when able to monitor well is better! I will keep in my mind for the future. :)
 
About can food: I am giving him 100g per breakfast and dinner, what he eats is 60-70g. As snack (when NOT testing) I've been giving him one tea or table spoon mixing some warm water to make it soupy, thinking it may help him hydrated (3-4 times a day). After the last PM testing, he eats less than 60g. (forgot to scale. I can assume around 30g). All together, he eats about 1.25 cans of Friskies (5.5oz can) a day.
I gave him 1.5 unit injection this morning at close enough to regular time.
 
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I'm back from my family time. Well done!
His numbers are dropping, also the pre shot numbers. He's doing really well. Him being rehydrated helps, his wet food helps, and the insulin is doing its job again after the stress caused by the former dose of 3 units.
We have to monitor what the effect of the food change and the 1.5 unit will ultimately be. The body can take up to two weeks to settle around the new situation.

If 1.25 can is what he eats per day, than that should be okay. So he's eating appr. 200 grams a day, or almost 200 grams. That should mean that his pre shot meal should be 70 grams, and his in-between-shots-meal 30 grams.

I hope today we will have an indication where his low point is approximately (at this moment). We will see at +3 and +5 (if Tux is willing to be tested). The low point can move as the body settles on the new food, so we must be careful with the dose and his levels. Better a bit too careful.

I will suggest some other test moments later, because there is more that I want to know, but first we need the low point. I'll check in later. My cat needs lap-time at the moment.
 
+3 tested 391.
He refused to come to me, so I fished him with a teaspoon of wet feed (some water mixed). After the test, I gave him the food as I promised him.
I know..... without food is better..
Off to go. Will be back in a few hours.
 
That's a pity, because the +5 will not be informative for me after he had his meal now ... And his levels will start to rise again too early. Only the teaspoon would not have mattered, though ...
 
Nederland said:
We seldom see bounces with caninsulin, actually. We do see Somoyi's, but only very rarely when the level was not yet in hypo levels.
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How are you telling the difference? Both are, technically, rebound hyperglycemia (or liver panic in the case that the level that caused it wasn't actually too low, just low for what the cat is used to). With the possibility of missing the actual low point when only testing at a set time each day, there really is no way of telling for sure if a cat did go low at some point or not.

Nederland said:
I'm still searching for a good amount of food per day. We use a rule of thumb: 100 grams of wet food equals 25 grams of dry food (in nutritional stuff that's in it). 1 can of 156 grams per day would equal 38 grams of dry food a day, and that is very little .... 2 cans may be too much ...
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Does it not make more sense to consider a cat's calorie requirement rather than an actual volume of food? Just as with human food, calorie content varies greatly (think about the difference in calories between 50 g of chocolate and 50 g of salad). This page gives a reasonable starting point http://www.allfelinehospital.com/getting-your-cat-to-lose-weight.pml although amounts do, of course, need to be adjusted on an ongoing basis for any individual cat.

Critter Mom said:
Given the cup-shaped nature of a typical Caninsulin curve, I'd be very interested to learn how you on the Dutch forum have been able to distinguish bounces from dose poop-out.
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I'm interested in this too. Even the manufacturer of Caninsulin shows the typical curve as being one where the cat is fairly high by the time pre-shot comes around as the dose has stopped working.
 
Nederland said:
That's a pity, because the +5 will not be informative for me after he had his meal now ... And his levels will start to rise again too early. Only the teaspoon would not have mattered, though ...
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I mean by I gave him *one teaspoon* of wet food *after* the +3. Not a whole meal.
I know by now.
I can't do +5. It's so nice outside, he is out somewhere in our property. I will just test when he is back.
 
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Kako said:
I mean by I gave him *one teaspoon* of wet food after the +3. Not a big meal.
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Nederland said:
I thought that this meant that you had given him all the food ..... sorry, I misunderstood. That's what you get when two people are not native speakers of english;)
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Sometimes it's hard when we communicate in details. :)
He used to come to me when I call him but now he runs away when he sees me. :( So I have to show food for him to come to me. Then after the test, I need to give it as promised.
Wish I don't have to do that. :(
 
manxcat419 said:
How are you telling the difference?
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Maybe we don't see them because we seldom test pre shot levels with caninsulin cats? If the level of the low point remains stable, we continue the dose. If the level of the low point goes up, we don't adjust the dose immediately, because tomorrow or the day after tomorrow the level can be normal again. Could be that there was a bounce in that case, which we didn't notice. But then again, if we would see it, we would just continue the dose just as in the case that we hadn't seen it. Remember that caninsulin causes a significant drop every day, the body is used to going form high to low and back again.

We are trying to figure out now on the dutch forum what the difference is between Somogyi and a bounce, we are still in doubt, but we think we have found a possible difference. I posted in the Thinktank a little piece of text on Somogyi. Maybe check there and continue the conversation there, to prevent this topic from being more about theory than about Tux?

manxcat419 said:
Does it not make more sense to consider a cat's calorie requirement rather than an actual volume of food
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Yes it does. Calories and nutritional values. But I'm completely unfamiliar with the cat food in the US and it is very important for a cat to have had enough to eat before shooting caninsulin. So I kept on about this.

Critter Mom said:
dose poop-out
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What's that?

Critter Mom said:
While I'm here, I'd like to say how much I value and appreciate the way that you are explaining the way that you and the other people on the Netherlands forum work both Caninsulin and feeding schedules. I am learning a great deal from you. When I was treating Saoirse with Caninsulin in the early days after her diagnosis I found myself trying to figure things out on my own a lot because the vets I was dealing with at the time were of precious little help. I am hoping to combine my own experience with what I'm learning about Dutch techniques to be (hopefully) better able to help other Caninsulin/Vetsulin users who arrive here in the future.

Doei! (sp?)
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(yes, Doei is the right word, though it is a bit slang)
Thank you, that's why I do it. I saw in the caninsulin/vetsulin area in some topics questions that I would have answered differently and on a serious subject as possible hypo's. I was concerned, so I opened a topic in the caninsulin area, which was moved to the Thinktank. In that topic I address several important things about caninsulin. You don't have to agree with me on what I write, of course, but then again, I learned from our caninsulin expert, who must have seen at least 800 caninsulin cats. And we never lost one on a hypo, using our protocol (if the members listened to advice, some are very stubborn....).
 
Jennie, thank you for the explanations. I think we're all just trying to understand exactly how your protocol works - there are some significant differences compared to how we tend to do things here and I do appreciate I'm asking some difficult questions. But it's all in the aim of a better understanding for all of us so that we can all help everyone's cats better. :) I will, definitely, look at the Think Tank post. :)
 
Kako said:
289!!!!! It's interesting!
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Good boy!
It's indeed interesting, it seems either one of two things: his low point is very late OR he has a really nice second peak. In the last case, he must have been lower before and is very slowly rising again.

I'm so sorry that he runs from you .... You absolutely must reward him after every test with a low carb treat. You wrote in the beginning that you fed him cooked meat. Just give him one little piece of cooked meat after every test, it has no carbs. He will get used to it and I hope he will come again when you call.
 
manxcat419 said:
there are some significant differences compared to how we tend to do things here
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We learn from your Prozinc approach and you can just choose what you want to learn from our caninsulin approach.
We also do things very differently with lantus, there is no comparing the two insulins. Prozinc, as far as we can see now, will also be completely different from Caninsulin, it will be closer to TR with lantus (although not the same).
 
Kako said:
Got done +5.75 (I wrote the number at +6).
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Kako, maybe if you could test again soon, and see if he rises, he could have his little meal? I feel so sorry for him, he must be hungry ...

But he's doing great, really, I'm very happy he is showing such good numbers.
 
Nederland said:
Good boy!
It's indeed interesting, it seems either one of two things: his low point is very late OR he has a really nice second peak. In the last case, he must have been lower before and is very slowly rising again.

I'm so sorry that he runs from you .... You absolutely must reward him after every test with a low carb treat. You wrote in the beginning that you fed him cooked meat. Just give him one little piece of cooked meat after every test, it has no carbs. He will get used to it and I hope he will come again when you call.
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Oh OK, a small piece of cooked meat. I will use them as after test treat. I wasn't feeding any meat (human food) since Dr. said NO.
 
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