? Would appreciate some convo about Jester's dosage and BG numbers

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shelaghc

shelaghc

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I know folks on the forum like to see a lot of mid-cycle numbers. But I'm not always able to manage those for various reasons.

That said, I'm trying out fine-tuning Jester's insulin dosage to .75U and would appreciate some feedback considering the information from the past month or so. Planning a mid-cycle test today to see what that dose does for him.

As points of information for the conversation:
I'm currently using generic BG strips w/ my OneTouch human meter. These strips seem to register a bit lower than the OEM strips (i.e. on 12-19 when using both kinds of strips for PMPS and late night mid-cycle testing, for PMPS OEM gave me 183 and Generic gave me 170; for mid-cycle OEM was 236 and Generic BG was 208).
Also, we started using a new vial of insulin on 12-20.
Obviously a fair amount of change in just a couple of days.

I did an almost curve on 12-18 (can't remember the motivation, but it was spontaneous) and a true curve on 12-29.
The first was before all the changes, the second was after.

On 12-8, Jester went a bit low (using OEM strips) - down to 53 BG - after giving him a 1U on a BG of 141.
I did a few tests during the low BG day until his BG went to a more comfortable number - not thinking about the differences between the human meter and the pet meter.
Per the vet, no insulin for a couple of days and he didn't go back above 150, using only AMPS testing, until 12-11.

Food-wise, Jester is very fussy about eating. Pre-diagnosis and, in fact, pre-everything, he was an okay eater, but preferred grazing. (One of my civvies can eat himself into a coma - JK - so I wasn't able to allow Jester free-feeding after getting the second kitty.)
But once Jester started down the sugar-kitty road, before I was able to afford the testing for his dx, he, of course, became ravenous and could eat as much as two and a half cans a day.
Now, at times I have to encourage him a *lot* to get even half a can into him at a time.
His current foods are low-carb Friskies pate and medium carb Friskies shreds.
He prefers the shreds; it's much harder to get him to eat a reasonable amount of the pate. Trust me - I rarely sit down to eat breakfast anymore, as I can spend as much as an hour convincing him to eat even a quarter can of the lower carb food and nearly always have to resort to the shreds after a lot of pate-coaxing.
Frankly, if I'm in a hurry, I don't even bother with the pate and even then, it can take half an hour to get half a can of shreds into him.

I've tried Fancy Feast and that's a crap shoot for whether he'll eat any at all.
And, no, Fortiflora doesn't entice him.

Weight-wise, he was 12.5 pre-diagnosis. By the time I could afford to get him diagnosed, he had lost about two pounds and the last time he was weighed at the vet's office he was down to about nine pounds. I've been on a mission to bulk him up (I can feel his hip bones and spine through his skin). If I could get him to eat higher calorie Rescue, I'd find a way to buy a case. But he's absolutely not interested.

My apologies for the lengthy pre-discussion post.
This is a lot of information, but it can save time in the convo if I have it all laid out there.

So, if you're still reading - thoughts?
Recommendations?
Suggestions?
 
shelaghc said:
I know folks on the forum like to see a lot of mid-cycle numbers.
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That is because, without them, you cannot know what the insulin dose is doing. That makes it hard to know if the dose is correct or should change. Even regularly getting just one mid-cycle test somewhere from +4 to +6 any/every time you possibly can would be helpful.

Your curve on 12/29 looked fine to me, indicating that the 1u dose was fine. You dropped it to .50 the next day with no mid-cycle tests to tell you if that was a good choice or not Then, you raised it to .75 the next day. I find consistent dosing to be important in making progress, and I have seen similar guidance given by others here. If you want to go with .75, I would suggest sticking with that for enough cycles to give it a chance. It takes a few cycles for them to adjust to a dose change. I believe the recommendation on this site is to stay with a dose at least 3 cycles.

Regarding foods, have you tried any kinds other than the Fancy Feast and Friskies? It took me several.. and I mean SEVERAL.. foods before I found any that my girls would eat enough of. I also make homemade chicken breast and bone broth for them which entice them to eat more than they would otherwise.
 
FurBabiesMama said:
If you want to go with .75, I would suggest sticking with that for enough cycles to give it a chance. It takes a few cycles for them to adjust to a dose change. I believe the recommendation on this site is to stay with a dose at least 3 cycles.
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That's my plan for the .75U. I'm hoping that kind of dose will even things out more.
I didn't realize that lowering to .5 for just one cycle was a bad thing. TBH, I thought the idea was to adjust the insulin each time for whatever the BG was. That's why I lowered it to .5 for that dose and raised it on the next.

FurBabiesMama said:
Regarding foods, have you tried any kinds other than the Fancy Feast and Friskies? It took me several.. and I mean SEVERAL.. foods before I found any that my girls would eat enough of. I also make homemade chicken breast and bone broth for them which entice them to eat more than they would otherwise.
Click to expand...

Jester's always like Friskies on the whole. The problems have come up since his diagnosis. Unfortunately, the one kind that's always been reliable - his go-to, always eat, food - is in the 20s on carbs.
And financially, I'm just not able to experiment with various brands, tastes, and textures.
Additionally, I'm concerned that experimenting could turn out badly.
The last time I did so, Jester stopped eating almost completely. For a week and a half, it was next to impossible to get him to eat more than 1/4 can in a day.
I was syringe feeding him out of desperation and the vet was almost no help whatsoever, except to put me into a panic by suggesting Jester might have cancer.
When he finally did start eating, he would only eat the worst of the worst - dry food. What makes that the worst is that he had a blockage when he was young and any dry food is supposed to be prescription only. I had none of that on hand - only standard dry food. When the vet's office gave me some samples of the prescription stuff, he wouldn't eat that at all anymore.

Frankly until his weight goes up to at least 11.5 or more, I won't experiment with alternative foods for him.
 
If you leave out the pate or shreds, does the other kitty eat it? It could be that Jester still prefers grazing and would eat better in frequent small meals - a tablespoon or so at a time. Would a timed feeder be an option? Or separate room for part of the day to allow more time to eat?

Cats are notoriously fussy when it comes to what and how they will eat. We are happy to continue to give suggestions if you are interested, but know that it takes time, determination, and persistence to shift a cat's eating patterns, and they are often inconvenient. I too miss the days when I could just put out a big bowl of kibble and know that they would eat. Unfortunately that's not an option for my kitties anymore. Believe me, I would give just about anything to have one food and no fussing!

FurBabiesMama has given you some good advice about dosing and the reasons for the mid-cycle tests. You don't have to do full curves all the time - just a test here and there in the middle is really helpful. I typically just do one in the middle of each cycle, and try to vary a bit when exactly I do it so I can build a complete picture of my cat's patterns. If you work all day, then weekend and evening tests can help. The curves you have look good at 1u. I don't know that you need to lower it, but if you want to, hold it until you can get some mid-cycles to see how it's working. As Furbabies.. said, at least three cycles, but more if you can't get any mid-cycles.
 
Djamila said:
If you leave out the pate or shreds, does the other kitty eat it? It could be that Jester still prefers grazing and would eat better in frequent small meals - a tablespoon or so at a time. Would a timed feeder be an option? Or separate room for part of the day to allow more time to eat?
Click to expand...

Unfortunately, my third kitty is notorious for eating out from under the other two - particularly Jester as he's more docile around her. Also, Jester never sits still to eat pate. I constantly have to move the bowl, add water, heat it up, move the food around in the bowl, etc. As I said, I never sit for breakfast anymore.

Djamila said:
Cats are notoriously fussy when it comes to what and how they will eat. We are happy to continue to give suggestions if you are interested, but know that it takes time, determination, and persistence to shift a cat's eating patterns, and they are often inconvenient. I too miss the days when I could just put out a big bowl of kibble and know that they would eat. Unfortunately that's not an option for my kitties anymore. Believe me, I would give just about anything to have one food and no fussing!
Click to expand...

Unfortunately, with three furkids, and all three of them with their own agendas, I'm at my wits' end about making sure Jester eats his stuff without problems. This evening I fended Sage off three times when Jester was actually sitting in one place eating (not without me having to fuss over the food for him multiple times though). I'm not sure there's much that can be suggested. I'm open to techniques, but changing his actual diet isn't practical right now.

Djamila said:
FurBabiesMama has given you some good advice about dosing and the reasons for the mid-cycle tests. You don't have to do full curves all the time - just a test here and there in the middle is really helpful. I typically just do one in the middle of each cycle, and try to vary a bit when exactly I do it so I can build a complete picture of my cat's patterns. If you work all day, then weekend and evening tests can help. The curves you have look good at 1u. I don't know that you need to lower it, but if you want to, hold it until you can get some mid-cycles to see how it's working. As Furbabies.. said, at least three cycles, but more if you can't get any mid-cycles.
Click to expand...

I honestly can't afford the equipment needed for mid-cycle tests every single day. I thought that was what the curve was for - to get the picture. I can do mid-cycle sometimes, but not constantly. I'm unemployed and don't have any kind of steady income (right now I'm working on savings) and I'm doing this all alone.

I wish I could afford all the things he needs without any thought about cost. But I just can't.
 
And oddly enough, Jester's PMPS is exactly the same as yesterday - 266.
I'm curious how it'll go over a week's time.
 
shelaghc said:
Unfortunately, my third kitty is notorious for eating out from under the other two - particularly Jester as he's more docile around her. Also, Jester never sits still to eat pate. I constantly have to move the bowl, add water, heat it up, move the food around in the bowl, etc. As I said, I never sit for breakfast anymore.



Unfortunately, with three furkids, and all three of them with their own agendas, I'm at my wits' end about making sure Jester eats his stuff without problems. This evening I fended Sage off three times when Jester was actually sitting in one place eating (not without me having to fuss over the food for him multiple times though). I'm not sure there's much that can be suggested. I'm open to techniques, but changing his actual diet isn't practical right now.



I honestly can't afford the equipment needed for mid-cycle tests every single day. I thought that was what the curve was for - to get the picture. I can do mid-cycle sometimes, but not constantly. I'm unemployed and don't have any kind of steady income (right now I'm working on savings) and I'm doing this all alone.

I wish I could afford all the things he needs without any thought about cost. But I just can't.
Click to expand...
Try adding Bonito flakes or FortiFlora to the food to entice him to eat
 
JanetNJ said:
Try adding Bonito flakes or FortiFlora to the food to entice him to eat
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As I stated in my original post:
shelaghc said:
And, no, Fortiflora doesn't entice him.
Click to expand...

I have no idea what Bonito flakes are, but I can't afford to buy another thing to experiment with. It's challenging enough to have to buy canned cat food for three cats - on average about $100 a month.
As I said:
shelaghc said:
And financially, I'm just not able to experiment with various brands, tastes, and textures.
Click to expand...
 
shelaghc said:
As I stated in my original post:


I have no idea what Bonito flakes are, but I can't afford to buy another thing to experiment with. It's challenging enough to have to buy canned cat food for three cats - on average about $100 a month.
As I said:
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These are Bonito flakes. It's a large bag and lasts me a few months.
Kaneso Tokuyou Hanakatsuo , Dried Bonito Flakes 3.52 Oz https://www.amazon.com/dp/B0052BGLMS/ref=cm_sw_r_cp_api_DmLsAbD6DTP7K

I feed canned food to 13 cats. Believe me I understand cost.
 
shelaghc said:
Okay, I'm interested now.

Do you know if those are available in supermarkets? Since this is a human food, I could use my food stamps for them instead of using a gift card and paying for shipping on Amazon.
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Possibly in the Asian section. If there's an ethnic/world market they would surely have it.
 
shelaghc said:
Okay, I'm interested now.

Do you know if those are available in supermarkets? Since this is a human food, I could use my food stamps for them instead of using a gift card and paying for shipping on Amazon.
Click to expand...
If you can't find it at the store, pm me your address and I'll have amazon mail a bag to you.
 
That's very kind of you @JanetNJ . But I don't want to take advantage. Many of the members here have been extremely generous to my Jester already.

btw, I'm already starting to think the .75U is a mistake. But how long should I continue to give it a fair go?

One of the reasons I thought I should reduce his dosage was a previous time when he did go low. Someone else suggested that a full unit might be too much, but half a unit might not be enough.
 
It looks like you gave it 3 cycles...I think you could up it to 1 unit when you can monitor. A lot of folks like to increase during the day so they can keep an eye on things, and that would be fine if you want to do it tomorrow.
 
Ok I see now we're you were close to too low. It was a lower preshot. If it's under 160 id reduce to 0.5-0.75 but otherwise give 1.
 
I went through one last cycle and his PMPS was nearly 300. But I can't stay up late one more night for a pre-bed testing. So I gave him .75U again and I'll start him up on 1U tomorrow.

My hope is that I can teach my cat sitter how to give Jester his insulin so I can go away for a few days. I don't expect him to learn how to do a BG check. That's a lot more involved.

But if he's basically good for the same dose day after day, then I can anticipate going on a trip once in a blue moon.
 
@JanetNJ and @FurBabiesMama - this is why 1U sometimes worries me.

Jester's AMPS this morning, after two days of .75U, was 382. I gave him a full 1U this morning and he nose-dived (nose-dove?) down to BG of 113 at +5 hours.
 
Rachel said:
That’s a really good number for mid cycle! It might cause a bit of bouncing but that should level out.
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I just get worried that he's going to go *too* low. It seems a little drastic when he drops down that far and that fast.
 
I'm happy with the number.
Is that kind of a drop not something to be concerned about?

His BG went down by over three times his AMPS.
 
As Rachel said, it might cause a little bouncing, but that's just part of the process, nothing to worry about. Looks like that 1u worked well today.
 
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