Dosage time dilemma

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shelaghc

shelaghc

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I posted this on the main board with a lot more explanation about eating times. Unfortunately, the only response I received was regarding food rather than dosage times.

So here's the bare bones:

Because of my upcoming job, I'm shifting Jester's morning insulin dosage to about 7:00AM, but I won't get home until around 5:00pm and he's going to want to be very hungry by then.

Do I do his PMPS right away, feed him, then wait until about 7:00pm to give him his evening insulin dosage?

I should also mention there are irregular monthly evenings I go out and will need to leave before 6:30 (and one obligation in which I'll have to be gone from home before 6:00pm).

I'm thinking that there's not a big difference between a 7:00am and 6:00pm schedule.

Would it be a big deal if I regularly gave him his evening injection at 6:00PM even though his morning dosage likely will be at 7:00AM?
 
Hmmm...it's not a huge deal, as with Prozinc your shot time can be off by an hour. However, it's super important to be sure that the number you shoot on is a rising number when you're shooting early. Is there any possibility of doing Jester's morning shot at 6 or 6:30? If not, I totally understand...just thought I'd ask that first.

You're starting the job Monday, right? I know that you indicated you wanted to get a curve beforehand, which would be great. What I'd suggest also over the next few days if possible is try to get a +11 and a preshot during the days. That might help give you a better indication of what he's likely to do in that last hour of the cycle which will definitely help us to help you make a decision.
 
Do you leave food out while you’re gone? You could get a timed feeder & set it at 4:30 to make sure its out of his system when you get home. Or freeze & put out when you leave for work so he won’t be as ravenous? If it’s low carb food then it’s not going to make a huge difference if it’s a shorter pd of time to test. I don’t know if any of this helps but just suggestions. I have tested & given Baby her insulin at 11 1/2 due to engagements. She goes high in the last hour... it hasn’t hurt her in any way. Good luck on the job!
Never mind as I just saw you can’t free feed due to other cats.. sorry. Separate?
 
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Yes, as Rachel has mentioned, it's safe to shoot on an 11/13 schedule, but the problem comes in that the PMPS, being an hour early, may show you numbers that feel too low to shoot. So collecting a few days of data to see what he does from +11 to +12 will help us make better decisions without making you stall for that last hour anyway. Many cats rise as much as 100 points in that last hour, others stay flat or rise very slowly.

I also wonder if you could shoot earlier in the morning so that maybe he's on a 5:30/5:30 schedule. I do that with Sam - I wake up earlier than I would need to, hop out of bed, and t/f/s very first thing. Then I either go back to bed or just start my day early. It was hard at first to make myself get up earlier than necessary (and even harder to make myself go to bed earlier at night), but I had the same problem that the second I got home in the evening he was demanding dinner and it was too hard to try to make him wait two hours. Plus, turns out I'm pretty productive in the mornings!
 
Djamila said:
I also wonder if you could shoot earlier in the morning so that maybe he's on a 5:30/5:30 schedule. I do that with Sam - I wake up earlier than I would need to, hop out of bed, and t/f/s very first thing. Then I either go back to bed or just start my day early. It was hard at first to make myself get up earlier than necessary (and even harder to make myself go to bed earlier at night), but I had the same problem that the second I got home in the evening he was demanding dinner and it was too hard to try to make him wait two hours. Plus, turns out I'm pretty productive in the mornings!
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Aaaaaaaauuuuuuggggghhhhh!

Nooooooooooooooooooo!!!!!!!!!!!!!

I'm a late night person. Getting up at 6:30 is going to be painful enough. I sometimes don't get to bed until 2:00am.
 
Djamila said:
Yes, as Rachel has mentioned, it's safe to shoot on an 11/13 schedule, but the problem comes in that the PMPS, being an hour early, may show you numbers that feel too low to shoot. So collecting a few days of data to see what he does from +11 to +12 will help us make better decisions without making you stall for that last hour anyway. Many cats rise as much as 100 points in that last hour, others stay flat or rise very slowly.
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This isn't going to be possible now. I don't have a few days left before Monday.
 
shelaghc said:
Aaaaaaaauuuuuuggggghhhhh!

Nooooooooooooooooooo!!!!!!!!!!!!!

I'm a late night person. Getting up at 6:30 is going to be painful enough. I sometimes don't get to bed until 2:00am.
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What are your work hours at your new job? You might have to bite the bullet anyway so you can rejig your test/feed/shoot schedule because of that.
 
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Becky & Baby Girl Kitty said:
Ok sorry I don’t keep up!! Why not feed him & then get your pm 2 hrs later? Test at 7 am & feed- test at 7pm? If he needs fed at 4am - feed him & test 2 hrs later... isn’t anything possible.... how bad is all that? lol js
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No worries - it wasn't a criticism.
Also separating them probably won't do any good. Jester can't stand being confined and all he'll do is dig at the carpet under the door.
 
shelaghc said:
Aaaaaaaauuuuuuggggghhhhh!

Nooooooooooooooooooo!!!!!!!!!!!!!

I'm a late night person. Getting up at 6:30 is going to be painful enough. I sometimes don't get to bed until 2:00am.
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LOL....I know it's painful - but you can always just go back to bed for an hour. :D Or this: :coffee::coffee::coffee:

You have Friday, Saturday, Sunday right? That should give us enough of an idea.
 
Djamila said:
LOL....I know it's painful - but you can always just go back to bed for an hour. :D Or this: :coffee::coffee::coffee:
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The kids would never let me go back to sleep. :-(

Djamila said:
You have Friday, Saturday, Sunday right? That should give us enough of an idea.
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How can I do today's +11? It's a little late now.

Also, I was planning to do a curve this weekend. Will that help?

Btw, Jester decided to give me a hard time about eating this morning. Yesterday he ate like a champ - over a full can in less than an hour. Today he's eaten less than a third of a can.

Monday is going to be a challenge , I think.....
 
Too late for this morning, but you could get a +11 and a PMPS this evening, couldn't you? That's the cycle we need to see anyway, since that's the one when you'd be possibly shooting an hour early.
 
Jester's going to be very cross with me today.
He finally ate his shreds at 10:00am and stopped around 11:00ish. Total food between the pate and shreds was a little more than one can.

So I'm not going to feed him again until around 5:00ish today. I'll take his +5 before I leave for the mechanic (oil change day). Then again when I get home.

One question that I must have left out:
On Monday we'll be on the new sked and Jester will likely be very hungry when I get home. I don't have to be anyplace Monday evening and want to give him his insulin at the appropriate 12 hour time.

I don't want to make him wait until 7:00pm to feed him at that point. I know PS are supposed to be fasting.
If I want to get a valid PMPS before a 7:00pm I need to wait another two hours to feed him. But I hate to make him wait any longer.

Can I take his PMPS when I get home around 5:00pm before he eats anything, feed him right after, then give him his insulin at 7:00pm without testing again?

Am I over-complicating this?
 
shelaghc said:
Jester's going to be very cross with me today.
He finally ate his shreds at 10:00am and stopped around 11:00ish. Total food between the pate and shreds was a little more than one can.

So I'm not going to feed him again until around 5:00ish today. I'll take his +5 before I leave for the mechanic (oil change day). Then again when I get home.

One question that I must have left out:
On Monday we'll be on the new sked and Jester will likely be very hungry when I get home. I don't have to be anyplace Monday evening and want to give him his insulin at the appropriate 12 hour time.

I don't want to make him wait until 7:00pm to feed him at that point. I know PS are supposed to be fasting.
If I want to get a valid PMPS before a 7:00pm I need to wait another two hours to feed him. But I hate to make him wait any longer.

Can I take his PMPS when I get home around 5:00pm before he eats anything, feed him right after, then give him his insulin at 7:00pm without testing again?

Am I over-complicating this?
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How about feeding a small meal at 5 PM then get that last minute PS test right at 7 PM, feed another small meal and give his shot?
 
Kris & Teasel said:
How about feeding a small meal at 5 PM then get that last minute PS test right at 7 PM, feed another small meal and give his shot?
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How much would a "small meal" be? I could try pate which he generally doesn't eat as much of. But if he's very hungry that rule might not apply.

(As I type this, he's sitting in front of me begging to be fed. Mind you, he ate the equivalent of a can already today.)
 
Sounds like the equivalent of 1/6 to 1/3 of a can which is about what I can get him to eat of the pate even when he's hungry. Cool - thanks!

I'm also thinking of skipping his usual pate in the morning and just going straight for shreds since he's more likely to eat more of that in one sitting.

Once upon a time Jester was an uncomplicated eater....

I do wonder if injected insulin does something to kitty taste buds to make them such complicated eaters.
 
shelaghc said:
Sounds like the equivalent of 1/6 to 1/3 of a can which is about what I can get him to eat of the pate even when he's hungry. Cool - thanks!

I'm also thinking of skipping his usual pate in the morning and just going straight for shreds since he's more likely to eat more of that in one sitting.

Once upon a time Jester was an uncomplicated eater....

I do wonder if injected insulin does something to kitty taste buds to make them such complicated eaters.
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I think it depends on the kitty. I'm extremely lucky to have three non picky good eaters.
 
Kris & Teasel said:
I think it depends on the kitty. I'm extremely lucky to have three non picky good eaters.
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Definitely jealous right now. Sage is my only completely non-picky eater. Bastian isn't too bad, but when he decides the food needs to be finessed, he starts pawing the floor around his dish as if to cover it up. And if there's anything on the floor close by it winds up in the dish....
 
shelaghc said:
Aaaaaaaauuuuuuggggghhhhh!

Nooooooooooooooooooo!!!!!!!!!!!!!

I'm a late night person. Getting up at 6:30 is going to be painful enough. I sometimes don't get to bed until 2:00am.
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Have you always been a late night person? If not, my guess is once you get in a new routine with this new job your body will be tired and ready for sleep at a more decent hour; however, that doesn't mean waking up early will be easy-peasy. Nobody likes hearing their alarm buzz, or to be waked out of a deep sleep.

Might consider adding OTC Melatonin to your nightly routine. You can read about it online. Our body naturally produces it, but adding a little more just before going to bed might help regulate your circadian rhythm.
 
Teenuh said:
Have you always been a late night person? If not, my guess is once you get in a new routine with this new job your body will be tired and ready for sleep at a more decent hour; however, that doesn't mean waking up early will be easy-peasy. Nobody likes hearing their alarm buzz, or to be waked out of a deep sleep.

Might consider adding OTC Melatonin to your nightly routine. You can read about it online. Our body naturally produces it, but adding a little more just before going to bed might help regulate your circadian rhythm.
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I'm theatre people. I've always been a night owl and can't stand waking up before 8:00am.

And I don't do chemicals if at all possible.

Not an option.
 
Okay - fasting for almost three hours, Jester's +6 was 133.
He was looking very hurt as I walked out the door without feeding him.
 
You may find that since you won't be there to cater to them, their pickiness will relax a bit. Our kitties tend to be as fussy as we let them be. Which means if we aren't home, they all manage just fine without us. Not right away, but as the new routine is established.

Also, I don't know what you fed Jester pre-diagnosis, but a lot of cats seem like easy eaters when they are being fed kibble or high-carb wet foods because it's full of crap covered in flavor enhancers. Kind of like we would be if we could eat junk food all day vs. having to eat vegan all day. It's much easier to eat sugar/salt/fat, than it is to eat veggies, fruits, and whole grains. We also eat a lot less of healthy foods than we do of junk foods. So just like us, when we switch our cats to healthier foods, they eat less and they eat slower. Really their bodies are regulating into healthier habits and ranges, but the contrast can feel scary and strange.

I agree with Kris about how to manage the test/feed/shoot time. If you test and feed at 5 and shoot at 7, your data is going to be pretty much useless because the BG would continue to rise from 5-7 and you won't really know where he's at when the insulin kicks in. It would be better to feed a small low carb snack at 5, and then do test/feed/shoot at 7. I still think the earlier schedule will work better though because of the evenings when you need to leave before 7. As always, up to you to decide what you think is best for you and all your fur babies. And it's not like you have to make a final decision by Monday. It can always evolve and change as you settle into your new routine and decide what works best for you all.
 
@Djamila Thanks for your excellent words. They help me to be less nervous about the upcoming changes.

@Kris & Teasel Thanks again for the ideas about getting through the food issues.

And thank you to everyone else weighing in. I appreciate you all taking the time to share your thoughts.


And now Jester's +8.5, after no food since 11:00am:

131

He's devouring a can of shreds as if he hasn't eaten in a week. But that's okay. His next dosage isn't until 7:30 so we have plenty of time for the two hour fast prior. I was mostly interested in what his BG was like if he went a longer period of time between meals.

UPDATE: still eating and almost done with the can!
UPDATE #2: finished the can - wow... he never does that. He usually eats about most of the can, then leaves the leftovers for Sage.
Monday is going to be an adventure.
 
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PMPS shot up to 298 after all that carby food. I'm wishing I'd given him pate instead.

Does anyone else think this might indicate most of his BG issues are more food related?

His food for the day was 1/6 can of pate with his insulin. Nearly an entire can of carby shreds (14, according to the big cat food info spreadsheet) between 10:00 and 11:30 (I got that wrong in my previous post), then nothing at all until nearly 5:00PM.

His +6 and +8.5 both were around 130.
Then he ate another full can of carby shreds and he shot up to nearly 300 - his highest BG in days.

Monday is indeed going to be interesting - particularly if I only give him a little low-carb pate to tide him over between the time I get home and the time of his PMPS.
 
Are you trying to fully transition to pate only, or you plan on still giving him carby shreds?

It's not mandatory, but I would start increasing a little more pate into his regular carby food and slowly giving him less shreds.
Forgive me if this was already suggested, as some of these threads get long.

I know it is hard, but try not to overly focus on his numbers. You won't stay sane.

I would just focus on getting those extra needed numbers. It'll help predict the what ifs come Monday.
 
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Teenuh said:
Are you trying to fully transition to pate only?
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I'd much rather he ate that only. But he's pretty resistant.
Jester likes to chew on things and he loves the gravy too much. I'm just grateful he eats shreds rather than Friskies indoor with all that rice.
That's what he loved best when he was diagnosed. Took me months to get him off that.
 
Yes it looks to me like the food is causing some of the higher BG. He would probably have better numbers on lower carb BUT...he’s gotta eat too. :) I am glad to hear he’s eating better though.
 
shelaghc said:
I'd much rather he ate that only. But he's pretty resistant.
Jester likes to chew on things and he loves the gravy too much. I'm just grateful he eats shreds rather than Friskies indoor with all that rice.
That's what he loved best when he was diagnosed. Took me months to get him off that.
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Did you try cold turkey? If so, I'd urge you to try again. It would take time, but you would slowlllllllllyyyyy increase the amount of pate you put in his regular food.

Ultimately, the choice is yours though. I know it can be a hassle.
 
shelaghc said:
I'd much rather he ate that only. But he's pretty resistant.
Jester likes to chew on things and he loves the gravy too much. I'm just grateful he eats shreds rather than Friskies indoor with all that rice.
That's what he loved best when he was diagnosed. Took me months to get him off that.
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I get it. Change is hard. Even for us adults. When I was vegan the hardest part was dairy. It took me a couple weeks to fully get off dairy products, and I was cranky. It was almost like I was going through withdraws. Haha.
 
Teenuh said:
Did you try cold turkey? If so, I'd urge you to try again. It would take time, but you would slowlllllllllyyyyy increase the amount of pate you put in his regular food.

Ultimately, the choice is yours though. I know it can be a hassle.
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Been there. Tried that.
At one point, his BG went down beautifully to what seemed like a remission.

Then he stopped eating - completely out of the blue. One day he was eating Fancy Feast happily, the next day he just up and stopped. Kept coming up to me for food and wouldn't eat anything I put in the bowl.
For about a week and a half I couldn't get Jester to eat more than 1/4 can of anything per day. I was syringe feeding him to keep him from starving. Tried appetite stimulants - the vet even gave him B12, then suggested it could be cancer related He dropped about a pound and I started panicking.

Finally got him to eat some dry food - worst stuff in the world for him. Not just because of the diabetes, but because he'd had a blockage as a kitten and was supposed to be on C/D - but he wouldn't eat that stuff this time.

Took another week or so before he was back to eating more normally again, but it was back to the high carb canned Friskies with rice.

Took about two months to get him off that and onto the shreds - and that was almost by accident when I caught him eating the shreds I put out for Sage.
Now every time I try to ween him off that by mixing something healthier - no matter how little - into his current stuff, he'll snub an entire bowl of food.
When I do give him pate, I only offer him as much as he wants. When he's done with it, he lets me know in his own way. That's when I pull out the shreds.

Trust me. I don't mess with Jester's food. I couldn't take him not eating again. I was having serious emotional meltdowns.
 
FYI: I was not suggesting cold turkey. I reread my post , and I wanted to make sure you understood that I in no way was suggesting cold turkey.

I was merely suggesting if you did then I'd try again, but with a different approach.

Cold turkey usually results in an unhapy feline.
 
Did the vet test for pancreatitis at that time? That's what it sounds like to me. And after a round of pancreatitis they often develop an aversion to the food they were eating when they got sick.
 
No.
Because of my financial situation, the vet was running a tab for me only for the diabetes treatment. Once he declared Jester was in remission, he said I needed to find another vet for any and all other services.

I was pretty much on my own and I still owe him nearly $300.

In any case, he's doing okay now whatever it was that made him almost completely stop eating.
 
So Jester's BG is still being very cooperative. While I didn't do a pre-bed test (I took a long hot bath and basically, nodded off afterwards. *g*), AMPS today was 288 with a fasting +6 at 127 - no food at all between about 10:30AM and 2:15PM.

The numbers are making me more confident that Jester's going to be okay, if a bit hungry, while I'm out all day.

Doing the curve tomorrow while I get all my prep done - cleaning, cooking, chilling - for my first day of work.
 
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