1/5 Jack 336@AMPS- last day of 7.5units-Undecided on increase to 7.75 or 8u

[Jack & Mopem'sMom]

Well, I had some hope yesterday evening after we saw some higher 100's, but alas, overnight Jack spiked to 336. We are definitely increasing insulin tomorrow, just wondering if I should go to 7.75 or 8 units. Previously Jack was responsive to an increase from 7 to 7.25 units but not this last time on the roller coaster. 7.25 units didn't even register, so after 2 cycles we went to 7.5 units and have been there for the last 6 days...today is day 7. But, combined with his stubborn refusal (he is now being referred to as 'that defiant cat you have' by my mother) to eat properly, and the vet's insistence that based on December's bloodwork there are no other underlying conditions, did not do much for his numbers except keep us away from the red. [insert very heavy sigh here] It's almost a year since Jack was first diagnosed, and even though he is better, he is far from where he could or should be. I just don't know what else to do for him. A friend argued that a shorter life lived the way he wants is better quality of life than me trying to impose restrictions he doesn't understand and views as punishment....I don't necessarily agree. Isn't it my responsibility to make sure he lives the best and longest life he can, food fights and all? Ignore me, my heart and head just hurt this morning. I honestly just came on the board to give an update- didn't mean to vent. But, everyone needs an outlet, and unfortunately you guys were it today.

Yesterday's thread:https://www.felinediabetes.com/FDMB/threads/1-4-jack-306-apms-day-6-of-7-5u.272606/

 

[Skye & Jackson]

I’m not an expert here. But I have a family member who has said something similar in past.

Personally, I’ve come to think it’s not an all or nothing scenario. You don’t have to just either fight him about food forever, or make him miserable. A few thoughts I have - again not an expert, just also have an SLGS (mostly) cat with similar numbers issues right now (though lower dosing):

1.) If Jack likes gravy foods, have you tried puréing some pate with some bone broth or even just water? Or just anything to make it more gravy-like in texture? Maybe add a little fortiflora or brewers yeast to the mix to make it more enticing. (My Jackson gets a lysine supplement sprinkled on his food that has brewers yeast as a base, and he seems to like that.)

2.) If kitty is a kibble addict, low carb kibble is better than high carb wet food. Some cats are super carb sensitive, and having almost any at all will send them into BG spikes for days or even longer. That happened to my Jackson about a week ago and we are on our second increase in that time already, trying to break back through the resulting glucose toxicity. I know that eating no dry food at all is the ideal, and some people are very passionate about that. But sometimes kitties don’t give us ideal. If this sounds like your Jack, look up Young Again Zero - my Jackson eats that between wet meals, and he will only eat his wet meals if there are some crunchies in his bowl for him to graze on later, even though he doesn’t actually eat much of them at a time. They just have to be there. Psychological I guess. It’s not cheap, but it’s only 1% carb. Even their non-zero version is only like 5% carbs. As long as your cat is a good drinker, it’s supposed to be kidney safe too (that being a caveat with dry food/moisture intake in general). And I’ve read that some cats are actually more stable through the day when they can graze a bit, particularly when on SLGS or similar (since TR already accounts for mini meals). My Jackson is also one of those, I’ve found via trial and error. Also, grazing can keep away ketones.

3.) If he still needs higher doses of insulin even after he gets on a lower carb diet, maybe he’s just not destined to live without it. (Although his needs should drop without the carbs, to at least some degree.) As much as we all want remission, some cats realistically just won’t. It’s okay to have to give him higher doses if that’s what he needs, and if he can get stable on it. It doesn’t mean you’ve failed him or that you’re a bad mommy, just that that’s his biology (if it comes to that). Shedding the carbs in his diet one way or another I think would give you a chance to get a better idea of that.

I went into all this with the ideals in mind: wet food, TR, quick remission. The bumps, mountains, and valleys since have taught me some patience and humility. I guess my viewpoint over the past few months with my boy has now become: Find compromises when you have to. Despite his stubbornness, Jack is your beloved friend, and trying to reach any ideal or perfection isn’t worth ruining your relationship if you can instead find some way that becomes “good enough”, that still doesn’t risk his health.

 

[Jack & Mopem'sMom]

Hi, and thanks for responding! I put my responses below yours. Thanks again, it's just been a bad week. I really appreciate your advice and input.

I’m not an expert here. But I have a family member who has said something similar in past.

Personally, I’ve come to think it’s not an all or nothing scenario. You don’t have to just either fight him about food forever, or make him miserable. A few thoughts I have - again not an expert, just also have an SLGS (mostly) cat with similar numbers issues right now (though lower dosing):

1.) If Jack likes gravy foods, have you tried puréing some pate with some bone broth or even just water? Or just anything to make it more gravy-like in texture? Maybe add a little fortiflora or brewers yeast to the mix to make it more enticing. (My Jackson gets a lysine supplement sprinkled on his food that has brewers yeast as a base, and he seems to like that.)
Yes, we have tried broth, water, even gravy from cat food like the filets and chunks on the pate. I've lost count on how many brands of pate cat food we have tried. We had a stint where I used a jealousy trick about giving his siblings food and not him for a bit, but that novelty eventually wore off. I will try brewers yeast...that's a new one for me, so thanks for that suggestion.

2.) If kitty is a kibble addict, low carb kibble is better than high carb wet food. Some cats are super carb sensitive, and having almost any at all will send them into BG spikes for days or even longer. That happened to my Jackson about a week ago and we are on our second increase in that time already, trying to break back through the resulting glucose toxicity. I know that eating no dry food at all is the ideal, and some people are very passionate about that. But sometimes kitties don’t give us ideal. If this sounds like your Jack, look up Young Again Zero - my Jackson eats that between wet meals, and he will only eat his wet meals if there are some crunchies in his bowl for him to graze on later, even though he doesn’t actually eat much of them at a time. They just have to be there. Psychological I guess. It’s not cheap, but it’s only 1% carb. Even their non-zero version is only like 5% carbs. As long as your cat is a good drinker, it’s supposed to be kidney safe too (that being a caveat with dry food/moisture intake in general). And I’ve read that some cats are actually more stable through the day when they can graze a bit, particularly when on SLGS or similar (since TR already accounts for mini meals). My Jackson is also one of those, I’ve found via trial and error. Also, grazing can keep away ketones.
He is definitely a kibble addict. Jack's kibble is a 50/50 mix of Dr Elsey's Pure Protein chicken (lowest carbs of all the flavors) and the YA. I did try to get him to do all YA as well as a 75/25 YA/Elsey mix but he gets diarrhea if I give him more than 50%.

3.) If he still needs higher doses of insulin even after he gets on a lower carb diet, maybe he’s just not destined to live without it. (Although his needs should drop without the carbs, to at least some degree.) As much as we all want remission, some cats realistically just won’t. It’s okay to have to give him higher doses if that’s what he needs, and if he can get stable on it. It doesn’t mean you’ve failed him or that you’re a bad mommy, just that that’s his biology (if it comes to that). Shedding the carbs in his diet one way or another I think would give you a chance to get a better idea of that.
My other cat was in remission in 9 months, so I guess I just had high hopes for Jack. He is a MUCH different personality though.

I went into all this with the ideals in mind: wet food, TR, quick remission. The bumps, mountains, and valleys since have taught me some patience and humility. I guess my viewpoint over the past few months with my boy has now become: Find compromises when you have to. Despite his stubbornness, Jack is your beloved friend, and trying to reach any ideal or perfection isn’t worth ruining your relationship if you can instead find some way that becomes “good enough”, that still doesn’t risk his health.

Thanks again for your support and advice!

 

[Diane Tyler's Mom GA]

Well, I had some hope yesterday evening after we saw some higher 100's, but alas, overnight Jack spiked to 336. We are definitely increasing insulin tomorrow, just wondering if I should go to 7.75 or 8 units. Previously Jack was responsive to an increase from 7 to 7.25 units but not this last time on the roller coaster. 7.25 units didn't even register, so after 2 cycles we went to 7.5 units and have been there for the last 6 days...today is day 7. But, combined with his stubborn refusal (he is now being referred to as 'that defiant cat you have' by my mother) to eat properly, and the vet's insistence that based on December's bloodwork there are no other underlying conditions, did not do much for his numbers except keep us away from the red. [insert very heavy sigh here] It's almost a year since Jack was first diagnosed, and even though he is better, he is far from where he could or should be. I just don't know what else to do for him. A friend argued that a shorter life lived the way he wants is better quality of life than me trying to impose restrictions he doesn't understand and views as punishment....I don't necessarily agree. Isn't it my responsibility to make sure he lives the best and longest life he can, food fights and all? Ignore me, my heart and head just hurt this morning. I honestly just came on the board to give an update- didn't mean to vent. But, everyone needs an outlet, and unfortunately you guys were it today.

Yesterday's thread:https://www.felinediabetes.com/FDMB/threads/1-4-jack-306-apms-day-6-of-7-5u.272606/

I can try tagging Wendy for you and see what she thinks
@Wendy&Neko

 

[Skye & Jackson]

He is definitely a kibble addict. Jack's kibble is a 50/50 mix of Dr Elsey's Pure Protein chicken (lowest carbs of all the flavors) and the YA. I did try to get him to do all YA as well as a 75/25 YA/Elsey mix but he gets diarrhea if I give him more than 50%.

Yikes. It does sound like you have tried all the things, and already knew as much or more as/than I about the various kibbles. I guess I just ended up really lucky that Jack’s favorite wet food type was already pate (although he had to be coaxed, argued, and fasted - long before diabetes, don’t worry - into including wet in his diet at all). We went through the food battle a couple years ago when he developed urinary crystals. Thankfully, a problem that became nullified with a diet change. But oh boy do I remember the weeks and months of trying all different higher-protein wet foods, all the styles and flavors and brands…. I had a spreadsheet, lol, with whether he would eat each one or not, multiple trials per type on different days too…. Now if only I had paid attention to carbs too, Jackson may not be diabetic today. Sigh.

I am familiar with the YA loose stool syndrome. Jackson mostly doesn’t suffer from it simply because he gets enough wet food too, which isn’t quite as high in fat. When he gets into high-sugar “I’m starving” mode, it’s happened though. They say it’s only supposed to happen when the cat eats “too much”, more than they need, but with cats dealing with high sugar and ketones, “too much” is what they need, so that would definitely be a balancing act.

Most of the carbs in filet and gravy type foods are actually in the gravy, or so I read in the what-to-do-when-hypo instructional posts. So any food like that is going to probably be high carb by nature. What’s the carb content of the Elsey’s kibble? If all he wants to eat for wet food is filets and gravy, I wonder if his sugar might actually balance better if - I’m probably posting heresy now - he ate more of the kibble blend instead.

 

[Wendy&Neko]

I think that Jack's nadirs on 7.5 units are high enough blues that you could go to 8.0 units. I'd save the 0.25 units changes for when you just want to lower the nadirs a bit. Your goals with SLGS is to get them between 90 and 149.

 

[Jack & Mopem'sMom]

I think that Jack's nadirs on 7.5 units are high enough blues that you could go to 8.0 units. I'd save the 0.25 units changes for when you just want to lower the nadirs a bit. Your goals with SLGS is to get them between 90 and 149.

Thanks for this, I didn't see it until after I gave him his shot this am so I went with 7.75 but will go to 8 tomorrow morning.

 

[Jack & Mopem'sMom]

Yikes. It does sound like you have tried all the things, and already knew as much or more as/than I about the various kibbles. I guess I just ended up really lucky that Jack’s favorite wet food type was already pate (although he had to be coaxed, argued, and fasted - long before diabetes, don’t worry - into including wet in his diet at all). We went through the food battle a couple years ago when he developed urinary crystals. Thankfully, a problem that became nullified with a diet change. But oh boy do I remember the weeks and months of trying all different higher-protein wet foods, all the styles and flavors and brands…. I had a spreadsheet, lol, with whether he would eat each one or not, multiple trials per type on different days too…. Now if only I had paid attention to carbs too, Jackson may not be diabetic today. Sigh.

I am familiar with the YA loose stool syndrome. Jackson mostly doesn’t suffer from it simply because he gets enough wet food too, which isn’t quite as high in fat. When he gets into high-sugar “I’m starving” mode, it’s happened though. They say it’s only supposed to happen when the cat eats “too much”, more than they need, but with cats dealing with high sugar and ketones, “too much” is what they need, so that would definitely be a balancing act.

Most of the carbs in filet and gravy type foods are actually in the gravy, or so I read in the what-to-do-when-hypo instructional posts. So any food like that is going to probably be high carb by nature. What’s the carb content of the Elsey’s kibble? If all he wants to eat for wet food is filets and gravy, I wonder if his sugar might actually balance better if - I’m probably posting heresy now - he ate more of the kibble blend instead.

I had looked a while ago at the kcals on the bags, and it said chicken was 4030kcal/kg and 544 kcal/cup. I wrote down the duck was 4055, the turkey was 4085 and the salmon was 4030. But, when I went to look for the info on the site, the info seems to have changed. I grabbed this screenprint just now. I just managed to confuse myself even more than normal...LOL And I appreciate your advice, and input. It helps to 'not be alone' when dealing with this.

 

[Jack & Mopem'sMom]

Yikes. It does sound like you have tried all the things, and already knew as much or more as/than I about the various kibbles. I guess I just ended up really lucky that Jack’s favorite wet food type was already pate (although he had to be coaxed, argued, and fasted - long before diabetes, don’t worry - into including wet in his diet at all). We went through the food battle a couple years ago when he developed urinary crystals. Thankfully, a problem that became nullified with a diet change. But oh boy do I remember the weeks and months of trying all different higher-protein wet foods, all the styles and flavors and brands…. I had a spreadsheet, lol, with whether he would eat each one or not, multiple trials per type on different days too…. Now if only I had paid attention to carbs too, Jackson may not be diabetic today. Sigh.

I am familiar with the YA loose stool syndrome. Jackson mostly doesn’t suffer from it simply because he gets enough wet food too, which isn’t quite as high in fat. When he gets into high-sugar “I’m starving” mode, it’s happened though. They say it’s only supposed to happen when the cat eats “too much”, more than they need, but with cats dealing with high sugar and ketones, “too much” is what they need, so that would definitely be a balancing act.

Most of the carbs in filet and gravy type foods are actually in the gravy, or so I read in the what-to-do-when-hypo instructional posts. So any food like that is going to probably be high carb by nature. What’s the carb content of the Elsey’s kibble? If all he wants to eat for wet food is filets and gravy, I wonder if his sugar might actually balance better if - I’m probably posting heresy now - he ate more of the kibble blend instead.