? What the heck do the numbers tell me? (some dosing ?s)

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shelaghc

shelaghc

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So I've been tracking Jester's BG pretty religiously for several weeks now. Because of financial limitations, I've mostly been testing AMPS and PMPS with some occasional forays into mid-cycle tests when his AM or PM numbers seemed to justify it.

He's gone as low as 53 (yikes!) and as high as over 500 (his highest since he was diagnosed) during all that time.

The last few doses I've been keeping him on .5U on the advice / suggestion of someone from the main board because his BG has mostly been in the mid to upper 100s.

But between yesterday morning and this evening he climbed from 180 all the way up to 415. I finally upped his insulin to 1U tonight and will check him again hopefully at the +5 point (that'd be about 1:30AMish - *yawn*).

So what the heck do these numbers tell me? And what should I be doing differently to keep him on a more regulated path?

I know this is a marathon, not a sprint. But why do his numbers jump all over the place like this when nothing else is changing?
 
Could you remind us about what food Jester is eating these days, and any other health issues? It sounds from your spreadsheet like he's showing some symptoms of inappetance. Any ideas on the cause of that? When was the last vet visit?
 
Djamila said:
Could you remind us about what food Jester is eating these days, and any other health issues? It sounds from your spreadsheet like he's showing some symptoms of inappetance. Any ideas on the cause of that? When was the last vet visit?
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Appetite's actually been pretty good the last few days. He's been eating around two cans or more a day. If he was eating more frantically - like before he was diagnosed - I'd be worried.

Mostly he's been eating Friskies shreds - carbs in the teens. Sometimes he eats a little Friskies pate, but not generally a lot of that. I'm not thrilled about the kind of food, but considering his weight is down to about 9lbs - from 12.5 summer of 2016 - I'm just happy he's eating.

I created a column for other meds and medical issues, btw.
Other obvious health issues seem to be resolved. He had a UTI - nearly three weeks worth of Clavamox for that. I thought he was getting an URI, a fair amount of sneezing and runny nose for a couple of days. But that went away.
I was waking up to foamy clear liquid-type vomit for a while. A few days' worth of pepcid seem to have fixed that.
 
donnalea said:
Could he have found something to eat that he shouldn't have?
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Outside of kitty leftovers I sometimes leave out at the end of the day (always the same kind of stuff they've eaten all day), there's really nothing he could be finding to eat. (He munches on carpeting sometimes.....)

Jester's not a people food kitty. Except for greasy stuff on a plate, he just doesn't like human food. And since his diagnosis, I've been careful not to let him lick my plate.
 
I think there are three leading options for what might be influencing his numbers:
1. food in the mid-teens for carbs is a bit high for any diabetic cat, but some cats are even extra sensitive. If you can coax him to stay in lower carb foods there may be some improvement. Also making sure he has food to graze on so he isn't going with an empty stomach - that can make them throw up too sometimes.
2. consistency of dosing. I know sometimes life intervenes, so I'm not saying this as judgement, just as an explanation of impact - moving the dose around, especially in larger increments, changing shot times, and skipping doses can cause instability in numbers (both dramatic highs and dramatic lows).
3. an underlying health issue.

So action steps might be to work on food, work on consistency, or go for a vet visit/blood work (pancreatitis, IBD, dental exam....?).
 
Vet visit, sadly, isn't possible because I can't afford it. We went there on Monday for a free visit, but all he would do is tell me I'm doing everything correctly. Jester's weight was down to 9 pounds and the vet just said he may never get the weight back on.

It's hard to get the pate into him - took me nearly an hour to get him to eat a half a can this morning and this afternoon he wouldn't eat it at all. I can't shove the pate down his throat and he's too damn skinny right now for me to let him go without eating at all if he won't eat low carb.

I can't leave food out because I have two other cats - one of whom is now overweight because every time I feed Jester she demands to be fed too. If I don't feed her, I either have to stick her in the bathroom or keep her away from Jester's food because she'll push him away and he won't do anything to stop her.

I try to be consistent with his insulin, but I was taking a class up until this past Thursday - had to leave by 4:30 and couldn't be home before 9:00ish.
For about a month I was working MWF and had to leave by 8:00, then not home until 7:00. So combined with the class, there was literally no way to have his insulin at the same time each day.

Both of those are over now, but I still have things coming up in the evenings that will make time consistency challenging.

For several days his BG was going very low and he was eating full cans of the mid-range carby food. There seems to be no real rhyme or reason to his BG going up and down.
 
shelaghc said:
Jester's weight was down to 9 pounds and the vet just said he may never get the weight back on.
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Kitties can gain some of, if not all, their lost weight, once their BG is decently regulated.

shelaghc said:
If I don't feed her, I either have to stick her in the bathroom or keep her away from Jester's food because she'll push him away and he won't do anything to stop her.
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What about isolating Jester in a room with the food he'll willingly eat?

shelaghc said:
he was eating full cans of the mid-range carby food.
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If that's all he'll eat in sufficient quantity then feed him that.

You might be able to smooth out the numbers better if you use 0.25 u dose increments instead of 0.5 u increments. Many of us also have success with what we call "fat" or "skinny" doses. That involves eyeballing just below a line or just above a line. It's surprising how effective these tiny changes can be.
 
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Kris & Teasel said:
What about isolating Jester in a room with the food he'll willingly eat?
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I have tried, but the only time it worked was once when I was desperate. He'd been only nibbling for a day or so, the majority of his actual eating occurring when I basically dedicated my time to encouraging him over and over again.
That day I came home for lunch to feed them all. I had to get back to work and he'd eaten barely a half can of food since the morning. So I shut him in the bathroom with a litterbox in the tub and the food on the floor and left.

Then I got worried because I knew I wouldn't be home for at least five hours so about three hours later I asked the cat sitter to come by and let Jester out, then to put the food bowl in the fridge so I could see how much he might have eaten. Turned out he ate less than half the bowl.

:::sigh:::

(That job has since gone away, btw.)

Kris & Teasel said:
You might be able to smooth out the numbers better if you use 0.25 u dose increments instead of 0.5 u increments. Many of us also have success with what we call "fat" or "skinny" doses. That involves eyeballing just below a line or just above a line. It's surprising how effective these tiny changes can be.
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Currently the syringes I have only show one unit markings. Someone is donating fifty with half unit markings to me. I just can't afford to buy any other equipment / supplies for him.
 
Have you tried any toppings on his food to get him to eat? Fort-flora or maybe crushing up treats on top?
 
Rachel said:
Have you tried any toppings on his food to get him to eat? Fort-flora or maybe crushing up treats on top?
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Jester runs hot and cold on fortiflora. Someone kindly gifted me with an almost full box so I can experiment.

That said, Jester doesn't always respond to it.

I've never thought of crushing treats. There's a dried salmon treat that he loves - although even that gets old, so to speak, with him.

I'll give it a shot. This evening I managed to finesse him into eating almost a half a can of pate, but this afternoon all he would eat was the higher-carb stuff.
 
After vigorously encouraging Jester to eat pate most of today, his BG went back down to 229. But his overall intake has been less than two cans all day, including some of the higher carb stuff in the middle of the day.

If I could get him to eat as much of the pate and with as much enthusiasm as the shreds, I have a feeling everything would be way calmer.
 
Maury wasn't a big fan of pate but I've been able to squeeze more flavours in over the past couple months (antijinx!). So he used to get Friskies shreds when we started because he liked them and I needed him to eat and gain some weight back. I actually had success with Fancy Feast Roasted Chicken, Roasted Turkey, Chunky Chicken, Chunky Turkey, Chunky Chopped Grill, and occasionally Flaked Chicken and Tuna. I try not to give fishy flavours more than once a week. The Roasted and Chunky flavours are low carb though, I think like around 6% versus the Friskies shreds which are closer to 11-14% carbs.

There is also the possibility Jester is just a bouncy boy. We have a few of them on the forum :cat:. Are you testing for ketones at all? You've come a long way since you joined :bighug:.
 
Noah & me said:
I've done this 1,000 times and then Janet said they made her readings go sky high. The Whiskas Temptations to be specific. Very aggravating.
@JanetNJ That was you wasn't it? :blackeye:
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Haha yeah. I use them when she goes too low. Crushing low carb treats on top is fine though.
 
Ate cumulatively about half to three quarters of a can of pate today and about a full can of shreds and now he's back down to 201.

:confused: :confused: :confused:
 
How quickly does food in the stomach affect BG?

Jester AMPS was 221 I wanted to do a +5 or +6. But I caught him nibbling on some of Sage's leftovers from breakfast just before 12:30 - about the +4 mark. So I took a quick BG within about 2 to 4 minutes of him munching - I'm being literal with that timestamp.

+4 was 154, then he ate a little pate. Thinking of checking him again at +6 anyway. (Not quite a curve, but it'll do for now.)

How accurate might that 154 have been?
 
So it looks like right now, with him eating both low and medium carby foods, 1U is working?

Still planning to check him again in a little over an hour (+6) once the pate he ate after the last one isn't affecting the numbers.

@Djamila Am I doing this right? Or am I overdoing it?
 
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