Jasper’s Journey – any advice welcomed

Hi!

In the first few weeks after Jasper was diagnosed in early November, I worked closely with my vet to try to determine the best dose for him. She has been great. She asked me to text her day and night with the results of Jasper’s glucose readings during those first few weeks and we would decide what to dose him at each cycle. She takes the low and slow approach, although we jumped from 1 unit to 2 units pretty quickly.

After getting some data and also based on the fact that Jasper has not been eating very well at times, my vet came up with the following protocol a couple of weeks or so ago: =>250=2u; 170-249=1u; 100-169=.5u; <100=n/s. That has worked pretty well but now I have questions about it.

At the same time, I started to transition Jasper over to Young Again dry food supplementing with as much wet food as he would eat. I had been feeding Jasper mostly wet in the early days because I had no dry that wouldn’t send his sugars sky high. As expected, he started refusing to eat his wet food and I had to watch him like a hawk to keep him from eating my other cat’s kibble (sometimes unsuccessfully).

But the Young Again food seems to have him inching closer to remission (knock on wood). I am now trying to transition him from Natural Balance premium wet foods (5-10% carbs per the Food Chart) to Tiki Cat (0% carbs) in hopes that it will help send him in to remission. He’s been eating Natural Balance wet food in addition to dry food for years so I don’t know if I will be successful, but I am trying it out.

Anyway, my main question I have today is could you look at Jasper’s spreadsheet and let me know if you think I am dosing him correctly? Two nights ago, his PMPS was 137 so I dosed him with a skinny .5 unit. He dropped low very quickly and I brought him back up slowly by giving him a higher carb (17%) wet food. Since then, he had a PMPS of 112 last night and I did not dose him at all. I fed him a Tiki Cat Velvet Mousse for the first time last night therefore I tested him often. He reached a high of 143. Do you think I should have given him a very small dose of like .25 unit last night after the PMPS of 112? Or, do you think I have been doing the right thing?

Sorry for the long post!

 

Jasper had AMPS of 101, so I did not give a dose. Took a +6 reading and got 120. I hope I am making the right decisions about dosing.

 

I’ll let the others advise on the dosing, but I don’t think I could shoot a 101. Have you tried the Tiki? How does he like it?

 

He's doing great! Looks like a kitty on a mission ... You were right to skip this AM.

 

Ok thanks, Sharon14! Yes, I tried one of the Tiki Velvet Mousse pouches last night and he loved it. Jasper has only ever liked the pate type wet foods, so he seemed to like the texture just fine. He is one of those that like something for a while and then suddenly doesn't anymore, so we'll have to wait and see if it is a permanent hit.

I bought some cans also, but I think they are all shreds of meat. I'm thinking of trying to puree a can of it myself tonight to see if he will eat it. We have an old Magic Bullet blender machine that I am hoping will work perfect for that.

 

Yeah I don't know that I'd shoot a 100 ever. I might not shoot below 150 even....are you usually able to monitor throughout the day if needed?

 

Thanks Kris! Do you think I was right to skip last night's dose as well or should I have given him a .25 dose?

His PMPS was 112, then he had +1=79; +2=103; +4=143; +6=121. I tested him so much because I was testing his response to the new Tiki Cat food.

As I was typing this, I saw your response Rachel. Thanks for that advice! And yes, I am usually home all day so I can monitor him closely.

 

Also, two nights ago, Jasper had a PMPS of 137, so I dosed him at a skinny .5 and he dropped like a rock to 50 at +2. I slowly got him back up by feeding him a higher carb wet food (he mostly ate the gravy off the chunks), so I am thinking of not shooting unless he is >150 like you suggested, Rachel. Would you give him a .5 unit dose then or drop it to .25 based on how he reacted to the skinny .5 units two nights ago?

 

I don't think I'd give more than 0.25 u right now - provided his PS is high enough to shoot (above 130? - just guessing).

 

Thanks Kris! That's what I am thinking also. Hopefully he'll be in the green and I won't have to worry about it.

 

Jasper's PMPS was 116, so I decided to not dose him again tonight. By the way, pureeing canned Tiki Cat did not go well. It had too much moisture and completely liquidified, lol. It would be perfect for syringe feeding if I need to assist feed again in the future, though.

I do have another question if anyone is reading . . . how do you determine if your cat is in remission and is ready to go OTJ? I'm not sure if I have seen any information on how best to determine that. Does the kitty need to be getting consistant greens in order to do that? Or, do some kitties go OTJ when they are getting low blues mixed with greens like Jasper?

 

Cats who go into remission with blues often come back out of remission pretty quickly, so it's better (if you can) to get him down into greens (mostly 50-80) if possible before declaring OTJ. Looking at his spreadsheet, I'd say he's heading that way. You might just need a few more cycles with the 0.25 or even smaller doses. You're making good decisions right now, and he's doing really well. Oh, OTJ is typically two weeks with no insulin and numbers below 120 (although again, the lower the better before calling it).

 

Thank you so much for that info Djamila! I do think I will try to give him a .25 or smaller dose if he gets back up in the 130s or higher and then monitor very closely.

Out of curiosity, does the small doses of insulin tend to kick start a kitty's pancreas into working better again? Or is it giving the pancreas a rest so it can continue to heal? Is that why Jasper may be stuck in the low blues/high greens and by giving him some smaller doses can help push him down into the numbers needed for remission?

I'm just trying to understand the medical side of things. I try to research these things but then my brain starts to hurt after a while.

 

Hmmmm.....those are good questions! Honestly, I don't know. My hunch would be that it keeps it from being overburdened while it's regenerating the cells (I can't remember what they are called) that it needs to fully function.

Have you read the front pages of felinediabetes.com? There are some great articles out there about all of this and you might find some info out there to answer that better than I can.

 

If you find out, make sure you post it here --- now I'm curious too!

 

Will do! I have read much of what is posted on the front page, but at the time I was more concentrating on the basics of getting started. I'll have to go back and read those again and see if I can find an answer when I get some free time.

 

Jasper's AMPS was close to 130 today (128), so I went ahead and gave him a skinny .25 unit dose this morning. I called it a .2 on my ss, but it is so hard to tell on those u-40 syringes. At +2, he dropped like a rock to 59. A good number as long as he doesn't go any lower. I'll be monitoring closely throughout the day until he starts to go back up.

 

Looks like he had a nice little surf today. Well done, Jasper!

 

@Djamila , do you think that was close to an ideal AM cycle or do you think it skirted too close to being low at the +2 mark? I liked his numbers today, but it took a lot of testing to ensure he was not headed in the wrong direction. Jasper was starting to get a little cranky with me. I'm struggling to get the right balance between optimal results without being anxious all day. I sure it's a struggle that most everyone goes through.

His PMPS was 119 and I decided to go ahead and dose him, especially since I fed him some Tiki Cat Aloha Friends food which is the only wet food they have with carbs but it is only .5% carbs (from pumpkin). I gave him a slightly smaller dose tonight (.15 unit) than the am cycle.

 

I think that was a great cycle! Did you feed the 54, or just monitor it? Assuming you just kept an eye on him, then my hunch is that he just has an early nadir. Not uncommon as kitties are working their way off the insulin. You might aim for testing closer to the +2-+3 range when you can. If you get a few cycles where you see an early drop and then by +4ish he's rising, that data will help you be able to relax a little with those quick drops. Once he's rising, don't keep testing - that way you can give his ears a break.

My kitty does it too. He's usually lowest around +3, so he drops fast and then surfs along. And he also gets grumpy if I test him more than once during a mid-cycle. Just keep giving Jasper love and treats and he'll forgive you Thankfully they have rather short memories as long as treats are involved.

The other thing is that when you skip a shot, you don't need to test during that cycle. You can grab one if you're just dying of curiosity, but a cat who has not received insulin is safe, so you can give his ears/paws a break during those cycles.

Kitties will naturally run 50-80, and some kitties will naturally (non-diabetic and without insulin) run down in the 40's, so I don't worry too much about cats being close to 50 as long as they have a human who is dosing carefully and keeping an eye on them. Speaking of dosing carefully, those tiny doses are super hard to keep consistent. One strategy is to take a syringe and pull up some colored water, then you can compare the "real" syringes to the one with the colored water and it will help keep you at least a little bit consistent in dose size. It's still far from perfect, but it can sometimes help.

Jasper is looking really good. Fingers crossed he keeps heading this direction!

 

Yeah, I just kept a close eye on him when he got the 54. The 54 was from his paw (to give his ears a rest) and those tend to be ever so slightly lower than an ear test. Since he was so low, I immediately retested using his ear and got a 59, so I decided to wait it out without feeding. It looks like he is headed towards a nadir at +2 or +3 again tonight. His nadir in the past tended to be around the +5 or +6, so maybe this is his new normal for the time being.

Thanks for your advice about the using colored water in another syringe to help dosing. I will try that. Thanks for all your help - it helps a ton!

 

You and Jasper are doing really well!

 

Aw, thank you so much!

Jasper had a great reading this morning: 69! He just surfed along after last night's small dose in the mid-60's until he started to rise at +7. So no shot this morning, no more pokes until later tonight and we got caught up on some much needed sleep.

I can tell he is feeling much better the past week. He has never been all that active of a kitty or much of a player past the age of 5 or so. Nowadays, when he gets in the mood, he will play with a string for a little while or will play hide and seek a bit with my other kitty. For the past two months, he wouldn't even do that. This past week he seems like he is getting back to his old self and actually started playing a little bit again. It's been a very encouraging week!

 

That's great! Hearing how he's acting, he does sound like the lower numbers are making him feel much better...I know what a relief that is!

 

Hi Luna, we've never "spoken" but I had a few minutes to check in on the forum and just wanted to say WOW on Jasper's progress! Looks like your food changes are paying off and you are starting your 14 day countdown . Great job developing your "momma sense"

 

Thank you so much, Yong! And, thank you for taking the time to look over Jasper's spreadsheet and commenting. The Young Again food has really made a difference for Jasper. The only issue with it is the softer (and sometimes rarely, runny) poo. I'm hoping that resolves once he gets used to his new food and as I feed him more Tiki Cat. He seems to love the fish flavors, but unfortunately not the chicken so much.

We had another green number and no shot this morning. I'm keeping my finger's crossed, knocking on wood, whatever it takes for him to continue on his path to remission.

 

Maury had some softer and much stinkier poo when I switched him to YAZ, just for a few days