? Dosing advice again.. what would you do??

So, Spot has done this a few times now, where I'll check him before bed, and he seems to be in good, un-scary numbers, but then his AMPS the next morning is either too low to shoot at all, or low enough to warrant a stall/reduction.

On 8/5, his PM+5 was 156, then he was 148 7 hours later (reduced to 1u but he was high by PMPS)
On 8/6, his PM+5 was 161, then he was 85 7 hours later, and 149 after stalling (gave normal 1.25u since he was rising)
Last night, his PM+6 was 122, but this morning he was at 45!! I fed him at that because no way was he going to come up enough to shoot, and an hour later he was up to 84.

I really have no idea what to do about dosing now. Should I go back to 1.25u tonight? Some of this is due to his weird eating habits, so it may be due to him not eating as much at certain times. I increased last night because he actually was eating for most of the day.. but then he didn't touch his food overnight. I would think though that by the time he passed the 6 hour mark, he would have been safe..... in the back of my mind I keep hoping that this is his pancreas trying to kick in again, but I'll probably see a super high number when I get home again today..... ugh.... why can't this just be easy?! Sometimes I feel like I look at these numbers until my eyes cross, but I just can't make sense of them

 

He’s eating like a little piggy since I got home tonight so I went ahead and gave him 1.5u. Crossing fingers for a shootable AMPS!

 

Good morning! I'm so sorry we didn't get back to you yesterday. I saw your post at work, but I was trying to fix something (which didn't get fixed...sigh) and when I got home to write back, my internet went down.

Okay, I'm not at my greatest first thing in the morning, so if I anything I say sounds like incoherent babble, just let me know. Today should be a better day at work so I can check in. Looking at his SS and just letting it roll by to see the colors, it looks like he definitely runs lower at night and higher during the day...normal kitty behavior really. Even when he is high enough to shoot, he's more likely to be yellow in the AM and pink in the PM. It also looks like you've been jumping around on dosing lately...understandable with some crazy numbers. I'm going to suggest first sticking to one dose. I'd go with 1.25 for at least 6 cycles unless he's too low to shoot like he was at that 45. It's possible that he just needs a bit of dosing stability no matter how high he is to settle down. So maybe first off stick with that dose if you can. See what that does. Then if that doesn't work, we can look at possibly different dosing for daytime and nighttime. I rarely ever suggest that but maybe that's what he needs...and that's okay if he does.

What do you think of this plan? Any questions?

 

I like Rachel's advice.

 

I agree that he needs a consistent dose. I feel like I try to stick with that as often as possible, but he likes to throw me curve balls that make it hard. I dosed him 1.5u again this morning before I saw this, cause he seemed to do well on it last night... we'll see what today brings...

I tried something new last night, and brought his food bowl into my room and set it on my side table... that seemed to do the trick to get him eating overnight. Maybe he just doesn't like to eat alone haha! Part of the problem is that he sometimes does what I expect him to and sometimes doesn't, so I have a hard time predicting what any given day will bring. On days he eats, 1.5u seems to be good, but if he's not eating, 1.25u can be too much... I know its better to have him a little high than too low, but sometimes when I see his numbers going high, its hard to resist upping the dose

I will go with 1.25u tonight and see if having his food in my room works again. If that works to keep him eating consistently overnight, then in a few days I'll consider going back up to 1.5u. I will do my very best to not react to high numbers for the next few days!

Hope you're having a better day at work today!

 

Ended up skipping tonight too so change will be tomorrow. He was eating fine this morning while I was working from home but I left at noon and he didn’t touch any food until I got home around 7. He drops so low even after only a few hours of not eating. And then today, he actually did eat between the 92 & the 62. I’m just so confused right now! I’m actually thinking about dropping to 1u for a few days and then adjusting from there... despite how much he seems to want it, I can’t be home all the time to make sure he eats

 

Oh these kitties! There was someone over on the Lantus forum who was getting up in the middle of the night to stir her cat's food because he wouldn't eat it unless it had been stirred recently. You're right: you can't just stay home all the time to make sure he eats. Do you have a timed feeder? I wonder if putting portions in the timer would help? Then the sound of it rotating might remind him to eat and make him think he's got new food.

 

LOL that sounds just like Spot! Won’t touch it if it’s been sitting too long... like 15 minutes....
I will have to look into the timed feeder. I don’t know what else I can do! The issue definitely seems to be getting worse over time. He never used to be this challenging.....

 

And just like that ... I found something to be grateful for... Romeo's numbers are all over the place, but at least he's eating consistently. I have a picky picky shihtzu at home though @SpotsMom, so I definitely feel your pain!!

 

Oh lordy can I relate to that. I often think wistfully about the days of kibble when I could just pour a bowl full, top it off in the morning, and leave knowing he was full and content until whatever random time I got home. But then I remind myself that the kibble was the cause of all of these health problems and I'm not so wistful anymore.

 

I had to go out of town unexpectedly a few months ago and my neighbor who is usually fine with coming over to feed the cats happened to be out of town too. I got a friend to come over but it was on a very different schedule than their normal feeding...all I could think of was how much easier kibble had been since it wouldn't matter when they came over! However, as Djamila said, then I remember my sweet Gypsy and her diabetes and THEN I remember how much healthier my 3 are now. They're none of them so young, but they run and play like they are a lot! I do miss the ease of kibble but I like the health benefits of raw. As a matter of fact...I'm fairly sure my cats have a healthier diet than I do!!!

 

Before he got sick, Spot was always a grazer, so food was barely a thought. I miss the freedom of an occasional late night or weekend away with no worry that he’s sitting home starving himself til I get back....

@Rachel feeding raw is a whole other level! I wish I had the willpower to feed myself the way I feed my cat... giving him just what he needs and cutting out all the junk!

 

Right?! My cats definitely eat healthier than I do. It would help if I had someone feeding me only what is good for me, instead of making my own choices of what is easiest/yummiest!

 

After 2 days of eating fairly normally, now he’s vomiting even after Cerenia. Poor guy seems absolutely miserable. I’m very glad he’s only on 1u today cause I would hate to have to worry about hypo in addition to everything else

 

Oh, poor Spot! I'm so sorry to hear he's sick today. Sending healing vines your way!

On the bright side: his cycles last night and this morning look nice!

 

Today's cycle has been picture perfect! So glad we reduced the dose!

He wasn't tolerating assist-feeding today, and vomited several times, so I had to pull out all the tricks to get him eating again.. the meds finally appear to be doing their job, and he's eating on his own right now. CBD, Cerenia, pepcid & cyproheptadine barely made a dent, but the bupe appears to have done the trick.... course, his pupils are huge and he's jumping at shadows... but he's finally eating (and holding it down!)

 

Awww poor Spot! I'm glad he's eating on his own..I hope he feels better soon!

 

Ah pain. Yes, the nausea meds aren't enough if he's in pain. Thank goodness for bupe! Those bupe eyes are truly somethin' else, but at least it makes them feel better!

 

!!

 

He seems to be feeling a lot better today! He’s eating well so far. He definitely seems to prefer eating in my room... even when I’m not in there haha. Still weird but whatever works!

I expect higher numbers today since he’s eating better. I continued with 1u this morning since he could go off his food in the snap of a finger. We’ll see how he does once the Cerenia wears off. Yesterday proved that 1u is good for crappy days, now I just need to decide what to do about good days.... just be ok with higher numbers? If only he could tell me when he’s going to not feel like eating!

 

So now it’s been a few days at 1u. Aside from his one bad day on Monday, he’s been eating well since then. I think that is reflected in his numbers. 1u was perfect for the day he wasn’t holding anything down but days he’s on his food he’s getting nothing out of it. What should I do??
My thoughts are that I will start test/feeding him an hour before his anticipated shot time to give him time to get a significant amount of food onboard.. or at least make sure he doesn’t fake me out by eating just enough to get a shot. Then make the decision about how much to give him based on whether or not his appetite is good. If he’s not interested in food give no more than 1u, if he scarfs it all down then 1.25u? I’ll have to account for taking his BG an hour early, so that could be a challenge if he’s close.. Any thoughts on this?

 

What about a half hour between testing and shooting? Is that enough time for him to eat? How long until you buy new syringes? I'm wondering if you get u-100's and use the conversion chart (it's easy once you figure it out) if you could make smaller variations in dose. Typically moving the dose around by a quarter unit just leaves the kitty with super inconsistent and hard to predict numbers. And yet I understand the dilemma you're in right now with the inappetance impacting everything.

It's definitely time to move back up to 1.25u. And hopefully he'll keep eating and none of this will matter.

 

A half hour would probably work. I have a little bit of wiggle room to stall if needed too so if half an hour isn’t enough (some days he’s just slow) then I can wait him out. I just had a new box of u40s delivered last week of course haha I’m willing to try out the u100s though. What were you thinking for dosing? Changing in 0.1 or 0.2u increments?

 

U-100s would be good when you get a chance. With those, we generally move the dose by 0.2 units. You're able to be more accurate with them than you usually are with u-40s and 0.25 units since that's all eyeballing.

 

Since you just got a new box, you can try moving the dose by "skinny" or "fat" So instead of going all the way from 1 unit to 1.25 depending on if he's eating, you can try just giving a fat 1u or a skinny 1.25u. So you almost go to the dose, but then give just a smidge more or less (depending on which way you think you can be most consistent). Often just a little bit can make a difference for sensitive kitties.

It's so difficult when they eat and respond in different ways from day to day. Pancreatitis stinks.

 

I can vouch for the effectiveness of skinny and fat doses.

 

Skinny doses could be a useful tool on days that he doesn't seem inclined to eat much. Every little bit helps when I'm trying to hit a moving target!

 

When I get home from work and he immediately starts eating all the food that’s been sitting out for him all day....... this cat!!

Sometimes, like Monday, he’s genuinely sick, but other times, like today, I feel like it’s completely behavioral. Like he sits here pouting waiting for me to get home and watch him eat. Poor high maintenance baby..........

 

Ah...Mom's home, I can eat!

These babies can be so high maintenance...I give Tigress CBD daily on a treat. She used to come running when I shook the treat bag. Now, she waits because she KNOWS I'll bring it to her on the couch so she can recline while eating it because I need her to get that CBD!

 

Haha brilliant little dictators

 

And then sometimes it’s just a little constipation. He was off all day yesterday and I couldn’t figure out why. Nothing was working to get him feeling better... well I woke up to 2 monster piles of poo in his box this morning LOL. Guess that explains it!

Fat 1u seems to be doing ok. Ideally I’d like to see him in lower blues on his higher days, but I’ll settle for safe numbers on his lower days. And he’s still loving having his food bowl right next to me at night... which accounts for the higher AMPS numbers. But that’s ok.. I’ll never complain about him eating at the wrong time!

 

He likely hit a green mid-cycle today, which makes two cycles in a row. And considering he's coming down from pinks, that's a pretty decent drop. Those PS numbers are still higher than we'd like to see, but you can't really complain given the nadirs. And you had great duration on that AM cycle today. Fingers crossed he keeps going like this and strings a few more of these cycles together.

I have to confess, Sam ate in my room for a long time. I only moved his nighttime food back out to the kitchen when I moved to the new house a couple weeks ago. Now the kitchen and bedroom are close enough that he can see me while he eats in the kitchen. I started it when he was so sick with p-titis and wasn't eating. Having food close at hand made it easier for me to get him to eat without having to get up in the middle of the night. When he was feeling better, he didn't like having his food back in the kitchen - he would just sit on the bed and cry because he was hungry but apparently no longer wanted to eat alone. Oh, how we spoil our babies!

 

Lol I tried to move him back to the kitchen a few times, but every time he just sits on my bedside table and stares at me until I bring him his food. I’m so wrapped around his little paw

 

Lol...maybe we should add this to the list of symptoms/side effects of pancreatitis.

 

I hate to jinx it but I’m going to live in the moment and celebrate a little. Spot has had an amazing few days!! Yesterday he played with the laser pointer for the first time in months!! Today I came home and he ran laps in the hallway... not just running out to greet me, but like playful laps!! I know this pancreatitis thing comes and goes so I know it won’t last forever but it’s so nice to see him being a happy kitty again! Also he and Zuri (new kitty) may just become friends after all. Zuri heard all the raucous and ran a lap with him before spot realized what was happening and looked at her like she was nuts. It’s nice to have something positive to report

 

Yay, Spot! That’s really nice to read. Running laps is quite a wonderful thing, and now I have this image of Spot only stopping bc he thought he might not look cool in front of the little one.

 

We need to celebrate these moments!

 

Yay for running, and double yay for making friends! Hopefully this is just the beginning of them bonding!