8-31 Jasper;Follow Up amps 126/ +1 167/+4 186/+5.5 191/+6.5 219

Hey Aaron and welcome to L, B & L ! Oh my, it took me some time to get through the thread you linked and wow, you had a crazy busy night. :eek: Jasper is so lucky to have someone so dedicated to him and he is coming down nicely. And you were so lucky to have Marje and Jill helping you with dosing strategies. They are the best!

Can you update the SS for today? And did you lower the dose to 1.75 as Marje suggested to run him more in blues so you can get some much needed sleep? And is Jasper eating on his own any?
 
Yeah it wasn't any fun. marje and Jill are absolutely great. It's all updated. I don't understand why hes going high tonight :( and he ate very little "food" on his own, mostly gravy and a little bit of baby food I got in
 
Your SS dates are off. Today is 8/31 and the numbers you are siting for today are showing for yesterday's AM cycle.

He is bouncing from those green numbers last night. Here is an explanation on bouncing:

- Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release Bouncing glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver".

Bounces can last up to 6 cycles or three days to clear.

The one nice thing about when a kitty is bouncing is that it is a time to catch up on much needed sleep, and to get a pokey break for you and your kitty.

Tonight's cycle, after you shoot, get a +2. And if the +2 number is the same or lower than the pre shot number, it is going to indicate an active cycle. Then you would want to continue to test until you can be sure that Jasper is going to stay safe.

If the +2 number is higher that the pre shot number, I would get another test before I fall into bed and if it continues upward, get some much needed sleep! You need it ! And like Marje said yesterday, you can't take care of Jasper if you jeopardize your health.
 
Bobbie And Bubba said:
And did you lower the dose to 1.75 as Marje suggested
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Aaron decided to stick with the 2u to help Jasper. I explained that the 2u was better for Jasper; the 1.75u would give Aaron a break and we could always go back up in dose. Aaron is super committed to Jasper and he decided to stick with 2u. :):)

Aaron and Jasper said:
I don't understand why hes going high tonight
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He’s bouncing from the lower numbers last night. When their livers are used to higher numbers but then the insulin causes a lower BG (not even low but lower than what they are used to), the liver goes into protective mode by dumping counterregulatory hormones and glucagon into the blood which raises the BG. It’s a normal reaction. It can take up to six cycles to clear those substances out and numbers come back to normal so we are patient. Of course, some cats only take a cycle before “clearing the bounce”.

I’m glad he’s showing some interest in foods. Have you given him the Nutrical? It is loaded with sugar so is not really the best option for a diabetic cat but we can see what it does to his BG. After all, we did say he needs more calories!! It’s worth a try....we can adjust the dose but if the BG goes way up, then we might need to try something else. Can you be sure an note on the SS when you give it so we can see if it does impact his BG? Thank you.
 
??
Also, general insulin question, isn't the point of different injection sights to get a quicker onset? Therefore skewing whatever data you're trying to discern? Do you all have a standard you'd like from me? I typically do scruff, but behind shoulder/arm for haste
 
Most folks use the scruff.

I tried not to shoot in the exact same spot each time, but always the scruff...while his head was in the food bowl; it was the only way I could ;)

The important thing is to get the insulin in. Wherever works best for Jasper is the way to go. I don't know that it makes much difference in onset; personally I think wherever you shoot, consistency is always good. The fewer variables the better.:cool:
 
Aaron and Jasper said:
??
Also, general insulin question, isn't the point of different injection sights to get a quicker onset? Therefore skewing whatever data you're trying to discern? Do you all have a standard you'd like from me? I typically do scruff, but behind shoulder/arm for haste
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I alternated between scruff, chest, and flank every day. While absorption is thought to be slower in the scruff, I never could discern a difference in Gracie. This is likely one of those ECID things.
 
Wow, Jasper! Look at that PMPS!
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Great news that he’s eating! Let’s try and go till +2. Be a good boy, Jasper!
 
Well.....I guess we trusted him a little too much! Time to feed him and give him some of that gravy ...check in 30 after he eats.

There might be a time when this kind of a drop can be fed with just LC but without him eating well on his own and you being tired, I think trying to boost him up a little is smart.
 
Aaron and Jasper said:
Lc? Low carb?

Nutrical?
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Yes LC is low carb...sorry.

I’ve never used Nutrical although I understand it can bring up low numbers.

One of the best ways to slow the BG down and yet keep it from skyrocketing is to try and alternate food with gravy. We’ve talked about feeding a bit higher carb food to him to help us get this dose in him safely. I’m not sure what you have there and can get in him to accomplish that.

It’s all a learning process because we have no data on him so it’s your choice as to what you want to try. With that much of a drop at +2, he is likely to have a fairly active cycle without “some” sort of intervention.

I want you to feel comfortable in what you need to do. I am not going to last too long tonight.
 
Can didn't work, he ate maybe half the gravy, no food. Bastard. I then wiped him with a glob of nutrical.
And what will I need to do? I know you had a long day.
If he refuses food should I stick to just gravy and nutrical or syringe some beechnut (harder each time)
Maybe he's just low at night?
 
Aaron and Jasper said:
Can didn't work, he ate maybe half the gravy, no food. Bastard. I then wiped him with a glob of nutrical.
And what will I need to do? I know you had a long day.
If he refuses food should I stick to just gravy and nutrical or syringe some beechnut (harder each time)
Maybe he's just low at night?
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It’s not uncommon for cats to go lower at night.

Yes if you can’t get food with gravy in him then I’d try the gravy on its own or the nutrical. If you do gravy and nutrical, you will likely overcarb him which is not the end of the world. We’ve all done it. They get through it quickly. The Beechnut likely doesn’t have much in the way of carbs.

I’m going to see if anyone is around to keep checking on you.

Edited to add: I sent Gill an email. She’s in Spain so it’s morning her time. I’m nit sure if she will see the email or not but hopefully she will.

Just remember to test and then, if numbers are still dropping or lower than you want to see (and definitely if he falls below 50), apply the brakes using your gravy, nutrical, and/or both if it comes to that. We call it lather, rinse, repeat. Test, feed, if necessary, test again in the appropriate time.

Keep in mind it takes about 30 mins from the time he eats to see an affect on the BG.

I can stay awake for one more test.
 
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Sorry to all parties, I accidentally fell asleep just before +3. Hopped up like I had forgot the stove :/
88 @ +8 only seems okay to me with the slight rise. I hit him with nutrical before I fell asleep and a little bit more of the wet chunks are gone. Sorry for the lack of info on this one guys, totally my fault. Hit him with another glob after +8 and he seemed to be snacking
 
I need to do something about his intake because I think that's the only thing holding us back. I'm going to go to the vet and ask for a broad spectrum antibiotic and a stimulant. Question is, I've seen three on the forum, should I use zofran, mirtazapine or cyproheptidine? He's eating little tastes of things but wants to roll the chunks back out with his tongue
 
Aaron and Jasper said:
I need to do something about his intake because I think that's the only thing holding us back. I'm going to go to the vet and ask for a broad spectrum antibiotic and a stimulant. Question is, I've seen three on the forum, should I use zofran, mirtazapine or cyproheptidine? He's eating little tastes of things but wants to roll the chunks back out with his tongue
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Morning!

I’ll respond here but then you will want to start a new thread for today. In this forum, we do a new thread every day...one per cat per day with all your questions. You’ll want to put the link to this thread...or condo as we call them here.....in the one your start for today.

Mirtazapine and cyproheptadine work to stimulate the appetite. It seems most vets like to give mirtazapine but very few have read up that it can be dosed more often than once every three days. Between the two, the overall preference around here seems to be for cyproheptadine which you can give daily. Word of caution: vets always prescribe too high of a dose which makes the kitty vet anxious and causes it to yowl. You’ll want to start with just a sliver.

Zofran is anti nausea and you absolutely want to have it on board before you give an appetite stimulant. Can you imagine how you would feel if you were sick to your stomach but then you were given something to make you want to eat?

Because my kitties have always eaten really well out of a syringe, I keep zofran here and I can give them that and then syringe feed because I don’t like how the stimulants affect them. In the case where Jasper might have nausea and doesn’t feel like eating but fights the syringe, you might have to go the stimulant route.

See you in today’s condo! :)
 
Good job shooting, I see his +1 is just about the same as his PS, can you get a +2? That would be my preference, certainly no later than a +3.

When the Lantus shot onsets (typically around +2) you might see his BG drop and you may need to counteract with food to keep him from going to low. Of course there is every chance he could bounce and numbers could rocket. But if there is a drop best that you catch it.

I posted here as I couldn't see a condo for today.
 
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