? Dosing advice for cat sitter

I'm getting a bit concerned about what to do about the cat sitter giving Jester his insulin.

Jester's BG has been high for a while now - mostly yellows, occasional blues, and so far today only pinks. He's also had a *really* big appetite - generally over 2 5.5 cans of Friskies a day. (So far today he's already eaten 1 and 1/4 cans.

His insulin dosage has been going up slowly, but it doesn't seem to make a difference so far. I was planning a curve tomorrow since it's the last full day I'll be away before my trip but now I'm wondering if I need to up the dosage again.

When I'm gone, he won't be eating as much since the sitter will only be coming twice a day. On top of that, the sitter won't be doing BG testing at all so I need to set up a "safe" dosage for three and a half days.

Help?

 

Remind me when you're going out of town? This coming weekend (Memorial Day weekend) right? Sorry, my memory isn't great.

I've got some thoughts, but I think a curve tomorrow would be fantastic. If you can do that we can take a look at it and make a decision together about what would be best for Jester. Don't panic! I just think it's best to make the decision after your curve. We WILL definitely help you make a decision before you go out of town. And we'll take into account the not eating as much and no BG testing...most of us deal with those same things when going out of town, and we usually just lower the dose slightly to account for it.

Sound good?

 

Thanks Rachel - yes, next weekend.

I'll be leaving after giving Jester his AMPS and AM insulin. Home on Monday but not until way after he'll be due for a dosage.

So you think I should just keep his dosage the same right now even with the higher numbers? We actually went through something similar earlier in the year. I'd increase Jester's insulin, he'd go down for a couple of cycles, then he'd drift back up again.

Right now I'm ignoring his insistent meows for food just so I can see what his BG will be without any extra between meals. But if I'm doing a curve tomorrow, maybe I'll just do it tomorrow instead. (I generally only give him lower carb pates in between meals.)

 

Let's see what happens after the curve tomorrow and decide on a good dose then. You may want to raise the dose after the curve and see how he does and just lower it for the time you're gone.

 

Update on Jester's BG and a question.
Does anyone know if UK syringes are significantly different to US syringes?

I recently got a big batch of U40 syringes from someone in the UK. While I haven't noted consistently when I've used those ones instead of US syringes, I thought I'd switch back to a US syringe for Jester's PM dosage.
His PMPS was 359 and his +3 was 235.
He ate a bit less this time for dinner, but not necessarily a significant amount less.

 

Trying to figure out if Jester is bouncing or if I really do need to increase his dosage.
Working on the curve today. On 1.5u we just got through his +6 and it's the first he's been under 200 (and only barely) since Friday right before bed.

@Djamila @Rachel @Kris & Teasel

Any thoughts? This was supposed to help with the dosage for the cat sitter next weekend and I'm getting nervous.

 

I would keep testing this cycle since he hasn't started rising yet.

What exactly are you nervous about?

 

Still testing - just went up to 201 on his +8.
Should I keep him at his present dosage until next week after my trip or should I bump him up another .25u tonight or tomorrow evening?
And how will all that effect the dosage with the cat sitter?

Plus, I wasn't thinking and I've been feeding him intermittently all day long. So today's curve won't mean as much for the sitter.

 

If it makes you feel any better I had to board Noah last week for 7 days. Maybe not "feel any better" but now you know it's not just you. Noah is 14, it all turned out okay.

 

Were they doing blood testing for Noah? Because the sitter won't be.

 

Yes they did! I typed many pages of do's and don'ts AND made them understand what bouncing is without getting a stupid look. There's a thread somewhere "Boarding Noah, freaked out" and I got a lot of advice and well wishers. I do not want to drag this thread in another direction but years ago Noah's brother Andrew was murdered by an incompetent tech at 2AM after we specifically told them "Don't do this".

 

I'm so sorry about Andrew.

One of my worries is that Jester's BG won't be taken the entire time I'm away. Plus, I really should be increasing his dosage because the lowest he's been all day is 197 - and that was after not eating for over three hours.

But no one has said if that's a good idea or not since we'll almost certainly be reducing the dosage for the catsitter so Jester doesn't go low.

 

It looks like you're getting a good response to the insulin. I think I would raise the dose...it's not bringing him low enough mid cycle. See what that does for him this week and then possibly lower it back to 1.5 for the weekend away.

 

Too late for tonight. He went back up to a pink 304 and I gave him his 1.5u.

Do you think it's safe to give him 1.75u in the morning when I can't monitor him during the day?

@Rachel - is it safe to increase the dosage tomorrow morning when I can't monitor Jester? I'm leaving the end of the week and time is running short to make changes.

Plus when I'm away, Jester won't be eating as much every day and that has to be taken into account for whatever his dosage will be.

 

I would think it would be safe. He hasn't dropped low...he had MORE than enough room to drop yesterday. So an increase shouldn't bring him THAT much lower.

 

Actually, his AMPS was 214 today. Decided to play it safe and keep him at 1.5U for now. Particularly since he won't be eating all day long.

Tomorrow (Tuesday) I'll be able to see how he does for closer to the full twelve hours instead of my usual day that gets me home around 5:00PM, as I have an appointment right after work and won't get home until after 6:00PM.

 

It's a stupid question now but why isn't the sitter testing? Obviously you want her to but I wish I could be invisible too.
One semi-positive about this is that a reduced dose would result in higher numbers which is not good but better than coming home to an open bottle of Caro and a note.
Does Jester free feed? We don't want to knock him totally off his routine but you did say he wouldn't be eating as much while you're away. I'm grasping at straws here but I feel your pain.

 

Jester is a shy kitty and it's hard enough to get him used to a new sitter who can give him his insulin. I don't know how he'd react to a stranger trying to get him to sit on their lap for blood tests. He knew my mom for years and, while he'd sit next to her, she could never coax him to sit on her lap.
Considering I had very little lead time on this, and because this sitter doesn't know *how* to test at this point, the decision was made to come up with a "safe" dosage for the 3.5 days I'll be away.

Jester can't be free fed. We're a three cat family.
He used to be a free-feeder and I've never completely been able to get him out of that mind-set. He walks away from his bowl and one of the other cats will finish his food for him - whether they're done with their own or not.
Because of that, someone always has to be around to make sure the other cats stay away from his food and/or move his bowl to wherever he's migrated so he'll be able to eat everything he's supposed to eat.
Also, he's lost a scary amount of weight and I allow him to eat as much as he wants whenever I'm home in order to try to replace some of those ounces.

 

I'm at a loss now. This only means so much to me because of what we just went through and Noah came home safe and sound. He can be compliant at the vet but if he hears a strange voice at the door you know he's behind the furnace so as far as a sitter poking holes in him I'd have better luck in Vegas. Is it even conceivable now to think about a vet boarding him? We struck gold having two vets here we can trust and it's out back-up vet that boarded Noah. I know I'm repeating myself.
Could your sitter zip Jester over to your vet once or twice during that time?
We're about the same age so we've probably gone through the same of a lot of life's little surprises and disappointments. Noah is 14 years old now and he handles these things better than I do. Maybe my superpower is to Never face the facts, it's gotten me this far.
At this point all I can do is this;
is for Jester.
is for you.
You will come home and Jester will be waiting for you.
Your pals, Noah and the boys, Cynthia and Dickson

 

Not an option. Neither vet that is familiar with Jester boards cats just for vacation purposes. Plus, Jester would likely freak out. If it was an option, I'd take him with me. But he doesn't travel well.
Either option would stress him out way too much. He's much better on home turf where all of his familiar smells are. He's far more likely to eat good meals with the patience of his sitter.
Actually there are two of them - the original sitter who all the kitties know very well and who Jester is comfortable with. And the new sitter who's taking care of injections.
Original sitter, after about two weeks of training, finally admitted he wasn't comfortable with the injection process. The new sitter actually had a diabetic kitty, but never learned to test. (I'm hoping we can work on that in the future so I can take longer trips without worry.)
So the original sitter will do the feeding and comforting and the new sitter will inject. Plus the original sitter lives right around the corner from me and, if I know him, might just stop by during the day if Jester hasn't eaten enough in the AM to give him a little more. He adores my babies.

Not likely - I'm leaving on Friday, returning on Monday night over a holiday weekend. I'll check his BG before I leave and give him his AM insulin.
@Djamila , @Rachel , and @Kris & Teasel said they would consult with me, look over Jester's SS, and come up with a dosage that's in a safe range and considers the probable lower food intake.
Also, I'll be in contact with the original sitter to see how much Jester is eating. If his intake goes down significantly, I'll instruct the second sitter to reduce the dosage.

Thanks very much. I appreciate that.

 

The "Following You" was just a little moral boost. Imagine doing this pre cellphone/internet? No reply needed, I've done all I can.
Good luck Jester, mommy loves you.

 

@Djamila @Kris & Teasel @Rachel
I've been worried about increasing Jester's dosage because of the upcoming trip. His curve over the weekend was almost all yellows and pinks.

I'd really appreciate some input. I'm not home during the day and I've been pushing his dosage time to later because the sitter won't be able to come until after 7:30am/pm.

Tonight I won't get home until after 6:00PM so his PMPS will be almost the right time for a change. (Dosage will likely be about 6:45PM.)

Thursday evening I have a choir I can't miss as I have an upcoming solo just two weeks later. So Jester won't get his insulin until around 8:00PM - although that will be about in line with the sitter's schedule.
But it also means I may be feeding him less than three hours prior to his PMPS that evening and his BG will likely be off as a result. (It usually takes about three hours for the carby foods to get through his system for a "clean" reading.) Planning to do a +9ish when I get home from work, in any case.

 

Looks like 1.5 is keeping him pretty steady. I do think you need an increase, but since you're going away for the weekend, obviously you don't want to do it then. I do think 1.5 would be more than fine for your dose while you're away. He's stayed pretty high on that dose...if you are uncomfortable with that, you could go a little lower.

 

I agree with Rachel.. The 1.5 u dose should be OK while you're away and plan on going to 1.75 u when you get home.

 

I agree with the 1.5u as well, and the increase when you get home.

 

The one concern is food. Because I'm around when Jester is hungry, I do give him more than the cat sitter is likely to give him.

Considering Jester will almost certainly be eating less, do you all think that the lower intake with the 1.5U will compensate enough to keep his BG in a reasonably safe range?

 

I understand the concern, but Jester has a looooong way to drop before he would be in any danger. And if you let him run higher, and he decides not to eat, then you're putting him at risk of ketones. I would recommend sticking with the 1.5u while you're gone unless he does something dramatically different in the next couple of days.

 

I agree. I think that the 1.5 will still keep him safe. Looking at his curve, he basically stayed above yellow. That means, he has several colors to go before it's unsafe. I think that even though he'll be eating less, he will still be more than safe on 1.5. The higher numbers can make him feel icky which will make him want to eat less...I think 1.5 is good and safe while you're gone and then an increase when you get home will hopefully help push him lower.

 

Actually, he's been pretty ravenous lately. I still wonder if he has a thyroid thing going on.

If you look at his food intake in the "remarks" cells, especially on days when I'm gone from about 8:00AM until 6:00PM - closer to the actual 12-hour point for his insulin - he'll pretty much hoover his food.

Since he started feeling better from the pancreatitis, finishing off a full can of Friskies plus has been pretty much the norm.