Jaxa (Dosing advice, please)

Both Pure Bites and Orijen make the same type of freeze dried treats for dogs and cats. The dog chunks are bigger but the bag is better value - just break up the chunks for Jaxa.

 

Cat-man-doo Life Essentials freeze dried treats are for both cats and dogs as well.

 

I order the purebites for my cats. I've also bought another brand at PetSmart...can't remember the name. If you look on the bag, just look for the ingredient list. It should have one thing listed...chicken (or whatever flavor you buy).

 

We have the PureBites chicken and catnip right now, but she likes to smell it instead of eating it. Dog loves it though. Also have VitalEssentials duck liver, but she eats that better if I crush it and add to her regular food. I want to find one more flavor, but she hated the freeze dried tuna treats (and the bonito), so thinking anything seafood is a bust at the moment. I want to get a sampler pack (PureBites I think has one I bookmarked a while ago), and then we can work through which ones she likes. It is hard; we get to a crossroads between my checkbook and her pickiness.

 

If you have a higher-end pet food store near you, they will often give samples of food and treats if you ask. And if not, they tend to have liberal return policies so you can bring back whatever you bought if your pet won't eat it. Really helps on the finances! I tend to buy things at the fancy store when I'm trying them out, and then order online once I know it's a winner.

 

We have a semi-decent store locally, that gave me some Taste of the Wild as a sample (the only kind they had samples of), but they are more well-meaning than knowledgeable. I asked about low carb foods the last time I went there and they seemed to think grain-free was automatically low-carb. They did have some freeze-dried treats and Cat-Man-Doo items though, and I got our CBD oil there a while back, so will take another look.

I am worried about our AMPS numbers though- red again today. I was happy that before all the reds were at the vet office, and none at home, but now I can't say that anymore. Maybe I am chasing numbers too much? I just don't know what happened; I need more middle numbers, but that might be hard today when I am expected to go to a distant relative's dance recital instead of being home. Need to check for any hidden stashes the dog may have left too, though I have been getting the food up every night. And maybe parts of rodents- she was lurking last night like she smelled a mouse.

*Does being at the dregs of the insulin (we're on the last of our first bottle) make any difference to effectiveness?

 

It's possible the last bit of your insulin has lost its oomph. I used to save the last bit of the previous bottle instead of using every drop. If something had happened (heaven forbid!) to my new bottle then at least I had some insulin around to see me through.

Those reds could be from a lower number overnight. If you could try setting an alarm for somewhere between +5 and +7 on a weekend night the data might be helpful. Can you do a curve tomorrow? I know you're busy today.

 

I'll try to do a curve; her +3 is pretty high too. Not much of a change from this morning, when usually I see more of a drop. I've seen more of a drop after a fur shot. I may switch bottles for the PM shot and then get tests after.

*She peed soon after the +3 and we had a negative ketone test*

 

The tricky thing is that if she's dropping lower at night, she'll likely just be high and relatively flat during the day today. So if you get a high flat curve today, it doesn't necessarily mean that she isn't getting enough insulin.

The other side of that is that it could mean she isn't getting enough insulin. It may take a few cycles of testing closer to the +5-+7 range to figure out what's going on.

 

We found Pure Vita Minnows (a long shot but I thought I would try) and she sniffed but didn't show much interest so will try again later, and Orijen regional red (liver and meat from angus beef, wild boar, goat and lamb) and I gave her a small one to see if she would eat it- she gobbled it up so I gave her two more pieces but those are still in her dish after she tried chewing them- so I broke them up a little more.

Will get a +3, and will try to get a +5 tonight. Try to do a decent curve tomorrow. My usual Sunday night plans were cancelled this week, but we still are gone for a bit in the AM.

 

I also use kindle to be on the board, smart phone to log BG and remarks, and have to fire up laptop to fix the ss if needed. It works right?

 

That is exactly what I have to do. Except I can't get to comments on my phone so that section is always blank.

Your ss works. I can open it.

 

Sounds like a good plan. I empathize: those middle of the night tests are hard. I wonder if something like ziwi peak might work for treats? It's a food, but my understanding is that it's low carb (you'd need to verify that) and it's a different texture than the freeze dried treats.

 

I can make comments on my phone in the ss. I do look at other's ss here on kindle, then the ss also is on my phone. I don't have a clue, just ambling along.

 

Not sure what our numbers mean today; I'm pretty sure she had eaten within the hour before the +9, but she grazes off and on during the day and night. Her PMSP was right after she was outside and then watched animal videos on YouTube; she was very good about sitting still for all of the tests today, and I will get a +3 and try for a +5 tonight.

 

I'm glad you got a curve today. These numbers suggest an increase to 4.5 u tomorrow. I think you can either stay at 4.25 u for evening or give 4.5 u both AM and PM.

 

Will probably do 4.5 in AM, and stick to 4.25 for PM for tomorrow. The +3 I just got was the best number we saw all day, would like a +5 too, but depends on if we fall asleep or not.

 

She was at 260 this morning, so I kept the 4.25. I just got nervous about being gone all day without being able to watch her if she goes too low.

 

I think we will go to 4.5 on Saturday morning when I can get a decent curve done. We had some decent numbers last night but she went up again this morning. Teaching my mother how to test and give the shots for the few times I will be away for training (work) this summer. Maybe I will be able to convince her to do some +6 tests in the day too.

 

We are so high tonight! I don't know if she is bouncing or if she got into something outside, when I was gone and she was being watched by my mother. She was scared by the neighbor dog, but that was hours ago. This really worries me though. Ketone test this AM was negative, but I am hoping she pees again so I can do another test. She has never been this high at home before. Called the vet just before they closed so I could set up a time to drop her off in the morning and get some blood tests done. The shot this morning seemed fine- not a fur shot, so I don't understand what drove the numbers up so much and it is freaking me out.

 

Hmmm...it could be a number of things. She might have gone lower than she's used to and be bouncing up. She could still be feeling kind of stressed from the dog thing. It could be what we like to call "oh look a squirrel!" syndrome (basically, something could have excited her in some way making her numbers high...this one means it could be something completely unrelated and that we don't know about but it isn't necessarily bad). Being vigilant about ketones is important, but remember that usually, if ketones are present, kitty will be lethargic and not eating. Ketones usually come from high numbers + not enough insulin + infection. They can develop at high numbers which is why we urge testing, but that doesn't necessarily mean they are LIKELY. If you got a test this morning that was negative, she's probably still negative. Couldn't hurt to get the test for your peace of mind, but I wouldn't stress too much.

Remember to breathe. I know this is stressful, but really it's just one number and one cycle. I wouldn't get worried if she was mine until it became a trend.

 

I wouldn't worry too much. You'd need daytime data to know for sure but she might have dropped quickly at one point or lower than her usual numbers. Either can cause a bounce.

 

She did eat her food, but just before we tested she was in dining room, made a funny meow and then hacked up clear fluid. She was outside for a while today, and the neighbor dog got our dog riled up, but that was hours ago. I worry that there is something else going on, or that maybe she got into something outside that I didn't see (more than grass). I think I want to get a full blood panel since we haven't had one in about two months. I worry a lot, but it seems like we are not getting very far lately.

 

It looks like maybe a bounce given our later numbers? Our +4 was 168, which was a huge drop but her nadir seems to be around +5 and she was eating so I wasn't worried she would go under 50 in the next hour, and she is lower this morning at 276 and seems fine. She doesn't know she is going to the vet yet though. I still want the blood panel and a good weigh-in, and once a month is not as bad as a weekly. Our first vet, while we were still treating the pancreatitis, was obsessed with the idea of cancer and now I keep worrying about that possibility. We lost our last two dogs to cancers (nasal and breast that went to the brain). No one nearby does ultrasound, and his suggestion was based on her glucose though, so I am hoping he was just full of crap.

 

Cancer is never impossible, but around here we often see that a kitty with cancer gets lower and lower BG. Like the cancer is eating the sugar or something. I'm more inclined to think that Jaxa may just have chronic pancreatitis - low enough to eat and be mostly okay, but enough to require a higher insulin dose. Or she may have a high dose condition, but honestly, it's too early to tell on that since she's only been on insulin for two months at this point. Or she may just have a secret stash of high carb kibble on someone's back porch that she can get into when she goes outside.

Looking at your PM numbers the last two nights, I wouldn't rule out a little bouncing as the cause of that red.

Let us know how it goes at the vet today!

 

We are always high at the vet, so that was not unusual. He wants to go to 5u also, so we will gradually increase as we have been doing. I decided to try 4.5 tonight since I am home and can get a +2 and +4 or +5. I added her other blood tests to her spreadsheet in the labs as well. Her two low tests from March are in the normal range now, the two that were high are still high but one is glucose (so expected) and the other is ALKP, but it was at 192 in March and now is 112, and the vet uses 14-111 as the "normal" levels so while I wish it were lower, it is a full 80 pts better than two months ago. Everything else is in normal ranges with some variance from the last test.

She was able to come home earlier than usual today too, and was outside for a bit this afternoon (and now that she had her shot and ate will probably want to lay in the sun some more.) She even played with the puppy for a bit. I'll be watching to make sure she doesn't bounce too low tonight, and then if things go well we will stick to the 4.5 tomorrow and Sunday.

 

So good to hear that overall things are improving!

 

A little worried; at +4 and she is at 68. She has been grazing as she has been dropping, so I'm not sure if I should just let it go and test, or if I should give her something. Her nadir is typically within the next hour, but I don't want to go below 50.

 

Well look at that! I'm sorry no one was around earlier when you were posting! Normally, if the kitty is grazing, you just keep monitoring, and then if they hit 50 you start to intervene, especially when they are close to nadir already. If they drop low early in the cycle, sometimes you would take a more aggressive approach to the food, although sometimes they'll drop low early and then just surf along for hours, never going lower. It can be nerve wracking to wait and watch though!

 

Just did her +5 and that was 57, so I got out a few friskies treats, but right now she is drinking. She isn't acting unusual at least.

 

I knew we would be over 300 this AMPS, but it isn't as bad as I thought. When she was at 57 I put out a couple treats and she was more interested in playing, so I put most away (and she did eat three but not until 330AM when I put the food dish up). Her +6 was showing her bg on the upswing again though, and by then she was more interested in her usual nighttime sleep spot on my bed, so I went to sleep too. And now that she has been fed and medicated she wants to go outside right now.

 

Whew! Exciting times! Sometimes they can have an initial dramatic response to s dose increase and then they settle.

 

It looks like we might be high and flat today, but she doesn't seem to care. I'm always freaking out like she might die at any second and Jaxa is just like, "meh, I think I'll go play."

 

Been there, done that!

 

And then she decided to have a drop after all. I shouldn't have let her stay outside so long, but she was on the deck and enjoying herself so I skipped the +6, and just got a (fasting) +8 which was at 93!

 

Lovely! You’re getting great action at this dose.

 

I just hope her PMPS is decent for a shot, and then need to get at least two more tests after that. Will try for a +3/6/9 curve tomorrow after her AM shot. Other people are starting to notice that Jaxa is moving better and has more energy since we started the b12, so I am really, really glad that we got her on that.

 

This is where I hesitate. She is at 259 for her PMPS, and that makes me wonder if I should give the 4.5 or 4.25, or even 4 instead.

*I did give almost 4.5 (it looked like it might have been more like 4 1/3u, not quite 4.25 and not quite 4.5 but with the u40 it is sometimes a lot of pushing and pulling to get it where I want it anyway. Will monitor, and she is eating.

 

That's great news about the B12! And a nice PMPS ...

 

Okay, maybe tonight we'll be flat. Got a +2 and +4 (though she did eat about 45 min before the +4); I was mostly worried she would drop lower than 50 tonight and she isn't doing that, but is not into the 300s either so that is good. Will do AMPS and go from there, do a curve tomorrow.

 

Not sure what today's numbers mean; we've been fairly even all day in the upper 200's. So no nice greens or blues like we've had the last two days, but at least she isn't sticking in the pinks or reds.

 

This type of flatness can happen after a low. A run of yellows like this can sometimes precede a drop so be vigilant. Who knows why - just a common observation.

 

I'll try for a +2/4 tonight. Each test today was just slightly lower than the one before it, even to her PMPS. She did have the food up for about four hours instead of two, and was outside a lot in the sun, but will watch tonight to see if we have a drop.

*Is it weird that her +2 is higher than her PMPS? I'm guessing it is due to her eating (little bit at a time) twice since her PMPS- during her shot and then again an hour later. And now she just ate again. I think Sundays are off for us in general- I visit family so her food is usually up earlier and the shot a little (15 min or so) later than other days, so then she is hungrier after the shot for a longer time. Will get another test at +4 to check how her bg is moving.

 

Yes, the increase at +2 is usually called a "food spike" some cats get them and some don't. When they're regulated, it often becomes less pronounced. Prozinc doesn't kick in until around +2, so if the first dose has worn off, and the new dose hasn't kicked in yet, their numbers increase for awhile.

 

I like that the 4.5u shots seems to be giving her some good movement, and maybe that is why she was higher tonight on a 4u shot this am? The lower numbers are scarier in some ways though; I'm worried about hypo more often. Higher numbers we are used to and can deal with treating, lower numbers freak me out because I don't know what happens when I'm not home. My mother is going to try to take control of this weekend with testing and shots, under supervision, and I wrote up instructions too. When I have to go to training in August she will hopefully be able to give a couple shots without me being home, and doing all of the proper testing, etc. (We like to plan in advance, lol)

Jaxa was outside most of today, and she and Pepper (dog) are sharing grass and toys now, and I found treats that they both can have, so things are looking up there. Will try to get in another test or two tonight (I fell asleep and missed our +4 and everything else last night). Considering the kind of day today was, I'd get out the bourbon but that would definitely make me fall asleep too early tonight. It'll have to wait.

 

Yes, those greens are scary, as great as they are. It would be very helpful to you if your mom learns to test and inject.

 

We are having lancet issues this week; when we started testing I had gotten the 33 gauge micro-thins, and lots of people said they were too small and that I should get a 28 gauge, or something bigger, so this last time I bought the 30. It is noticeably bigger. And she noticeably hates them. It took about 35 minutes to get the test for her PMPS tonight because she kept flinching away and then jumping off the bed. I poked three times and got a small amount of blood only for her to jerk and smear it into her fur. I finally had to stop and separate for about five minutes because it was getting so frustrating. Tomorrow, when I go to get a few things I am going to look for the 33 gauge again. For those she would lay across my lap and let me poke.

 

Yet another example of ECID - Every Cat Is Different.

 

I bought a 200 count, so at this point I would give them away if anyone was nearby and wanted them. I was dumb and bought the lancing device too which was not able to be returned (cheap though). I should just bring it all to one of the homeless shelters and see if they have anyone in need of those things.

 

That's a good idea actually.

 

I haven't been totally unhappy with our numbers lately; it seems like we are generally trending in the right direction. My mother is going to try giving the shots and tests this weekend, though I will probably do some of the middle tests just to make sure we get some good +3/5 or +6/7 times too. It would help if I wasn't so exhausted all the time; I keep planning to do a second test after PMPS and then I fall asleep and it is so close to AMPS when I wake it doesn't seem worth chasing Jaxa around.

*AM: Not a bad number this morning. We bent the needle though- was going to give the shot and it felt funny so I lifted the needle and the first third of it had bent, not going into her skin because it was too thick there I guess. So I went and got a different needle set up and gave the shot in another location. I'm hoping I wasn't supposed to treat that as a furshot- I hadn't touched the plunger, there was no movement of insulin, the whole amount was still inside when I switched.

 

She'll be fine. It seems you have strong evidence that nothing went in. It'll be great to have your mom helping. She'll probably be nervous at first like we all were but keep telling her it gets easier.

 

We had such nice pretty blues last night, and she got a new scratch-pad to work out her aggression towards the dog (for stealing her grass outside).

One thing that I thought would change was how much she drinks, but I'm not really sure if she is drinking "excessively" since she is mostly drinking from one dish and doesn't seem to be peeing more than she did a year ago (when her bg tests were always normal at the vet). She was always obsessed with water- drinking, playing, putting toys in it.

 

I wouldn't worry about drinking. Many people struggle to get enough water into their kitty. Try to get a couple of tests today between +4 and +8 if you can. You have a good collection of data for evenings but daytime numbers can be different in some kitties.

 

Weird +6 was exactly - exactly- the same as +3. She was having a traumatic test though with me trying to demonstrate to my mother, and the dog squealing and yapping- had to hold Jaxa down to get the test done because she gets freaked out when the dog barks. So not sure how helpful the test was.

+9 was lower; a little less stressed. I think my mother was more stressed than Jaxa. They get to do it again for the PMPS and then my mother gets to give her first shot. I'm having her prep the needle too- under my direction.

 

Next time something like that happens you might want to pause on the test until things have settled down and the dog isn't barking. If Jaxa starts to associate testing with fear and being forced, it can make it much harder to do. Hopefully she'll forget what happened and be okay. Sounds like your mom is stressed enough without Jaxa being scared too! It's so great that she's learning to do this so you'll have someone to help out!

 

We took her into her usual room for the +9 and PMPS and that was a little easier, though my mom thinks she needs to hold the cat down each time so she doesn't get away. She isn't as patient as I am; I usually go at Jaxa's pace and let her find a spot to lay down, and explained that and had her let the cat go a few times so Jaxa could find a spot and then we moved to where we could hold just her ear. I only did a +3 last night to let her ear rest a little more though.

 

Well, I'm home sick so I get an extra day of testing during a weekday. She has been getting some blues at the +3s, so I want to see her +6 today.

She has also been enjoying more outside time. Last night she got into the kiddie pool (for the dog) that had rain water in it and waded a bit with all four feet before getting out to wash her toes. She hasn't done anything like that in years.

 

So I did get a few extra tests in during the day, and while she got into the blues, it was a dramatic drop like we have had some evenings. I am not sure if that is a good sign that this dose is getting her there, or if we need to move to 4.75u. I am worried that we dropped really low into the dark greens a few times ten days ago. I worry about changing things when I am not home as much in the day, or when things are really busy at work (and I have to go out of town a few times for training).

Am I being too chicken? Should we move to 4.75 or stay the same and try to get more tests closer to nadir to see if she is hitting some higher greens?

 

It looks like you have enough data to justify the increase to 4.75u. You could set an alarm for tonight to just be certain that she isn't dropping during the PM cycle.

On the way to getting regulated, insulin needs can change quickly, so what happened ten days ago doesn't mean it will happen now (unfortunately).

I think we all understand being a little chicken about dose increases, especially when you have to go to work. It really does look like she's safe enough to handle it though.