Is This Somogyi Rebound?

Getting a bit stressed about this feline diabetes thing. @-) Blue is on PZI insulin and was diagnosed only 2 weeks ago. We have him the usual 2.5/3.0u dose (which we have taken down gradually from his original 4.0U).This morning his BGL zoomed down to a low range and now it has bounced back up. There seems to be little effect from his 2.5 Unit dose this morning. We gave him a small .5 dose this afternoon to see if he would drop, but nothing. I'm concerned about this upcoming evening dose as well. I dont want him to bottom out again should it be rebound.

I was using the Relion Ultima and am now using the OneTouch UltraMini as I've seen some crazy numbers with the Relion (a 200 point spike in 1/2 hour a few days ago.)

I should also note that the PZI attains Nadir usually around hour 8 and not hour 5 as the chart shows. Also, if this is rebound, should I Proceed with his
next usual PMPS dose should he still be in the 300's?

Blue is being fed a high protein/low carb diet. He has shown no clinical signs of hypo.

As always, all opinions appreciated!

 

OK, I'm confused. Did the drop this morning come before or after the shot that you said had little effect?

The drop followed by a rise to a high number looks to me like rebound, but I am no sort of dosing expert. I hope somebody who knows a lot more than me will come along soon.

For the moment, I'd keep doses low, unless and until a person who knows dosing better than I do comes along and tells you differently. From what I've read, I gather that rebound can take many hours to clear, and pounding it down with insulin is not the way to go, because that can cause an unexpected drop later on.

Are you checking for ketones? Those can develop if the amount of insulin is inadequate (usually don't, but can).

 

Blue's shot last night triggered the drop to the BGL of 35. Overnight he went up to 355 and this morning's shot had no effect. As of now I plan on lowering this evening's PM injection to 2.0 and hopefully it has an effect. Like you said, I don't want to pump him full of insulin and have him go hypo. Hopefully I can get some more opinions on this before his next scheduled dose - in 1 hour.

I plan on checking for ketones when I can catch him in the box. Since he's been on the juice, he doesn't seem to go much anymore and it's difficult to catch him. I also plan on monitoring his BGL every few hours after tonights dose.

Thanks for chiming in.

 

Have you tried posting in the PZI support group forum? Put in your header Dosing Advice and maybe some of those PZI experienced members will see it. I know nothing about PZI and its pretty different than Lantus.

 

OK I'll post over there and link to this. Danke!

FTR he is on PZI human recombinant insulin.

http://felinediabetes.com/FDMB/viewtopic.php?f=24&t=10935

 

I think it is highly likely that you did infact see rebound from that first dose, but it can take a few cycles for the effects from rebound to clear so you have to be patient. I think a drop to 2 is good, or even 1.5 or 1 might not be a bad idea (not knowing your history much). Patience really is required for this journey...

Jen

 

... and I'm not a very patient person which makes it even tougher. ;-) I'll keep his dose down for a few cycles at least and hopefully it will start to get back to normal levels. He has had Ketones so I'm a bit concerned with that. 10 hours ago he was negative for Ketones. It's like walking a tightrope! thanks for the input.

 

yeah, the ketone issue makes things tight, so don't drop to 1 unit but definitely drop a bit.....

 

I have not read the other post over in PZI land.. but I will after I post this. Looks to me that there still maybe some overlap working through Blue's system, so I am glad you did shoot a bit lower. Looking at his SS. It seems that he definitely starts to raise by +10. Waiting until next PS seems to bring him back into the pink (300's). Since he's just starting out and you're trying to get an idea of his data. You may want to wait another hour or two when his PS is low, so you do not skip a dose. I know this may be hard since it's all about timing and patients, but you're doing a great job. Looks like 1.2 is a good dose, but I feel if you can catch the raise before it hits pink again... you'll be lowering the 1.2 soon :smile: If you catch yellow at +9.5ish I'm guessing that's about 6:30am? If it were me - I'd think about shooting 1.0 and not 1.2 because of bg 53 earlier today.

I know I am posting late.. sorry, I will check back in the morning. Sending you good vibes cat_pet_icon