? bouncing numbers

[Karen & Rudy]

I thought maybe after his dental work that I would get some more consistent numbers, but nothing its working. His numbers go from a nice pre shot of 240 to HI on the meter (over 600). I have no idea what to do anymore.

Up his dose? Start thinking of a new insulin?

I am in the process of interviewing new vets as well, it is more difficult than I thought. Any thoughts and advice are welcome, I know I'm not the first one to go through this. I feel that he is old and fragile and I don't want to make the wrong choices, but I feel like a failure at this point because I'm doing no better for him than when he was diagnosed 9 months ago :-(

 

[Larry and Kitties]

Could be bounce. I would reduce the does to 1 or 1 1/2 units.

 

[Bron and Sheba (GA)]

I have a very bouncy cat and she bounces because she drops too fast from preshot to nadir. I am trying to manage this by feeding the curve, that is giving food to try and stop her dropping too fast. Another reason for bouncing is dropping lower than the cat is used to . It might not be really low but the cat thinks it is and tries to 'save itself' by releasing chemicals from the liver which sends the blood sugar high. Bouncing is frustrating but there are strategies to try and manage them.
You need to get more blood tests in the middle of the cycle at about + 5 or 6 if you can both during the day and at night. This will help the experienced people on this board to see what the problem is.
I am not experienced enough to help you with dosing but I will ask a couple of people who know a lot about bouncing to help you.
@Elizabeth and Bertie
@julie & punkin (ga)
@Wendy&Neko

 

[Chris & China (GA)]

What I'd do is start getting some mid-cycle testing during the day (like around 5-7 hours after the AM shot) and at LEAST a "before bed" test on the PM cycle.

Rudy may be dropping much lower at night and that's what's causing the bouncing

 

[Sue and Oliver (GA)]

I think we have discussed a sliding scale for Rudy before? It seems like 2 units might be a good dose for his pink pre shots, but too much for the yellows. Although we don't know without some midcycle numbers, it seems likely he drops lower on the lower range pre shots and then bounces up for the next cycle. When you can be home, a curve plus a mid cycle number at night should give you (and us) some valuable info, and a direction to move concerning dosing.

 

[rhiannon and shadow (GA)]

I agree that we could really use that data.... some mid cycle tests.... am and pm....

Either blue numbers make him bounce really hard..... or even the more likely..... greens .....
those black bounces show his body is reacting big time to some low number.....
but we need to see what he's doing.....

 

[Karen & Rudy]

I think we have discussed a sliding scale for Rudy before? It seems like 2 units might be a good dose for his pink pre shots, but too much for the yellows. Although we don't know without some midcycle numbers, it seems likely he drops lower on the lower range pre shots and then bounces up for the next cycle. When you can be home, a curve plus a mid cycle number at night should give you (and us) some valuable info, and a direction to move concerning dosing.

we did discuss that and my vet threw a fit :-(
I just got off the phone with a potential new vet and they don't use prozic at all. they would switch him to lantus. does this sound like a good idea at this point or should I keep looking for a new vet? they are really open to home testing and will write a script for just about anything for me to buy online no problem. they will even give me b12 and let me administer shots at home. all good news, but not sure if switching is a good thing or bad thing at this point....

 

[Sue and Oliver (GA)]

A change in insulin could be a good idea. It might depend on your schedule. Lantus works best 12/12 and doesn't do well with the variations you can do with ProZinc, like shooting early or late. I think the nicest thing about Lantus is that you get a number and have a dose for that number, no looking for patterns. It's pretty straight forward. You might go over to their forum and read through the stickies and the threads. You would want to be sure your new vet supports their protocol, whether you want to use the tight regulation or start low, go slow.

Some cats do well with a sliding scale; some don't. But it has never made much sense to me to give a dose that takes a 350 number down 60% and then give that same dose on a 200 with ProZinc. I think it is wise to adjust the dose if you get a lower than expected number. He does seem to be reacting well to the ProZinc and has some nice numbers thrown in there. It would be a matter of seeing how low a dose takes him and adjusting for that.

Up to you but be sure your new vet would use an established protocol for Lantus so you don't end up wanting to do something he might not support.

 

[julie & punkin (ga)]

Bron tagged me about your spreadsheet, but I'm really not skilled with ProZinc. You've been helped by folks who know more about ProZinc than em.

The one thing I'd add is to suggest that you think of your spreadsheet like a jigsaw puzzle. When you're doing a puzzle, you don't need every piece to see what the picture looks like. But if you only have the edge pieces, or only have one stripe down the middle, you really can't tell what the picture is. Whenever people have trouble figuring out if their dose is too high, or if the cat's high numbers are bouncing numbers caused by the cat going too low, or dropping too fast, I always suggest that you try to sprinkle your tests around. If you can get just 2 more tests each day - one in the day cycle and one in the night cycle, after 3 -4 days you're suddenly going to have an infinitely better picture of what's going on inside your Rudy's body. Then it becomes easy to figure out what's going on and how to adjust the dose.

There are pros and cons to each of these insulins. One thing you need to consider about Lantus is that its dosing is based almost entirely (not 100%, but perhaps 95%) on how LOW the dose takes the cat. The low point in the cycle is almost always sometime between about 3-8 hours after the shot. So in order to figure out the dose, you really need a midcycle test. It's not safe to only decide based upon the preshot number what you're going to give for a dose. You have to chase those low points so you know how low the dose is taking the cat. It's something for you to consider.

The option for folks that don't want to test much is the Start Low Go Slow dosing method. To decide on dose changes with it, you do a curve every 2-3 hrs once a week.

There are yellow labeled stickies at the top of the Lantus/Lev insulin support group that explain SLGS and the Tight Regulation Protocol - the two dosing methods that we help people with. Regardless of which dosing method you want to use, you still have to figure out how low the current dose is taking the cat's blood sugar before you adjust it. It's worth your time to take a look and see what's going to work for your life.

Good luck! Just ask if you have more questions.