? 4/13/18/Ravan/amps515/+3 412/+8.5 228/pmps439/+4 250/+8 383/ 290

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Most likely a bounce, can’t tell for sure without any data from last night. See the pm cycle on 4/10? You had a similar preshot to last night, Ravan went down to a high blue and then bounced to the 424 in the morning. Many cats like to go lower at night. Ravan probably went to a lower number that he is not used to. Bounces will usually quiet when you get to a working dose of insulin. I would get tests today in the +7 to +9 area to see if the bounce is breaking. Hang in there.
 
@Stacy & Asia
bg pmps 374 +3 397 +8 377

Yesterday got into 200's Now amps 515? Is this still a bounce? Will he bounce this High everytime I increase the dose?
 
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@Stacy & Asia
@Sienne and Gabby (GA)

Would you both Please look at Ravan's SS & tell me if you see where his Nadir occurs? To me it's all over the place.

March 26 to 31 I thought it was going in the right direction then I did a fur shot & it all went downhill!

April 7 I increased the dose & thought it started looking good again. ( I was using Generic Keto strips & had a difficult time seeing a difference between neg & trace)

It was advised to increase the dose again (after only 4 days on the last increase) because of the trace ketones ( since then I bought the Ketostix & can tell the reading better. so Far it's been neg)

Since this last increase I'm concerned his bg looks higher than ever.

He was raised on Raw meat diet but was off that for nearly a yr ( refused to eat it?) He has been getting various canned food an occasional piece of raw liver, Recently FFeast classic

About 2 weeks ago he started eating his raw meat again? I do not feed him 2 hrs before a shot.

I read on one of the posts that a Bounce is caused by Too much insulin?

Your input & advice would be appreciated.
 
@Tracey&Jones

Could you pleas look at Ravans 'SS & give me your opinion?

I'm concerned about his High reading after the last increase? Today is the 3rd day & they are higher than they were last week!

Any suggestions?
 
Hi JoyBee, you are right, nadir is all over the place. :p Some cats will not have a predictable nadir, some do, some move around. Regardless, it won’t really become clear what the patterns are until you get to a good working dose. If the insulin amount is enough, things are more stable and you are better able to see what is typical and what isn’t.

I know it’s concerning that the numbers seem to have gone up with the insulin increase, but you have increased safely and steadily, you haven’t skipped a good dose. I hear you are still concerned about the early increase, hopefully this will ease your mind, even on SLGS, had you followed the guidelines as written, your dose would be 1.5 now anyway. You went from 1 to 1+ to 1.25 to 1.5 when it should have been 1 to 1.25 to 1.5. Increasing or decreasing in amounts smaller than .25 when you start, and especially when you haven’t neared a good dose, is not recommended. All it does is delay the process until the next increase and keeps your cat in organ damaging higher numbers.

Bouncing is normal, looking at it a different way helped me understand and accept it, check out this thread about bouncing:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=55306
 
I agree with Stacy. I think you may still have a bounce from that blue.

Keep patient as hard as that is. Keep giving him extra food and make sure he is drinking. Glad you are testing for keytones.

With SLGS you would wait 8 more cycles to increase again.
 
JoyBee said:
@Stacy & Asia
@Tracey&Jones

Thank you both for your advice. I'll hang in there for 8 more cycles

How do I increase according to the Nadir if I don't know where the nadir is?

I'm very concerned about the big # over 500
Click to expand...

You have a nadir in every cycle, it is the lowest number you catch in each cycle. So you do know the nadir, it’s just not in the same place predictably each cycle yet. You don’t need to know where the nadirs are to increase, you just need to know what the nadirs are. Those larger numbers should go away when Ravan has enough insulin.
 
@Stacy & Asia

? bg at 5:30 228 not interested in eating at all. Had a few bites of his raw meat diet at 1pm When his #'s are high he eats every 2 hrs & drinks a lot of water. When the reading goes down he won't eat!

If bg goes below 200 at shot time PM Do I reduce the dose? If he still won't eat? Syringe feed?

I read that if the Nadir is below 90 you should decrease the dose." For future reference "what dose would I give at 1.5 units?
 
JoyBee said:
@Stacy & Asia

? bg at 5:30 228 not interested in eating at all. Had a few bites of his raw meat diet at 1pm When his #'s are high he eats every 2 hrs & drinks a lot of water. When the reading goes down he won't eat!

If bg goes below 200 at shot time PM Do I reduce the dose? If he still won't eat? Syringe feed?

I read that if the Nadir is below 90 you should decrease the dose." For future reference "what dose would I give at 1.5 units?
Click to expand...

Unregulated diabetic cats often eat a lot because they cannot make proper use of their food, they eat and eat and it does not fix the problem. Despite there being so much glucose available, it cannot enter the cells that need it because of not enough insulin or insulin resistance. He could be having less of an appetite because his numbers are lower and he can convert some of his food into energy. This is not abnormal. However, there is a difference between decreased appetite and inappetance, that’s where know thy cat comes in.

For SLGS, in the beginning, if the preshot number is below 150 and you are not able to monitor, you would skip the shot. If numbers anywhere in the cycle are below 90, you reduce the dose the next time you shoot. For slightly higher numbers, from the sticky:

  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.
Because you do monitor frequently, I think you would do just fine to shoot between 150 and 200. Numbers like that seem scary at first, but they are key to regulation, especially at preshots. The insulin can grab on to a good number and try to balance it rather than having to grab a high number and pull it down. As long as you are prepared with test strips, higher carb food, some type of sugar like honey, you have what you need. If you are concerned over the preshot number, do not feed him, post and ask for help.
 
JoyBee said:
I read on one of the posts that a Bounce is caused by Too much insulin?
Click to expand...
Not true. Wish I had a dime for every time someone miss uses the term bounce on here. A bounce is from going lower than they are used to or fast drops, that's it. Some cats bounce on yellows if they aren't used to it. Ravan definitely bounces from blues. Neko's spreadsheet started getting really ugly ( including bounces to Hi or over 600 ), when she first started seeing low blues. I took it as a sign the insulin was finally starting to do it's job and get her into good numbers. The bounces will pass over time. Ravan' spreadsheet looks like that of a lot of other cats who have recently started insulin.

As for tonight's PMPS, some cats do a jump up in numbers, just before coming down and breaking the bounce, it's cycle six after the blue that causes the bounce. A good time to break the bounce.

When they earn a reduction by going below 90, you reduce the dose by 0.25 units.
 
There's some hint that Ravan's nadir is mid-cycle but his nadir isn't reliable at this point. A couple of things to consider. For all of our cats, nadirs can and do change.For example, Gabby's nadir was at around +3 or +4 except when it wasn't.

The "ideal" Lantus cycle is flat -- there's no discernible nadir. It may be that Ravan is one of those kitty's who has flat cycles from day 1.

I want to second what Wendy said. Decreasing insulin to try to fix bounces just doesn't work. Too much insulin being the cause of a bounce is what amounts to an urban myth. All that happens if you reduce the dose is that your cat is in lousy numbers for even longer and you have keep increasing the dose anyway. So, you lose time in the overall process of achieving regulation.
 
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