8/20 Cosmo AMPS 515, +3 518, +6 504, +9 502 PMPS 508 +3 500,+8 455,+10 445- Bounce day 2

thebigfuzz

thebigfuzz

Member Since 2012
Yesterday:
https://www.felinediabetes.com/FDMB...79-9-515-pmps-443-2-443-3-5-376-5-364.233838/

I had a long nap yesterday, so I was up late and decided to do some testing to see if he would break his bounce last night. He did come down a bit into the 300 range. Went to bed after +5 and he is back up into the 500's this am.

Based on my data, I suspect he may break his bounce today/tonight, so I am on the lookout for any crazy slides - which Cosmo is a fan of.

While I was awake, I was reading a bit on the somogyi effect - which came up on Cosmo's blood work results now that I think of it (in text). I realize the effect usually pertains to overnight lows, followed by high am BG. On FDMB, I read that the treatment is to decrease the dose by 25-50%.

Cosmo is prone to big steep drops, followed by days of really high numbers. Hmmm... :bookworm:

Thoughts?
 
Cosmo's trying to work the insulin. Even after reducing, he's putting in some effort. Hope the next couple cycles brings better #s.
Be good Cosmo:cat:

Thanks again for last night/this morning Tanya!! You rock:bighug:
Have a great day
 
thebigfuzz said:
Yesterday:
https://www.felinediabetes.com/FDMB...79-9-515-pmps-443-2-443-3-5-376-5-364.233838/

I had a long nap yesterday, so I was up late and decided to do some testing to see if he would break his bounce last night. He did come down a bit into the 300 range. Went to bed after +5 and he is back up into the 500's this am.

Based on my data, I suspect he may break his bounce today/tonight, so I am on the lookout for any crazy slides - which Cosmo is a fan of.

While I was awake, I was reading a bit on the somogyi effect - which came up on Cosmo's blood work results now that I think of it (in text). I realize the effect usually pertains to overnight lows, followed by high am BG. On FDMB, I read that the treatment is to decrease the dose by 25-50%.

Cosmo is prone to big steep drops, followed by days of really high numbers. Hmmm... :bookworm:

Thoughts?
Click to expand...

My vet was certain that Butters had the somogyi effect and that's why she dumped Butters as her patient. So I came to the board to ask about it and figure out what to do, after finding very little info doing a search on the site:

https://www.felinediabetes.com/FDMB...bouncing-or-somogyi-or-something-else.232542/

Wendy&Neko had helped me. She said Somogyi had been disproven in cats on Lantus and TR, reference this paper here.
The huge difference of course is that Cosmo is on SLGS not TR.
@Wendy&Neko if you have time, do you have any thoughts on Somogyi in cats like Cosmo, on Lantus doing SLGS? THank you.
 
I think Cosmo has some glucose toxicity, from all his time in higher numbers. He is also taking about six cycles to clear his bounces, based on how long it took him last time. I expect that would mean action tomorrow during the day, or possibly tonight.

Please disregard that reading on Symogyi - that was a study done on a small number of humans, done decades ago on fast acting insulins we no longer use, much less depot insulins. Unfortunately the veterinary world seems to have taken on the phrase without really knowing the history or how it really relates to cats. Lyla gave you the link to a cat relevant paper (though more recent one vets might not have read). The basic premise on a cat being on too high a dose, is if they started on too high a dose (which Cosmo did not), increase by too large an amount (also not true in this case), or without testing to see how low the dose is taking the cat. True you've missed the odd night time tests but you've also gotten a number of them. Cosmo must have special gastro food for his megacolon - high carb food means cats need larger doses.

Side stories - we once had a cat who the caregiver thought was getting all low carb wet. Linda had a few other cats, some getting dry. She didn't think the FD cat could jump up to where the dry was stored. He got up to 5.5 units of Levemir. One day the caregiver decided to put all her cats on low carb wet. After a couple of days and nights of really scary numbers - Scooter went into remission. High carb dry can make a huge difference in dose needed. We had another caregiver who adopted a cat eating vet high carb dry and on 11 units of Levemir. :eek: He was hugely fat, had to eat to keep himself safe. Anyway, on low carb wet, his dose was around 1.5 units.

By the way, a +2 or even +3 test is a good indicator of how the cycle might go. Both last night, and today, they are about the same or higher than the preshot. Last night was exactly the same, which means a normal Lantus cycle, today's was higher, meaning a quiet or bounce cycle. If you ever get a +2 at night that is lower than the preshot, that's the time to set the alarm for another test. You saw that on both 8/14 AM cycle and the 8/17 PM cycle.
 
Thanks @Wendy&Neko

I was just reading the links on Glucose toxicity...the treatment sounds scary o_O I suppose the part we aren't doing yet is backing off the dose as much as maybe we should as soon as he drops. I'm not sure what you recommend?
 
The treatment for glucose toxicity is giving the insulin they need. I recommend following SLGS. Hold this dose to see if he clears the bounce and gets to better numbers in the 7 days. If not, you increase again, by 0.25 units. If he drops below 90, reduce by 0.25 units.
 
Oh goodness, Cosmo! What on Earth are you doing in the coal mine again?! This is no place for a kitty, come back this minute!
 
I think he may be breaking his bounce late on PM cycle. He was very hungry (with an empty bowl. They finished it off between +3 and +8) at +8, ate about 1/8 cup of kibble and then had a lower number at +10. Hoping to have a nice slow slide on AM cycle, if that's what he has decided to do. I want his liver 'unpaniky' :rolleyes:
 
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