Myrtle bouncing the last couple of days

[Myrtlesmum]

Even though she hasn't been getting that low, she seems to have been bouncing the last couple of days. Not sure whether I should maintain the current dose or go lower? Would going lower mean her bg would stay too high though?. Nadir is always around the 7-8 hour mark for her based on experience from this spreadsheet and previously. I'm genuinely perplexed as to how to proceed. If anyone could look at her spreadsheet and share your thoughts, I would be most grateful. Thanks!

 

[Sue and Luci]

The first thing that jumps out at me is the lack of tests at night....what's going on there? Without night time tests it's hard to say that this is a bounce. Could just be normal numbers OR it could be that she's dropping lower at night.

There's no evidence to support a reduction at this time.

 

[Myrtlesmum]

The first thing that jumps out at me is the lack of tests at night....what's going on there? Without night time tests it's hard to say that this is a bounce. Could just be normal numbers OR it could be that she's dropping lower at night.

There's no evidence to support a reduction at this time.

I’ve been working nights a lot lately so unable to test - I’m a casual worker at the moment so I need to take work where I can either day or night and I’m pretty much wrecked and trying to get sleep on a messed up schedule when I am home - doing my best when it comes to testing. Although as her BG has doubled in 4 - 5 hours at the end of the cycle the last 2 days, I would have thought that’s evidence of a bounce? I can’t seem to find much info on bouncing - if anyone could point me in the right direction on more info on this topic, it would be appreciated.

 

[JaxBenji]

Hi! Here's info on bouncing from "The Basics" sticky at the top of the board -

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

I get life is hectic and you are doing your best Are you able to grab anything at night before you go to work? Like even +1,+2, or +3? Or when you get home? As you may know a lot of kitties like to go lower at night than during the day. Hang in there

 

[Sienne and Gabby (GA)]

My thoughts were the same as Sue's. If there's any way you can grab a test even it it's at +2 or +11 on the evenings that you're working. (We're more used to seeing people working days vs nights. Many of our newer members don't realize they should get PM cycle tests. We do understand how work can interfere with your managing Myrtle's diabetes!)

Basically, what bounces are all about is a large or rapid drop in test numbers. So, if Myrtle were to drop into low numbers, if she had a big drop (e.g., 400s to the 60s), or a fast drop (vs a gentle slide), there's a high likelihood her numbers would spike into a high range. The mechanism behind a bounce is that the liver and pancreas, in response to the drop in number, does into "panic" mode and releases a stored form of glucose along with counter regulatory hormones. This is what causes the spike in numbers. In can take roughly 3 days/6 cycles for the bounce to clear although once your kitty becomes used to spending time in lower numbers bounces are less frequent and clear more quickly. Bounces are a normally occurring, protective response that annoys us but is not dangerous or unusual.

Given that Myrtle isn't new to diabetes, it's less likely that she's bouncing. I'd also be reticent to suggest reducing the dose unless I can see a documented drop into reduction worthy numbers. Your signature doesn't indicate which dosing method you're following. Have you been able to decide?

 

[AliceR]

You might be entertained by Catman's SS. Talk about bouncing. I too can't test at night but I squeeze in a +2 now. Had to shift my scheduled shot time a little to make it happen.

If anything those blues look great! I thought we were headed there 2 days ago and then yesterday happened (while I was at work and DH was in charge... ). We tried TR but I couldn't handle it so we are going slow now.

 

[Myrtlesmum]

Hi! Here's info on bouncing from "The Basics" sticky at the top of the board

Thank you so much for that link - it lead me to a link in that sticky that is an in depth discussion on bouncing. It actually answered a couple of my questions

"swings from 100s to 300s repeated[ly] . . . indicate it is probably too much insulin" and also discusses the pros and cons of reducing the dose - and the advice was generally to ride it out. I'm hoping that now that it's over a month after Myrtle's dental that all these swings are leading to better numbers (fingers crossed). Having said all that, today is not a good day and I've actually increased her dose a smidge - hoping it was the right thing to do. Vet suggested I give 1.1 am and 1.0 pm? (basically plunger on the line or just so you can see the line). Myrtle has always been very insulin sensitive in the past and I do think 1.1 consistently may be too much?? I'll see how we go and try to get in as much testing as I can.

 

[Myrtlesmum]

Given that Myrtle isn't new to diabetes, it's less likely that she's bouncing. I'd also be reticent to suggest reducing the dose unless I can see a documented drop into reduction worthy numbers. Your signature doesn't indicate which dosing method you're following. Have you been able to decide?

Thanks Sienne. I agree, I won't be reducing the dose at this stage (please see my response to JaxBenjii). I'm doing SLGS with a hint of inpatience - I just don't think I can get in enough tests to do Tight Regulation and Myrtle has always been very insulin sensitive in the past so increases need to tightly monitored. I appreciate your input - thanks!