5/14 Fred update. Breaking that bounce!

[Purrberry]

https://www.felinediabetes.com/FDMB...543-7-518-pm-dosing-advice-after-hypo.247311/

So just a quick update on Fred. So many people graciously helped us out!

So, as per my last post yesterday, Fred was at 534 for PMPS. I gave 7u, his new dose. I crashed out early, having been up with him all night previously, but before going to bed gave him extra food just to try and make darn sure we had an uneventful night. He ate that right up. Also put extra in the timers. I thought, "Surely he will be fine. He'll be in this bounce forever". The last I saw of him before passing out was him lying next to the bed, looking as miserable as he had all day.

Two hours later, at +3, I'm awakened by a cat landing on my head, all purry and perky and starving. Just like Wednesday night. "Dear God, no..NO!! Not again!" Off we went to be tested, me with my heart in my throat. Thank goodness, he was at 360. A lousy number on any other day, to be sure, but it meant he had dropped 176 points in three hours! And we were ~6 long hours from nadir. Fed him some of his regular dry, and tested after another 30 minutes. He was up 13 points to 373...likely the food. At this point, I convinced myself he couldn't possibly drop another 300 points with more food to come in the timers and passed back out. I awoke to a very happy cat with a "nice" PMPS of 302.

I had to rush out this AM but tested him at +6.5 when I returned home. 214. This bad boy is breaking the bounce fast. Oddly, the harder and higher the bounce, the faster he seems to break them. We'll see where he is for PMPS. If he's still on the way down, I do feel I'll reduce to keep him safe. I have read that after a hypo, they can become more sensitive to insulin, so perhaps that's the case here.

I have a MUCH happier cat today, and that's all I need for now!

 

[Summer and Susie (GA)]

Don't reduce yet. You did reduce after your scary night. With SLGS you don't reduce again until they go lower than 90. Fred is starting to show better numbers with the 7 units. You don't want to jeopardize the progress he is making. Let the 7 units play out and then, definitely, if he goes below 90 you reduce to 6.75. I think you need to give him a chance to adjust to this dose unless he does drop a lot. I think it was a mistake to take him down to 3.5 units the other day. It really threw him off. Just give this dose some time, Kathleen. I'm interested to see what his PMPS will be. I think it will still be pretty high. Then test at +2 tonight after his 7 unit shot at PMPS and his dinner. If the +2 is higher, or about the same, you might be able to go to sleep for the evening. If it is lower you will need to check again later tonight. Of course, all of this will depend on the numbers but I'm not expecting him to go too low tonight after the bounce we saw. I could be wrong so hopefully someone with more knowledge will come along and comment.

 

[Wendy&Neko]

I have a MUCH happier cat today, and that's all I need for now!

Woohoo, that's the most important part.

I have read that after a hypo, they can become more sensitive to insulin, so perhaps that's the case here.

That's a symptomatic hypo, which sounds like Fred did not have, he just had lower numbers. It's possible you broke through some glucose toxicity though.

Let's see where he goes on this dose, he's in plenty safe numbers now. If he does go below 90 again, you'd reduce by 0.5 units - at Fred's size of dose.

There are things you do when kitty is on higher dose that you don't do with a kitty on a lower dose. Doing the half dose or BCS yesterday was perfectly fine this time. With that higher dose is a higher depot, so being cautious first couple times you see lower numbers is a good thing to do. When you have a higher dose cat, there are things you have to learn about how your cat responds. In this case you want to learn if he'll bounce after lower numbers, whether a BCS is a good thing, and how much of a BCS makes sense. Because my Neko was pretty guaranteed to rocket to the moon after lower numbers, I didn't often have to BCS. Later when she was less bouncy, I found a 2/3 dose was better than a 1/2 dose. But I've seen others where a 1/2 dose or even skip is appropriate, depending on the situation. (See Oberon today ).

 

[Purrberry]

That's a symptomatic hypo, which sounds like Fred did not have, he just had lower numbers. It's possible you broke through some glucose toxicity though.

Gotcha, and I hope so!

you want to learn if he'll bounce after lower numbers,

Well, we know the answer to that one...lol.

whether a BCS is a good thing, and how much of a BCS makes sense.

These..definitely good things to know, but I always find it tough to figure out with Fred because he's such a bouncer. I shot the 134 the other night feeling perfectly confident, so he blew a hole in that one! Now he's reverted me back to my "scared to shoot lower blue" state...at least temporarily. I think he's on his way up for tonight, anyway. He was higher at +8.5, and using "tail as barometer", his BS is on the move. He always gets very swishy when things are moving in either direction. He'll probably bounce from breaking the bounce!