? Need some ideas to stop bouncing

Yvonne & Andy &BJ (GA)

Yvonne & Andy &BJ (GA)

Member Since 2015
Andy had been doing pretty good for a while and then we had a vet appointment and his fructosamine was over 500. After checking my meter (human), I found it was way off, reading over 100 pts lower than my husband's meter. Vet wanted a curve so I started back using my alphatrak 2 meter since they use that in the practice. I also was having problems measuring small doses using Carepoint Vet needles with 1/2 unit markings. Many of the markings were out of line with the plunger so switched to Monojets with 1/2 units which seem to be much more accurate. Anyways, since I've done all that over the last month, I can't stop him from bouncing. He had a recheck of his fruct last week and it was over 400 so it came down some. Vet said 2 choices: it was not super high so could continue as is and recheck in a month again to see trend or increase to 1 unit to see how he does. I chose continue as is because on .5u he can drop up to 300 pts. He has a long history of bouncing - he does not want to be under 150 and I have tried for years to follow both of the protocols on this list. I have only been able to maintain him using Lantus on a shot per bg basis.
I have not been keeping up with his spreadsheet so here are his #'s for the past week:
9/3 286 .5u; vet appt; 364 .5u
9/4 165 .25u; 401 .25u
9/5 300 .25u; 341 .5u
9/6 179 .25u; 302 .25u
9/7 252 .25u; 418 @+4; 381 .5u
9/8 106 0u; 386 .25u
9/9 240 .25u; 478 .5u
9/10 165 0u; 425 @+5

I will try to update my spreadsheet asap at least for this past month.

Any ideas on this problem cat are most welcome. My vet practice does not use Lantus so I am pretty much on my own with Andy. Thanks!!
 
Thought it had been a while! Here is your last post here: https://www.felinediabetes.com/FDMB/threads/3-10-andy-update.211766/

We'll be able to help you once you update the spreadsheet with some data. Maybe even the last couple weeks to start?

Cats stop bouncing once they spend time in normal numbers. What do you mean by "he does not want to be under 150"? Without being under 150, he'll never get used to normal numbers and keep on bouncing. And some cats bounce forever. I see what numbers you have above show skipped doses, which won't help. Consistency is important with dosing.
 
Wendy&Neko said:
Thought it had been a while! Here is your last post here: https://www.felinediabetes.com/FDMB/threads/3-10-andy-update.211766/

We'll be able to help you once you update the spreadsheet with some data. Maybe even the last couple weeks to start?

Cats stop bouncing once they spend time in normal numbers. What do you mean by "he does not want to be under 150"? Without being under 150, he'll never get used to normal numbers and keep on bouncing. And some cats bounce forever. I see what numbers you have above show skipped doses, which won't help. Consistency is important with dosing.
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Hi Wendy - Yes, it's been awhile - been maintaining status quo. Over the yrs, Andy will often bounce if he goes under 150 - he is a forever bouncing cat - the skipped doses were a test to see what effect it would have on his #'s - before last month I was using a human meter and his #'s were decent for him but the meter was wrong and needles were off so his doses were too low etc. Now I just can't get a handle on a good dose - he has just never been "normal". We do the best we can - lost our good vet last year so no guidance there - can't even go in for appts with him due to covid restrictions so it's hard. He is healthy otherwise, no other issues show up except a slight heart murmur. I am working on the spreadsheet.
 
I found that unless I kept Neko's nadirs in the 70-80 range (human meter), she became very bouncy. It was a process that took time to learn what worked for her.

Good to hear Andy is otherwise well. Mild heart murmurs are not unusual with older cats. Neko had that for a while.

Could you update your signature to include what type of meter you are using. Not all relevant to you now, but this post tells you what should go in the signature.
New? How You Can Help Us Help You!
 
Yvonne & Andy said:
Andy had been doing pretty good for a while and then we had a vet appointment and his fructosamine was over 500. After checking my meter (human), I found it was way off, reading over 100 pts lower than my husband's meter. Vet wanted a curve so I started back using my alphatrak 2 meter since they use that in the practice. I also was having problems measuring small doses using Carepoint Vet needles with 1/2 unit markings. Many of the markings were out of line with the plunger so switched to Monojets with 1/2 units which seem to be much more accurate. Anyways, since I've done all that over the last month, I can't stop him from bouncing. He had a recheck of his fruct last week and it was over 400 so it came down some. Vet said 2 choices: it was not super high so could continue as is and recheck in a month again to see trend or increase to 1 unit to see how he does. I chose continue as is because on .5u he can drop up to 300 pts. He has a long history of bouncing - he does not want to be under 150 and I have tried for years to follow both of the protocols on this list. I have only been able to maintain him using Lantus on a shot per bg basis.
I have not been keeping up with his spreadsheet so here are his #'s for the past week:
9/3 286 .5u; vet appt; 364 .5u
9/4 165 .25u; 401 .25u
9/5 300 .25u; 341 .5u
9/6 179 .25u; 302 .25u
9/7 252 .25u; 418 @+4; 381 .5u
9/8 106 0u; 386 .25u
9/9 240 .25u; 478 .5u
9/10 165 0u; 425 @+5

I will try to update my spreadsheet asap at least for this past month.

Any ideas on this problem cat are most welcome. My vet practice does not use Lantus so I am pretty much on my own with Andy. Thanks!!
Click to expand...


I'm curious as to why you dropped from .5 units on 9/3 to .25 units on 9/4? If you look at my spreadsheet Shooter is VERY bouncy. Hoping he settles down someday.
 
Heather82372 said:
I'm curious as to why you dropped from .5 units on 9/3 to .25 units on 9/4? If you look at my spreadsheet Shooter is VERY bouncy. Hoping he settles down someday.
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Hi Heather - I have been using Lantus dosage based on his preshot numbers only because it has worked best for him in the past up until a month ago. It has been my best guess based on how he responds. Prior to about a month ago, he was running in the 100-200's but when vet checked his fructosamine, it was over 500. We could not understand those #'s so did some checking and found the human meter I was using was over 100 pts off from my husband's meter and the syringes I was using were off. So he was possibly being underdosed for quite a while. So changed meter to Alpha trak 2 which vet practice uses and changed syringe brand. Now I am trying to get a handle on his dose but he is bouncing and out of whack. In the past, I've used various insulins and finally settled with Lantus due to it keeping him the most consistent the longest time. I updated my ss now since I switched to the alpha so take a look at that. Thanks.
 
From what I can see on your most recent data, inconsistent dosing will lead to wildly varying numbers. If you're always changing the dose and skipping doses, there's no way of knowing how the insulin is working.
 
PerfumedCatMom said:
From what I can see on your most recent data, inconsistent dosing will lead to wildly varying numbers. If you're always changing the dose and skipping doses, there's no way of knowing how the insulin is working.
Click to expand...

I just now realized these numbers are from 2019. Hopefully Yvonne will update her spreadsheet soon. There's really no way of helping until everyone can see what's going on currently.
 
@Heather82372 There are two spreadsheets in the signature, you have to look at the one with the URL address for 2021. There isn't enough mid cycle data, and just one night time test, so we can't really say anything about the dose.

A couple suggestions. First, when you switched from Carepoint to Monojets, you might have inadvertently changed his dose a bit. Monojets have a hub up top that can store extra insulin, not sure about the Carepoint. The switch to the AT will give you higher numbers than you are used to, so that part's not unexpected. And lastly, how would you feel about doing an experiment? Pick at dose, I'd suggest 0.5 units to start, and shoot the same dose AM and PM, regardless of preshot number, unless he earns a reduction. That mean's you'll have to read this Sticky Note
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
and decide which dosing method you'd like to follow. Regardless of which one, you still do the same dose AM or PM, but the reduction point is different between the two. It'll also mean doing more testing for the next little while, so we can figure out what is happening. We dose based on how low the dose is taking the cat. So that would mean the preshots, plus at least two other tests, one each in the AM and PM cycles. If you can do that for a few days, we can figure out where you should go with the dose. Consistent dosing might also help even out his numbers.
 
Wendy&Neko said:
@Heather82372 There are two spreadsheets in the signature, you have to look at the one with the URL address for 2021. There isn't enough mid cycle data, and just one night time test, so we can't really say anything about the dose.

A couple suggestions. First, when you switched from Carepoint to Monojets, you might have inadvertently changed his dose a bit. Monojets have a hub up top that can store extra insulin, not sure about the Carepoint. The switch to the AT will give you higher numbers than you are used to, so that part's not unexpected. And lastly, how would you feel about doing an experiment? Pick at dose, I'd suggest 0.5 units to start, and shoot the same dose AM and PM, regardless of preshot number, unless he earns a reduction. That mean's you'll have to read this Sticky Note
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
and decide which dosing method you'd like to follow. Regardless of which one, you still do the same dose AM or PM, but the reduction point is different between the two. It'll also mean doing more testing for the next little while, so we can figure out what is happening. We dose based on how low the dose is taking the cat. So that would mean the preshots, plus at least two other tests, one each in the AM and PM cycles. If you can do that for a few days, we can figure out where you should go with the dose. Consistent dosing might also help even out his numbers.
Click to expand...

Yes, I can do that - it is taking me a while to get back into using the site again - forgot a LOT but it's gradually coming back! Had a lot of other issues today with my Mom (I am caregiver) so hopefully can work on this more tomorrow. I did more updating on his ss and removed the older sheets since they were using the human meter. I may eventually go back to a human meter again but want to wait until things are ironed out more with my vet - she is new to Andy. Thanks.
 
Wendy&Neko said:
@Heather82372 There are two spreadsheets in the signature, you have to look at the one with the URL address for 2021. There isn't enough mid cycle data, and just one night time test, so we can't really say anything about the dose.

A couple suggestions. First, when you switched from Carepoint to Monojets, you might have inadvertently changed his dose a bit. Monojets have a hub up top that can store extra insulin, not sure about the Carepoint. The switch to the AT will give you higher numbers than you are used to, so that part's not unexpected. And lastly, how would you feel about doing an experiment? Pick at dose, I'd suggest 0.5 units to start, and shoot the same dose AM and PM, regardless of preshot number, unless he earns a reduction. That mean's you'll have to read this Sticky Note
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
and decide which dosing method you'd like to follow. Regardless of which one, you still do the same dose AM or PM, but the reduction point is different between the two. It'll also mean doing more testing for the next little while, so we can figure out what is happening. We dose based on how low the dose is taking the cat. So that would mean the preshots, plus at least two other tests, one each in the AM and PM cycles. If you can do that for a few days, we can figure out where you should go with the dose. Consistent dosing might also help even out his numbers.
Click to expand...
Yvonne & Andy &BJ (GA) said:
Yes, I can do that - it is taking me a while to get back into using the site again - forgot a LOT but it's gradually coming back! Had a lot of other issues today with my Mom (I am caregiver) so hopefully can work on this more tomorrow. I did more updating on his ss and removed the older sheets since they were using the human meter. I may eventually go back to a human meter again but want to wait until things are ironed out more with my vet - she is new to Andy. Thanks.
Click to expand...

Wendy - PMPS is 141 - he is still coming down from this am - I am concerned about giving the .5 - what do you think? .25?
 
You've shot similar numbers in the past. If you have enough test strips, can continue to monitor, and have HC food and/or syrup, my suggestion is to give 0.5u, and test again at +1 and +2. The +1 will give you an indication of what food bump he is getting, and if the +2 is lower than preshot, that usually indicates watching the cycle more closely. He hasn't earned a reduction yet following either dosing method.

You may also want to start another condo, with date, name and PMPS and subsequent tests, in case you need additional help through the cycle. We suggest starting a new condo each day, and this thread has an old question on the title so it may not get as many eyes on it.
 
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Lantus dosing is not based on the pre-shot numbers. It's based on the nadir. Also, remember, you have roughly 2 hours from your shot before onset. During that time, your cat will have eaten and there's not much insulin that will be affecting BG levels.
 
Christie & Maverick said:
You've shot similar numbers in the past. If you have enough test strips, can continue to monitor, and have HC food and/or syrup, my suggestion is to give 0.5u, and test again at +1 and +2. The +1 will give you an indication of what food bump he is getting, and if the +2 is lower than preshot, that usually indicates watching the cycle more closely. He hasn't earned a reduction yet following either dosing method.

You may also want to start another condo, with date, name and PMPS and subsequent tests, in case you need additional help through the cycle. We suggest starting a new condo each day, and this thread has an old question on the title so it may not get as many eyes on it.
Click to expand...

OK - just need to get up to speed using the board again - it's been a while since I've been active!;)
 
To answer "how you stop bouncing" the answer is "get them used to lower numbers". You do that by shooting these lower preshots. Think of this as a gift.
 
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