Possible Somogyi

Pika and Shellz

Pika and Shellz

Member Since 2023
Hello! So I’m not sure if I’m having the Somogyi Effect or not. But his graph shows a steep decline quickly like 200 points in 1.5 hours and then a huge rise after his lowest point. And his rise goes higher than before and really fast. And this tends to be the trend he does on this dose. There has been a few times where he does a mellow slow decline, or a steady numbers through the 12 hours. but I usually see a huge drop in numbers really fast then he shoots up high in about 3-4 hours after his low. (Low usually hits 4 hours ish after injection) I know he isn’t going Hypo but I don’t think you have to go hypo to get somogyi. Just the huge drop really fast with steep incline after.
 
Hello Shellz! He is bouncing. He is not used to those lower numbers anymore so his liver reacts by "panicking" and releasing sugar. He needs time to get used to those lower numbers again. I think it's a good sign for now!
I am adding your previous post so other members can read and answer your questions: https://www.felinediabetes.com/FDMB/threads/new-member-my-story-first-post.275400/#post-3057430
Welcome here! Have patience, he will get better, you are in the right place :bighug:
 
What you saw was him bouncing from lower numbers. You are right that bounces can be triggered by sharp drops in the BG as well as drops to numbers that his body is not used to and not necessarily hypo. This is our definition of 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)."

Why did you reduce the dose tonight? He hasn't earned a reduction. With SLGS you would reduce if his BG drops below 90. Do you have a regular glucose meter to verify his BG with what the Libre shows? The Libre can read much lower at normal numbers (50-100) and we suggest that the lows are verified with a glucose meter since dosing is based on nadirs. Here's a detailed document on the Libre written by another FDMB member:
https://docs.google.com/document/d/...f13UiOiEM-6MsrFNpR9ztaPawF6dLk2b906QZ6VP6/pub

I would take him back to 2u tomorrow morning.
 
To add to what Bhoona said because your cat has been having ketones you don’t want to lower the dose unless a reduction has been earned so you won’t need to deal with dka which is as serious if not more serious than a symptomatic hypo. Please add ketones at diagnosis to your signature.
 
When you modify your signature, please add the insulin type and dosing method you'd like to use too.

Bouncing is a very normal and annoying (to us) phenomenon for newly diagnosed cats. With the amount of data you have, you can see he isn't getting too low. In fact, if you are following SLGS, you'd be increasing the dose in a couple days as there are no numbers below 150.

For what it's worth, there is research out there that says that cat on long lasting insulin (like Lantus and Levemir), where there is home testing and safe increases, do not get Symogyi. The original "research" was a very small study on humans and fast acting insulin. It doesn't really translate to modern day and cats. If you are interested in the details or want to educate your vet, here is the paper disproving it. Rebound hyperglycaemia in diabetic cats.pdf
 
I also meant to add that Hills M/D dry is high carb. Is there any way you can cut it out and feed only the low carb wet food? If you have to feed dry, there are low carb options in dry food as well – Young Again, Dr. Elsey’s Cleanprotein and Wysong Epigen 90.
 
Oh I see! So this was his biggest bounce he has ever done. But he tends to bounce in both his shots except for when I have an issue with administering his shot (fur shot, pulled away, or me just being me) then he does a beautiful slow decline.. but I have no idea if he gets the full 2. I never had data on 1 unit. That was his first diagnoses shot and I went blind for 2 weeks and I was beyond uncomfortable with shooting blind and upping the dose.

So can bouncing happen on both cycles? since he has been on 2 units he tends to bounce on both cycles. He does this like 150-250 point drop then starts hiking Everest.. so his daily patterns does have these 2 big waves in them from consistently bouncing. but on Glargine (no name just Glargine) shouldn’t we have a beautiful slow decline and a slow rise vs a quick drop and quick rise in the bounce. A more flatting the curve.

I did do his 2 this morning. I’m sorry I panicked last night and decreased by .5 I really thought I was having the debunked somogyi. Thank you for all the info!

he is on the Hill prescription due to his Urinary Crystals. He mostly eats just his wet food that I add extra water too but I also like him to eat dry to help clean his teeth. on Thanksgiving we were in the ER due to not urinating. So have to continuously treat him and my other male for Crystals. And all my cats eat the same food (total of 3 cats technically 4, one is outside only) and the M/d is much lower carbs than W/d or the C/d that I believe caused the diabetes. My other male cat is a dry food junky… and other is IBS and cannot do meals she needs to eat small nibbles all day and M/d has been working with her IBS.

Once again thank you all so much!! You’re all life savers! And give me the confidence that I can do this!!
 
Max was on CD way too long. He blocked once and the vet pierced his bladder and I nearly lost him. He never blocked again and did fine on all wet food when I switched from CD. Unfortunately I was feeding hc canned. Then he got pancreatitis which the combo led to fd. All this to say it might be worth trying lc canned food.
 
tiffmaxee said:
Max was on CD way too long. He blocked once and the vet pierced his bladder and I nearly lost him. He never blocked again and did fine on all wet food when I switched from CD. Unfortunately I was feeding hc canned. Then he got pancreatitis which the combo led to fd. All this to say it might be worth trying lc canned food.
Click to expand...

Luckily he was only on cd for 2.5 months but that was long enough to cause FDM. But now I have to keep something that will treat the crystals that he likes to form. He never blocked but we had to watch him like a hawk for the first 3 days until he actually voided his bladder. that was why we missed the diabetics for so long. We thought these big pees and drinking more water was good.. since we needed him to drink more water and to take big pees due to the crystals in November. It was the weight loss I couldn’t shake and then noticing his miss jumps… and lo and behold!! Here we are today!! CD helps initially but causes so many bigger problems! They need to make a food with the urine protection that is a true low carb. M/d is one of the lower ones I’ve found that still treat the crystals.
 
Found out what was going on!! He is having some insulin resistance due to underlying infections. He was doing really good with making a beautiful curve.. then we had our day in the 180s and and under with the huge bounce. Then he stayed above 300 basically with no trends. And I had no idea what was going on.. and feeling like a failure due to his numbers not coming down. I am getting less panicky at all this. Im not perfect and I am full of flaws so I apologize for my cluelessness. I just want to help my fur babies.

We just got home from the Vet office and had a Urinary Analysis ran and yup.. he was suffering a UTI.. his urine smelt so bad (started after his huge bounce) The exact words from the vet “his pee is super gross like it’s nasty” we are running a culture in the urine I will find out about those later. We are did give him Convenia as the antibiotic but NO ketones!! Yay!! And I was so worried about those ketones but she said do not worry about the ketones. So what I’ve been doing has been working.. but he had an underlying UTI that was causing some insulin resistance.

My dr today (I got to a vet that is a husband and wife, I usually see the husband, and I love it because they talk to each other and two heads are better than one) is having me hold the dose at 2 units as we get his infection addresses. Also she was highly impressed at the spreadsheet you have created here. And she admitted that she tells her fur children and her actual child that they cannot be a diabetic for she knows how difficult it is on us parents. But she was super impressed with all the info I was able to present her thanks to you amazing people here!

brings me to a new question about insulin. Umm so pharmacist told me not to refrigerate it when I picked it up but everyone else has told me (just on Monday so damage is done to the insulin already since I got it Feb 16th) that I need to keep it in the fridge to keep it longer. Can someone please clarify and do I need a new bottle.. I know it says it expires 28 days after opening. But it’s been kept in a cupboard away from light and heat…. But I still have messed up so much in his treatment did I duck up his glargine insulin?
 
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