3/23 Bear AMPS 275, +4 285, +6.5 171

Meredith Bear’s Mom

Meredith Bear’s Mom

Member Since 2022
Hi friends,

Wow, I haven't posted in a while!!

Bear seems to be doing better! He's had some nice blues and greens over the past few weeks. Our vet however thinks that he might be bouncing (the random reds and yellows) from possibly dropping too low. Her recommendations seem to be more in line with the SLGS protocols, so I am going to switch him over to following those rules. He is still on the 2 big meals twice a day, which he seems to be still doing okay with. However, he has been extra grumpy lately, not sure if that has something to do with it.

He has been regaining a lot of strength and energy. He is able to jump up now, which he was never able to do in the time that I've had him! The Solensia injections have really made a huge difference.

Previous post: https://felinediabetes.com/FDMB/posts/3054811/
 
@Meredith Bear’s Mom
Hi Meredith can you put the date you when you switched back to SLGS in your signature and also put it up top on your spreadsheet so members know
I also see on your SS in the remarks section

Possible Somogyi effect? decrease to 1 unit

I thought you were feeding Bear small snacks during each cycle such as a tsp or two of his wet food , not just 2 meals twice a day, I could be wrong though

I don't know if it was such a good idea to drop back down to 1 unit ,
I guess you can see how that works out, just a suggestion maybe you want to tag a few experienced members and see what they think, I'm only looking out for that cutie pie .
So if you are going to follow SLGS you probably know to hold the dose for 7 days unless Bear drops under 90, then you would decrease by 0.25 units, if he doesn't you need to do a curve
Good luck with everything :cat: I'm glad the Solensia has helped

There is actually no such thing as Somogyi effect in cats. Don’t know why vets often quote it.
Here is information @Sienne and Gabby (GA) wrote about Somogyi :
Simply put, no.
This is a soapbox issue for me. I'll try to be succinct. The term first appeared in 1938 and was named after Michael Somogyi. It was based on a very small sample of humans and urine glucose was being measured. The "research" (if you can call it that) appeared in a local St. Louis medical publication - not a major medical journal. The results have never been replicated and have been contested in recent years. Consequently, the entire idea of Somogyi in humans is controversial. There's an article in Wiki that is a decent summary as it relates to humans.

With cats, there hasn't been any research let alone research with new insulin such as Lantus and Lev that are pharmacologically very different from what was available in 1938. I haven't a clue why vets continue to contend that a cat is in "chronic Somogyi rebound" when a cat may be bouncing off of a low number or fast drop. With humans, the recommendation is typically to decrease the dose in order to alleviate the problem What we've seen repeatedly is that when a caregiver does this, the cat stays in high numbers (because you're not giving enough insulin) and you end up wasting a good deal of time as a result of working the dose back up.

As long as you are systematically increasing the dose according to the protocol, you won't be giving too much insulin.
Here is an explanation of Bouncing:





      • 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).
 
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Diane Tyler's Mom said:
@Meredith Bear’s Mom
Hi Meredith can you put the date you when you switched back to SLGS in your signature and also put it up top on your spreadsheet so members know
I also see on your SS in the remarks section

Possible Somogyi effect? decrease to 1 unit
I thought you were feeding Bear small snacks during each cycle such as a tsp or two of his wet food , not just 2 meals twice a day, I could be wrong though

I don't know if it was such a good idea to drop back down to 1 unit ,
I guess you can see how that works out, just a suggestion maybe you want to tag a few experienced members and see what they think, I'm only looking out for that cutie pie .
So if you are going to follow SLGS you probably know to hold the dose for 7 days unless Bear drops under 90, then you would decrease by 0.25 units, if he doesn't you need to do a curve
Good luck with everything :cat: I'm glad the Solensia has helped

There is actually no such thing as Somogyi effect in cats. Don’t know why vets often quote it.
Here is information @Sienne and Gabby (GA) wrote about Somogyi :
Simply put, no.
This is a soapbox issue for me. I'll try to be succinct. The term first appeared in 1938 and was named after Michael Somogyi. It was based on a very small sample of humans and urine glucose was being measured. The "research" (if you can call it that) appeared in a local St. Louis medical publication - not a major medical journal. The results have never been replicated and have been contested in recent years. Consequently, the entire idea of Somogyi in humans is controversial. There's an article in Wiki that is a decent summary as it relates to humans.

With cats, there hasn't been any research let alone research with new insulin such as Lantus and Lev that are pharmacologically very different from what was available in 1938. I haven't a clue why vets continue to contend that a cat is in "chronic Somogyi rebound" when a cat may be bouncing off of a low number or fast drop. With humans, the recommendation is typically to decrease the dose in order to alleviate the problem What we've seen repeatedly is that when a caregiver does this, the cat stays in high numbers (because you're not giving enough insulin) and you end up wasting a good deal of time as a result of working the dose back up.

As long as you are systematically increasing the dose according to the protocol, you won't be giving too much insulin.
Here is an explanation of Bouncing:





      • 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).
Click to expand...
Thanks for this Diane. I’m going to look into it more tomorrow on my laptop at work.

I feel defeated again. I feel like I’m failing Bear. Everytime the vet tells me to do something it seems to be wrong. But I also feel out of line telling a vet what to do. I trust the knowledge that’s on this page immensely. I feel so conflicted and like I’m doing everything wrong. Just wanted to vent for a little.
 
Meredith Bear’s Mom said:
Thanks for this Diane. I’m going to look into it more tomorrow on my laptop at work.

I feel defeated again. I feel like I’m failing Bear. Everytime the vet tells me to do something it seems to be wrong. But I also feel out of line telling a vet what to do. I trust the knowledge that’s on this page immensely. I feel so conflicted and like I’m doing everything wrong. Just wanted to vent for a little.
Click to expand...
You are not failing Bear, if I were you I would post everyday so members can see what's going on , You don't want to tag anyone to take a look at your SS now ?
You don't really have to tell your vet anything that you are doing.
When did she recommend switching to SLGS , did you take Bear for an office visit? or did you give her his numbers via e mail or on the phone
Keep testing at night after his PMPS number , maybe like a +3 and +6 at least

@Meredith Bear’s Mom
 
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Diane Tyler's Mom said:
You are not failing Bear, if I were you I would post everyday , You don't want to tag anyone to take a look at your SS now ?
You don't really have to tell your vet anything that you are doing.
When did she recommend switching to SLGS , did you take Bear for an office visit? or did you give her his numbers via e mail or on the phone
Keep testing at night after his PMPS number , maybe like a +3 and +6 at least

@Meredith McCann
Click to expand...
Okay, I will be better about posting. I can tag @Bron and Sheba (GA) and @Wendy&Neko perhaps?

Our vet didn’t recommend switching to SLGS, in fact I don’t think she knows much about it except from the info I provided. She is just providing suggestions from what she knows. She has the link to his spreadsheet and she looks at it everyday. She really is trying very hard to help him and she goes out of her way to check in on him and call me after hours.

I suppose I can try to be more of a stickler of wanting to follow this protocol. I just feel like kind of a jerk telling a vet what to do. But I also want what’s best for Bear of course. she’s going to a diabetes talk this weekend so maybe that will yield some helpful insights? I think if I can gather more data and studies to show her that might make her feel better about it. I know there is a bunch here, I’ll dig around tomorrow.

I’ve set an alarm for 3 hours and will do another 3 after that.
Thanks as always @Diane Tyler's Mom
 
Meredith Bear’s Mom said:
Okay, I will be better about posting. I can tag @Bron and Sheba (GA) and @Wendy&Neko perhaps?

Our vet didn’t recommend switching to SLGS, in fact I don’t think she knows much about it except from the info I provided. She is just providing suggestions from what she knows. She has the link to his spreadsheet and she looks at it everyday. She really is trying very hard to help him and she goes out of her way to check in on him and call me after hours.

I suppose I can try to be more of a stickler of wanting to follow this protocol. I just feel like kind of a jerk telling a vet what to do. But I also want what’s best for Bear of course. she’s going to a diabetes talk this weekend so maybe that will yield some helpful insights? I think if I can gather more data and studies to show her that might make her feel better about it. I know there is a bunch here, I’ll dig around tomorrow.

I’ve set an alarm for 3 hours and will do another 3 after that.
Thanks as always @Diane Tyler's Mom
Click to expand...
I do believe she is really trying to help Bear ,she sounds like she really cares .
Sometimes you just have to say to your vet I think I want to try it my way, meaning your way lol
One other thing why are you only feeding him twice a day ?
 
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Diane Tyler's Mom said:
I do believe she is really trying to help Bear ,she sounds like she really cares .
Sometimes you just have to say to your vet I think I want to try it my way, meaning your way lol
One other thing why ate you only feeding him twice a day ?
Click to expand...
She wanted to see if feeding two big meals twice a day would help regulate him instead of the small ones.
 
I think it's a good idea that you tagged Wendy and Bron to take a look at your SS
and see what they have to say that you lowered Bears dose to 1 unit
I'm sure they will give you some good advice and maybe suggest what to say to your vet
I can also tag
@Suzanne & Darcy
@Sienne and Gabby (GA)
@tiffmaxee
Hi ladies can you please skim through these posts Meredith is feeling defeated with Bear's BG numbers , I feel bad for her
@Wendy&Neko
Hi Wendy I see Meredith tagged you , I'm only tagging you again so you can read the posts and see what's going on and why she tagged you . I hope it's ok
 
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I'll go one more than Diane's older quote from Sienne. There have now been studies on "Symogyi" that have shown with the gentle acting insulins, proper monitoring and safe increases, like as followed by TR with Lantus or Levemir, Symogyi does not exist. You or your vet may be interested in reading this one: Rebound hyperglycaemia in diabetic cats.pdf A while ago we had a vet who was a member here when this topic came up - it does that a lot. :rolleyes: She admitted it was taught in most of the vet schools to be a thing.

My vet really cared about my cat too. I had been going to her for years and years and she was thrilled that I was going to treat the diabetes. So many clients chose otherwise. :( But she started us on the wrong insulin and did a few other things I learned later weren't right. I had a partnership with my vet. Later when a locum vet switched us to Lantus, I told her which protocol I was going to follow and showed her the papers, the spreadsheet, and kept her updated. Later on we learned about acromegaly together. But it took me weeks to convince the vet to get the testing done for it in the first place. I asked her to humour me. A good vet will work in partners with their clients. One of her phrases was "what do you want to do?"

SLGS is a dosing method developed on FDMB, so it's more than likely your vet doesn't know about it. TR is the only peer reviewed published dosing protocol.
Meredith Bear’s Mom said:
She wanted to see if feeding two big meals twice a day would help regulate him instead of the small ones.
Click to expand...
Been hundreds and hundreds of cats who have done that experiment on FDMB. The answer is no, same as for human diabetics. Feeding just twice means Bear has no recent food on board to balance out the lower numbers in the middle of the cycle. So he's going lower and bouncing hard. I see no reason to get anything beyond a +3 tonight unless he's dropped a lot by then.
 
Wendy do you think she should go back to shooting 1.25 units or stay with the 1 unit for now?
I realize it's up to her , I told her I didn't think it was such a good idea reducing his dose to 1 unit
 
Wendy&Neko said:
I'll go one more than Diane's older quote from Sienne. There have now been studies on "Symogyi" that have shown with the gentle acting insulins, proper monitoring and safe increases, like as followed by TR with Lantus or Levemir, Symogyi does not exist. You or your vet may be interested in reading this one: Rebound hyperglycaemia in diabetic cats.pdf A while ago we had a vet who was a member here when this topic came up - it does that a lot. :rolleyes: She admitted it was taught in most of the vet schools to be a thing.

My vet really cared about my cat too. I had been going to her for years and years and she was thrilled that I was going to treat the diabetes. So many clients chose otherwise. :( But she started us on the wrong insulin and did a few other things I learned later weren't right. I had a partnership with my vet. Later when a locum vet switched us to Lantus, I told her which protocol I was going to follow and showed her the papers, the spreadsheet, and kept her updated. Later on we learned about acromegaly together. But it took me weeks to convince the vet to get the testing done for it in the first place. I asked her to humour me. A good vet will work in partners with their clients. One of her phrases was "what do you want to do?"

SLGS is a dosing method developed on FDMB, so it's more than likely your vet doesn't know about it. TR is the only peer reviewed published dosing protocol.

Been hundreds and hundreds of cats who have done that experiment on FDMB. The answer is no, same as for human diabetics. Feeding just twice means Bear has no recent food on board to balance out the lower numbers in the middle of the cycle. So he's going lower and bouncing hard. I see no reason to get anything beyond a +3 tonight unless he's dropped a lot by then.
Click to expand...
This is really helpful and very good advice. Thank you for sharing this.
 
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