2/6 Niko | AMPS 151, +4 180, +5 330, +8 500

Niko's Mom

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Previous: https://felinediabetes.com/FDMB/threads/2-5-niko-amps-140-4-266-7-230.298104/

Another nice blue AMPS today! Little bounce last night but Niko seems to have cleared it (yay!)

Here's to hoping he has another good surf, I have switched to the TR method and will be evaluating his dose in the next 2 days (doing a 5 day hold to start since he's a newbie).

Question for you folks -- I'm also part of the FB group, which I know is different, but they tend to advocate that sometimes too much insulin looks like too little insulin, and they suggest that reducing the dose stops 'bouncing'. Is there merit to that? I've seen differing advice for kitties if they're bouncing -- usually, they ask for a decrease instead of an increase.

In other news -- we talked to his vet about TR, who never heard about Rand and Roomp, but I sent her the article and medical study because she was interested! She is willing to let us do TR (as long as we know the hypo risks) since we are one of her only clients who track and monitor their cats like this. Hoping she gains some insight from the study. She is a general vet, not a specialist, but it feels good to be passing on some knowledge.
 
Great news that your vet is open to that type of communication. I think a lot of folks struggle with that.
 
Great news that your vet is open to that type of communication. I think a lot of folks struggle with that.

She's amazing, honestly! She is quite well-versed in what I would I assume is general feline diabetes protocols, she pushed Lantus and had a lot of good info that coincided with this forum. She was very excited to read about this study because based on vet protocol, they usually just hold the dose (which we have at 1.50) for months and just wait for the pancreas to kick in, mostly because she had a lot of patients experience hypo episodes and she's worried about that.

We have weekly check-ins so I'll ask her thoughts on the study once she's had a chance to read it. I'd love it if more vet professionals took the time to educate themselves instead of relying on outdated methods.
 
She's amazing, honestly! She is quite well-versed in what I would I assume is general feline diabetes protocols, she pushed Lantus and had a lot of good info that coincided with this forum. She was very excited to read about this study because based on vet protocol, they usually just hold the dose (which we have at 1.50) for months and just wait for the pancreas to kick in, mostly because she had a lot of patients experience hypo episodes and she's worried about that.

We have weekly check-ins so I'll ask her thoughts on the study once she's had a chance to read it. I'd love it if more vet professionals took the time to educate themselves instead of relying on outdated methods.
Yep exactly right. They probably only see a handful of diabetic cats, so whatever minimizes the risk of hypo is just probably what they recommend.
 
Niko started stumbling around and losing balance. Immediately applied karo syrup and high carb food. He got stabilized within seconds. We just took his BG and its at 180 on the dot, but this is food influenced. I think this was a hypo event, mini seizure? We try again in 20 minutes? Withhold food?
 
I’m not experienced enough to help you, but I will talk to you until someone else jumps in.

If this were my cat, I’d call the vet if the symptoms were severe. That is based on the sticky. Test again 15 mins after the syrup and repeat the process (teaspoon of HC food as well) until above 50.
 
I think this probably warrants a dose reduction? It definitely seemed like a seizure to me but we didn't catch his BG prior to the karo... we will test every 20 minutes without food going forward.
 
I’m not experienced enough to help you, but I will talk to you until someone else jumps in.

If this were my cat, I’d call the vet if the symptoms were severe. That is based on the sticky. Test again 15 mins after the syrup and repeat the process (teaspoon of HC food as well) until above 50.

Will do. symptoms lasted about 10 seconds before we jumped into action. but his BG was 180 after karo. would it skyrocket that much if he was at 50 or below?
 
Okay. Still concerning about the stumbling. The syrup will work fast, the food takes a little longer. I’d keep testing idk every 20-30 minutes until someone more experienced comes by.
 
he's up to 275 20 minutes after HC food and karo. i think he's safe but so weird that he momentarily lost control of his back legs. we didn't catch the BG value but would this warrant a dose reduction? really freaked me out.
 
I think this probably warrants a dose reduction? It definitely seemed like a seizure to me but we didn't catch his BG prior to the karo... we will test every 20 minutes without food going forward.
I don’t know the TR rules but are you supposed to be with holding food? Did I read this right? If it were me I’d be feeding my cat bc Karo wears off.
 
I think you need to continue to monitor bc the karo and HC wears off fast. I have something about your original question re bouncing. Let me find the reference it may be what the FB group means. I have no idea who is right about it I’ve been asking this very question often for the last 8 months
 
I don’t know the TR rules but are you supposed to be with holding food? Did I read this right? If it were me I’d be feeding my cat bc Karo wears off.

when he showed seizure signs, we fed him high carb food and karo right away, and tested, which showed a BG of 180. 20 minutes later, he is at 275. we are testing again in 20 but i feel like if he was hypo, would karo/food shot him up from a 50 to almost an 180 within minutes...?
 
265 now after an additional 20 minutes. just appears tired, probably from the BG jumping, but acting normal physically/neurologically. that was terrifying. i dont want to go through that again.

i have to leave for work in about 1.5 hours. do you folks think he will be okay? i'll continue testing him every 20 minutes before i leave, and leave extra food out. or should i stay home? my partner will be back home soon as well but Niko will be left alone for about 3-4 hours.
 
when he showed seizure signs, we fed him high carb food and karo right away, and tested, which showed a BG of 180. 20 minutes later, he is at 275. we are testing again in 20 but i feel like if he was hypo, would karo/food shot him up from a 50 to almost an 180 within minutes...?
Idk. Hopefully a mod will drop in with some advice and clarity.

re your original question on the FB opinion (I don’t do FB) see this link
https://www.dvm360.com/view/poorly-regulated-diabetic-cats-need-systematic-exam


Different things I’ve seen by vets refer to this as reactive hyperglycemia or sometime somogyi (with many saying true somogyi does not exist for cats but that a similar effect is seen with either low BG or a rapid decrease in BG


Here is the section in question:
upload_2025-2-6_15-35-51.png


In other words it describes the same thing that is called a bounce here, and the same mechanism, but the EXACT opposite solution. Per this viewpoint, yes the drop causes the cat to drive up its glucose levels, and that this effect lasts up to six cycles BUT according to this viewpoint the problem is the insulin is too much and the “normal” cycles are because the too high insulin dose is balanced with the extra glucose; this will be followed by a cycle with hypoglycemia (or near ly so but aborted by feeding cat a lot)—this is the cat without the excess hyperglycemia due to insulin effect and the too high dose of insulin causing the hypo.

I haven’t seen convincing evidence from either camp that they are right. I haven’t had success with increasing nor decreasing. But my cat is complicated by his tumor. Still I would love to see either side prove they are correct
 

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265 now after an additional 20 minutes. just appears tired, probably from the BG jumping, but acting normal physically/neurologically. that was terrifying. i dont want to go through that again.

i have to leave for work in about 1.5 hours. do you folks think he will be okay? i'll continue testing him every 20 minutes before i leave, and leave extra food out. or should i stay home? my partner will be back home soon as well but Niko will be left alone for about 3-4 hours.
I’d be freaked out also and since no one has dropped by am going to tag a few
@Wendy&Neko @Bron and Sheba (GA) @Bandit's Mom
 
I’d be freaked out also and since no one has dropped by am going to tag a few
@Wendy&Neko @Bron and Sheba (GA) @Bandit's Mom
thanks, appreciate you replying to this thread in the meantime, as well as the resources you have for the bouncing. i'll read through them. :)

i almost feel like i gaslit myself into thinking it happened because we caught his BG at 180 right after the syrup (i'd expect it to be below 100 still?!) and now i'm wondering if he was even low!? but that was definitely a wobbly, mini seizure where he couldn't get his legs to work... so i can't be that crazy, right?
 
I have never seen a cat hypo at 180. That would be odd. Did you take a second reading? I’m guessing how scared you were you didn’t. The karo brought the bg up a lot. It wears off quickly though. Can you test again 30 minutes from the last test? If still a good bg you could feed more leave out lots of food for while you are gone.
 
I have never seen a cat hypo at 180. That would be odd. Did you take a second reading? I’m guessing how scared you were you didn’t. The karo brought the bg up a lot. It wears off quickly though. Can you test again 30 minutes from the last test? If still a good bg you could feed more leave out lots of food for while you are gone.

he has been at 103 before with no issue! we unfortunately didnt test right away after the seizure. we had him eat for 5 minutes, with the karo syrup applied. but the wobblyness subsided seconds right after we gave him karo/food.

so far, since then, he has tested 275 immediately 30 mins after, then we didn't feed, he is now at 265. i plan to test in 30 minutes again.

i would consider it not being hypo-related but that was the telltale sign of a hypo seizure... just didn't catch the number to prove it. i feel insane.
 
it was his back legs. it kinda looked like he lost his motor ability for a second, kept trying to go one way but went the other way. what's FD? can it randomly present one day?
Feline diabetes, sorry. Not trying to scare you, just hoping to highlight this for others reading to see if they’ve seen it before.
 
Poor Niko!!! How scary for you both. It looks like you've gotten some great advice here about leaving him with lots of food, etc. Perhaps a vet trip might be warranted. Please keep us posted, Ana.
 
it was his back legs. it kinda looked like he lost his motor ability for a second, kept trying to go one way but went the other way.
I agree he ought to be followed up with his vet. Off the top of my head I’d check his potassium level —a low level can cause weakness in his legs (although I’d expect it to stay not resolve) and low potassium is fairly common in diabetic cats due to the intracellular shift from insulin

I’m glad he’s better and relieved @tiffmaxee dropped by. I hope he continues to do well.
 
Poor Niko!!! How scary for you both. It looks like you've gotten some great advice here about leaving him with lots of food, etc. Perhaps a vet trip might be warranted. Please keep us posted, Ana.

thank you very much. he is totally fine right now. motor abilities normal, jumped up on the washing machine without an issue, relaxing on the couch now.

going to schedule a call with his vet and see if she thinks he needs to be brought in.

i am thinking of reducing his dose tonight just out of caution....
 
he is now at 330 (about 1.5 hours after this episode). liver might be reacting with a bounce... makes me think it may have been a low BG episode with him.
 
thought so too... but it lasted all of 10 seconds, ending right after karo syrup administration. does diabetic neuropathy present like that? i have b12 supplements i can start putting into his food.
I have NO IDEA. I'm Dr. Googling it over here which, as we all know, is dangerous. Someone with experience will weigh in on this, I'm sure. What I'm reading so far is that it is insidious, and not sudden. I'm not 100% sure what that means in terms of exactly how it would present. Here is a link to a discussion on this forum about diabetic neuropathy in cats. https://felinediabetes.com/FDMB/threads/neuropathy-hind-legs-cant-walk.242916/

I'd see the vet, Ana.
 
I have NO IDEA. I'm Dr. Googling it over here which, as we all know, is dangerous. Someone with experience will weigh in on this, I'm sure. What I'm reading so far is that it is insidious, and not sudden. I'm not 100% sure what that means in terms of exactly how it would present. Here is a link to a discussion on this forum about diabetic neuropathy in cats. https://felinediabetes.com/FDMB/threads/neuropathy-hind-legs-cant-walk.242916/

I'd see the vet, Ana.

thanks so much, will do. scheduled a call with her today, we will bring him in if she thinks we should.
 
I'm just noticing that Niko is only 2.5 years old! Bless his little heart! He's barely out of kitten-hood. I hope you can get his BG under control and into remission--he's got a long life in front of him.
 
I’m just reading this. I’m glad you have had great support and I see Elise has posted as well. She is very experienced.:)
Diabetic neuropathy would not come on so quickly and go just as quickly so I very much doubt it is that.
You need to make sure he can stay up (his BG) on his own for 2 hours after the last high carb food. I would not leave him on his own before that.
Karo can bring BG up pretty quickly but just 5 minutes to 180 is maybe a stretch but not impossible.
It does sound like a hypo event but I would get the vet to check Niko over to see everything else is ok, as we don’t know what the BG was before the karo.
And to be on the safe side I would reduce the dose of insulin to 1.25 u
 
I’m just reading this. I’m glad you have had great support and I see Elise has posted as well. She is very experienced.:)
Diabetic neuropathy would not come on so quickly and go just as quickly so I very much doubt it is that.
You need to make sure he can stay up (his BG) on his own for 2 hours after the last high carb food. I would not leave him on his own before that.
Karo can bring BG up pretty quickly but just 5 minutes to 180 is maybe a stretch but not impossible.
It does sound like a hypo event but I would get the vet to check Niko over to see everything else is ok, as we don’t know what the BG was before the karo.
And to be on the safe side I would reduce the dose of insulin to 1.25 u

Thanks so much. he is currently at 330 (this isn't food influenced) from 265 after about 30-40 mins. to me, it's looking like his liver is in life-saving mode, making me think he was below 180 before the episode.... can cats exhibit these hypo symptoms at a BG level of 80 or something similar? i doubt it but i cant think of anything else other than a hypo episode to cause this -- stumbling for 10 seconds, alleviated by karo syrup and HC food.... his only symptom prior to this was that he was very restless, wanting to play/walk around.

we will do 1.25u moving forward tonight. i guess i'm not getting any sleep as i'll be up to monitor him lol.
 
I'm just noticing that Niko is only 2.5 years old! Bless his little heart! He's barely out of kitten-hood. I hope you can get his BG under control and into remission--he's got a long life in front of him.

thank you for your kind words. he is a very young boy. his diabetes was steroid induced, originally for his skin allergies. allergies have went away but now we have the diabetes (ironic, isn't it?).

he's such a fighter. he had ketones of almost 7 with no DKA upon diagnosis, he didn't even have a change in behavior or appetite. we only caught it because i smelled the ketones shortly after putting him on a diet-change only regime.

this hypo is scary for me because i dont want it to impede his journey to remission but that means i'll have to be brave in the consistency of his dosing.
 
Thanks so much. he is currently at 330 (this isn't food influenced) from 265 after about 30-40 mins. to me, it's looking like his liver is in life-saving mode, making me think he was below 180 before the episode.... can cats exhibit these hypo symptoms at a BG level of 80 or something similar? i doubt it but i cant think of anything else other than a hypo episode to cause this -- stumbling for 10 seconds, alleviated by karo syrup and HC food.... his only symptom prior to this was that he was very restless, wanting to play/walk around.

we will do 1.25u moving forward tonight. i guess i'm not getting any sleep as i'll be up to monitor him lol.
I have seen a couple of cats over the years who have been very sensitive to insulin who had hypo symptoms when the BG was higher than 50…but I can’t remember the exact BG number. But it is very unusual.
When my Sheba dropped really low, her only symptom was extreme hunger and she was frantic for food. Every cat is different.
The event you describe does sound like a hypo event and the fact she responded so quickly supports that theory.
Was it just 5 minutes before you took the BG or could it have been longer?
 
It is also possible that the episode was a mini seizure lasting just 10 seconds, caused by something entirely different and the fact it appeared to respond to karo immediately could be a coincidence. The vet can guide you on this.
Even if it is a seizure caused by something else, the vet will most likely wait and see if it happens again.
One of my cats had a strange little seizure every so often and saw a specialist and they said they could give her tablets twice a day for the rest of her life or we could wait and see what happened. She was otherwise well. As they were not frequent or severe we chose to wait and see. Since then she has not had another seizure that we have observed.
 
I'm also part of the FB group, which I know is different, but they tend to advocate that sometimes too much insulin looks like too little insulin, and they suggest that reducing the dose stops 'bouncing'. Is there merit to that? I've seen differing advice for kitties if they're bouncing -- usually, they ask for a decrease instead of an increase.
This is incorrect. There FB group associated with FDMB is not supposed to give dosing advice and this is an example of why not. If you start in a low dose, do small increases and monitor enough to know how low he is going, then too much does not look like too little. You do a great job testing, I doubt his dose is too high. The number of too high doses fitting the above I have seen in my time here can be counted on one hand. It included a cat whose vet started him on 10 units!

Reducing the dose stops the bouncing, they go high and flat instead. They have to spent time in normal numbers to get used to them, and that is how you stop bouncing.

I agree with Bron, I expect today could have been something else and should be checked but th3 Vet.
 
i guess i'm not getting any sleep as i'll be up to monitor him lol.
With you in solidarity! I'm going on three nights of monitoring.
This is incorrect. There FB group associated with FDMB is not supposed to give dosing advice and this is an example of why not. If you start in a low dose, do small increases and monitor enough to know how low he is going, then too much does not look like too little. You do a great job testing, I doubt his dose is too high. The number of too high doses fitting the above I have seen in my time here can be counted on one hand. It included a cat whose vet started him on 10 units!

Reducing the dose stops the bouncing, they go high and flat instead. They have to spent time in normal numbers to get used to them, and that is how you stop bouncing.

I agree with Bron, I expect today could have been something else and should be checked but th3 Vet.

For what it's worth, as an aside from Niko and Ana's current situation, but related to the FB group, things over there concern me. The group is open to anyone commenting, and, of course, many, whether they have experience and/or expert knowledge jump in and offer advice on the most dangerous of situations (like dosing situations). I know those comments and advice are well-intentioned, but some people do not understand the complicated nature of this disease, and they don't realize that their advice could actually be seriously detrimental, even life-threatening. The FB mods are absolutely fantastic, and when I have had a pressing question and couldn't raise someone over here, I've gone over there and they have been life savers, but I know who the mods/admins are, and I know who to tag for a response. The group is so helpful for offering a lot of good advice, but I think things get scary when John Q. Public offers dosing advice. I don't know what the solution is (or if there needs to be one). Whenever I have the chance, I try to always point people to this forum because I feel it's a safer environment for advice. But when I look at the posts rolling through my feed from the FD FB page, I typically look at them with a side glance because I'm worried about what I'm going to read and how detrimental the advice is going to be.
 
I have seen a couple of cats over the years who have been very sensitive to insulin who had hypo symptoms when the BG was higher than 50…but I can’t remember the exact BG number. But it is very unusual.
When my Sheba dropped really low, her only symptom was extreme hunger and she was frantic for food. Every cat is different.
The event you describe does sound like a hypo event and the fact she responded so quickly supports that theory.
Was it just 5 minutes before you took the BG or could it have been longer?

Thanks for answering! It was such a fast onset, one minute he was playing and then he stumbled off the couch and kept wobbling and tried running away but couldn’t do so properly.

In the haze of it all, it may have been longer than 5 minutes but I don’t think it was more than 10 at best…. Between the karo, food, and getting the test, I’d say 10 mins max. It was so scary I probably just thought it happened faster.
 
It is also possible that the episode was a mini seizure lasting just 10 seconds, caused by something entirely different and the fact it appeared to respond to karo immediately could be a coincidence. The vet can guide you on this.
Even if it is a seizure caused by something else, the vet will most likely wait and see if it happens again.
One of my cats had a strange little seizure every so often and saw a specialist and they said they could give her tablets twice a day for the rest of her life or we could wait and see what happened. She was otherwise well. As they were not frequent or severe we chose to wait and see. Since then she has not had another seizure that we have observed.

I thought it was unrelated for a second as well. I called the vet and she seems convinced it’s a hypo but said to monitor, similar to what you said.

I could see it being unrelated but he has never had any other issues before… I thought maybe feline hyperesthesia because he had skin issues in the past but he has never had mobility problems or seizure like symptoms before. He also didn’t have those rolling skin symptoms that come with FSH. It really seemed super random.

I guess because it’s day 3 of the dose increase (around the time the depot settles), that he was quite low at preshot, responded to the syrup immediately, and because of his crazy spike of 200 points within 2 hours I’m inclined to think it was hypo. But I could be wrong. I hope it doesn’t happen again, it was awful to watch.
 
This is incorrect. There FB group associated with FDMB is not supposed to give dosing advice and this is an example of why not. If you start in a low dose, do small increases and monitor enough to know how low he is going, then too much does not look like too little. You do a great job testing, I doubt his dose is too high. The number of too high doses fitting the above I have seen in my time here can be counted on one hand. It included a cat whose vet started him on 10 units!

Reducing the dose stops the bouncing, they go high and flat instead. They have to spent time in normal numbers to get used to them, and that is how you stop bouncing.

I agree with Bron, I expect today could have been something else and should be checked but th3 Vet.

thanks for this answer. I always wondered about the difference, the FB group seems to have a different opinion and I’ve seen kitties on there sitting on doses for months with no movement, but some kitties do respond to reductions so I was curious.
Vet seems to not be concerned about the seizure event. I think because he’s generally healthy, we had a whole panel work up earlier this month (urine + blood) which, besides his diabetes, was entirely unremarkable.

If it happens again and we get normal numbers from him, she said we should be more inclined to bring him in…. I’d rather this just be a one time hypo than an additional issue for him, he’s such a young boy.
 
Thanks for answering! It was such a fast onset, one minute he was playing and then he stumbled off the couch and kept wobbling and tried running away but couldn’t do so properly.

In the haze of it all, it may have been longer than 5 minutes but I don’t think it was more than 10 at best…. Between the karo, food, and getting the test, I’d say 10 mins max. It was so scary I probably just thought it happened faster.
Definitely worth getting checked out by the vet. I would not assume it was a hypo and leave it.
And I know how scarey watching seizures are. I had a dog who had a prolonged seizure and it was very distressing to watch.
 
Definitely worth getting checked out by the vet. I would not assume it was a hypo and leave it.
And I know how scarey watching seizures are. I had a dog who had a prolonged seizure and it was very distressing to watch.

okay, I’ll press the vet for an exam. What do I tell them to check for him? Does it involve additional testing?
 
okay, I’ll press the vet for an exam. What do I tell them to check for him? Does it involve additional testing?
They probably won’t do any testing at this stage because it’s a one off but I think they need to be open to the idea that it could have been a seizure that was not related to FD. They will probably do a physical exam on him and look in his eyes and do a few basic tests for coordination.
 
I wanted to thank everyone here for taking the time to give advice, console, and reply to myself and Niko. The help on this forum is fantastic, and helped me not have a breakdown. You all are angels.

he is doing well, he just broke his BG record for 500… at +8. I’m inclined to believe this is a response to a potential hypo, he has never been close to this high before.

we will administer 1.25 tonight, monitor, and I shall make a new thread tomorrow.
 
They probably won’t do any testing at this stage because it’s a one off but I think they need to be open to the idea that it could have been a seizure that was not related to FD. They will probably do a physical exam on him and look in his eyes and do a few basic tests for coordination.

perfect, thanks for the info, we will be bringing him in for an exam maybe in a week or so, or earlier if he does it again… his BG is at 500 right now (he barely ever grazes 400) so I’m starting to think it was a hypo. But I won’t rule out the unrelated seizure theory.
Youve been fantastic, thanks so much.
 
It never hurts to have a backup meter for a reality check. Meters don’t often go bad, from what I’ve seen here and in real life, but it’s nice to rule out that variable.

Has Niko had any meds recently (Solensia injection, for example, or flea/tick meds) or has anything changed in your home? (burning candles, different detergent, spraying for bugs, exposure to essential oils, etc etc)

Did Niko show any signs of pain or confusion when the potential seizure occurred?
 
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