06/30 Baby G PMPS 323 +6 318

babyg

babyg

Member Since 2019
Previous thread: https://www.felinediabetes.com/FDMB/threads/06-26-baby-g-pmps-365.265100/#post-2969051

Hi, everyone,

Just wanted to post an update. The vet did not want me to raise her dose and wants me to keep her on the 3 for another week to a month because of the Somogyi effect, but shouldn't any bouncing have been over and done with by now? So far I am thinking like how you guys advised earlier, that she needs to go up to 3.25. I'm not getting the data I would like since her sensor failed, but from what I can tell, the 3 is doing nothing for her. So disappointing and confusing since it was doing fantastic for a minute there. Granted, she is preferring more of the dry food again, but I don't think that's having a major impact, and she still eats some of the wet too. I'd say overall she appears to be doing and feeling a lot better. She's maintaining her weight which is another good sign.
I've got stuff coming this weekend so I can try to place the sensor myself (hair clippers and Skin Tac). I joined that Facebook group of people who do the sensors themselves, so hoping with all the resources on there that I won't screw up putting it on, lol. I'm hoping if I can get the sensor on her this weekend, to up her dose and then I can monitor her much better since we'll have that on and I'll be home too. I just don't feel comfortable raising her without that. It's so invaluable to me in keeping her safe.
As far as any other advice from the vet, she suggested if the diarrhea doesn't get better now that Baby G's eating better again and ingesting more of the Fortiflora, that we can 1) do a fecal test, 2) put her on Flagyll, 3) maybe try a novel protein diet. Today she had a solid poop, so seems like the Fortiflora is key.
 
babyg said:
Previous thread: https://www.felinediabetes.com/FDMB/threads/06-26-baby-g-pmps-365.265100/#post-2969051

Hi, everyone,

Just wanted to post an update. The vet did not want me to raise her dose and wants me to keep her on the 3 for another week to a month because of the Somogyi effect, but shouldn't any bouncing have been over and done with by now? So far I am thinking like how you guys advised earlier, that she needs to go up to 3.25. I'm not getting the data I would like since her sensor failed, but from what I can tell, the 3 is doing nothing for her. So disappointing and confusing since it was doing fantastic for a minute there. Granted, she is preferring more of the dry food again, but I don't think that's having a major impact, and she still eats some of the wet too. I'd say overall she appears to be doing and feeling a lot better. She's maintaining her weight which is another good sign.
I've got stuff coming this weekend so I can try to place the sensor myself (hair clippers and Skin Tac). I joined that Facebook group of people who do the sensors themselves, so hoping with all the resources on there that I won't screw up putting it on, lol. I'm hoping if I can get the sensor on her this weekend, to up her dose and then I can monitor her much better since we'll have that on and I'll be home too. I just don't feel comfortable raising her without that. It's so invaluable to me in keeping her safe.
As far as any other advice from the vet, she suggested if the diarrhea doesn't get better now that Baby G's eating better again and ingesting more of the Fortiflora, that we can 1) do a fecal test, 2) put her on Flagyll, 3) maybe try a novel protein diet. Today she had a solid poop, so seems like the Fortiflora is key.
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Any way that you can test more on the weekends since you work
I can tag a few members for you, also I have found this posted my numerous members
@Bron and Sheba (GA)

@Bandit's Mom

@Wendy&Neko

@Sienne and Gabby (GA)








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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Thank you.
Her preshot this morning is 360. I'll let the vet know but I believe I'm going to raise her to 3.25 tonight. To me she clearly needs more insulin. I'll be home with her, and can hopefully install the sensor Saturday. She also is getting a new insulin pen this morning so hopefully that'll help. I give her a new one every month to make sure she always has fresh. I'm just eager to get her numbers better and don't understand what the vet is waiting for.
 
babyg said:
Thank you.
Her preshot this morning is 360. I'll let the vet know but I believe I'm going to raise her to 3.25 tonight. To me she clearly needs more insulin. I'll be home with her, and can hopefully install the sensor Saturday. She also is getting a new insulin pen this morning so hopefully that'll help. I give her a new one every month to make sure she always has fresh. I'm just eager to get her numbers better and don't understand what the vet is waiting for.
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If you are using the lantus and drawing the insulin the pen should at least you 6 months or so there is no need to use a new pen every month

Glargine/Lantus or any of the biosimilars (generics) last far longer than 28 days. Barring any problems, you should be able to use a pen until you run out of insulin in the pen. I used a pen for almost 6 months . (The pharmaceutical company only ran tests for a 28 day period since they were developing the insulin for humans who use much larger doses than our cats.)

It is only humans who carry their insulin around with them. For cats, insulin is kept in the fridge, taken out twice a day for shots

When you keep them in the fridge put the on the middle shelf never on the door
If you have more than one pen they will be good until the expiration date on them, as long as they are kept in the fridge
 
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Many vets tend to fear their clients won’t test enough so are content with cats being higher than good for them. Doing that keeps the cat comfortable in higher bg. Then when you increase they do better but bounce because they aren’t getting used to normal bg. That means you need to keep increasing the dose and your cat never gets used to normal bg. I know I suggested an increase last time you mentioned this.

It’s good she had a normal poop. if the diarrhea returns I know my vet would do as your vet suggested. You don’t want to give flagyl if the poop is normal as when it starts to work it can cause constipation. If a feral test is needed and it’s clean then I would try a novel protein. It needs to be one she has never eaten before. If that doesn’t work then you need more tests to see why the loose stool. I’ve had to do all that fir a cat. I hope none of that is necessary.

I disagree about the dry food not having an effect but your cat has to eat enough to keep her weigh up. Feeding any dry for many cats means a little more insulin is needed than if eating all low carb wet.
 
The teaching hospital vet called, surprisingly, to check on us. She said to raise her to 3.5. I think it's funny how different vets have different opinions; seems like managing diabetes is an art as well as a science. I'm thinking to do the 3.25 as recommended here and then go from there.
 
tiffmaxee said:
You would have increased 4 days agp with SLGS. What was the amps?
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For yesterday (6/30)? 322. I just got home and finished updating her spreadsheet now. When I mentioned to both vets (local and teaching) about raising her .25, they didn't agree with that and said to do the half unit. My brother is saying to do the half unit too because I'll be home with her the next three days and can see what it's going to do without losing time off work later if I see the .25 is doing nothing and need to up her again. He says the quarter dose is going to do nothing and I have to stop the glucose toxicity right away and not play with it. But I feel uneasy with the half and know normally SLGS we do quarters. Each quarter is just one drop, so a half is two drops. One wouldn't think a drop could do much but seems like it can? I don't think I'd be as scared if it weren't that she once had blues on the 3. What the heck am I going to see on 3.5. :eek::nailbiting:
On a good note, I finally got all the supplies in to place her sensor, but I'm going to wait to put it on in the morning so the vet is open in case I have an issue. My dad is going to come over to potentially help hold her still.
Whatever I do tonight, it's definitely going to be an all-nighter for me. :(:coffee:
Just wanted to add to explain how I feel on something...changing her dose is stressful to me because I feel like no matter what I do, I'm going against somebody's advice and someone somewhere is going to think I'm wrong, whether it's one of the vets, both of the vets, my brother, or people on here. :( I'm giving too much insulin; I'm giving too little insulin; I'm changing the dose too fast; I'm holding it too long, etc. I'm an indecisive person in general in life lol so I really do seek to listen to others' opinions/wisdom/experiences to help guide me. Glad I don't have actual human kids 'cause I would suck, lol. Ultimately I'm just trying to do what's best for my cat and I hope I always make the right choice for her sake.
Edited to add: I gave her 3.25.
 
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