08/12 Theodore 484 + 2

NadineTheodore

Member Since 2023
Hi,

Theodore was having crazy high numbers. Vet called me after I raised to 3.75 units (on my way to 4) believing he is experiencing Somogyi effect. Asked me to lower it to 2 units, said not to panic as it takes 5-7 days to clear so not to worry about the numbers. I am doing research online and normally it says to reduce units to half if it is a Somogyi effect which then I am still technically high in terms of units and does it truly take 5-7 days? His numbers have improved in the sense they're not in the 30s but still consistently in the 20s
 
Somogyi does not happen with cats. I’ll see if I can link information on that. I don’t see any indication of even a bounce as there are not any low numbers or big drops that might cause a bounce. I just see high numbers which means you have not hit the breakthrough dose yet. If it were a bounce which is caused by a quick drop in bg or a cat having a lower bg than used to it generally takes 4-6 cycles to clear. With a history of DKA I would not reduce the dose. Going down to 2 units was a mistake in my opinion. I’d increase to 2.5 which will likely not be enough.
 
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Rebound hyperglycaemia in diabetic cats
Kirsten Roomp1 and Jacquie Rand2
Abstract
Journal of Feline Medicine and Surgery
2016, Vol. 18(8) 587–596
© ISFM and AAFP 2015
Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1098612X15588967 jfms.com
Objectives Rebound hyperglycaemia

The link is in the basics sticky too. You can download it.

https://felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/
 
Scroll down to
Rebound hyperglycaemia in diabetic cats
Kirsten Roomp1 and Jacquie Rand2
Abstract
Journal of Feline Medicine and Surgery
2016, Vol. 18(8) 587–596
© ISFM and AAFP 2015
Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1098612X15588967 jfms.com
Objectives Rebound hyperglycaemia

The link is in the basics sticky too. You can download it.

https://felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/
Thank you for the information. I will read it through, we still did not test for acro as she is saying acro cats do not react to low doses of insulin the way Theodore did. Is that correct?
 
e still did not test for acro as she is saying acro cats do not react to low doses of insulin the way Theodore did. Is that correct?
Nope, not at all correct. For example, take a look at Neko's 2012 spreadsheet. Ignore before 3/14 when I had a meter that wasn't working properly. Lots of similarities in very brief good numbers surrounded by ugly ones. The largest research study on acromegaly by the Royal Vet Clinic, that showed that 1 in 4 diabetic cats has acromegaly, and saw a range of doses from 1 unit to 35 units. Research paper here, you could pass this onto your vet if you wish.

Please increase Theodore back to 3.75 units. His numbers have gotten awful since the reduction and I'm worried about him going DKA again. Please test absolutely every day for ketones at this point. High and flat numbers are not good for his body. Plus as Elise (tiffmaxee) said, Somogyi is something that vets used to be taught exists, but has been disproven to exist in cats. The original work on Somogyi was done almost 100 years ago, on a small number of humans, on short acting insulins, and wasn't a peer reviewed paper.
 
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Nope, not at all correct. For example, take a look at Neko's 2012 spreadsheet. Ignore before 3/14 when I had a meter that wasn't working properly. Lots of similarities in very brief good numbers surrounded by ugly ones. The largest research study on acromegaly by the Royal Vet Clinic, that showed that 1 in 4 diabetic cats has acromegaly, and saw a range of doses from 1 unit to 35 units. Research paper here, you could pass this onto your vet if you wish.

Please increase Theodore back to 3.75 units. His numbers have gotten awful since the reduction and I'm worried about him going DKA again. Please test absolutely every day for ketones at this point. High and flat numbers are not good for his body. Plus as Elise (tiffmaxee) said, Symogyi is something that vets used to be taught exists, but has been disproven to exist in cats. The original work on Symogyi was done almost 100 years ago, on a small number of humans, on short acting insulins, and wasn't a peer reviewed paper.

:(thank you. I feel so frustrated with his numbers
 
Nope, not at all correct. For example, take a look at Neko's 2012 spreadsheet. Ignore before 3/14 when I had a meter that wasn't working properly. Lots of similarities in very brief good numbers surrounded by ugly ones. The largest research study on acromegaly by the Royal Vet Clinic, that showed that 1 in 4 diabetic cats has acromegaly, and saw a range of doses from 1 unit to 35 units. Research paper here, you could pass this onto your vet if you wish.

Please increase Theodore back to 3.75 units. His numbers have gotten awful since the reduction and I'm worried about him going DKA again. Please test absolutely every day for ketones at this point. High and flat numbers are not good for his body. Plus as Elise (tiffmaxee) said, Somogyi is something that vets used to be taught exists, but has been disproven to exist in cats. The original work on Somogyi was done almost 100 years ago, on a small number of humans, on short acting insulins, and wasn't a peer reviewed paper.

also is it safe to raise him straight to 3.75 or should I gradually do it?
 
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Go straight to 3.75 units - you don't need to gradually increase. You jumped down, you can jump right back up. Just make sure you can monitor the cycle you do it. Some cats will have a strong reaction to a jump, even though that dose isn't taking them too low.
 
Go straight to 3.75 units - you don't need to gradually increase. You jumped down, you can jump right back up. Just make sure you can monitor the cycle you do it. Some cats will have a strong reaction to a jump, even though that dose isn't taking them too low.
Okay thank you, I will up his dose back up tonight since I am out most of the day today--just did slight increase this morning to 2.5U and checked for ketones, there were none. :) I will also ask to do an acro test, I just want to know why he's so difficult to control
 
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