10-19 HENRY AMPS 416 Day 3 of BOUNCE
- Thread starter Golf2015
- Start date
Bandit's Mom
Member Since 2019
I am surprised at the high numbers after days of low numbers on next to no insulin. Is he getting into any contraband (HC food - cat or human) that you aren't aware of?
Nan & Amber (GA)
Member Since 2016
I was wondering the same thing. It's hard to explain the bouncing unless a) there's something else going on (contraband, or possibly a hidden health issue that is causing discomfort), or b) there was a low that was much lower that wasn't caught with testing. His body should be pretty used to being in blue/dark green, so you'd think it wouldn't react that strongly to them.
I don't think bounces are expected to last longer than three days, so if this is a bounce, you should start seeing him come down very soon. If he stays high, it's something else, and until figuring it out, the only thing to do is dose around it with more insulin. But let's see how things go over the next couple of days.
Nan & Amber (GA)
Member Since 2016
Hmmm.... just read through yesterday's thread, with the urinalysis strips showing negative glucose in the urine, and it's bumped up another possibility: could your meter or your strips be "off"? Usually I'd discount this possibility with such a huge difference (compared to previous weeks) over several days, but with the urinalysis not agreeing with the meter readings... hmmmm.
Did you by chance open a new package of strips recently? I think the AT2 uses coding for the strips, if you opened a new package did the code change? Again, such a huge difference in BG numbers is hard to explain from something like this or a bad battery or whatever, I'm kind of grasping at straws.
In any case, in the previous thread you were talking about trying a human meter. Even if you don't switch entirely, that would be a nice double-check on the AT2's numbers!
Did you by chance open a new package of strips recently? I think the AT2 uses coding for the strips, if you opened a new package did the code change? Again, such a huge difference in BG numbers is hard to explain from something like this or a bad battery or whatever, I'm kind of grasping at straws.
In any case, in the previous thread you were talking about trying a human meter. Even if you don't switch entirely, that would be a nice double-check on the AT2's numbers!
Bandit's Mom
Member Since 2019
@Nan & Amber (GA) could the large 4.5 unit depot and the couple of 2 unit shots in between have kept him low for more than a week?
Nan & Amber (GA)
Member Since 2016
Hmmm.... We have the 4.5U depot fully loaded, then four cycles to deplete, then two cycles of 2U, four more cycles to deplete, then a 17 
... Whatever is going on here, if it's not a wonky meter, it's not the normal workings of the depot, I think.
Tagging @Marje and Gracie for help on this. My recollection is that there is a rare condition (insulinoma? maybe something else depot-insulin specific where a very large crystaline deposit is made?) that can cause large pulses of insulin to be released and cause patterns like this, but I don't know anything more than that.
... Whatever is going on here, if it's not a wonky meter, it's not the normal workings of the depot, I think.Tagging @Marje and Gracie for help on this. My recollection is that there is a rare condition (insulinoma? maybe something else depot-insulin specific where a very large crystaline deposit is made?) that can cause large pulses of insulin to be released and cause patterns like this, but I don't know anything more than that.
JL and Chip
Member Since 2009
I don’t believe the BG reading of 17. In my experience (and per the user’s manual), the AlphaTrak2 shows “LO” for readings under 20.
Something doesn’t make sense.
If it truly displayed 17, then maybe the meter was accidentally set to mmol/L? This is a reallllll stretch, but are there possibly missing decimal points in some of those other numbers??
Something doesn’t make sense.
If it truly displayed 17, then maybe the meter was accidentally set to mmol/L? This is a reallllll stretch, but are there possibly missing decimal points in some of those other numbers??
Golf2015
Member Since 2020
The BG 17 is incorrect I look at my private spreadsheet the number should be 107. I have corrected the error.
When the strip is engaged in the meter 37 is displayed 100% so this variable should be eliminated
What do I moving forward from here?
I do have a second AlphaTrak2 meter brand new because the cost of the strips combined with a meter included is just an additional $5.00. I have a third meter arriving today with 50 strips.
When the strip is engaged in the meter 37 is displayed 100% so this variable should be eliminated
What do I moving forward from here?
I do have a second AlphaTrak2 meter brand new because the cost of the strips combined with a meter included is just an additional $5.00. I have a third meter arriving today with 50 strips.
Attachments
Golf2015
Member Since 2020
We let him outside during the daylight hours =~ 8 hours, but having said that he outside during the normal readings too
The backyard is controlled - high wood fence (have chicken wire around the top perimeter to prevent any escapes) nothing can enter or leave the back yard. Folks in this neighborhood do not like cats loose running the streets.
Last edited:
Golf2015
Member Since 2020
I did open a new package but the code was the same 37
Golf2015
Member Since 2020
Henry's feeding in a 24 hour period
(4) time every six hours (6:00am, 12:00pm, 6:00pm, & 12:00am) No Deviation from this schedule
80 calories each feeding combination of wet & dry each feeding (wet - 40 Cal & Dry - 40 Cal)
Wet food > Earthborn Holistic - Carbs 5%
Dry Food > Dr. Elsey's high Protein - Carbs 5%
Attachments
Last edited:
Nan & Amber (GA)
Member Since 2016
Well, that's a relief!
I guess maybe try a few side-by-side comparison readings with the meters, to see if you're getting a consistent picture. Kind of stumped, here, about what is going on-- the only other thing I can think of is that maybe he ate something outside that disagreed with him. Other than that, we're down to "cats are cats" and FD being a mysterious disease, sometimes insulin needs just change just because.
Even though the question of the 17 has been, thankfully, resolvedHmmm.... We have the 4.5U depot fully loaded, then four cycles to deplete, then two cycles of 2U, four more cycles to deplete, then a 17
Tagging @Marje and Gracie for help on this. My recollection is that there is a rare condition (insulinoma? maybe something else depot-insulin specific where a very large crystaline deposit is made?) that can cause large pulses of insulin to be released and cause patterns like this, but I don't know anything more than that.
, I want to look at the SS and threads to see about some of the other issues brought up. I will say that it would be hard for me to believe that a cat with a 17 on an AT would not have been showing significant signs of hypoglycemia and that would have caused Robert to respond with a 911 or, better, a trip to the ER.Just for information, insulinomas are rare in cats, only six cases having been documented. None of the six cats was diabetic (i.e. not receiving exogenous insulin). The insulinoma is a tumor within the pancreas consisting of insulin-producing beta cells which go into overdrive. That’s a bit of an oversimplification but is a quick synopsis.
I’m going to look back through the SS and threads and see if I can make sense of it or if, as Nan says, he’s just being a cat that likes to throw some curves.
Golf2015
Member Since 2020
I’ve looked back through all your posts, Robert, as well as the log that you kept for him. It was very smart of you to do that. It is possible to transfer that data to our format of the SS you did for him and if you need help doing that, please send me a private message. It’s very informative data as to how we got where we are today. In addition, if you decide to switch to a human meter, PM me and I can reformat your existing SS for you.
First, what I am going to post is absolutely no criticism of anything done or advised. It is purely my observations.
Bron was correct that increasing the dose by 0.5u based on the curves provided was a bit much and led to him being overdosed. My speculation is he was dropping into low numbers and that’s why, when you did a curve, you saw high ones. I won’t belabor the issue of the need to get a test every single time before you shoot because it looks like you’ve taken that to heart and the midcycle tests you’ve been getting are very helpful. You are a good dad to Henry!
I have seen overdosed cats take more than ten cycles to drain the depot once insulin is withheld but he was below 200 on an AT for many cycles with just a “bolus”, really, of Lantus three times (two doses of 2u and one of 0.5u).
He is most definitely bouncing right now from the green numbers on 10/16 following a dose of 2u the night of 10/15. It appears that 2u is enough to get him into green numbers but not enough to hold off a bounce. I’m not trying to play Monday morning quarterback but I would have suggested that you put him on 1.5u every 12 hours with preshot and midcycle tests (and more if he was dropping). I will say that we are all about safety and that is what Bron and others had in mind when they suggested 0.5u with so little data to go on. Again, no criticism of their recommendation or your data collection.
Having said that, I’m not a proponent of dose hopping so if he doesn’t clear the bounce today, I would increase his dose to 0.75u. Please note that if he wasn’t on dry food and could do TR, I would recommend increasing to 1u since his nadirs are over 300, even considering a bounce. It is definitely your decision on what you wish to feed him and I’m not going to push for you to change his diet. I did see that you’d like to do TR and I don’t blame you; it’s a better choice especially since you are retired and home to test. However, it is a prerequisite of TR, as written in the Roomp and Rand TR protocol, that the cat be fed only canned or raw food and that’s because it’s easier to control low numbers and the curve overall with those foods. TR is aggressive so feeding canned and raw gives us a bit more of a safety net.
The reason I am not suggesting you pop him right up to 1.5u is because we want to let his depot stabilize. I wouldn’t have suggested it even if you were able to do TR. However, if he does need around 1.5u of insulin, following SLGS back up is going to take a long time and I don’t see any reason to leave him in high numbers if you are willing to test. Sometimes, we have to set aside guidelines temporarily, in a situation such as this, and get the kitty into better numbers sooner. I would suggest we reassess every six cycles, if you are willing to test and gather some data. We could get him to a better dose a little faster and then get him back on SLGS.
As others have said, it’s important to stay on top of his ketone testing.
Please let me know if any questions you have. I hope this is helpful. I’m so glad you and Henry found us!
First, what I am going to post is absolutely no criticism of anything done or advised. It is purely my observations.
Bron was correct that increasing the dose by 0.5u based on the curves provided was a bit much and led to him being overdosed. My speculation is he was dropping into low numbers and that’s why, when you did a curve, you saw high ones. I won’t belabor the issue of the need to get a test every single time before you shoot because it looks like you’ve taken that to heart and the midcycle tests you’ve been getting are very helpful. You are a good dad to Henry!
I have seen overdosed cats take more than ten cycles to drain the depot once insulin is withheld but he was below 200 on an AT for many cycles with just a “bolus”, really, of Lantus three times (two doses of 2u and one of 0.5u).
He is most definitely bouncing right now from the green numbers on 10/16 following a dose of 2u the night of 10/15. It appears that 2u is enough to get him into green numbers but not enough to hold off a bounce. I’m not trying to play Monday morning quarterback but I would have suggested that you put him on 1.5u every 12 hours with preshot and midcycle tests (and more if he was dropping). I will say that we are all about safety and that is what Bron and others had in mind when they suggested 0.5u with so little data to go on. Again, no criticism of their recommendation or your data collection.
Having said that, I’m not a proponent of dose hopping so if he doesn’t clear the bounce today, I would increase his dose to 0.75u. Please note that if he wasn’t on dry food and could do TR, I would recommend increasing to 1u since his nadirs are over 300, even considering a bounce. It is definitely your decision on what you wish to feed him and I’m not going to push for you to change his diet. I did see that you’d like to do TR and I don’t blame you; it’s a better choice especially since you are retired and home to test. However, it is a prerequisite of TR, as written in the Roomp and Rand TR protocol, that the cat be fed only canned or raw food and that’s because it’s easier to control low numbers and the curve overall with those foods. TR is aggressive so feeding canned and raw gives us a bit more of a safety net.
The reason I am not suggesting you pop him right up to 1.5u is because we want to let his depot stabilize. I wouldn’t have suggested it even if you were able to do TR. However, if he does need around 1.5u of insulin, following SLGS back up is going to take a long time and I don’t see any reason to leave him in high numbers if you are willing to test. Sometimes, we have to set aside guidelines temporarily, in a situation such as this, and get the kitty into better numbers sooner. I would suggest we reassess every six cycles, if you are willing to test and gather some data. We could get him to a better dose a little faster and then get him back on SLGS.
As others have said, it’s important to stay on top of his ketone testing.
Please let me know if any questions you have. I hope this is helpful. I’m so glad you and Henry found us!
Last edited:
Golf2015
Member Since 2020
OK, I think the way I'm interpreting this ==> start 1.0 unit tomorrow morning if the numbers remain the same, Correct
Correction recommend 0.75?
My private spreadsheet data was under VET supervision. Once the 4.5 units started that was on me
Last edited:
Yes, 0.75u in the morning if you don’t see at least lower blue numbers.
And, again, no criticism of prior dosing because I assumed your vet had input. Your log was very consistent with how I’ve seen most vets advise on the use of insulin.
Golf2015
Member Since 2020
You’re welcome. Henry is a lucky boy!
Not necessarily. One of the reasons the numbers are so high could be a bounce + not enough insulin. That’s why we need to increase the dose if he doesn’t see low blue or green numbers by shot time tomorrow. And actually, six cycles ended at your p.m. shot and you could have increased tonight but it’s best to do the increase during the day cycle just in case he pulls any shenanigans.
Golf2015
Member Since 2020
Well a slight bit of good news his PMSP reading is the lowest since the bounce period started 357
Again I cannot Thank You enough
Take Care
Keep in mind that every meter has an allowable 20% variance so Henry’s BG is flat
But...it’s not higher so that’s great news!I’m on west coast time and retired so I’m not around until later in the mornings. If you are unsure what to do in the morning, ask for help and be sure to remind whoever is helping to read through today’s thread.
Paws crossed and have a good evening!
I think @Olive & Paula used that one.
Golf2015
Member Since 2020
It also appears have good reviews at least from a human stand point since its a human meter
Thank You
Olive & Paula
Member Since 2015
Yes I have one. The drop size is small which is great. I did find it temperamental. I used it for ketone testing. I find it zips blood slowly so if you move it away to quickly, or don't get it just right, it will error out.
Golf2015
Member Since 2020
OK, One question does it require cleaning the surface of ear ==> Reason I asked a YOUTUBE VIDEO suggest from a human standpoint you use alcohol wipes on your finger prior to pricking it
Thank You
I think almost all human meters say to use wipes. None of us do on cats.
Golf2015
Member Since 2020
Olive & Paula
Member Since 2015
I never used wipes on ears. And I never used on me the few times I tested myself.
Golf2015
Member Since 2020
You mention you use it for KETONES Do you use it for BG readings as well?
Olive & Paula
Member Since 2015
Very rarely for glucoses, only to double check an odd reading. I preferred my mini meter.
Golf2015
Member Since 2020
Well my intention was to use it for BG readings. The mini meter is just a preference? nothing more?
Olive & Paula
Member Since 2015
Yes the mini was just a preference for doing glucoses. It was slim and easier to hold.