Re: 10/7 Ozy AMPS-282,+8-190
I don't think the term "bouncing" existed when the protocol was developed.
Now this is coming from somebody who never used Lantus or followed any protocol, so take it for what it's worth.
Bounces don't matter. My cat bounced. I didn't care. You are not going to stop them from happening. So you just put up with them until they go away, or until they eventually stop happening. That day might never come. Or it might take years.
I am not trying to single anyone out, but let me use Marje and Gracie as an example. I'll never stop believing that Gracie won't one day go off the juice. But Marje has been doing this for quite some time. And Gracie is on a pretty small dose of insulin, right? I don't know how many greens there are on Gracie's SS, but "hundreds" is not an overstatement.
And Gracie still bounces. Does Marje "care"? Of course she cares, but do the bounces really matter? I'm not trying to put words in her mouth, but I'd guess she would say "no, not really". They happen. The key is that Marje recognizes them when they happen, and accepts them for what they are. A nuisance, and something that she can try multiple ways to make go away. And they always do go away. Until they happen the next time. Then she sighs, she shrugs, and she makes adjustments. And I'm fairly sure that Marje looks forward to each and every green she sees, whether they cause a bounce or not.
There is only one way that I know of that will stop a cat from bouncing. Give a dose of insulin that is so low that the cat won't drop fast or far enough to trigger a bounce. That's completely counter-productive of course. Because nothing gets better, and it can lead to glucose toxicity, and resistance to insulin.
Bounces also have a positive side. They let you know that "things are working" between the pancreas and liver just the way nature intended them to work. That "system" is in place to stop a cat from going hypoglycemic, and to keep BGs more even 24 hours a day. In a non-diabetic cat, it probably happens on rare occasions, in very small amounts? But there's no "volume control". In diabetic cats, it seems that the process goes way overboard, and once a bounce is triggered, there's no controlling how far the BGs are going to climb. It would be awesome if we could put a "dimmer switch" on the liver instead of just an "ON/OFF" switch. But we can't.
I think this refers mostly to what we call "New Dose Wonkiness", but this is off the Tilly page. I've highlighted the words I think are important, and that we need to apply to "bouncing".
Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations.
