12/10 Lucky AMPS 177 Bounce Question

[Luckyducky]

Hello everyone. I'm sorry for dropping off the face of the planet for the last month or so... :YMSIGH: it's been an exhausting/disheartening period for me (for various reasons I can't get into here), and I've decided to delay my job search for a while longer to work some other things out. Lucky so far has been doing well, but the neuropathy in his legs doesn't seem to have improved any (it hasn't gotten worse either, but he's been on the Zobaline supplement for almost 4 months now), and I mainly wanted to check in because I'm frustrated with his bouncing numbers, which are making it difficult to easily follow the TR protocol.

Here's a link to his SS, and his numbers since yesterday:

Readings for 12.9 to 12.10
AMPS 346
+6 305
PMPS 304
+6 97
+8 135
AMPS 177
+2 150
+4 194
+6 299
+9 389

His numbers have been going up and down pretty quickly lately, and it's hard to follow the TR protocol since it seems every other day he's going through a bounce (it makes me wonder if I ought to switch to the Start Low Go Slow approach, since the bounces are making me delay the dose changes by almost a week sometimes). One of my major wonderances is whether his dose might be too high, since I've heard a rapid drop can be a signal of an overly high dose, and he dropped pretty quickly in the first 6 hours of yesterday's PM cycle from the 300's to 97. That said, I haven't seen a lot of greens lately either, though I also wonder if I might just be missing the readings when they happen.

I also wanted to mention that Lucky seems to have put on a bit of weight, he's about 14 pounds now (I think he was a little over 13 the last I visited the vet about 4 or 5 months ago). I'm pretty sure it's related to the neuropathy in his legs, since he isn't running around at all anymore. I'm considering reducing his intake from 2 1/2 cans a day to just 2, but he still seems to get hungry at various parts of the day, so I'm not sure. I do exercise with him a few times a day for 5-10 minutes at a time, but in between that and his meals he's mostly sleeping or sitting, and I've the feeling the exercise he's getting isn't enough.

Thank you all so much for whatever help and advice you can provide, and before I forget, best of wishes for the holiday season too. I just hope for the best for Lucky.

 

[Wendy&Tiggy(GA)]

Hello there
Dont know if we have "met" before. Lucky is sure one lucky boy to have you as his mama bean. Anyhoo his SS looks very much like my Tiggys. I do like that he has put weight on.. losing weight is such a bad sign.. weight gain means he is metabolising his food which means he is getting enough insulin for that. Tiggy also has neuropathy and the pills dont seem to help.. my vet says he has never seen a case resolve but I wont give up hope.. as long as he is bouncing it might have an impact.

I am wondering if you should hold the doses longer - dont drop the dose unless he goes under 50 three times, or under 40 once. He seems to be varying around that same dose and this might stablisize things a bit. Also i am counting the times he went into green on each dose ... recently his 2IU - 2 greens (and one of these was probably depot), 2.25IU 2 greens, 2.5Iu three greens. Not scientific but it makes me wonder if 2.5IU might work better.. might let him sneak up there.

How is his pee? Is he showing urine glucose? There is no infection anywhere? teeth? UTI?

 

[Sienne and Gabby (GA)]

Wendy's questions are worth considering as is her suggestion about using the alternate criteria for dose reductions.

The other factor worth considering is that there is no "rule" about increasing during a bounce. We generally advise new members to wait until a bounce clears before increasing so that someone who's inexperienced at steering the cycle with food doesn't have to contend with the bounce breaking at the same time you raise the dose and you end up with low numbers. It's more of a confidence/experience issue than anything else. What I'm trying to say in a long winded fashion is that you've been at this long enough that your could raise the dose before the bounce clears.

There are people on the board who will suggest reducing the dose if a cat is bouncing. With Lantus, if you have been systematically making dose adjustments (and you have), it's unlikely that Lucky is over dose. For pretty much every time that I've seen someone decrease the dose, they end up with a cat in high numbers, they have to increase -- often to a higher point than where they started -- and they lose time. In addition, they risk glucose toxicity developing which ends up increasing the bouncing. Again, my long winded way of saying I don't think you should reduce the dose.

Have you asked your vet about Lucky's back legs? Could he have arthritis? If so, you could always try Cosequin and see if that helps.

 

[Luckyducky]

Thank you both for the fast replies, I really appreciate it. I've raised his dose to 2.25u for his last shot based on some of the advice, hopefully it'll work out for him.

@Wendy: I'd been getting the feeling I should be holding his doses longer until he stabilizes more from the bounces, so it's helpful that you suggested that. I haven't checked his urine for ketones, I'll have to check the next time he uses the restroom (hopefully my test strips are still okay, I opened them in July and I think they're supposed to last up to 6 months, though I'm not sure). I might try your advice to drop the dose after he drops below 50 three times, my only worry is that it seems difficult to catch him when he drops into the greens, he seems to go into the greens only for a small window of time, so my concern would be constantly raising the dose because I keep missing the window. But we'll see, thank you so much for your insight and the encouraging words, I'll keep at it as best I can.

@Sienna: Thank you so much as always for your insight. I'll try to keep Lucky with the increased dose for now then, and let the numbers guide me lower when appropriate per the protocol and Wendy's suggestion. The last time I visited the vet (towards the end of July) it was actually because Lucky was getting weak in his back legs, and after some blood tests and looking Lucky over the vet believed the weakness was likely due to diabetic neuropathy. I do remember the vet recommending getting an x-ray to see if there were any problems (maybe it was to check for arthritis, I don't recall, but I think I remember it maybe being about checking for spinal issues). Anyway, I turned it down because it sounded like it wasn't as likely, and also because the cost seemed excessive (almost $200, IIRC), and I wanted to see what the effect of his dental cleaning would have on his numbers before getting an x-ray done. Maybe I should go get an x-ray done now, I'm not sure.

Thanks again to you both for your help, I do appreciate it. It breaks my heart to see Lucky walking so awkwardly all the time, and I just hope I can help him get better.