2/25 Sweetie AMPS 225, +4.5 83, PMPS 400 big swings!!

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Sweeties-Mom

Sweeties-Mom

Member Since 2013
(Previous Condo added later)
I snuck out from work (my boss is OK with it) to test Sweetie and am disturbed at such a big swing from this morning! He ate 1/3 of his breakfast (which is 1/2 a 5.5oz can) right after the morning shot, and had eaten another 1/3 by the time I got here to test at +4.5.

These big drops make me nervous naturally, even though the 83 itself sounds great. So I went back over the chart and calculated the swings in bg tests even though in some cases I don't have any data between the AM and PM pre-shot tests. Still one swing was 242, another 185, and several others were between 100 and 150.

At what bg reading should I reduce the AM dose so I don't come home to a comatose kitty? Could his pancreas be kicking in some insulin sometime before the two readings I got in the 80's?
 
Re: 2/25 Sweetie AMPS 225, +4.5 83 big swing??

If you're following the Tight Regulation Protocol, the dose isn't reduced unless BG drops below 50. This goes back to my point about Sweetie not yet having an insulin depot formed. The depot is what gives Lantus it's duration and allows for the cumulative action of each shot.

The other thing that may be going on is that for some cats, a flat yellow cycle is sometimes an indication that you're going to see an active cycle. Sweetie may be one of those cats that telegraphs her intentions.
 
Re: 2/25 Sweetie AMPS 225, +4.5 83 big swing??

Thank you Sienne. I reread the depot page it is starting to make a little more sense.

Sweetie did his own spacing out of his breakfast food today: he ate 1/3 at 7, 1/3 by 11:15, and the rest by 12:30. I'll have to look into the timer food bowl, and having a second cat (young too) in the house who eats everything at once complicate things. Mostly I'll put Flynn outside while I'm gone and have Sweetie inside to graze.

The vet's office had called to check on Sweetie last Friday so I dropped off my spreadsheets today. The vet called me back and was NOT encouraging of so much home testing! She definitely wants me to back off and only test 2xday right before the shots unless I am doing a full curve. But I'm a rebel...

If his 7pm bg is under 200 tonight, should I still give him his regular 1.0u shot? The vet suggested either 1/2 or skip if it below this threshold.
 
Re: 2/25 Sweetie AMPS 225, +4.5 83 big swing??

welcome to LL!

Sweetie is doing great for just having started out. Most cats don't even get to green numbers this quickly. :smile: That can be tricky, of course, because it doesn't give you time to get acclimated before you have to start dealing with lower numbers.

Just so I can be sure - Sweetie is on 100% wet food now, correct?

As far as what to do with the evening shot, for newbies we usually suggest that if the cat is under about 180 at shot time, post for advice. Someone will be able to walk you through the decision. We have a sticky on Shooting and Handling Low Numbers that will help if nobody is around, but it is most helpful to have help the first couple of times.

The second thing I want to say - while the 80s are great, it is perfectly understandable to be nervous at first. You don't have much data yet, and (as I said before), Sweetie is actually responding better than most new cats so things are moving kind of quickly. Most people get to work UP to a good dose. If you want to reduce the dose a little bit so you can ease into things, there is absolutely nothing wrong with that. Plenty of people do it that way, and it shouldn't slow Sweetie down very much. It's totally your decision and we'll support you either way.
 
Re: 2/25 Sweetie AMPS 225, +4.5 83 big swing??

had to come say I liked your little note about being a rebel...
many vets don't encourage testing...
testing helps you know how Sweetie is doing on the dose and when an adjustment is needed...

it would be great if we had a scanner that we could wave over the cat ( a kid , a dog) and know their bg...
but we don't. Testing is what we have and fortunately most cats do well with it and even run to their spot to get tested after
the routine is established.
 
All that worrying about shooting low for nothing - his PMPS was back up to 400! He had (finally) finished his breakfast when I left him at 12:30pm, so no food from then until the 6:45pm test. So is this the Rebound/Somogyi effect? I asked the vet about it today and she said the "Somogyi effect is very rare". But why else the large increase when he had no access to food? He did have a little vomit - apparently he mistakenly swallowed the little green cap on the lancet along with his treats at the midday test (I'll be more careful about that in the future).

Yes he is on 100% canned now since December, EXCEPT for:
- if he eats some dry food that the neighbors put out for strays (they just told me they will TRY to not leave it out or let him eat it)
- when he was at the vet and they gave him dry because he wouldn't eat the canned
- when I sprinked about 1 tbsp on his food the next day because he wasn't eating much (and didn't eat much of that dry food either as it was pretty stale).

Of course I'm hoping for a quick remission but I need to settle down I see. But I'll read up on all the shooting low links in anticipation of being OTJ someday!

It sounded to me like the vet thinks the home testing is just torturing the cat for "nothing". I may downplay it to her in the future. Unfortunately Sweetie is getting more sensitive, not less, on his ears, but I've been successful in getting the drop anyway. And he does willingly jump up on the chair to get tested because he loves the freeze-dried chicken so much.

Thanks everyone!
 
I would say that number is either he visited the neighbors....
or it's a bounce from that nice green 83. ...

Their bodies react when they get in the nice numbers but they aren't used to it. Panicky liver ...
 
hi Cathy

well done on the testing and starting over here!

Sweetie's ears will start bleeding better in a little while and it will be easier to get blood. Soon, you will be able to test him in his sleep (I do sometimes with Honey) and he won't bat an eyelid ;-) .

Denise.
ps. we're almost neighbours :-D
 
Your vet is correct that Somogyi in cats is rare. In fact,it hasn't been documented. But, in theory, Somogyi results from a chronic overdose.

What you are seeing is what we call a "bounce". When kitty is first dx, he/she has likely been at high BG levels a while. The liver acclimated to this. Once the depot fills with lantus or levemir, and the cat's BG drops lower than the liver is used to or drops fast or drops low, then the liver dumps counterregulatory hormones and glucagon into the blood system raising the BG. It can take 72 hours for that to clear.
 
Hi Cathy!

This is my first time visiting Sweetie's condo and I must say you're doing quite a fantastic job so early on in the game. :thumbup

From your first post:
Sweeties-Mom said:
I feel like protesting the cat food manufacturers somehow. There should be a large warning label if the carb % is over some threshhold, like on cigarettes: CAUTION: THIS FOOD MAY CAUSE FELINE DIABETES IN YOUR CAT.
Click to expand...

ITA! If they have to put warning labels on coffee cups that "contents may be hot," then why the heck don't they have to put warning labels on cat food that "contents may cause hyperglycemia and/or kidney failure and/or hyperthyroidism and/or...." Dry food is like giving our cats a pack of cigarettes a day to smoke!

Sweeties-Mom said:
The vet's office had called to check on Sweetie last Friday so I dropped off my spreadsheets today. The vet called me back and was NOT encouraging of so much home testing! She definitely wants me to back off and only test 2xday right before the shots unless I am doing a full curve. But I'm a rebel...
Click to expand...

Unfortunately, most vets are under the impression that cats don't like home-testing. It is very rare for a cat to never get acclimated to testing; in fact, a lot of cats (including Michelangelo) seek out testing because all they have to do to get a treat is let you poke them in the ear. I think in Mikey's mind, he considers me D-U-M-B for not realizing he's the one making out the best in this trade-off. :lol:

If you haven't seen it yet, here are some more testing tips that might help you.

Marje and Gracie said:
Your vet is correct that Somogyi in cats is rare. In fact,it hasn't been documented. But, in theory, Somogyi results from a chronic overdose.
Click to expand...

Marje is quite right. But, be aware that a lot of people will use the common definition of Somogyi Rebound, which is actually just a "bounce" when a cat goes from low numbers to high as the liver tries to compensate (glycogenolysis). The technical definition of Somogyi Rebound would be if his numbers spiked over his "normal" high and there was the presence of certain hormones (glucagon, as well as the stress hormones epinephrine, cortisol, and growth hormone). For example, if the cat's range is generally 60 to 300 over the course of the day, then he drops to 39 and bounces back up to 280, that is NOT Somogyi Rebound by definition. If the cat drops to 39 then bounces back up to 330, that might be Somogyi Rebound only if there is the presence of the additional hormones and other factors have been ruled out (i.e. stress, insulin worn off, etc...). With these narrow definitions, at the moment true Somogyi Rebound has yet to be scientifically proven to exist.

So, how has Sweetie been doing these last couple of days?
 
Just stopping by to see how you guys are getting along. Bounces are normal - it takes awhile for the numbers to flatten out. You're both doing great!
 
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