2/27 Boots AM 119

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LadyW

Member Since 2017
He dropped almost 500 points since the 5:30p yesterday 2 units. I have a call in to the vet for next steps. Thank you all for your support yesterday.
 
Wow! I think he may have gone to those sky high numbers after having dropped way down on Feb 9th. If so, that is what we refer to as a "bounce". Now seems like Boots is coming back down into a more more normal range.
Looks like you decided to his shot this morning. If so, when you get a chance, you can enter SS (for skipped shot) or NS for (no shot). I'm not sure which one is most appropriate and hopefully someone will let us both know.
Great job getting the spreadsheet, and signature set up.
Please let us know and post the feedback your vet gives you.
Hopefully one of the more experienced people here will weigh in with opinions. Also just a thought, he may go higher by PMPS tonight if you skipped this morning but don't worry too much, with all the help here you'll be able to get him on track.
 
Thanks. I need to do one more BG around 4pm and call the vet with today's results at 4:30. Needless to say, that 600+ scared me a lot.
 
Barbara & Uncle said:
If so, when you get a chance, you can enter SS (for skipped shot) or NS for (no shot).
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I believe NS is what we use the most.

That was a heck of a bounce. Here is an explanation of bouncing:
you can spot a bounce this way (this only took me 6 months to learn and a bunch of people explaining it! i'm a slow learner!)

yesterday morning you had a 215 - then it went 235, 271, 270, and then 308 this morning - basically straight up. no curve. and then look backwards in the ss and the night before was that sweet little 148 12 hours earlier.

if you imagine that night-time cycle, starting at 148, kitty probably went down in a nice little curve, hitting something under 100 mid-cycle. that lower-than-usual number would've shocked her body. they get accustomed to whatever range they're in, and any sudden dip lower can set this off.

"HELLO WE"VE GOT A 911 HERE- KITTY'S GOING DOWN!" yells Mr. Liver. Fortunately, mr liver has a storehouse of counter-regulatory hormones and stored sugar (in case kitty needs a little nommy sweets in the middle of the night) and when Kitty gets into a range of numbers lower than usual, Mr. Liver lets loose with the sugar and the hormones and sends Kitty on a rocket to the moon. this is the cat's body's protective mechanism to keep the cat from becoming hypoglycemic. unfortunately, mr liver doesn't seem to know that anything above 40ish isn't a crisis and it will do this regardless of the range of numbers, even at 200 if the cat has become accustomed to 400.

A second cause of a bounce is if a cat drops very quickly. 100 points in an hour, for example, regardless of the range the BG number is in, can cause a bounce as well.

So, what to do now? don't increase the dose because of these higher numbers. once this bounce clears, which can take up to 3 days of high numbers if mr liver is super-active, then if you had increased the dose, it would be too high. you are entering the phase of treatment that we say requires "Patience Pants." when you think you're seeing a bounce, you have to wait it out, then you can see what the dose really does. You will know the bounce has cleared when you start seeing numbers you were seeing before - like that 148 again.
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Your vet may refer to it as the Somogyi Effect, but that is actually something that has never been proven to exist in cats. See this research paper on the subject: http://www.felinediabetes.com/FDMB/...7/?temp_hash=0619dea4f9f1fa3174caa4172e32bf0c
 
Here is your post from yesterday: http://www.felinediabetes.com/FDMB/threads/boots-bg-568-otj-2-weeks.173876/ We include those links to help people follow along.

Don't worry too much about those high numbers you saw. First of all, you have an AlphaTrak that reads higher than the human meters most of us use. And second, several of us have kitties that have read that high on human meters. :banghead: Including my Neko. As long as they don't stay in high numbers, it's OK.

I think you'd want to start back on an even lower dose, maybe 1 unit. It looks like Boots still needs some insulin.
 
Thank you for the bounce explanation and for the reassurance on the high numbers.

1 unit 2x is sounding like it may be in the future. At 4:00p, Boots tested at BG 581. For tonight, vet wants me to repeat the 2u at 5:30, and re-check BG in the a.m. He suggested the possibility of 1x daily shots. Will post my follow-up with him in the a.m.
 
LadyW said:
He suggested the possibility of 1x daily shots.
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Lantus has a 12 hour cycle, so only shooting once a day will result in very uneven numbers - the manufacturers recommend shooting twice a day, and we endorse that here. Do you know how much experience your vet has with cats on Lantus? It's considered kind of new in cats (although it isn't really), and if he hasn't had much experience with it, he might not be aware of certain things.
 
The one thing I will add about high numbers is that you should try to catch a ketone test if they are in high numbers.
 
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I don't think I would be satisfied with a 1x either - too much fluctuation which would be very hard on the organs. I do have a lot of confidence in my vet, and he's not afraid to seek answers. His wife is actually the diabetic cat "expert" and I know he consults with her as well as the younger vets in the practice. They've also been very open to suggestions I've had in the past.

I believe an antigen test was done 2/9 as he wanted to check for infections and organ failure.
 
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