313 Tessie Lou AMPS 377 - How long does bounce last?

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tessielou

tessielou

Member Since 2010
Good morning everyone,
Tessie Lou has such a high AMPS today. And, she was in 300s yesterday, too. The day before, she had her lowest AMPS ever, at 171. So yesterday, I assumed the high numbers yesterday was a "bounce." Now that she's even higher today, I'm not sure what is happening.

Any thoughts?
Oh, and she is on Amoxicillin for suspected low grade pancreatitis. This is day 9, and I thought it was working until these 300s started showing up... Weird.
 
Hi Sandy,
I understand that it can take up to 72 hours for a bounce to clear. I'm not sure about the effects of the antibiotics on blood glucose.
I hope that Tessie Lou will come down soon and that someone familiar with the action of antibiotics on bg will be able to give you an answer.

Hang in there,

Ella & Rusty
 
The easy answer is that a bounce can last up to 72 hours.

I know I probably say this every time I open your SS. PLEASE, get at least one test during both the AM and PM cycle. There have been no PM checks in 10 days. You don't know if Tessie Lou is dropping during the night. You are holding on to doses for way too long which will only make it harder if your cat's numbers do begin to come down -- her liver will not recognize what is a normal BG level because she's spending too much time in higher numbers. If you review the dosing protocol, with nadirs that are above 200, you hold a dose for 3 days before increasing and 5 days if the nadir is below 200. You've been at the same dose for 16 days. However, I am not comfortable making any recommendation about dose without spot checks. Jill put this post together to remind people about the importance of spot checks and dose.

Also, if your cat has an infection, dose is especially important since infection increases the risk for DKA and one way to combat the risk of ketones is with insulin.
 
Sienne and Gabby said:
I know I probably say this every time I open your SS. PLEASE, get at least one test during both the AM and PM cycle. There have been no PM checks in 10 days. You don't know if Tessie Lou is dropping during the night.
Click to expand...

I have been limiting spot checks because her ears have been so sore and obviously hurting her. My vet suggested giving her ears a rest by just doing preshot checks. That is what I've been doing until two days ago when she had the 171 AMPS. Then, I checked her frequently that day.

Sienne and Gabby said:
You are holding on to doses for way too long which will only make it harder if your cat's numbers do begin to come down -- her liver will not recognize what is a normal BG level because she's spending too much time in higher numbers. If you review the dosing protocol, with nadirs that are above 200, you hold a dose for 3 days before increasing and 5 days if the nadir is below 200. You've been at the same dose for 16 days. However, I am not comfortable making any recommendation about dose without spot checks. Also, if your cat has an infection, dose is especially important since infection increases the risk for DKA and one way to combat the risk of ketones is with insulin.
Click to expand...

I have been holding the dose, per my vet's instructions. She believes in holding a new dose for two weeks. When her numbers started creeping up on the dose increase, she wanted to give the antibiotic and watch for improvement, without the added variable of a dose increase.

Since I found this board, I have been impressed with the FD experience of other members and find it very valuable. I have said from early on that my "plan" was to try to balance my vet's advice with the advice of this board. It seems it can't be done. I appreciate how frustrating it must be to try to help someone who is not strictly following the protocol, and for that, I'm really sorry. Just trying to, like I said, do a "balancing act," which I've been unsuccessful at. Thank you all for all the help and support.
 
Morning guys! Sorry for the pink amps today - In suspect that Tessie Lou is bouncing. I hope it clears for her soon. It can take up to 72 hours to see better numbers. Maybe today she will. Paws crossed!

I know on the ears... sometimes they do get sore. Have you tried neosporin on them? it does help them heal. Some others here on the board use vitamin E on them too, with great results.

It can be difficult to balance what a vet says, and what you will read here. Been there too. I found that with my vet, though they understand diabetes very well, they really didn't understand lantus well at all. It has been a learning experience for both of us. They've taught me, and I've taught them. I think too part of the challenge is that most vets view numbers in the 200's as regulated, and as we all know that is not the case here - we all know our kitties can do better. Bottom line is that you need to do what works best for you. It is indeed a balancing cat. Good luck - don't ever feel that you are unsuccessful - you are here, you home test, and you are helping Tessie Lou.

I hope you guys have a great sunday! and that your weather is better than ours. :-D
 
I don't want to put you in a position where you feel uncomfortable or feel like you are defying your vet. That wasn't my intent. Perhaps you could share the article I'm attaching with your vet. It's the formal publication in a top tier veterinary journal of the dosing protocol we use. Many vets are less familiar with Lantus than they are with other types of insulin that have been around longer. They know that cats have a wonderful chance of remission with Lantus but they approach it's use just they way they would with other types of insulin. As a result, they will encourage you to only get pre-shot tests (that's if they encourage you to home test at all). What they overlook is that Lantus dosing is based on the nadir, not on the pre-shot numbers. Likewise, because Lantus is a long-acting insulin, doses do not need to be held as long as 2 weeks. Hopefully, you and your vet can work together to get Tessie into remission or tightly regulated.
 

Attachments

Hi Sandy: I, like Sienne, want you to feel comfortable with your vet. I have the most awesome vet and her way of managing FD was similar to your vet's until Gracie got FD and I introduced my vet to the Lantus protocol and showed her what cats often really do on lantus. She said that she has learned that the people in FDMB know much, much more about managing FD than she does. She had never had a client keep a SS and so had no idea that cats go so low, bounce up, etc. etc. Her philosophy was the same as other vets...keep them on the same dose unless the urine tests neg for sugar, and then lower them. A diabetic cat can become accustomed to high glucose numbers and then become insulin resistant.....thus the protocol. But you do have to be able to test them if you are going to up the dose. If you can at least get her into healing numbers (below 200), that may be the best you can do with your own personal situation and THAT IS GREAT!! The tight regulation protocol is tough but if you can get Tessie Lou in healing numbers, it would be super. We're here to support you!!!
 
Re: 313 Tessie Lou AMPS 377 PMPS 258

Thanks for the encouragement, Michelle. Yes, I do use Neosporin and I think it helps. I hadn't heard of Vitamin E--good to know. I'm going to visit with my vet tomorrow regarding a dose increase and following the tight protocol. In the meantime, Tessie had a nice 258 PMPS tonight, so maybe the bounce has cleared.

Sienne, thank you for the document. I appreciate your taking the time to do that and I will share it with my vet.

Marjorie, that's interesting about your educating your vet. Hopefully, I will get to that place with my vet soon. She is really great, and seems to be taking a lot of interest in Tessie Lou. We talk once or twice a week. I'll share the protocol with her tomorrow. Thank you, too, for the pep talk! Some days aren't so great...

Night all,
 
YAY on the pmps! nice, good job Tessie Lou. Good luck at the vet - I hope that goes well. I will be thinking of you and Tessie Lou, and looking forward to hearing how it goes. :-D
 
Re: 313 Tessie Lou AMPS 377 PMPS 258 +4 190

Thanks Michelle. We'll keep plugging away here :smile:

And, Hi Celi, sorry I missed your "hi" from earlier today. Hope you and your family had a good Sunday.

I'm really going to bed now. This time change is tough on us old people! :lol:
 
i hear ya on those poor kitty ears. someone suggested the neosporin cream with pain relief - is that the one you're using, or just regular neosporin? if not, maybe it would help. i'm putting it on both ears every evening when we're done for the night and it's making a world of difference. i'm also switching places on the ears and using both ears every day to spread the owies around.

Good luck with your vet. i've been taking info to my vet as well. i really like him but just don't think he's as up on the very latest with feline diabetes as I would like. He knew some of it, but not all. we were going in once a week, different times a day, and that was all the BG testing punkin was having done. Like i read in the PDF, he was content with BG between 100-200 as a goal, but we would've missed punkin's dropping lower into hypoglycemic numbers if we hadn't been testing at home.

Sienne, thanks for posting the protocol PDF. I"m going to take that one in to the vet too.
 
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