4/11 New Member, Question about "Rebound Effect"

Discussion in 'Feline Health - (Welcome & Main Forum)' started by MisterBee, Apr 11, 2021.

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  1. MisterBee

    MisterBee New Member

    Joined:
    Apr 11, 2021
    Hello to everyone, very glad to find this forum.

    I have a cat named Pigpen (a cranky calico) who lived on my neighbor's front porch for nine or ten years. The neighbors gave her to my wife and I after they moved two years ago, and we successfully transitioned her into a housecat about six months after we took over her care. My guess on her age is somewhere between eleven and fourteen. She has no other health problems that I know of, except a sensitive stomach. (Strangely, she has never seemed to tolerate wet food very well and has eaten dry her entire life.)

    Pigpen was diagnosed as diabetic ten days ago. The vet put her on ProZinc. On a followup visit she installed a FreeStyle Libre sensor, and I've been keeping track of Pigpen's numbers at home since Thursday for every shot cycle.

    The numbers so far seem pretty high -- the curves have generally been from upper 400s at shot time down to the lower 200s at the nadir. But my main concern at the moment is an apparent "rebound" during two of the seven cycles which causes the next cycle to look flat and very high.

    The first two cycles I checked had a definite curve, but during the third one her numbers began to unexpectedly go back up, and rapidly, a little less than mid-way through the cycle. The lowest number I got from that cycle was 293 (I had to leave the house for a good while after that and I don't think I got the nadir.) She was up to 500 at the next shot-time and I kept getting that frustrating "HI" reading (over 500) for much of the next cycle. No apparent downward curve. I found an article on the "rebound effect" at Diabetic Cat Care which kept me from getting *too* scared, and I waited to see if the curve would resume within a day or two.

    It did, quickly, going down to 229, 215, and 224 during the next three cycles. But four hours into that last cycle, the number started unexpectedly shooting up again. And now, I'm seeing another "flat cycle," getting nothing but the "HI" reading four hours following the shot.

    So my question is -- can these very high, flat cycles be attributed to a rebound effect attributable to a "panicky liver," even if the nadir isn't going any lower than the 215-230 range? I asked the vet about it, and she explained the Symogi Effect, saying that couldn't be a factor here because the nadir wasn't anywhere near hypoglycemia. But I've read conflicting information, and I'm not sure she and I are talking about the same thing.

    If this is some kind of "rebound effect," I'm concerned about the effect that changes in Pigpen's dosage might have on it. The vet had her on 1 unit of ProZinc the first five days, then after doing a curve at the office on Wednesday she said to go up to 2 units. And then on Friday, after I discussed the latest numbers with the vet, she said to go up to 3 units. I was a bit queasy about upping the dosage that much and that fast, so I fudged a bit and only went up to 2.5 units at first to see what happened. I did do 3 units on the last shot. I know that Pigpen's numbers are high, but I'm also wondering whether dumping a higher dose of insulin on a panicky liver might do more harm than good, if that's what's going on here.

    Anyway, apologies for such a long first post, and I'd appreciate any guidance.
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi and welcome to the forum.
    What you are describing sounds very like bouncing. Bouncing can happen when the cat drops too low, too fast or lower than the cat is used to. This can cause the cat to panic and dump stored glucose and regulatory hormones into his system which raises the blood glucose. Bounces can last from 1 to 6 cycles and there is nothing you can do but wait them out.
    Without seeing the BG data we can’t help you much. You might like to set up a spreadsheet and enter the data you have collected already. Here is a link to how to set up the SS https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

    Can we you tell us what you are feeding Pigpen. Are you offering snacks during the cycles as well as before the insulin?

    Do you have a hypo kit set up in case of low numbers. Here is a link https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

    With increasing the dose, we recommend only going up in 1/4 unit increments so you don’t miss the best dose and it is safer for the the cat. I would not increase in 1 unit increments.
     
  3. MisterBee

    MisterBee New Member

    Joined:
    Apr 11, 2021
    Thanks for the links. I've done the spreadsheet and published it (I think).

    The bounce disappeared again on the Sunday PM - the nadir wasn't any lower than the others (215), but it was more sustained. Alas, the number came back up quickly near the end of the cycle and I"m once again getting overnight "HI" readings.

    Pigpen's food -- she is on Hill's m/d dry. Two main meals a day, at shot times, and she snacks one or two more times in the eight hours after shot time before I put her bowl away four hours before the next shot. I know I can do better on carbs than Hill's but she seems to have trouble eating wet food consistently (discomfort, loose stools at times). And then after a bout of discomfort with a wet food, she typically doesn't want to eat it again.
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I think you are increasing the dose too quickly.
    I am not a Prozinc user so will tag @Deb & Wink and @JanetNJ
    Here is a link to using prozinc
    https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/
    and another one
    https://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

    The m/d dry is around 16 or 17% carbs which is bordering on high carb. I would keep trying to find a low carb food she will eat.
    Which country do you live in.? There are some low carb options in the US for dry food if you can’t get Pigpen off the dry food.
    You are not going to get more normal numbers while you are feeding the higher dry food.
     
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  5. MisterBee

    MisterBee New Member

    Joined:
    Apr 11, 2021
    I'd be interested in hearing about low carb dry food alternatives. The only one I found via googling was Evo, and my understanding is that was discontinued a few years ago. Yes,. I am in the US.
     
  6. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    There are only 2 low carb kibbles. Dr. Elsey's Clean Protein chicken (available on Amazon and Chewy) and Young Again Zero (only available on their website). They're both pretty expensive but they are nutrient dense so the cat doesn't need to eat much.

    It's still going to be much better for Pigpen to eat a low carb canned diet though. The kidneys are the weakest organ in cats and keeping as much water flowing through them as possible helps to keep them healthier.

    Has he ever been diagnosed with IBD/IBS?
     
  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I don't know why vets keep dragging up the Symogi effect, as it has been debunked for more than 60 years. It's a myth.

    Transitioning your cat from dry to wet food

    When the BG levels are that high, sometimes you do have to increase the insulin dose very rapidly. Not every cycle though. Not every single day. You need to give the insulin time to see an effect.

    I agree with what others have said about the high carb dry food keeping Pigpen's BG levels inflated. If you transition to a lower carb food, that can rapidly drop the overall BG levels, so more monitoring is needed during that food change.

    Any rapid food change can upset a cat's digestive system. So you go slowly on the transition, and introduce the new food slowly.
     
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