5/22 Billie PMPS 212 +2 123 +2.75 124 +4.5 171

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Deanna & Billie

Deanna & Billie

Member Since 2014
Good morning everyone! It looks like Billieboo is still bouncing.

In other news, she is completely obsessed with chicken. I have been giving her boiled chicken as a thank you after every test, and she is very excited about the chicken and less excited about her regular food. I've tried shredding the chicken and mixing it into her food, but for some reason, she doesn't love that as much as just plain chunks of chicken. I'm happy to spoil her, but I want to make sure she is eating enough cat food, especially before her shots. I'm also using parmesan cheese sprinkled on wet food if I feel that she isn't eating enough around shot time. She is eating either Hound & Gato, Evo 95, FF Classic Chicken, or occasionally Merrick Turducken if I am going to work and want to make sure she eats while I'm gone. The Turducken is her favorite, but it has 9% carbs.

I hope everyone has a nice day! It's raining here, and the cats are enjoying the cool breeze in their window seat.
 
Re: 5/22 Billie AMPS 293

Just checking in on you and Billie this morning! You're doing a good job with the testing. I'm glad you found some treats Billie loves. I never could get Jersey to eat any "human" food like that. Her treat after testing was playing with "da bird." :lol:

I don't give dosing advice, but it may be getting close to time to consider an increase. I'm sure the more experienced users will help you with that soon.

Have a great day, Deanna!
Shelly
 
Re: 5/22 Billie AMPS 293

Hi Shelly! It's always nice to hear from you! I hope you and Jersey are enjoying the day.

I am also wondering if we might be heading toward a dose change, but I'm unsure about whether we would increase or decrease. In a lot of my reading about bounces, I have found people saying that a dose should be decreased if repeated bouncing occurs, because the initial dose might be too high.

Her first bounce happened on 5/17 after she hit 85 that afternoon. She stayed highish with some lesser drops for exactly 6 cycles. The cycle after that, she went down to 110 at +4, then jumped up to 256 at +6 and has been highish since then. I'm saying highish because I have been looking at other cats' bounces that go into black and I am thankful that we are not seeing that kind of spike. Tomorrow morning's cycle will be the 6th cycle since the last bounce, so I'll see how things settle after that and will ask everyone for some dosing input.

Thanks for stopping in!!!
 
Re: 5/22 Billie AMPS 293

Hi Deanna and extra sweet Billie!

I have found people saying that a dose should be decreased if repeated bouncing occurs, because the initial dose might be too high.
Click to expand...
Can I ask where you're seeing this? I can't remember ever seeing this discussed in my year or so here. The only thing I can think of is that if someone starts on too high a dose, it can cause lots of bouncing so they need to reduce and usually start over..working their way up slowly. We often see cats here who were started on 2 or 3 units, quickly increased and their caretaker wonders why they go from really low, to really high, back to really low again. Since you started on a dose appropriate for Billie, this doesn't pertain to you!

Just FYI---the 300's you've gotten for AMPS on 5/20 and 5/21 were most likely bounces from the fast drops on the PM cycle before. Billie dropped pretty quickly (from 299-226 and 195-140) on those PM cycles between Pre-shot and +2 and lots of times, those fast drops will cause bouncing, just like going into lower numbers can.

Overall, Billie's looking really great!
 
Re: 5/22 Billie AMPS 293

Hello Deanna, here is the link to your last two posts:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=119090 and
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=119044.

We like to see the link to the previous days condo's so we can backtrack and see what was suggested previously. To put the link in there, just go to your previous posting, copy the web address, then when you start a new condo, click the URL button and paste the link in between.

As I mentioned before, the initial starting dose for Lantus is held for 5-7 days. But you had a furshot (deliberate miss) on the morning of the 18th so the cycle count starts over after that. Those 5 days is 10 cycles and today is the 8th cycle. Just two more cycles and if you don't see green by then I'd increase by .25U. She did get very close to green a couple nights ago so is looking very good for a cat new to insulin.

Billie does not look overdosed to me. Some cats just like to bounce and Billie isn't bouncing very high. I don't know if anyone has introduced you to the concept of patience pants yet. Time to find yourself a nice comfortable pair and try them on for a few more cycles. :lol: Seriously though, the waiting for the depot to stabilize is one of the hardest things to do.
 
Re: 5/22 Billie AMPS 293

Hi Deanna:

I haven't posted on your condo yet, so I just wanted to say welcome to LL. I'm not one of the advice givers, but I like to provide support and encouragement to others, because I know how it helps me to receive it. You are in the right place to get the best possible help for Billie. The wonderful, smart, compassionate people here saved Cinco's life after he was first diagnosed, and I am not exaggerating. Since then, they have helped me through a lot of really tough spots and I think the world of everyone here. I know it's overwhelming, all the info coming at you, and you are so worried about your kitty and want to make sure you get it right. Just relax and read lots and let the people here guide you when you aren't sure. Don't be afraid to ask questions. Looks like you are off to a great start!
 
Re: 5/22 Billie AMPS 293 +2 252

Hello and thank you all for your help! Sorry I didn't link our condos from yesterday. I knew I forgot something this morning!

Chris, to answer your question about where I read that sometimes bouncy cats need a reduced dose, here are a few links.

viewtopic.php?f=28&t=108796

http://www.felinediabetes.com/concurrent-somogyi.htm

http://sugarcats.blogspot.com/2006/03/s ... s.html?m=1

Wendy, thank you for the patience pants! I needed them :) I will wait until after the 10th cycle before doing anything. I just want to make sure I'm not increasing her dose when I should be decreasing it. I started her at 0.75 units based on her weight of 8 lbs. I know it's not a big dose, but considering her quick drops and bounces, is it possible that it's too much for her as a starting dose? Let me know what you all think of the information in the links above.

Tricia, it's nice to meet you and Cinco!! Thanks for saying hi! I am blown away every day by how supportive and kind everyone here is. I feel like buying everyone flowers :lol:
 
Re: 5/22 Billie AMPS 293 +2 252

Oh OK Deanna! The Somogyi Effect is a hotly debated topic. Some say it's real, some say it's not, so it's kind of hard to argue one side or the other.

I think that what I said earlier is still true though...Most of the time when you see people here suggesting a reduction to try to stop the bouncing, it's because the cat was started at too high a dose in the first place. For example, someone starts at 3 units twice a day because that's what their vet recommended and isn't testing at all or enough and only seeing high numbers. We might ask them to reduce because without getting tests mid-cycle, it's entirely possible that the cat is going too low at nadir (or lower than the cat's body is used to) and then "bouncing" back up for Pre-shot tests....so it looks like they're not getting enough insulin, when actually they're getting too much.

Since you started Billie on a reasonable dose to start with and are home testing (and doing a wonderful job!), I don't think it's anything you really need to worry about. Billie will bounce now and then, because all cats "bounce until they don't", but you're not seeing those wild swings from really high to really low and back up again.

Billie is really looking great! When she does bounce, she'd not going near as high as most do when they're new! She may be one of the lucky ones that could end up only having to be on insulin for a short while and then maintained with the low carb diet :-D
 
Re: 5/22 Billie AMPS 293 +2 252

It's a nice place, isn't it, deanna? i think it says something about people who love cats!

There are some semantics that are confusing - the term Somogyii is used inconsistently both here and around the internet. Sometimes a cat is overdosed on insulin and the blood sugar stays high to keep the cat alive for as long as that dose stays high. we call the temporary phenomenon (up to 72 hrs) that happens when a cat goes into any range lower than they are used to, a bounce. We do see cats come in here that were started on 4 or 5 units, say, who have been overdosed and their blood sugar will stay high as the cat's body tries to compensate for the too-large dose of insulin. In that case, yes, we suggest people lower the dose. sometimes those cats even go off of insulin and become diet-controlled when that happens.

But bounces are different. They are a normal response in the body and it does not necessarily mean a cat is overdosed or needs a dose reduction. Here's a link to a post i wrote a couple of years ago about bouncing New Dose Wonkiness & Bouncing. Bouncing is mentioned in the second post. The first one addresses high numbers that manifest in the first 24 hrs after a dose increase - another situation where one wouldn't decrease the dose from the high numbers.

Cats get rapidly accustomed to being in high numbers when they become diabetic, and when that happens they will bounce from any range lower than they are used to. So if they've gotten used to 400's, and they hit 200, their body perceives it as too low and the liver reacts. This is really common and obviously, they don't need less insulin. Often, in fact, a bouncy cat will benefit from a little more insulin - but that's decided on a case by case basis.

In Billie's case, she's bounced from blue numbers - all in the 100's - to those morning 300's you've seen. The point of Tight Regulation is to get a cat into normal numbers (50-120) and keep them there. When they get reaccustomed to that range and spend some time there, the pancreas has a chance to heal and begin producing insulin again. When that happens - the cat can become diet-controlled. If you hope for her to go off of insulin, you'll want your focus to be on getting her into the normal range and keeping her there.

We avoid the concern of a too high dose of insulin by starting at an appropriate dose (based on weight and previous insulin use), being systematic in increasing doses following the protocol's guidelines, and testing often enough that if a cat going low we will know it. It's not something you have to worry about at this point - and we definitely keep our eyes out for new kitties and look for what dose they started at, how the dose was increased, etc.

In any case, that might've been more than you wanted to know, but i wanted to reassure you that Billie isn't overdosed! We'd be able to tell if she was.

I agree with Wendy's suggestion to wait 2 more shots (total of 10 after the skipped shot) at this dose and if you aren't seeing greens by then, increase by 0.25u. It's important to wait the "just right" amount of time on a dose and to increase on schedule, because you don't want a cat's body to get too used to being in numbers that are still above the normal (50-120) range.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

Billie is looking great!

edited to add - i started writing this before Chris posted and got sidetracked with a phone call. Chris' basically said the same thing i'm saying, i just like to use more words. ;-) :lol:
 
Re: 5/22 Billie AMPS 293 +2 252

Chris and Julie,

Thank you so much for the information and encouragement!! I really appreciate the thorough responses and the time you put into them. I do want to know everything I can possibly know about what is going on with Billie, so everything you said is super helpful. Thank you! :smile:

I see the sense in increasing the dose rather than decreasing it, and I will plan on bumping her up to 1 unit for tomorrow night's shot unless we see a reason not to based on what she does tonight and tomorrow. I am very hopeful that she will get off the juice and be diet controlled in time!! That is definitely our goal. I want her to be healthy, and she wants me to stop interrupting her napping/grooming/bird watching schedule to poke her!

Tonight's PMPS is looking better. Maybe she is on her way out of the bounce. I'll see what +2 brings. Thank you again!!! I am convinced that cat lovers are the best people around.
 
Re: 5/22 Billie AMPS 293 +2 252 PMPS 212

I'm glad Wendy, Julie, and Chris were able to help you with bouncing and (possible) upcoming dose changes. I'm also glad that you voiced your concerns. I had the same fear that you did - that the dose was too high and Jersey was bouncing because of it. I never voiced those worries. Looking back, I wish I would have so that someone could have explained it to me. It would have saved me a lot of needless worry! :YMSIGH:

You're doing great, Deanna. I know how hard it is to tackle all of this, but you're in the best place to get Billie's diabetes under control. It was so hard to put my trust in strangers on the internet when we first started out, but they never steered me wrong. I may not have trusted them in the beginning, but I wouldn't hesitate a second to trust them now! Like Tricia, I credit the people here with saving Jersey. I just can't say enough good things about them...... :-D
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop???

Thank you Shelly!!! It could be weird trusting strangers, but I can just tell that everyone on here is genuine and wanting to help out of kindness. It's really inspiring! I'm happy and grateful that people like you folks exist.

I just got a +2 and she is at 123 - almost 100 points down from her PMPS. I will definitely get a +3 and watch closely. Should I do anything now like feed medium carb food?
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop??? Seeking advice!

You could feed a couple tsp of low carb food. Looks like you might be seeing that green soon. :-D
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop??? Seeking advice!

Okay, thank you! She's eating some of her regular low carb food sprinkled with chicken right now. Should I be worried about this drop? It startled me because it and seems fast, but maybe it's to be expected if she's coming off a bounce?

I did a second test just now to make sure I didn't get a messed up reading, and it said 110. She's definitely heading for green!
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop??? Seeking advice!

I'd like to weigh in on Somogyi. It's not been documented to occur in cats but the concept of it is that it results from a
chronic
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overdose and the result is seeing numbers tank and then go straight back up. So it might look like a bounce but the difference is
chronic
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overdose.

I've seen Dr. Lisa refer to two forms of rebound as warranted and unwarranted where warranted is when a dose reduction needs to be taken because the dose is too high. Unwarranted is what we typically call a bounce in LL.

As far as the drop....yes...I would be very vigilant and would get a +3 to see if she is still coming down fast. It might be an active cycle.
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop??? Seeking advice!

Thank you Marje! Do you think that the rebound we are seeing in Billie is warranted or unwarranted?

I will get a +3 for sure, and I will stay up as long as I need to. I know to follow the steps in the "Handling Low Numbers" sticky if she drops toward 50.
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop??? Seeking advice!

Unwarranted because I don't think she needs a reduction. Unless she continues into green tonight, I'd be thinking about an increase. She's new to Lantus and you've held the starting dose 7 days, 14 cycles per the protocol.

If she gets into green tonight, I would definitely hold the dose.
 
Re: 5/22 Billie PMPS 212 +2 123 Big drop??? Seeking advice!

Sounds good. Thank you very much!! I just did a +3 (well, more like a +2.75) and she's at 124. I'll get a +4.
 
Re: 5/22 Billie PMPS 212 +2 123 +2.75 124

I'd probably give her a couple hours unless you want to go to bed. If you want to get some sleep, test her before bed; if she's up...time for sleep. If she's flat or down, you might want another test in a couple hours.
 
Re: 5/22 Billie PMPS 212 +2 123 +2.75 124

Okay! I will stay up for a couple hours or set an alarm if I get sleepy. I have the day off tomorrow, so that's lucky. Thanks again. Hopefully these numbers do some good.
 
Re: 5/22 Billie PMPS 212 +2 123 +2.75 124

Blue numbers are always good! A move in the right direction.

I think it is fine to nap for a couple hours and then grab a quick test.

Night!
 
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