7/18 Moonie AMPS 209, +2 193, PMPS 212, +2 183, +4 124

[Connie & Parker & Moonie]

7/17 Moonie +12 62, AMPS 70, +1 82, +2 67, +3 78, +5 95, PMPS 93, +1.5 109, +3 117, +5 197

Well we’re bouncing back to the moon today after that scary bounce break yesterday early morning

This is going to be a dumb question - but how do we get out of this bouncing cycle if our bounces seem to be caused by the severe downward motion of bounce breaks, which come at the end of the cycle? Meaning if it’s an early onset drop, we can combat it with front-loaded feeding to slow it - but if the bounce break (and rapid drop) comes at the end of a cycle, we really shouldn’t be feeding past +6-8 except in cases of emergency right? So how do get out of this cycle?

Another dumb question - should we consider temporarily going back to 3.25u and watching Moonie like a hawk until she flattens out? For whatever reason, that dose seemed to exert so much downward pressure that Moonie couldn’t bounce. I miss those flat greens even if they’d come with the occasional lime. Though she got to a scary nadir on the 3u so maybe that’s not right.

Finally, Sara asked this on my condo yesterday - but what about a “fat” 3u?

Sorry just coming up with any and all ideas that might tether Miss Moonie to Earth! Though it seems like her friends Mister and Khloe have been bouncing too, so maybe she just doesn’t want to feel left out

Thanks in advance for any and all thoughts and suggestions and happy Caturday! Hope everyone has a wonderful weekend

 

[Sara & Khloe]

Connie, you have the green bug! I think you may need theselol Be aware that Khloe leveled out today (looks like Mister did too!) so knowing these 3, Moonie will follow behind shortly!
Hope someone answers your question about feeding bounce breaks soon, I’ll probably have to pop in here to see the answer too!

Moonie, let me be extra extra clear today! The order is greens ABOVE 50 and NO LATER than your usual nadir within the next 24 hours. NO malicious compliance with those scary 50s at +8 - +10. There is some Freeze Dried Chicken waiting for you once the orders have been followed CORRECTLY. Neither one of us want to use the wood glue again, so let’s try to work together, ok? Ok! Sign your paw print here, here, and here. Head pats and nose boop

 

[Connie & Parker & Moonie]

Connie, you have the green bug! I think you may need theselol Be aware that Khloe leveled out today (looks like Mister did too!) so knowing these 3, Moonie will follow behind shortly!
Hope someone answers your question about feeding bounce breaks soon, I’ll probably have to pop in here to see the answer too!

Moonie, let me be extra extra clear today! The order is greens ABOVE 50 and NO LATER than your usual nadir within the next 24 hours. NO malicious compliance with those scary 50s at +8 - +10. There is some Freeze Dried Chicken waiting for you once the orders have been followed CORRECTLY. Neither one of us want to use the wood glue again, so let’s try to work together, ok? Ok! Sign your paw print here, here, and here. Head pats and nose boop

Fingers crossed! You’re so funny Sara laying out the terms and conditions so clearly for Miss Moons this time! No loopholes

If Mister and Khloe are flattening out that’s probably the best sign Moonie isn’t too far behind!

 

[Sara & Khloe]

Fingers crossed! You’re so funny Sara laying out the terms and conditions so clearly for Miss Moons this time! No loopholes

If Mister and Khloe are flattening out that’s probably the best sign Moonie isn’t too far behind!

I actually need to add a condition because Moonie is a little stinker! No 50s at PS, +1, or +2 either Moonie! I got my eyes on you..

And exactly! Plus you were thinking of an increase so you just know she’s gonna show you up! It’s all the right conditions for a perfect storm. Now let’s hope she picks her canned food tonight easily

 

[Marje and Gracie]

This is going to be a dumb question - but how do we get out of this bouncing cycle if our bounces seem to be caused by the severe downward motion of bounce breaks, which come at the end of the cycle? Meaning if it’s an early onset drop, we can combat it with front-loaded feeding to slow it - but if the bounce break (and rapid drop) comes at the end of a cycle, we really shouldn’t be feeding past +6-8 except in cases of emergency right? So how do get out of this cycle?

On a perfect, normal cycle you don’t want to feed after nadir if you can help it. If she starts to break a bounce later in the cycle, you can feed up to and at +10. I’d try LC first and see if that slows her down since it’s late in the cycle. Just avoid feeding two hours before PS unless she drops into the 40s

Finally, Sara asked this on my condo yesterday - but what about a “fat” 3u?

The modified protocol does allow for this but Sienne’s, Wendy’s, and my mentors (& former moderators) always said cats do better with increases/decreases of 0.25u.

IMHO, I’d continue to hold this dose as long as you are seeing 50s/60s every couple of cycles.

 

[Connie & Parker & Moonie]

She went from 212 -> 183 @ +2 -> 124 @4, so she will likely rebound tomorrow we think due to the speed of the drop tonight. Will it be a long night though? We will see!

Apologies if it’s been answered here elsewhere, but does it even make sense to reduce in cases where the dose is causing fast decreases? I’m still going through literature about the pharmacokinetics and how it all works, so this might be a silly question

-P

 

[Marje and Gracie]

She went from 212 -> 183 @ +2 -> 124 @4, so she will likely rebound tomorrow we think due to the speed of the drop tonight. Will it be a long night though? We will see!

Apologies if it’s been answered here elsewhere, but does it even make sense to reduce in cases where the dose is causing fast decreases? I’m still going through literature about the pharmacokinetics and how it all works, so this might be a silly question

-P

I don’t really see these as big drops. The big drops are 50 mg/dL.

I’m confused as to your question? Do you mean reduce to see if she won’t drop fast? No, you don’t want to do that. But it’s not a silly question.

Or maybe you mean don’t decrease if she drops below 40 due to a bounce breaking cycle? I also wouldn’t do that. Drops below 40 need a reduction for safety. It’s safer to reduce and have to go back up than miss a reduction.

 

[Connie & Parker & Moonie]

I don’t really see these as big drops. The big drops are 50 mg/dL.

I’m confused as to your question? Do you mean reduce to see if she won’t drop fast? No, you don’t want to do that. But it’s not a silly question.

Or maybe you mean don’t decrease if she drops below 40 due to a bounce breaking cycle? I also wouldn’t do that. Drops below 40 need a reduction for safety. It’s safer to reduce and have to go back up than miss a reduction.

The former - I meant reduce the dose to make her bounce less, and give her time to flatten out, and the. Resume the normal dose. But we won’t do that. Thank you Marje!

Just for the record is it a drop of 50mg/dL over an hour? Or the cycle?

-P

 

[Marje and Gracie]

I meant reduce the dose to make her bounce less, and give her time to flatten out, and the. Resume the normal dose. But we won’t do that. Thank you Marje!

Unfortunately what can happen is the overall curve goes up because she doesn’t have enough insulin. Reducing the dose due to bouncing to try and get it under control is called a rebound check and we have found they never work.

Instead, it’s best to try and ignore the bounces and experiment with feeding the curve so it flattens more. Often, this will let you get a bit more insulin in and the BG stays flatter and in better numbers.

I’ve seen cats bounce for a long time, then stop and go into remission within a few weeks. Crazy but the liver just snaps at some point and it’s a race to the finish line. But I’ve also seen cats who are diabetic for 8-10 years and never stop bounding but have some decent numbers in between.

I was able to minimize Gracie’s bouncing using R at very specific times when she started a bounce. However, that is a very advanced technique and requires a lot of hand holding for a period of time. Sadly, we don’t have as many experienced R users as we used to so we primarily just work with the acro cats now if they need it. But even that is becoming less necessity with cabergoline.

 

[Connie & Parker & Moonie]

Unfortunately what can happen is the overall curve goes up because she doesn’t have enough insulin. Reducing the dose due to bouncing to try and get it under control is called a rebound check and we have found they never work.

Instead, it’s best to try and ignore the bounces and experiment with feeding the curve so it flattens more. Often, this will let you get a bit more insulin in and the BG stays flatter and in better numbers.

I’ve seen cats bounce for a long time, then stop and go into remission within a few weeks. Crazy but the liver just snaps at some point and it’s a race to the finish line. But I’ve also seen cats who are diabetic for 8-10 years and never stop bounding but have some decent numbers in between.

I was able to minimize Gracie’s bouncing using R at very specific times when she started a bounce. However, that is a very advanced technique and requires a lot of hand holding for a period of time. Sadly, we don’t have as many experienced R users as we used to so we primarily just work with the acro cats now if they need it. But even that is becoming less necessity with cabergoline.

Thank you Marje for your help! You can tell who’s asking which questions because I’m convinced we messed up by reducing her dose to 3u and should have just handheld her through 3.25u

Maybe we should both get our patience pants on. I admit I have a hard time not letting the numbers dictate my feelings at times

 

[Connie & Parker & Moonie]

On a perfect, normal cycle you don’t want to feed after nadir if you can help it. If she starts to break a bounce later in the cycle, you can feed up to and at +10. I’d try LC first and see if that slows her down since it’s late in the cycle. Just avoid feeding two hours before PS unless she drops into the 40s


The modified protocol does allow for this but Sienne’s, Wendy’s, and my mentors (& former moderators) always said cats do better with increases/decreases of 0.25u.

IMHO, I’d continue to hold this dose as long as you are seeing 50s/60s every couple of cycles.

Thank you Marje! Patience pants it is

We’ll try this approach and try to stay more on top of her curve. This probably means more testing for poor Moonie’s ears but hopefully she doesn’t mind the treats