7/31 (India) Shorshe (Custom Dose) Greens followed by two days of yellows

S

Shorshe’s Mum

Member
Hello All,

I am noticing that whenever shorshe is going into greens (50-99) in teh next 24 hours her numbers shoot to the yellows and stay that way for at least 1-2 cycles before a day of mostly blues and then an AMPS/PMPS in the blues which then again results in green. Should I reduce her dosage to 1.5 (currently fat? 1.6 U)?

She is currently having some liver issues and has less of an appetite and is often syringe fed in combination with small amounts of dry food (prescription m/d) that she eats on her own. She cannot be given any appetite meds currently due to high liver values.
 
Good observations. What she is doing is very normal for a diabetic cat. It is called bouncing. You do not reduce the dose unless she drops below your reduction number which I cannot see on either your SS or signature.
Here is an explanation on bouncing
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Bron and Sheba (GA) said:
Good observations. What she is doing is very normal for a diabetic cat. It is called bouncing. You do not reduce the dose unless she drops below your reduction number which I cannot see on either your SS or signature.
Here is an explanation on bouncing
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
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@Bron and Sheba (GA) thanks for the quick response.

Do you think the repeated bounces are a reason why she is experiencing high hepatic numbers or liver stress?
My city in India doesn't have a lot of testing. A vet I consulted said that it could be DKA (which seems unlikely as she last had trace amounts of ketones in her urine about 3 weeks ago and nothing since fingers crossed) or Diabetic Hepatopathy. I am planning to take her centrifuged blood with me when I go back to Bangkok (where I live, Shorshe lives with my parents in India) for further tests (serum bile acids, serum cortisol, FPL and IGM). But I have had another cat go into acutely high liver numbers in Bangkok and the actual cause was never ascertained, so I am not sure without liver biopsy if the tests can necessarily pinpoint exact cause of high hepatic enzymes.

When can I expect to see reduction in bounces and flatter curves? And what can I do to facilitate this?
Unfortunately I have to return to Bangkok soon-ish. I don't think my aged parents can do as much of a tight monitoring as I can when I am here.

re Reduction Number: I would like to try TR but Shorshe is not eating much by herself at the moment so it's a lot of coaxing, syringe feeding etc. So I put "custom" dosing in that I am not exactly following TR. Also, Shorshe will not eat most complete wet food (only complementary tuna ones) so she will always be on combo diet, in which case I don't know if her reduction number should be 90 or 50? Help!
 
Madhura/Maddie said:
you think the repeated bounces are a reason why she is experiencing high hepatic numbers or liver stress?
Click to expand...
No. And it’s not from DKA either.
Madhura/Maddie said:
When can I expect to see reduction in bounces and flatter curves? And what can I do to facilitate this?
Click to expand...
Every cat is different. Some cats stop bouncing sooner rather than later and some cats bounce all the way to remission. Just keep doing what you are doing.
Madhura/Maddie said:
Reduction Number: I would like to try TR but Shorshe is not eating much by herself at the moment so it's a lot of coaxing, syringe feeding etc. So I put "custom" dosing in that I am not exactly following TR. Also, Shorshe will not eat most complete wet food (only complementary tuna ones) so she will always be on combo diet, in which case I don't know if her reduction number should be 90 or 50? Help!
Click to expand...
Probably 90. I’ll see what @Bandit's Mom thinks. She might have some other ideas as well.
 
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