8/2 Max AMPS 400 +2 523 +4 492 +6 452 +9 442 PMPS 452 +2 482

Hope he clears the bounce soon too, Lori. I'm sure those subQ fluids are helping. Did you get an okay on them considering his murmur? I might have missed it. Is your vet appt. on Wednesday for the cardiologist?
 
Good morning. No, his appointment is for the regular vet this week. Couldn’t get Cardiologist appt until November 1st. He’s going to NC State Veterinary Hospital for that. We’ve been there before when he was diagnosed with asthma. They were very good. His regular vet ordered the subQ fluids taking the murmur into consideration and he’s getting small amounts daily. We really didn’t have a choice because he was dehydrated last week. I cannot seem to get him to drink any water from his bowl anymore for some reason. I add it to his food but that’s about the only way I can get it into him.
 
I’m not really sure how long a bounce lasts. He has been in the high numbers for so long, it really worries me. I’m trying so hard to be patient and praying that they come down soon. I don’t really understand everything like I should I guess, but do the increases in the dose so quickly cause the bounce?
 
Max & Lori said:
I’m not really sure how long a bounce lasts. He has been in the high numbers for so long, it really worries me. I’m trying so hard to be patient and praying that they come down soon. I don’t really understand everything like I should I guess, but do the increases in the dose so quickly cause the bounce?
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Bouncing can take up to six cycles to clear. Some cats clear faster, others take longer and sometimes it depends on how close you are to the fitting dose. The increase in the dose doesn’t necessarily cause the bouncing although they are somewhat related. Whenever a cat who has been at higher BGs suddenly has a BG it’s body is not used to, the liver and pancreas react (to protect the cat and bring the Bg back up to the new “norm”..which is too high) by excreting counterregulatory hormones. This dumps glucagon into the blood and the BG shoots up which is what we call a bounce. This can happen even if the CG has been giving the same dose for a while. Bounces can happen because of a lower number or a steep dive.

On a typical bounce clearing cycle, you would expect the BG at a PS to be higher than the rest of the cycle and continue to drop through the cycle so the lowest BG would be at +12. Bounce clearing cycles can be very active and bear watching just because a big and fast drop at onset…usually +2…can cause another bounce. If we see Max does that, we have ways to flatten that cycle out. My Gracie would do it so I learned how to feed and test to counteract that early fast and steep drop.

Ask for guidance at any time you feel you need it.

In this forum, the first time you see 150 or below, we ask that you stall the shot without feeding and post for help on your options. Depending on how much data you have, whether it’s the a.m. or p.m. cycle, whether you have supplies, and whether you are able to and are available to test, we have different options which include shooting the full dose on time and monitoring, skipping, stalling and shooting full dose, shooting a reduced dose. If someone advises you shoot, they are obligated to stay with you (or find someone who can) until the BG heads up. We work with you to slowly adjust to shooting lower and lower BGs. Most members doing TR shoot any BG 50 or above as long as they have supplies and can test. That’s not something we will expect you will learn to do overnight. It takes a bit to learn to shoot lower and lower,

When we started, we couldn’t envision being brave or knowledgeable enough to shoot any number below 150. We shot our first blue in three weeks and first green a few cycles later. Nail biters but membersstayed with us online and helped us know what to feed and when. You get a lot of support.

Here is a post on Dealing with Low Preshots. You can bookmark any info or sticky post you want to keep by clicking on “watch thread” and be sure “watch without notification” is clicked. Then you can find it by clicking on “watched threads” at the upper left of any page. This post might help as well.

Be aware of New Dose Wonkiness as you might see it in the next few cycles.
 
Thanks for this good information. I’ve still got a lot to learn but it’s starting to sink in. I’m such an analytical thinker. Sometimes it takes me a while to “get it” but once I do I’m committed to it.
 
When you go to the vet this week, Lori, are you going to get more bloodwork? If so, are you thinking of getting another fpl Pancreatitis test? Might be useful to see if the number is holding steady or has increased (it may or may not go back down as the Pancreatitis resolves, sometimes the number just stays permanently inflated for some kitties but it doesn't mean the Pancreatitis isn't improving).

Have you seen some improvements in Max as you've been doing the home therapies for the Pancreatitis?
 
Max & Lori said:
Good morning. No, his appointment is for the regular vet this week. Couldn’t get Cardiologist appt until November 1st. He’s going to NC State Veterinary Hospital for that. We’ve been there before when he was diagnosed with asthma. They were very good. His regular vet ordered the subQ fluids taking the murmur into consideration and he’s getting small amounts daily. We really didn’t have a choice because he was dehydrated last week. I cannot seem to get him to drink any water from his bowl anymore for some reason. I add it to his food but that’s about the only way I can get it into him.
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I totally understand. The SubQ's should help him feel better. They did with my cat who had CKD. I just always worry when there is a murmur or other heart problem. I never see my Susie drinking water either so I have to add it to her food too. Sounds the NC State Veterinary Hospital is a great place to be taking Max. Hope the insulin increase will help bring him down, Lori.
 
Margaret (and Pearl) said:
When you go to the vet this week, Lori, are you going to get more bloodwork? If so, are you thinking of getting another fpl Pancreatitis test? Might be useful to see if the number is holding steady or has increased (it may or may not go back down as the Pancreatitis resolves, sometimes the number just stays permanently inflated for some kitties but it doesn't mean the Pancreatitis isn't improving).

Have you seen some improvements in Max as you've been doing the home therapies for the Pancreatitis?
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I might suggest saving the money and just go off clinical symptoms for a bit longer. My Gracie was one who never actually had pancreatitis (ultrasound done) but because she head on and off issues with her liver as well as IBD, her specfPL was always elevated. The majority of her 5.5 years as diabetic, she was asymptomatic for everything.
 
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