Advice for bouncers and divers?

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Pumbaa

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Over the last two months, since Pumbaa was diagnosed, I've read several posts about controlling bounces and dives. If I remember correctly, more so about how to prevent dives, which cause bounces.

It would be great to have one thread dealing with this issue, instead of posts on many threads, discussing this.

Pumbaa is a major diver and bouncer, as are many other FD cats.

What can we do, the caretakers, to even out the dives and bounces? Based on a cat who is only getting low-carb canned food, and who is getting insulin regularly, as in every 12 hours per Lantus and Levimir protocols. (I didn't include Pro-Zinc in here because of the no shed variable. The shed makes a big difference, I assume, in this advice.)

So, how do I prevent bounces and dives, when my FD cat is free-feeding. I don't want him to go hungry, and realize that he will instinctively eat more when he is dropping into dangerous BG ranges, so I always make sure that my kitties have low-carb food available. 24/7/365.

Help! From many of us who are dealing with the frustration of diving/bouncing FD kitties.

Suze
 
Suze... one thing is that you should not assume he will eat if he gets low. My Gracie has been in the 20s and did not ask for food or even act hungry. I would never base her safety on the presumption that she would eat when low nor would low carb food bring her up if she was in the 30s.

Many members feed at certain times to control dives. This will help with bouncing; the other thing that causes it is numbers lower than the liver is accustomed to...they don't have to be that low...just lower then the new normal the liver recognizes.

while bounces can be frustrating...they aren't bad. They tell you the kitty's liver is working as it should. I would worry about a liver in a newly diagnosed cat that doesn't bounce in response to low numbers.

Cats bounce until they don't. Some snap sooner, some later. Patience..... :-D
 
Marjorie and Gracie said:
Suze... one thing is that you should not assume he will eat if he gets low. My Gracie has been in the 20s and did not ask for food or even act hungry. I would never base her safety on the presumption that she would eat when low nor would low carb food bring her up if she was in the 30s.

Marge, thank you for the above and for your entire post. But especially for the above as I have read posts stating that it's okay to go away (work, sleep, errands, life) when FD cats are diving as long as they have food out, and in some cased, high-carbed food.

Way too tired to type any more. But thank you!

Suze
 
Marjorie and Gracie said:
Cats bounce until they don't.

I'm still chuckling over the above sentence this morning. :)

It sounds like something Forrest Gump would have said, and I mean that is a good way!

Suze
 
Mainly, it's just a waiting game as far as bouncing goes. Marge is right, they bounce until they don't; Mikey bounced for a couple of months and then decided to get with the program. He still bounces on occasion, but now it's usually into the high 100's instead of the high 200's. For him, it was a matter of getting the dose right for his nadirs and then waiting it out.

As for diving, I wouldn't go to bed or leave in the middle of an active dive. I pretty much know if he's going to do his high-dive act by +1 and for sure by +2, and take steps to stop it by giving more to eat, sometimes a little MC to stop him. And since I know his nadir is at +3, once his numbers are rising or stable after +2, I can leave or go to sleep confidently. As the preshot numbers have come down, Mikey has toned down the dives, but he still likes to pull one on occasion to keep me on my toes, Saturday being the latest. But if you look at his SS, it was clear by +1 he was diving and I was able to use a MC mixture of LC with a little gravy mixed in to slow it down and keep him safe. He did have a small bounce the next morning.

The best advice is what you keep hearing on here, and I know it's frustrating, believe me, but it's true: ECID, and they are in charge of the whole deal. We're just along for the ride. We just learn our individual cats' quirks and go with what works for them.
 
Amy:

Beautiful SS! :)

I'll have to study Pumbaa's SS and see if I could have predicted a dive and given him some higher-carbed food to slow down the dive.

Suze
 
Some thoughts on managing diving AND spiking:

Food is generally given in the 1st half of the cycle as that is when the insulin is taking effect and the glucose is being lowered.
The food may help that be a gradual drop, not a dive.

Food given just prior to the insulin shot may generate a food spike about 2 hours after eating.
For a cat with a tendancy to high food spikes, it may help to start with a mini-meal of perhaps 1/4 to 1/3 of the food.
After +2 arrives, you may provide the remainder, either a) as all the remaining food if the cat will graze (optionally frozen or with part frozen), or b) as another mini meal, followed by a final mini meal at +4. (and you may adjust the times a bit, based on how you observe your cat to respond!)

For a cat with a tendancy to dive, you may want to start with a slightly higher calorie meal, so if the cat doesn't eat a lot, there are still enough calories on board to work with the insulin. (although it takes longer, fats may be broken down into carbohydrates through various metabolic processes). Within the limit of 10% calories from carbohydrates, you could even choose an ounce or two of slightly higher carb food to start the cycle. Diligent data collection will help you determine what works best for your cat.

Using an auto feeder can help spread the food out over time, very helpful for the scrafer cat!
For feeder recommendations, the Petmate 5 meal has been used successfully by a number of folk here. It may be found on Amazon.

Without a feeder, freezing food and having it thaw over the cycle allows the cat to nibble on it as it thaws.

After the nadir, the insulin effect begins waning and the glucose normally rises. Adding food then fuels the fire, so to speak. If your cat is a grazer, food available during this time should be as low carb as you can keep it, so it digests gradually to work with with the remaining insulin effects.

No food 2 hours before the next shot lets you see a glucose level when there isn't a food spike covering the end result. Obviously, if your cat needs to eat because he's in hypo, you disregard that and feed according to the protocol for handling hypos.
 
Pumbaa said:
It sounds like something Forrest Gump would have said, and I mean that is a good way!

And I take it in a good way...after all...you could say that FD is like a box of chocolates...you never know what you're going to find.

With all due respect, I disagree with BJ about feeding a meal with more calories. You can have a food that has more calories but is lower % calories from carbs. So what you want to do is to feed a food that has a higher %calories from carbs. It's often the thought among new members that feeding the food with the lowest % of calories from carbs is best. But in reality, many cats do better with a food that is low carb but still has a higher % of carlories from carbs. I found this to be very true with Gracie. Once I changed her food from 1-2% calories from carbs to 4% and started feeding to catch the dives, she did better on lantus. Since moving her to lev, I also feed her 8-10% calories from carbs and it works quite well for her.

But it comes down to Pumbaa and what works for him; for that...you will just need to experiment with the foods and the schedule to catch the dives. One way to help is to manage the curve with low carb food on a specific schedule to flatten it....which would result in feeding so the low numbers come up and the diving stops. Once you have the overall curve flattened, then you can adjust the insulin. Often that means raising the dose a bit to bring the entire curve down. One thing to note is that "managing the curve" to flatten it means to take his normal amount and type (% calories from carbs) of food, divide it up into minimeals to feed at specific times to work with the insulin. It does not mean propping up numbers with HC food or karo.
 
Another tactic is to slightly offset when you shoot; instead of shooting immediately after eating, you could wait 15-30 minutes to give the food some time to start digesting and entering the bloodstream. This does spread out the time you need to use for your test - feed - shoot schedule, but if you're home at the time routinely, it is do-able.

And I did mention using higher carb food in my prior post; it was buried in the 5th paragraph.
 
Scooter did the dive n' spike for a while too. Pink preshot, green nadir, pink preshot, pink/yellow the next day, dive back down to green, rinse - repeat. He could go from 300 to 50 and then back up to 300 in a cycle, easy. And then after a while, it just magically stopped. Just like that. And he was regulated for 2 weeks! And then it started again. And now he's regulated again! I don't know where I'm going with this. Cats are weird. I don't think it's so much of a matter of controlling bounces/dives, rather, just shooting consistently through them and waiting it out. I did do a little bit of carb management, like, gave him 3 or 4% at shot time, then around +4 would start giving him 5 or 6%, but time seemed to work better than anything else did :lol:
 
Marje and BJ:

I have been meaning to add to my SS the %KCal of protein/fat/carbs on the foods I already list, to make it easier for me to see trends and figure out what food to feed when.

I like the idea of having a little more control over dives and bounces, just based on what food I feed. And how I feed it.

I may not be smart enough to see a dive coming, but I am smart enough to react once I see it, and try and slow it down. :)

And I would love to not have to resort to honey/syrup/pure sugar products to stop a drop below 50. This morning, the little bit of gravy, for the extra carbs, plus the pure protein of the sardines and the fat from the cheese, worked perfectly to bring Pumbaa's numbers up, slowly but surely. He's now bouncing from those low numbers, but as of a few minutes ago, his highest reading has been 251, and not in the 300 or 400 or higher range. I'm happy about this! :)

I am so looking forward to having the Hobo's Guide to Nutritional Values in Cat Food more updated, so that we know, today, that the values of what we are feeding for low carbs, and for higher carbs when we need them, are up to date!

Suze
 
Well, there was a possible solution all along. Thanks for asking this question, Suze. I would not have thought of this. I really thought that Lantus' mechanism was not supposed to depend on the food intake. However, at least until your cat stops using its liver to muck up the works, or to HELP your cat avoid the liver issue, this could work. In all the talk about bouncing, I never heard about this idea. I suppose its pretty advanced, and I certainly haven't had the time to dig deep like you have been doing. Thank you!

At the moment I'm waiting my cat out to try to get him a dose before I go to bed because skipping the dose when he's too low is just exacerbating the problem I've had with him bouncing. Time for another test. Goodnight.
 
Dale: Glad you're finding the information as interesting as I am. And I hope it helps you with Max!

Suze
 
This is a great post! We dealt with our first real experience with dives and bounces this weekend and man was it stressful but we were able to make it out of the woods with some HC gravy food and lots of testing :)
 
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