Advice on current dosing & interruption in treatment

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Nancy Lynne

Member Since 2020
Hi all - I need help in two areas. The first is general feedback on Grandma's chart. I have not been able to do a curve on her since she's an outdoor cat but my landlord will be gone next week and I hope to bring her in for the day so I can do it. My vet was concerned we're dealing with the Somogyi Effect, which the lone 40 reading could support but won't know for sure until I can do a curve. She suggested I make more food available for her during the day, so instead of her daily treat of freeze-dried chicken or fish at 2-3p I also gave her some DM dry food around 11a yesterday and then her treat around 2p. As you can see she was back into the 300's last night.

Which leads me to my second problem. In two weeks I have to go out of town for a memorial service and it looks very unlikely that I'll be able to find anyone to give Grandma her shots. Best case, I can find someone to feed her and the other two cats in the morning and evening. My vet hedged when I asked about the effects of not having insulin for a period of time on Grandma, but she she did say it would be important to have food available to her throughout the day. The only way to do that is with a timed feeder with dry food but I worry about that pushing up her numbers. Any thoughts on interruption of insulin would be appreciated as that will help me determine the length of my trip. I'd like to be gone a week but I'm thinking I should keep it to 4 nights. I really need to be with my family, but I'm also hoping to keep Grandma as healthy as possible.

TIA
 
Nancy Lynne said:
My vet was concerned we're dealing with the Somogyi Effect,
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There is no such thing as the Somogyi Effect. It was based on one study of a small number of cats.
What you are seeing are bounces. The short answer is that a cat gets into low numbers, or lower numbers than it's body is used to and it is seen as a danger. The liver and pancreas combine their forces and dump a load of glucose into the system. It can take up to 6 cycles to clear a bounce.

Definition of a bounce: 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).

That said … since you did get a mid-cycle reading of 40 on an AlphaTrak (the take action number is 68!), and since you cannot get many mid-cycle tests in, you really need to drop Grandma's dose to 0.25 units immediately.

It is important to keep Grandma safe. At the moment, there is only that 40 mid-cycle test to go by. She could well have gone below 68 on other days. Is it at all possible to test Grandma outside? Can she be trained to appear at a specific time of day? Feeding extra special treats might bring her to or near your door.

Read these and print them out for reference.

 
I agree with @Red & Rover (GA). There is no such thing as Somogyi effect. What Red and Rover said about bouncing is correct. As you are not getting any in-between tests done, Grandma could easily be dropping during the cycle and bouncing back up at the end of each cycle. 40 is very low on an alphatrak meter.
I would drop the dose to 0.25 units immediately.
And I would feed Grandma at least twice during the cycles as well as before the shot each day and night.

I would not recommend you leave Grandma without insulin for even a day. The problem with withholding insulin from a diabetic cat is that ketones can form and Grandma could get sick very quickly.
Could you board Grandma at the vet for the time you are away?
 
Thanks for all the input. I have dropped Grandma to .25 and I have been feeding her freeze-dried chicken or salmon treats at 11a and 3p and her numbers look good. As for boarding Grandma, there is a local place but honestly after being an outdoor cat for 13 years this would be incredibly stressful for her and more detrimental to her health. I keep looking for someone to take care of her but I live in a VERY rural area and I don't think I'm going to have any luck. My plan is to be gone 4 nights so she would miss 8 shots. Someone will be able to feed her in the morning and evening but the only way to get her food during the day would be with an automatic feeder so it would have to be dry food. I know that no dry food is good, but what is the best of them for a diabetic cat?
 
I like the 0.25 dose. He will probably be ok for a couple days. If you must leave dry consider dr elseys clean protein chicken or epigen 90. Both under 10 percent carb. When I go away I board at my vet. Not sure if that's an option.
 
Thanks for the dry recommendation, I'm checking them out now! I think I'm going to have to roll the dice with Grandma going without insulin, I truly think she would not do well with boarding. She was a feral cat that's been outside her whole life. I've been the first person to get near her when her "owner" died two years ago and I inherited her (and two other cats), but it took a long time. She's very sweet and mellow but just doesn't trust people other than me.
 
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Nancy Lynne said:
Thanks for the dry recommendation, I'm checking them out now! I think I'm going to have to roll the dice with Grandma going without insulin, I truly think she would not do well with boarding. She was a feral cat that's been outside her whole life. I've been the first person to get near her when her "owner" died two years ago and I inherited her (and two other cats), but it took a long time. She's very sweet and mellow but just doesn't trust people other than me.
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understand. I have several former ferals. Sometimes all we can do is what we can do.
 
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