Hi Ginny,
I saw in another thread where Dr. Lisa didn't think that "bouncing" was as common an occurrence as some of us tend to think, so I thought maybe he needed a little more. (of course, I may have misinterpreted that)
I think that in general, that's right. I think, again in general, and not only in PZI, the "bounce" word is extremely overused, and worried over too much.
I think the terms that Dr. P. uses are "warranted" and "unwarranted". It's the "unwarranted" that you are probably referring to.
When you see a number that seems to look like kitty has "skyrocketed", you have to look for and identify a
good reason for it. If you can't find one, then that falls into the unwarranted category. The number just is, because it just is. It's one number, one cycle, one day, and might mean little to nothing.
An example of a warranted bounce, or warranted concern, would be if all of a sudden one day, kitty went way low. Then next cycle you see really high numbers, or later in the same cycle you see really high numbers. That would be evidence that there was cause and effect. The very low caused the very high.
This is what makes a sliding scale difficult. For example, look at your spreadsheet on 11/29 and 11/30.
11/29
amps 284 1.4
+5 129
+7 257
PMPS 289
That was an okay curve, right? A little room to drop further, maybe. And you ended up where you started.
Next day
AMPS 388 1.6
PMPS 427 1.4
No tests in between, so we thought "bounce, gotta be". But what was that based on? The high PMPS, right, and a higher AMPS too. The problem is there's no "real" evidence to back up that thinking. I guess we assumed that the blue 129 the day before caused the high numbers? But it wasn't "really low". It was not close to hypo numbers. So there's nothing to conclusively prove that the 129 caused the high numbers the next day. Mabye it was just a bad day for Alex? You don't know for sure what that 1.6 did to that 388. But based on the day before, it should not have pushed him too low. The AMPS on the 30th was 100 points higher than the 29th, so I think it's a safe assumption that the small increase to 1.6 wasn't enough to drop him 100 points plus more, which it would have had to have done to cause a "bounce" to 427 that night. Is that making sense so far? The bounce could not be considered "warranted".....nothing caused it that we can prove anyway.
Flash forward to yesterday...
AMPS 378 1.7
+6 217
+9 210
PMPS 344 1.8
Not really a great cycle. Nadir someplace around 200. Nothing that would cause a warranted bounce.
AMPS 384 1.8 Same thing you had yesterday, increase by only .1u.
PMPS 437 But with no data in between. So if that 437 is a bounce, then what caused it? He shouldn't have gone any lower than he did yesterday. That .1 isn't going to cause a huge drop below the 200 he had yesterday. It didn't cause a bounce yesterday. It probably didn't cause one today either. He just had a high number, that's all. But nothing that warrants the determination that is is due to going too low, so unwarranted.
I think what it boils down to is this, and this is also something Dr. P. said in one of Copper's threads when I pointed out what may have been just one wonky number on Copper's SS:
carlinsc wrote:
what if it was just one wonky meter reading. What if it wasn't a 455, but maybe a pink gone bad?
She said:
This is an example of why I loathe labeling a cat X based on ONE lab value. ie....I get hundreds of people writing to me every year in a panic because their cat has been Dx'd with CKD based on only ONE blood panel. Makes me crazy....
Look for repeatability before panicking or making any important decision.
One cycle that looks weird, or one BG test that looks weird....it's just that. One. I think she's saying that if you don't have hard "data" to explain the "wonk", then it's just "wonk", and you shouldn't make an important decision, like a dose adjustment because of it. If you see a repeating pattern or if the numbers continue to get worse then that's another thing.
I think that if you see 3 or 4 days in a row where all you are getting is pink and red PS's, and yellow mid cycles, that it shows that an increase is needed. If you see flat curves, or slightly inverse ones, it also means an increase is needed. If you see an inverted curve that looks like a mountain, or a curve that looks like a deep valley, that might mean a little less is needed, but you should see effects after one of those things happening. If you don't, then it's just a weird cycle. If it repeats, then it means "do something".
.....hopefully I didn't botch that, or put words in Dr. P's mouth.
Carl
pmps
