Bouncing

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Barbara Carella

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Hi. My cat Simon has been diabetic for about two years. His numbers are all over the place and I can't seem to regulate him. Sometimes his numbers go from very high to very low in one day.I just read someone's post who seems to be having the same problem and it was suggested that the cat may be bouncing. I have had him to the vet numerous times to have him checked over. I was calling the vet every couple of weeks with Simon's numbers and the vet kept changing the amount of Pro Zinc. This went on for six months and the vet was just guessing what to give him. He said I may have to accept the high numbers. I feel he has not helped me at all. I'm very frustrated. Also, I am using the Alpha Trac meter and am having a hard time affording the strips but am afraid to switch. What do you suggest?
 
The
vast majority of us use human meters duch as a Relion micro from walmart. Much cheaper! And perfectly fine to use.
Ehat sort of numbers and ehat doses are you seeing lately?
Also, what does kitty eat?
Carl
excuse the typos.. I can barely see the phone, nevermind these tiny keys...
 
Give us some more info and we will try to help. As Carl asked, dosage and numbers over a period of time would give us a better picture. Do you feed wet low carb?
 
I had Simon on Purina DM but he lost a lot of weight so I switched him to Friskies dinners. He gained weight and looks much better. I give him Pro Zinc twice a day and test him prior to feeding him. These are his numbers for the last week-
75-1 unit 285-2 1/2 units 124-2 1/2 units 467-4 units 61-0 units 252-3 units 60-
373-3 units 414-4 units 46- 0 units 226-3 units 416-4 units 198-2 1/2 units
His numbers were 60 this morning. Do I still give him a little insulin so his numbers don't bounce back up?
 
I hope you didn't give him any insulin this am. If you did, you need to be testing often today and be prepared to deal with hypo numbers. We urge new members not to give insulin under 200.
 
I wanted to get that out early in case you were on the board and hadn't given insulin.

If you see a number in the 40 range, go over to Health and ask for help. (There will be more people there.)

Basic idea of bouncing: He has a high number and you shoot a dose. Getting mid cycle numbers might have shown you that he got down into the double digits during the cycle. His body reacted to the low numbers by releasing extra glucose. That glucose raised the number for the next preshot, artificially. If you shoot extra insulin into that higher number, it continues to be too much insulin and he drops low and bounces again.

It doesn't seem that he is bouncing as much as the insulin is lasting longer than 12 hours and he is being chronically overdosed. The 4 units at 414 gave you an unshootable preshot for the next cycle (46 if I am reading your numbers right) A long cycle and an unshootable preshot is a clear indication that the previous dose was too high. At that point, you lower the dose.

PZI is flexible but we urge new members to pick a starting dose and keep it for a few cycles, getting midcycle numbers. Once you know how the insulin is working at that dose, you can raise it by .25 or .50 if you need to. Jumping between 0 units and 4 units is very hard on his body.

We would be glad to help you with dosing. For now, please post your numbers like this so we can see how he has been doing:

amps (morning number before shot and eating) # units
+6 (6 hours after the shot. This number is vital to see how the insulin is working. Please get some mid cycle numbers today)
pmps (evening preshot before eating) # units

So the first cycle you posted might look like this:

amps 75 one unit
pmps 285 2.5 units
 
Since you are using an AT meter, and Pro zinc, I would not advise ever giving insulin on a pre shot number below 150. Normal bg on an AT meter is 70-150. That 60 is technically "hypoglycemic", although with no insulin given, would not be considered to require intervention. Definitely not a number you would shoot into.
Carl
 
But if I don't give him any insulin under 150, isn't he going to shoot up high? There was no one on the sight this morning to give me any help. I gave him 1/2 a unit because I didn't want him to go so high. He seems fine.
 
What you should try to do in the case of a low pre shot is stall without feeding. Test again 30-60 minutes later to see if he's risen above normal without food. If so, then feed and shoot a tiny dose.
Carl
 
If you skip a shot, yes, he may be higher the next time as he would have been 24 hours without insulin. One way to handle it is to do what Carl suggested. Then not only can you see that he is in safer numbers, but you want to be sure the number is going up, not down. The other way to handle that is to lower the dose on both ends so you have normal preshot numbers and normal midcycle numbers.

Can you get some midcycle numbers today to see how the insulin is working? Six hours after the shot would be very helpful.

Here is a document full of info about ProZinc that should be helpful: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799 it is long and has lots of links but will give you a good foundation in how PZI works.
 
I can't wait 30-60 minutes to test again if he has low numbers as I have to go to work. Also, if his numbers are in the normal range (100-300), how much insulin should I give? What is a good starting dose?
 
Normally a good "starting dose" is 1u BID, but you've been doing this for 2 years, right? Have you kept a log of his numbers so that you could share them with the vet? Have you been just testing at shot time, or have you gotten mid-cycle numbers? If you have some data, if we could get you set up with a spreadsheet that would make it much easier to figure out what is going on with him. I know you have been adjusting the dose based on the preshot numbers, which is fine, lots of folks do that here. But if we can see a couple weeks of data in a SS, we'd be able to help you a lot easier.

If you can't wait to test, then skipping is the safest option. Not ideal, but trying to guess how much to shoot on low preshots if you can't be around to monitor is risky business.

Carl
 
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