BS 39- Insulin sensitivity question

[ewest]

Munchie had hypo incident today (39) and had high bounce at end of cycle. I read that cats can be more sensitive to insulin after this happens. Does this sensitivity last for a certain period or is it completely individual? Just wondering if I need to be cautious tomorrow as well (imagining I do and will be checking her). I will be testing her throughout night but wanted to get input on insulin sensitivity after hypo incident.

 

[Sienne and Gabby (GA)]

It really depends on what you are calling "hypo." Cats can drop into low numbers and not exhibit symptoms of hypoglycemia. There are also episodes of symptomatic hypoglycemia. We see very few times when a cat experiences symptomatic hypoglycemia. Gabby dropped to 37 the other evening and it was not hypo.

With Lantus, if a cat truly has a hypoglycemic episode, the duration can stretch for a long time -- we've seen episodes run over 16 hours. Throughout much of that time, it is a struggle to get numbers to stabilize in a safe range. In the case of a true hypo incident, insulin sensitivity occurs and it's often advised to skip the shot the next cycle.

Please bear in mind that for a cat that's been diagnosed for more than one year, it takes a drop below 40 for the cat to earn a dose reduction. A brief visit to those lower numbers is not necessarily hypo.

 

[ewest]

Ok, she didn't have any symptoms. Fortunately I was home and checking her and offerred food when found it was low. Since she tends to drop lowest at end of cycle scares me that she would have continued down...though don't know if her body would've bounced to compensate which is what happened even with her eating.

 

[Libby and Lucy]

glad she didn't have symptoms. This type of bounce is normal after an excursion into lower numbers. Sometimes it will take up to 72 hours for the bounce to clear out. Reducing to 1.25u today was the right thing to do. Then when the bounce clears out, you'll be able to see where this new dose can take her. Congrats on the reduction!

 

[Sienne and Gabby (GA)]

Personally, I find it helpful to distinguish between low numbers and symptomatic hypoglycemia. Most of our cats will dip their toes into low numbers. It sounds like you caught the drop and handled things well. If you are ever unsure of what to do, don't hesitate to post. There's usually someone around who can lend support. Also, remember there's a sticky note that includes information on handling both low pre-shot numbers and low numbers during the cycle.

I'd like to make a suggestion re. your SS. You have the 39 on Munchie's SS colored in red. You might want to choose some other color since the 400s are coded in red. Just glancing at your SS would cause someone to misinterpret the cell.

Also, for the future, when you have a cycle with a low number where a dose reduction is earned (i.e., below 50), you have a choice. If there's a bounce by the next shot time, you can hold your current dose and "shoot through the bounce." You would then take the 0.25u reduction at the subsequent shot time. I'm guessing you took a larger reduction thinking this was a situation where insulin sensitivity could come into play. (You might want to note that on your SS.)

The numbers on 8/27: If there were no symptoms that suggested that Munchie was having a pancreatitis flare, I would guess that the high numbers were a bounce. I think it's likely that Munchie was in at least blues during the PM cycle the night before given that you saw a blue pre-shot at AMPS on 8/27. Those blacks are likely a bounce from those lower numbers. (Munchie seems to be rather bouncy!)

From one of the notes on your SS, it sounds like you are feeding Munchie just at pre-shot time. FWIW, most of us spread food out over the first half of each cycle. Since it looks like you're gone during the morning during the work week, had you given any thought to a timed feeder?

 

[ewest]

Yes right now I feed morning and evening before her shot. I've been thinking lots about whether to have food available throughout the day when I'm gone in case she needs it. I feed raw and have found a timed feeder with ice packs but I honestly still feel a little worried the food could spoil. I'm not confident she would go for it (or my other cat) and that it might sit out all day (9 hours). Offerring different food is tricky because my other cat is in stage 4 kidney failure and might get diarrhea from eating something else. The only good thing is except for yesterday she seems to have lowest numbers at the end of her cycle (well yesterday might have too except we didn't want to get any lower). Having her get too low when I'm gone is still a fear of mine. Though it also seems hard to say with her numbers where her happy medium is. A few 200's mixed in with some 100' and 300's seem good at this point.

Also if she eats during day, then she won't have as much at regular mealtime and I had been told that if she doesn't eat her regular amount to 1/2 the dose. She practically didn't eat anything which is why I halved it. Her early evening numbers indicated to me she might drop too low again if I hadn't offerred her food at her 300 reading before I went to bed since that was the beginning of her cycle and tends to get lower at the end.

 

[Sienne and Gabby (GA)]

What about freezing some of the raw and allowing it to thaw over the course of the day? (That's assuming you're making your own raw food.) I'm pretty sure there are people here who use the frozen pucks and do leave them out over the course of the day so there's food available.

One other thought is to try leaving the food out on a weekend or day when you can be around to monitor. You'll have a better sense if your kitties will eat and, hopefully, who's eating and how long the food sits out.