Bouncing
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”. It should be noted that “bouncing” is a term we use in the FDMB and might not be recognized elsewhere.
Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucagon, 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). You cannot avoid all bouncing. It is normal and natural, and frustrating. There are some things to keep in mind that can help though:
- Following a bounce, a cat’s BG may stay high and flat for several cycles. Avoid the temptation to increase the dose at this point. If the BG does not return to normal in 6-8 cycles, an increase might be needed based on the method of regulation you are following.
- Some vets might have little/no understanding of the bouncing phenomenon. Consequently they will look at a single BG number or a single in-office curve and change the dose without realizing that they could be looking at a bounce number, or a high-flat cycle following a bounce, and increasing the dose will make it worse.
- There is also a common misconception, often by vets, that bouncing is caused by chronic Somogyi rebound. Michael Somogyi published one paper based on a very small number of human diabetic subjects on the topic in 1938 in a local St. Louis medical journal. There has been no replication of the research and, in fact, anyone that has attempted to replicate the research with humans failed to find similar results. The research has never been done with cats and, just as importantly, has never been done with cats (or humans) using a long-acting insulin.
- When it’s not a bounce: in general, during a cycle, the blood glucose should decrease for a few hours, and then begin to increase again. If you plot the numbers on a graph, they should look like a smile. This rise in BG towards the end of the cycle is normal. It is not bouncing. As a cat gets better regulated, the cycle will get a little flatter and the PS numbers will decrease, but in the beginning, it can feel like that rise at the end is a bounce. It often isn’t. It’s just the insulin losing duration. As you slowly reach a better dose for your cat, the insulin will last longer and the numbers will look better.
