High BG in mornings

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Patty & Tiger

Patty & Tiger

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I am so confused as to why Tiger's BG is so high in the mornings and sometimes in the PM. His numbers are still all over the place. It has been since Thanksgiving that he was diagnosed. He is still eating good, and seems to feel good. He is on ProZinc, and I just upped his dose to 2 units this morning. Can someone check out his chart and see if they have any advice for us. :?
 
I replied on Health, but this forum is a better place for dose advice. Here is my post from Health:


Hmmmm. It is hard to decipher. He gets pretty nice nadirs. A week ago he got some nice greens midcycle. It is hard to tell if he is bouncing around (from blues to reds) or if the insulin is wearing off before the 12 hour cycle is done. Any chance you could get some numbers at the +8 and +10 mark? I wonder if he has a late nadir or if he starts right back up about that +8 mark.

When during the cycle does he eat? All wet low carb? Low carb snacks?
 
The mid cycle numbers sure are nice.

I'm leaning towards bouncing. They can bounce from steep drops just as fast as they can from low numbers. Today he dropped about 400 points in 6 hours.
 
The bounce is when their body reacts to a lower number than they are used to and releases extra glucose. Once they get acclimated to lower numbers, they stop reacting. It's one of those ECID things(every cat is different). Some cat's bounce a lot ( see Bookworm's posts. Cassie is our forum's Tigger). Some cata bounce a while and then settle.
 
Re: TID dosing?

I have posted Tigers numbers from the curve last night and this morning he is still 514. Someone in Health mentioned possible TID dosing...... :? Does anyone have any opinions on this and how is that done.
 
Patty & Tiger said:
How do you stop a bounce?
Click to expand...
It's not easy, because it is instinctive. Technically the only way to avoid them is to not let the BGs drop low enough for them to happen, and that's counter productive to the treatment. You cat's body has to relearn what normal blood glucose feels like, and the more hours in a day they can be lower than what he's used to, the more likely it is that he'll quit bouncing. "Kitties bounce until they don't" is the way some people put it.
Carl
 
Good afternoon Patty -

I think it was me that suggested TID. I would definitely hope that Sue & Robin & Carl continue to give you some more guidance before you get to the point of trying TID. Grayson didn't bounce much when we were on ProZinc, so I don't have the experience to advise you on pulling out of a bounce. I know that most bouncing kitties need to hold the dose for longer before they increase. If that's the issue, then you may not need to think about TID. The kitty will balance out over time.

If, however, you guys conclude that that's the direction you might want to go, I would ask you to look at your schedule and see if it would even be possible. I work 5 minutes from home, so I could slip out and be back at work in 15 minutes. Most people can't do that. Shooting every 8 hours is much more demanding on your life than BID. If you work full time and commute an hour each way, you probably won't be able to do it. Also, it may mean getting up at 2 am or 4 am to shoot, depending on your hours. Despite living close, I did not function well when I couldn't get a solid block of sleep during the night. It's also a LOT to ask of your petsitter, if you don't have someone helping you (I live by myself) and you have to go away.

All that being said, you're seeing substantial drops on a normal dose. Most of us that have done TID were also shooting 3-6 units BID. It was easier to divide the total insulin (for 24 hours) into 3 doses when you're looking at larger numbers. ie: 6u x 2=12u per 24 hrs. 12u divided by 3 doses =4u. You can use the other needles and the conversion chart, as was mentioned, but you have to be REALLY careful. Thank God Grayson is insulin resistant, or I would've killed him by shooting the correct dose on the wrong needle - essentially 2.5x what his dose should've been at the time!

Perhaps you could do a test drive... when you'll be around... and do a curve. When he starts that climb, if it's at or just past +8, shoot 1/3 of your total daily dose. This dance is a lot abotu trial and error. That's why we encourage people to get lots of tests in, so you can see patterns and make informed decisions.

Fingers crossed that all goes well and you can get away from those blacks & reds.

Lu-Ann
 
Carl explained the bounce thing very well.

Sometimes you can stop the bouncing by lowering the dose and let them even out but you were still getting the big swings on .8 unit so I doubt that will help.

You can check out the tid dosing to see if you are up for it or look at a longer lasting insulin like Lantus or Lev.
 
Yeah, I agree. It is either bouncing (although he would have to be a VERY bouncy cat to bounce every cycle) or the insulin is wearing out before +12. TID is certainly a possiblity - IF it will fit into your schedule. It is a big time commitment. Sometimes when ProZinc wears out before the 12 hours are up, one of the L insulins work better because they tend to have a lower cycle.
 
maybe the other insulins might work better. I am going to finish up the prozinc, because he doesn't have much of it left. When I go to the vet to get more I am going to show him Tiger's chart and see if he thinks that the other L insulins might be better. He is a good vet and likes the home testing and working with me on this. I will keep everyone up to date and will be picking your brains for more advice. Thanks for being here.
 
Patty -

Don't be surprised if your vet isn't familiar with the L's. My vet has all her FD clients on ProZinc. It was a learning opportunity for both of us. Fortunately this board has some AMAZING links that help the vets realize we're not just talking to a bunch of yutzes on line. A LOT of good info and scientific (veterinary) studies that they will put much more stock into.

I printed out the most important documents, read through them, highlighted them, then copied and highlighted for my vet. Clearly, they have other clients, and don't have time to do the extensive research we are able to do. And although they have their medical books to refer to, I was able to say, "here are some of the articles I found valuable in my research that I wanted to share with you" - to help fast track having you both on the same page. A lot of times it's all about how you present the info you find.

Because my vet was at square one learning about acromegaly (mentioned for 10 seconds in vet school with a picture and "here's what one looks like, but you'll never see one - next topic please...", I took the lead when it came to dosing with the Levemir. If she hadn't been aware of what I was reading and the legitimacy of the articles and the experienced people here, she would've been reluctant for me to call the shots like I did.

It's really great when you can be a partner WITH your vet in your pet's care. Hoping that's what you'll have. Good luck!

Lu-Ann
 
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