How to deal with bounces

E

EttaD

Member Since 2025
I’m very confused. My 14.5 yo boy (Buddy) has been diabetic for 14 months now and just a week ago transitioned from Senvelgo to ProZinc. There’s a good chance that he was hanging out in periods of hypo while on Senvelgo because his fructosamine was only 195, but he was losing weight and had ketones in his urine.

Since switching to prozinc, He has been steadily testing at 22-24 mmol range. Vet put him on 1 unit but then moved him to 2 units.

Testing has been difficult, especially in the morning. This morning, he tested at 3.3. We didn’t give him his insulin and in a panic actually gave him high carb food and a bit of honey (it was a stupid move). Tonight he was 24.2.

He also eats a lot because he is super skinny and hungry always. He’s only eating fancy feast pate and rarely gets a dry that is 9% carbs (SquarePet). He’s also tapering off of prednisolone for his IBD.

The vet said we should still give him the 2 units even if his BG is low because he will spike up. This makes me very nervous. Am I right to be nervous?

I wonder if the 2 units are too high for his night dose.

I am considering the freestyle libre to see if we can get some better ideas of what’s going on.

Any suggestions would be deeply appreciated.
 
EttaD said:
There’s a good chance that he was hanging out in periods of hypo while on Senvelgo because his fructosamine was only 195, but he was losing weight and had ketones in his urine.
Click to expand...
Hi there. Welcome to the FDMB! We can’t necessarily know if he was spending any time in hypoglycemic numbers. Those would be BG numbers below 50 on a human meter (so below 2.8) but for it to indeed be a true hypoglycemic event there would need to be symptoms too. But anyway, a fructosamine of 195 shows that his average BG over the course of the previous two weeks or so was around 195, which is definitely too high (but not awful.) Still, you are correct that it doesn’t tell us the nadir of his daily cycles, which is really important information.

EttaD said:
He’s also tapering off of prednisolone for his IBD.
Click to expand...
This could significantly lower his BG, so even though his BG numbers are quite high right now (according to what you have indicated) I would monitor his numbers carefully during the time that his prednisolone is being tapered down. How many more days do you have to go? How will his IBD be managed without the steroid? Have you discussed Budesonide with your vet as an alternative to prednisolone?
 
EttaD said:
The vet said we should still give him the 2 units even if his BG is low because he will spike up. This makes me very nervous. Am I right to be nervous?
Click to expand...
I don’t know exactly what the vet meant by this, but that isn’t the way I would handle the situation. I am glad you did not give a dose this morning. The AMPS (a.m. preshot) number was safe (not a hypoglycemic number) but without a lot of testing data regarding his nadirs on this dose, you could not know if it was safe to give insulin. You could have waited without feeding him to see of his BG was rising over the course of the next hour or so — but if not… then skipping the shot was appropriate.
 
Suzanne & Darcy said:
Hi there. Welcome to the FDMB! We can’t necessarily know if he was spending any time in hypoglycemic numbers. Those would be BG numbers below 50 on a human meter (so below 2.8) but for it to indeed be a true hypoglycemic event there would need to be symptoms too. But anyway, a fructosamine of 195 shows that his average BG over the course of the previous two weeks or so was around 195, which is definitely too high (but not awful.) Still, you are correct that it doesn’t tell us the nadir of his daily cycles, which is really important information.


This could significantly lower his BG, so even though his BG numbers are quite high right now (according to what you have indicated) I would monitor his numbers carefully during the time that his prednisolone is being tapered down. How many more days do you have to go? How will his IBD be managed without the steroid? Have you discussed Budesonide with your vet as an alternative to prednisolone?
Click to expand...
He will be off the steroid completely with the last dose on December 25. We went on it because we thought he was losing weight because of the IBD. In fact it was likely that the senvelgo had stopped working for him. So once we have the diabetes under control, we will tackle the IBD. Likely a novel protein.
 
Suzanne & Darcy said:
I don’t know exactly what the vet meant by this, but that isn’t the way I would handle the situation. I am glad you did not give a dose this morning. The AMPS (a.m. preshot) number was safe (not a hypoglycemic number) but without a lot of testing data regarding his nadirs on this dose, you could not know if it was safe to give insulin. You could have waited without feeding him to see of his BG was rising over the course of the next hour or so — but if not… then skipping the shot was appropriate.
Click to expand...
We are going to do a curve on the weekend and probably try a Libre on him to see what’s going on. I’m tired of guessing.
 
I would like to be able to help you with this journey. If you can get a spreadsheet set up, it would help you and definitely help me to provide dosing assistance.
EttaD said:
We are going to do a curve on the weekend and probably try a Libre on him to see what’s going on. I’m tired of guessing.
Click to expand...
are you able to test him with a handheld glucometer? The Libres are a handy tool, but since the Libre sensors give false low readings when the BG is lower than 100 it’s important to be able to check the low numbers with a handheld human glucometer (since the Libre is also a human monitor.)
 
Suzanne & Darcy said:
I would like to be able to help you with this journey. If you can get a spreadsheet set up, it would help you and definitely help me to provide dosing assistance.

are you able to test him with a handheld glucometer? The Libres are a handy tool, but since the Libre sensors give false low readings when the BG is lower than 100 it’s important to be able to check the low numbers with a handheld human glucometer (since the Libre is also a human monitor.)
Click to expand...
We use a handheld right now. I’ll start a spreadsheet.
 
You must log in or register to reply here.
Back
Top