? Is this a bounce?

[Jenny and Grady]

I was so excited to see yellows yesterday but back in the red (AMPS) and pinks today. Is this what a bounce looks like? Is this Grady's body's way of compensating for the lower numbers yesterday? Just trying to understand what the numbers mean.

Also, will I need to do a full glucose curve before increasing to 3.5 units? I am holding him here for a week, since I think the SLGS method will work best for us. If I need to do a full curve before increasing, I will, but I would prefer not to have to stick him more than I need to.

Thanks for the help!

 

[tiffmaxee]

It's likely a bounce. According to SLGS you do a 12 hour curve testing every 2 hours or 18 hour and test every 3 hours. It's up to you if you do the full curve. I might opt to stop testing after nadir and two rising tests if my cat though. That is not what the protocol calls for though.

 

[julie & punkin (ga)]

I agree that it's likely a bounce from the yellow numbers yesterday - his body is used to pink.

It looks to me like there is also enough data to show that this dose is only getting him to the yellow numbers, so if you want to increase the dose to 3.5u you could. The only reason I'm saying this, which is from the tight reg guidelines rather than SLGS, is because you've said he's got neuropathy in all 4 legs. The sooner his blood sugar gets down, the sooner that's going to improve. With the Tight Reg guidelines for a cat that is constantly over 200 with no tests under that point, you can increase as soon as 3 days (6 cycles) and you have enough info from the 8 cycles already on this dose to say that he's constantly over 200.

If you want to wait a full week on the dose you can, but I would still do spot checks, just in case there are unexpected low numbers.

 

[Jenny and Grady]

I agree that it's likely a bounce from the yellow numbers yesterday - his body is used to pink.

It looks to me like there is also enough data to show that this dose is only getting him to the yellow numbers, so if you want to increase the dose to 3.5u you could. The only reason I'm saying this, which is from the tight reg guidelines rather than SLGS, is because you've said he's got neuropathy in all 4 legs. The sooner his blood sugar gets down, the sooner that's going to improve. With the Tight Reg guidelines for a cat that is constantly over 200 with no tests under that point, you can increase as soon as 3 days (6 cycles) and you have enough info from the 8 cycles already on this dose to say that he's constantly over 200.

If you want to wait a full week on the dose you can, but I would still do spot checks, just in case there are unexpected low numbers.

Thanks Julie. We will increase to 3.5 in the morning. I think I am finally understanding what is going on with the numbers.

 

[julie & punkin (ga)]

It's a process and you're doing just fine!! Keep asking questions and it will become clear as you go along. Hang in there!

 

[Jenny and Grady]

Another quick question. If he is in the middle of a bounce and I increase his dose, will that counteract the bounce? Should I expect/hope to see lower numbers right away or do we have to ride out the bounce?

 

[julie & punkin (ga)]

It won't counteract the bounce, exactly. Hard to say how exactly his body will respond. We do try to avoid increasing a dose when a bounce is likely to be clearing because that can often cause a lot of downward momentum, as in the cat's blood sugar can drop rapidly. But I don't think you have to worry about that if you increase tomorrow.

All cats have patterns in how they respond to insulin, but before we've seen the particular kind of activity, it's hard to predict what any cat might do.

Have you seen the link on the difference between Lantus and Levemir? It's got a great explanation of how Lantus works and understanding that can help you understand the whole process a little better. It's on the sticky about the depot.