Jack 5/16 rebound?

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Darlene & Jack

Darlene & Jack

Member Since 2011
Yesterday Jack was in the 300's all day, varied from 306-397.

Todays numbers:

190 @ AMPS shot .8 un
184 @ +1 (i left for work at this time, 7am)
109 @ +3 had my dtr check him before she left for class and had her give him 1 tbsp higher carb FF w/gravy as no one would be home until almost +9 to check him and I was afraid he would drop more since this was only at +3
140 @ +8.5
494 @ +10.5
473 @ PMPS shot .8 un

What a roller coaster! Usually he is increasing for the first few hours after his AMPS, so I was really surprised at the +3 reading. And I was surprised by the 190 AMPS considering he barely dropped yesterday.
Rebound this afternoon?
 
:shock: Wow, that is some fast rise in just 2 hours.
I'm not thinking rebound...I'm thinking...did Jack possibly get into any forbidden food?
That is just so unusual for any insulin much less levemir.
Any chance this morning was a furry shot?
 
There was nothing around that he could have gotten into that I know of. He acted like he was totally starving when I got home, though there was food still in the auto feeder. Sometimes he eats from it, sometimes he doesn't. I think when he sees me home he'd rather wait for fresh food. He knows if he rolls around and looks extra cute I will put some out. Just double checked with the kids...he was in their sight the whole time in those 2 hours and didn't even eat any cat food then.

I don't believe it was a fur shot this morning, he was nice and still for it and I felt the needle go in.

I just never know what to expect from him...I certainly didn't expect him to shoot up to almost 500. :-(
 
Most likely it is rebound because the low would have occurred before the 140 and that +8.5 check just happened to catch the point right before the steep climb. The one tablespoon of high carb was not enough to counteract the insulin effect apparently.

Lori, this steep climb is not unusual at all because the insulin has nothing to do with the mechanism which causes the extremely high BG response, other than being overdosed. In my experience Levemir has very little power over a hard rebound which is created by the breaking down of glycogen in the liver in response to a lower than usual BG.

"Hormones epinephrine and cortisol, as well as growth hormone and glucagon,[2] causing temporary insulin-resistance, will also be released into the bloodstream." That's from the Pet Diabetes Wiki section on rebound, which has been re-written apparently and is very easy to understand. Everyone should check it out. It includes a lot of examples and references to what happens, especially on longer-acting insulins.

While I know we decided to maintain the dose at .8U, I am pretty convinced from today that you should go a little lower with dose. The idea is that you want to soften the drop, you do that by lowering dose.

You are going to see highs for probably another cycle or 2 tomorrow, but don't wait to lower the dose if that's what you decide to do. I recommend .5U.

Sorry he's got the high numbers now. But from my experience, unless the cat has been completely off insulin, 500s almost always indicate rebound. 494 is close enough.

It gets easier to figure out, I promise. And I know it doesn't seem possible that such a tiny amount of insulin as .5U can work well, but it can.
 
I also think there is a good possibility that he dropped lower between the +3 test and the +8.5 test - that missing time block, to fast drop to +3 and him being very hungry when you got home are evidence that he may have been lower.

Also, it may have been a safe low like 80 or 70, but if he hasn't seen those good numbers in a while it can cause rebound. His body is used to higher BGs right now.
 
I don't know about all of you but Tom on Lev. takes hours to show me when I have H/C'd him.
I do believe these numbers are a set back due to the high carb +3.
IMHO
but like everyone, I could be wrong.
 
So this morning I decided to go with the 0.5 un.

384 @ AMPS shot 0.5 un
340 @ +3
193 @ +9
133 @ PMPS shot 0.5 un

I shot the 0.5 because I can be home tonight and followed the advice to shoot the full dose over 100 if I can be home to monitor...so I hope this works! Kind of surprised at these low numbers this afternoon.
 
Darlene, I wanted to clarify what I posted before. I apologize for being a little vague... :roll:

Jack quite possibly dropped lower, but I don't think it was too low (dangerous) - it was just an unfamiliar number and caused rebound because he was not used to it. Often, holding the same dose for a while allows them to get used to the lower numbers. If not, then only a small dose reduction might be needed. You may find that dropping to .5u is too low a dose. Maybe try .7u.

Shooting a lower PS when you are there to monitor is a good decision and useful for building the data that will tell you if it is OK to shoot those lower numbers. I found with Beau that I could not shoot a full dose on lower numbers, but with Jeddie I can. I think that Jeddie responds much more "normally" than Beau did (Beau just never reads the memos!).
 
Thanks Sheila...I might need to go back up a little. Will see how he does today. I was glad I was home and able to monitor after shooting the low number, like you said, it's good data to see what happens. Though with Jack, I can never really seem to find a pattern! He likes to change it up all the time.

Happy Birthday to my sweet baby Jack today...he and his sister Jordan are 9 today!!
 
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