New Member - Numbers were down, now they are back up with same dose :/

Status
Not open for further replies.
SweetGreyRudy

SweetGreyRudy

Member Since 2024
Hi All,

We've seen a strange trend with Rudy's numbers over the last week. There were a couple day there where 2.5U was getting him to the mid-100 range and we were so excited, then all of a sudden that same dose has him back in the 300s. Wondering if anyone has insight into if this is normal or what could be causing this. We bumped him up to 2.75 yesterday per tight regulation and hoping to see another decrease. Thanks!
 
Welcome Kai , I'll tag a few experienced members for you, I see you switched to the Relion Meter, can you add that to your signature and the date you switched , Just tap on your name up top then tap signature and add it . , Add TR also to your signature .
You might want to add to your Title New Member first.
Look to the right tap in Thread Tools then tap on Edit Title and add it then tap Save
 
SweetGreyRudy said:
Hi All,

We've seen a strange trend with Rudy's numbers over the last week. There were a couple day there where 2.5U was getting him to the mid-100 range and we were so excited, then all of a sudden that same dose has him back in the 300s. Wondering if anyone has insight into if this is normal or what could be causing this. We bumped him up to 2.75 yesterday per tight regulation and hoping to see another decrease. Thanks!
Click to expand...
@Suzanne & Darcy
@Wendy&Neko
@Bron and Sheba (GA)
 
Hi Kai,
Thr first thing I would suggest you do is to try and get a test in during every pm cycle. At the moment we have no idea what is happening during half of every day. It is possible Rudy could be dropping low. Even a before bed test is helpful.
Also if you are doing TR, you need to be getting a test in every cycle.
Do you think this is doable?
 
Last edited:
Bron is correct. I also think that it would be very helpful if you could run a curve on the weekend or on your day off (if you are not able to get more tests in on a regular day.) What is your regular work schedule like? Is your kitty getting snacks during the early portion of the cycle?
 
Are you familiar with the concept of bouncing? It's very common, even more so for recently diagnosed cats.
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". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, 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).

The cycles with higher numbers could have been numbers from a bounce, in reaction to lower numbers you might not have been seeing in the night time cycles. Many cats go lower at night.
 
Hi all,

Thank you so much for the responses - I just updated our signature as well.

We can definitely start taking a before bed reading to see what his numbers are doing in the eve. Right now we do shots at 9am/9pm, and 9am/3pm/9pm pre-shot reading and meal with no snacks between meal times. I will start doing a reading 9am/3pm/9pm/12am unless you all think that 12am is too soon after 9pm feed. I work from home so am flexible. Also, we will plan for another curve test this Sunday. Let's get some more data!

As far as bouncing goes, if he is bouncing from drops in the night is that something that we need to adjust dosing for? Or just something to be mindful of when reading numbers?

Lastly, might be good to note that his mood has improved significantly over the last week. He has been so lethargic and sad since DX but this week he has been playful again and less wobbly.
 
Last edited:
SweetGreyRudy said:
I will start doing a reading 9am/3pm/9pm/12am unless you all think that 12am is too soon after 9pm feed
Click to expand...
A 12 mn test would be great. If that test is much lower than the Preshot BG, that could be a red flag telling you he could drop lower so I would get another test in an hour or two later. I would also give a snack at 12mn.

You could also vary the mid cycle test in the am cycle. Try a +5 or a +7 sometimes.
SweetGreyRudy said:
As far as bouncing goes, if he is bouncing from drops in the night is that something that we need to adjust dosing for? Or just something to be mindful of when reading numbers?
Click to expand...
If he drops under 50 you would need to reduce the dose. Otherwise the dose would stay the same. But you may need to give a few more snacks to slow any drop. Let’s see what the numbers tell us. Then if necessary we can work out a plan.
 
Sounds good- we will plan to do a +5 or +7 reading today in AM cycle, with the addition of the night time reading. Also we will do a curve on Sunday. Hoping that will get us some insights and enough data to make a plan if needed. Thank you again for the support, we appreciate it immensely.
 
Hi there @Sienne and Gabby (GA) yes we have been trying to get some readings before bed. I just updated the spreadsheet with the last couple of days of tests. Unfortunately, we had a bit of a family emergency on 4/7 and I think it stressed Rudy out which is why numbers are high for that day. Still, the numbers are fluctuating pretty wildly. Any thoughts? We are thinking of raising him to 3U
 
His levels are bouncing. In other words, when he drops into a lower range like the numbers you saw yesterday AM, his liver and pancreas will overreact and dump a stored form of glucose along with counterregulatory hormones into his system. This causes blood glucose numbers to spike. It can task several days for the bounce to clear. Withi Rudy's numbers dropping to 104 yesterday, I would not raise the dose just yet.
 
Ok thank you, that makes sense. With bouncing numbers, how does one adjust dosage and know when it's time to start reducing?

He was in the 100s all day yesterday, spiked to high 300s last night, was still high 300s this morning, and I just went to do his +6 test and it was at 70! With this information do you think it's time to start considering reduction?

Also- do bouncy cats ever stop bouncing? It's been a couple weeks of some good bouncing trends since we bumped up to 2.5.

Thank you as always for the help and support.
 
@Sienne and Gabby (GA) @Wendy&Neko @Bron and Sheba (GA)

Sorry to bother you all again- we got more numbers in the spreadsheet and are more confused than ever. A couple of weeks ago 2.75U was getting Rudy down to 75! But now we are back up consistently in the high 200s and 300s. We wanted to consult here before moving him up to 3U. I am aware of bouncing but he's rarely dipping past 200 anymore. We used to see dips before a bounce but this feels like he's plateaud.

We also adjusted his food and are wondering if he needs more calories? The vet recommended 225-250 calories a day for him to lose weight which is a significant diet compared to what he had before so we are starting at 260cals. He is getting 100cals each at 9am/9pm, plus 30cals each at 3am/3pm. I'd wager he was getting a little more than that with his past meals.

Can you please help with any direction or guidance? We would love to get his numbers back down :/

Thanks!
 
It looks like you switched Rudy from Tiki Cat to Arcana. While they are both low in carbs, the Tiki Cat is zero carbs and the Arcana (at least the one variety I looked at) is 7%. That shift may explain some of the higher numbers. Some cats are exquisitely sensitive to carbohydrates. If I'm remembering, the Tiki Cat is also quite low in calories. I didn't think to look at how that compares with the Arcana. I'd just make sure you're thinking of calories and carbs as different. You can feed Rudy as much low/no carb food as he wants and it shouldn't have a big effect on his numbers unless he is truly very carb sensitive. However, if he's gaining weight on a very low carb food, you need to limit his intake due to calories intake.

There are two other points that come to mind. Insulin needs change. A dose that was good last week isn't great this week. Your dosing strategy has to follow what the numbers tell you. In addition, holding the dose if the dose isn't getting numbers where you want them may not be a great idea. In Rudy's case, it's hard to know if you need to hold the dose or increase. Given that he hasn't seen green numbers in a while, you may need to increase his insulin. Remember, with Lantus and especially with TR, you base your dosing on how low the dose is taking the numbers.

The other observation is that you weren't able to get PM tests for over a week. You don't know if numbers had dropped and if what you were seeing during the AM cycle was a bounce. Just as an example, the PM cycle on 4/22 looks like Rudy's numbers were dropping. He started at 321 at PMPS and by PM +4, he was 234 and at AMPS the following day, his BG was 137. His numbers were dropping throughout the evening cycle. By PMPS on 4/23, his numbers were back at 300. He bounced.

I'd also like to make a suggestion. You seem to be on top of the basics. You may want to consider posting on the Lantus board. The board is as busy as Health -- there is usually someone around 24/7. Some of the members you're already familiar with also post there. There is a huge amount of expertise that is specific to Lantus available there.
 
@Sienne and Gabby (GA) Thanks for the response, I'll create a post on the Lantus board. Still learning where to get my questions best answered here- there is such a wealth of information!

The Arcana premium pate we've switched Rudy to is free of carrageenan, potato, pea, lentil, and legumes. The first few ingredients are all meat products followed by pumpkin and locust bean gum 6/7 ingredients down. The analysis per can is 10% protein, 2.5% fat, 1% fiber, and 80% moisture. So, we figured this was a good wet food option? His snacks are freeze dried raw bites and entirely free of carbs.

Since we posted a couple of days back, we've upped his dose to 3U, timed meals 9AM/9PM and small snack bites at 1PM/5PM/1AM/5AM. We're hoping that with the consistent feedings every 4 hours plus the upped dose that we'll see his numbers drop again? Would you suggest that we wake up in the night to get his night time nadir to determine if he's dropping then?
 
The Arcana is approximately 6.5% carbs. That's based on the guaranteed analysis not on "as fed" values so it's an estimate. It's low carb but like I said, some cats are incredibly sensitive to carbs and some cats will have a temporary change in numbers with any new food. There are cat food carbohydrate calculators on the web if you need to get an estimate. Just remember, most of the information on the label or on line tends to be the guaranteed analysis.

I hope he does well with the dose increase.
 
Status
Not open for further replies.
Back
Top