Number going up after giving insulin?

Hello! This is the second time that Dallas's BG has gone up after giving insulin and we definitely aren't giving fur shots. Does anyone know what could be a reason for this? Also, how much data do we need in order to determine whether or not it's safe to shoot under 11.1? Should we be checking him more often? Thank you!!

 

If you can, also post this in the Lantus forum. While more peeps hang here, the insulin experts weigh in there. Hugs.

 

Oh I didn't know. I will! Thank you!!

 

@Wendy&Neko
Could this be "bouncing"??

 

I'm not sure what that means

 

Wendy&Neko can answer... I am a newbie.

 

Here is the definition of bouncing:
Bouncing - 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).

Sounds like you've nailed part of it @Ann & Sister. Dallas isn't used to those low blues he saw today. The other factor could be the missed shot yesterday morning. Sometimes you'll get some wonky numbers as the depot rebuilds. Plus 211 and 221 are within meter variance, they are allowed to be out by 20% so those could be practically the same number.

To answer your question about how low to shoot, gradually lower the number as you get data to show you how he does. You've shot 211 full dose, you could probably lower that to 180-190 now when you are around to monitor. Shooting lower usually means flatter cycles. As he showed you on 7/15, a high preshot could mean high and flat or a dive.

 

Ok, I think I might understand what "bouncing" means. So is it possible that Dallas was on his way to being hypo? I don't think it was dropping too fast (from my knowledge), but then again we weren't able to check before +7.5 because my boyfriend was at work and I am away for work, so it's hard to say. Sending my boy into a hypo episode scares me so much. But, it sounds like there are a few possible reasons.

Since we recently missed another shot does this mean we have to continue on this dose for another week for the depot to rebuild?

How do I convert mg/dl to mmol/L. Does 180-190=10-10.5? If he reaches these number it's safe to give the full 1.25u or should it just be 10-25% of his dose?

 

Bouncing is a reaction to numbers lower than they are used to. A cat mired in numbers above 300 can bounce when see yellows, which are more than safe. Dallas isn't used to lower blues yet. The more he sees them, the more used to them he'll become, and bounce less as a result.

Do you have an autofeeder for Dallas? Having food available around his nadir or low point is a way to help keep him safe if you aren't at home.

mg/dL is 18 * mmol/L. The US spreadsheet tab does that for you. I'm thinking you could give full dose on slightly lower numbers than you have been to date, provided you are around to monitor. If nervous, you can always do a partial dose and see what happens. All data is good data.

I think the depot is mostly there by now. The timing of increase will depend on which dosing method you want to follow.

 

Ohhh ok, I get it now!

I do have an auto feeder, which we've been putting out for him 3 hours and 6 hours after his insulin. His nadir seems to be happening more around +7 +8, so maybe we'll change the timings around. I told my boyfriend to only shoot at between 10.5-11.1 if he'll be home all day.

I'd like to follow the SLGS method.

 

Could you then put SLGS in your signature? It's just faster than opening up the spreadsheet (which I do anyway). With seeing numbers between 90 and 149, you would hold the 1.25 unit dose anyway. You can count tonight as cycle 3 of 14. So continue holding for 14 cycles, unless he goes below 90 (5.0).