Tonka - coming down off a rebound?

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jmalasiuk

Member Since 2014
Hi, I started one post back in November (thanks to those who responded), but have been trying to sort my way through all the stickies and posts on similar topics and haven't posted since then, so I'll reintroduce here.

Tonka (my 12 year old boy) was diagnosed back in August, but because of my crazy work schedule (I get sent out of town for extended periods, and was away more than I was home this fall, unfortunately), I've only been able to test him sporadically. I have a wonderful cat sitter who comes in twice a day to feed, water, medicate and love up the cats, but she's not comfortable with blood testing Tonka (she does have good knowledge of diabetic pets though, and gives him his injections and keeps careful track of his water and food intake, energy levels and litter box use).

I try to do a good curve on him whenever I'm home so we have at least a few days' of good data and at least spot checks most other days that I'm not out of town. Unfortunately, his levels are all over the board. Based on how quickly he bounces from high to low (but only on some days), and from low to high (regularly), I'm guessing that most of his sporadic readings are due to rebounding and the days that he stays high are his still being in rebound mode.

If anyone with experience with similar fluctuating numbers could take a look at his spreadsheet and give me your thoughts, that would be great.

Right now, he seems to be coming down consistently throughout the day (started at 16.4 [~295] before his morning shot, and has been steadily lowering - last test was 5.5 [~99] at 10+). From what I've read on the board, it sounds like this is typical of cats coming off a rebound. If so, should I perhaps reduce his dose tonight, to avoid dropping further and rebounding all over again?

Note: From what I could tell, 0.5 units was too low a dose, unless he was rebounding from even that much and I just didn't have enough tests to catch the lows before the highs. We've been at 1.0 units twice a day since December 31, so it hasn't quite been three full days at this dose. I've adjusted his levels in less time than that previously (my reasoning - whether it's been good or bad - is in the comments column in his spreadsheet), but this was mainly when I was concerned that he'd drop too low on the current dose and I would be unable to monitor him because of work (I'm an hour from work even when I am in town, so usually out of the house 10 to 12 hours a day).
 
I checked the spreadsheet link once this posted (took me a while to get the hang of Google Docs), and it was still linking to an older version of his spreadsheet. I just reinserted it and it seems to be the correct version now.
 
Lantus works best when you continue the same dose for at least 3 days, up to 5 days. It takes that long for the effects to build up
I'd go back to the 0.75 units because I suspect he may go too low by the time you hit the 5th or 6th shot at 1 unit on day 3.
 
Thanks, that was what I was thinking, but wanted some feedback. On Lantus, is it normal for (some) cats to have such significant peaks in activity that he tends to get, or is that more likely a sign that his dose is too high and will eventually level out once I get him to the appropriate dose? I see high numbers and immediately want to increase the dose to bring them down, but in human patients, that only works because we tend to use short acting insulin in addition to a long acting insulin like Lantus. I'm gathering (finally) that even if he's consistently high for a while on a lower dose, he might come down closer to normal after several days at the ideal dose and curve a little less extremely, as long as he doesn't drop so low that he rebounds. Can that be the case?
 
Tonka's preshot level is 6.7 [~120], so he is rising now. Is it even safe to inject him (at 0.75), if I don't know how far he will drop at that dose? From past experience, I'm leery to give him no insulin, since he'll likely climb way up and it'll take a few days to bring him back down. I'll be home all night so I can keep watch of him and offer him some kibble if he winds up needing carbs to curtail a drop. Maybe a 0.5 dose and see where that takes him, now that he's starting from a good level?
 
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