? What is “bouncing”?

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Erin and Moe (GA)

Member Since 2019
Can someone please explain what a bounce is? What triggers it and is there anything I can do to prevent it?

Moe is recently out of remission and we are struggling to get control this time around. Last time he responded so quickly and we never had any issues. He apparently bounced yesterday after having a couple of really good days. I was so shocked by his high numbers yesterday, seemingly out of the blue.
 
When a cat goes out of remission, it can be harder to get him back there than the first time around. It can still be done, but you may find the journey isn't the same as the first time.
Many things can knock a cat out of remission: steroid shots, food change, infection, dental issues, etc. Has your kitty been checked to make sure he doesn't have an infection?

Here's a simplified explanation of bounce. When a cat's body is used to running on high sugar levels, the liver can freak out when those levels fall, even if they are still high or fall to normal levels. "Help," the liver shouts. "We're crashing! Release all the stored sugar!" The liver and pancreas release stored sugar, which can bump the sugar levels quite high. Take a look at my Billy's speadsheet at line 13. Textbook case of bounce. His BGL were starting to drop into normal ranges, and bam, one morning his BGL jumped up to over 400. You can also see what I did about it, which was absolutely nothing. It was so tempting to raise his insulin dose that morning, but you don't want to dose for the bounce. You want to change doses based on the lowest mid-cycle readings. Bounce usually clears itself up in a few cycles. (Forgive me if I over explain. I know this isn't your first rodeo. I'd rather say too much than too little.)

Now, I am not used to reading numbers on a pet meter, so you may want to wait for advice from someone who is. Looking at your chart, it doesn't especially look like bounce to me. A clear sign of bounce is when the nadir (lowest reading) is at least 50% lower than the pre-shot reading. You might consider raising his dose to .75 for 3 12-hour cycles and see how that goes. Monitor Moe and be ready to drop it back down if necessary. He had a nice low reading a few days ago. It's possible his pancreas just needs a tiny bit more help to keep healing.

Tagging @Deb & Wink because she is more experienced than me and I'm not familiar with the specific insulin you are using.
 
"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)."

Description copied from this "Sticky" or pinned post at the top of the Lantus ISG forum. Look about 1/2 way down.
Sticky The Basics: New to the Group? Start here!

Basically, it comes down to knowing when your cat reacts, the onset, the nadir, the duration, the overlap, when to feed your cat. In a nutshell, "Know thy Cat."

Some people learn to "feed the curve" to help control those bounces. I can cut and paste a bunch of those type comments if you'd like.

Feeding at +11 is not the best time. Should be a 2 hour gap between food and pre-shot tests. So those pre-shot tests don't look higher than they might really be in a couple of hours when the lantus insulin onsets.

Test, feed, shoot in a short window is good when using lantus. Some people manage to do all that in 5-10 minutes. I think my arthritic knees would make it more like 15 minutes these days. ;)

Remarks column is a good spot to note what + time you feed, and quantities, remarks on appetite, and such like.

Possible fur shot last night by any chance?

SLGS or TR? Neither your signature or the SS indicates which dosing protocol you are using. Unless I missed it.
I'd suggest you add a line at the top of the SS to say what meter you are using, the insulin, SLGS or TR, date fell out of remission.


 
Juls, I was already replying when you posted your response. Never even saw the tag until after I sent my post.

Hey, I'm a slow typist these days. Arthritic fingers hurting today.
 
Thank you both for your replies. That helps a lot. Our previous go-round Moe responded so quickly and without issues that I didn’t have to learn any of this stuff. I’m feeling a little humbled right now.

Deb, to respond to some of your remarks, I guess I’m following the SLGS protocol right now. I haven’t really made a conscious decision. I’ll update the SS I test Moe as soon as I get home from work (about 4:15pm), feed 1/2 to 1 ounce, then no food until 6:30 pm when I test again and shoot. I’ll change my notes in the SS to make that clearer.

Possibly a fur shot on Saturday evening, 2/29.
 
I’ll change my notes in the SS to make that clearer.
Thank you.

Possibly a fur shot on Saturday evening, 2/29.
Or maybe on 3/1/20 PM cycle?

If you think you have ever done a "fur shot" or partial injection of the insulin, never give more insulin as you can never be sure how much insulin actually got in. Then note the possible fur shot/partial dose in the remarks column. Some people also put a ? after the dose in the U or units column on the SS. Makes it stand out better.

I guess I’m following the SLGS protocol right now. I haven’t really made a conscious decision.
You can always begin with one dosing protocol and change to the other one.

Sticky Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
 
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