What is meant by 'Bounce'?

[Dee Dee C]

I see this term, but I am uncertain what, exactly, is bouncing? I have been testing my cat, Clarence, and the numbers I get seem a bit confusing. I haven't started a spreadsheet for him yet. Tested for a few days just to get the hang of it. He is doing okay, but doesn't seem quite himself. Honestly, I'm a bit confused and overwhelmed by it all.
Based on the tests at the vet on the 20th, he increased his dose to 2 units 2x a day. Guess I really don't know what to expect from all of this. After feeding him and he gets his shot, he gets really sleepy (this might be very normal for him and I'm just still in panic mode). The lowest number I got with the testing has been 135, so I don't think I need to worry about him being too low, really.
Advice? Thoughts?
Thanks!

 

[Karen&Rocket]

Not giving advice unfortunately, just adding that I've been trying to figure out the bounce concept too. I just recently started getting some overnight numbers, and noticed that he goes much lower (though apparently not dangerously low) during the night cycle. Otherwise his numbers are sky high and I'm wondering if this is some sort of bounce or something else. Anyway would love a good explanation of bounce too.

 

[Veronica & Babu-chiri]

When a cat gets lower numbers that he is used to or he went down very quickly, even if he's far from hypo, his body reacts to try to avoid what it thinks is a potentially dangerous situation and releases glucose causing then that after a "very low" (again very low could be 300 if the cat was in 500) you get a very high number, a bounce can actually last a few cicles ( even as much as 3) or clear quickly it all depends on the cat.

Also when a cat that has been on relatively high numbers starts getting low numbers he can act a bit down, because his body was used to the high amount of sugar in the blood and he feels "bad" as if his numbers were too low even if they are ok, this usually lasts just a little while if he continues acting like that then you should check him.

 

[Lisa and Witn (GA)]

When we refer to bouncing we are talking about Somogyi Effect. If the insulin dose is too high, the body tries to protect itself from becoming hypoglycemic (too low glucose level) by producing extra glucose. So when the glucose levels are tested it appears that the current dose is not working and needs to be increased. This is the reason why you often see recommendations that you start over with a low dose, such as 1 unit, and very slowly increasing it over several weeks and by small increments, such as 1/2 unit. This resets the body and will help you find the optimal dose that works best for your cat. You will often see us say "Start low and go slow. Most cats only need 1 - 2 units twice a day. Only certain health conditions, such as Acromegaly, require much higher doses.

 

[Karen&Rocket]

When we refer to bouncing we are talking about Somogyi Effect. If the insulin dose is too high, the body tries to protect itself from becoming hypoglycemic (too low glucose level) by producing extra glucose. So when the glucose levels are tested it appears that the current dose is not working and needs to be increased. This is the reason why you often see recommendations that you start over with a low dose, such as 1 unit, and very slowly increasing it over several weeks and by small increments, such as 1/2 unit. This resets the body and will help you find the optimal dose that works best for your cat. You will often see us say "Start low and go slow. Most cats only need 1 - 2 units twice a day. Only certain health conditions, such as Acromegaly, require much higher doses.

My vet saw our chart a little while back, and has basically said Rocket's not bouncing. Could he be wrong? And in Rocket's case, if we wanted to start over trying a lower dose, is there a way to go from 4.5U back down to 1 or 1.5 without it being dangerous? His spreadsheet scares the hell out of me.

 

[Lisa and Witn (GA)]

My vet saw our chart a little while back, and has basically said Rocket's not bouncing. Could he be wrong? And in Rocket's case, if we wanted to start over trying a lower dose, is there a way to go from 4.5U back down to 1 or 1.5 without it being dangerous? His spreadsheet scares the hell out of me.

Most people will just start over with 1 unit. Depending on their test results, they may also want to check for ketones. One recommendation is to stay at the new dose for about a week before determining if an increase is needed. If it does need to be increased only raise it by 1/2 units and stay at that dose for another week before increasing it again. The important thing is you must be testing before every shot

 

[Karen&Rocket]

Most people will just start over with 1 unit. Depending on their test results, they may also want to check for ketones. One recommendation is to stay at the new dose for about a week before determining if an increase is needed. If it does need to be increased only raise it by 1/2 units and stay at that dose for another week before increasing it again. The important thing is you must be testing before every shot

Wow. Ok, I'll have to think about that one, and do it when I know I'll be around most of the time to test him. I'm having surgery in four weeks, and while my husband can do the shots, I'm the only one who tests. I'll be in the hospital for two days/nights. I hate the idea of going into surgery when I'm so stressed about this. Ugh, sorry for venting but... oh well, I'm sure we all understand.

 

[Veronica & Babu-chiri]

My vet saw our chart a little while back, and has basically said Rocket's not bouncing. Could he be wrong? And in Rocket's case, if we wanted to start over trying a lower dose, is there a way to go from 4.5U back down to 1 or 1.5 without it being dangerous? His spreadsheet scares the hell out of me.

I think you should ask this question in the Prozinc forum, I have no experience with Prozinc but he does apear to be reacting to the insulin which usually doesn't point to needing a reduction or to start over, if you decide to go back down there's no actual danger of lowering the dose except for the fact that his numbers could go even higher and given his high numbers you should definitely watch closely for ketones

 

[Veronica & Babu-chiri]

Wow. Ok, I'll have to think about that one, and do it when I know I'll be around most of the time to test him. I'm having surgery in four weeks, and while my husband can do the shots, I'm the only one who tests. I'll be in the hospital for two days/nights. I hate the idea of going into surgery when I'm so stressed about this. Ugh, sorry for venting but... oh well, I'm sure we all understand.

Maybe your husband can get the hang of testing in this four weeks ? if not depending on his numbers when the time of your surgery comes you can decide what is safer to do , four weeks is a lot of time lots of things can change

 

[Lisa and Witn (GA)]

I think you should ask this question in the Prozinc forum, I have no experience with Prozinc but he does apear to be reacting to the insulin which usually doesn't point to needing a reduction or to start over, if you decide to go back down there's no actual danger of lowering the dose but given his high numbers you should definitely watch closely for ketones

I agree, you always want to check with the users in the forum for the insulin you are using. What I described above is the a general description of bouncing and recommendations. ECID (Every cat is different) and the users in your insulin group would be able to provide the best advice.

 

[Karen&Rocket]

I think you should ask this question in the Prozinc forum, I have no experience with Prozinc but he does apear to be reacting to the insulin which usually doesn't point to needing a reduction or to start over, if you decide to go back down there's no actual danger of lowering the dose except for the fact that his numbers could go even higher and given his high numbers you should definitely watch closely for ketones

I've posted a couple times in the Prozinc forums in the last few days and I'm afraid they're getting sick of me But I'll do that today. Thank you for the advice on checking for ketones; that's something I plan on doing tomorrow at the latest (I work different hours today unfortunately).

Maybe your husband can get the hang of testing in this four weeks ? if not depending on his numbers when the time of your surgery comes you can decide what is safer to do , four weeks is a lot of time lots of things can change

I'll try to teach him, but he is very reluctant. Hopefully things will get better. We'll see. I just wish this was a little bit easier. Thank you.

 

[Dee Dee C]

Thanks for explaining 'bounce' - I didn't know it was called that. Clarence experienced the Somogyi effect when he was at the vet for his first curve and the vet explained it to me, didn't know that was 'bouncing'. I've changed the way I'm feeding him because his home tests were really high, especially the pre-shot tests. His numbers seem to be lower with how I'm feeding him now -- basically giving him one can of FF Tender Beef and then letting him eat fish if he wants more food. I was giving him 1 1/2 cans. He just seems lethargic to me, but whenever I test him, he isn't really 'low' at all. He isn't drinking a lot of water anymore and doesn't seem ravenous. But also doesn't seem active. I have to admit, I'm keeping him a lot more confined (which he probably doesn't like) and observing him more than I did before. He doesn't seem to have gained his weight back yet, either. How long before he would start gaining weight back?

 

[Veronica & Babu-chiri]

hank you for the advice on checking for ketones; that's something I plan on doing tomorrow at the latest (I work different hours today unfortunately).

Good thing about checking ketones is you don't have to have a special hour to do so just have to catch some pee which may not be so easy

I just wish this was a little bit easier. Thank you.

Hang in there it does get easier with time and practice

 

[Lisa and Witn (GA)]

Dee Dee, do you have a spreadsheet with his readings? Many members have a link to their spreadsheet in their signature. Are you testing before every shot?

You should share your spreadsheet with the Vetsulin forum and ask them to review it and give you advice. From what you are describing it sounds like his glucose levels are not under control yet. The Vetsulin users may suggest changing his dose or switching to a longer lasting insulin.

 

[Veronica & Babu-chiri]

He just seems lethargic to me, but whenever I test him, he isn't really 'low' at all. He isn't drinking a lot of water anymore and doesn't seem ravenous.

They do take a few days to become used to living with normal numbers, is good that he's not so thirsty or hungry those are good signs

He doesn't seem to have gained his weight back yet, either. How long before he would start gaining weight back?

It take a loooong time for them to regain weight, for Babu it was almost a year and he didn't actually regained all of his weight just got back to a resonable weight

 

[Dee Dee C]

Dee Dee, do you have a spreadsheet with his readings? Many members have a link to their spreadsheet in their signature. Are you testing before every shot?

You should share your spreadsheet with the Vetsulin forum and ask them to review it and give you advice. From what you are describing it sounds like his glucose levels are not under control yet. The Vetsulin users may suggest changing his dose or switching to a longer lasting insulin.

,
I don't have his #s in a spreadsheet yet. I need to make time to do his spreadsheet, which I probably won't get for a day or two. I haven't tested him before every shot, when I did test him before his shots, he was always fairly high. This morning I tested 2 hrs. post shot and got 236. I will get his spreadsheet done and posted at the vetsulin forum in a couple days.

 

[Dee Dee C]

They do take a few days to become used to living with normal numbers, is good that he's not so thirsty or hungry those are good signs


It take a loooong time for them to regain weight, for Babu it was almost a year and he didn't actually regained all of his weight just got back to a resonable weight

Clarence was down to a little less than 13 lbs. when he was diagnosed. He has weighed as much as 18 lbs, which is probably abit too heavy, so I'm hoping he will get around 15 or so, which is probably a good weight for him.

 

[Veronica & Babu-chiri]

,
I don't have his #s in a spreadsheet yet. I need to make time to do his spreadsheet, which I probably won't get for a day or two. I haven't tested him before every shot, when I did test him before his shots, he was always fairly high. This morning I tested 2 hrs. post shot and got 236. I will get his spreadsheet done and posted at the vetsulin forum in a couple days.

The sooner you can get the spreadsheet up the easier it is going to be for everyone to help you.

One important thing to consider is that testing before shooting is not so much to dose but to make sure is safe to give insulin, so we strongly recommend to always test before shooting, you should withdraw all food 2 hours before the test to make sure the result is not food influenced, and for Vetsulin they recommend you feed after the test and wait a few minutes before shooting.

 

[Lisa and Witn (GA)]

Once his glucose levels are under control his body will start processing food properly. He should start to gain weight then. Right now because his body is not processing the food properly he is starving and that is why you see him losing weight.

 

[Noah & me (GA)]

I'm afraid they're getting sick of me

No one here gets sick of questions, it's how we learn. There is no test for bouncing and many vets have never heard of it. A constantly higher dose can be a symptom but should not be taken as a symptom of a bounce and nothing else. Noah bounced until I had the nerve to cut his dose in half. Don't just do this as an experiment, he was my second diabetic cat and I had been dealing with this for a few years.
There's a sticky for this somewhere. Anyone?

 

[Karen&Rocket]

No one here gets sick of questions, it's how we learn. There is no test for bouncing and many vets have never heard of it. A constantly higher dose can be a symptom but should not be taken as a symptom of a bounce and nothing else. Noah bounced until I had the nerve to cut his dose in half. Don't just do this as an experiment, he was my second diabetic cat and I had been dealing with this for a few years.
There's a sticky for this somewhere. Anyone?

Hehe, thank you. There is SO very much to learn. I got a great reply to my other post from Worf's Mom earlier today - http://www.felinediabetes.com/FDMB/threads/morning-feeding-question-and-a-little-desperation.216119/ if you're interested - we have an appointment with our "second opinion" vet tomorrow, and I'm hoping she'll be open to the possibilities. If not, I may try cutting his dose very carefully (and after researching, and asking more questions about exactly the safest way to do it) first.