? Scarily high AMPS number. Bouncing?

Alfie's been on 2.5U of Prozinc for a few cycles now. His pre shot numbers have been climbing and this morning are off the charts. So high I did two readings to check it wasn't a faulty strip! 38.2 and 35.9!!

I've given him his AM shot as normal. Any suggestions what is happening here and what I should do next?

And is there anything else I should do or not do when his numbers are that high? He seems fine in himself.

 

Update - BG had halved at +2, has now DOUBLED at +4.

Called the vet hospital, they've said to keep monitoring and try and check for ketones. Other half has dashed out to pick up sticks.

Alfie still seems fine in himself, just hungry. Not drinking excessively or vomiting.

 

It looks like Alfie is a very bouncy boy and is still reacting to that lovely blue. The general guideline is that bounces can last up to 6 cycles after the precipitating event (some of Teasel's have lasted longer). This is the 4th cycle after the cycle that produced the blue. As unnerving as it is, keep the dose and be vigilant as you count cycles. Test for ketones and if Alfie seems fine, is eating and using the litter box properly, try not to worry. I know - easier said than done.

Notice that he did something similar on June 10 after some low-ish yellow numbers. He might have done it on June 12 after that blue the PM before before but you have no daytime tests to know for sure. This is to reassure you that there's precedent here. Bouncing, especially dramatic bouncing, is very frustrating but some kitties react that way. @StephG could tell you stories about Chuck's drama!!

My advice is to stay with the careful increases. I'd go up to 2.75 u tomorrow AM. Steel yourself for some more blacks. They tend to get less bouncy as you get to a dose that produces good numbers. Alfie has been high for many weeks and his body thinks that anything in a half way decent BG range is a cause for panic. Some people on FDMB even refer to bouncing as "liver panic" because of the liver's role in storing glycogen that gets mobilized and turned into glucose to flood the bloodstream during a bounce phase.

I hope this helps.

 

Thank you Kris.

I've spoken to a vet (our vet unfortunately doesn't work on Thursdays). She's advised us to keep test BG every hour and will speak to me again before his evening shot.

It's worrying when the numbers are so high even the vet falls off their chair in shock!

He's so high the meter has stopped registering and is just reading 'Hi'. He's negative for ketones and seems fine, just more thirsty and hungry (understandably!). I haven't fed him since his +2 snack this morning. Hopefully he will start to come back down. I'd be happy just to see a number on the meter at this point!

 

If you can manage testing every hour you might get some useful info or you might not. If he's in a bounce cycle, he'll give you a high, flat curve. Before I came to FDMB last August 2016, I'd been doing near weekly curves for my vet from April 2016 on - always high and flat. Teasel's ProZinc dose would go up a bit ... another high, flat curve ... dose up ... high, flat curve. I wasn't testing the way we do here, only that weekly curve. The curves showed almost zero response to the ProZinc. Then I decided to do it differently (slow learner!), set up my SS and FDMB testing routine and voilà: I saw what was happening, how bouncy/erratic he was, and why the weekly curves were an exercise in futility. Have a look at Teasel's SS prior to my switch to Lantus. Lots of pink and red and that's after 5 months of tracking his BG the FDMB way, adjusting his doses, etc. Maybe his bounces aren't as high as Alfie's but he was/is very unpredictable. He's calmed down a lot on Lantus and I've recently switched to using a human meter that reads lower. That has had the effect of shifting his numbers down into nicer colours - nice psychological boost, if nothing else. His improvement, though, is real.

 

Oh Jen! Hugs to you!!

Yes to everything Kris has said. I would also add that along with the erratic cycles you'll get from the blue the other day, I would call this a bounce even within this one cycle. He dropped 50% from AMPS to +2. Anytime a kitty drops 50% in a cycle, they have a good chance of a bounce: spiking way up high. Alfie not only dropped 50%, but he did it in two hours! That's a pretty dramatic cycle!

The vet may come back with a big dose increase. Alfie does need more insulin, but please please don't give him a big increase. I think Kris has given you some good advice on that to just move to 2.75. You are getting great responses to the insulin at this level already. A ton insulin would either make the bouncing worse, or stick him up in high flat cycles for way too long. Baby steps are a better approach with a sensitive cat. In the past couple of days, he's had a blue, then last night he dropped nearly 50%, and today he dropped 50%. Both of those are great cycles at this point. Still overall too high, but good insulin responses. So slow movements up are going to be your best bet.

Remember that as scary as these numbers are, you've already noted that Alfie seems fine. So give him some head scratches and test for ketones, and try not to worry too much. It's going to get better!

 

Oh Jen I'm so sorry you're having a rough day! I'd say Alfie is definitely bouncing. Get that ketone test if you can (it'll make YOU feel better) and focus on how he SEEMS, not what his number is. Does he seem okay? Will he play some? Eat his favorite treats? Do his normal routine (for my cats, that's sleep in various places around the living room ). If so, I think he's fine.

I know it's way too high of a number, but remember that it's still early days for you guys. A lot of kitties come here presenting some pretty high numbers...it takes time for them to come back down. This is a marathon, not a sprint. He WILL come back down (you've seen it, so you know he will!). Try to do something relaxing. I know it's easy for me to say, but try to find something to distract yourself (a long shower, a movie/book you like, a walk around the neighborhood, a glass of wine...whatever works!).

 

Thank you. Just tested at +9 and we're back in the numbers! Phew! (Never thought I'd be relieved to see a 36!!)

Speaking to the vet earlier she mentioned increasing to 3U tonight, but is holding off a decision until later. She doesn't want to step on our usual vets toes. I'm sure if I say I only want to increase by 0.25U and from tomorrow morning, she will be fine.

If the high cycle on 10th June is similar (I'd assumed at the time it must have been a fur shot, but not sure after today), he might have a more responsive evening cycle as he did then.

Just glad I happen to be off work this week so I can do lots more readings than usual. He's still fine in himself so I'm trying to relax and not panic about the numbers!

 

Update:

Spoken to the vet, she's happy for us to increase to 2.75U from tomorrow morning (originally suggested 3U from this evening). Will stick with 2.5U this evening.

Fingers crossed he has a better cycle this evening!

 

Sounds like a plan! I know it's been a stressful day for you, so please do something nice for yourself tonight!

 

I like what the others have said too . Alfie kind of reminds me on Maury's early days on Prozinc. Blue or yellow would make him bounce. By 7th cycle on his highest dose, we broke through his glass ceiling/floor. Took over another month for his body to not panic as much when going into normal nadir numbers . Unless he gives you a oddly low PMPS, sticking with 2.5U tonight sounds good and then increase in the morning

 

Thank you all for your support today, it really has made all the difference

It has been a super stressful day, afraid to leave the house and expecting to have to rush him to the vet hospital at any moment! But we've learnt we can get through even the scariest high numbers ok! (Probably a blessing the Alphatrak meter stops registering over 41!! )

We've had a quiet evening, poor Alfie is wiped out and fast asleep. His +3 looks ok so I'm off to bed and hubby is staying up to do a later test just to keep an eye on him.

Increasing to 2.75U tomorrow morning. Onwards and upwards!

 

Have a good sleep

 

Oh, is that what it means?! I thought the meter was just greeting me.

 

Well, after all of yesterday's drama he had a good cycle last night and this morning has had his lowest AMPS since he was diagnosed!

Because of that, I've kept him at 2.5U this morning just to see how this cycle plays out, after his blue a few days ago. And depending how today goes will increase to 2.75U tomorrow.

Given the stress put on his system yesterday the last thing he needs today is his first hypo!

 

Hurray! Good call. Let's see what he does today.

 

Sometimes it can be beneficial to let them have gentler drops before trying to push lower. Let's hope he's ok with those yellows

 

yellows are a lot better than blacks! I wouldn't change anything for another cycle.

 

I've been there many times with Chuck. He is one of the cats Yong mentioned that needs gentle drops. He bounces but since we switched to Lantus he doesn't seem to bounce as high. He's been testing my opinion on that the last couple days.
I hope Alfie calms down a bit for you.

 

Well he had a good cycle yesterday morning but back to the black pre shots last night and this morning. And his preshot numbers seem to be on an upward curve, apart from the pink yesterday morning.

So I have increased to 2.75U this morning. Not sure if that's the right thing to do or if I should have let him run a few more cycles at 2.5.

But I go back to work on Monday so won't be around to monitor mid cycle in the mornings, so safer to increase his dose while I'm here I think.

 

I think the increase is fine. You were at 2.5 for plenty of time.

 

You'll get there, Jen. Those nicer numbers that are poking through are good signs. Ignore the blacks.

 

Thanks both. He's having another high flat cycle this morning but the odd blues and yellows from previous days are encouraging!

 

Indeed! His flat cycle is how he is showing his bounce, just like last time. Hang in there! You are doing great

 

Yep, those flat cycles usually follow bounces..it's nothing to worry about! You're doing wonderfully!