1/1/18 Archie AMPS 500 - is this a bounce?

Hi,

this is only the 5th day we're doing Lantus (1Unit/12 hours) and the third day we're checking BG. I'm so confused by his numbers - day 1 of testing they were amazing, since then his numbers are so high. It's frustrating to not know what to do about it. Should we go back to giving him more carbs (before his diagnosis we fed Purina Beyond & Stella and Chewy plus dry food, now we're on TikiCat (Dr. Pierson's spreadsheet lists those as the highest protein and no carbs). It's a steep learning curve and just wondering if there is anything we can do to lower his BG quickly. He's not a super active cat (has never been, plus was always weak on the hind legs) so I can't make him exercise or anything. Thank you!

 

Hi, he may have gone lower in the evening of the 30th. Which caused him to go higher on the 31st then he seemed to take a pretty deep drop to that 170. That looks like it may have led to another bounce.

Is there any way you can get a +2 or +3 "before" bed test in? I am wondering if he is going lower at night as well.

On the food change - yah! However, when moving to a low carb diet the glucose numbers can change dramatically. Good thing that you are testing!

He may need a little lower of a dose due to the food changes but I think we need a bit more data on the night time movement. I am not an expert however, hopefully someone with more experience will come along shortly.

 

Hello and welcome. One of the most frustrating things you'll find about the blood sugar readings at first is that they don't seem to make sense. It helps to remember than insulin is a hormone, and not a drug. Analyzing one cycle at a time can drive you crazy - I was guilty of that a lot when I started. What you are looking for is overall trends on a dose. In particular, you want to be able to answer the question "how low is this Lantus dose taking my kitty across all the cycles?". The answer to that drives our dosing decisions. It will be particularly helpful getting some night time tests to answer that question. Many kitties go lower at night. Getting a +2 or a test before you go to bed will really help fill in the details.

Sticking with a low carb wet or raw food diet is best. That means something under 10% carbs, it doesn't have to be zero carbs. Many of us feed 3-5% carbs. Some cats actually do better with a few carbs than zero carbs.

 

I know she’s just following the directions of her vet, but not shooting every 12 hours is the reason for the crazy high numbers during the morning cycle. Since I’ve only recently returned to the board, I’m not sure if this has been talked about before.

 

Today his numbers are even going up! AMPS 536, AMPS +2 575 - what is going on? @Patty&Champ - we're shooting every 12 hours (except on 1/1 when we overslept and gave it 50 min late). Would that make the BG rise so extremely?

 

Bounces can last up to six cycles after the event that cause them to go low. And by that, I mean a number lower than they are used to. During the bounce, numbers can wobble around. He could still be bouncing from the blues he saw on the 30th, if he wasn't used to them. My Neko saw quite a few blacks at the beginning. They are ugly, but as long as he does eventually come down it's OK.

Good job getting some tests in last night.

 

Thank you @Wendy&Neko ! Is there anything that we can do to bring the levels down / overcome the bounce faster or should we just keep going as prescribed 1Unit per 12 hours?

 

Unfortunately, you just have to wait out the bounce at this point. At some point you'll evaluate the 1.0 unit dose and see if Archie needs an increase. People here use either Tight Regulation protocol (TR) or Start Low Go Slow (SLGS) method as the guidelines for how to change doses. Take a read of the two and see which one suits you best. SLGS would have you wait 7 days before increasing, TR says to wait 5-7 days.

 

@Wendy&Neko - thank you! If it is a bounce, wouldn't we try to decrease the insulin? I'm still super new to all of this, but I thought that if we keep giving him the same amount of insulin that leads him to drop very low and causes the bounce that over time the depot would make it impossible for him to get out of the bounce? So confusing. Sorry.

 

No, we reduce when we see a number than earns a reduction, which is 68 on the AT for TR and 90 for SLGS. A bounce just means he saw a number lower than he's used to, not necessarily a really low number. Over time he'lll get used to the lower (but still normal blood sugar) values, and bounce less. And yes, bounces are one of the more confusing topics when you are new.