6/29 update: at a loss / How do you tell if bouncing is an issue

Hi,

I've read a few posts and the sticky mentioning bouncing but am not sure how you tell if that's an issue and if it is the issue what can be done about it?

Finn's AMPS have been really high lately but he's had a few good mid-cycle - a full curve is not really possible; I'm already scratched and clawed from the twice daily readings but checking different times on different days it looks like +7 is a good place to test for nadir. Of course then the issue is that if his number is really low I'm afraid to dose and he won't let me near him to do a PMPS; so you'll see he's missed a few PM shots for various reasons (I've tried to capture in the remarks column so I can remember myself what was going on day to day).

I'm getting a bit frustrated with the AMPS numbers but there have been other things that maybe could be contributing?? Both Finn and my non-diabetic cat (Louis) had GI issues for over a week. They seem to be resolving these past few days by adding a 1/2 teaspoon of pumpkin to their food. We also had thunderstorms one night and I know Finn's terrified of thunder (I can only imagine what his numbers are going to be on 4th of July Basically, I'm not sure if he's going high PS because of stress...he seemed to have better PS numbers at lower doses but they weren't really going down as far as the limited data I have could tell.

I also feel like he doesn't quite act himself at higher doses; not lethargic but hides more is generally not as relaxed if that makes sense. Any ideas what's going on with his numbers?? should I stick with the 2 for awhile longer and see if there are improvements? Knowing I can generally only really get one PMPS number (I'll keep trying for more) should I aim for +7 and at what number would I skip a shot. Sorry for my rambling series of questions; I'm seriously wondering if I should switch to Lantus but want to make sure I'm getting enough data with Prozinc and doing things right before starting over.

 

You'll get better answers than mine soon. Noah's numbers would climb higher and higher until the amount of insulin I was pumping in him was ridiculous. Most vets can't grasp bouncing never mind the basics of diabetes. It was only when I came here that I trusted the knowledge that went into writing that sticky. For me it was like throwing less water on a fire that was getting bigger but reducing Noah's dose almost by half brought his numbers back in line.
That's not very scientific is it? The theory is valid but knowing when it's happening is up to you. Unless your insulin is close to expiring a steady rise in numbers would make me try a smaller dose and start over again.

 

First, have we explained bouncing? Forgive me if we have...I like to make sure. If we did, skip this next part.

Here's a great explanation of bouncing that Kris wrote:

1. BG goes low OR lower than usual OR drops too quickly.
2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

As for whether Finn is bouncing or not...it's hard to say for sure. I hear you that a curve isn't possible. I also hear you about the PMPS number...but it's so hard to tell what's going on without that. Is there ANY way you can grab one or two in the next few days? The reason I ask is because we can see he's in high numbers AMPS. You've gotten the occasional mid-cycle test, which is great. But without the PMPS to see what's going on at the end of the cycle, we just can't tell. We need to see both ends of the cycle to be sure. The AM and PMPS plus the mid cycles give us the info we need.

My GUESS is that he might be bouncing, based on what is on your SS. If he is, that sucks, but it isn't the end of the world. We have seen some super bouncy kitties here before. It happens. The best defense for this is to do tiny dose increases...any chance you could do dose increases in .25 units rather than .5 units?

As for the testing...is there anything we can do to help? Do you give special bribes...er...treats for testing?

 

Thank you! I thought I grasped bouncing from what I've read here but you explained it really well. As for testing, Finn is...Finn. I was not cat experienced when I adopted him and a friend of friend was fostering and described him as shy, which was fine and I adopted him. He's not just shy. He was part of an abandoned litter and the last to be trapped at 4-6 mo old so he was basically not human experienced or cat experienced when I adopted him. I'm basically the only human he allows to pet him or pick him up and up until his diagnosis I pet him daily but rarely stressed him by trying to pick him up.

He will run away if I try to test or dose while he is eating so I have to pick him up for both. He used to LOVE temptations treats but I cannot find a compliant replacement. I've tried various dehydrated meats, and bonita flakes and nope he is not remotely interested. He gets the Dr. Elsey's dry food as a treat (basically a tablespoon or so) at shot time so one option might be to just give him a little more kibble to try to get extra tests in for a few days. He used to love human grade tuna, which I would give him for his birthday, adoptiversary and christmas but after his first urinary blockage years ago I cut that out worried that it was not good for him (but I am somewhat convinced his blockages were more stress related - the first was when I had a fence installed with lots of noise/banging and the second was after a move and I'd left overnight); basically I'm not sure if ok to give him a tiny bit of tuna for a few days since the blockages were just as terrifying as hypo potential. Over the next few days, pre-firework stress, I'll see if his beloved dry food will entice him to emerge and tolerate my poking for an AMPS, +7 and PMPS. Wish me luck! I feel so bad for him but I'm trying to get him to remission so we both have a better quality of life.

 

Hi Laura! My kitty was feral too. It took a long time to get him used to the testing routine, and he'll never lie still and docile like the cats in the home-testing videos! But he does cooperate now. It just took time and patience and consistency and treats. You might try using Dr. Elsey's only as a test and shot treat. That way he comes to associate something he loves with the testing. You can also try picking him up, putting him in the testing place, and just rubbing/holding his ear for about as long as a test, then giving 3-4 kibble pieces and letting him go. It will start to get him trained without the fear of being poked every time. You can do that several times/day and it just becomes a happy routine. Then the times when you do poke he'll have a little more patience before bolting away.

As far as the tuna, I don't know if that could be a problem with the blockage or now. Was he eating dry food at the time they happened? could it have just been the stress and not the tuna? If no one else repsonds to that, you might post that part of your question out on the Main forum and see if others have some info about that.

Good luck with the testing! Let us know how it goes.

 

Ohh blockages ARE scary! Did the vet tell you why he blocked? Was it crystals, mucus plug, etc? I ask because stress can cause the urethra to become inflamed which can cause blockages for males with their narrow urethra. Tuna COULD be the cause...but my guess is that it's more likely to be stress. I don't give fish very often either because we have 2 cystitis kitties at home and fish can be inflammatory, but I don't think the occasional bit of it as a treat would hurt much. Most important is getting plenty of water and stress reduction as best as you can.

 

I'm trying to sort the same thing out right now. I'm having trouble telling if my cats dose is too high or if it's her bag teeth that are doing it. She's going to have her tooth pulled on the 6th, but in the meantime her dose is climbing and climbing. So I decided this morning to bring it down for a couple days and see what happens. Worse case I have to bring the dose back up again. Although in my case I do think tooth pain is a contributing factor. Poor thing has a huge hole in one and a lession on another.

 

I've heard cosequine, typically given for arthritis, can help with cats prone to urethral swelling. Other arthritis medications as well.... Dasuquin, adequan

 

The vet did say he had crystals. He was eating only dry food before the first blockage. I feel so guilty for not doing more research and the foster was all look how easy he is you can just leave kibble out. He was eating wet food before the second blockage but was also getting the prescription urinary s/o dry (both super high carb probably leading us to here).

 

Thank you! It is good to hear from someone who has a cat like mine. When Finn was first diagnosed I'd go on youtube and see those videos and they'd make me want to cry. I think the Dr Elseys is best bet for treats. He was getting more of it to supplement overnight but the nondiabetic cat was preferentially eating that over the wet food (I know better now) and they both had terrible poops so they're basically only getting it at shot time now (nondiabetic Louis gets it as a treat for not interfering with shot time).

 

I need to take Finn for a cleaning as well. I"m a bit scared of the dental honestly and hoped to have him regulated a bit before taking that plunge but it could be a contributing factor. I'll have to get it scheduled and see if that helps. Good luck with her dental!

 

Also leave several water sources around. My one cat was getting autism yearly. She hasn't had one in four years since I added two additional water fountains and began adding water to their food. . They notoriously don't drink enough.

 

I added a fountain after he blocked and he is much more attracted to that than a standing bowl. Now we have two fountains; one on each floor of the house. I've started mixing some water in his food but can only add a bit or he won't eat (so picky!)

 

Great!

 

So Finn has been doing great the last few days. He has been hanging out and relaxed like pre diagnosis days and his numbers seem pretty good to me. He was high AMPS yesterday but there’d been storms overnight and I know he’s terrified of thunderstorms. I’ve even managed an extra BG test the past few days. Today I did his PMPS (which tends to be around +10 because he won’t wait 12 hours for food) and his number is highest ever?! I had vacuumed in another room for all of one minute (I was just cleaning up litter) not long before testing him; could that have led to this high a jump??? Should I stick with 2 units or start over again and keep checking +6/7. It was so frustrating to see such a high number when he’s been so himself lately.

This pic was him before I tested; he was so calm I’d retest to confirm but I’m already pushing my luck with three tests and two injections; it’s just going to stress him out to test again

 

I'd stay at 2 u AM and PM for now. If he doesn't show you more low blues at nadir in 3 or 4 cycles, bump him up to 2.25 u (PS permitting) both AM and PM. Varying the dose according to PS is best saved for when he's closer to his really good dose. That black is so out of place it might have been a wonky strip. We usually recommend retesting immediately when you get a crazy number that seems totally out of pattern, either too high or too low.

 

Thank you! It’s so strange I’m going to tell myself it was a bad strip since he’s now happily eaten some food and gone back to napping

 

Why is he waiting 12 hours to eat? My cat would eat me if I tried to make him wait that long. It's recommended that diabetic cats eat several small meals throughout the day (or you can just let them graze if they will do that and not just inhale everything in the dish). Is there some reason why Finn needs to just eat twice/day?

 

I guess he doesn’t technically get two meals at 12 hours. He basically free feeds but eats most of his food twice a day and will snack a bit around lunch but doesn’t eat much after that. If I see his bowl is empty I do add more food.

I work from home and finish work around four. I have started taking bowls away around 2-3 so his PMPS isn’t food influenced. As soon as I come out of the home office they’re looking for a new can for dinner so I try to get PMPS around 4-5 PM then feed (I shoot at 7 AM/PM). I guess what I mean to say is that I can’t really do PMPS at 12 hours because it would be food influenced at that point so it’s easier to get a +9/10 or so that’s not food influenced since he is accustomed to an afternoon siesta in the sun