7/15RAVAN/+9 250/+11 400/pmps412/+4 242/+7 265/

7/14/Ravan/amps424/+7 340/pmps HI/+4 467/+8 392

Do I wait another cycle to increase dose ,it's been 4 cycles.Wendy & Dyana said to wait 6 cycles I'm just double checking because his Bg is still High?

 

Hold the dose this AM just in case he's starting to break this bounce....if he's not still coming down at PMPS, I might say go ahead and increase to 1.5 but let's see what happens today first

 

It's not only greens that make kitties bounce; he could be bouncing from the blue a few cycles ago. So I agree with Chris, hold the dose this morning. This bounce has to break soon!

 

@Judy and Boomer
@Chris & China

AMPS 502 Maybe these numbers are from his Kidney disease or Pancreatitis? It doesn't look like this is getting better?

 

Breathe. Not only the blue bouncing but maybe also from the pink to blue in short period of time.

However, look how long those blues lasted. That is all good. Think of it this way, Raven was starting to test out the blues and kinda liking it, then remembered this isn't normal for me and hit the panic button and went zooming back to where he's comfortable. Now it will take a bit to coax him back down again.

 

@Olive & Paula
That " HIGH "# pmps scares me. Will it go back that high again tonight. This can't be good for his Kidney Disease!
When his BG goes this high he starts leaking urine .He's not feeling good ,didn't even want to go outside. He LOVES to go out.

I'm very worried about the black #"s especially over 600

 

Yesterday he at least had Pink. +5 BG 412 looks like he's headed to black again. Could these #'s be from his kidney problem & the Pancreatitis ?

What exactly could happen if you increase the dose in a bounce?

 

+5 412 Looks like he's headed to a Black # pmps This can't be good for his Kidney disease? Yesterday he at least had a pink #.

Are we sure this is a Bounce & not from his recent Pancreatitis attack or his Kidney Disease?

What "Exactly" can happen if you increase insulin during a bounce?

 

I think you could go ahead and go up to 1.5 tonight as long as you're able to test

I don't see any sign of him breaking this bounce and he's running too high for comfort

The problem isn't increasing "during a bounce".....it's what might happen if the bounce "breaks" at the same time you increase

 

@Chris and China

I was reading a post from 2013 about bouncing.Please Comment Question "Why would I want to get as much insulin as possible in the cat?"

Answer "Lantus and Levemir are known to have a harder time bringing down higher numbers.More Insulin helps bring down the higher numbers in a bouncer's cycle. More insulin will help counteract the spikes "

 

@ Sienne and Gabby (GA)

I was reading a post from 2013 about bouncing You were in that post Please look at Ravan's SS & I'd like your opinion on what to do. His bouncing very high Just had Lab work He has stage 2 kidney disease & I think he had a Pancreatic attack several days ago.

BG is staying High for over 2 days. Is this still a bounce or is it high from his medical problems?

 

Totally agree with Chris, unless he suddenly comes down today you should increase tonight.

 

There's no definitive way to tell if the high numbers are from the drop into the blues a few days ago of if it's from a pancreatitis flare. What do you keep on hand to manage pancreatitis? The pancreatitis is painful and the pain will increase Ravan's numbers. The kidney disease would have not effect on numbers. Is Ravan acting like he's in pain or discomfort. My guess is that if he didn't want to go outside, it's due to pancreatitis. Do you have any buprenorphine at home? (It's a pain med.) Also, chances are that he leaks urine because when his numbers are up, he drinks more and he may be too uncomfortable to want to get up to go to his box.

As Chris said, the issue is more that if a bounce breaks at the same time you increase the dose, there could potentially be a lot of momentum behind the dropping numbers due to a bounce that's breaking. It could be a wild cycle which is why we are cautious about when to raise a dose in a cat that is bouncy.

I would have to go back and see the context of the post you're referring to. Generally speaking, Lantus and Lev are gentle insulins. They do not "yank" numbers down the way short acting insulins do. When numbers are coming down, it's easier for Lantus and Lev to "grab on" and bring numbers down further. There are options like using a bolus insulin (e.g., Humulin R) but it requires a great deal of attention and someone who is familiar with it's use to guide you since the use of a basal insulin (Lantus) with a bolus insulin such as R can be dangerous if you don't know what you're doing.

Bounces can last 3 days/6 cycles. In some cats, they may last a bit longer. As a cat gets used to being in lower numbers, the bounces may not last as long.

So help me understand. Your signature says you're following TR. If so, why didn't you increase Ravan's dose on 7/8? With TR, you evaluate the dose every 6 cycles. If the nadirs have been below 200, you hold the dose for a total of 5 days/10 cycles and then evaluate. If the nadirs are mostly above 200, you increase the dose after 3 days/6 cycles. I think you're holding Ravan's dose too long. If you are worried about the effect of the high numbers on your kitty's kidney function, then you need to be diligent with regard to aggressively increasing the dose when an increase is warranted.

Regarding the kidney issues, did your vet discuss diet with you? You want Ravan on a high protein, lower phosphorus, and low carb diet. Weruva (Steak Frites) and Tiki Cat (their chicken flavors) that will meet those criteria. My vet also started Gizmo on calcitriol. Not all vets use calcitriol -- apparently, a lot depends on where the vet is trained. FWIW, when Giz was diagnosed with Stage 2 kidney issues, his SDMA was elevated as was his creatinine. They are both back to normal levels. His urine concentration is still off but otherwise, he's doing very well. He's now on a raw diet due to IBS.

 

@Judy and Boomer
@Chris & China
@Sienne and Gabby (GA)

+9 250 He could still go up to HIGH at 9PM What do I do now at shot time if he goes higher Stay at 1.25 or Increase to 1.50?

 

If his numbers are rising, I'd go ahead and increase.....if they're still dropping, stall, don't feed and post for help

 

@Sienne and Gabby (GA)

I didn't increase Insulin because Ravan was sick that entire day. The next day I had Lab work done & was Told he has stage 2 kidney disease & pancreatitis.
On 7/11 he went down into green 7/12 blue then a BIG Bounce. Right now Bg has finally dropped to 250.

He doesn't appear to be in pain, Vet said he prefers not to put him on meds at this time. Ravan's urinalysis was good no infection.
Ravan was raised for over 15 years on a Raw meat diet never had dry food or "Treats" When he started getting insulin back in February he went off his Raw meat for a while. It was suggested I try FF Classic & to my surprise he ate it.

Over the last few months he's gone back on Raw meat diet & occasionally has canned food Low carb/low phosphorus. His Lab report is on SS. SDMA 26 elevated /Creatinine 2.4 slightly elevated. His Electrolytes were all OK Calcium was Good.

Ravan has been eating good for the last few days.

 

The good news is that Ravan's phosphorus levels are normal. Creatinine is right at the top of the range.

Cats don't show pain very often. If you ever have a chance to ask a human who's had pancreatitis what it was like, they will tell you that the pain is awful. There can be other meds to treat pancreatitis, but at the very least, pain meds will allow Ravan to be more comfortable.

If you've not seen this, the Primer on Pancreatitis may be informative.

 

How about grabbing a test at +11 and posting. Let the numbers guide your decision.

 

@Sienne and Gabby (GA)

Last year Ravan's brother was given Bupe he went into respiratory arrest. They could not get him stabilized, he died. Since then I'm scared to death of that med. I Give him Arnica & Omega 3 for inflammation.
My vet is very cautious with the Bupe since what happened . (I read Bupe is used off label on cats & should not be given if the cat is having any respiratory problems. It was given to my cat at the emergency clinic. I brought him in because he started having trouble breathing.)
I kow many people here use that pain med without a problem but I'm afraid of it!

 

Most of us use bupe for pain. However, I agree. If Ravan's littermate had a bad reaction, there's no way to know if he'd react similarly. I would talk to your vet about something for pain, if even on a trial basis to see if it helps. I would, however, be very clear that you do not want an NSAID. They can cause acute kidney failure in cats and one of the more commonly prescribed NSAIDs, meloxicam (Metacam) has an FDA black box warning for it's use in cats.

 

@Sienne and Gabby (GA)
I'll post Ravan's bg by 8:45pm (Central time) In about an hour & a half. If it's the same or lower I shoulds hold the Dose?

If it's higher I should Increase to 1.5?

ARE you saying Pancreatitis causes pain all the time? I thought they have an attack which is painful but when it's over they are not in any pain?

Ravan is from a litter of 5 born in my garage I raised them from 5 days old. 3 have died One from Heart attack,one from Melanoma, & his sister last year from kidney failure. I have his sister Peggy Sue & Alice a stray kitten taken in 16 yrs ago So they are all 16 all having medical problems.Peggy Sue has elevated Liver enzymes ,Alice Stomatitis.

 

@Sienne and Gabby (GA)

I am so very disappointed! Ravan's BG 400 +11 Does the yellow at +9 mean the bounce is breaking & I should wait till tomorrow? Or do I increase to 1.5 now?

Wanted to add that Ravan hasn't had any vomiting.& he's still eating Good.

Is this still considered a bounce? Or something else?

 

@Chris & China
I have CW Paws Hemp Oil that I give Peggy Sue when she went off her food. Is it OK to give Ravan a few drops for Pain?

 

Quite a few other people here use CBD oil for their kitties so I'm sure it'd be fine.

I think you should go ahead and increase tonight since his numbers are going up again

 

I increased dose to 1.5 units

Does anyone think I should switch to Levemir? Because of Ravan's Huge bounces?

 

There is no guarantee that a switch to Lev will help with bouncing.

 

Hey there. There have been those that have switched to Lev with better flatter cycles. Usually, 6 months is a good amount of time to give an insulin a chance. You could try Lev and see if that helps with his bouncing. We have a saying around here : The best insulin is the one that works for your cat.

With the price of insulin, I would use up the Lantus that you have before making the switch.