7/30 Figaro pink/red/black 5 days. Bounce vs glucose toxicity?

[Figaro's Liz]

http://www.felinediabetes.com/FDMB/threads/7-27-figaro-bouncing-pmps-363-2-463-5-5-530.217428/

Primary question: how do you tell if you are dealing with bouncing (perhaps serial bouncing?) vs glucose toxicity?

I'm trying to understand if Figaro could still be bouncing. We have been at this dose for 20 cycles. I have seen blue, but not for FIVE days, and no green. I keep waiting for the bouncing to stop or try to catch a dip, but no luck.

I cannot be home to monitor Figaro during the day. I might be able to run home for a mid-cycle but I don't know that it would tell much that I'm not already seeing.

All outward signs good, by the way. He purrs and plays, seems bright-eyed, GI seems good, pretty low daily stressors that I can see. Confusing.

 

[Perry & Jenn]

I can't advise, but I can bump.

 

[AmandaE]

Morning Liz! I’m not exactly sure about telling the difference between Glucose Toxicity and a bounce but I’m not sure Figaro numbers represent either. This is what I *think* I know about both Bounces last about 1-6 cycles and are brought about by numbers much lower than Figaro he has become accustomed to. I *believe* Glucose toxicity happens when the body doesn’t release enough insulin and the cat spends a lot of time in high numbers which results in insulin resistance. You would be able to test whether he had GT by trying a dose increase.

I have a feeling these values are Fig’s typical BG values. It looks like you should consider an increase. When is the next time you can do a curve?

 

[Penelope and Mačka]

Isn't glucose toxicity when diabetes is uncontrolled and side effects can potentially happen (like neuropathy, etc...)?
In Macka's experience, bounces can last a long time (8 cycles) and it's very frustrating. However, I don't see why you shouldn't increase the dose? You've been at 1 unit for a long time now. Let's crack those blues again!

 

[Figaro's Liz]

Morning Liz! I’m not exactly sure about telling the difference between Glucose Toxicity and a bounce but I’m not sure Figaro numbers represent either. This is what I *think* I know about both Bounces last about 1-6 cycles and are brought about by numbers much lower than Figaro he has become accustomed to. I *believe* Glucose toxicity happens when the body doesn’t release enough insulin and the cat spends a lot of time in high numbers which results in insulin resistance. You would be able to test whether he had GT by trying a dose increase.

I have a feeling these values are Fig’s typical BG values. It looks like you should consider an increase. When is the next time you can do a curve?

Thanks, Amanda. GT is still kind of a foreign concept to me. The "cat on a pogo stick" discussion thread is what makes me wonder if GT is setting in, but again, not understanding what GT really looks like has me confused. So I am hoping to get a little clarity on it.

He hit greens at a dose somewhere between .75-1u two weeks ago, so that is one point of hesitation. And then there is 7/25, blues, but then not a lot of action after that. I was expecting... err, something more I suppose!

I know we should increase despite a bounce if we have a sense of nadirs, and I guess I am feeling like it's time to increase since this is starting to look like riding high rather than bouncing, but I wonder if I'm missing something (i.e. Phoebe Squeak's surprise yesterday). I feel like i never see a nadir. I have to be at work this week, so a curve can't happen in the daytime, and since I can't monitor following the increase I am more nervous about it and just trying to... make the right call. May try to run home for +6 just to see.

 

[AmandaE]

Thanks, Amanda. GT is still kind of a foreign concept to me. The "cat on a pogo stick" discussion thread is what makes me wonder if GT is setting in, but again, not understanding what GT really looks like has me confused. So I am hoping to get a little clarity on it.

He hit greens at a dose somewhere between .75-1u two weeks ago, so that is one point of hesitation. And then there is 7/25, blues, but then not a lot of action after that. I was expecting... err, something more I suppose!

I know we should increase despite a bounce if we have a sense of nadirs, and I guess I am feeling like it's time to increase since this is starting to look like riding high rather than bouncing, but I wonder if I'm missing something (i.e. Phoebe Squeak's surprise yesterday). I feel like i never see a nadir. I have to be at work this week, so a curve can't happen in the daytime, and since I can't monitor following the increase I am more nervous about it and just trying to... make the right call. May try to run home for +6 just to see.

It looks to me like Figaro currently has somewhat of a floating nadir. I agree it hasn't settled into a predictable time yet.

You shouldn't hesitate to increase based on past experiences of Figaro's reactions because his body will be changing as you treat him You especially shouldn't compare him to other cats . Do you think you could do a night time curve? because his BG is so high I think you should try to increase soon. Maybe you could try doing a curve where you test every two hours before you go to bed and then set an alarm for every 3 hours after that so that we have enough info to move forward

 

[Figaro's Liz]

It looks to me like Figaro currently has somewhat of a floating nadir. I agree it hasn't settled into a predictable time yet.

You shouldn't hesitate to increase based on past experiences of Figaro's reactions because his body will be changing as you treat him You especially shouldn't compare him to other cats . Do you think you could do a night time curve? because his BG is so high I think you should try to increase soon. Maybe you could try doing a curve where you test every two hours before you go to bed and then set an alarm for every 3 hours after that so that we have enough info to move forward

Oh I would never compare Figaro to other cats! But I am looking at other peoples' methods and experiences (very much so) and trying to figure out what is relevant. ECID for sure.
I should probably go ahead with a night curve tonight. I actually planned to do one last night, but was thrown by the 507 and just figured it probably wasn't worth his ears to continue.
Thanks for your suggestions to help me work through it. Probably I need to put on my adult pants and be brave for the increase.

 

[AmandaE]

Oh I would never compare Figaro to other cats! But I am looking at other peoples' methods and experiences (very much so) and trying to figure out what is relevant. ECID for sure.
I should probably go ahead with a night curve tonight. I actually planned to do one last night, but was thrown by the 507 and just figured it probably wasn't worth his ears to continue.
Thanks for your suggestions to help me work through it. Probably I need to put on my adult pants and be brave for the increase.

I agree that when you need to do a curve and you're getting higher numbers it's typically not worth it to do a curve, but in this case we suspect that he is definitely staying high all night... we just need a few test to confirm the theory so that we can do an increase!

Yes, the adult pants... now... where did mine go again?!

 

[Sienne and Gabby (GA)]

Glucose toxicity and bouncing are not mutually exclusive. Glucose toxicity can develop if you've been holding a dose that doesn't get your kitty into good numbers for too long. Your cat treats the high numbers as the new "normal." What can then happen is that it's harder to get your kitty out of those numbers and bouncing may likewise occur. Also, keep in mind that bounces can last roughly 3 days.

At this point, you've held Figaro's dose for almost 10 full days. That's longer than SLGS suggests and way longer than TR requires. He's clearly bouncing off of blue numbers.

To my eyes, you need to increase Figaro's dose.

 

[Figaro's Liz]

Glucose toxicity and bouncing are not mutually exclusive. Glucose toxicity can develop if you've been holding a dose that doesn't get your kitty into good numbers for too long. Your cat treats the high numbers as the new "normal." What can then happen is that it's harder to get your kitty out of those numbers and bouncing may likewise occur. Also, keep in mind that bounces can last roughly 3 days.

At this point, you've held Figaro's dose for almost 10 full days. That's longer than SLGS suggests and way longer than TR requires. He's clearly bouncing off of blue numbers.

To my eyes, you need to increase Figaro's dose.

Thanks, Sienne, I appreciate the clarification. Up we go.

 

[AmandaE]

Thanks, Sienne, I appreciate the clarification. Up we go.

YES FIGARO !!!!

good luck with the increase Liz!!