9/24 Great explanation of bouncing that helped Gussie& I

Discussion in 'Lantus / Levemir / Biosimilars' started by Gussie's mom (GA), Sep 24, 2017.

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  1. Gussie's mom (GA)

    Gussie's mom (GA) Well-Known Member

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    Jun 25, 2016
    Hi All
    Wanted to post up a great explanation that @julie & punkin (ga) wrote. It really helped me to understand the process and consequently helped me to pull on those patience pants though they pinched something awful some days...
    Hope it helps some of you struggling with this bouncing trampoline thing!
    Give your kitties some scritches from Gussie and I....
    Here goes, I recommend the whole read..I kept it bookmarked and read it often!:bighug::cat:
    Thank you @julie & punkin (ga)

    Re: New Dose Wonkiness (NDW)

    when you increase a dose of lantus, you would expect the BG numbers to go lower, right? that's logical. more insulin = lower numbers. only there is a lag time sometimes - increase the dose and for some reason the numbers go higher. that can last a day or so, and then suddenly you start seeing those lower numbers you expected. we call those higher numbers "New Dose Wonkiness" or NDW.

    this is the reason we wait following each dose increase to let it settle and see what it's really doing.

    now not every cat does that, of course. ECID. sometimes you increase the dose and you immediately see lower numbers. the point of this post is to say that IF you increase a dose AND you see higher numbers, give it a couple of days for things to settle down and then you can assess the dose to see what it's really doing.



    the second part of the post is saying that this doesn't apply to a cat when you DECREASE a dose. let's say mookie drops below 50 today and you decrease the dose. if you see higher numbers following the dose decrease, that's not NDW. NDW only applies when you're increasing a dose. higher numbers following a dose decrease can be from one of two things. one possibility is that it simply isn't enough insulin. another possibility is if the cat dropped quickly, or if the cat dropped into a lower range of numbers than it was used to, that can cause a bounce.

    BOUNCING

    Here is an example of a bounce from someone's recent condo:

    you can spot a bounce this way (this only took me 6 months to learn and a bunch of people explaining it! i'm a slow learner!)

    yesterday morning you had a 215 - then it went 235, 271, 270, and then 308 this morning - basically straight up. no curve. and then look backwards in the ss and the night before was that sweet little 148 12 hours earlier.

    if you imagine that night-time cycle, starting at 148, kitty probably went down in a nice little curve, hitting something under 100 mid-cycle. that lower-than-usual number would've shocked her body. they get accustomed to whatever range they're in, and any sudden dip lower can set this off.

    "HELLO WE"VE GOT A 911 HERE- KITTY'S GOING DOWN!" yells Mr. Liver. Fortunately, mr liver has a storehouse of counter-regulatory hormones and stored sugar (in case kitty needs a little nommy sweets in the middle of the night) and when Kitty gets into a range of numbers lower than usual, Mr. Liver lets loose with the sugar and the hormones and sends Kitty on a rocket to the moon. this is the cat's body's protective mechanism to keep the cat from becoming hypoglycemic. unfortunately, mr liver doesn't seem to know that anything above 40ish isn't a crisis and it will do this regardless of the range of numbers, even at 200 if the cat has become accustomed to 400.

    A second cause of a bounce is if a cat drops very quickly. 100 points in an hour, for example, regardless of the range the BG number is in, can cause a bounce as well.

    So, what to do now? don't increase the dose because of these higher numbers. once this bounce clears, which can take up to 3 days of high numbers if mr liver is super-active, then if you had increased the dose, it would be too high. you are entering the phase of treatment that we say requires "Patience Pants." when you think you're seeing a bounce, you have to wait it out, then you can see what the dose really does. You will know the bounce has cleared when you start seeing numbers you were seeing before - like that 148 again.

    edited for clarity.

    Punkin's SS
    Punkin's Profile & pictures
    Punkin & Anya video, Punkin Acupuncture
    DX 12/4/10 Lantus, 1/2012 R, 14 lbs, 12.5 yrs old DLH orange male, ACROMEGALY dx 6/2/11
    Punkin's SRT Treatment Sept 2011 GA may 20, 2013 age 15
    Dec 22, 2011Report
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  2. Carol & Murphy (GA)

    Carol & Murphy (GA) Well-Known Member

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    Thanks, Les!!
     
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  3. MissMolly

    MissMolly Member

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    May 4, 2017
    Thank you for posting this because sometimes Molly's numbers make me a little stir crazy to say the least :(
     
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  4. Gussie's mom (GA)

    Gussie's mom (GA) Well-Known Member

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    It’s a patience dance this sugar dance....
     
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  5. Bronx's dad (GA)

    Bronx's dad (GA) Well-Known Member

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    Nov 30, 2016
    Thanks for sharing Les. Early on, you always reminded me to keep the patience pants on before I understood why Bronx was stuck in the blacks & reds. Hopefully this great explanation by Julie helps out some of the newer folks, I still have a hard time wrapping my head around the whole clearing a bounce thing. :bookworm:
     
  6. Gussie's mom (GA)

    Gussie's mom (GA) Well-Known Member

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    Jun 25, 2016
    Hi Paul! Those pants do pinch don’t they?:bighug::bighug: I remember You pulling them on;)
    Ah memories right? :bighug::bighug:I’m glad my reminders helped..I was not able to give dose advice but encouragement, that I could give and totally understood why it helped;)
    Nice to hear from you! Bronx is looking good!:cat:
     
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  7. Phoebes (GA)

    Phoebes (GA) Well-Known Member

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    Jan 16, 2017
    Is it ok to slap Mr. Liver?? :) excellent description
     
  8. Tasha & Darwin

    Tasha & Darwin Well-Known Member

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    Jun 22, 2017
    This is great! Makes a lot of sense, and makes me think I need to be wearing those patience pants! Haha!
     
  9. Gussie's mom (GA)

    Gussie's mom (GA) Well-Known Member

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    Jun 25, 2016
    :)
    Here you go, your own pair!
    6B928648-0442-43A7-A331-651F861B9C72.jpeg
    :bighug:
     
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